Medical Investigation (2004) s01e03 Episode Script

Coming through! Welcome home.
Yes, ma'am.
God bless America.
- Here, seven seven? - Coming up, soldier.
Excuse me, darling.
Buy me a drink? Oh, my god, what's wrong with you? I don't know.
It's my, it's my chest.
Handerson, what's up, man? Get me out of here.
Dude, we all want to get out of here, man.
but the army has our ass right now.
Hey! Let's get him out of here.
Easy, easy, easy.
I got him, I got him.
you all right.
- Let's get up.
Come on, come on.
- Everybody, move, move, move! Get out of the way! Get out of the way! Wasn't that part when the helicopter crashed into the roller coaster cool? It was like Maybe next time we'll see a comedy, what do you say? Yeah, I want to see that new Adam sandler movie.
Sure.
Soon as you turn 18.
Something wrong, dad? Nope, 11 messages.
Are you going to answer them all now? Nope, I'm going to wait until we get to the car.
We're going to get some ice cream right? Dr.
Stephen Connor? We're from the Walter reed army medical center.
- How did you guys - your wife told us where you were.
We've been trying to reach you, sir.
- Dad, what's wrong? - I don't know.
We have a medical code yellow, doctor.
How sure are you? Sure enough to alert the Pentagon, sir.
Look, buddy, I have to go to work now.
We'll get ice cream next time, okay? All right, let's go.
Walter Reed Army Medical Center Washington, D.
C.
PFC.
Richard henderson of the first cavalry division, fourth brigade, had just finished his rotation, guarding munition stockpiles outside of Fallujah.
When did he arrive stateside? About five days ago, along with three others in his unit.
What diagnosis are you working from, sir? Possible exposure to a biological or chemical agent during a recent deployment in Iraq.
What was the contaminant? Backtracking, the army believes it was an unexploded ordnance the four soldiers came in contact with.
- Where's the shell now, sir? - That's the damn thing.
No one thought the shell was hot until the soldiers became ill.
Reconnaissance in Fallujah is trying to locate it, but I don't have to tell you what a cluster-job that's turning out to be.
The four soldiers, did they all have the same exposure with the shell? No, PFC.
Henderson and private Van horn had the most direct contact.
This is where they were placed before being put in isolation.
Has the room been secured? Knowing what a pain in the ass you were in flagging Gulf war syndrome, what do you think, captain? How are the soldiers' conditions, colonel? It's easier to explain if you see for yourself.
Were any of the four soldiers symptomatic before leaving Iraq? Not according to their transfer papers or reentry exams.
Normally chemical exposure doesn't have an incubation period.
If they were exposed to a chemical agent, they would've been down within the first 24 hours.
Our fear is that we're dealing with a new type of agent, perhaps a biological weapon with an incubation period.
We're going to run our own tests at the NIH, but expect full access to all medical records You'll have whatever you need.
The army doesn't want to be on the wrong side of this one.
Like they were in the Gulf war syndrome, sir? Call Eva, get her up to speed.
I expect a full press lockdown on this one.
Colonel, why aren't there more reported cases overseas? We've been there for over a year.
Why now? Stephen, the truth is, we don't know, but if this is the result of some undiscovered biological agent then the war has entered the next phase.
Here's a cheery way to start the day.
The institutional review board is threatening an investigation of our clinical trial.
Now what? They're concerned that this round of experimental drugs isn't effectively minimizing patient suffering.
Tell the IRB brain trust there's a reason they're called experimental drugs.
Yeah, I'm not sure how long that song and dance is going to last.
They mean business.
Looking for Barrett fidler? I'm just wondering how he's doing.
I haven't heard from him in a while.
How did you know I was looking for Barrett? Everybody has their favorites.
Personally, I always look forward to seeing this one reporter from the post every time we have a national health alert.
All right, what about the idea that this agent could be transmittable through touch or bodily fluids? No one at Walter reed has reported pulmonary problems similar to the soldiers, including staff who had direct contact with them.
The bartender said PFC.
Henderson danced with at least a dozen women last night.
So if it is possible, we should have seen a spike by now.
If it has an incubation period, maybe it's coming.
I'll alert ERs in the D.
C.
area to look for any spike in acute respiratory distress syndrome.
ARDS.
All right, Miles, run tests on the soldiers for biological agents found in Iraq.
I'll start with the bacterial culture for anthrax.
For everything.
Order antibody tests for anything even thought to be present in the Persian gulf.
Fortunately, the Pentagon doesn't want this leaking any more than we do, not until we know absolutely what we're up against.
They're sending someone to liaison with you, a Gladys halperin.
Just what we need, more government.
All right, find out everything about her, but until you know more, I'd just as soon keep every bureaucrat at arm's length.
I know the military hasn't told us everything.
Just like last time.
You know, you're probably right.
The conspiracy theories are going to have to wait for another day.
Let's just investigate the medicine, okay? Hey, Connor.
I know it's not the first thing on your mind right now, but we have a problem with the Von recklinghausen's clinical trial.
- The last thing I read about it - They were fine, I know, but now some of the participants are having a reaction to one or more of the drugs.
severe rashes and a high creatinine level.
It could be an intercurrent illness or a positive response to the immune system attacking the neurofibromas.
Thanks.
I'll look into it.
Connor.
- Stephen.
- Hey, Lis.
Did you get the separation papers? Uh, yeah, I got the papers yesterday.
We have to talk about them.
We need to talk to Jack first.
Stephen.
You're the one who asked for this.
If you're going to tear his life apart, he should hear my side of the story.
Well, you had your chance last night.
Well, I had something to do, something came up.
- I heard.
Just like old times.
- You heard? You know what? I'm going to tell Jack about the separation in my own way and in my own time.
Did you hear that? This is Barrett.
If I were home I wouldn't have picked up anyway so don't blame yourself.
Leave a message.
Barrett, hi, it's Dr.
Durant, Natalie.
I was expecting to see you this morning.
Actually, um, I need to see you, to, to make sure that you're not having a negative reaction to the treatments.
Anyway, you have my cell, so call me, okay? Hey, Joe? I'm Dr.
Stephen connor at the NIH.
How are you feeling? Here, let me help you with that.
The guys in my unit? They're being taken good care of.
I understand you were out doing a recon report when the ordnance was found? Yes, sir.
Was it an isolated shell or was it part of a storage site? It's hard to say.
The sandstorm was blowing pretty thick, sir.
Those shamal winds can get pretty nasty.
Did you get the nosebleeds? Every day.
It sounds like you were there, sir.
Different war, but the same damn sand.
Look, Joe, I was wondering if you were exposed to any fallout from blown munitions or chemical dumps prior to finding the shell.
I'm sure we all were, sir.
We used to say that that whole war zone was like a big bowl of toxic soup made with some bad-ass ingredients.
What do you remember about the shell? I didn't find it, sir.
Henderson and Muldoon did.
It was kind of unusual because it looked brand new compared to the older scrap ordnance we come across.
Did you try to save the shell? Excuse the informality, sir, but, we were a little more concerned with saving our own asses.
I'd really like to see the guys now, sir.
As soon as you're stronger.
I'd really like to make sure that they're okay.
Powell.
Powell! / Yeah, what do you get? He's having a grand mal seizure.
I need phenobarbital.
Log roll him over to the right lateral position.
Go! Okay, good.
Hold on.
Blood phenobarbital now! Hold it, Easy.
Joe, easy, easy now.
This is a nasty-ass bug.
What the hell are we dealing with? Natalie's uncovered two additional ARDS cases.
Two middle-aged women at different hospitals across the city.
Interesting.
Do you know if they had any direct contact with the soldiers? No, no, not yet.
- What is that, mustard gas? - Yeah.
Is it me or is this investigation beginning to smell an awful lot like the inoculation program we went through for the gulf war? I knew I should have turned my computer off - as soon as you came in the room.
- Listen, all I'm saying is Nothing that I haven't heard over and over and over again The military has a track record.
They forced us to get inoculations before the war and then as soon as soldiers start getting sick.
/ Frank, Frank.
/ The military blames it on fatigue or pre-existing conditions instead of admitting the shots we took made us even sicker.
It's the Gulf war syndrome all over again.
What do you have to eat around here? Licorice.
Bookcase.
Help yourself.
So, how do these new ARDS cases affect your gulf war syndrome theory? Complicates it, but doesn't dismiss it.
Anyway, I tried piecing together who the soldiers have been in contact with since returning.
It will take weeks.
Apparently, these guys were very popular.
Gladys halperin's here to see you.
What did you find out about her? Still looking.
/ Okay.
The epidemiology of the disease appears to have echoes of sarin, perhaps smallpox.
It's too early to make a firm diagnosis, but have you found the shell yet? Not yet.
There's several hundred marines searching every munitions dump in Fallouja as we speak.
Can the soldiers provide a more accurate description? Not right now.
They're fighting for their lives.
Please sit.
I'm sure you understand the critical importance of finding the ordnance.
With it, finding a cure for the men will be much easier.
I mean consequences far beyond these four men.
My realm is medicine, Ms.
Halperin.
I leave the politics to the politicians.
Can you confirm a WMD exposure without the shell? I can confirm they were exposed to some type of agent.
But without the shell, I'd be making an unfounded conclusion.
Excuse me.
Something wrong? There's always something wrong, isn't there? Well, perhaps when the soldiers are well I can come back.
Who do you work for? I don't quite know your meaning.
You don't work for the Pentagon.
Is it the administration? CIA? All I'm asking is, if your conclusion is a wobbler, let the answer lean towards the truth.
NSA? Contractors? The U.
N.
? There are forces at play much larger than you know, Dr.
Connor.
- Yes? - I think we've got something.
I'm on my way.
Get out of my office.
I just got a call.
A local convalescent home.
Five residents died of pulmonary complications in the last 48 hours.
It's likely one or more of the soldiers visited the nursing home.
Miles, see if any of the soldiers are related to the nursing home victims.
It's a long shot, but I'll see if there's a connection between the two hospital deaths and the nursing home.
There might be a much simpler explanation for these nursing home deaths.
And you're basing your prognosis on what? Nursing homes are incubators for all kinds of disease.
They throw in a little neglect and loneliness comes with I watched my grandfather die in one of those places.
Okay, despite your personal bias, if there's a connection, find it.
Dr.
Connor, I'm sorry I/ Miles! just do it.
Yes, sir.
You okay? I need you to broaden your testing.
To include? Potential reaction to the army's ongoing inoculations for smallpox and anthrax.
Really? Did that Halperin woman get to you? No.
Powell did.
Convalescent Home Bethesda, Maryland I haven't been in one of these places in years.
This looks more like a social club.
We redesigned our facility three years ago and added a variety of programs for our residents.
We have a film club, a reading circle, field trips to outlet malls.
We really are an activity center.
Not bad.
Not the snake pit you expected? Not yet, but the day's still young.
One thing never changes, they all have that musty smell.
Are you always this cheerful? I guess things have changed somewhat.
The residents seem happy enough.
Why should you think that the people who take care of the elderly actually care about them? Barrett? What? Can I come in? This cluster of tumors has gotten bigger.
I'd like to run some tests to make sure.
Not another test.
/ Barrett The tumors are getting bigger because I'm not getting the real drug.
In fact, I think I've put on a few pounds taking all those sugar pills.
You know that in a double-blind trial even the doctors don't know who's receiving the experimental treatment or the placebos.
My tumors are getting bigger.
The pain never lets up.
It's getting worse.
The clinical trial may be double-blind but I'm not.
Come in to NIH this afternoon.
If everything checks out, I'll increase your pain meds.
Patients getting the real drug have new rashes and skin sores.
You find any new ones on me? I'm quitting the trial.
How are my boys, sir? They're hanging on, but their lungs are filled with fluid.
Are they dying? Not without a fight.
That's because they're good soldiers.
I have a favor to ask, sir.
Anything you want.
The four of us, we made a promise.
That if something should ever happen, that one of us would make sure that our families weren't told by two faceless reps of the army.
They'd be told by a friend.
I understand.
I know it's a lot to ask of you.
No.
No, it's not.
But I'm here to see that no one ever makes good on that promise.
Okay? But, sir if something does happen to me I want you to tell the army chaplain not to take it personal, but I would like Father Yost from st.
Angela's - Dr.
Connor, right here! - I'll be right back.
Let's go, ventilate! What do we have? He's in cardiac arrest and non-responsive.
He went into a coma.
/ Damn it! Okay, this was Marla's room and her home for the past few years.
She was a good christian woman.
81, had 14 grandchildren, three sons, and a daughter.
Did Marla leave the facilities often? No.
None of them did.
All five were bedridden.
So, they never came in direct contact with one another.
/ Never.
In fact, they were in different corners of the home.
Did their families or friends ever visit? That's the problem.
At their age, you find out exactly how much your friends and family really care about you.
No one's come to call in weeks.
Any military personnel come to visit, young men in their 20s? Uh, no.
Why would you think So no social contact among the victims, no contact with their loved ones.
That's right.
What does that tell you? That whatever killed them might've come from somewhere inside this building.
What did you find out about the anthrax and smallpox inoculations? Preliminary test results show no apparent connection between the inoculations and the disease.
But the five deaths at the convalescent home are actually eight.
Explain.
In the last two months, a total of 12 residents died at the convalescent home.
I believe three previously attributed to flu-like symptoms are actually undiagnosed ARDS.
You believe? I also believe the lung tissue samples I requested will prove it.
If this were airborne or transmittable by touch, and the soldiers were sick before they left Iraq, then someone on the transport plane should have been infected.
It doesn't add up.
We've got two women from different parts of the city sick, with no apparent connection to the five, maybe eight deaths at the convalescent home.
And four soldiers who showed no signs of being sick overseas.
It's impossible.
There isn't a biological or chemical weapon that strikes so randomly, unless it's This isn't a medical code yellow.
This has nothing to do with Iraq.
The disease we're fighting is right here, in our backyard.
Stephen, making a decision to stop looking overseas for an answer doesn't make medical sense.
There's no chance this disease was brought on by a biological or chemical weapon.
Without understanding more about the disease pathology or its incubation period, you don't know that.
We have to make a choice.
Any more time spent in the wrong direction we risk losing the lives of the men we have here, and I'm not going to let that happen.
What do you have on Gladys halperin? I can't find her name on any government payroll.
We have no way of knowing who she is.
As soon as she calls, you call me, then call the police.
So listen now the IRB is threatening to shut down the trial because of the ongoing pain issues.
Tell them we've temporarily halted treatment.
- That might not be enough.
- It'll have to be.
Just do your job, Eva.
We've already lost two of the soldiers and it's not looking good for Vasquez.
His heart rate was erratic, exaggerating his edema.
He went into respiratory arrest.
I believe the answer we're looking for isn't medical.
It's personal.
It's about who these people are and what their lives are about, but somehow, the answer's right here.
It's right in front of us.
We just gotta start asking the right people the right questions.
So what's your medical specialty? I'm not a doctor.
I'm a toxicologist.
You fooled me.
From how you and Dr.
Connor speak, I take it you served.
The USS blue ridge off the coast of Kuwait city.
The first time around.
Then you know what they've been through.
Like it was yesterday.
Good and bad.
Sometimes it's easy to forget that an institution the size of the military still consists of individuals worthy of our trust and respect.
Even if we both don't always think the institution deserves the same.
That's something I didn't think we agreed on, sir.
I ask that you not confuse the U.
S.
military with the enemy.
- Who did you lose? - Excuse me? To Gulf war syndrome.
Who did you lose? My C.
O.
My friend.
I'm sorry for your loss.
Shirley.
Hi.
/ Hi.
Did Barrett fidler call in for an appointment today? Barrett No.
Far as I can see, he's not on the books.
Excuse me.
St.
Stephen medallion.
That's who my mom named me after.
He was the first christian martyr.
What is it? The two women with ARDS.
What hospitals are they being treated at? St.
Ignatius and Good shepherd.
Why? We may have just found the strangest commonality possible.
Yeah, Stephen.
I need you to find out if the two women at the ERs Karen gaul and Rebecca dimarco? Yes.
Find out if they're catholic and if they regularly attend mass at st.
Angela's.
What's going on? The commonality we've been looking for.
This disease might be killing catholics.
St.
Angela's Bethesda, Maryland If the answer's here, please, tell me where it is.
How could people with nothing in common besides faith become infected? During mass, parishioners are asked to offer each other a sign of peace.
Natalie, what have you got? Rebecca dimarco's a catholic.
And she went to mass at st.
Angela's? Yes.
Karen gaul attends there as well.
Good work.
Okay.
The hospitalized women were here.
The elderly weren't.
What am I missing? What other ways could it have happened? Every mass, hundreds of people place their fingers into the holy water, Crossing themselves with potentially dangerous germs and bacteria.
The communion.
The eucharist passes from the hand of the priest to the parishioners and directly into their mouths.
I'm sorry for making you wait.
Seems like hearing confession takes longer every year.
I'm afraid it's a sign of the times, Father.
In your message you said you had some pictures you wanted me to look at.
/ Oh.
Yeah.
Thank you.
Father, I was wondering if you recognize any of these men.
Yes, Joe vasquez, I know.
And the others, They were at a saturday mass.
And these five here.
I'm just trying to find anything that connects them to the soldiers.
No, I'm sorry, I, I don't know them.
I have to excuse myself, but before I go, was there anything I can do for you? / No.
No, thank you, Father.
Um, actually if you'd keep my wife and my son in your prayers, I'd appreciate that.
The answer's got to be here somewhere.
Natalie, get everyone down here.
We're testing everything.
All right, so the priest isn't infected and neither is the church.
So, let's focus on something we actually know.
Joe's on a ventilator delivering 100% oxygen, but his pulse OX keeps dropping.
What about the two women, Gaul and Dimarco? Their disease is following the same pattern as the soldiers'.
We also know that the soldiers and the two women appear to have been infected at the church.
We know that the residents of the convalescent home who were shut-ins got sick from the same illness but had no relationship with the soldiers.
Those soldiers and the two women, Gaul and Dimarco have all been inside the church.
Yeah, but the five elderly residents haven't been.
They don't fit the pattern.
They're the outlyers.
Wait a second.
The missing piece isn't at the church.
It's at the convalescent home.
When did Barrett fidler last renew his meds for the Von recklinghausen trial? Uh, Fidler Barrett fidler, he hasn't requested them for the past three weeks.
You sure? Yeah.
Thanks.
Why would you do it with the IRB breathing down our necks? Do what? Shirley morris's security card mysteriously went missing for about an hour just long enough to be used to access a computer center.
Yeah, and? The only computer center with the database for every clinical trial.
Did you tell Barrett fidler which drug he was prescribed? Was there any unauthorized access to the database? No.
/ No.
So don't worry about it.
And I resent the accusation.
And I resent you implying that I don't do my job.
If I didn't, the clinical trial your friend is involved with would have been scrapped about an hour ago.
There wasn't a breach.
And I respect the job you do, Eva, and how well you do it.
Where is everybody? The first time you were here, the residents were scared.
Now they're terrified.
So they're all hiding inside their rooms.
As much as possible.
Have there been any new signs of residents becoming ill? / No.
What about other places I can check where the residents congregate? Places a disease would have the greatest opportunity to spread to others.
Well, you've seen just about everything.
What about the chapel? We don't have one.
Really? Why's that? We have people of all faiths here.
Those who choose to, go to their own personal place of worship.
And those who can't go out, especially catholics? Has a lectern visited the home lately? Do you know who you're looking for? Not by name.
Looking for the same person who comes at the same time, sunday after sunday, week after week.
Wait a second.
Do you know this guy? Mr.
Robert mccann? Priests have civilians called lecterns, they'd hand out the eucharist in one line while the priest would do the same in another.
Lecterns also had another job.
to go outside the church and give communion to those who couldn't attend mass.
- To the sick and the elderly.
- So if they couldn't come to god God would come to them.
Looks like he hasn't been here in a while.
Mr.
Mccann? Mr.
Mccann? Mr.
Mccann? Miles, check the back of the house.
12 messages.
If he's missing, you'd think someone would've noticed.
Bed's made, but he's not here.
Metropolol succinate.
Beta blockers.
Looks like our guy has a bad heart.
Not anymore.
Looks like he's been dead for a couple of days.
What do you think, Frank? I think I'll walk around him.
Frank's always had a bit of a weak stomach.
I thought you were a navy man.
I'll be just fine.
This could be our patient zero.
Yeah.
We got to find the source of the disease and identify it first.
I may have something.
What do you got? Mouse droppings.
I'm betting those came from a deer mouse.
Hantavirus? / Yeah.
Let's break out the mask and gloves.
Hey! Walk lightly.
Don't kick up any dust.
Sweeping up the mouse droppings, this guy could have inhaled millions of particles of infected dried urine.
Poor guy just wanted to sweep out his garage and now he's dead.
Along with at least five others.
Symptoms fit.
A febrile illness, hemoconcentration, pulmonary edema.
What's this? Looks like it's been chewed into submission.
I'm going to have to dissect what comes out of that hole.
What are you looking at me for? I mean, I'll lift and shake it, but catching whatever the hell comes running out of that thing is up to you.
Or you.
What exactly are we looking for on this jacket? Dried, infected mouse urine from the sin nombre virus.
Great.
In 1993, an ancient strain of Hantavirus killed two dozen people in the rural southwest, all from inhaling aerosolized deer mouse waste.
Even better.
Did you know Hanta is also known as the "Four corners virus" because it was first identified by scientists on an indian reservation in New mexico? Navajos.
As interesting as that may be, I really need to start concentrating here.
It's a bio-safety level four pathogen found in our own backyard.
Or in this case, in a garage filled with mouse urine.
This jacket is saturated.
I hate mice.
You know, the deer mouse isn't the only one that can kill you.
The rice rat carries the bayou hantavirus and the cotton rat carries the black creek canal hanta.
Well, for the record, I hate rats, too.
After returning from overseas, your boys went to church to pray for the men left behind.
They received communion from a lectern who was already sick.
He passed microscopic particles of the virus from his jacket, to his hands and to their mouths.
As a precaution, we also notified the other parishes where Mr.
Mccann may have volunteered.
Vasquez has a hell of a battle in front of him.
/ Yeah.
You know I can't stop you from quitting the trial.
It's an option you've always had.
This isn't about the trial anymore.
I thought that's why you were here.
I'm here because I'm your friend and I want to help you.
You want to help me? You want to make my life easier? Then help me take it away.
Barrett Don't quit the trial.
You have absolutely no reason to.
I'm not going to be the NIH's guinea pig while I slowly waste away.
You're not going to waste away.
Trust me when I tell you this.
What are you saying? You know I can't break the confidentiality of a double-blind study.
But what I'm saying is, don't stop taking the drug.
If there's a chance that I can help you, I'm not going to let you give up.
Survival rate's 25%.
And I've done everything I can do help you.
Whatever happens next is out of my hands.
It's in someone else's.
Someone who won't let you down.
Trust him.
¢Ý Children waiting for the day they feel good happy birthday, ¢Ý ¢Ý happy birthday ¢Ý ¢Ý When I feel the way that every child should ¢Ý ¢Ý look right through me, ¢Ý ¢Ý look right through me ¢Ý ¢Ý and I find it kind of funny I find it kind of sad ¢Ý ¢Ý that dreams in which I'm dying are the best I've ever had ¢Ý ¢Ý I find it hard to tell you I find it hard to take ¢Ý ¢Ý but people run in circles, it's a very, very¢Ý ¢Ý mad world, mad world ¢Ý ¢Ý enlarging your world ¢Ý ¢Ý mad world¢Ý All right, here's the deal.
No more action films for a while, okay? Next time, we're going to rent one of my favorites, the Sting.
Hmm? You know, Paul newman, Robert redford? - Who are they? - Who are they? Can we go to the arcade before we go home? Yeah, sure.
But, look, before anything gets in the way, I think there's something that we need to talk about.
Sit down.
I know.
You and mom are splitting up for good.
I could tell.
It's okay, dad.
Now I can be like all my friends.
¢Ý Mad world ¢Ý ¢Ý mad world ¢Ý ¢Ý enlarging your world ¢Ý ¢Ý mad world¢Ý