Monday Mornings (2013) s01e03 Episode Script
Who's Sorry Now
1 Facial droop right side, arms are numb, speech slurred.
He's incoherent.
Okay.
Initiate code stroke.
Call sung.
What's going on? What's wrong with him? No.
He's okay.
- Don't push me away! - Ma'am, I'm not pushing you away.
Your husband has had a stroke.
We need to make a plan, and we need to do it very fast.
He was admitted last night ptosis.
They paged me to take a look.
What's his history? Living on the streets for at least five years, in In and out of psych wards, no family.
It's purple and bulbous.
He's been previously diagnosed with schizophrenia.
I see government.
There you are.
I see government.
He's been going on and on.
About how the cia put extra salt on his french fries.
To dehydrate him and what did the supreme court do? They killed stevie ray vaughan.
Okay.
mr.
Carter? Huh? How long has your eyelid been drooping like this? I-I can hear you.
Yeah.
They al always go in advance.
May I? I'm not cia, sir.
How long's he been in here? He comes and goes, sometimes for a day or two, Depending on the severity of his psychosis.
let's get an mri.
Oh, he's not insured.
Not that that matters.
White ones.
It's always white ones.
I think.
Yeah.
That's right.
I-I can hear you.
What's happening is that you have yet again.
Barred an instrument rep from the o.
R.
In defiance of our express directives Because they interfere with the procedures.
They exalt the interest of the hardware ln defiance of hospital policy Over the the patient And in particular defiance of me.
Oh, well, it's all about you, isn't it, buck? - You listen to me, missy.
- missy? How lovely to see the children at play.
Dr.
Ridgeway, let me start with you.
I have delightful news.
You won't have to worry about.
Attorney tompkins complicating your life, At least not for the immediate future, The case has gone away.
Really? How? Our attorney deemed it unwinnable, so we've settled.
I beg your pardon? Well, that's what happens.
When you nick the olfactory nerve of a chef, Or rather when you delegate the nicking of said nerve.
To a resident with no previous experience of the procedure.
Oh, and you can wipe that smile off your face, buck.
The attorney has set his sights on you now.
Me? Why? Something to do with your insistence.
On pronouncing a rather-alive patient dead.
You'll be meeting with our lawyer first, scott henderson.
He's waiting for you on the third floor.
Large occlusion there.
Lot of plaque.
Middle cerebral artery, swelling.
Need hemicraniectomy.
I'm sorry.
I didn't understand a word he said.
Your husband needs surgery.
To relieve the pressure on his brain.
The sooner we do it, the more brain cells we can save.
He had a massive stroke.
Medications, thrombolytics already given.
And what's a hemi Craniectomy.
Remove part of skull bone.
- Create flap.
- What do you mean, "flap"? Only one entrance into skull.
Hole at base.
If no room, brain squish out of hole.
What is he talking about? The brain is swelling, so we need to create more room.
So we remove part of the skull.
And do what with it? Stomach.
We store the skull bone in the abdomen.
The peritoneum in the belly.
Actually nourishes the skull bone.
It keeps it healthy while he recovers.
And the operation is it risky? Yes, ma'am.
Will die without.
oh, my god.
Promise me you'll save him.
Please.
I will do.
"If no room, brain squish out hole"? Mm.
Wow.
So all this time they've been thinking it's schizophrenia, When that has been growing inside his head.
Perhaps growing for five-plus years.
It's a bilobed meningioma.
It's on your frontal lobes.
Now, the good news is I might be able to fix it.
With surgery, but there are risks.
Need dedicated TDM interconnections.
The I.
S.
A.
N.
alleviates post D.
A.
delay.
Reduces routing issues.
Yeah.
I'll take care of the routing issues.
In the meantime, please, sign here.
Says that you understand the inherent risks.
The soft-switch architecture is not right.
It just isn't right.
Absolutely.
Please, sign here.
It says that you understand the risks of surgery.
And that you knowingly consent to the procedure.
You want to scrub up, be part of this? I would, but I know it isn't my place to raise this concern If you have a concern, doctor, it's your duty to raise it.
Okay, the consent Was anything but informed.
The man had no idea what I was talking about.
But with no family, no guardian, I'd either have to go to court, Which could take time he does not have, Given the size of the meningioma, Or I simply get another neuro who will agree.
That the surgery is as necessary as it is urgent.
Are you that neuro, dr.
Robidaux? Um Yes.
Good, then.
Scrub up.
So you're not getting sued now.
This is great.
No, it's bad, because I've lost.
Even before being allowed to defend myself.
Look we get sued.
Big deal.
It happens.
Be glad you now don't have to deal with mitch tompkins.
Okay, you are way too mellow.
How great was this date with lieberman? Oh! Not get paged? We did, sung, which is why we're on our way to see you.
Walk leisure.
This urgent.
Stroke patient.
Hemicraniectomy.
Need you.
And you.
Patient old.
Fat.
Scrub.
Okay.
Yeah.
A gangbanger gets shot in the head by another banger, And the family is suing me, the doctor.
Welcome to american jurisprudence.
You think that's funny? I didn't intend it as funny.
Mr.
Tompkins sues doctors in bulk.
And typically extracts onerous settlements, More times than not, By getting defendants to make incriminating Or, worse, dumb declarations on the record.
And if first impressions count, You strike me as low-hanging fruit.
Have you ever been deposed by mr.
Tompkins before? No, but I can certainly handle the answer to that question would be "no.
" You leave it at "no.
" you do not qualify, elaborate, or explain.
The more you say, the more you pay This has been my experience with mitch tompkins.
Okay.
Mr.
Carter, how we doing? I know.
I'm sorry? I know that you're cia.
And you're trying to cut these secrets out of my head.
You just try to relax, okay? I'll make you better.
I want my lawyer.
Whoa.
What did he say? He said, "let's do it.
" I'm not sure I'm comfortable with what I just heard.
That's not what I got from the pre-op eval.
Uh, h-hold on, everybody.
Let's all take a moment.
While dr.
Wong gets himself comfortable.
Maybe, in the meantime, we can all watch a little tv.
I direct your attention.
To the monitor featuring a large bilobed meningioma, One which needs to come out of the head.
Look I have assessed this patient, doctor, And found him to lack any comprehension.
Of his medical condition, And therefore incapable of expressing informed consent.
There is no alternative source for such consent.
It therefore falls to me to weigh the risks.
Of performing the proposed treatment versus not performing.
My medical opinion is that this tumor needs to come out.
Do you really mean.
To substitute your judgment for mine, dr.
Wong? No.
Good, then.
Please put him to sleep.
Cia.
It's the cia.
There are so many cia.
And then they have That's I'm telling you, the way one glass of wine, ngs go He went from geek to cyrano de bergerac.
Shh! No talk.
Not high school.
- Was I being loud? - I didn't think so.
- Shh! - I stand corrected.
You ready? Yeah.
Bring it here, babe.
Often finds me crying in the car The suture.
Forceps.
And I am still pretending I believe you You doing okay? Me? I feel like I'm at disneyland.
Have you ever had a tumor on both hemispheres before? Once.
This is rare.
Just as long as no one says your name You ready? Just as long as no one Nice.
Well, first of all, let me say And I'll even say it for the record I happen to be a big proponent of organ donation.
I have a brother-in-law who would not be alive today.
But for our organ donation network.
So, to the extent that you are a participant in this process And I know you are, as head of transplants at chelsea general Let me start off by offering a heartfelt thank you.
I should also like to mention, for the record, That when a life is lost, many, many people suffer.
The victim himself, the family, hospital staff, Even the doctors.
Am I right, dr.
Tierney? Has my client's loss of life caused you to suffer any? I, like you, am pained by any loss of life, mr.
Tompkins.
My pain here is mitigated by the reality that, Through the gift of transplants, other lives were saved.
How very well said.
And I'm heartened, I must say, to see you have.
Your own personal suffering in check.
Shall we turn to my client's suffering, then? He taking any breaths on his own? None.
I haven't given him anything for a bit.
But he's not lightening up.
No neuromuscular blockade on board? Not for a while.
And no pain response.
He's got decerebrate posturing! How's his end-tidal co2? Normal.
Bring down more.
Has he had any mannitol? Diuretics? Max dosage.
Steroids, too.
Can you buy him some more room? No! There's too much edema.
Malignant brain edema.
He's herniated his brain stem.
Fixed and dilated.
What was his glasgow coma scale to start? Seven.
He's only three now.
Three's low can go.
Caloric reflex? Ice water.
No oculovestibular reflexes.
Swelling could not be contained.
Pressed on other parts of brain.
He's dead? H-he's He's brain dead, yes.
He's on a ventilator.
His body is still working, but I'm afraid he's gone.
We are so sorry.
He's A ventilator? He's on a machine? Yes.
He didn't want a machine.
That's why we filled out all that paperwork the directive.
The advance directive doesn't actually apply during surgery.
he's really dead? Okay.
Hey.
He's gone.
How can he be gone? Are you okay? Because we can cut the night short if I'm okay.
that poor woman.
They had no children.
He was all she had.
What? What are you thinking? Nothing.
That isn't true.
You were looking at me funny and thinking something.
It wasn't anything appropriate.
Second date, We're already keeping stuff from each other.
I guess that means we're fast-tracked.
Okay.
I have been hoping all day.
That tonight I would be kissing you.
And what I was thinking just now.
Is how that's probably not going to happen.
carla? I told you not appropriate.
Are you okay? somebody, help! Ma'am! Somebody help her! Are you okay? Get her a chair now.
Ma'am? Ma'am, look at me.
I'm dr.
Sydney napur, I work at chelsea general.
Are you getting air okay? Ma'am? Ma'am? Call 911! she's not breathing! Somebody call it! Mr.
Carter? Mr.
Carter? How we doing? I'm dr.
Wilson.
I performed the procedure.
What procedure? You had a large tumor.
On either side of your frontal lobe.
Do you have any memory of meeting me before? And this is dr.
Robidaux.
She assisted me with the procedure.
How we doing? Well, I think we're still trying to figure that out.
Okay, mr.
Carter, for tonight, I just want you to rest, okay? We'll go over everything tomorrow.
It's cooper.
I'm sorry? My name is brian cooper.
Uh, you were admitted as james earl carter.
Okay, I have no idea who that is.
But my name is brian cooper.
Look, is my wife here? I-I'd really like to talk to my wife.
Well, um, we can certainly arrange that if Would you happen to know how to contact her? Yeah.
You can call her at 503-278-8106.
She lives at 1215 bitteroot drive in beaumont.
Her name is marylin.
Whoa.
Sir, ar-are you okay? What year is it? What year did you think it was? What happened to me? What happened to me? - Just keep pushing me! - We're headed! Code team is waiting in the cath lab.
You're good to go.
Asystole! Not responding to I.
V.
Or tracheal epi.
Get me an intracardiac dose! You okay? Yeah.
Fine.
You don't look fine.
She's really an extraordinary woman dr.
Napur.
Can I be honest? Yeah.
You're overmatched, my man.
That woman will run through you like crap through a goose.
Just my opinion, but Crap through a goose.
Dr.
Park.
Hi.
Fran horowitz from risk management.
We've met before.
How are we today? Busy.
Go away.
Of course, this will just take a minute.
I understand that you lost a patient yesterday.
And you're meeting with his wife this morning.
Can we talk about that for a second? No.
Busy.
Well, understanding that you're busy, I'd nevertheless like to have a conversation.
And, in fact, harding hooten personally asked me.
To stop by for a chat.
I know you're familiar with the sorry coalition, And the multitude of studies that show, From a risk-management perspective, A doctor's compassion Not sorry.
Sorry dead.
Not sorry do.
Do nothing wrong.
Go.
Yes.
Notwithstanding that the procedure was done correctly.
From a medical and technical standpoint, Studies do show that a doctor's contrition Not sorry do.
Sorry dead, not do.
Go away.
Yes.
Why don't I just leave you some information to review.
This is a pamphlet created by the sorry coalition.
Doctors find that it, too, can be be very helpful.
Keep in mind that family members' primary motive.
When having these post-mortem conversations.
Is simply ascertaining exactly what happened.
Now, if we were to role-play for a second, And I, as eloise fernwood, were to ask you, "what happened, doctor? Why did my husband die?" Your answer might be Fat.
Eat too much bad food.
Yes.
Um, I'm going to leave you a few more pamphlets.
These and these and these.
First, regarding yesterday's session, A heartfelt thank you.
I feel much more up to speed.
Though a bit conflicted, I must say.
Given your actions, I have absolutely no doubt.
That your efforts contributed greatly.
To the preservation of life.
Well done.
Now In going over the transcript, I do have a question.
At the time you harvested the organs.
Of my client, gavin jasper, how dead was he? How dead was he? This would be my question, yes.
He was dead.
But you mistakenly thought him dead before, right? Which occasioned him to gesticulate at you.
The very reason I had the neuro-resident conduct the exam.
Was to confirm the patient's death.
When it was revealed to me that he was not dead, I left.
I returned to harvest the organs.
Only after he had officially been pronounced deceased.
Excellent.
All cleared up.
Wonderful.
Except I'm still a bit confused.
What constituted gavin jasper as dead? After the patient underwent.
A clinical neurological assessment, He was given what is known as an apnea test.
Basically, the ventilator is stopped.
You allow the carbon dioxide levels to increase.
You check to see whether the patient can breathe or gasp.
If he cannot, he is deemed brain dead.
And that's what happened here? Correct.
Mr.
Jasper was taken off a ventilator.
He did not gasp.
He did not breathe.
You pronounced him dead.
Yes.
Correct.
At which point you put him back on a ventilator.
And kept him alive while you cut out all his organs.
No.
No? He was not put back on a ventilator? Yes, he was.
Why? To keep him dead? To keep his organs alive.
See this is where I get confused.
Was he dead or alive? He was absolutely dead.
His heart had stopped.
No.
The heart was beating.
In fact, he could still have had a heart attack.
Yes.
How common is that, doctor? For a dead man to have a heart attack? We are talking about brain dead, okay? Your patient was brain dead.
No, he was my client, actually.
He was your patient, doctor.
Your patient.
When my client was put back on a ventilator, Could this have prolonged his suffering? Absolutely not.
The pain center of the brain was dead.
Well, that's good to know.
So there would be no need for, say, an anesthesiologist? The anesthesiologist was there to make sure.
The parts were properly oxygenated.
Wasn't he also making sure.
That mr.
Jasper wouldn't suffer muscle spasms? Yes.
And controlling muscle spasms with anesthesia Isn't that a form of pain management? Just so I'm clear, my dead client, Your dead patient whose lungs were breathing, Whose heart was beating, had an anesthesiologist.
Present to manage his pain.
Your client was not capable of feeling pain.
He was brain dead.
And you made sure of this, right? Before cutting out his parts.
You did an e.
E.
G.
On him.
To see if there was any activity in his cortex.
You tested him for higher brain activity, right? No? You just gave him a little apnea test, Then, whoosh, Started removing the kidneys and liver? How dare you? All right.
All right.
Gee.
That was actually my next question.
You got all the organ recipients on hand.
A schoolteacher, a doctor, an engineer All these wonderful lives to be saved.
A black kid, gunshot to the head.
What are we waiting for, right? Sure looks dead enough for me.
And you have no real memories of the last 7 years? I-I've gots of the last sa hazy recollection.
Of being either on a street or Or an alley.
The lab work does indicate some drug abuse.
Uh, we were able to locate a marylin cooper.
And, uh, you have two daughters, emma and michaela? Yes.
Yes.
Are are they here? What? Mr.
Cooper, you went missing.
A missing person's report was filed in 2006.
In 2009 Your wife was granted a divorce in absentia.
And she's remarried.
What? Was I wrong to just blurt it out? Well.
It had to be said.
Okay, first thing, let's get a counselor in with him.
I did make contact with his ex-wife.
She's coming in.
O-okay.
Okay.
Let me talk to her first.
Mm-hmm.
No, no, no, no, no.
I do not want this case settled.
Absolutely How much are we looking at? High six figures, minimum.
What? I didn't fire the gun! I didn't pull the trigger.
Buck.
We never order up extra tests if they met criteria.
I mean, my god, if we double, triple, quadruple check.
Every thug that comes in here with a hole in his head.
And clinical proof of brain death.
This is exactly why we're looking at high sixes, Let alone you hovered over this patient like a vulture, Waiting for him to die.
The fact that it was a black banger only makes it worse.
And that you would celebrate.
The successful harvesting of his organs.
In front of his mother I did not celebrate.
We saved six lives, for god's sake.
Now, what? We're gonna get whacked with a lawsuit for that? Are you serious? Do not settle this case, harding.
Thank you, buck.
I will take that under advisement.
This is unbelievable.
Settle it.
We think, um Suffered sequelae of his stroke during procedure.
Sometimes bad things happen.
Did were there complications during the procedure? No.
It went as planned Until dead.
Your husband was not in good physical condition.
We try our best, but Sometimes these things happen.
So I have advance directive.
He not want artificial means.
You want disconnect ventilator? Hey! You.
Uh-oh.
Yeah.
"Uh-oh" is right.
Did you actually tell lieberman I would go through him like crap through a goose? In a good way.
What is wrong with you? You're too much for that guy.
You don't even know him.
Yeah, but I know you, syd.
All I was doing was making sure.
He didn't take you for granted.
First of all, what business is it of yours That I protect my people? And by the by, given your track record with men, I stand by my "crap through a goose" analogy.
Dr.
Napur.
First off, very well done on saving a life last night, Starting off with the successful, Though I have been told, Slightly awkward execution of the heimlich.
And then your extraordinary en-route intubation.
And eventual resuscitation, Buttoned off finally with your brilliant bypass.
What'd I do? I beg your pardon? You got that Monday-morning look in your eye.
Am I getting 311'd? Oh, don't be silly.
I got the page, harding, does it toll for me? It does not.
However, if it were to toll for you I knew it.
What'd I do? Well, you did rather declare yourself.
Last night in the restaurant.
As a doctor from chelsea general.
In so doing, any subsequent treatment you rendered.
Would potentially incur a liability.
On the hospital's behalf.
We don't like being held accountable.
For things that transpire in restaurants.
Next time, let's just give the lady a big squeeze.
Without the song and dance, shall we? He started to behave erratically, Both at home and at work.
He started drinking.
And one day, he just Never came home.
He He just didn't come back.
It hardly seems Possible? Yeah, I know.
In fact, this case will likely get written up.
In a lot of journals.
But in between all the fine print, I'm afraid, will be a great deal of anguish, For him, for you, your children.
And how shall I handle this? Mrs.
Cooper It's kupcheck now.
I'm a neurosurgeon.
W-we're cutters.
We open up brains, we resect tumors.
We're we're cutters.
And what we've opened up here, I'm afraid We are not equipped to But your husband your ex-husband.
Is meeting with a counselor right now.
And my feeling is that you should, as well, Before you see him.
And and how is he? He's Well, he's very scared.
And he's missing you a lot.
You and the girls.
Okay, as we seem to have a fulet's get started.
Dr.
Wilson.
Oh, there's no need for you to come up, But, um, could you tell us about brian cooper.
Uh, brian cooper was a homeless man, Suffering from delusions, who was admitted.
To the psych ward two nights ago.
Suspecting a physical root for his psychosis, I ordered an mri where it was determined.
That he was suffering from a benign but large.
Bilobed meningioma.
Surgery was performed, the tumor was resected.
The delusions have disappeared, and, at this point, We're hoping for a full recovery.
Wow.
I'd call that a miracle, dr.
Wilson.
Wouldn't you call that a miracle? I imagine mr.
Cooper must be very excited.
That such a miracle was performed.
Did he strike you as being excited that you performed it? Mr.
Cooper lacked any and all competence.
To provide informed consent.
Does he have family? None that we could find, so I made the decision How hard did you look? I'm sorry? How hard did you look to find this man's family.
Before you subjected him to a life-threatening brain surgery? Hmm.
It's difficult sometimes not to rush, hmm, When there are great miracles to be had? Did you discuss the matter with any of your colleagues? With dr.
Robidaux.
Dr.
Robidaux, please stand.
Comments? Uh, well, with all due respect, I'm not sure I was even inclined to order up an mri.
The man was homeless, a diagnosed schizophrenic, With no insurance.
As for the procedure itself, he didn't just fail to consent, He refused to give it.
In fact, I think he told dr.
Wilson to go eff himself.
In my opinion, 99 out of a hundred doctors.
Would have welcomed the invitation.
To just walk away.
The only reason that mr.
Cooper is healthy, Perhaps even alive, Is because he got the one surgeon.
Willing to ignore all the bureaucratic b.
S.
And just do what was necessary.
That would be my comment.
With all due respect.
Well, that's certainly one way of looking at it.
This was certainly a very lucky patient.
Not just to get ty wilson's gifted neurological hands, But also his legendary ego.
After all, his life might have been saved.
Because he just happened on the one doctor.
Who refuses to recognize the possibility.
That he might ever be wrong.
Please take a seat, dr.
Wilson.
Buck, do come and join us, please.
Actually, I've changed my mind.
Go back where you were.
Dr.
Park.
Come tell us about floyd fernwood.
62-year-old male.
Middle cerebral artery occlusion.
Code stroke called.
Perform urgent decompressive hemicraniectomy.
Dead.
Oh, what was that last bit? Dead.
And that's the end of the story, doctor? A patient died, move on to the next thing, is it? Did you meet with fran horowitz.
From risk management, doctor? Yes.
Did you read the pamphlets as provided.
By the sorry coalition? Are you aware of the "sorry works" philosophy, doctor? Tell us about that philosophy, dr.
Park.
Say sorry, patient or family less likely sue.
Stupid.
Stupid? Yes.
Did nothing wrong, not say sorry.
Make no mistake, make no apology.
But what exactly did you convey to mrs.
Fernwood.
After her husband passed? Well, actually, let's just rewind, shall we? Let's go back to, um Let's go all the way back to "dead.
" Did mr.
Fernwood die on the operating table? Brain dead.
Put on ventilator.
Ventilator disconnect this morning.
Now dead-dead.
Prior to surgery, Did mr.
Fernwood have an advance directive? Yes.
And what were his wishes as regards.
To artificial life-sustaining treatment? No life-sustaining measures if condition irreversible.
So how is it that he ended up connected to a ventilator.
In the face of irreversible coma and brain death? I mean, most of us would recognize that.
As "life-sustaining.
" I didn't know what the advance directive said.
But no matter, directive no good during surgery anyway.
Suspended.
Ah, so after surgery, we had a patient who was brain dead, Hooked up to a respirator.
Ask mrs.
Fernwood what want do.
We then disconnect.
Now patient dead-dead.
"Ask mrs.
Fernwood what want do"? Why bother to ask her anything at all? Courtesy.
Courtesy.
Oh, my giddy heart.
I didn't know you had that in your bag of tricks, doctor.
You didn't think to ask before the surgery, As is required? Wouldn't that have been a more appropriate, Courteous course of action to take? I'm curious, doctor.
Why do you think people even bother with advance directives? I mean, if one chooses not to be kept alive artificially, Why doesn't one just communicate that to family and friends.
And next of kin? Why go to all the trouble of executing a legal document? That seems like such a to-do, does it not? One reason might be to save a loved one.
From making an excruciating moral decision.
I have an advance directive.
Do you know why? Because, should I find myself hooked up to a bloody machine.
One day, I don't my wife facing a doctor.
Who says to her, "what want do?" I don't want my spouse in the terrible position.
Where she has to pull the plug and end the life.
On the one person she loves most of all.
Can you imagine causing such agony to someone, doctor? Buck.
You know, I've decided to have a go at you after all.
Please come and join us.
Oh, you can stay right there, dr.
Park.
I present to you all today.
The case of the dueling ventilators.
Now, we're all in the business of healing, am I right? Ameliorating suffering where and when we can? But suffering sometimes extends beyond the patient To the patient's family.
Dr.
Park, you looked into the eyes of a grieving widow.
While her husband was sustained on a machine, When you said, "what want do?" That was not your best work, doctor.
And dr.
Tierney, you gave us all a grand display.
Only last week in this very room, Regaling us all with your life-saving heroics.
You were callous First with gavin jasper, then with his mother.
You were callous to the point of indecency.
And your indecency was again on full display.
During your deposition.
I look around this room, I look around this hospital, And I see such brilliant minds, such gifted hands.
All this talent, science, and technology Why do we need any humanity? It's probably best if you go in alone first.
You say he's met with a counselor, as well? Yes.
Um I'm not sure if you should go in, At least not yet.
I understand.
The neurological news is good.
In fact, it's stunning.
Emotionally, you certainly face some challenges, but, uh Do I even have a life here to resume? I mean, really? Mr.
Cooper, your life was deep in the toilet.
Mainly due to the psychological deficits caused by the tumor.
That has been fixed.
So I would say, for the first time in seven years, You actually do have a life to resume.
It's gonna be a haul, But I think it's one that you can make.
all right.
Let's do this.
Come on.
I-I really want to get this over with.
Oh, my god.
Hi.
welcome back.
hey, daddy.
Emma? Yeah.
michaela? ohh.
Hey.
Do you realize, For all the mishegoss on healthcare, All the money spent on research, development, Cures, whatever, We're basically just eating ourselves to death? I don't just mean obesity, but also toxins That guy who stroked out on sung's table, The woman that gagged at the restaurant.
Do you have any sense the staggering amount of preventable deaths.
Caused either by bad food or cigarettes.
You want to solve healthcare? We should impose a fat tax, a cigarette tax, a sugar tax.
Do you ever stop? No.
I don't, actually.
What are you thinking? It's inappropriate.
So it's true? You come to this hellhole every night? what can I do for you, buck? I've got a question for you 'cause you give honest answers.
Am I an asshole? Another rum and coke for my man here.
Uh, no, I-I don't drink rum.
And you want to know if you're an asshole? A conscience is gonna clean Like bleach-white teeth Yeah, I know This ain't what it used to be Said the choice was easy Came on like a thief Gone like a thrill Sang the key After you leave Dr.
Park.
After you leave mrs.
Fernwood.
Said you're gonna be I am so, so sorry.
Guilt free After you leave After you leave Oh, you're gonna be Guilt free
He's incoherent.
Okay.
Initiate code stroke.
Call sung.
What's going on? What's wrong with him? No.
He's okay.
- Don't push me away! - Ma'am, I'm not pushing you away.
Your husband has had a stroke.
We need to make a plan, and we need to do it very fast.
He was admitted last night ptosis.
They paged me to take a look.
What's his history? Living on the streets for at least five years, in In and out of psych wards, no family.
It's purple and bulbous.
He's been previously diagnosed with schizophrenia.
I see government.
There you are.
I see government.
He's been going on and on.
About how the cia put extra salt on his french fries.
To dehydrate him and what did the supreme court do? They killed stevie ray vaughan.
Okay.
mr.
Carter? Huh? How long has your eyelid been drooping like this? I-I can hear you.
Yeah.
They al always go in advance.
May I? I'm not cia, sir.
How long's he been in here? He comes and goes, sometimes for a day or two, Depending on the severity of his psychosis.
let's get an mri.
Oh, he's not insured.
Not that that matters.
White ones.
It's always white ones.
I think.
Yeah.
That's right.
I-I can hear you.
What's happening is that you have yet again.
Barred an instrument rep from the o.
R.
In defiance of our express directives Because they interfere with the procedures.
They exalt the interest of the hardware ln defiance of hospital policy Over the the patient And in particular defiance of me.
Oh, well, it's all about you, isn't it, buck? - You listen to me, missy.
- missy? How lovely to see the children at play.
Dr.
Ridgeway, let me start with you.
I have delightful news.
You won't have to worry about.
Attorney tompkins complicating your life, At least not for the immediate future, The case has gone away.
Really? How? Our attorney deemed it unwinnable, so we've settled.
I beg your pardon? Well, that's what happens.
When you nick the olfactory nerve of a chef, Or rather when you delegate the nicking of said nerve.
To a resident with no previous experience of the procedure.
Oh, and you can wipe that smile off your face, buck.
The attorney has set his sights on you now.
Me? Why? Something to do with your insistence.
On pronouncing a rather-alive patient dead.
You'll be meeting with our lawyer first, scott henderson.
He's waiting for you on the third floor.
Large occlusion there.
Lot of plaque.
Middle cerebral artery, swelling.
Need hemicraniectomy.
I'm sorry.
I didn't understand a word he said.
Your husband needs surgery.
To relieve the pressure on his brain.
The sooner we do it, the more brain cells we can save.
He had a massive stroke.
Medications, thrombolytics already given.
And what's a hemi Craniectomy.
Remove part of skull bone.
- Create flap.
- What do you mean, "flap"? Only one entrance into skull.
Hole at base.
If no room, brain squish out of hole.
What is he talking about? The brain is swelling, so we need to create more room.
So we remove part of the skull.
And do what with it? Stomach.
We store the skull bone in the abdomen.
The peritoneum in the belly.
Actually nourishes the skull bone.
It keeps it healthy while he recovers.
And the operation is it risky? Yes, ma'am.
Will die without.
oh, my god.
Promise me you'll save him.
Please.
I will do.
"If no room, brain squish out hole"? Mm.
Wow.
So all this time they've been thinking it's schizophrenia, When that has been growing inside his head.
Perhaps growing for five-plus years.
It's a bilobed meningioma.
It's on your frontal lobes.
Now, the good news is I might be able to fix it.
With surgery, but there are risks.
Need dedicated TDM interconnections.
The I.
S.
A.
N.
alleviates post D.
A.
delay.
Reduces routing issues.
Yeah.
I'll take care of the routing issues.
In the meantime, please, sign here.
Says that you understand the inherent risks.
The soft-switch architecture is not right.
It just isn't right.
Absolutely.
Please, sign here.
It says that you understand the risks of surgery.
And that you knowingly consent to the procedure.
You want to scrub up, be part of this? I would, but I know it isn't my place to raise this concern If you have a concern, doctor, it's your duty to raise it.
Okay, the consent Was anything but informed.
The man had no idea what I was talking about.
But with no family, no guardian, I'd either have to go to court, Which could take time he does not have, Given the size of the meningioma, Or I simply get another neuro who will agree.
That the surgery is as necessary as it is urgent.
Are you that neuro, dr.
Robidaux? Um Yes.
Good, then.
Scrub up.
So you're not getting sued now.
This is great.
No, it's bad, because I've lost.
Even before being allowed to defend myself.
Look we get sued.
Big deal.
It happens.
Be glad you now don't have to deal with mitch tompkins.
Okay, you are way too mellow.
How great was this date with lieberman? Oh! Not get paged? We did, sung, which is why we're on our way to see you.
Walk leisure.
This urgent.
Stroke patient.
Hemicraniectomy.
Need you.
And you.
Patient old.
Fat.
Scrub.
Okay.
Yeah.
A gangbanger gets shot in the head by another banger, And the family is suing me, the doctor.
Welcome to american jurisprudence.
You think that's funny? I didn't intend it as funny.
Mr.
Tompkins sues doctors in bulk.
And typically extracts onerous settlements, More times than not, By getting defendants to make incriminating Or, worse, dumb declarations on the record.
And if first impressions count, You strike me as low-hanging fruit.
Have you ever been deposed by mr.
Tompkins before? No, but I can certainly handle the answer to that question would be "no.
" You leave it at "no.
" you do not qualify, elaborate, or explain.
The more you say, the more you pay This has been my experience with mitch tompkins.
Okay.
Mr.
Carter, how we doing? I know.
I'm sorry? I know that you're cia.
And you're trying to cut these secrets out of my head.
You just try to relax, okay? I'll make you better.
I want my lawyer.
Whoa.
What did he say? He said, "let's do it.
" I'm not sure I'm comfortable with what I just heard.
That's not what I got from the pre-op eval.
Uh, h-hold on, everybody.
Let's all take a moment.
While dr.
Wong gets himself comfortable.
Maybe, in the meantime, we can all watch a little tv.
I direct your attention.
To the monitor featuring a large bilobed meningioma, One which needs to come out of the head.
Look I have assessed this patient, doctor, And found him to lack any comprehension.
Of his medical condition, And therefore incapable of expressing informed consent.
There is no alternative source for such consent.
It therefore falls to me to weigh the risks.
Of performing the proposed treatment versus not performing.
My medical opinion is that this tumor needs to come out.
Do you really mean.
To substitute your judgment for mine, dr.
Wong? No.
Good, then.
Please put him to sleep.
Cia.
It's the cia.
There are so many cia.
And then they have That's I'm telling you, the way one glass of wine, ngs go He went from geek to cyrano de bergerac.
Shh! No talk.
Not high school.
- Was I being loud? - I didn't think so.
- Shh! - I stand corrected.
You ready? Yeah.
Bring it here, babe.
Often finds me crying in the car The suture.
Forceps.
And I am still pretending I believe you You doing okay? Me? I feel like I'm at disneyland.
Have you ever had a tumor on both hemispheres before? Once.
This is rare.
Just as long as no one says your name You ready? Just as long as no one Nice.
Well, first of all, let me say And I'll even say it for the record I happen to be a big proponent of organ donation.
I have a brother-in-law who would not be alive today.
But for our organ donation network.
So, to the extent that you are a participant in this process And I know you are, as head of transplants at chelsea general Let me start off by offering a heartfelt thank you.
I should also like to mention, for the record, That when a life is lost, many, many people suffer.
The victim himself, the family, hospital staff, Even the doctors.
Am I right, dr.
Tierney? Has my client's loss of life caused you to suffer any? I, like you, am pained by any loss of life, mr.
Tompkins.
My pain here is mitigated by the reality that, Through the gift of transplants, other lives were saved.
How very well said.
And I'm heartened, I must say, to see you have.
Your own personal suffering in check.
Shall we turn to my client's suffering, then? He taking any breaths on his own? None.
I haven't given him anything for a bit.
But he's not lightening up.
No neuromuscular blockade on board? Not for a while.
And no pain response.
He's got decerebrate posturing! How's his end-tidal co2? Normal.
Bring down more.
Has he had any mannitol? Diuretics? Max dosage.
Steroids, too.
Can you buy him some more room? No! There's too much edema.
Malignant brain edema.
He's herniated his brain stem.
Fixed and dilated.
What was his glasgow coma scale to start? Seven.
He's only three now.
Three's low can go.
Caloric reflex? Ice water.
No oculovestibular reflexes.
Swelling could not be contained.
Pressed on other parts of brain.
He's dead? H-he's He's brain dead, yes.
He's on a ventilator.
His body is still working, but I'm afraid he's gone.
We are so sorry.
He's A ventilator? He's on a machine? Yes.
He didn't want a machine.
That's why we filled out all that paperwork the directive.
The advance directive doesn't actually apply during surgery.
he's really dead? Okay.
Hey.
He's gone.
How can he be gone? Are you okay? Because we can cut the night short if I'm okay.
that poor woman.
They had no children.
He was all she had.
What? What are you thinking? Nothing.
That isn't true.
You were looking at me funny and thinking something.
It wasn't anything appropriate.
Second date, We're already keeping stuff from each other.
I guess that means we're fast-tracked.
Okay.
I have been hoping all day.
That tonight I would be kissing you.
And what I was thinking just now.
Is how that's probably not going to happen.
carla? I told you not appropriate.
Are you okay? somebody, help! Ma'am! Somebody help her! Are you okay? Get her a chair now.
Ma'am? Ma'am, look at me.
I'm dr.
Sydney napur, I work at chelsea general.
Are you getting air okay? Ma'am? Ma'am? Call 911! she's not breathing! Somebody call it! Mr.
Carter? Mr.
Carter? How we doing? I'm dr.
Wilson.
I performed the procedure.
What procedure? You had a large tumor.
On either side of your frontal lobe.
Do you have any memory of meeting me before? And this is dr.
Robidaux.
She assisted me with the procedure.
How we doing? Well, I think we're still trying to figure that out.
Okay, mr.
Carter, for tonight, I just want you to rest, okay? We'll go over everything tomorrow.
It's cooper.
I'm sorry? My name is brian cooper.
Uh, you were admitted as james earl carter.
Okay, I have no idea who that is.
But my name is brian cooper.
Look, is my wife here? I-I'd really like to talk to my wife.
Well, um, we can certainly arrange that if Would you happen to know how to contact her? Yeah.
You can call her at 503-278-8106.
She lives at 1215 bitteroot drive in beaumont.
Her name is marylin.
Whoa.
Sir, ar-are you okay? What year is it? What year did you think it was? What happened to me? What happened to me? - Just keep pushing me! - We're headed! Code team is waiting in the cath lab.
You're good to go.
Asystole! Not responding to I.
V.
Or tracheal epi.
Get me an intracardiac dose! You okay? Yeah.
Fine.
You don't look fine.
She's really an extraordinary woman dr.
Napur.
Can I be honest? Yeah.
You're overmatched, my man.
That woman will run through you like crap through a goose.
Just my opinion, but Crap through a goose.
Dr.
Park.
Hi.
Fran horowitz from risk management.
We've met before.
How are we today? Busy.
Go away.
Of course, this will just take a minute.
I understand that you lost a patient yesterday.
And you're meeting with his wife this morning.
Can we talk about that for a second? No.
Busy.
Well, understanding that you're busy, I'd nevertheless like to have a conversation.
And, in fact, harding hooten personally asked me.
To stop by for a chat.
I know you're familiar with the sorry coalition, And the multitude of studies that show, From a risk-management perspective, A doctor's compassion Not sorry.
Sorry dead.
Not sorry do.
Do nothing wrong.
Go.
Yes.
Notwithstanding that the procedure was done correctly.
From a medical and technical standpoint, Studies do show that a doctor's contrition Not sorry do.
Sorry dead, not do.
Go away.
Yes.
Why don't I just leave you some information to review.
This is a pamphlet created by the sorry coalition.
Doctors find that it, too, can be be very helpful.
Keep in mind that family members' primary motive.
When having these post-mortem conversations.
Is simply ascertaining exactly what happened.
Now, if we were to role-play for a second, And I, as eloise fernwood, were to ask you, "what happened, doctor? Why did my husband die?" Your answer might be Fat.
Eat too much bad food.
Yes.
Um, I'm going to leave you a few more pamphlets.
These and these and these.
First, regarding yesterday's session, A heartfelt thank you.
I feel much more up to speed.
Though a bit conflicted, I must say.
Given your actions, I have absolutely no doubt.
That your efforts contributed greatly.
To the preservation of life.
Well done.
Now In going over the transcript, I do have a question.
At the time you harvested the organs.
Of my client, gavin jasper, how dead was he? How dead was he? This would be my question, yes.
He was dead.
But you mistakenly thought him dead before, right? Which occasioned him to gesticulate at you.
The very reason I had the neuro-resident conduct the exam.
Was to confirm the patient's death.
When it was revealed to me that he was not dead, I left.
I returned to harvest the organs.
Only after he had officially been pronounced deceased.
Excellent.
All cleared up.
Wonderful.
Except I'm still a bit confused.
What constituted gavin jasper as dead? After the patient underwent.
A clinical neurological assessment, He was given what is known as an apnea test.
Basically, the ventilator is stopped.
You allow the carbon dioxide levels to increase.
You check to see whether the patient can breathe or gasp.
If he cannot, he is deemed brain dead.
And that's what happened here? Correct.
Mr.
Jasper was taken off a ventilator.
He did not gasp.
He did not breathe.
You pronounced him dead.
Yes.
Correct.
At which point you put him back on a ventilator.
And kept him alive while you cut out all his organs.
No.
No? He was not put back on a ventilator? Yes, he was.
Why? To keep him dead? To keep his organs alive.
See this is where I get confused.
Was he dead or alive? He was absolutely dead.
His heart had stopped.
No.
The heart was beating.
In fact, he could still have had a heart attack.
Yes.
How common is that, doctor? For a dead man to have a heart attack? We are talking about brain dead, okay? Your patient was brain dead.
No, he was my client, actually.
He was your patient, doctor.
Your patient.
When my client was put back on a ventilator, Could this have prolonged his suffering? Absolutely not.
The pain center of the brain was dead.
Well, that's good to know.
So there would be no need for, say, an anesthesiologist? The anesthesiologist was there to make sure.
The parts were properly oxygenated.
Wasn't he also making sure.
That mr.
Jasper wouldn't suffer muscle spasms? Yes.
And controlling muscle spasms with anesthesia Isn't that a form of pain management? Just so I'm clear, my dead client, Your dead patient whose lungs were breathing, Whose heart was beating, had an anesthesiologist.
Present to manage his pain.
Your client was not capable of feeling pain.
He was brain dead.
And you made sure of this, right? Before cutting out his parts.
You did an e.
E.
G.
On him.
To see if there was any activity in his cortex.
You tested him for higher brain activity, right? No? You just gave him a little apnea test, Then, whoosh, Started removing the kidneys and liver? How dare you? All right.
All right.
Gee.
That was actually my next question.
You got all the organ recipients on hand.
A schoolteacher, a doctor, an engineer All these wonderful lives to be saved.
A black kid, gunshot to the head.
What are we waiting for, right? Sure looks dead enough for me.
And you have no real memories of the last 7 years? I-I've gots of the last sa hazy recollection.
Of being either on a street or Or an alley.
The lab work does indicate some drug abuse.
Uh, we were able to locate a marylin cooper.
And, uh, you have two daughters, emma and michaela? Yes.
Yes.
Are are they here? What? Mr.
Cooper, you went missing.
A missing person's report was filed in 2006.
In 2009 Your wife was granted a divorce in absentia.
And she's remarried.
What? Was I wrong to just blurt it out? Well.
It had to be said.
Okay, first thing, let's get a counselor in with him.
I did make contact with his ex-wife.
She's coming in.
O-okay.
Okay.
Let me talk to her first.
Mm-hmm.
No, no, no, no, no.
I do not want this case settled.
Absolutely How much are we looking at? High six figures, minimum.
What? I didn't fire the gun! I didn't pull the trigger.
Buck.
We never order up extra tests if they met criteria.
I mean, my god, if we double, triple, quadruple check.
Every thug that comes in here with a hole in his head.
And clinical proof of brain death.
This is exactly why we're looking at high sixes, Let alone you hovered over this patient like a vulture, Waiting for him to die.
The fact that it was a black banger only makes it worse.
And that you would celebrate.
The successful harvesting of his organs.
In front of his mother I did not celebrate.
We saved six lives, for god's sake.
Now, what? We're gonna get whacked with a lawsuit for that? Are you serious? Do not settle this case, harding.
Thank you, buck.
I will take that under advisement.
This is unbelievable.
Settle it.
We think, um Suffered sequelae of his stroke during procedure.
Sometimes bad things happen.
Did were there complications during the procedure? No.
It went as planned Until dead.
Your husband was not in good physical condition.
We try our best, but Sometimes these things happen.
So I have advance directive.
He not want artificial means.
You want disconnect ventilator? Hey! You.
Uh-oh.
Yeah.
"Uh-oh" is right.
Did you actually tell lieberman I would go through him like crap through a goose? In a good way.
What is wrong with you? You're too much for that guy.
You don't even know him.
Yeah, but I know you, syd.
All I was doing was making sure.
He didn't take you for granted.
First of all, what business is it of yours That I protect my people? And by the by, given your track record with men, I stand by my "crap through a goose" analogy.
Dr.
Napur.
First off, very well done on saving a life last night, Starting off with the successful, Though I have been told, Slightly awkward execution of the heimlich.
And then your extraordinary en-route intubation.
And eventual resuscitation, Buttoned off finally with your brilliant bypass.
What'd I do? I beg your pardon? You got that Monday-morning look in your eye.
Am I getting 311'd? Oh, don't be silly.
I got the page, harding, does it toll for me? It does not.
However, if it were to toll for you I knew it.
What'd I do? Well, you did rather declare yourself.
Last night in the restaurant.
As a doctor from chelsea general.
In so doing, any subsequent treatment you rendered.
Would potentially incur a liability.
On the hospital's behalf.
We don't like being held accountable.
For things that transpire in restaurants.
Next time, let's just give the lady a big squeeze.
Without the song and dance, shall we? He started to behave erratically, Both at home and at work.
He started drinking.
And one day, he just Never came home.
He He just didn't come back.
It hardly seems Possible? Yeah, I know.
In fact, this case will likely get written up.
In a lot of journals.
But in between all the fine print, I'm afraid, will be a great deal of anguish, For him, for you, your children.
And how shall I handle this? Mrs.
Cooper It's kupcheck now.
I'm a neurosurgeon.
W-we're cutters.
We open up brains, we resect tumors.
We're we're cutters.
And what we've opened up here, I'm afraid We are not equipped to But your husband your ex-husband.
Is meeting with a counselor right now.
And my feeling is that you should, as well, Before you see him.
And and how is he? He's Well, he's very scared.
And he's missing you a lot.
You and the girls.
Okay, as we seem to have a fulet's get started.
Dr.
Wilson.
Oh, there's no need for you to come up, But, um, could you tell us about brian cooper.
Uh, brian cooper was a homeless man, Suffering from delusions, who was admitted.
To the psych ward two nights ago.
Suspecting a physical root for his psychosis, I ordered an mri where it was determined.
That he was suffering from a benign but large.
Bilobed meningioma.
Surgery was performed, the tumor was resected.
The delusions have disappeared, and, at this point, We're hoping for a full recovery.
Wow.
I'd call that a miracle, dr.
Wilson.
Wouldn't you call that a miracle? I imagine mr.
Cooper must be very excited.
That such a miracle was performed.
Did he strike you as being excited that you performed it? Mr.
Cooper lacked any and all competence.
To provide informed consent.
Does he have family? None that we could find, so I made the decision How hard did you look? I'm sorry? How hard did you look to find this man's family.
Before you subjected him to a life-threatening brain surgery? Hmm.
It's difficult sometimes not to rush, hmm, When there are great miracles to be had? Did you discuss the matter with any of your colleagues? With dr.
Robidaux.
Dr.
Robidaux, please stand.
Comments? Uh, well, with all due respect, I'm not sure I was even inclined to order up an mri.
The man was homeless, a diagnosed schizophrenic, With no insurance.
As for the procedure itself, he didn't just fail to consent, He refused to give it.
In fact, I think he told dr.
Wilson to go eff himself.
In my opinion, 99 out of a hundred doctors.
Would have welcomed the invitation.
To just walk away.
The only reason that mr.
Cooper is healthy, Perhaps even alive, Is because he got the one surgeon.
Willing to ignore all the bureaucratic b.
S.
And just do what was necessary.
That would be my comment.
With all due respect.
Well, that's certainly one way of looking at it.
This was certainly a very lucky patient.
Not just to get ty wilson's gifted neurological hands, But also his legendary ego.
After all, his life might have been saved.
Because he just happened on the one doctor.
Who refuses to recognize the possibility.
That he might ever be wrong.
Please take a seat, dr.
Wilson.
Buck, do come and join us, please.
Actually, I've changed my mind.
Go back where you were.
Dr.
Park.
Come tell us about floyd fernwood.
62-year-old male.
Middle cerebral artery occlusion.
Code stroke called.
Perform urgent decompressive hemicraniectomy.
Dead.
Oh, what was that last bit? Dead.
And that's the end of the story, doctor? A patient died, move on to the next thing, is it? Did you meet with fran horowitz.
From risk management, doctor? Yes.
Did you read the pamphlets as provided.
By the sorry coalition? Are you aware of the "sorry works" philosophy, doctor? Tell us about that philosophy, dr.
Park.
Say sorry, patient or family less likely sue.
Stupid.
Stupid? Yes.
Did nothing wrong, not say sorry.
Make no mistake, make no apology.
But what exactly did you convey to mrs.
Fernwood.
After her husband passed? Well, actually, let's just rewind, shall we? Let's go back to, um Let's go all the way back to "dead.
" Did mr.
Fernwood die on the operating table? Brain dead.
Put on ventilator.
Ventilator disconnect this morning.
Now dead-dead.
Prior to surgery, Did mr.
Fernwood have an advance directive? Yes.
And what were his wishes as regards.
To artificial life-sustaining treatment? No life-sustaining measures if condition irreversible.
So how is it that he ended up connected to a ventilator.
In the face of irreversible coma and brain death? I mean, most of us would recognize that.
As "life-sustaining.
" I didn't know what the advance directive said.
But no matter, directive no good during surgery anyway.
Suspended.
Ah, so after surgery, we had a patient who was brain dead, Hooked up to a respirator.
Ask mrs.
Fernwood what want do.
We then disconnect.
Now patient dead-dead.
"Ask mrs.
Fernwood what want do"? Why bother to ask her anything at all? Courtesy.
Courtesy.
Oh, my giddy heart.
I didn't know you had that in your bag of tricks, doctor.
You didn't think to ask before the surgery, As is required? Wouldn't that have been a more appropriate, Courteous course of action to take? I'm curious, doctor.
Why do you think people even bother with advance directives? I mean, if one chooses not to be kept alive artificially, Why doesn't one just communicate that to family and friends.
And next of kin? Why go to all the trouble of executing a legal document? That seems like such a to-do, does it not? One reason might be to save a loved one.
From making an excruciating moral decision.
I have an advance directive.
Do you know why? Because, should I find myself hooked up to a bloody machine.
One day, I don't my wife facing a doctor.
Who says to her, "what want do?" I don't want my spouse in the terrible position.
Where she has to pull the plug and end the life.
On the one person she loves most of all.
Can you imagine causing such agony to someone, doctor? Buck.
You know, I've decided to have a go at you after all.
Please come and join us.
Oh, you can stay right there, dr.
Park.
I present to you all today.
The case of the dueling ventilators.
Now, we're all in the business of healing, am I right? Ameliorating suffering where and when we can? But suffering sometimes extends beyond the patient To the patient's family.
Dr.
Park, you looked into the eyes of a grieving widow.
While her husband was sustained on a machine, When you said, "what want do?" That was not your best work, doctor.
And dr.
Tierney, you gave us all a grand display.
Only last week in this very room, Regaling us all with your life-saving heroics.
You were callous First with gavin jasper, then with his mother.
You were callous to the point of indecency.
And your indecency was again on full display.
During your deposition.
I look around this room, I look around this hospital, And I see such brilliant minds, such gifted hands.
All this talent, science, and technology Why do we need any humanity? It's probably best if you go in alone first.
You say he's met with a counselor, as well? Yes.
Um I'm not sure if you should go in, At least not yet.
I understand.
The neurological news is good.
In fact, it's stunning.
Emotionally, you certainly face some challenges, but, uh Do I even have a life here to resume? I mean, really? Mr.
Cooper, your life was deep in the toilet.
Mainly due to the psychological deficits caused by the tumor.
That has been fixed.
So I would say, for the first time in seven years, You actually do have a life to resume.
It's gonna be a haul, But I think it's one that you can make.
all right.
Let's do this.
Come on.
I-I really want to get this over with.
Oh, my god.
Hi.
welcome back.
hey, daddy.
Emma? Yeah.
michaela? ohh.
Hey.
Do you realize, For all the mishegoss on healthcare, All the money spent on research, development, Cures, whatever, We're basically just eating ourselves to death? I don't just mean obesity, but also toxins That guy who stroked out on sung's table, The woman that gagged at the restaurant.
Do you have any sense the staggering amount of preventable deaths.
Caused either by bad food or cigarettes.
You want to solve healthcare? We should impose a fat tax, a cigarette tax, a sugar tax.
Do you ever stop? No.
I don't, actually.
What are you thinking? It's inappropriate.
So it's true? You come to this hellhole every night? what can I do for you, buck? I've got a question for you 'cause you give honest answers.
Am I an asshole? Another rum and coke for my man here.
Uh, no, I-I don't drink rum.
And you want to know if you're an asshole? A conscience is gonna clean Like bleach-white teeth Yeah, I know This ain't what it used to be Said the choice was easy Came on like a thief Gone like a thrill Sang the key After you leave Dr.
Park.
After you leave mrs.
Fernwood.
Said you're gonna be I am so, so sorry.
Guilt free After you leave After you leave Oh, you're gonna be Guilt free