Emily Owens M.D. (2012) s01e04 Episode Script
Emily And... The Predator
Previously on Emily Owens M.
D.
- Pits? - Don't you recognize me? Do I recognize you? You were my tormentor, my nemesis.
Cassandra Kopelson.
From high school.
Now I remember why we called you "Pits.
" What were you expecting? She's a jerk.
Congratulations, Dr.
Kopelson.
You'll be assisting on the next gallbladder that walks in.
I don't need your pity.
My hands shook, and I choked.
I think she's got a crush on you.
We're going out.
On a date.
I like you.
I just I don't see you that way.
I really hope we can still be friends, because I.
.
value our friendship.
In Mrs.
Everdine's ninth grade biology class, we watched a video called.
"The Greatest Predators of the Animal Kingdom.
" Lions, and tigers, leopards and cheetahs, bears On your right, on your right! However, they left out the most dangerous of creatures: The Cassandra Kopelson.
Back then, she was stalking Alan Zolman, the boy I liked.
And to this day, her hunting method has not changed.
She begins with a technique I call, "The Laugh and Linger.
" Then comes the "Whisper Come Hither.
" Advancing to the "Cold Little Shiver.
" Until she takes down her gazelle.
I saw Alan Zolman fall.
She lured him in, ripped out his heart, and left it rotting behind the school bleachers.
He was never the same.
But I won't let that happen again.
Not to Will.
You all right? Great! I'm not gonna lie, Pits.
You don't look so great.
Ah, come on.
She said it was her first day back.
From the dead? Sorry.
The important thing is not that it's been a while since I've exercised, but that I'm exercising now.
Agreed.
Let's race to the end.
Gut it out, Owens.
I will not let it happen.
God, I hate running.
These stupid blisters.
You went running just to keep them from being alone together? No, I went running because it's good for my health, which, as a doctor, you should Dr.
Owens.
I need you.
We're looking at possible kidney failure.
I need you to get me a medical history.
Does she have any preexisting conditions? I don't know.
Any allergies food? Chemical? - I don't know.
- All right, vial.
Another vial.
- Is she taking any medications? - I just don't know.
Sir, what exactly is your relationship to the patient? I'm her husband.
Look, we only met four months ago.
It was an arranged marriage.
What's happening to Amira? Is she okay? - You have to help her.
- We're gonna try and figure that out.
Drop those off at the Nurses' Station.
We need an ABG, ammonia level, LFT's and - A tox screen, stat.
- Got it.
Are you joining us, Dr.
Owens? Yes, I'm I'm sorry.
I need two volunteers.
Who wants some extra work? I'm in.
Yeah, me, too.
I'm also in.
531, He needs a bypass, but BP and heart rate are elevated and not responding to medication.
Figure out what's going on.
Start with thyroxicity.
You can't keep them apart forever.
No.
Not forever.
Just until he realizes that she's a predator.
Will can take care of himself.
No, he won't see it coming.
She's camouflaged as a regular person.
I know exactly why you volunteered, Pits.
Don't look so surprised.
It's the same reason I did.
Look, we both want to be Gina's research assistant, but for the sake of our patient, we need to work together as a team.
This isn't a competition, okay? Yeah, right.
Agreed.
Do you kw a Dr.
Hamata? Go answer it, I'll get started on the tests.
Um, Dr.
Hamata? I'm Dr.
Owens.
Know how to do an ultrasound? Yeah.
Theoretically.
I haven't done one, but Oh! Micah's girlfriend.
Huh, she's really pretty.
Okay, see right there? Why did you go to pretty? That's so demeaning.
You could have commented on anything, - anything in the world, like - Sorry about that.
Spend half my medical career filling out paperwork.
Her voice.
She has a crisp, clear voice.
Why are you smiling? I'm excited for my first obstetrical patient.
Okay, word of advice? Don't go into OB.
I thought it was going to be all magical, and the miracle of life, and the woman warrior, and blah-blah-blah.
It's just anxious women and husbands on BlackBerrys.
We induce, nothing opens, we just slice and we scoop.
When I get knocked up, I'm having a home birth.
Intake too, okay? Any bleeding or spotting? A little spotting.
Yes, that's why we're here.
Okay, uh how about headaches? No, no headaches, but her feet do hurt mostly in the evenings, just a little swollen.
Sorry.
I'm the biological mother of the twins.
She's our surrogate.
And her sister.
Not medically relevant.
Gotcha.
Okay.
Any trouble urinating? No.
Is everything okay? That's what we're going to find out.
All right, let's just take a look at Fetus A.
You know, she's probably dehydrated.
She never drinks enough water.
- I drink water, Ellen.
- No, not enough.
Ten to 12 glasses a day, Dr.
Hamata said.
What? What's the matter? What's wrong? Umthe thing is, I'm not a specialist, so we should get a second opinion.
The male fetus has structures on the left that are underdeveloped.
The mitral valves and the aortic valves are atretic.
The left ventricle is tiny.
Mm-hmm.
And the aorta.
Damn.
Another reason not to go into OB.
Hypoplastia what? Hypoplastic left heart syndrome.
Uh, Fetus A has a valve Andrew.
His name's Andrew.
Andrew has a valve releasing blood from his heart that's too narrow.
As a result, the left side is shrinking and shutting down.
This is made complicated by a second defect.
There isn't an opening between the walls of his heart.
Without it, pressure builds in the underdeveloped left ventricle and pushes blood back into the lungs.
So what does this mean? If left untreated, the child won't survive long after birth.
I'm sorry.
How how do we treat it? Well, there is an in vitro surgery which could repair the heart, but it's risky.
And if we try it well, there is a chance we could lose both babies on the operating table.
Oh, my God.
This is, this is not happening.
Is there another option? Um you could do nothing.
Opt for compassionate care.
After Andrew is born, he'll receive treatment aimed at relieving his suffering without extending his life.
He won't feel any pain.
In the first weeks of conception, cells multiply at an extraordinary rate, splitting and replicating to determine everything you will ultimately become.
It's amazing, when you think about it.
How much has to be timed perfectly, how much has to go right.
Perfect.
You doing great here.
But it doesn't always go right.
Mistakes occur.
Great, now slowly withdraw.
All right.
One biopsy down, one kidney to go.
How are you doing, Amira? A guy got hit by a train in While You Were Sleeping.
He was in a coma.
This is not as bad as that.
Plus the painkillers you gave me helped.
You a movie buff? Romantic comedies.
I love romantic comedies.
What's your favorite one? That's hard.
Maybe Love Actually.
Or When Harry Met Sally.
I love the way she orders off the menu.
I don't I don't see it.
What don't you see? Why would she have only one kidney? Most likely, an error occurred during conception.
It's actually not that uncommon.
And in and of itself, it isn't a problem.
The problem is that her blood work showed a below normal glomerular filtration rate and an elevated blood urea nitrogen level.
Which means that Her one kidney is in distress, and possibly failing.
Go to her.
So you can fix it, right? We won't know until we get the biopsy results back, but we'd like to start her on dialysis right away.
It's gonna be okay.
I'll call your parents in India and I'll let them know.
Yeah? Test results for Dr.
Bandari's extra credit assignment.
Great.
And do you know where Dr.
Kopelson is? On the roof, having lunch with Dr.
Collins.
Uh test results.
Gina's patient.
Thyroid's normal.
Huh.
What is it then? Well, I'll leave you guys to it.
Got to get back to the floor.
I'm thinking dehydration might be making the blood pressure and heart rate spike.
- But - It's possible.
Hey, what was Will like in med school? Did he have any serious relationships? No, a total commitment phobe.
- Insulinoma? - Nah, he's not hypoglycemic.
Never met a commitment phobe that didn't profess his love for me.
It'd be pretty stupid, though, to start a relationship with another intern, 'cause then if it doesn't work out, which it probably won't, it'd be pretty awkward, right? What about a pheochromocytoma? An adrenaline secreting tumor? Oh, I already asked Gina.
She ruled it out.
Mercury poisoning? No skin involvement, no rashes.
I got to get this.
It's fine.
Let's get together in an hour and brainstorm.
We'll figure it out.
Okay.
You made a decision? What? Uh, no.
Oh.
Um, I'm sorry.
I was paged.
The nurses said that you made a decision.
- We paged you.
- We did make a decision.
We can't risk both babies, so We're not gonna do the surgery.
Okay.
I'll let everyone know, and as soon as we get your tests, we'll get you discharged.
You didn't even want to talk to me before you told her? No offense.
Why would we Maybe because I'm carrying your babies.
Right, exactly.
We are the parents.
Claire, this is a tough enough decision to make without involving a third party.
- I'm your sister.
- I know you're my sister, Claire.
Don't be melodramatic.
I'm sick of you acting like I'm not involved.
For the last time, these are our babies.
Yeah, and this is my room, and I want you out.
I will tell Dr.
Bandari that you've elected not to do the procedure.
Did we get the kidney biopsy back yet? No, but I ordered it stat.
If you really want stat you need to stand outside the laboratory and glare at the technicians.
And bring them Swiss Rolls.
Those guys love Swiss Rolls.
What's with the limp? I took up running.
- Swiss Rolls? - Yeah, works every time.
Tell me you at least have good running shoes? I'm an intern; how am I supposed to afford them? For running shoes? No, Swiss Rolls.
I told you, we need Swiss Rolls.
Oh.
Your biopsy results revealed that you have focal segmental glomerulosclerosis.
It's a disease that causes scar tissue to develop on the kidneys.
Now, unfortunately, there isn't a way to reverse the damage.
You need a transplant.
We've already added you to the donor list, but it would be in your best interest to get your family and friends tested.
People that share a common geographical family heritage have a better chance of matching.
My wife and I were born in the same village as her parents.
You could test us.
And Sushil, of course.
I'm feeling dizzy, light-headed.
Her BP's getting a little low.
You know, it might just be the shock or maybe her body needs a break from dialysis.
What do you say we finish this treatment tomorrow? Okay, you can unhook her.
All right, why don't you follow me? We'll get started on the blood work.
Are you okay? Yes, I am.
Thank you.
Excuse me? Dr.
Owens? Can I ask you a question? Yes, of course.
I was told there is a video library in the hospital.
Would it be possible for me to get a copy of Never Been Kissed or My Best Friend's Wedding? And failing that, The Wedding Singer? Yes, I'll see what I can do.
Okay.
How about You've Got Mail? Yes, great.
Okay, coming down.
You think my patient has an pheochromocytoma? Interesting theory, Dr.
Kopelson.
Schedule an abdominal CT, a plasma fractionated metanephrine test and a nuclear scan of his head, throat and abdomen.
Find it.
Hey, a pheochromocytoma was my idea.
And this is not a competition.
You said that she ruled it out.
Because I mixed up the cases I was working on.
It was an honest mistake.
Like I said, mistakes occur all the time.
And let's be clear that was no mistake.
I'm not going to let her under my skin.
- Good plan.
- Because she's a bully - and always has been.
- If you cared.
Which I don't.
Exactly.
Because I know exactly who she is.
But Will doesn't.
He thinks that she's funny and delightfully blunt.
And ridiculously hot.
He needs to see her evil core.
The way she made Kendall Peterson cry.
Who's Kendall Peterson? This girl at our school who Cassandra tortured.
Her back literally gave out from the stress.
Why not just tell Will? About Kendall Peterson? Not to date Cassandra.
Oh, no, I can't.
'Cause he'll think it's because I like him.
- Which you do.
- Yeah, but that's beside the point.
This has nothing to do with me.
I'm trying to protect him.
Why don't I take that pathology report down to Dr.
Collins for you? Oh, yeah, great.
He's on four.
So what are you What are you doing here? I had a question for Will.
What are you doing here? I have his path report, and you clearly just ran here.
Why are you stalking us? Are you scared I'm gonna date your friend? - No.
- You should be.
I'm going to date your friend.
That's pretty confident.
Not pretty confident.
Pretty and confident.
Everything okay? - Yeah, great.
- Yeah.
Picked up your path report.
Might ask you a favor at some point.
Hey, Cassandra, I treated a patient named Kendall the other day, and it reminded me of Kendall Peterson.
Do you remember her? Yes.
I was just horrible to that girl.
It's one of my biggest regrets.
I felt so bad, I reached out and apologized a few years back.
We're actually close friends now.
You apologized? To Kendall? Where's my apology? I didn't see you at her wedding.
Were you there? Didn't you have a question or something for Will? I did have a question.
Um What are other ways to locating pheochromocytoma - For your extra credit project? - Exactly.
They're usually found in the abdomen, but we scanned the abdomen.
- Did you run a nuclear scan? - Yeah, nothing I feel like I read something about, uh, what's it called? You run a cath through the groin and take continuous samples.
Selective venous sampling.
- I'll get into it.
- I'll come with you.
It's really not a two person job.
Feel free to stay behind.
Great, you can get started on the cath, and I'll tell Gina.
That's not going to happen.
Dr.
Owens, wait.
Is that a patient of yours? Shoot.
Bad luck.
The surrogate contract is clear.
We have the legal right to make whatever choice needs to be made concerning our children.
It's all spelled out right here.
I don't think that your sister is disputing that.
I think she just wants to be included.
We are the parents.
Oh, that's my lawyer.
Just give her the contract.
Calling you right back.
Dr.
Owens.
I was just telling the Gurangs how lucky they are.
Sushil's tissue and blood typing make him an ideal candidate for donation.
Oh, that's great news.
Yes, I know.
Sushil, you do not have to You're my wife.
Of course I will.
Let's get you admitted.
And Dr.
Owens will check Amira out.
Okay.
Okay, let's give you a listen.
What will happen if I don't accept his kidney? Um, kidney rejection is always a risk, But Dr.
Barnes says that Sushil is a great match.
No, I mean, what if I don't want it? Um, you'd you'd be on dialysis at least three times a week until we found another donor.
Dialysis was not so bad.
And that would mean my family in India would have more time to get tested.
But, Amira, your husband is a great match.
I cannot take his.
Why not? Amira, doctor-patient confidentiality means I can't tell anyone what you say to me.
If Sushil's mistreating you No, no, he is a wonderful man.
Kind and smart and considerate.
It is just I am not 100% sure about us.
I want love in my life.
Romantic love.
And my mother told me it will happen with time, but what if it does not come? I don't want to live my whole life without it.
But if I take his kidney, I would be trapped.
That's not necessarily true.
I could never leave a man who did something like that for me.
Never.
Can you tell him there was a mistake? That he is not a match after all? I can't lie about test results.
But how can I tell him? He'll be so hurt.
I guess if it's important enough, you'll just find a way to say it.
Hey.
You got a second? Sure.
Okay.
- Everything okay? - Huh? Yeah, yeah, yeah.
I just, you know, wanted to talk to you about something.
I wasn't sure I was gonna say something.
It's actually kind of weird, and then I thought, well, if I don't say something, that would be weird, you know? So of the two options, weird and weird, I'm going with weird.
Please, just don't let it be about - It's about Cassandra.
- No.
The thing is the two of us have been, I don't know, um, flirting.
but I know that you two have your whole competitive thing.
And after what you told me about how you feel, I just wanted to make sure you'd be okay if I asked her out.
Just tell him the truth.
It's not okay.
Anyone but Cassandra.
Find a way to say it.
Yeah, totally.
Cool.
I mean, I had to ask, right? Because our friendship is really important and I didn't want you to feel uncomfortable.
Uncomfortable? No.
Miserable? Yes.
Patients need to warn you when they're about to projectile vomit all over you.
They also need to not eat Chinese food directly following a procedure.
He asked you.
He could have said no.
How? That would have been so awkward.
We're just getting back to being friends.
Why can't he see Cassandra for who she really is? - Hot? - No, selfish! Look! She's the kind of person who leaves her sneakers on the floor because she doesn't want to stink up her locker, but she doesn't care about stinking up the entire room! I leave my sneakers in my locker.
Now my clothes smell.
But that's what you're supposed to do.
What are you doing? Ending the conversation.
Great.
Now I have to go get them.
Why? She's been a bitch to you since the fifth grade.
You know, you're right.
Screw her, screw her shoes.
Hey.
How are you feeling? A little nervous.
But like you said, if it is important, you will find a way to say it.
Why is she staring at me like that? She doesn't mean now, does she? Sushil, I need to talk to you.
I cannot accept your kidney.
I don't understand.
Why not? You have been so sweet, so good to me.
But I am worried that at the end of the day maybe I'm just not that into you.
I am so sorry, but how can I take your kidney If I'm not sure that we will last? Stop! Just stop! I'm not sure either.
I'm willing to give you my kidney but I'm not sure either.
Dialysis is my choice until we find another donor.
Oh, did you give Claire the contract? Yes, I did.
Now you really have to stay in the waiting room.
No.
No, I'm done waiting.
Look, I have a right to see my children, even in utero.
So tell Claire to let me back into the room or I am going to get An injunction? She's lost her mind, right? I think she's just in a hard situation.
So am I, but I'm not an employee.
I'm her sister.
I know she is my sister.
That's why we have the contract which clearly lays out the agreement so things aren't muddy.
But things are always muddy.
It's not like she's delivering a package.
She's pregnant.
She's flooded with hormones.
I don't care about her hormones.
What matters is they are my children.
I know they're her children.
That's never been disputed.
Right.
And I think she's just trying to assert herself, maybe a little strongly, because of the babies.
This is not about the babies.
Of course it's about the babies.
It's not.
Go on, tell your sister.
Great.
Wait.
You have to make sure she doesn't yell at me.
You have to make sure she understands the legal situation.
See? Right there she's treating me like a surrogate.
- She is our surrogate.
- I am her sister.
What does she want me to do, sing "Kum-Bah-Yah"? No! I want her to see me! I don't even know what that means! It means you're my big sister, and all I want for you to do is to like me.
- I like - No, no, no, you don't.
You never have.
I'm just your annoying little sister.
I've always been your annoying little sister.
And I thought that if I did this for you, if I carried your children, it'd would bring us closer together.
But you can't even look me in the eye any more.
It's too hard.
What is? This.
Seeing you pregnant.
I didn't know that I would feel this way.
It's just, you get to feel them kicking, you get the cravings for watermelon, and you know them.
And I have no connection.
You're their mother.
It doesn't feel like it.
Which is not your fault.
I am so grateful.
And I do like you, Claire.
I love you.
I love you so much.
Wait.
I'm not sure.
Um, I'm not sure about the decision.
I keep trying to convince myself I am, but I'm not.
You know Andrew.
God, what do you think we should do? I have to answer this.
What's going on? She was 30 minutes into dialysis and her BP crashed.
Give me an amp of epi now! Okay, come on, stay with me here.
What do we have? How much did you take off? We only got 500cc's off when she coded.
Give her a liter bolus.
Owens, get up here, get me an airway.
Follow my lead, here we go.
Come on.
What's happening to her? Please? Get him out of here, now.
She went into hypotensive shock.
Right now she's in a coma, We're helping her breathe with the ventilator.
Dialysis puts great strain on the body.
This happens sometimes.
We'd like to keep her sedated until we can be sure that her breath and her blood pressure are stable.
But she will wake up? Hopefully, but her kidney has failed.
Toxins are building up.
She's in critical condition.
You mean, she could die? She needs a transplant right away.
We moved her to the top of the donor list, but No I'm giving her mine.
Wait.
You heard her.
She doesn't want it.
Rhea, Rhea.
Why should he have surgery? I have power of attorney, right? So I can make decisions for her? Good.
Then I'm giving her my kidney.
Okay, we need to get you checked in right away.
You can stand on those feet for the next four hours? Yeah.
Why? You're gonna make your first cut.
You okay? Yeah.
Yeah.
I just I didn't expect it to be today.
I thought I would, I thought I would know in advance.
Have some time to think about it.
That's why I didn't tell you in advance.
Are you implying that I overthink? You're overthinking.
Okay.
I'm nervous every single time I go in there.
I think if you're not nervous, then you're doing something wrong.
You can do this.
Just find your landmarks.
Hands on the field, gentle traction.
Slice quickly, straight line, gentle pressure.
Enough so you don't have to redo it, but not too much or you'll slice through the peritoneum.
Ready, Dr.
Owens? Suction.
Continue.
Sub cue.
Electrocautery gun.
Down to the fascia.
Retraction.
I'm through to the sub cue fat.
All right, keep going.
Peritoneum incised at 14:45.
Looking confident, Dr.
Owens.
Verging on ballsy, even.
I've never been called ballsy in my life.
It's a day of firsts.
Okay, good, now get your landmarks.
Can you page me, and only me, when the selective venous sampling comes back for the patient in 531? I already got it.
Oh.
How do you have them? They're not due for another two hours.
Mmm.
Swiss Roll? No! What do the results say? It's my patient, too.
Let me see.
Would you have shown them to me? No.
So why should I show them to you? Because my hand shook.
I was in surgery, and my hand shook, and when Gina sees me now, that's what she thinks; I might not be cut out for this.
And I don't know what it is about you, but I just get I just get really insecure.
Whatever, um.
.
It was wrong to take credit for your idea.
And I'm sorry.
Can I have a tissue? Did Cassandra Kopelson actually just apologize to me? Um Anyways, uh You should give the results to Dr.
Bandari.
You deserve it.
Schedule the tumor removal; I'll do the bypass right after.
Good work, Dr.
Kopelson.
You are that threatened by me? Grow up.
This has nothing to do with you.
This is the real world, and everything counts.
Only one of us is going to be Gina's research assistant, and you were just collateral damage.
Anyone but Cassandra.
You asked how I felt about you dating her, that's how I feel.
Date anyone in the world, except for Cassandra.
- Wait.
- No, Will.
She is awful.
She always has been.
- People change.
- No.
She hasn't.
Just trust me, it's for your own good.
I don't need you protecting me, okay? I can handle it.
I can't handle it.
I just can't.
This doesn't seem right.
Emily, you can't tell me who to date.
- You asked.
- I was trying to be a good guy.
Then be a good guy.
Anyone except for her.
I'll think about it.
Medical case 4032.
In vitro heart surgery to repair hypoplastic left heart syndrome.
Oh, God, I hope we made the right decision.
I'm at the heart.
Zoom in, quadrant six.
Find me the aortic valve.
Freeze.
Got it.
Okay, once I penetrate the wall, we have maybe two minutes before bradycardia sets in.
Guide wire and balloon.
Set.
Heart rate's dropping.
Might have to do with the needle I just stuck in it.
I'm in position.
Start infla Stop! Wire just bumped the interior wall, curled over.
Retracting.
Reset.
Going again.
Heart rate's still dropping.
I'm back in.
Start inflating.
We're cardiac tamponade.
Pressures compressing it.
We have to pull out.
- No, the valve isn't clear yet.
- We don't have time.
Just a few more seconds.
We don't have a few more seconds.
Done.
Retract.
Retract! Stable.
He's stable.
What happened? You had an extreme reaction to dialysis.
We had to do a kidney transplant.
What? Where did it come from? But I told you I was not sure.
I know.
And I'm not either.
And I don't know your food allergies or your medical history or even your favorite movie.
But I know when I saw you almost die, I didn't want to lose you.
That's so romantic.
Dr.
Owens? Could we have some privacy please? Yes.
Of course.
Sorry.
Dr.
Owens.
Hope you're not ignoring hospital protocol.
Denver Memorial tradition.
Drink with your colleagues after your first cut.
Vodka soda.
Heard you did well in the OR, Dr.
Owens.
I Yes, I did.
Thank you.
And thank you for coming.
I really appreciate it.
Don't overthink it.
Cheers.
Hey.
He tell you all about the tradition? I was just getting to that part.
What part? First cut pays first round.
Oh.
Okay.
Let's dance.
- There's no one dancing.
- Yet.
- I don't dance.
- I've seen you.
- I don't In public.
- Oh.
Okay, do not freak out.
You don't need heat this month.
Okay.
I won't ask her out.
You and I just got back on track, and, uh, that's more important, so Thank you.
Yeah.
And just so you know, high school wasn't the greatest time for me, either.
My house was TP'd once a week.
You win.
I, uh, I blew her off earlier, so When it's important enough, you speak up.
You tell people what you need.
You show them who you are.
You expose yourself.
You ask.
And you do this knowing that there are consequences.
There's collateral damage.
But you've chosen this.
So you can't feel guilty about it.
You just can't.
D.
- Pits? - Don't you recognize me? Do I recognize you? You were my tormentor, my nemesis.
Cassandra Kopelson.
From high school.
Now I remember why we called you "Pits.
" What were you expecting? She's a jerk.
Congratulations, Dr.
Kopelson.
You'll be assisting on the next gallbladder that walks in.
I don't need your pity.
My hands shook, and I choked.
I think she's got a crush on you.
We're going out.
On a date.
I like you.
I just I don't see you that way.
I really hope we can still be friends, because I.
.
value our friendship.
In Mrs.
Everdine's ninth grade biology class, we watched a video called.
"The Greatest Predators of the Animal Kingdom.
" Lions, and tigers, leopards and cheetahs, bears On your right, on your right! However, they left out the most dangerous of creatures: The Cassandra Kopelson.
Back then, she was stalking Alan Zolman, the boy I liked.
And to this day, her hunting method has not changed.
She begins with a technique I call, "The Laugh and Linger.
" Then comes the "Whisper Come Hither.
" Advancing to the "Cold Little Shiver.
" Until she takes down her gazelle.
I saw Alan Zolman fall.
She lured him in, ripped out his heart, and left it rotting behind the school bleachers.
He was never the same.
But I won't let that happen again.
Not to Will.
You all right? Great! I'm not gonna lie, Pits.
You don't look so great.
Ah, come on.
She said it was her first day back.
From the dead? Sorry.
The important thing is not that it's been a while since I've exercised, but that I'm exercising now.
Agreed.
Let's race to the end.
Gut it out, Owens.
I will not let it happen.
God, I hate running.
These stupid blisters.
You went running just to keep them from being alone together? No, I went running because it's good for my health, which, as a doctor, you should Dr.
Owens.
I need you.
We're looking at possible kidney failure.
I need you to get me a medical history.
Does she have any preexisting conditions? I don't know.
Any allergies food? Chemical? - I don't know.
- All right, vial.
Another vial.
- Is she taking any medications? - I just don't know.
Sir, what exactly is your relationship to the patient? I'm her husband.
Look, we only met four months ago.
It was an arranged marriage.
What's happening to Amira? Is she okay? - You have to help her.
- We're gonna try and figure that out.
Drop those off at the Nurses' Station.
We need an ABG, ammonia level, LFT's and - A tox screen, stat.
- Got it.
Are you joining us, Dr.
Owens? Yes, I'm I'm sorry.
I need two volunteers.
Who wants some extra work? I'm in.
Yeah, me, too.
I'm also in.
531, He needs a bypass, but BP and heart rate are elevated and not responding to medication.
Figure out what's going on.
Start with thyroxicity.
You can't keep them apart forever.
No.
Not forever.
Just until he realizes that she's a predator.
Will can take care of himself.
No, he won't see it coming.
She's camouflaged as a regular person.
I know exactly why you volunteered, Pits.
Don't look so surprised.
It's the same reason I did.
Look, we both want to be Gina's research assistant, but for the sake of our patient, we need to work together as a team.
This isn't a competition, okay? Yeah, right.
Agreed.
Do you kw a Dr.
Hamata? Go answer it, I'll get started on the tests.
Um, Dr.
Hamata? I'm Dr.
Owens.
Know how to do an ultrasound? Yeah.
Theoretically.
I haven't done one, but Oh! Micah's girlfriend.
Huh, she's really pretty.
Okay, see right there? Why did you go to pretty? That's so demeaning.
You could have commented on anything, - anything in the world, like - Sorry about that.
Spend half my medical career filling out paperwork.
Her voice.
She has a crisp, clear voice.
Why are you smiling? I'm excited for my first obstetrical patient.
Okay, word of advice? Don't go into OB.
I thought it was going to be all magical, and the miracle of life, and the woman warrior, and blah-blah-blah.
It's just anxious women and husbands on BlackBerrys.
We induce, nothing opens, we just slice and we scoop.
When I get knocked up, I'm having a home birth.
Intake too, okay? Any bleeding or spotting? A little spotting.
Yes, that's why we're here.
Okay, uh how about headaches? No, no headaches, but her feet do hurt mostly in the evenings, just a little swollen.
Sorry.
I'm the biological mother of the twins.
She's our surrogate.
And her sister.
Not medically relevant.
Gotcha.
Okay.
Any trouble urinating? No.
Is everything okay? That's what we're going to find out.
All right, let's just take a look at Fetus A.
You know, she's probably dehydrated.
She never drinks enough water.
- I drink water, Ellen.
- No, not enough.
Ten to 12 glasses a day, Dr.
Hamata said.
What? What's the matter? What's wrong? Umthe thing is, I'm not a specialist, so we should get a second opinion.
The male fetus has structures on the left that are underdeveloped.
The mitral valves and the aortic valves are atretic.
The left ventricle is tiny.
Mm-hmm.
And the aorta.
Damn.
Another reason not to go into OB.
Hypoplastia what? Hypoplastic left heart syndrome.
Uh, Fetus A has a valve Andrew.
His name's Andrew.
Andrew has a valve releasing blood from his heart that's too narrow.
As a result, the left side is shrinking and shutting down.
This is made complicated by a second defect.
There isn't an opening between the walls of his heart.
Without it, pressure builds in the underdeveloped left ventricle and pushes blood back into the lungs.
So what does this mean? If left untreated, the child won't survive long after birth.
I'm sorry.
How how do we treat it? Well, there is an in vitro surgery which could repair the heart, but it's risky.
And if we try it well, there is a chance we could lose both babies on the operating table.
Oh, my God.
This is, this is not happening.
Is there another option? Um you could do nothing.
Opt for compassionate care.
After Andrew is born, he'll receive treatment aimed at relieving his suffering without extending his life.
He won't feel any pain.
In the first weeks of conception, cells multiply at an extraordinary rate, splitting and replicating to determine everything you will ultimately become.
It's amazing, when you think about it.
How much has to be timed perfectly, how much has to go right.
Perfect.
You doing great here.
But it doesn't always go right.
Mistakes occur.
Great, now slowly withdraw.
All right.
One biopsy down, one kidney to go.
How are you doing, Amira? A guy got hit by a train in While You Were Sleeping.
He was in a coma.
This is not as bad as that.
Plus the painkillers you gave me helped.
You a movie buff? Romantic comedies.
I love romantic comedies.
What's your favorite one? That's hard.
Maybe Love Actually.
Or When Harry Met Sally.
I love the way she orders off the menu.
I don't I don't see it.
What don't you see? Why would she have only one kidney? Most likely, an error occurred during conception.
It's actually not that uncommon.
And in and of itself, it isn't a problem.
The problem is that her blood work showed a below normal glomerular filtration rate and an elevated blood urea nitrogen level.
Which means that Her one kidney is in distress, and possibly failing.
Go to her.
So you can fix it, right? We won't know until we get the biopsy results back, but we'd like to start her on dialysis right away.
It's gonna be okay.
I'll call your parents in India and I'll let them know.
Yeah? Test results for Dr.
Bandari's extra credit assignment.
Great.
And do you know where Dr.
Kopelson is? On the roof, having lunch with Dr.
Collins.
Uh test results.
Gina's patient.
Thyroid's normal.
Huh.
What is it then? Well, I'll leave you guys to it.
Got to get back to the floor.
I'm thinking dehydration might be making the blood pressure and heart rate spike.
- But - It's possible.
Hey, what was Will like in med school? Did he have any serious relationships? No, a total commitment phobe.
- Insulinoma? - Nah, he's not hypoglycemic.
Never met a commitment phobe that didn't profess his love for me.
It'd be pretty stupid, though, to start a relationship with another intern, 'cause then if it doesn't work out, which it probably won't, it'd be pretty awkward, right? What about a pheochromocytoma? An adrenaline secreting tumor? Oh, I already asked Gina.
She ruled it out.
Mercury poisoning? No skin involvement, no rashes.
I got to get this.
It's fine.
Let's get together in an hour and brainstorm.
We'll figure it out.
Okay.
You made a decision? What? Uh, no.
Oh.
Um, I'm sorry.
I was paged.
The nurses said that you made a decision.
- We paged you.
- We did make a decision.
We can't risk both babies, so We're not gonna do the surgery.
Okay.
I'll let everyone know, and as soon as we get your tests, we'll get you discharged.
You didn't even want to talk to me before you told her? No offense.
Why would we Maybe because I'm carrying your babies.
Right, exactly.
We are the parents.
Claire, this is a tough enough decision to make without involving a third party.
- I'm your sister.
- I know you're my sister, Claire.
Don't be melodramatic.
I'm sick of you acting like I'm not involved.
For the last time, these are our babies.
Yeah, and this is my room, and I want you out.
I will tell Dr.
Bandari that you've elected not to do the procedure.
Did we get the kidney biopsy back yet? No, but I ordered it stat.
If you really want stat you need to stand outside the laboratory and glare at the technicians.
And bring them Swiss Rolls.
Those guys love Swiss Rolls.
What's with the limp? I took up running.
- Swiss Rolls? - Yeah, works every time.
Tell me you at least have good running shoes? I'm an intern; how am I supposed to afford them? For running shoes? No, Swiss Rolls.
I told you, we need Swiss Rolls.
Oh.
Your biopsy results revealed that you have focal segmental glomerulosclerosis.
It's a disease that causes scar tissue to develop on the kidneys.
Now, unfortunately, there isn't a way to reverse the damage.
You need a transplant.
We've already added you to the donor list, but it would be in your best interest to get your family and friends tested.
People that share a common geographical family heritage have a better chance of matching.
My wife and I were born in the same village as her parents.
You could test us.
And Sushil, of course.
I'm feeling dizzy, light-headed.
Her BP's getting a little low.
You know, it might just be the shock or maybe her body needs a break from dialysis.
What do you say we finish this treatment tomorrow? Okay, you can unhook her.
All right, why don't you follow me? We'll get started on the blood work.
Are you okay? Yes, I am.
Thank you.
Excuse me? Dr.
Owens? Can I ask you a question? Yes, of course.
I was told there is a video library in the hospital.
Would it be possible for me to get a copy of Never Been Kissed or My Best Friend's Wedding? And failing that, The Wedding Singer? Yes, I'll see what I can do.
Okay.
How about You've Got Mail? Yes, great.
Okay, coming down.
You think my patient has an pheochromocytoma? Interesting theory, Dr.
Kopelson.
Schedule an abdominal CT, a plasma fractionated metanephrine test and a nuclear scan of his head, throat and abdomen.
Find it.
Hey, a pheochromocytoma was my idea.
And this is not a competition.
You said that she ruled it out.
Because I mixed up the cases I was working on.
It was an honest mistake.
Like I said, mistakes occur all the time.
And let's be clear that was no mistake.
I'm not going to let her under my skin.
- Good plan.
- Because she's a bully - and always has been.
- If you cared.
Which I don't.
Exactly.
Because I know exactly who she is.
But Will doesn't.
He thinks that she's funny and delightfully blunt.
And ridiculously hot.
He needs to see her evil core.
The way she made Kendall Peterson cry.
Who's Kendall Peterson? This girl at our school who Cassandra tortured.
Her back literally gave out from the stress.
Why not just tell Will? About Kendall Peterson? Not to date Cassandra.
Oh, no, I can't.
'Cause he'll think it's because I like him.
- Which you do.
- Yeah, but that's beside the point.
This has nothing to do with me.
I'm trying to protect him.
Why don't I take that pathology report down to Dr.
Collins for you? Oh, yeah, great.
He's on four.
So what are you What are you doing here? I had a question for Will.
What are you doing here? I have his path report, and you clearly just ran here.
Why are you stalking us? Are you scared I'm gonna date your friend? - No.
- You should be.
I'm going to date your friend.
That's pretty confident.
Not pretty confident.
Pretty and confident.
Everything okay? - Yeah, great.
- Yeah.
Picked up your path report.
Might ask you a favor at some point.
Hey, Cassandra, I treated a patient named Kendall the other day, and it reminded me of Kendall Peterson.
Do you remember her? Yes.
I was just horrible to that girl.
It's one of my biggest regrets.
I felt so bad, I reached out and apologized a few years back.
We're actually close friends now.
You apologized? To Kendall? Where's my apology? I didn't see you at her wedding.
Were you there? Didn't you have a question or something for Will? I did have a question.
Um What are other ways to locating pheochromocytoma - For your extra credit project? - Exactly.
They're usually found in the abdomen, but we scanned the abdomen.
- Did you run a nuclear scan? - Yeah, nothing I feel like I read something about, uh, what's it called? You run a cath through the groin and take continuous samples.
Selective venous sampling.
- I'll get into it.
- I'll come with you.
It's really not a two person job.
Feel free to stay behind.
Great, you can get started on the cath, and I'll tell Gina.
That's not going to happen.
Dr.
Owens, wait.
Is that a patient of yours? Shoot.
Bad luck.
The surrogate contract is clear.
We have the legal right to make whatever choice needs to be made concerning our children.
It's all spelled out right here.
I don't think that your sister is disputing that.
I think she just wants to be included.
We are the parents.
Oh, that's my lawyer.
Just give her the contract.
Calling you right back.
Dr.
Owens.
I was just telling the Gurangs how lucky they are.
Sushil's tissue and blood typing make him an ideal candidate for donation.
Oh, that's great news.
Yes, I know.
Sushil, you do not have to You're my wife.
Of course I will.
Let's get you admitted.
And Dr.
Owens will check Amira out.
Okay.
Okay, let's give you a listen.
What will happen if I don't accept his kidney? Um, kidney rejection is always a risk, But Dr.
Barnes says that Sushil is a great match.
No, I mean, what if I don't want it? Um, you'd you'd be on dialysis at least three times a week until we found another donor.
Dialysis was not so bad.
And that would mean my family in India would have more time to get tested.
But, Amira, your husband is a great match.
I cannot take his.
Why not? Amira, doctor-patient confidentiality means I can't tell anyone what you say to me.
If Sushil's mistreating you No, no, he is a wonderful man.
Kind and smart and considerate.
It is just I am not 100% sure about us.
I want love in my life.
Romantic love.
And my mother told me it will happen with time, but what if it does not come? I don't want to live my whole life without it.
But if I take his kidney, I would be trapped.
That's not necessarily true.
I could never leave a man who did something like that for me.
Never.
Can you tell him there was a mistake? That he is not a match after all? I can't lie about test results.
But how can I tell him? He'll be so hurt.
I guess if it's important enough, you'll just find a way to say it.
Hey.
You got a second? Sure.
Okay.
- Everything okay? - Huh? Yeah, yeah, yeah.
I just, you know, wanted to talk to you about something.
I wasn't sure I was gonna say something.
It's actually kind of weird, and then I thought, well, if I don't say something, that would be weird, you know? So of the two options, weird and weird, I'm going with weird.
Please, just don't let it be about - It's about Cassandra.
- No.
The thing is the two of us have been, I don't know, um, flirting.
but I know that you two have your whole competitive thing.
And after what you told me about how you feel, I just wanted to make sure you'd be okay if I asked her out.
Just tell him the truth.
It's not okay.
Anyone but Cassandra.
Find a way to say it.
Yeah, totally.
Cool.
I mean, I had to ask, right? Because our friendship is really important and I didn't want you to feel uncomfortable.
Uncomfortable? No.
Miserable? Yes.
Patients need to warn you when they're about to projectile vomit all over you.
They also need to not eat Chinese food directly following a procedure.
He asked you.
He could have said no.
How? That would have been so awkward.
We're just getting back to being friends.
Why can't he see Cassandra for who she really is? - Hot? - No, selfish! Look! She's the kind of person who leaves her sneakers on the floor because she doesn't want to stink up her locker, but she doesn't care about stinking up the entire room! I leave my sneakers in my locker.
Now my clothes smell.
But that's what you're supposed to do.
What are you doing? Ending the conversation.
Great.
Now I have to go get them.
Why? She's been a bitch to you since the fifth grade.
You know, you're right.
Screw her, screw her shoes.
Hey.
How are you feeling? A little nervous.
But like you said, if it is important, you will find a way to say it.
Why is she staring at me like that? She doesn't mean now, does she? Sushil, I need to talk to you.
I cannot accept your kidney.
I don't understand.
Why not? You have been so sweet, so good to me.
But I am worried that at the end of the day maybe I'm just not that into you.
I am so sorry, but how can I take your kidney If I'm not sure that we will last? Stop! Just stop! I'm not sure either.
I'm willing to give you my kidney but I'm not sure either.
Dialysis is my choice until we find another donor.
Oh, did you give Claire the contract? Yes, I did.
Now you really have to stay in the waiting room.
No.
No, I'm done waiting.
Look, I have a right to see my children, even in utero.
So tell Claire to let me back into the room or I am going to get An injunction? She's lost her mind, right? I think she's just in a hard situation.
So am I, but I'm not an employee.
I'm her sister.
I know she is my sister.
That's why we have the contract which clearly lays out the agreement so things aren't muddy.
But things are always muddy.
It's not like she's delivering a package.
She's pregnant.
She's flooded with hormones.
I don't care about her hormones.
What matters is they are my children.
I know they're her children.
That's never been disputed.
Right.
And I think she's just trying to assert herself, maybe a little strongly, because of the babies.
This is not about the babies.
Of course it's about the babies.
It's not.
Go on, tell your sister.
Great.
Wait.
You have to make sure she doesn't yell at me.
You have to make sure she understands the legal situation.
See? Right there she's treating me like a surrogate.
- She is our surrogate.
- I am her sister.
What does she want me to do, sing "Kum-Bah-Yah"? No! I want her to see me! I don't even know what that means! It means you're my big sister, and all I want for you to do is to like me.
- I like - No, no, no, you don't.
You never have.
I'm just your annoying little sister.
I've always been your annoying little sister.
And I thought that if I did this for you, if I carried your children, it'd would bring us closer together.
But you can't even look me in the eye any more.
It's too hard.
What is? This.
Seeing you pregnant.
I didn't know that I would feel this way.
It's just, you get to feel them kicking, you get the cravings for watermelon, and you know them.
And I have no connection.
You're their mother.
It doesn't feel like it.
Which is not your fault.
I am so grateful.
And I do like you, Claire.
I love you.
I love you so much.
Wait.
I'm not sure.
Um, I'm not sure about the decision.
I keep trying to convince myself I am, but I'm not.
You know Andrew.
God, what do you think we should do? I have to answer this.
What's going on? She was 30 minutes into dialysis and her BP crashed.
Give me an amp of epi now! Okay, come on, stay with me here.
What do we have? How much did you take off? We only got 500cc's off when she coded.
Give her a liter bolus.
Owens, get up here, get me an airway.
Follow my lead, here we go.
Come on.
What's happening to her? Please? Get him out of here, now.
She went into hypotensive shock.
Right now she's in a coma, We're helping her breathe with the ventilator.
Dialysis puts great strain on the body.
This happens sometimes.
We'd like to keep her sedated until we can be sure that her breath and her blood pressure are stable.
But she will wake up? Hopefully, but her kidney has failed.
Toxins are building up.
She's in critical condition.
You mean, she could die? She needs a transplant right away.
We moved her to the top of the donor list, but No I'm giving her mine.
Wait.
You heard her.
She doesn't want it.
Rhea, Rhea.
Why should he have surgery? I have power of attorney, right? So I can make decisions for her? Good.
Then I'm giving her my kidney.
Okay, we need to get you checked in right away.
You can stand on those feet for the next four hours? Yeah.
Why? You're gonna make your first cut.
You okay? Yeah.
Yeah.
I just I didn't expect it to be today.
I thought I would, I thought I would know in advance.
Have some time to think about it.
That's why I didn't tell you in advance.
Are you implying that I overthink? You're overthinking.
Okay.
I'm nervous every single time I go in there.
I think if you're not nervous, then you're doing something wrong.
You can do this.
Just find your landmarks.
Hands on the field, gentle traction.
Slice quickly, straight line, gentle pressure.
Enough so you don't have to redo it, but not too much or you'll slice through the peritoneum.
Ready, Dr.
Owens? Suction.
Continue.
Sub cue.
Electrocautery gun.
Down to the fascia.
Retraction.
I'm through to the sub cue fat.
All right, keep going.
Peritoneum incised at 14:45.
Looking confident, Dr.
Owens.
Verging on ballsy, even.
I've never been called ballsy in my life.
It's a day of firsts.
Okay, good, now get your landmarks.
Can you page me, and only me, when the selective venous sampling comes back for the patient in 531? I already got it.
Oh.
How do you have them? They're not due for another two hours.
Mmm.
Swiss Roll? No! What do the results say? It's my patient, too.
Let me see.
Would you have shown them to me? No.
So why should I show them to you? Because my hand shook.
I was in surgery, and my hand shook, and when Gina sees me now, that's what she thinks; I might not be cut out for this.
And I don't know what it is about you, but I just get I just get really insecure.
Whatever, um.
.
It was wrong to take credit for your idea.
And I'm sorry.
Can I have a tissue? Did Cassandra Kopelson actually just apologize to me? Um Anyways, uh You should give the results to Dr.
Bandari.
You deserve it.
Schedule the tumor removal; I'll do the bypass right after.
Good work, Dr.
Kopelson.
You are that threatened by me? Grow up.
This has nothing to do with you.
This is the real world, and everything counts.
Only one of us is going to be Gina's research assistant, and you were just collateral damage.
Anyone but Cassandra.
You asked how I felt about you dating her, that's how I feel.
Date anyone in the world, except for Cassandra.
- Wait.
- No, Will.
She is awful.
She always has been.
- People change.
- No.
She hasn't.
Just trust me, it's for your own good.
I don't need you protecting me, okay? I can handle it.
I can't handle it.
I just can't.
This doesn't seem right.
Emily, you can't tell me who to date.
- You asked.
- I was trying to be a good guy.
Then be a good guy.
Anyone except for her.
I'll think about it.
Medical case 4032.
In vitro heart surgery to repair hypoplastic left heart syndrome.
Oh, God, I hope we made the right decision.
I'm at the heart.
Zoom in, quadrant six.
Find me the aortic valve.
Freeze.
Got it.
Okay, once I penetrate the wall, we have maybe two minutes before bradycardia sets in.
Guide wire and balloon.
Set.
Heart rate's dropping.
Might have to do with the needle I just stuck in it.
I'm in position.
Start infla Stop! Wire just bumped the interior wall, curled over.
Retracting.
Reset.
Going again.
Heart rate's still dropping.
I'm back in.
Start inflating.
We're cardiac tamponade.
Pressures compressing it.
We have to pull out.
- No, the valve isn't clear yet.
- We don't have time.
Just a few more seconds.
We don't have a few more seconds.
Done.
Retract.
Retract! Stable.
He's stable.
What happened? You had an extreme reaction to dialysis.
We had to do a kidney transplant.
What? Where did it come from? But I told you I was not sure.
I know.
And I'm not either.
And I don't know your food allergies or your medical history or even your favorite movie.
But I know when I saw you almost die, I didn't want to lose you.
That's so romantic.
Dr.
Owens? Could we have some privacy please? Yes.
Of course.
Sorry.
Dr.
Owens.
Hope you're not ignoring hospital protocol.
Denver Memorial tradition.
Drink with your colleagues after your first cut.
Vodka soda.
Heard you did well in the OR, Dr.
Owens.
I Yes, I did.
Thank you.
And thank you for coming.
I really appreciate it.
Don't overthink it.
Cheers.
Hey.
He tell you all about the tradition? I was just getting to that part.
What part? First cut pays first round.
Oh.
Okay.
Let's dance.
- There's no one dancing.
- Yet.
- I don't dance.
- I've seen you.
- I don't In public.
- Oh.
Okay, do not freak out.
You don't need heat this month.
Okay.
I won't ask her out.
You and I just got back on track, and, uh, that's more important, so Thank you.
Yeah.
And just so you know, high school wasn't the greatest time for me, either.
My house was TP'd once a week.
You win.
I, uh, I blew her off earlier, so When it's important enough, you speak up.
You tell people what you need.
You show them who you are.
You expose yourself.
You ask.
And you do this knowing that there are consequences.
There's collateral damage.
But you've chosen this.
So you can't feel guilty about it.
You just can't.