Monday Mornings (2013) s01e04 Episode Script

1 Benjamin Decada, 19, obsessive-compulsive disorder.
A 34 on the Ybocs scale normal being 6 to 10.
He's no longer able to even feed himself.
His parents have kept him alive by force-feeding him protein shakes.
Which brings us to the punch line, Dr.
Ridgeway.
Why are we here? I'm seeking approval to perform an unconventional radiosurgical treatment an anterior capsulotomy using gamma knife.
Psychosurgery.
Except instead of cutting Mr.
Decada open, I'll be using radiation to sever the connective pathways in his brain that contribute to the obsessive thoughts.
- Bullshit.
- Something to say, Dr.
Villanueva? - She's talking about a high-tech lobotomy.
- It's not a lobotomy.
She's gonna go into the kid's brain, do a little snip-snip to change his personality.
- It's not a snip-snip.
It's radiation.
- That adds up to lobotomy.
- This has been done before.
- It hasn't been done here.
In fact, it was first done over 20 years ago.
Yeah, 20 years, and most hospitals don't do it Most patients have improved.
Some have dropped more than 20 points on the Ybocs.
Benjamin Decada could rejoin society.
In success, he gets his life back.
Dr.
Wilson, have you consulted with Dr.
Ridgeway on this matter? How delightful to see you can play well with others.
Or is it only certain others? Do you concur that gamma knife is indicated here, Dr.
Wilson? Yeah, I do.
This kid is out of options.
- This is perhaps his only shot.
- And how good exactly is his only shot? Buck, comment? One patient in Sweden underwent a similar procedure only then to become a rapist.
No doubt buck is offering that constructively.
That was not a gamma-ray procedure.
And it involved much larger lesions.
We would target a more localized area.
What about cysts, hmm? One of six patients operated on with new model gamma knife in Rhode Island developed cysts.
Doctors from brown pioneer stop doing altogether.
Now recommend thermal capsulotomy.
Okay, in those cases, two lesions were created on either side of the lower anterior capsule.
I'm proposing that we only create one on each side.
- Not work.
- It can work! Look, we see suffering, we try to stop it.
That's what we do.
Yes, that is what we do.
And often with spectacular results.
And we like spectacular, don't we, Dr.
Ridgeway? Makes us feel oh-so spectacular.
Dr.
Ridgeway, how is your marriage? I beg your pardon? I asked, how is your marriage? I don't think my personal life is relevant to this discussion.
Oh, I think you're quite wrong there.
We're not just doctors, after all.
We're people human beings.
Our personal affairs are inextricably bound up with our professional behavior.
And we're not just any people.
We're supernovas.
Hardwired to succeed.
And when we fail, we often try to compensate.
We're so desperate for affirmation, in fact, that we can be quite pathetic.
I mean, just think the chance to perform a gamma-knife psychosurgery.
Oh! Sexy.
How are things at home, Dr.
Ridgeway? Nobody says "goodbye" anymore.
Difficulty breathing horse kick to the chest.
Bay three.
How are you doing, sweetheart? We were just goofing around.
Okay, you and the horse? The horse she was riding well, had been riding.
Any shortness of breath? One, two, three.
I forgot the rule to stay a kick away! It's okay.
It's okay.
Just turn your head to the right.
Yes.
And turn your head to the other side.
Tachycardic.
B.
P.
'S low.
Pulsus paradoxus.
O2 stat 94.
Any medical history I need to know about? I don't know.
I can't reach her mom.
- And who are you? - Her trainer.
Okay, get an echo.
Tell them to come down here and do all that.
We need consent to treat.
Can you sign? No.
I-I don't know if you can treat.
She's they're they're Christian scientists.
Corrections by No1 Okay, the first thing you need to do is calm down.
Do not tell me that.
There's nothing more inflammatory you can say to an agitated person than "calm down.
" Chill then.
How's that? To bring up my marriage in 311 my marriage.
And Villanueva calling it a lobotomy? For God's sake! Well, it's surgery to effect a psychological cure.
That's it's gamma rays, Syd.
We do it every day.
To destroy tumors, not part of the brain.
This boy cannot function.
He will probably die if we do nothing, either by his own hand or starvation.
Do we really think I'm trying to save him because my marriage sucks?! You had to expect push back here.
This hospital doesn't favor psychosurgery, and you Okay.
Try and take a deep breath for me.
Can you? Hurt? A lot! We're going to do something to get that pain under control.
- I'm not in pain.
- But you just said it hurts a lot.
I just need to concentrate.
On what? She's going into respiratory distress.
Can you breathe easier like this? Uh-huh.
I'll set up an ambu bag.
Tracheal deviation.
Call Dr.
Napur.
Right away.
First off, I am very, very grateful.
Beyond you have to know that.
If I have a child, I might name him sung.
That's how grateful I am.
What wrong? Well since the procedure, I've had a-a certain Behavioral side effect, which, frankly, I have a great deal of difficulty even talking about.
What mean? She's having desires.
All the time.
Inappropriate Urges.
Sex? I've never had much of an appetite for And I don't want one.
This is very embarrassing.
Can you fix this? Can I fix her want sex? Yeah.
Dr.
Park, again, we are so grateful to you for I-I mean, h-her tremors are gone.
So much good has come from this.
But the ability to control your base impulses is what separates man from beasts, and I cannot have a wife who is in constant need.
Sex good.
Hmm? Good her, good you, help prostate.
I don't believe you're hearing us.
Sex good help prostate, make pee better, reduce stress.
Go.
Horse hoof to the chest.
The blood is building up in the pericardial sac, collapsing the heart.
Tamponade.
Yeah, she needs to be tapped, but we can't find either parent.
She's a minor, Christian scientist Court order? No time.
How old? And how Christian is her science? She's concentrating on healing now.
Our hands are tied.
Gato.
Her heart is being crushed by her own blood.
Dr.
Villanueva.
Hi.
Fran horowitz risk management.
Good news we've made contact with her parents.
They're on their way.
My personal life? In that room, my personal life?! When you first interviewed here, I expressly warned you, should you take the job, I own you.
And from what I've observed of your behavior lately do you really think I proposed surgery to consciously, of course not.
But to fully rein in our unconscious, that's a much trickier proposition.
What this really comes down to is, you doubt me as a neurosurgeon.
If Ty Wilson stood up and said gamma knife was indicated, you wouldn't doubt him for a second, but me two things about that.
First, I happen to think you're a brilliant neurosurgeon.
Second, you're no Ty Wilson.
Oh.
Now, at the risk of further incurring your wrath, let me say a third thing.
Whatever's going on between you and Dr.
Wilson look at me, Dr.
Ridgeway.
I'm offering this in the form of friendly advice.
Now, your focus may or may not be compromised by your feelings for Ty.
His focus, on the other hand You'll never Nick it.
So don't be fooled.
I want to meet him.
The OCD boy who needs the procedure.
I want to meet him.
Sung, how are you, my friend? Question do you tweet? I should think people would rather fancy following you on Twitter.
I-I quite enjoy the delicious little sung Park-isms that make their way around the building.
Today's are especially delectable.
"Sex good.
Make pee better.
" And gems like those travel fast.
They have, in fact, made their way to the attention of Mitch Tompkins.
You are being sued, old chap.
There is a sac around the heart the pericardium.
The kick must have caused some sort of internal bruise.
The blood needs to be drained so the heart will be able to pump.
That's not possible.
What's not possible? We appreciate your concern and kindness, but we I'm not trying to be kind.
We're trying to save your daughter's life.
In a way that contradicts our beliefs.
Mrs.
rivers, sir, with all due respect, you cannot pray this away.
Would you like to see the bruise? Doctor, I realize that you don't recognize prayer as I pray all the time, but as a treatment, I we respect your position, doctor.
We'd just like you to respect ours, especially I don't.
Not if it jeopardizes an innocent life, I don't.
Gato.
Look, your God brought abra to us, where a needle can cure the problem.
That's all it is.
One needle.
No.
- Look, I believe in God, sir.
- Please.
Remove that tubing.
Pulse ox is dropping.
She is going to die.
Remove the tubing so we can take her home.
You could face manslaughter charges, sir.
And you could face battery charges.
We know our legal rights, doctor, as I'm sure you know yours.
Now, please Remove the tubing.
Okay, but can I at least bandage the abrasions? It'll act as a splint on the chest while you drive home.
But This way.
Gato, what are you doing? Leave.
Gato! You can stay, or you can leave, doctor.
Good news.
Abra! Mommy! She's gonna be fine.
What happened? She just got better a miracle.
Is she really okay? Yeah.
She'll be just fine.
I actually think this one will go away.
The likelihood that a deep-brain stimulation would render her oversexed have you ever known this to happen? No.
And, uh, to your knowledge, - were there any complications with respect to the procedure - No.
You performed this operation before? Once.
And the outcome there? Dead.
The patient died? Died dead.
Okay, he's Marked up a deposition for tomorrow and asked me to waive notice not something that I typically agree to.
But in the interest of making this go away, my gut says let's just do it.
I take it you've been deposed before.
Three times two settle, one dismiss, always right.
Who's always right? Me.
Always? Always.
One time, thought wrong.
Wrong.
Right.
Hey.
Lisa Decada.
Harding hooten, chief of staff.
Hello.
Pleased to meet you.
And where's, um This is Ben.
Hello, young man.
Honey, can you say hello to Dr.
hooten? Uh, not not yet.
It's not right.
If he doesn't take two steps sideways after every third step forward, he's afraid his grandmother might die.
And he's not at school now? He had to drop out in 11th grade.
It was just too much.
I quit my job for one where I could work nights so my husband or I can be with him at all times.
Please.
Ben? May I speak to you for a few moments? Do you understand what we're talking about here today? Ben? H-help me.
We'll schedule him for Thursday.
I was planning to get Ty to assist.
I think he's booked solid Thursday.
No, Ty won't be assisting you on this.
I will.
Now, it's important that you and Ben both know this procedure does kill brain cells.
That's been explained, doctor.
Both Ben and I consent.
Mrs.
Decada, given the suffering already endured by both of you, I need to be satisfied that your thinking has not been compromised by any undue duress.
There are no guarantees.
This is rarely done.
But it has been done successfully, right? Yes.
All told, about 100 times.
Once on a boy very much like your Ben a young lad who developed such a fear of offending God, he couldn't go to the bathroom by himself.
Now, this procedure is rare, but it has worked, and it can here, but again, we're a little loathe to do an operation that will destroy part of a person's brain.
You've seen my son, doctor.
Is there any chance his symptoms could just disappear over time? On their own, no.
What are we waiting for then? We wait because, again, we'd be altering his brain.
Tell me again Exactly how you would do it.
We'd put him under a local anesthetic.
We attach a stereotactic frame to localize the radiation and keep him perfectly still.
He goes into a big machine.
Gamma rays are emitted from hundreds of cobalt beams, which all converge on a specific focal point in the brain, forming a lesion.
And the risks? Cysts, a low risk of stroke, apathy none of which we expect to happen.
In fact, once the symptoms lessen, he'll likely be able to reach his full potential.
If he were your son I would probably want to do whatever I could to mitigate his suffering.
Can we talk about this? No.
Gato, you cannot expect me to turn a blind eye to what I saw.
That's exactly what I expect.
Otherwise, the hospital gets sued, I get my ticket punched, and things get very messy.
So let's go out, have a drink, and let today's narrative be "little girl lives.
" It's not that simple.
Yes, it is.
Your father's working.
Some tea? Thank you.
What's this? Need study.
Get sued.
Sued? For what? Dbs.
Woman now want sex.
Blame me.
Need study deposition.
Hey.
Hi.
What are you doing? Looking at this gamma-knife thing.
So you're doing it? They approved it.
The 311 went okay? It was approved.
But I wouldn't say that the 311 went okay.
We can't go back, we can't go back So, what happened? Harding hooten asked How's my marriage? Why would he ask you about your marriage at a 311 meeting? Because nothing's off limits in there.
Tonight And because I suspect he's heard rumors.
I want a bookMark You're having an affair.
Tonight With who? I want a bookMark I'm so sorry.
Well I want a bookMark As long as you're sorry.
Do you love him? Ooh I might.
Mark, it's not gonna go anywhere, nor do I want it to.
It was just just what, Tina? Just one of those things? Ah, ah-ah-ah Ah, ah, ah Tonight Tonight So, now what? Now it's My marriage has been pretty much over for a long time, Syd.
And I know you know that, as kind as you've been not to point it out.
What can I do? How can I help? You'll stay with me for a while.
You can't go back to that house.
He's moving out.
He packed up last night.
Even so.
Can't go back there, not for You have a dog, a cat, any real reason you got to be there? No.
We couldn't even commit to a dog.
Well, first, let me say how utterly delighted I am to be here.
I typically find my visits to Chelsea general to be enormously fruitful.
Before we go on the record, let me say if at anytime you do not understand my question, Dr.
Park, please feel absolutely free to say so, and I will restate it.
Though in theory this is supposed to be an adversarial process, I would never endeavor to forsake good manners.
Which is why I like to think, more times than not, my depositions tend to be a benign experience.
Though Admittedly, not always.
Shall we begin? I-is she okay? She will be.
But, uh, we need to be there for her a little bit more.
Pick up some slack if she needs us to.
Dr.
Napur.
Tell me about the young equestrian you were treating, the one of the Christian science faith.
She was stable at discharge.
She'll be fine.
Excellent.
And how exactly did she become "fine", if I might ask? Good medical treatment? We didn't really have to do anything, actually.
She just spontaneously healed? Hmm, don't you love it when that happens? Did you hear, Dr.
Robidaux? Her heart sac was filling with blood.
And then suddenly, it drained itself.
Got to love that God guy.
Sorry.
Uh-oh.
We've got trouble.
Ty.
Mark.
You seen Tina? Um, in her office, I think.
Look, Mark marriage is over anyway Right? Isn't that what people in your position like to say to yourselves? "Marriage was over anyway.
No harm, no foul.
" Mark? Consider yourself served.
Dr.
Wilson.
If I might speak to Dr.
Ridgeway for a moment? First, are you all right? Yeah.
I will be.
Could you look at me? I'll be fine, Harding.
I wouldn't touch a patient if I wasn't convinced of that.
Tina, I wouldn't let you treat Benjamin Decada if he were the last patient on earth.
But he's not.
There will be another patient after Benjamin, and another one after that, and another one after that.
There are many lives in play here.
I need you back in the saddle.
So you'll scrub up and you'll buck up, as the expression goes.
Thank you.
I won't let you down.
I won't let Ben down.
Oh, it's not for you.
What's up? So, everybody knows.
Well, pretty much.
How'd you even know to find me here? You come here a lot.
My guess is, you sit here, take all of this in, and ask yourself, "am I a doctor, a wife, or a mother," all the bullshit that biology does to the female's brain once she hits a certain age.
You're a doctor.
A very good one.
Maybe a decent mother one day.
But you weren't meant to be with Mark.
That's all.
How can you know that? Because he's not a doctor.
You need to be with a surgeon.
At the end of the day, we all need someone we can talk to.
And I suspect you didn't have that with Mark.
I'm not crystal-balling you.
Nah.
I've been there.
I'm divorced, remember? Yeah.
Look, I'm not here to hold your hand.
I need another surgeon to work the E.
R.
late night.
You're it.
Excuse me? Yeah, you heard me.
Besides, it sucks going home to an empty house, anyway.
Believe me.
I know.
And when exactly do you expect me to sleep? I think you'll figure that out.
Find the right coordinate, picked brain, ptremor stop.
Ptemor stop.
The operation was a success, then, was it? Yes.
Complete success.
Complete success.
So the idea that my client was left with an overactive libido, that would be of little, if any consequence? Not foreseeable what happen.
Not foreseeable what happened? No.
Doctor, did you ever come across the tale of Phineas gage in all your studies? Of course.
What is that tale, if you wouldn't mind regaling us? Construction foreman for rail road.
Piece of iron shot in his brain.
Accident.
Go through frontal lobe.
Did he survive? Yes.
No complications? Became grumpy.
Affect personality.
Reasoning skills diminish.
His brain was changed? - Yes.
- And why did that happen, doctor? Not know.
Brain very mysterious.
Physiology still not understood completely.
Even in 2013, the human brain remains largely unknown to us? - Yes.
- So, it might be foreseeable, then, that sticking a probe into a brain might affect that brain in mysterious ways.
By the way, did you mention all this to my client, doctor? Did you tell her that the physiology of the brain is so mysterious that anything could happen once you start sticking probes into heads? Did you point out that unforeseeable events might occur? As it turned out, the pleasure center of my client's brain was affected by this deep-brain stimulation, was it not? Seems so.
You inserted a probe into Beth Hostetler's brain, stimulated her brain tissue, and in so doing, awakened an insatiable carnal desire.
Would that be a fair description of what transpired? Fair description would be she had disabling tremor.
Ruin her life.
I make stop.
I see.
Going into this procedure, doctor, did you have any sense that Beth Hostetler was a religious woman, someone whose very being could be undermined by this newfound promiscuity? You should be ashamed.
I'll ask you not to address my client, sir.
She's my patient.
I address.
You come, beg me to help.
You have tremor, you want stop.
That's what you tell me.
I give you life back, and now you come with lawyer, look for money.
Doctor shame.
Maybe procedure affect honor.
Maybe dbs change integrity.
Maybe if you hadn't have been so dismissive, so rude not sue me rude, not sue me dismissive.
Sue me medical malpractice.
Where is your honor? Two weeks ago, you could not hold pen, could not write.
First thing you do after procedure, you sign name on complaint, sue me for malpractice.
No honor, you.
No honor, you.
No honor, you.
Especially you.
Shame.
Everybody! Okay.
Benjamin, today's the day.
Are you ready, my friend? Yes.
Well, first we're gonna attach this frame to your head.
It's called a stereotactic frame.
It's a stabilizer.
It'll keep your head in place.
Will it hurt? You won't feel it.
We'll give you a shot, like novocaine at the dentist.
It's been cleaned, right? Everything's been cleaned? I promise.
Now, once it's attached, they'll take you to another room, and I'll meet you there.
Where are you going now? Well, I've been summoned to a big-kahuna meeting.
Actually, I did the summoning.
I'm the big kahuna.
Dr.
Ridgeway will be here with you.
The frame you can do it, right? Absolutely, Ben.
Of course.
Do we know who this is for? I have a pretty good idea.
Tell me.
No, I don't want to ruin the surprise for you, buck.
All right.
Thank you all.
This will be a short one, as I have procedure scheduled.
So let's get right to the guest of honor.
The big cat himself.
Would you join us, please, Dr.
Villanueva? Okay.
Abra rivers.
Abra rivers, 15-year-old female kicked in the chest by a horse.
I performed a pericardiocentesis, removed 30cc of blood, patient stabilized.
- And I expect a full recovery.
- Splendid.
Is that the whole story, or is there more, doctor? Uh, both the patient and her parents refused treatment on religious grounds.
And you chose to unilaterally override their religious concerns? Indeed.
Ah, doctor, do you have a particular repugnance to Christian science, or would you have discriminated against any other religion? I'm an equal-opportunity bigot, if that's where you're headed.
If a patient comes into my E.
R.
dying and I have a means to prevent it, I'm going to do it.
Period.
Because in your E.
R.
, you're the almighty? You got that right.
Hmm.
I so love it when I get it right.
But you also enjoy getting it right, don't you, doctor? For the problem I have here, gato, is that it's not your E.
R.
It's Chelsea general's.
And when you violate hospital policy, not to mention the law, you jeopardize the integrity of this institution and all the don't turn away from me.
You may not dignify Christian science, but you will damn well respect me.
I've earned it.
Plus it comes with my title.
Harding.
It's "do no harm.
" A 15-year-old girl is alive.
I'm sorry if your integrity got dinged.
Such a deliciously defiant big cat, aren't we? Comments? Anyone? I have a comment.
Now, I may have done the same thing as you, doctor.
After all, when a person walks into a hospital, there is an implied consent to treatment at some level.
And the idea of letting a little girl die No.
No, the more I think of it, the more convinced I am I would have done exactthe same as you.
Except for one difference.
I might have given the matter some pause.
I might have taken a beat to acknowledge the patient's autonomy, her personal sovereignty.
We doctors, we see the organs, the diseases, all the parts.
And in doing so, sometimes we skip over the whole.
Perhaps I, too, might have overridden the religious rights of this family, just like you did.
But I would have at least recognized them first.
Dr.
Park.
I am ashamed.
You gave me back my life.
I'm dismissing the lawsuit.
And I'm so sorry.
I don't know what came over me.
Or why.
Perhaps the procedure caused an error in my judgment.
Maybe I'll sue you for that later.
I'm kidding.
Anyway Before I signed a complaint, I drew a picture.
I was a little bit of an artist before I got the tremors.
And when I got my hands back, I decided Anyway Forget about the lawsuit.
It was a big mistake.
I just I want to leave you today with a profound apology, my sincerest gratitude, and this picture.
I hope you don't mind I gave you a little bit of a smile.
The anterior internal capsule is very well-defined here.
We can put four-millimeter isocenters here and there, one shot each side of the lower capsule.
Standard dose? Yeah, I think 140 gray should do very well for the next several months.
Careful around the blood vessels.
They could have contributed to the cysts in the other patients.
Right.
I'll meet you at radiation therapy.
I'm gonna recheck the frame before we start.
Okay.
What's happening? Oh, we just finished programming the radiation doses.
We're about to begin.
Wow.
Talk about high-tech.
Yeah.
Listen.
Not now, okay? We can talk later, but right now Got it.
Good luck.
Thank you.
Well, well, well.
You look better, I see.
It's the man who speaks softly and carries a big needle.
I don't know what you're talking about.
I know what you did.
I may have been half-unconscious, but well, if you came here to chew me out, you're late.
It's already been done.
You saved my life.
That was the idea.
But you also took something from me.
What? My faith.
I'm breathing.
And my heart it's beating.
But the way that God might just let me die Whoa, what the hell are you talking about? I mean, catholic hell, not Christian science hell.
Sweetheart, you lived.
And from where I sit, God and I tag-teamed you on this one.
You think I should lose my faith? No.
If it works for you, keep it.
I'd lose the horse, though.
Take care of yourself.
You, too.
He's set.
Okay.
Here we go.
Fingers crossed.
Indeed.
Hello? Dad, hey.
Hi.
So funny.
I was thinking of you today, too.
Just missing you, I guess.
How are you? How's mom? Me? I'm great.
Yeah, I I had this totally radical procedure today.
Radiological psychosurgery.
Radiation.
Uh, it's called gamma knife.
I'll send you a YouTube link.
You can see what it is.
Yeah, it's gonna have to sink in, dad.
Your little girl's a brain surgeon now.
Mark's good.
Uh, you know what? I just walked in the door.
Can I call you back in like 10? Yeah.
Okay.
I love you.
Why I was the one worth leaving Why I was the one worth leaving Why I was the one worth leaving Why I was the one worth leaving No, you don't.
I've got bald dibs on this place.
Whatever he's having.
So, uh, how did the lobotomy work out? Very well.
So well, in fact, we're thinking of trying one on you.
Oh, you doing stand-up now, huh? Just because you look funny don't make you funny.
"Someone comes into my E.
R.
dying", I fix it.
Uh" "You damn well better respect me.
It comes with the title.
" That's not bad.
So, it really did go OK? The boy is gonna be alright? I think he has every chance, yes.
- Here's to that.
- Indeed.
- Such a defiant, big cat.
- Yes alright, alright.
Corrections by No1