Watson (2024) s01e09 Episode Script
Take a Family History
1
- Previously on Watson
- I want this patient admitted
to my spinal project.
How would you do this?
Gigi Grigoryan.
- Who is she?
- GIGI: Ingrid.
Come on. It's Mom's birthday.
[SIGHS] Mom's been gone 20 years, Gigi.
I'm sure she won't mind
if we eat a little late.
Devin Chaplin.
Executive director of human resources.
How long have you guys been
eating lunch together? Is it often?
- Sometimes.
- Uh, not usually.
You have an extremely
dangerous person working here.
- Excuse me?
- Ingrid Derian is an incredible talent,
but if she stays at UHOP,
sooner or later, there's
going to be fallout.
The people around her
will take the damage,
including maybe you, Dr. Morstan.
ANNOUNCER 1: We're here
with you on New Year's Eve.
ANNOUNCER 2: That's right.
The whole team will be here
9:01, and nobody's been
knocked out in a fight?
Ah, give it half an hour.
New Year's never disappoints.
Aw.
[LAUGHS]
We have a trauma activation in Resus 2.
The patient is a 14-year-old female
with a spinal cord injury.
EMT: Let's move, people.
She fell ten feet onto concrete,
she landed directly on her back.
She complained she
couldn't feel her legs
before we intubated.
Let radiology know we're coming.
- We need an emergent CT.
- IVO: Gigi.
- Gigi, it's okay, baby.
- You're her father?
Gigi. Yes. Yes.
- Lift.
- What happened tonight?
She must have been
leaning against a railing.
I-I keep telling the landlord
that he needs to replace it.
AMATO: How high up?
IVO: Two floors.
- Is Gigi gonna be all right?
- We need to do our work.
We'll get you information
as soon as we have it.
We're taking your daughter to radiology.
You can follow me.
Excuse me, is my sister here?
Is she here? Is Gigi here?
Yeah, they just brought
her in. She had a fall.
I-I came home, and
the entire building was
down in the courtyard.
They said that she fell
from the second floor.
She can't feel her legs?
Is my sister gonna be paralyzed?
I should get you a
doctor. What's your name?
Didi.
Sorry. That's my nickname, um
Ingrid. My real name is Ingrid Derian.
The "Spinal Signal" connects an
implant in the patient's brain
to others in his spinal cord.
It converts the patient's
thoughts into a signal
and transports them right
over the injured tissue.
Like a digital bridge. Before that day,
that man hadn't taken
a step in nine years.
This is nothing short of a miracle.
Which, following basic logic,
means that you would be
If you call me a "miracle worker,"
I will stab you in the jugular
with that stupid letter opener.
That's still accurate.
- Not quite.
- [PHONE CHIMING]
We haven't performed the
first surgery at UHOP yet.
How about I call you a
miracle worker when they do?
- [PHONE CHIMING]
- If I can have the five days off
I will need for the fundraising tour,
I permit you one use of
the term "miracle worker."
I accept your terms, Dr. Derian.
Hey. Everything okay?
[SOBBING] My whole body's sore!
What do you mean, everything hurts?
My muscles ache. My arms hurt.
Okay, well you had ECT today.
Some discomfort is normal.
This isn't that!
My arms feels weird. Please come home.
Okay. I'll be right there.
Stay on the line with me.
Everything all right, Ingrid?
[SMOKE DETECTOR RINGING]
Gigi? What are you doing?
Turn-turn off the stove!
It's my arms. The pain
Tell me what's happening.
Everything's in pain.
- The muscles in my arms
- [RINGING STOPS]
are on fire.
I'm gonna examine you, okay?
You're gonna flex and extend your arms.
[PAINED GROANING]
- That's as far as it goes? Okay.
- [PANTING]
Okay, we're gonna get you
to Fort Duke or West Penn.
No! UHOP's the best, that's
why you wanted to work there.
There are too many questions
if we go there, Gigi.
Those are both excellent
emergency departments.
These are my arms, Ingrid!
- And I'm not becoming a quad.
- Of course not.
No one says that's gonna happen.
Then take me to UHOP.
I won't tell them we're related.
- Okay?
- Okay.
[GIGI PANTING]
[SIRENS WAILING]
Hello. Hi.
My name is Dr. Ingrid Derian,
I'm a neurologist at the Holmes Clinic.
I'm concerned about this patient.
She's a participant in
our Spinal Signal Project.
She needs to be seen right away.
ANDREWS: Can you breathe?
Is your airway obstructed?
She's in pain. She needs
to see an attending.
[BREATH QUIVERING]
Hey. Listen to me.
Your name is Gigi Grigoryan.
- I know, I changed it.
- Okay, no slip-ups though, okay?
You can't tell them
about any of the changes
we made to your meds.
You cannot tell them about
the electroconvulsive
therapy treatments.
- But what if it's related?
- It's not. I promise.
There is something else.
We'll figure out what it is.
Good evening, my name's Dr. Mira Leela.
I'm the attending in
charge. What seems to be
Dr. Leela, the patient
is a 30-year-old female
with a history of spinal cord injury.
She's experiencing worsening
myalgias and rigidity.
- What's your name, dear?
- Gigi Grigoryan.
LEELA: Miss Grigoryan.
We'll take you to a proper
examining room immediately
and we're gonna figure out exactly
what's making you uncomfortable, okay?
I'm coming with you.
LEELA: You're not a relative, are you?
Then, I appreciate your
concern for your patient,
but we need to work.
We'll keep you updated
- every step of the way.
- Can we just have a moment?
Hey.
You're gonna be okay, Gigi.
No mistakes.
Not a single one.
I lied to get you into this program.
If they find out we're sisters,
I'm gonna lose my job here
and you're gonna get
kicked out of the program.
Do you understand?
We did this so you could walk again.
All of it, everything, will be gone.
♪
I don't want to pick one.
This is science. You're
putting up a dating profile.
You're coercing me into
putting up a dating profile.
It's Valentine's Day.
The entire world is coping
with the disappointment of
unreasonable expectations.
It is proven that today is the best day
to put up a virgin profile.
I don't like the term "virgin profile."
You need a picture with a
dog if you want to get likes.
You have three options.
Adam's golden retriever
STEPHENS: Which he named after himself.
- His name is John Quincy.
- STEPHENS: Okay.
So you came as close to naming
it "Adam" as you possibly could.
Micah's Doberman presents
a more active image,
while my little foster gal
shows that you have a kind heart.
Oh, yeah. Go with the
little three-legged lady.
She suits ya.
Excuse me. Her name is Tripod.
So your fling is lending you his dog,
and I see he sent you
Valentine's Day flowers.
Is rebound boy catching feelings?
I am not, in fact, sure of that,
but I am positive that is not the issue.
Stephens, we have stained
glass windows at our disposal.
Quaint Pittsburgh brick.
An eligible bachelor capable
of diagnosing any infectious disease.
So pick a dog, any dog,
muster a smile and enjoy
your feast of interested women.
- [SCOFFS]
- Oh.
Can we also maybe just try
these?
I like my glasses.
I think they might help.
- I can't see.
- INGRID: Does not matter.
Wear those.
Damn it.
Gigi's fever's rising.
BP's on a steady climb upwards.
Your Spinal Signal patient?
- Anything we can do?
- I got it!
They just need to do
their job in the ER.
Okay, so, do I just pose
- with one of these dogs, or ?
- SASHA: Mm-hmm.
MARY: Sorry. Is Watson around, or ?
STEPHENS: Dr. Morstan.
We were just, um
MARY: Taking pictures
for a dating profile.
- I heard.
- WATSON: Mary.
To what do we owe the pleasure?
Don't tell me there's a VIP patient
with a flesh-eating disease
you'd like us to take in?
Mm, could be something like that.
Maybe just walk with me?
[QUIETLY]: Okay, yeah.
[PHONE CAMERA CLICKS]
Devin asked me to make
us a reservation at Emund.
On Valentine's Day?
Every restaurant has a fixed menu
and the service is awful.
Oh, nevertheless. She had it in her head
that couples should do
something on the most
"romantic night of the year."
The most romantic night of the year is
whenever something romantic happens.
If you try to schedule it,
it makes it the least romantic night.
Yes, your position is clear.
And yet, here I am
with a reservation, a
bottle of wine, and no date.
Oh, would it surprise
you to learn that even
executive vice presidents
of human resources can
sometimes be less than faithful?
No. No, I
No, no, I'm just
surprised that I'm your backup.
I left home to help Sherlock.
You lost our baby girl while I was gone.
I just didn't think that I
would be on the top of your list.
It's out there now, John.
We both know about it.
I feel like we can finally
have a conversation again.
[ELEVATOR DINGS]
I prepaid for the meal,
and I can use a friend.
But if you're too busy, I'll
just drink my Sangiovese alone.
♪
Can you tell me what
room Gigi Grigoryan is in?
They have her in four.
But I think they're
drawing blood right
[SINGSONGY]: You're welcome.
MOYNIHAN: Ivo Derian?
I'm Dr. Moynihan, I'm the attending
- spine surgeon here.
- IVO: Hi.
You're Gigi's sister?
- Didi.
- Gigi's suffering
from an unstable
thoracic spine fracture.
She's suffered a T9 spinal cord injury.
Now, ordinarily,
we would bring her into the OR
and we would decompress the spinal cord
and stabilize the fracture.
But you're not going to do that?
Well, Gigi also has a grade
III splenic laceration.
So, if we put her on her abdomen
to be able to do the spinal surgery,
there is the possibility that her
spleen could rupture mid-procedure.
Right now, we have to
observe her in the ICU
and wait and see if
the spleen heals itself.
You mean just wait?
You just said she had an
unstable spinal fracture.
What's gonna happen if you don't fix it?
This is her spine!
Is my sister gonna wind up paralyzed?
Based on the location of the injury,
your sister's arm function
shouldn't be at risk.
Oh, yeah, so she'll
just be in a wheelchair.
Damn, Ronnie.
- Who's Ronnie?
- IVO: He owns the building.
I'm gonna sue him.
I'm gonna sue him for that
railing, I promise you.
Didi.
[CROWD SINGING "AULD LANG SYNE"]
Didi.
Is there anything I should know
about what happened tonight?
INGRID: I wasn't there.
You believe he's telling the truth?
Is there anything I can do for you?
You can help Gigi.
You can keep my sister
out of a wheelchair.
CROWD: Should auld acquaintance ♪
- Be forgot ♪
- Stop singing!
- My sister has a broken back!
- Didi.
No. My sister has a broken back.
And no one's gonna help her walk again,
and you're singing?
I'm so sorry, Miss Didi.
There's a chapel if you want quiet.
Come on.
- Let's go.
- No. No.
Okay.
[MUSIC PLAYING IN DISTANCE]
What?
Sorry about your sister.
Thanks.
You know, I used to think
a doctor is just a doctor.
If someone worked that hard in school,
if they took an oath
to protect other people,
you should be in good hands, right?
It's not true.
You know, there are doctors
who can't stop drinking.
There are even doctors
who, when given the chance
to keep a 14-year-old
out of a wheelchair,
think only about protecting
themselves from liability.
Yeah.
- Looks like Gigi got one of them.
- Yeah, she did.
You know, Dr. Moynihan's
a big deal, but
[INDISTINCT CHATTER]
that doesn't mean he's
the best surgeon here.
You know, there are people here on staff
that might not have his title, but
they're better.
I don't know who any
of these people are.
I do.
Start there.
You won't do better.
GIGI: This isn't getting better, Ingrid.
They don't know what's wrong with me.
My heart rate won't go down.
My blood pressure's still climbing,
and I can tell from
the look on your face
that that's not all
that's wrong with me.
What are you looking at?
Your CK value is 6,000.
That's off the charts.
You're experiencing rhabdomyolysis.
Your muscles are breaking down.
[BREATHING SHAKILY]
Ingrid, come here.
What you're doing for me is incredible,
but they don't know what's
going on with me around here,
and neither do you.
You work with four of the
smartest doctors in this hospital,
and you are hiding me from them
while I keep getting sicker.
All right. Okay.
So, they say it's gonna be
about another 45 minutes,
30 if we're lucky.
I was nice.
Our reservation was 15 minutes ago.
- And I was still nice.
- [CHUCKLES]
So what you want to do?
Not wait an hour.
I say we get takeout.
Take this to the spot.
Okay.
Okay, yeah. [LAUGHS] All right.
[WINE POURING]
[SIGHS]
Happy Valentine's Day.
Happy Valentine's Day.
You ever think about her?
Ginny and what she might've been?
Mm.
I've pictured her 100 different ways.
It starts to fade, though.
I was mad at the world for months.
I was mad at you.
But it's not a tragedy, John.
It's a sadness.
I mean, we're not the first
couple who couldn't have a baby.
Let it go, little by little.
That's never been your strong suit.
[PHONE BUZZING]
- Ah, sorry.
- It's okay.
You have to check.
- [SIGHS]
- [PHONE BEEPS]
- Good evening, Dr. Derian.
- INGRID [OVER PHONE]: Dr. Watson, I'm sorry.
- Are you busy?
- No, I was just
Don't worry about it. What do you need?
There is a patient, 30-year-old
female, she's a participant
- in our Spinal Signal Project.
- Uh-huh.
Her fever's elevated and I
- [INGRID CONTINUES INDISTINCTLY]
- I understand, yeah. No.
No, I'll be right there.
It's [SIGHS] one of
her Spinal Signal patients.
Sounds bad. I'm sorry.
- I I got to
- No, don't apologize.
Just don't leave me hanging.
I'm the medical director of UHOP.
I'd like to see the
Holmes Clinic in action.
Unless you think I have
nothing to contribute?
SASHA: Come on, Tripod. Let's go.
You guys sleep in your college shirts?
I am wearing my college shirt.
Adam is wearing his safety school shirt.
Well, I had to put something back on.
Would you stop flaunting your fling?
Forget the fling. Did you
really have to bring your dog?
Her name's Tripod, and she's not my dog.
I have to take her back
to the shelter soon.
Good evening, everyone.
Dr. Morstan.
Hi.
The medical director's gonna lend us
the benefits of her insights.
I am confident she'll
be able to keep up.
So, Dr. Derian.
Gigi Grigoryan.
[SIGHS] What do we need to know?
Excuse me. Excuse me.
Um, are you Dr. Mary Morstan?
Yeah, are you all right?
I heard that you're the best
spine surgeon in this hospital.
I do orthopedics, and I've only been
an attending here for less than a year.
I need your help, Dr.
Morstan. My name's Didi.
My sister
I need you to save her.
I need you to keep Gigi
out of a wheelchair.
Dr. Moynihan has certain sharp corners,
but it's no accident
he runs this department.
Right now, Gigi's splenic
laceration is contained.
It won't keep bleeding
because it's walled itself off.
If we put pressure on
your sister's abdomen
to do the intervertebral fusion surgery,
there's a very high risk of a
splenic rupture mid-operation.
[STAMMERS] Why does she
need a spleen exactly?
What?
Well, people live all
the time without spleens.
My aunt got hers removed
when she was a kid.
It won't rupture if it's not there.
You said your name's Didi?
Splenectomy, that's smart.
I mean, I'd have to
convince general surgery
to do the splenectomy,
and it'd be risky to
operate on Gigi's spine
right after an abdominal surgery.
And if my sister spends the
rest of her life in a wheelchair,
isn't that risky, too?
Or is it only a risk if someone
in the hospital can be blamed?
Let me show you something.
Look at this.
That's where he pinches me.
My dad,
when he wants it to really hurt,
but doesn't want anyone to see.
I can take it on, but
he's starting on Gigi.
I've been watching it happen.
Do me a favor,
look at the same spot
on my sister's arm.
And think about what happened tonight
and how she went through that railing.
My sister doesn't
deserve to be a paraplegic
because it's too risky to help her.
INGRID: Gigi Grigoryan is
a 30-year-old female patient
with a history of spinal
cord injury and paraplegia.
She's enrolled in our
Spinal Signal Project,
and two hours ago she presented
to the UHOP ER with fever,
myalgias, rigidity, and now,
there's evidence of rhabdomyolysis.
You worked closely with her for months.
Is there anything else we need to know?
She's been a model candidate.
Adhered to every protocol we've asked.
The rapid onset suggests
maybe, um, sepsis or influenza.
We could send a CBC, blood cultures,
and a viral panel.
The initial CBC in the ER
didn't show any leukocytosis.
She hasn't had any sick
contacts or recent travel.
What about prescription
meds or substance abuse?
Could be serotonin syndrome.
No prior psych history in her charts.
No other prescription medications,
no substance use, and
all of the bloodwork
we've done for the trial supports that.
Okay, so she has fever, rigidity,
autonomic instability.
What about malignant catatonia?
No, it's not that.
What possible reason do you
have to exclude that diagnosis?
We can't work with you,
Dr. Derian, if you keep
shooting everything down.
I'm just trying to stay on point.
The patient's temperature
is already at 102,
and her fever's not coming down.
Ingrid is right. We are
working on two fronts here.
We have to figure out
what's wrong with Gigi
and manage her symptoms
so she doesn't deteriorate further.
Sasha and the Crofts,
give her an antipyretic
and cool her with ice packs.
Ingrid, follow the patient's CK levels
and start an aggressive
fluid resuscitation.
Send electrolytes and a tox screen.
Dr. Morstan, if you're up for
a, uh, potential all-nighter,
I'd like you to dig through her charts
for other types of underlying causes.
Of course. And you? What are you doing?
I have my own theory to follow up on.
ADAM: A mystery errand.
That's one of Watson's favorite moves.
♪
[SIGHS]
You can't report this, you know.
I have a duty here.
No, y-you have a patient
who needs surgery right now.
If you take my dad into custody,
who's gonna make that call?
How old are you, Didi?
Seventeen.
I can't authorize the surgery.
Child Protective Services can do it.
Have you worked with them much?
Just get my dad to
sign the authorization.
Keep my sister out of a wheelchair.
When this is over,
Gigi can tell you exactly what happened.
Y-You can call whoever you want.
[MONITOR BEEPING STEADILY]
♪
STEPHENS: This feels wrong.
What? Checking the apps
while we're treating Gigi?
No.
Well, I mean, yes, but that's
a waiting game at the moment.
I mean this.
You look cute. You're
not getting any matches?
I'm actually kind of
getting a lot. [CHUCKLES]
It's just, this stuff I wrote.
"Infectious disease specialist seeks
incurable chemistry"? That's just
bragging that I'm a doctor.
That's how the game is played.
I wouldn't know what to say
to these people if we did meet.
"Don't ask me to look at your moles"?
I'm just making it more me.
How's her fever?
Gigi's latest labs just came in.
Her potassium levels
are elevated 6.8.
We'll put her on IV
calcium, glucose and insulin.
And if that doesn't bring it down?
Intensive care, dialysis.
And then, who knows?
IVO: Uh
[INHALES SHARPLY] I-I
I don't understand, I thought
this surgery was too risky.
MARY: Well, there's always
a chance of complications.
But if we don't fix Gigi's fracture now,
she's almost certainly going
to lose the use of her legs.
Okay.
- Dad.
- Just
Can I talk to that other doctor?
- What was his name?
- Dr. Moynihan's
- Yes.
- gone home for the night.
I could have him paged.
I think I'd like that, thank you.
Of course.
By the way, has anyone put you
in touch with the police yet?
- What?
- That railing,
it was poorly maintained, right?
I'm happy to call them down here.
There could be criminal liability.
Oh, no, no, no. Thank
Thank you. I'll-I'll do that.
Okay, um
So, you we think that
this could save Gigi's legs?
I wouldn't be here if I didn't.
Okay, thank you, Doctor.
God bless you.
Dr. Morstan, thank you.
This can go a lot of ways, Didi.
I understand, I know. I
But she has a chance now because of you.
♪
You wanted to see me?
When I suggested a diagnosis
of malignant catatonia
for Gigi Grigoryan,
you shot me down but you
wouldn't give me a reason.
Her fever is spiking.
Yes, that's how you changed the subject,
but would you like to tell me
how you're connected to this patient,
and why you're so sure
that she doesn't have
malignant catatonia?
She is my patient in the
Spinal Signal Program.
She's obviously a lot more than that.
Nor is it difficult to rule out
the closest connection of all.
A piece of your DNA, and a piece of hers
and I can move on to the next theory.
You lied to everybody in
the clinic tonight, Ingrid.
We're treating your sister.
♪
What are they talking about in there?
They better wrap it up fast.
The patient's potassium
levels are headed back up.
I'm going in.
No. Sorry.
Um, yeah, you go in, if you like,
obviously, but
Dr. Watson does have a
way of getting answers.
[SIGHS]
When did your sister change her name?
When I heard about the
first Spinal Signal Project
in Europe, I was already
specializing in neurology.
She'd never get into the studies
because of the conflict of interest.
So you created a whole
new identity for her.
You built it up all throughout the years
and you pushed her application through.
Why?
Why would you risk
everything that you built?
I owe it to Gigi.
Gigi.
That's her real name?
Ginnifer.
She's always hated it.
You say you "owe it" to her.
Is Gigi in a wheelchair because of you?
Yes.
What did you do?
I failed her.
I don't understand.
Since it's all coming out anyway,
why don't you ask her?
Mary?
Tell her.
Gigi Grigoryan is Dr. Derian's sister.
What? I'm calling security.
I want you out of here.
INGRID: Do you remember Gigi?
Do you remember Gigi Derian?
Oh, my God, it's you.
You're
Didi.
Who's Didi?
MARY: I know you removed at least
a hundred spleens, but
this right here, tonight,
is why you built that muscle memory.
I need this to be the
fastest one you've ever done.
As soon as you close, flip
the patient on her abdomen
so we, the spine team,
can start right away.
We need to stabilize
the T9 vertebral fracture
by fusing two up and two down.
We do what we're trained
to do here, we do our jobs,
and this girl walks out of
UHOP on her own two feet.
- We all good?
- All good.
Let's do it, Dr. Morstan.
[EXHALES]
WATSON: So, you operated
on Ingrid's sister?
Ingrid called herself Didi then.
Well, we kept records.
It would have come up
when she applied to the clinic.
Well, this was ages ago, John,
before you and I even started dating.
2008, '9?
We were still transitioning
to digital records.
You think I did something
to the paper records?
You went to Pitt Medical School.
You did your residency here.
Records get misfiled all the time, lost.
That's why we switched to digital.
Why don't you tell him
how the surgery went?
MARY: Prep was going well.
MOYNIHAN: Stop. Get out. Doctor?
MARY: Then Moynihan found out
we were going to do the operation.
[MUFFLED ARGUING]
♪
[MUFFLED ARGUING CONTINUES]
Should old acquaintance ♪
- Stop the surgery.
- INGRID: No!
No, please! Gigi! Dad.
Never brought to mind? ♪
Should old acquaintance ♪
- Be forgot ♪
- CROWD: Five, four,
three, two, one.
- Happy New Year!
- [CHEERING, APPLAUSE]
For auld lang syne ♪
My dear ♪
For the sake ♪
Of auld lang syne. ♪
I'm not comfortable watching this.
Maybe we should wait outside.
No one's going no place.
They're having a private
conversation. It's awkward.
If Dr. Watson wanted
us gone, he'd say so.
Might need us.
Might need you.
We're staying right here.
Dr. Moynihan was the department chair.
He accused me of giving you false hope.
- Did you?
- No.
Gigi, she had an incomplete
spinal cord injury.
Why didn't you fight harder?
He was my boss.
You were an attending surgeon.
He did not have the
authority to stop a procedure
that you deemed necessary.
He had the authority to fire
me if I went ahead with it.
He had the willingness to
call every academic hospital
in the country and warn
them not to hire me.
Why?
Why wouldn't he let you try to save her?
Because he was Moynihan.
Because he already said
surgery was a bad idea,
and he had to be right.
He died with a 25-year-old wife
and two 40-year-old daughters.
That's who I was dealing with.
My sister Gigi
wanted to dance at the
New York City Ballet.
When she was 14,
she got an offer to train
year-round at the Joffrey.
Fourteen.
When she was 15,
six months after that night,
she took a handful of sleeping pills.
[SNIFFLES]
The person Gigi dreamed of becoming
died on your operating table that night.
She has major depressive disorder,
and now she fights to
dream about anything.
Wait, wait, wait, wait, wait.
Major depressive disorder?
Did you disclose that on her application
for the Spinal Signal Project?
INGRID: Of course not.
I wanted her to be the
best candidate in the stack.
So then you were getting
her, what, lithium somehow?
Then you stopped
so she could give blood
samples during the trial.
Then you decided to treat
the problem with ECT.
Electroconvulsive therapy.
How'd you know that?
Because ECT is the treatment
for malignant catatonia.
That's why you dismissed the
diagnosis when I brought it up.
You had already given it to her.
Ingrid, did you give your sister
succinylcholine before ECT?
Yes, of course. That's standard.
Call the pharmacy.
Send up some dantrolene.
Dantrolene? For what?
Gigi very likely has a
mutation to her RYR1 receptor.
When you administered succinylcholine,
you made your sister vulnerable
to malignant hyperthermia.
INGRID: Gigi. The medication I
gave you before the ECT treatments.
It did this. I'm so sorry.
Sorry for not knowing I'm a mutant?
[CHUCKLING WEAKLY]
I wanted this as much as you did. More.
I pushed you.
It's not your fault.
They're going to intubate you
and hyperventilate you with 100% oxygen.
Then we'll administer dantrolene.
Your blood pressure, your heart rate,
the pain and rigidity
it'll all start to go
away in about ten minutes.
What's going to happen with
the Spinal Signal Project?
What's gonna happen with you?
I don't know.
GIGI: What do the other doctors think?
We're not telling them.
Watson and Dr. Morstan
are the only ones who know.
You ready?
♪
[EXHALES SOFTLY]
INGRID: Hi, Gigi.
[STRAINING]
I can't feel my legs.
You fell.
Do you remember that?
Yeah.
You landed on your back.
You have something called
a T9 spinal fracture.
Um
They tried to stabilize it.
I even found a doctor who
was willing to do the surgery.
And you were in the operating room,
and they stopped it.
They said it was too risky.
[INHALES SHAKILY]
[SIGHS]
So, my legs? I can't walk?
I'm so sorry. I'm sorry.
I was supposed to protect you.
But I-I'm gonna fix this, okay, Gigi?
I promise.
I'm paralyzed. You can't fix that.
Um
I need you to tell me one thing.
When you went through that railing
when you fell,
was that Dad?
Okay, um
Don't tell anyone.
We can't trust anyone.
Okay? It's just you and me.
MARY: I did what any
doctor would've done.
Not any doctor. Just most doctors.
I was the only one willing to try.
[SIGHS]
I can't do it to your sister again.
I'm not pulling her from the program.
[EXHALES]
You know, I was warned
that you were a dangerous
person to have around.
I should have listened.
You're a talented
neurologist, Dr. Derian.
I'm sure once you start looking around,
you'll have no trouble
finding another position.
I'm not looking for another job.
If you don't find another
job within two months,
if you're not gone from UHOP forever,
then you're fired.
I've never forgotten that
night. And I never will.
But you can't be around here anymore.
SHINWELL: So you just wrote
a bunch of bitter nonsense,
and you got all these matches?
I wouldn't call it
bitter nonsense, I just
rewrote it to sound more like me.
Bitter nonsense. Got it.
Y-You would not believe
how forward the discourse is on here.
I have like a dozen offers
to look at people's moles.
They don't mean medically.
Well done, then.
Just have fun.
I'm sure you'll find a way
to turn it into an exam.
Oh. Hey, y'all.
Nice glasses. [CHUCKLES]
All right.
Y-You're taking her back
to the shelter today?
My landlord said it was her or me, so
Mind if I come along?
I don't know. Um
It's quiet around my place.
I thought she might
make a nice addition.
You're gonna adopt Tripod?
"Sauce."
Her new name is Sauce.
It's short for Isosceles.
[CHUCKLES] All right.
Come on.
- "Sauce."
- [STEPHENS CHUCKLES]
SASHA: There are six kinds of triangles.
Why "Sauce"?
STEPHENS: I'm not gonna
call a dog "obtuse."
- Mm-hmm.
- "Equilateral" doesn't really shorten
- to a punchy nickname.
- Mm-hmm.
- And "Scalene" sounds like she's sick.
- Mm.
She's not sick.
Sauce is doing just fine.
I think she likes you.
[ELEVATOR DINGS]
[KNOCKING AT DOOR]
I just talked to Dr. Morstan.
I know.
Do you want me gone?
That isn't my decision.
That's not an answer.
I realize that.
I knew not to trust you, Ingrid.
I understand why you did what you did.
But I'm not gonna stand in
the way of any consequences.
♪
♪
[SPORTSCAST PLAYING OVER RADIO]
SPORTSCASTER: Dan
Quinn scores three times
helping the Penguins pass
the Jets, eight-three
[GASPS, STAMMERS]
[SNIFFS]
IVO: What is this?
We're not home?
We made a stop.
[ENGINE TURNS OFF]
[PASSENGER DOOR OPENS, CLOSES]
Oh
What is this?
Just a place.
I come here sometimes.
Oh. Sit down.
Those drinks were really strong.
I know.
Y-You must've wanted this.
At some point.
What?
Kids.
Me. Gigi.
What happened?
[SNIFFS] I want you now.
And I love you, Didi.
I want you now.
I-I don't really like
that nickname anymore.
I love you and I love your sister.
I'll never hurt you again, okay?
- I know that.
- Okay.
[YELPS]
You know, they give fentanyl
to intubated patients.
[MOANING]
They hung it right there on Gigi's IV.
Get your hands on some syringes,
take a little bit out at a time.
Yeah, that's good.
Come get me.
- [EXCLAIMS]
- [WATER SPLASHES]
[PAINED MOAN]
[WEAKLY]: I'm your father
No.
You're nobody now.
♪
- Previously on Watson
- I want this patient admitted
to my spinal project.
How would you do this?
Gigi Grigoryan.
- Who is she?
- GIGI: Ingrid.
Come on. It's Mom's birthday.
[SIGHS] Mom's been gone 20 years, Gigi.
I'm sure she won't mind
if we eat a little late.
Devin Chaplin.
Executive director of human resources.
How long have you guys been
eating lunch together? Is it often?
- Sometimes.
- Uh, not usually.
You have an extremely
dangerous person working here.
- Excuse me?
- Ingrid Derian is an incredible talent,
but if she stays at UHOP,
sooner or later, there's
going to be fallout.
The people around her
will take the damage,
including maybe you, Dr. Morstan.
ANNOUNCER 1: We're here
with you on New Year's Eve.
ANNOUNCER 2: That's right.
The whole team will be here
9:01, and nobody's been
knocked out in a fight?
Ah, give it half an hour.
New Year's never disappoints.
Aw.
[LAUGHS]
We have a trauma activation in Resus 2.
The patient is a 14-year-old female
with a spinal cord injury.
EMT: Let's move, people.
She fell ten feet onto concrete,
she landed directly on her back.
She complained she
couldn't feel her legs
before we intubated.
Let radiology know we're coming.
- We need an emergent CT.
- IVO: Gigi.
- Gigi, it's okay, baby.
- You're her father?
Gigi. Yes. Yes.
- Lift.
- What happened tonight?
She must have been
leaning against a railing.
I-I keep telling the landlord
that he needs to replace it.
AMATO: How high up?
IVO: Two floors.
- Is Gigi gonna be all right?
- We need to do our work.
We'll get you information
as soon as we have it.
We're taking your daughter to radiology.
You can follow me.
Excuse me, is my sister here?
Is she here? Is Gigi here?
Yeah, they just brought
her in. She had a fall.
I-I came home, and
the entire building was
down in the courtyard.
They said that she fell
from the second floor.
She can't feel her legs?
Is my sister gonna be paralyzed?
I should get you a
doctor. What's your name?
Didi.
Sorry. That's my nickname, um
Ingrid. My real name is Ingrid Derian.
The "Spinal Signal" connects an
implant in the patient's brain
to others in his spinal cord.
It converts the patient's
thoughts into a signal
and transports them right
over the injured tissue.
Like a digital bridge. Before that day,
that man hadn't taken
a step in nine years.
This is nothing short of a miracle.
Which, following basic logic,
means that you would be
If you call me a "miracle worker,"
I will stab you in the jugular
with that stupid letter opener.
That's still accurate.
- Not quite.
- [PHONE CHIMING]
We haven't performed the
first surgery at UHOP yet.
How about I call you a
miracle worker when they do?
- [PHONE CHIMING]
- If I can have the five days off
I will need for the fundraising tour,
I permit you one use of
the term "miracle worker."
I accept your terms, Dr. Derian.
Hey. Everything okay?
[SOBBING] My whole body's sore!
What do you mean, everything hurts?
My muscles ache. My arms hurt.
Okay, well you had ECT today.
Some discomfort is normal.
This isn't that!
My arms feels weird. Please come home.
Okay. I'll be right there.
Stay on the line with me.
Everything all right, Ingrid?
[SMOKE DETECTOR RINGING]
Gigi? What are you doing?
Turn-turn off the stove!
It's my arms. The pain
Tell me what's happening.
Everything's in pain.
- The muscles in my arms
- [RINGING STOPS]
are on fire.
I'm gonna examine you, okay?
You're gonna flex and extend your arms.
[PAINED GROANING]
- That's as far as it goes? Okay.
- [PANTING]
Okay, we're gonna get you
to Fort Duke or West Penn.
No! UHOP's the best, that's
why you wanted to work there.
There are too many questions
if we go there, Gigi.
Those are both excellent
emergency departments.
These are my arms, Ingrid!
- And I'm not becoming a quad.
- Of course not.
No one says that's gonna happen.
Then take me to UHOP.
I won't tell them we're related.
- Okay?
- Okay.
[GIGI PANTING]
[SIRENS WAILING]
Hello. Hi.
My name is Dr. Ingrid Derian,
I'm a neurologist at the Holmes Clinic.
I'm concerned about this patient.
She's a participant in
our Spinal Signal Project.
She needs to be seen right away.
ANDREWS: Can you breathe?
Is your airway obstructed?
She's in pain. She needs
to see an attending.
[BREATH QUIVERING]
Hey. Listen to me.
Your name is Gigi Grigoryan.
- I know, I changed it.
- Okay, no slip-ups though, okay?
You can't tell them
about any of the changes
we made to your meds.
You cannot tell them about
the electroconvulsive
therapy treatments.
- But what if it's related?
- It's not. I promise.
There is something else.
We'll figure out what it is.
Good evening, my name's Dr. Mira Leela.
I'm the attending in
charge. What seems to be
Dr. Leela, the patient
is a 30-year-old female
with a history of spinal cord injury.
She's experiencing worsening
myalgias and rigidity.
- What's your name, dear?
- Gigi Grigoryan.
LEELA: Miss Grigoryan.
We'll take you to a proper
examining room immediately
and we're gonna figure out exactly
what's making you uncomfortable, okay?
I'm coming with you.
LEELA: You're not a relative, are you?
Then, I appreciate your
concern for your patient,
but we need to work.
We'll keep you updated
- every step of the way.
- Can we just have a moment?
Hey.
You're gonna be okay, Gigi.
No mistakes.
Not a single one.
I lied to get you into this program.
If they find out we're sisters,
I'm gonna lose my job here
and you're gonna get
kicked out of the program.
Do you understand?
We did this so you could walk again.
All of it, everything, will be gone.
♪
I don't want to pick one.
This is science. You're
putting up a dating profile.
You're coercing me into
putting up a dating profile.
It's Valentine's Day.
The entire world is coping
with the disappointment of
unreasonable expectations.
It is proven that today is the best day
to put up a virgin profile.
I don't like the term "virgin profile."
You need a picture with a
dog if you want to get likes.
You have three options.
Adam's golden retriever
STEPHENS: Which he named after himself.
- His name is John Quincy.
- STEPHENS: Okay.
So you came as close to naming
it "Adam" as you possibly could.
Micah's Doberman presents
a more active image,
while my little foster gal
shows that you have a kind heart.
Oh, yeah. Go with the
little three-legged lady.
She suits ya.
Excuse me. Her name is Tripod.
So your fling is lending you his dog,
and I see he sent you
Valentine's Day flowers.
Is rebound boy catching feelings?
I am not, in fact, sure of that,
but I am positive that is not the issue.
Stephens, we have stained
glass windows at our disposal.
Quaint Pittsburgh brick.
An eligible bachelor capable
of diagnosing any infectious disease.
So pick a dog, any dog,
muster a smile and enjoy
your feast of interested women.
- [SCOFFS]
- Oh.
Can we also maybe just try
these?
I like my glasses.
I think they might help.
- I can't see.
- INGRID: Does not matter.
Wear those.
Damn it.
Gigi's fever's rising.
BP's on a steady climb upwards.
Your Spinal Signal patient?
- Anything we can do?
- I got it!
They just need to do
their job in the ER.
Okay, so, do I just pose
- with one of these dogs, or ?
- SASHA: Mm-hmm.
MARY: Sorry. Is Watson around, or ?
STEPHENS: Dr. Morstan.
We were just, um
MARY: Taking pictures
for a dating profile.
- I heard.
- WATSON: Mary.
To what do we owe the pleasure?
Don't tell me there's a VIP patient
with a flesh-eating disease
you'd like us to take in?
Mm, could be something like that.
Maybe just walk with me?
[QUIETLY]: Okay, yeah.
[PHONE CAMERA CLICKS]
Devin asked me to make
us a reservation at Emund.
On Valentine's Day?
Every restaurant has a fixed menu
and the service is awful.
Oh, nevertheless. She had it in her head
that couples should do
something on the most
"romantic night of the year."
The most romantic night of the year is
whenever something romantic happens.
If you try to schedule it,
it makes it the least romantic night.
Yes, your position is clear.
And yet, here I am
with a reservation, a
bottle of wine, and no date.
Oh, would it surprise
you to learn that even
executive vice presidents
of human resources can
sometimes be less than faithful?
No. No, I
No, no, I'm just
surprised that I'm your backup.
I left home to help Sherlock.
You lost our baby girl while I was gone.
I just didn't think that I
would be on the top of your list.
It's out there now, John.
We both know about it.
I feel like we can finally
have a conversation again.
[ELEVATOR DINGS]
I prepaid for the meal,
and I can use a friend.
But if you're too busy, I'll
just drink my Sangiovese alone.
♪
Can you tell me what
room Gigi Grigoryan is in?
They have her in four.
But I think they're
drawing blood right
[SINGSONGY]: You're welcome.
MOYNIHAN: Ivo Derian?
I'm Dr. Moynihan, I'm the attending
- spine surgeon here.
- IVO: Hi.
You're Gigi's sister?
- Didi.
- Gigi's suffering
from an unstable
thoracic spine fracture.
She's suffered a T9 spinal cord injury.
Now, ordinarily,
we would bring her into the OR
and we would decompress the spinal cord
and stabilize the fracture.
But you're not going to do that?
Well, Gigi also has a grade
III splenic laceration.
So, if we put her on her abdomen
to be able to do the spinal surgery,
there is the possibility that her
spleen could rupture mid-procedure.
Right now, we have to
observe her in the ICU
and wait and see if
the spleen heals itself.
You mean just wait?
You just said she had an
unstable spinal fracture.
What's gonna happen if you don't fix it?
This is her spine!
Is my sister gonna wind up paralyzed?
Based on the location of the injury,
your sister's arm function
shouldn't be at risk.
Oh, yeah, so she'll
just be in a wheelchair.
Damn, Ronnie.
- Who's Ronnie?
- IVO: He owns the building.
I'm gonna sue him.
I'm gonna sue him for that
railing, I promise you.
Didi.
[CROWD SINGING "AULD LANG SYNE"]
Didi.
Is there anything I should know
about what happened tonight?
INGRID: I wasn't there.
You believe he's telling the truth?
Is there anything I can do for you?
You can help Gigi.
You can keep my sister
out of a wheelchair.
CROWD: Should auld acquaintance ♪
- Be forgot ♪
- Stop singing!
- My sister has a broken back!
- Didi.
No. My sister has a broken back.
And no one's gonna help her walk again,
and you're singing?
I'm so sorry, Miss Didi.
There's a chapel if you want quiet.
Come on.
- Let's go.
- No. No.
Okay.
[MUSIC PLAYING IN DISTANCE]
What?
Sorry about your sister.
Thanks.
You know, I used to think
a doctor is just a doctor.
If someone worked that hard in school,
if they took an oath
to protect other people,
you should be in good hands, right?
It's not true.
You know, there are doctors
who can't stop drinking.
There are even doctors
who, when given the chance
to keep a 14-year-old
out of a wheelchair,
think only about protecting
themselves from liability.
Yeah.
- Looks like Gigi got one of them.
- Yeah, she did.
You know, Dr. Moynihan's
a big deal, but
[INDISTINCT CHATTER]
that doesn't mean he's
the best surgeon here.
You know, there are people here on staff
that might not have his title, but
they're better.
I don't know who any
of these people are.
I do.
Start there.
You won't do better.
GIGI: This isn't getting better, Ingrid.
They don't know what's wrong with me.
My heart rate won't go down.
My blood pressure's still climbing,
and I can tell from
the look on your face
that that's not all
that's wrong with me.
What are you looking at?
Your CK value is 6,000.
That's off the charts.
You're experiencing rhabdomyolysis.
Your muscles are breaking down.
[BREATHING SHAKILY]
Ingrid, come here.
What you're doing for me is incredible,
but they don't know what's
going on with me around here,
and neither do you.
You work with four of the
smartest doctors in this hospital,
and you are hiding me from them
while I keep getting sicker.
All right. Okay.
So, they say it's gonna be
about another 45 minutes,
30 if we're lucky.
I was nice.
Our reservation was 15 minutes ago.
- And I was still nice.
- [CHUCKLES]
So what you want to do?
Not wait an hour.
I say we get takeout.
Take this to the spot.
Okay.
Okay, yeah. [LAUGHS] All right.
[WINE POURING]
[SIGHS]
Happy Valentine's Day.
Happy Valentine's Day.
You ever think about her?
Ginny and what she might've been?
Mm.
I've pictured her 100 different ways.
It starts to fade, though.
I was mad at the world for months.
I was mad at you.
But it's not a tragedy, John.
It's a sadness.
I mean, we're not the first
couple who couldn't have a baby.
Let it go, little by little.
That's never been your strong suit.
[PHONE BUZZING]
- Ah, sorry.
- It's okay.
You have to check.
- [SIGHS]
- [PHONE BEEPS]
- Good evening, Dr. Derian.
- INGRID [OVER PHONE]: Dr. Watson, I'm sorry.
- Are you busy?
- No, I was just
Don't worry about it. What do you need?
There is a patient, 30-year-old
female, she's a participant
- in our Spinal Signal Project.
- Uh-huh.
Her fever's elevated and I
- [INGRID CONTINUES INDISTINCTLY]
- I understand, yeah. No.
No, I'll be right there.
It's [SIGHS] one of
her Spinal Signal patients.
Sounds bad. I'm sorry.
- I I got to
- No, don't apologize.
Just don't leave me hanging.
I'm the medical director of UHOP.
I'd like to see the
Holmes Clinic in action.
Unless you think I have
nothing to contribute?
SASHA: Come on, Tripod. Let's go.
You guys sleep in your college shirts?
I am wearing my college shirt.
Adam is wearing his safety school shirt.
Well, I had to put something back on.
Would you stop flaunting your fling?
Forget the fling. Did you
really have to bring your dog?
Her name's Tripod, and she's not my dog.
I have to take her back
to the shelter soon.
Good evening, everyone.
Dr. Morstan.
Hi.
The medical director's gonna lend us
the benefits of her insights.
I am confident she'll
be able to keep up.
So, Dr. Derian.
Gigi Grigoryan.
[SIGHS] What do we need to know?
Excuse me. Excuse me.
Um, are you Dr. Mary Morstan?
Yeah, are you all right?
I heard that you're the best
spine surgeon in this hospital.
I do orthopedics, and I've only been
an attending here for less than a year.
I need your help, Dr.
Morstan. My name's Didi.
My sister
I need you to save her.
I need you to keep Gigi
out of a wheelchair.
Dr. Moynihan has certain sharp corners,
but it's no accident
he runs this department.
Right now, Gigi's splenic
laceration is contained.
It won't keep bleeding
because it's walled itself off.
If we put pressure on
your sister's abdomen
to do the intervertebral fusion surgery,
there's a very high risk of a
splenic rupture mid-operation.
[STAMMERS] Why does she
need a spleen exactly?
What?
Well, people live all
the time without spleens.
My aunt got hers removed
when she was a kid.
It won't rupture if it's not there.
You said your name's Didi?
Splenectomy, that's smart.
I mean, I'd have to
convince general surgery
to do the splenectomy,
and it'd be risky to
operate on Gigi's spine
right after an abdominal surgery.
And if my sister spends the
rest of her life in a wheelchair,
isn't that risky, too?
Or is it only a risk if someone
in the hospital can be blamed?
Let me show you something.
Look at this.
That's where he pinches me.
My dad,
when he wants it to really hurt,
but doesn't want anyone to see.
I can take it on, but
he's starting on Gigi.
I've been watching it happen.
Do me a favor,
look at the same spot
on my sister's arm.
And think about what happened tonight
and how she went through that railing.
My sister doesn't
deserve to be a paraplegic
because it's too risky to help her.
INGRID: Gigi Grigoryan is
a 30-year-old female patient
with a history of spinal
cord injury and paraplegia.
She's enrolled in our
Spinal Signal Project,
and two hours ago she presented
to the UHOP ER with fever,
myalgias, rigidity, and now,
there's evidence of rhabdomyolysis.
You worked closely with her for months.
Is there anything else we need to know?
She's been a model candidate.
Adhered to every protocol we've asked.
The rapid onset suggests
maybe, um, sepsis or influenza.
We could send a CBC, blood cultures,
and a viral panel.
The initial CBC in the ER
didn't show any leukocytosis.
She hasn't had any sick
contacts or recent travel.
What about prescription
meds or substance abuse?
Could be serotonin syndrome.
No prior psych history in her charts.
No other prescription medications,
no substance use, and
all of the bloodwork
we've done for the trial supports that.
Okay, so she has fever, rigidity,
autonomic instability.
What about malignant catatonia?
No, it's not that.
What possible reason do you
have to exclude that diagnosis?
We can't work with you,
Dr. Derian, if you keep
shooting everything down.
I'm just trying to stay on point.
The patient's temperature
is already at 102,
and her fever's not coming down.
Ingrid is right. We are
working on two fronts here.
We have to figure out
what's wrong with Gigi
and manage her symptoms
so she doesn't deteriorate further.
Sasha and the Crofts,
give her an antipyretic
and cool her with ice packs.
Ingrid, follow the patient's CK levels
and start an aggressive
fluid resuscitation.
Send electrolytes and a tox screen.
Dr. Morstan, if you're up for
a, uh, potential all-nighter,
I'd like you to dig through her charts
for other types of underlying causes.
Of course. And you? What are you doing?
I have my own theory to follow up on.
ADAM: A mystery errand.
That's one of Watson's favorite moves.
♪
[SIGHS]
You can't report this, you know.
I have a duty here.
No, y-you have a patient
who needs surgery right now.
If you take my dad into custody,
who's gonna make that call?
How old are you, Didi?
Seventeen.
I can't authorize the surgery.
Child Protective Services can do it.
Have you worked with them much?
Just get my dad to
sign the authorization.
Keep my sister out of a wheelchair.
When this is over,
Gigi can tell you exactly what happened.
Y-You can call whoever you want.
[MONITOR BEEPING STEADILY]
♪
STEPHENS: This feels wrong.
What? Checking the apps
while we're treating Gigi?
No.
Well, I mean, yes, but that's
a waiting game at the moment.
I mean this.
You look cute. You're
not getting any matches?
I'm actually kind of
getting a lot. [CHUCKLES]
It's just, this stuff I wrote.
"Infectious disease specialist seeks
incurable chemistry"? That's just
bragging that I'm a doctor.
That's how the game is played.
I wouldn't know what to say
to these people if we did meet.
"Don't ask me to look at your moles"?
I'm just making it more me.
How's her fever?
Gigi's latest labs just came in.
Her potassium levels
are elevated 6.8.
We'll put her on IV
calcium, glucose and insulin.
And if that doesn't bring it down?
Intensive care, dialysis.
And then, who knows?
IVO: Uh
[INHALES SHARPLY] I-I
I don't understand, I thought
this surgery was too risky.
MARY: Well, there's always
a chance of complications.
But if we don't fix Gigi's fracture now,
she's almost certainly going
to lose the use of her legs.
Okay.
- Dad.
- Just
Can I talk to that other doctor?
- What was his name?
- Dr. Moynihan's
- Yes.
- gone home for the night.
I could have him paged.
I think I'd like that, thank you.
Of course.
By the way, has anyone put you
in touch with the police yet?
- What?
- That railing,
it was poorly maintained, right?
I'm happy to call them down here.
There could be criminal liability.
Oh, no, no, no. Thank
Thank you. I'll-I'll do that.
Okay, um
So, you we think that
this could save Gigi's legs?
I wouldn't be here if I didn't.
Okay, thank you, Doctor.
God bless you.
Dr. Morstan, thank you.
This can go a lot of ways, Didi.
I understand, I know. I
But she has a chance now because of you.
♪
You wanted to see me?
When I suggested a diagnosis
of malignant catatonia
for Gigi Grigoryan,
you shot me down but you
wouldn't give me a reason.
Her fever is spiking.
Yes, that's how you changed the subject,
but would you like to tell me
how you're connected to this patient,
and why you're so sure
that she doesn't have
malignant catatonia?
She is my patient in the
Spinal Signal Program.
She's obviously a lot more than that.
Nor is it difficult to rule out
the closest connection of all.
A piece of your DNA, and a piece of hers
and I can move on to the next theory.
You lied to everybody in
the clinic tonight, Ingrid.
We're treating your sister.
♪
What are they talking about in there?
They better wrap it up fast.
The patient's potassium
levels are headed back up.
I'm going in.
No. Sorry.
Um, yeah, you go in, if you like,
obviously, but
Dr. Watson does have a
way of getting answers.
[SIGHS]
When did your sister change her name?
When I heard about the
first Spinal Signal Project
in Europe, I was already
specializing in neurology.
She'd never get into the studies
because of the conflict of interest.
So you created a whole
new identity for her.
You built it up all throughout the years
and you pushed her application through.
Why?
Why would you risk
everything that you built?
I owe it to Gigi.
Gigi.
That's her real name?
Ginnifer.
She's always hated it.
You say you "owe it" to her.
Is Gigi in a wheelchair because of you?
Yes.
What did you do?
I failed her.
I don't understand.
Since it's all coming out anyway,
why don't you ask her?
Mary?
Tell her.
Gigi Grigoryan is Dr. Derian's sister.
What? I'm calling security.
I want you out of here.
INGRID: Do you remember Gigi?
Do you remember Gigi Derian?
Oh, my God, it's you.
You're
Didi.
Who's Didi?
MARY: I know you removed at least
a hundred spleens, but
this right here, tonight,
is why you built that muscle memory.
I need this to be the
fastest one you've ever done.
As soon as you close, flip
the patient on her abdomen
so we, the spine team,
can start right away.
We need to stabilize
the T9 vertebral fracture
by fusing two up and two down.
We do what we're trained
to do here, we do our jobs,
and this girl walks out of
UHOP on her own two feet.
- We all good?
- All good.
Let's do it, Dr. Morstan.
[EXHALES]
WATSON: So, you operated
on Ingrid's sister?
Ingrid called herself Didi then.
Well, we kept records.
It would have come up
when she applied to the clinic.
Well, this was ages ago, John,
before you and I even started dating.
2008, '9?
We were still transitioning
to digital records.
You think I did something
to the paper records?
You went to Pitt Medical School.
You did your residency here.
Records get misfiled all the time, lost.
That's why we switched to digital.
Why don't you tell him
how the surgery went?
MARY: Prep was going well.
MOYNIHAN: Stop. Get out. Doctor?
MARY: Then Moynihan found out
we were going to do the operation.
[MUFFLED ARGUING]
♪
[MUFFLED ARGUING CONTINUES]
Should old acquaintance ♪
- Stop the surgery.
- INGRID: No!
No, please! Gigi! Dad.
Never brought to mind? ♪
Should old acquaintance ♪
- Be forgot ♪
- CROWD: Five, four,
three, two, one.
- Happy New Year!
- [CHEERING, APPLAUSE]
For auld lang syne ♪
My dear ♪
For the sake ♪
Of auld lang syne. ♪
I'm not comfortable watching this.
Maybe we should wait outside.
No one's going no place.
They're having a private
conversation. It's awkward.
If Dr. Watson wanted
us gone, he'd say so.
Might need us.
Might need you.
We're staying right here.
Dr. Moynihan was the department chair.
He accused me of giving you false hope.
- Did you?
- No.
Gigi, she had an incomplete
spinal cord injury.
Why didn't you fight harder?
He was my boss.
You were an attending surgeon.
He did not have the
authority to stop a procedure
that you deemed necessary.
He had the authority to fire
me if I went ahead with it.
He had the willingness to
call every academic hospital
in the country and warn
them not to hire me.
Why?
Why wouldn't he let you try to save her?
Because he was Moynihan.
Because he already said
surgery was a bad idea,
and he had to be right.
He died with a 25-year-old wife
and two 40-year-old daughters.
That's who I was dealing with.
My sister Gigi
wanted to dance at the
New York City Ballet.
When she was 14,
she got an offer to train
year-round at the Joffrey.
Fourteen.
When she was 15,
six months after that night,
she took a handful of sleeping pills.
[SNIFFLES]
The person Gigi dreamed of becoming
died on your operating table that night.
She has major depressive disorder,
and now she fights to
dream about anything.
Wait, wait, wait, wait, wait.
Major depressive disorder?
Did you disclose that on her application
for the Spinal Signal Project?
INGRID: Of course not.
I wanted her to be the
best candidate in the stack.
So then you were getting
her, what, lithium somehow?
Then you stopped
so she could give blood
samples during the trial.
Then you decided to treat
the problem with ECT.
Electroconvulsive therapy.
How'd you know that?
Because ECT is the treatment
for malignant catatonia.
That's why you dismissed the
diagnosis when I brought it up.
You had already given it to her.
Ingrid, did you give your sister
succinylcholine before ECT?
Yes, of course. That's standard.
Call the pharmacy.
Send up some dantrolene.
Dantrolene? For what?
Gigi very likely has a
mutation to her RYR1 receptor.
When you administered succinylcholine,
you made your sister vulnerable
to malignant hyperthermia.
INGRID: Gigi. The medication I
gave you before the ECT treatments.
It did this. I'm so sorry.
Sorry for not knowing I'm a mutant?
[CHUCKLING WEAKLY]
I wanted this as much as you did. More.
I pushed you.
It's not your fault.
They're going to intubate you
and hyperventilate you with 100% oxygen.
Then we'll administer dantrolene.
Your blood pressure, your heart rate,
the pain and rigidity
it'll all start to go
away in about ten minutes.
What's going to happen with
the Spinal Signal Project?
What's gonna happen with you?
I don't know.
GIGI: What do the other doctors think?
We're not telling them.
Watson and Dr. Morstan
are the only ones who know.
You ready?
♪
[EXHALES SOFTLY]
INGRID: Hi, Gigi.
[STRAINING]
I can't feel my legs.
You fell.
Do you remember that?
Yeah.
You landed on your back.
You have something called
a T9 spinal fracture.
Um
They tried to stabilize it.
I even found a doctor who
was willing to do the surgery.
And you were in the operating room,
and they stopped it.
They said it was too risky.
[INHALES SHAKILY]
[SIGHS]
So, my legs? I can't walk?
I'm so sorry. I'm sorry.
I was supposed to protect you.
But I-I'm gonna fix this, okay, Gigi?
I promise.
I'm paralyzed. You can't fix that.
Um
I need you to tell me one thing.
When you went through that railing
when you fell,
was that Dad?
Okay, um
Don't tell anyone.
We can't trust anyone.
Okay? It's just you and me.
MARY: I did what any
doctor would've done.
Not any doctor. Just most doctors.
I was the only one willing to try.
[SIGHS]
I can't do it to your sister again.
I'm not pulling her from the program.
[EXHALES]
You know, I was warned
that you were a dangerous
person to have around.
I should have listened.
You're a talented
neurologist, Dr. Derian.
I'm sure once you start looking around,
you'll have no trouble
finding another position.
I'm not looking for another job.
If you don't find another
job within two months,
if you're not gone from UHOP forever,
then you're fired.
I've never forgotten that
night. And I never will.
But you can't be around here anymore.
SHINWELL: So you just wrote
a bunch of bitter nonsense,
and you got all these matches?
I wouldn't call it
bitter nonsense, I just
rewrote it to sound more like me.
Bitter nonsense. Got it.
Y-You would not believe
how forward the discourse is on here.
I have like a dozen offers
to look at people's moles.
They don't mean medically.
Well done, then.
Just have fun.
I'm sure you'll find a way
to turn it into an exam.
Oh. Hey, y'all.
Nice glasses. [CHUCKLES]
All right.
Y-You're taking her back
to the shelter today?
My landlord said it was her or me, so
Mind if I come along?
I don't know. Um
It's quiet around my place.
I thought she might
make a nice addition.
You're gonna adopt Tripod?
"Sauce."
Her new name is Sauce.
It's short for Isosceles.
[CHUCKLES] All right.
Come on.
- "Sauce."
- [STEPHENS CHUCKLES]
SASHA: There are six kinds of triangles.
Why "Sauce"?
STEPHENS: I'm not gonna
call a dog "obtuse."
- Mm-hmm.
- "Equilateral" doesn't really shorten
- to a punchy nickname.
- Mm-hmm.
- And "Scalene" sounds like she's sick.
- Mm.
She's not sick.
Sauce is doing just fine.
I think she likes you.
[ELEVATOR DINGS]
[KNOCKING AT DOOR]
I just talked to Dr. Morstan.
I know.
Do you want me gone?
That isn't my decision.
That's not an answer.
I realize that.
I knew not to trust you, Ingrid.
I understand why you did what you did.
But I'm not gonna stand in
the way of any consequences.
♪
♪
[SPORTSCAST PLAYING OVER RADIO]
SPORTSCASTER: Dan
Quinn scores three times
helping the Penguins pass
the Jets, eight-three
[GASPS, STAMMERS]
[SNIFFS]
IVO: What is this?
We're not home?
We made a stop.
[ENGINE TURNS OFF]
[PASSENGER DOOR OPENS, CLOSES]
Oh
What is this?
Just a place.
I come here sometimes.
Oh. Sit down.
Those drinks were really strong.
I know.
Y-You must've wanted this.
At some point.
What?
Kids.
Me. Gigi.
What happened?
[SNIFFS] I want you now.
And I love you, Didi.
I want you now.
I-I don't really like
that nickname anymore.
I love you and I love your sister.
I'll never hurt you again, okay?
- I know that.
- Okay.
[YELPS]
You know, they give fentanyl
to intubated patients.
[MOANING]
They hung it right there on Gigi's IV.
Get your hands on some syringes,
take a little bit out at a time.
Yeah, that's good.
Come get me.
- [EXCLAIMS]
- [WATER SPLASHES]
[PAINED MOAN]
[WEAKLY]: I'm your father
No.
You're nobody now.
♪