Monday Mornings (2013) s01e10 Episode Script
Family Ties
1 Huh huh please allow me to introduce myself I'm a man of wealth and taste I've been around for a long, long year stole many a man's soul and faith 58-year-old woman knocked down by a skateboarder, fell backwards about 10 steps.
Was she breathing on her own? A few agonal breaths.
Pupils? Left fixed, right barely reactive.
Has she responded at all? Some incomprehensible sounds, initially.
Glasgow score of four, but then nothing.
So we downgraded her to a three.
Get a stat C.
T.
page Dr.
Park.
Doctor! I've really been here a long time.
Whose patient are you? That's just the thing nobody's.
I-I've been in the waiting room for over two hours.
Okay, I need you to go back to the waiting room.
I promise we'll be with you as fast as we can.
Severe chest pain.
Difficulty breathing.
B.
P.
's 98/74.
O2 stat's 94.
Heart rate is 110.
Pain was 9 of 10 and administered aspirin and morphine en route.
I need a 12 lead EKG, stat.
What were you doing when the pain came on? This douche bag snatched my backpack, so I chased him.
Then I just my chest! Okay, let's get him into bay 1, quick.
Pleased to meet you tightness? Arm pain? Headache? Yeah.
My arms are fine.
I feel a little like puking.
S.
T.
segment elevation.
Ischemia in the inferior leads.
I'm going to give you something to put under your tongue.
I want you to tell me if it helps.
I need enzymes on him.
How old are you? Feeling better? About a four or five now.
Initiate code stemi.
Robidaux, I want you to stay with him, take him to the cath lab, and page Dr.
Napur.
This kid's having a heart attack.
Whoo GCS 3.
Collided with a skateboarder.
Cat scan shows a large left-sided hemorrhage.
Let's get her to the O.
R.
, save what brain function we can.
She gone.
It's only been an hour.
Come on, Sung.
She's here, and so are we.
Come on.
There it is, an obstruction in the right coronary artery.
Have you ever seen somebody this young with a heart attack? 16? No.
Inferior wall M.
I.
Ready to watch a cardiac stent? Okay.
Absolutely! So, Mr.
knox.
What's going on? Well, I had back surgery a couple years ago, and things have never been the same.
The pain's still pretty bad.
On a scale of 1 to 10? I'd say an 81/2? I mean, it comes and goes, but it's mostly continuous.
Is there anything in particular that brings on the pain? Everything in particular the bending, the lifting, the turning.
You guys prescribed something to me once before.
Um, what was it? Uh, lor lor-something? Lortab? I think that was it.
It really seemed to help.
How often do you take painkillers? Only when I need 'em.
Who is your primary? Uh, Dr.
wu over at Portland area physicians.
And what pharmacies are you using? Uh, the four-and-twenty around the corner.
No others? Why do I suddenly feel like I'm being interrogated? Look, are you on any other medications? No.
Do you currently take prescriptions for back pain? It's easy for us to check this out.
Yeah, no, I am, uh, but I'm such a spaz.
I spilled it in the bathroom sink, and so most of it got ruined.
That's why I'm here.
I-I need an emergency refill.
Okay.
Just relax.
I'll be back in a minute.
Well, where are you going? I'm going to make some phone calls.
I'll return with your treatment options.
Mr.
Malloy? How is she? It's not good.
The tests show there's no blood flow to her brain.
We tried everything we could but the damage was just too extensive.
She's dead? She is brain-dead, yes.
How can From colliding with a skateboarder? We are so sorry.
By the time she got to us, she was already gone.
C-can I see her? You can.
Of course.
We'll bring you back in just a bit.
Also, your mother was an organ donor.
We've contacted the registry, and someone from the organ procurement agency will be coming wait, wait, wait.
Can you give me a minute, just to process the fact that my mother's Before you start I-I I so apologize for the insensitivity of this, but we're required.
The timing on organ donation I need a minute, okay? Please, can you just give me a minute? Should I speak to him? Excuse me? You worse me, bedside.
Sung? Is that really necessary? The thing is, for us to make effective use of her organs I explained that.
Let's just give him a moment on this, okay? His mother just died.
Hey.
How you feeling? Okay, I guess.
Rough day.
What happened? Nothing new.
Some wank called me "man boobs," then grabbed my bag.
I started after him.
Then by the time we reached the field, everything just hurt.
Have you ever had pain during physical activity before? It's just uncomfortable, so I avoid it.
Take the elevator, ride the bus.
Darryl? Darryl.
Baby, are you okay? I'm fine, Nana.
Is this your grandmother.
Hi.
I'm Dr.
Sydney Napur.
What happened? Is he okay? Baby, are you okay? I had a heart attack.
A what? A what?! There was a blockage in his heart that was preventing him from getting enough oxygen.
We had to put in a stent to reopen the passageway.
Oh, my lord.
Um, he will be okay, but, uh But what? This young man needs to make some dramatic lifestyle changes.
He has asthma, he has a this had nothing to do with asthma, ma'am.
I don't think I like your tone, doctor.
Will his parents be coming in? If he had parents, they'd be here.
I'm his parent.
I'm okay.
I'm sorry, no.
I-I don't want her organs to be harvested.
S-she's a registered donor.
I understand that.
And it makes sense, she's a selfless person.
But I'm telling you, as her son, that registration doesn't reflect her true intent.
On what basis do you look.
My mother agreed to be an organ donor six years ago, I understand that.
What you guys need to appreciate is that I speak to her every single day, and I can tell you the person she is now, or Was an hour ago, and She wouldn't consent to having her organs harvested.
I'm afraid it's a legally-binding consent.
It's on her driver's license.
Your wishes can't override hers.
- Who is this ghoul? - Gregory.
It's a federal law.
It's called the uniform anatomical gift act.
The agreement your mother made is irreversible.
Which means that we are legally required to procure her organs.
I'm getting a lawyer.
Pasta.
Burgers.
Burritos.
That's what you serve? It's what he serves.
I work late, so Darryl usually takes care of dinner, which, more times than not, is either fast food or frozen.
Mrs.
Fisher, do you realize how bad that is? Processed food, fast food? It's what I can afford.
Eating this way is what's making Darryl so sick.
His lipid panels show very high risk.
He's severely obese.
Everyone in my family is You know, fat.
It's in our genes.
Does he get any exercise? I'll try to get on him about that.
You make it sound as if I failed him.
Well somebody has.
He's 16 with the body of a 50-year-old.
It's just so frustrating.
People think "it's just food.
What's the harm?" Food is public enemy number one.
It's practically the leading cause of death in this nation.
Food.
You know, I think I saw that kid once.
Fisher? He came in with a strep throat.
His cholesterol and triglycerides were through the roof.
Oh, at 16.
God, the nation nearly sat Shibah for the death of the twinkie.
Do you know what's actually in twinkies? Among other things, the ingredients found in rocket fuel.
Syd.
We're doctors.
We can only do so much.
We can't be tilting at windmills Or ding dongs Or snow balls.
It's really not funny.
What was Darryl's fractionation, anyway? Was it something ridiculous? I don't know.
I didn't run it.
You didn't run it? You just got the total? You didn't break it down? And now I'm in trouble.
Not even a lipid panel? I saw him for strep throat, so And you could see the kid was fat, with elevated cholesterol.
Can I please just eat? No, of course not.
I forgot.
Food is the enemy.
Well, food and me.
You know what? I think I'll, uh I'll just go smoke a cigarette.
Come on.
I'm not a drug addict.
I hurt my back.
Son, you're a drug addict.
Are you the poster boy? Is it needles or cocaine? No.
It's pain medication.
But you're a drug addict just the same.
You've been going to different E.
R.
's, multiple pharmacies, getting prescriptions for opiates, narcotics are you telling me that my pain isn't real? I am telling you you have a problem, one which I will not enable.
This is ridiculous.
Where's that blonde doctor? Son.
Don't call me "son.
" Okay? I am in serious pain here, and you're a doctor.
You need to treat me, you fat bastard! I'll treat you for a broken jaw.
Would you like to have one? Please.
I really hurt.
I believe you.
But more than anything, you need to detox.
Court? That kid is hauling us into court? How can he do that? By hiring an attorney, buck, and believe me.
Lawyers make very good haulers, but right now first of all, the woman's consent is legally binding.
Now being challenged by the son.
Second, if we do not harvest these organs quickly, the viability which is why we have to go to the courthouse now.
So, she's still hooked up to a machine? Well, Harding's going to fight the court order, while prospective donees are being put on standby.
It's absurd.
The woman signed a donor card.
Ohh.
Hey, I'm I'm sorry.
Hello.
I'm Asher knox.
We, uh, met briefly in the E.
R.
Yes.
Hi, I'm sorry to bother you, but, um That other E.
R.
doctor, the big guy, the African-American man, he He sort of threw me out.
Dr.
Villanueva wouldn't have turned you away if he felt you needed treatment, Mr.
knox.
Well, he he thinks I need drug treatment.
And, uh, I-I do.
I-I'm addicted to pain medication.
And I realize I need to get treatment for that, but but right now, I I just need help, period.
That Dr.
villa guy or whatever made some calls.
And, uh, I can't go to any more E.
R.
's or pharmacies.
H-h-he can't do that.
He he can't do that.
I mean, I I could sue you guys.
Look, we cannot give you drugs, so But I-I-it's just it's just to ease the pain, please.
It's not that simple.
It is that simple.
You think I want to be this way? Doctors did this to me.
Just just write me a script.
Tide me over for a little bit.
I can't do that.
Yes, you can! - Aah! - Hey! Tina? Tina? Probable hematoma, subdural, epidural.
Page Dr.
Wilson.
No, check that.
Dr.
Park.
Call Sung.
Some blood in her mouth.
I think it localized.
You okay? I'm fine.
Breath sounds are clear throughout.
What happened? She was attacked, head injury.
Tina? She's not conscious.
Pupils? Is she localizing? Any kind of response at all? We need a C.
T.
oh, my God.
My God.
Where is she now? Harding.
They just called our case.
Well, should she need surgery, I want Dr.
Park to perform.
You understand? Not Ty Wilson.
Just keep us informed.
We should be back within the hour.
Is everything okay? No.
Brain swell.
Subdural hematoma.
Prep surgery now.
Let's go.
Tina? Tina? Need take surgery now.
Brain bleeding.
I'm doing it.
I do.
I said I'm doing it! Stand down! Dr.
Wilson.
Dr.
Park will perform the procedure.
What am I missing here? She's a registered organ donor.
Yes, your honor, which would suggest that she agreed to have her organs harvested.
But in ascertaining the validity and therefore enforceability of any such agreement, we look to see if there was an actual meeting of the minds.
Here, I submit there was none.
Because? Well, there's no indication that she truly knew what organ donation even entails.
In fact, most people do not.
Why? Because they're simply not told.
One almost gets the sense that the less people know, perhaps the more likely they are to donate.
Your honor, if I might have a word.
Forgive me.
I don't mean to forsake any proper court decorum, but there are lives, innocent lives, hanging in the balance, and I would hate for those lives to be hinged on Mr.
Tompkins's talent for brevity.
And who are you? Forgive me.
My name is Harding Hooten.
I'm the chief of staff at Chelsea general.
Excellent! What a splendid idea.
Let's hear directly from Chelsea general's chief of staff.
We can all learn firsthand about the organ-donation business.
And in the process, we could even save time.
Your honor, might we put Dr.
Hooten under oath, in the interest of accuracy? I guess my question would be or I should say my assumption When a person say, like my client's mother checks the "organ donor" box on her driver's license application, is it made clear to her that not only her organs may be harvested, but also her skin and her tissue? I really have no idea what your client's mother was specifically told.
Here's the paperwork Mrs.
Malloy signed.
Oh, well, it's actually an application for a driver's license with a little box to check.
Is there anything in here declaring that her tissue and skin would be harvested? I believe online there is a section for exclusions should you ah, you'd have to go online to read it.
The reality is most people do not.
In fact, there is no way to specify, "do not sell my tissue for cosmetic use.
" Most people, my client's mother being one of them, simply have no idea that hospitals derive huge revenues from these tissues, tissues sometimes used for things like penile enlargements, lip-plumping, wrinkle repair, nose cartilage.
You think my client's mother knowingly agreed to let her body parts be used posthumously to augment a male recreational appendage? The majority of organs are used for life-saving measures.
We don't is it your testimony, doctor, that Chelsea general does not use or sell organ donations for profit? Yes, money is made allowing outside companies to harvest tissue for cosmetic use? Mr.
tompkins, what we are endeavoring to do here today is to use your client's mother's liver and kidneys to save three lives.
Should you not be able to read that in the form perhaps not, because nowhere in the fine print is it prominently declared that you are a putz.
It's my client who feels like a putz today, sir, sitting here as you're about to carve up his mother for profit.
Well, then, perhaps you should tell your client that we are using his mother's body parts to save human life.
For someone who lays claim to full disclosure, why are you throwing up trees to obscure his view of the forest? The forest here is the not-so-underground transplant industry that reaps millions, if not billions of dollars.
Oh, now you are overstating the case.
It's a racket.
A racket?! If Mrs.
Malloy's skin graft goes from here to Hoboken to cover a nose burned off a 5-year-old to prevent his a life being one of scorn and disfigurement, that, sir, is not a racket! What do you think you're doing? I'm going in there.
That's what I'm doing.
She's my best friend.
And should she become unstable, I want to be there.
You got a problem with that? Nope.
Trauma craniotomy.
Evacuate subdural hematoma first, deal with other injuries later.
Her B.
P.
's up and her heart rate's down.
Should we give her meds, bring that pressure down, too? No.
Kill her.
Bring down, dead.
What coags? Normal.
C.
T.
on monitor? Already up.
Gee, Sung, take your time.
No big rush.
You want be here? Be quiet.
Doctor.
Five seconds.
You wake up.
You be strong, and you wake up.
I love you, Tina.
I love you.
You wake up.
Scalpel.
Scalpel.
Forceps.
Drill.
4-0 prolene.
No.
One voice.
Sit.
Just tell me.
Sit.
Drain blood.
Evacuate hematoma, but A lot of bleeding.
Trauma.
We keep sedated, wake up slow, help with swelling.
You leave the bone off? Yes.
She strong.
We do everything.
Now we wait Pray.
Well, we shouldn't be here much longer.
She's just coming out of surgery.
Look.
This is a little unorthodox.
I'm happy to give the summation, but I think we could be in the toilet on this one.
What?! This is pretty much a straight contract case, and there is a real question as to meeting of the minds.
Add to that, the benefit of the doubt won't go to you.
Any ambiguity is construed against the drafter, which in this case, is the hospital.
I think our case is stronger if you make it.
Me? Well, it seems I'm the one who delivered us to the commode.
I can do it.
That I cannot recommend.
I'm sorry, doctor, but your propensity to alienate cannot be overstated.
This is my passion.
If there's anything that That makes me a good person, it's my commitment to this program.
The question becomes, can you communicate that passion without making the judge hate you? Maybe not.
But if he's a good judge, he'll rule on the issue, not on my personality.
I know this issue.
Yeah, very good.
Okay, buck.
The ball is in your hands.
Is there anything That I could do? No.
I'm sorry.
I know this is hardly the time, but In moments like these, truths reveal themselves, you know? When you ask if there's anything you can do there really isn't.
There should be, you know? My best friend is lying comatose.
Sitting here right now, I'd I'd rather be alone.
Hey! Are you kidding me?! Did you give him this?! He was thirsty.
He doesn't feel well.
He doesn't feel well because of all the sugary drinks and fatty foods that he's been allowed to this is his problem! And so are you! Hey, lady, lay off my grandma.
Lay off? Y-you need to lay off crap like this! This will give you another heart attack! And if I can't get that through your head, I will take it up with child services.
In fact, that's the best idea I've had all day.
The ethical thing would have been for my client's mother to be told that her body parts, upon her death, would be used to derive revenue for the hospital, whether or not they saved lives.
The honest thing would be to tell people that even while there's a ban on organ sales in this country, there's nothing to stop the hospitals from selling tissues and parts to other countries, which they routinely do.
Your honor, this practice is not nearly as transparent as it needs to be, which can only cause people to distrust the program and result in fewer organ donations being made.
And that will cost lives.
Human life.
That's right up there with profit, isn't it? I'm Dr.
buck Tierney, chief of transplantation at Chelsea general.
Your honor, we charge for a lot of things.
Bad food in the cafeteria, the parking.
And we definitely make money on cosmetic surgery, some of which makes use of tissue and skin harvested at the time of organ donation.
But at our core, we are nonprofit.
And at our core, we are about healing and saving lives.
But you do also profit from some of these donations? We recover expenses.
Why not just be transparent? Wouldn't that make much more sense? Well, it might.
It might, your honor, but this whole this whole endeavor is dependent on the human spirit, on the proclivity of people who want to help their fellow man.
There is a fear that were we to publicize the reality that we do on occasion sell harvested tissue, people might be less inclined to want to donate.
But isn't that exactly Mr.
tompkins' point? Whatever point Mr.
tompkins made is buried in his demonizing of our program, sir, and I reject that.
We are not in the transplant business because it is big money we just are not.
To suggest that it is is as cynical as it is vile, your honor.
Now, I could parade before you hundreds well, thousands of people who are alive today because of the gift of a transplant.
Right now, worldwide, the number approaches one million.
It's one million people, your honor.
And right now, there are hundreds of thousands of people waiting.
They're desperate for an organ that may prevent their death.
Their only hope is this program.
And to think that this hope of theirs might get squashed.
Why? People like Mr.
tompkins who vilify the right now, young man, there's a father of two in our hospital.
His liver has failed, and he is dying.
He is dying.
Your mother's liver is a perfect match.
There's also a 7-year-old boy and a 5-year-old girl, and they are desperately praying that their father receives your mother's organ.
I Never met your mom, son.
Perhaps she'd want to answer these prayers.
Perhaps not.
- Anything? - No.
She just came off the thiopental, so We're just waiting for her to wake up.
Any signs of that? No.
Well, at least they caught the punk who did this, if that matters.
Tina? Do you know who this is talking to you now? This is the big cat standing here.
I need you to wake up, okay? My E.
R.
is undermanned.
I got patients.
So, I need you to wake up and get your ass down to the E.
R.
asap.
You feel me? Do you feel me? Let me know.
Okay, it seems to me, the best solution here would be to let the decedent's organs be used for life-saving purposes, but to exclude her skin and tissue from being utilized for cosmetic reasons.
Mr.
Malloy, does that seem fair? Uh, no.
No? May I ask why? I-I think my mother would be very angry at these people.
She would be very angry.
Why? She got knocked down by a skateboarder.
Then she goes to Chelsea general, a hospital that's supposed to s and they didn't save her.
They did nothing.
Things are not fair.
They did nothing.
She was my best friend.
We spoke every single day.
You just want to use her to save other people? Where was anyone to save her? You've every right to be angry, Mr.
Malloy.
And your mother certainly would be entitled to such anger.
But would she wish this to be her final legacy? How many hours since the surgery? Anybody keeping count? Five hours.
She's taken care of every one of us.
Pulled us all through various crises.
Are you kidding me? Now? It's 10:00 at night.
Harding, come on.
Now? Please take your seat, Dr.
Villanueva.
Dr.
Tierney.
How did it go? Fine.
We took only liver and kidneys.
The son seems Okay.
Right.
Let's get started, shall we? Dr.
Napur.
Join us, please.
Tell us about Darryl Fisher, would you? Darryl Fisher, 16, heart attack on his high-school campus.
Injury to the interior wall, obstruction in the right coronary artery.
Cardiac output mildly reduced.
I put in a stent, patient is recovering well in his room.
Well done, Dr.
Napur.
Did you do anything else? Perhaps file a neglect claim against the patient's caretaker? I reported the grandmother to child services.
Yeah, I did.
She was feeding the kid crap.
She brought him a giant frozen drink right here in this hospital.
You reported the patient's grandmother, his primary and only caretaker, to the authorities and accused her of child abuse.
You know what? As a cardiothoracic surgeon, I happen to be on the front lines.
The estimated cost of obesity-related illness is over $190 billion.
Heart disease, stroke, diabetes, cancer all the leading causes of preventable deaths.
And where are we on this? The medical community just sits back silently.
It's tantamount to malpractice.
We're supposed to be doctors, for God's sake.
Where is the outrage?! I'm sick of it! And if I have to start ratting out grandmothers to send a wake-up call, I will do it.
So, you're not just a doctor now.
You're a de facto state agent, fully vested with police powers.
I'm a doctor who is willing to take whatever steps necessary and suppose child services decides to intervene? Why the hell are we here right now?! It is 10:00 at night.
Why are you calling this meeting now?! You have somewhere to go, Dr.
Napur? You have a date? Harding, somebody I love very dearly is lying in a hospital bed.
A lot of people in this room That you would see fit to call this meeting at this time is are we supposed to suspend operations in this hospital now? Why can't it wait until tomorrow?! Because maybe now is the best time.
Why? If for no other reason, to keep ourselves occupied.
To keep ourselves occupied?! Yes! Are you kidding me?! That's what people do.
Occupy ourselves.
It's what people do, Dr.
Napur.
When loved ones lay Potentially dying.
And there's nothing we can do, we We occupy ourselves.
Your notifying child services, alleging child endangerment against a grandmother who's trying her best to rai you grossly overstepped your authority, Dr.
Napur.
And in my opinion, your human dignity.
As causes go, child obesity is a very serious one, but the manner in which Approximately, uh, six minutes ago Dr.
Tina Ridgeway Woke up.
She, um She held my hand.
She squeezed my hand when I asked her to.
She she said "hello.
" Language skills intact.
Hey.
Hey.
You look horrible.
So do you.
What's your excuse? Don't you ever do this to me again.
I'll try not to.
Oh, no, you don't.
This is an I.
C.
U.
There's no more than two people in here at a time.
Gladys, it's okay.
Not with me, it isn't.
I don't care that you're doctors Gladys.
Pick your battles.
Uh, how's she doing? Everybody quiet.
Need examine.
Hey, Sung.
I guess I owe you.
Quiet.
No talk.
Uh, don't want to check my language skills? It was the left side of my brain.
Quiet.
Who me? Who you? At the moment, I'm feeling a little like Dorothy.
Got knocked out, hit on the head, only to wake up surrounded by everyone I love.
Hey.
Hey.
She fine.
Need rest.
Yeah, sounds good.
I'm kind of tired.
Well, let's let her rest.
No.
I like it that you're all here.
Just let me just close my eyes for a sec.
Don't go.
The moon has a face and it smiles on the lake and causes the ripples in time She's really? I'm luck to be here with someone I like yes.
Recover.
Fine.
Who maketh my spirit to shine Amen.
Eh, brother? Don't let us get sick indeed.
Don't let us get old don't let us get stupid, all right? just make us be brave make us play nice let us be together tonight
Was she breathing on her own? A few agonal breaths.
Pupils? Left fixed, right barely reactive.
Has she responded at all? Some incomprehensible sounds, initially.
Glasgow score of four, but then nothing.
So we downgraded her to a three.
Get a stat C.
T.
page Dr.
Park.
Doctor! I've really been here a long time.
Whose patient are you? That's just the thing nobody's.
I-I've been in the waiting room for over two hours.
Okay, I need you to go back to the waiting room.
I promise we'll be with you as fast as we can.
Severe chest pain.
Difficulty breathing.
B.
P.
's 98/74.
O2 stat's 94.
Heart rate is 110.
Pain was 9 of 10 and administered aspirin and morphine en route.
I need a 12 lead EKG, stat.
What were you doing when the pain came on? This douche bag snatched my backpack, so I chased him.
Then I just my chest! Okay, let's get him into bay 1, quick.
Pleased to meet you tightness? Arm pain? Headache? Yeah.
My arms are fine.
I feel a little like puking.
S.
T.
segment elevation.
Ischemia in the inferior leads.
I'm going to give you something to put under your tongue.
I want you to tell me if it helps.
I need enzymes on him.
How old are you? Feeling better? About a four or five now.
Initiate code stemi.
Robidaux, I want you to stay with him, take him to the cath lab, and page Dr.
Napur.
This kid's having a heart attack.
Whoo GCS 3.
Collided with a skateboarder.
Cat scan shows a large left-sided hemorrhage.
Let's get her to the O.
R.
, save what brain function we can.
She gone.
It's only been an hour.
Come on, Sung.
She's here, and so are we.
Come on.
There it is, an obstruction in the right coronary artery.
Have you ever seen somebody this young with a heart attack? 16? No.
Inferior wall M.
I.
Ready to watch a cardiac stent? Okay.
Absolutely! So, Mr.
knox.
What's going on? Well, I had back surgery a couple years ago, and things have never been the same.
The pain's still pretty bad.
On a scale of 1 to 10? I'd say an 81/2? I mean, it comes and goes, but it's mostly continuous.
Is there anything in particular that brings on the pain? Everything in particular the bending, the lifting, the turning.
You guys prescribed something to me once before.
Um, what was it? Uh, lor lor-something? Lortab? I think that was it.
It really seemed to help.
How often do you take painkillers? Only when I need 'em.
Who is your primary? Uh, Dr.
wu over at Portland area physicians.
And what pharmacies are you using? Uh, the four-and-twenty around the corner.
No others? Why do I suddenly feel like I'm being interrogated? Look, are you on any other medications? No.
Do you currently take prescriptions for back pain? It's easy for us to check this out.
Yeah, no, I am, uh, but I'm such a spaz.
I spilled it in the bathroom sink, and so most of it got ruined.
That's why I'm here.
I-I need an emergency refill.
Okay.
Just relax.
I'll be back in a minute.
Well, where are you going? I'm going to make some phone calls.
I'll return with your treatment options.
Mr.
Malloy? How is she? It's not good.
The tests show there's no blood flow to her brain.
We tried everything we could but the damage was just too extensive.
She's dead? She is brain-dead, yes.
How can From colliding with a skateboarder? We are so sorry.
By the time she got to us, she was already gone.
C-can I see her? You can.
Of course.
We'll bring you back in just a bit.
Also, your mother was an organ donor.
We've contacted the registry, and someone from the organ procurement agency will be coming wait, wait, wait.
Can you give me a minute, just to process the fact that my mother's Before you start I-I I so apologize for the insensitivity of this, but we're required.
The timing on organ donation I need a minute, okay? Please, can you just give me a minute? Should I speak to him? Excuse me? You worse me, bedside.
Sung? Is that really necessary? The thing is, for us to make effective use of her organs I explained that.
Let's just give him a moment on this, okay? His mother just died.
Hey.
How you feeling? Okay, I guess.
Rough day.
What happened? Nothing new.
Some wank called me "man boobs," then grabbed my bag.
I started after him.
Then by the time we reached the field, everything just hurt.
Have you ever had pain during physical activity before? It's just uncomfortable, so I avoid it.
Take the elevator, ride the bus.
Darryl? Darryl.
Baby, are you okay? I'm fine, Nana.
Is this your grandmother.
Hi.
I'm Dr.
Sydney Napur.
What happened? Is he okay? Baby, are you okay? I had a heart attack.
A what? A what?! There was a blockage in his heart that was preventing him from getting enough oxygen.
We had to put in a stent to reopen the passageway.
Oh, my lord.
Um, he will be okay, but, uh But what? This young man needs to make some dramatic lifestyle changes.
He has asthma, he has a this had nothing to do with asthma, ma'am.
I don't think I like your tone, doctor.
Will his parents be coming in? If he had parents, they'd be here.
I'm his parent.
I'm okay.
I'm sorry, no.
I-I don't want her organs to be harvested.
S-she's a registered donor.
I understand that.
And it makes sense, she's a selfless person.
But I'm telling you, as her son, that registration doesn't reflect her true intent.
On what basis do you look.
My mother agreed to be an organ donor six years ago, I understand that.
What you guys need to appreciate is that I speak to her every single day, and I can tell you the person she is now, or Was an hour ago, and She wouldn't consent to having her organs harvested.
I'm afraid it's a legally-binding consent.
It's on her driver's license.
Your wishes can't override hers.
- Who is this ghoul? - Gregory.
It's a federal law.
It's called the uniform anatomical gift act.
The agreement your mother made is irreversible.
Which means that we are legally required to procure her organs.
I'm getting a lawyer.
Pasta.
Burgers.
Burritos.
That's what you serve? It's what he serves.
I work late, so Darryl usually takes care of dinner, which, more times than not, is either fast food or frozen.
Mrs.
Fisher, do you realize how bad that is? Processed food, fast food? It's what I can afford.
Eating this way is what's making Darryl so sick.
His lipid panels show very high risk.
He's severely obese.
Everyone in my family is You know, fat.
It's in our genes.
Does he get any exercise? I'll try to get on him about that.
You make it sound as if I failed him.
Well somebody has.
He's 16 with the body of a 50-year-old.
It's just so frustrating.
People think "it's just food.
What's the harm?" Food is public enemy number one.
It's practically the leading cause of death in this nation.
Food.
You know, I think I saw that kid once.
Fisher? He came in with a strep throat.
His cholesterol and triglycerides were through the roof.
Oh, at 16.
God, the nation nearly sat Shibah for the death of the twinkie.
Do you know what's actually in twinkies? Among other things, the ingredients found in rocket fuel.
Syd.
We're doctors.
We can only do so much.
We can't be tilting at windmills Or ding dongs Or snow balls.
It's really not funny.
What was Darryl's fractionation, anyway? Was it something ridiculous? I don't know.
I didn't run it.
You didn't run it? You just got the total? You didn't break it down? And now I'm in trouble.
Not even a lipid panel? I saw him for strep throat, so And you could see the kid was fat, with elevated cholesterol.
Can I please just eat? No, of course not.
I forgot.
Food is the enemy.
Well, food and me.
You know what? I think I'll, uh I'll just go smoke a cigarette.
Come on.
I'm not a drug addict.
I hurt my back.
Son, you're a drug addict.
Are you the poster boy? Is it needles or cocaine? No.
It's pain medication.
But you're a drug addict just the same.
You've been going to different E.
R.
's, multiple pharmacies, getting prescriptions for opiates, narcotics are you telling me that my pain isn't real? I am telling you you have a problem, one which I will not enable.
This is ridiculous.
Where's that blonde doctor? Son.
Don't call me "son.
" Okay? I am in serious pain here, and you're a doctor.
You need to treat me, you fat bastard! I'll treat you for a broken jaw.
Would you like to have one? Please.
I really hurt.
I believe you.
But more than anything, you need to detox.
Court? That kid is hauling us into court? How can he do that? By hiring an attorney, buck, and believe me.
Lawyers make very good haulers, but right now first of all, the woman's consent is legally binding.
Now being challenged by the son.
Second, if we do not harvest these organs quickly, the viability which is why we have to go to the courthouse now.
So, she's still hooked up to a machine? Well, Harding's going to fight the court order, while prospective donees are being put on standby.
It's absurd.
The woman signed a donor card.
Ohh.
Hey, I'm I'm sorry.
Hello.
I'm Asher knox.
We, uh, met briefly in the E.
R.
Yes.
Hi, I'm sorry to bother you, but, um That other E.
R.
doctor, the big guy, the African-American man, he He sort of threw me out.
Dr.
Villanueva wouldn't have turned you away if he felt you needed treatment, Mr.
knox.
Well, he he thinks I need drug treatment.
And, uh, I-I do.
I-I'm addicted to pain medication.
And I realize I need to get treatment for that, but but right now, I I just need help, period.
That Dr.
villa guy or whatever made some calls.
And, uh, I can't go to any more E.
R.
's or pharmacies.
H-h-he can't do that.
He he can't do that.
I mean, I I could sue you guys.
Look, we cannot give you drugs, so But I-I-it's just it's just to ease the pain, please.
It's not that simple.
It is that simple.
You think I want to be this way? Doctors did this to me.
Just just write me a script.
Tide me over for a little bit.
I can't do that.
Yes, you can! - Aah! - Hey! Tina? Tina? Probable hematoma, subdural, epidural.
Page Dr.
Wilson.
No, check that.
Dr.
Park.
Call Sung.
Some blood in her mouth.
I think it localized.
You okay? I'm fine.
Breath sounds are clear throughout.
What happened? She was attacked, head injury.
Tina? She's not conscious.
Pupils? Is she localizing? Any kind of response at all? We need a C.
T.
oh, my God.
My God.
Where is she now? Harding.
They just called our case.
Well, should she need surgery, I want Dr.
Park to perform.
You understand? Not Ty Wilson.
Just keep us informed.
We should be back within the hour.
Is everything okay? No.
Brain swell.
Subdural hematoma.
Prep surgery now.
Let's go.
Tina? Tina? Need take surgery now.
Brain bleeding.
I'm doing it.
I do.
I said I'm doing it! Stand down! Dr.
Wilson.
Dr.
Park will perform the procedure.
What am I missing here? She's a registered organ donor.
Yes, your honor, which would suggest that she agreed to have her organs harvested.
But in ascertaining the validity and therefore enforceability of any such agreement, we look to see if there was an actual meeting of the minds.
Here, I submit there was none.
Because? Well, there's no indication that she truly knew what organ donation even entails.
In fact, most people do not.
Why? Because they're simply not told.
One almost gets the sense that the less people know, perhaps the more likely they are to donate.
Your honor, if I might have a word.
Forgive me.
I don't mean to forsake any proper court decorum, but there are lives, innocent lives, hanging in the balance, and I would hate for those lives to be hinged on Mr.
Tompkins's talent for brevity.
And who are you? Forgive me.
My name is Harding Hooten.
I'm the chief of staff at Chelsea general.
Excellent! What a splendid idea.
Let's hear directly from Chelsea general's chief of staff.
We can all learn firsthand about the organ-donation business.
And in the process, we could even save time.
Your honor, might we put Dr.
Hooten under oath, in the interest of accuracy? I guess my question would be or I should say my assumption When a person say, like my client's mother checks the "organ donor" box on her driver's license application, is it made clear to her that not only her organs may be harvested, but also her skin and her tissue? I really have no idea what your client's mother was specifically told.
Here's the paperwork Mrs.
Malloy signed.
Oh, well, it's actually an application for a driver's license with a little box to check.
Is there anything in here declaring that her tissue and skin would be harvested? I believe online there is a section for exclusions should you ah, you'd have to go online to read it.
The reality is most people do not.
In fact, there is no way to specify, "do not sell my tissue for cosmetic use.
" Most people, my client's mother being one of them, simply have no idea that hospitals derive huge revenues from these tissues, tissues sometimes used for things like penile enlargements, lip-plumping, wrinkle repair, nose cartilage.
You think my client's mother knowingly agreed to let her body parts be used posthumously to augment a male recreational appendage? The majority of organs are used for life-saving measures.
We don't is it your testimony, doctor, that Chelsea general does not use or sell organ donations for profit? Yes, money is made allowing outside companies to harvest tissue for cosmetic use? Mr.
tompkins, what we are endeavoring to do here today is to use your client's mother's liver and kidneys to save three lives.
Should you not be able to read that in the form perhaps not, because nowhere in the fine print is it prominently declared that you are a putz.
It's my client who feels like a putz today, sir, sitting here as you're about to carve up his mother for profit.
Well, then, perhaps you should tell your client that we are using his mother's body parts to save human life.
For someone who lays claim to full disclosure, why are you throwing up trees to obscure his view of the forest? The forest here is the not-so-underground transplant industry that reaps millions, if not billions of dollars.
Oh, now you are overstating the case.
It's a racket.
A racket?! If Mrs.
Malloy's skin graft goes from here to Hoboken to cover a nose burned off a 5-year-old to prevent his a life being one of scorn and disfigurement, that, sir, is not a racket! What do you think you're doing? I'm going in there.
That's what I'm doing.
She's my best friend.
And should she become unstable, I want to be there.
You got a problem with that? Nope.
Trauma craniotomy.
Evacuate subdural hematoma first, deal with other injuries later.
Her B.
P.
's up and her heart rate's down.
Should we give her meds, bring that pressure down, too? No.
Kill her.
Bring down, dead.
What coags? Normal.
C.
T.
on monitor? Already up.
Gee, Sung, take your time.
No big rush.
You want be here? Be quiet.
Doctor.
Five seconds.
You wake up.
You be strong, and you wake up.
I love you, Tina.
I love you.
You wake up.
Scalpel.
Scalpel.
Forceps.
Drill.
4-0 prolene.
No.
One voice.
Sit.
Just tell me.
Sit.
Drain blood.
Evacuate hematoma, but A lot of bleeding.
Trauma.
We keep sedated, wake up slow, help with swelling.
You leave the bone off? Yes.
She strong.
We do everything.
Now we wait Pray.
Well, we shouldn't be here much longer.
She's just coming out of surgery.
Look.
This is a little unorthodox.
I'm happy to give the summation, but I think we could be in the toilet on this one.
What?! This is pretty much a straight contract case, and there is a real question as to meeting of the minds.
Add to that, the benefit of the doubt won't go to you.
Any ambiguity is construed against the drafter, which in this case, is the hospital.
I think our case is stronger if you make it.
Me? Well, it seems I'm the one who delivered us to the commode.
I can do it.
That I cannot recommend.
I'm sorry, doctor, but your propensity to alienate cannot be overstated.
This is my passion.
If there's anything that That makes me a good person, it's my commitment to this program.
The question becomes, can you communicate that passion without making the judge hate you? Maybe not.
But if he's a good judge, he'll rule on the issue, not on my personality.
I know this issue.
Yeah, very good.
Okay, buck.
The ball is in your hands.
Is there anything That I could do? No.
I'm sorry.
I know this is hardly the time, but In moments like these, truths reveal themselves, you know? When you ask if there's anything you can do there really isn't.
There should be, you know? My best friend is lying comatose.
Sitting here right now, I'd I'd rather be alone.
Hey! Are you kidding me?! Did you give him this?! He was thirsty.
He doesn't feel well.
He doesn't feel well because of all the sugary drinks and fatty foods that he's been allowed to this is his problem! And so are you! Hey, lady, lay off my grandma.
Lay off? Y-you need to lay off crap like this! This will give you another heart attack! And if I can't get that through your head, I will take it up with child services.
In fact, that's the best idea I've had all day.
The ethical thing would have been for my client's mother to be told that her body parts, upon her death, would be used to derive revenue for the hospital, whether or not they saved lives.
The honest thing would be to tell people that even while there's a ban on organ sales in this country, there's nothing to stop the hospitals from selling tissues and parts to other countries, which they routinely do.
Your honor, this practice is not nearly as transparent as it needs to be, which can only cause people to distrust the program and result in fewer organ donations being made.
And that will cost lives.
Human life.
That's right up there with profit, isn't it? I'm Dr.
buck Tierney, chief of transplantation at Chelsea general.
Your honor, we charge for a lot of things.
Bad food in the cafeteria, the parking.
And we definitely make money on cosmetic surgery, some of which makes use of tissue and skin harvested at the time of organ donation.
But at our core, we are nonprofit.
And at our core, we are about healing and saving lives.
But you do also profit from some of these donations? We recover expenses.
Why not just be transparent? Wouldn't that make much more sense? Well, it might.
It might, your honor, but this whole this whole endeavor is dependent on the human spirit, on the proclivity of people who want to help their fellow man.
There is a fear that were we to publicize the reality that we do on occasion sell harvested tissue, people might be less inclined to want to donate.
But isn't that exactly Mr.
tompkins' point? Whatever point Mr.
tompkins made is buried in his demonizing of our program, sir, and I reject that.
We are not in the transplant business because it is big money we just are not.
To suggest that it is is as cynical as it is vile, your honor.
Now, I could parade before you hundreds well, thousands of people who are alive today because of the gift of a transplant.
Right now, worldwide, the number approaches one million.
It's one million people, your honor.
And right now, there are hundreds of thousands of people waiting.
They're desperate for an organ that may prevent their death.
Their only hope is this program.
And to think that this hope of theirs might get squashed.
Why? People like Mr.
tompkins who vilify the right now, young man, there's a father of two in our hospital.
His liver has failed, and he is dying.
He is dying.
Your mother's liver is a perfect match.
There's also a 7-year-old boy and a 5-year-old girl, and they are desperately praying that their father receives your mother's organ.
I Never met your mom, son.
Perhaps she'd want to answer these prayers.
Perhaps not.
- Anything? - No.
She just came off the thiopental, so We're just waiting for her to wake up.
Any signs of that? No.
Well, at least they caught the punk who did this, if that matters.
Tina? Do you know who this is talking to you now? This is the big cat standing here.
I need you to wake up, okay? My E.
R.
is undermanned.
I got patients.
So, I need you to wake up and get your ass down to the E.
R.
asap.
You feel me? Do you feel me? Let me know.
Okay, it seems to me, the best solution here would be to let the decedent's organs be used for life-saving purposes, but to exclude her skin and tissue from being utilized for cosmetic reasons.
Mr.
Malloy, does that seem fair? Uh, no.
No? May I ask why? I-I think my mother would be very angry at these people.
She would be very angry.
Why? She got knocked down by a skateboarder.
Then she goes to Chelsea general, a hospital that's supposed to s and they didn't save her.
They did nothing.
Things are not fair.
They did nothing.
She was my best friend.
We spoke every single day.
You just want to use her to save other people? Where was anyone to save her? You've every right to be angry, Mr.
Malloy.
And your mother certainly would be entitled to such anger.
But would she wish this to be her final legacy? How many hours since the surgery? Anybody keeping count? Five hours.
She's taken care of every one of us.
Pulled us all through various crises.
Are you kidding me? Now? It's 10:00 at night.
Harding, come on.
Now? Please take your seat, Dr.
Villanueva.
Dr.
Tierney.
How did it go? Fine.
We took only liver and kidneys.
The son seems Okay.
Right.
Let's get started, shall we? Dr.
Napur.
Join us, please.
Tell us about Darryl Fisher, would you? Darryl Fisher, 16, heart attack on his high-school campus.
Injury to the interior wall, obstruction in the right coronary artery.
Cardiac output mildly reduced.
I put in a stent, patient is recovering well in his room.
Well done, Dr.
Napur.
Did you do anything else? Perhaps file a neglect claim against the patient's caretaker? I reported the grandmother to child services.
Yeah, I did.
She was feeding the kid crap.
She brought him a giant frozen drink right here in this hospital.
You reported the patient's grandmother, his primary and only caretaker, to the authorities and accused her of child abuse.
You know what? As a cardiothoracic surgeon, I happen to be on the front lines.
The estimated cost of obesity-related illness is over $190 billion.
Heart disease, stroke, diabetes, cancer all the leading causes of preventable deaths.
And where are we on this? The medical community just sits back silently.
It's tantamount to malpractice.
We're supposed to be doctors, for God's sake.
Where is the outrage?! I'm sick of it! And if I have to start ratting out grandmothers to send a wake-up call, I will do it.
So, you're not just a doctor now.
You're a de facto state agent, fully vested with police powers.
I'm a doctor who is willing to take whatever steps necessary and suppose child services decides to intervene? Why the hell are we here right now?! It is 10:00 at night.
Why are you calling this meeting now?! You have somewhere to go, Dr.
Napur? You have a date? Harding, somebody I love very dearly is lying in a hospital bed.
A lot of people in this room That you would see fit to call this meeting at this time is are we supposed to suspend operations in this hospital now? Why can't it wait until tomorrow?! Because maybe now is the best time.
Why? If for no other reason, to keep ourselves occupied.
To keep ourselves occupied?! Yes! Are you kidding me?! That's what people do.
Occupy ourselves.
It's what people do, Dr.
Napur.
When loved ones lay Potentially dying.
And there's nothing we can do, we We occupy ourselves.
Your notifying child services, alleging child endangerment against a grandmother who's trying her best to rai you grossly overstepped your authority, Dr.
Napur.
And in my opinion, your human dignity.
As causes go, child obesity is a very serious one, but the manner in which Approximately, uh, six minutes ago Dr.
Tina Ridgeway Woke up.
She, um She held my hand.
She squeezed my hand when I asked her to.
She she said "hello.
" Language skills intact.
Hey.
Hey.
You look horrible.
So do you.
What's your excuse? Don't you ever do this to me again.
I'll try not to.
Oh, no, you don't.
This is an I.
C.
U.
There's no more than two people in here at a time.
Gladys, it's okay.
Not with me, it isn't.
I don't care that you're doctors Gladys.
Pick your battles.
Uh, how's she doing? Everybody quiet.
Need examine.
Hey, Sung.
I guess I owe you.
Quiet.
No talk.
Uh, don't want to check my language skills? It was the left side of my brain.
Quiet.
Who me? Who you? At the moment, I'm feeling a little like Dorothy.
Got knocked out, hit on the head, only to wake up surrounded by everyone I love.
Hey.
Hey.
She fine.
Need rest.
Yeah, sounds good.
I'm kind of tired.
Well, let's let her rest.
No.
I like it that you're all here.
Just let me just close my eyes for a sec.
Don't go.
The moon has a face and it smiles on the lake and causes the ripples in time She's really? I'm luck to be here with someone I like yes.
Recover.
Fine.
Who maketh my spirit to shine Amen.
Eh, brother? Don't let us get sick indeed.
Don't let us get old don't let us get stupid, all right? just make us be brave make us play nice let us be together tonight