The Resident (2018) s03e01 Episode Script

1 - Previously on The Resident.
- How's Jessie? Her kidneys are failing.
So my kidneys will never work again? The drug trial did irreversible damage.
I will have a triple transplant and make history.
Maybe even come here as an intern.
I can't think of anything more amazing.
Red Rock Mountain Medical is the top health care conglomerate in the southeast.
We don't need Chastain.
We will be stronger together.
We have to keep fighting.
The risk is pretty low for the donor.
Anybody need a kidney around here? Thank you, Dad.
Dad.
- You're my baby girl.
- It's gonna be okay.
Where's the crash cart?! Mm.
Black-eyed Susans are my favorite.
Remember that time you ran away from our family picnic? Must've been, like, four or five.
Yeah.
Mom and Dad were frantic, but I knew where to find you.
Here.
Dad was so sweet that day.
He he was crying when he picked me up, and I I remember I was so happy in his arms.
I keep trying to rewind the clock.
There must have been something I could have done differently.
Remember what I told you, Nic? This is not your fault.
It's getting late.
It's time.
We need to scatter her ashes.
Nicky, honey, it's been almost a month.
I'm not ready.
Welcome to another rewarding day under the heel of Red Rock Mountain Medical.
"Red Rock, Red Rock.
" How's Nic? UH, THE SAME: not good.
We're all worried about her.
We miss her.
How can we help? She'll be here this morning for her dad's post-op.
I'll talk to her.
Sounds good.
Where's Jonah? I took my eyes off him for two seconds and he disappeared.
You know, he's probably hiding somewhere.
He's afraid of needles.
How much do you expect to make with this new neurosurgery center? A steady churn of high-risk invasive brain and spine procedures generates half a billion a year.
And this new neurosurgeon you want to have he's a rainmaker? He was at his last hospital.
He will be if he comes here.
- When are you seeing him? - Lunch today.
He won't commit to Chastain unless the two of you get along.
I'll work my charm.
I couldn't sleep last night, thinking about coming back here.
Come on.
Jessie! Keep trying! You ever gonna be able to work in this place again? I don't know.
This is where Jessie was killed.
No one killed Jessie, Dad.
She went into surgery with a weakened heart and died of a massive blood clot.
It's a known complication that could happen to anyone.
Yeah, well, I just want to see her records.
Get another opinion on what caused her death.
Why? They did the autopsy.
I saw the results.
Yeah, we should just get an expert to check it, that's all.
I We may have a case to bring a lawsuit.
Unbelievable.
Always looking for an angle, even in your daughter's death.
No, I'm not looking for an angle.
And this is not about money.
But somebody here - has to be held responsible.
- Jessie's gone.
And she's not coming back.
There's no point in affixing blame.
I mean, I don't blame you, after all.
You Me? What? Why would you? I put my life on the line.
I donated a kidney.
Eventually.
It did no good.
So you blame me, because you're down a kidney and Jessie still died.
- No, I don't.
- Yeah, you do.
You blame me because I pushed for the surgery.
It was her only chance.
I did everything I could - to protect her.
- Whoa, whoa, whoa.
Whoa, whoa.
Nic, I do not blame you.
Do the post-op on your own.
I-I got to take a walk.
Oh, come on.
Okay.
Excuse me.
Just one second.
I'll be right back.
Welcome, Eloise, to your first day as a sub-intern at Chastain.
I feel like I'm dreaming.
I've imagined this moment so many times.
I-I can't believe it's real.
Devon.
- You remember Dr.
Pravesh? - Of course.
Eloise.
Last time I saw you, you were recovering - from a triple transplant.
- Now I'm hoping to match here, and become a doctor at the hospital - that saved my life.
- Well, you can learn a lot from this guy.
He's our top intern.
And soon he'll be a second-year resident - with an intern of his own to torture.
- Oh, yeah.
Oh, yeah.
Don't do that.
Now, Dr.
Pravesh is gonna go over all the additional safety precautions you need to take when you're around patients.
You do know that I've been dealing with cystic fibrosis my entire life.
I'm kind of an expert in infection control here.
I promise, I can take care of myself.
I'll hold you to that.
Dr.
Hawkins, I need a hand.
An eight-year-old has gone missing.
His name is Jonah.
He, uh, he was right here in the bed and I went to get some water.
Someone thinks they saw a little boy enter the stairs to the basement.
I don't know why they didn't stop him, but I'm going to check.
Annie? Conrad.
What? - Wow.
- What? Oh, I haven't seen you since Oh, the mountain bike race at Stone Mountain.
Right? What, two years ago? Yeah.
- Oh, it's so good to see you.
- You too.
So they needed another PhD particle physicist - to fix this thing again? - Yeah, well, you know, the plumber tried to snake it, but you know how fussy these proton beam accelerators can be.
They are fussy.
Is everything all right? Came down here looking for a little boy who ran away from the ER.
Oh, well, I didn't see anyone.
You know what, let's check the treatment room.
Hey, hey, hey, wait, I smell gas.
W What the hell was that? What happened? An explosion in the proton beam accelerator room.
Fi-Fire.
Don't move.
I have to find the boy.
Jonah.
Jonah.
Let me go.
Let me I just I have to find Jonah.
My baby.
I No, no, no.
I have to find him.
I have to find What's going on? Where's Conrad? He went down there.
Oh, my God.
Right here, right here.
Conrad! Conrad, it's Nic.
Open the door.
Open the door.
Oh, my God.
You're bleeding.
No, I'm okay.
I'm okay.
- I can't get the door.
- Let me-let me try, let me try.
Oh, it must have been damaged in the explosion.
It's jammed shut.
Get out of the building.
There's a fire.
- The whole place could go up.
- We're not leaving you.
Is anyone else with you? A woman and the boy, both badly injured.
Go back, get somebody to break down the door - and then get out of here.
- Go! Go! Nic, get out of here! - Go.
- No.
Go! Annie.
Annie! Annie.
Can you crawl to the door? - Yeah.
Yeah.
- Go.
Go.
Conrad?! Oh, my God.
Wake up.
You're okay.
We need some help over here! Hey.
Hey, hey, hey.
Hey, hey.
You're safe.
The fire's out.
There was a gas leak, but they capped it off.
Where are Annie and Jonah? They're both alive and they're being treated now.
Dr.
Hawkins, I'll strap you down if I have to.
You were exposed to a lot of smoke and the blast may have caused other injuries.
- You have any pain? - All over.
He may have a fractured rib.
My left ankle's killing me.
It's really swollen.
Add it to the list of imaging we need.
Okay.
- Pupils equal and reactive.
- Have we scared you off - your first day? - Are you kidding? I'm good.
Eloise, the ER is no place for a triple transplant survivor.
I'm gowned, gloved, masked, safe as everyone else.
Please, let's focus on the patient.
My neck it hurts.
- We need to maintain his C-spine.
- We got you, buddy.
I know it's hard.
Try not to move your head.
Airway intact.
Breath sounds clear bilaterally.
We should put him on high-flow oxygen in case of possible - carbon monoxide exposure.
- Good call.
Let's get him in a face mask.
Make sure to send - a carboxyhemoglobin level.
- Eloise, help me out.
- How's he looking? - Minor injuries and burns.
But I'm concerned about his C-spine.
Jonah, can you squeeze my finger? Possible spinal cord injury.
Let's get him to CT now.
All right.
Let's go.
BP 60/40, tachy in the 140s.
- She's crashing.
- Bolus a liter LR and get blood ready for transfusion.
No breath sounds on the left.
- Trachea deviated on the right.
- Tension pneumo.
The shrapnel must've pierced her lung.
- Chest tube kit.
- No time.
Scalpel.
Sats are coming up, but her pressure's still tanking.
Irving, chest tube.
Okafor, ultrasound.
Abdomen is filled with fluid.
- She's hemorrhaging.
- Damn shrapnel.
She's not stable for CT.
Let's take her to OR.
Now.
- Where are you taking her? - OR Two.
Hey, can you finish this? Thanks.
Nic.
What the hell Are you all right? - I'm fine.
- What about Conrad? He's banged up pretty bad, but he'll be okay.
Thank God.
The other two weren't so lucky.
What can I do to help? Nothing.
Just go home.
Take the keys.
- Nic, come on.
Hey.
- I'm gonna stay with him.
Nic, Nic.
Nic.
Shrapnel everywhere.
This woman has saved a lot of lives.
It's time we save hers.
I'll take the chest.
You got the abdomen.
Here, sit down.
Yes, ma'am.
I did triathlons with Annie.
I saw her once give up the lead in a race just to help someone who took a fall.
That's Annie.
Does she have any family that we need to notify? I'm not sure.
I know she got a divorce.
And then, not long after that, her son died in a car accident.
God, that's awful.
Just ran the bowel.
No obvious injuries.
Shrapnel by the abdominal wall.
Well, I took out three from the chest wall.
The last one I see is there.
Lodged into the aortic arch and abutting the pulmonary artery.
- Of course.
- We pull this out, she might blow.
She might blow if we don't pull it out.
Well, she won't, because you know what to do, right? Yes, I do.
I'll clamp the proximal and distal aorta and control the PA with vessel loop, just in case.
Nice job.
And pull on three.
One, two, three.
Pressure's dropping fast.
All right, we got this, Chu.
Just buy us some more time.
We're maxed on pressors.
All right.
We are done.
Look at that.
Pressure's coming back.
Of course it is.
I love this game.
Wonder Twins do it again.
5-0 Prolene.
Hey, what's going on? I'm, uh faking a fainting spell to get your attention.
Come on, lie down.
Careful.
I told you it was too soon to get off that gurney.
I just I just need some fluids.
- I'm light-headed.
- Okay.
- I'll get you an IV.
- No, don't.
Stay with me.
Okay.
When I saw you lying on the ground I thought I was so scared.
I'm not going anywhere.
You're stuck with me.
I love you.
I love you, too.
I've only seen this one time before in my entire career.
Occipital-cervical dislocation.
What does that mean? Internal decapitation.
It's when the spinal column is separated from the skull base.
The blast from the explosion must have done this.
Well, the patient you saw before did they make it? No.
Most don't.
Let's get him to the OR.
SSEPs and MEPs on.
Fusing C1 and C2.
Blast.
Again.
It's the cord.
Gonna have to perform a laminectomy to give the cord more room, then fuse.
Doesn't that mean he could end up a quadriplegic? Not if I can help it.
Rongeurs.
What are you still doing here? You're supposed to be meeting Dr.
Cain.
Two of today's patients are still critical.
And they're being taken care of.
You're not needed here.
Dr.
Cain is not a man you keep waiting.
Do you know how much he bills? Uh $80 million a year.
80 million.
I want you to focus on that number.
Got it.
Oh! Oh.
Kit Voss just reattached that boy's head.
If she'd been off by a fraction of a millimeter, an eight-year-old would be paralyzed for life.
Or dead.
Dr.
Voss bills two million a year.
Cain is our future.
Voss is our past.
I can't guarantee her contract will be renewed.
What we need is more doctors like that.
Ah.
Thank you.
Dr.
Cain.
- Call me Barrett.
- Randolph.
It's an interesting hobby you got here.
Yeah, it's outsider art, all from Georgia.
Wherever I live, I try to immerse myself in the local culture.
Can I get you both some champagne? No.
That would be lovely.
Yes, please do.
Are we the only ones here? - Show's not open yet.
- Oh.
They offered me a preview.
I don't know probably thought I was more likely to buy if I had first pick.
They were right.
Hey, I'm sorry I'm late.
We had a bit of an emergency this morning.
Yeah, I heard about that.
Is it true that the proton beam therapy facility is a total loss? Yeah.
$220 million investment destroyed.
If I didn't know better, I'd think Red Rock blew it up themselves.
I was thinking the same exact thing.
Proton beam therapy facilities they lose millions annually.
Well, when Chastain built it, they had profit projections way north of reality.
How far north? The arctic circle.
And now Red Rock walks away with a big insurance payout.
Where I grew up, they call that insure and burn.
Or a stroke of good luck.
Except, of course, for the two people who nearly died.
See anything that tempts you, Dr.
Cain? Most definitely.
I'll take that one.
Great choice.
I'll get the paperwork going.
This is gonna double its value in five years.
And if it doesn't, is it still art? Oh, it will.
It will.
Lunch at the Provence Grill? - On Red Rock Mountain Medical.
- Oh, well, in that case, I'll have the oysters and more champagne.
Thank you.
I want to go check on Annie.
Okay, let's go.
Uh, Mina wants to talk to you.
I'll be fine.
I won't do anything crazy.
I'll come find you.
How's he doing? The ankle's gonna be an issue for a while, but I'm just so glad he's okay.
Mm.
And how are you? We've all been worried.
You're probably the one person I know who understands how I feel.
Does it ever get any easier? I wish I could promise you it would.
Walk with me.
When my sisters died, I could hardly get out of bed for two years.
I do not want that to happen to you.
Every day, I wake up, and the first thing I think is she's not here.
And she's never gonna be here again.
It's like there's a hole in your heart that you'll never fill.
My whole life, I had one job.
Take care of Jessie.
Okay, that was not your only job.
You take care of so many people.
I know, I know.
My patients need me.
No, I was not gonna say that.
What I was gonna say is that you you need your patients.
Work, Nic, is the only way out of grief.
- Thank you.
- Yeah.
See the mother and child? Think something's wrong.
- Hey.
- I know.
- You okay? - Um It's my baby.
She's been sick, coughing and wheezing.
Well, let's get her in to see a doctor.
No.
The last time I went into an ER, it cost me $6,000.
The hospital sued me when I couldn't pay, and now they're docking it from my paycheck.
We can't live off what we have left.
I came here to have her seen in the free clinic, but it was closed.
That's horrible.
So I've been waiting out here, hoping Diana would get better.
She's wheezing badly.
We need to get her in there now.
Oh, it's okay.
- Come on.
- Come on.
Surgery was successful.
We're certain we got all the shrapnel.
How do you feel? Like I just got split in half.
How are you doing? That's typical Annie Diamonte.
Worried about everybody but yourself.
I got a few bruises.
Small fracture of an ankle bone, but it won't even need surgery.
We should stop talking.
You need your rest.
In the injury Olympics, you solidly got me beat.
When can I go home, Dr.
Hawkins, do you think? I'd rather not stay here any longer than I have to.
What like, what, a week or two? Temperature's 102.
5.
- Sats are back up in the 90s.
- Is she okay? She has bilateral wheezes and is using accessory muscles.
Likely an infection.
Labs are back.
Viral swab is positive for RSV.
Everyone put on a mask and gown.
Eloise, RSV is extremely dangerous for people who have had a lung transplant.
I'm aware.
I'm gloved.
I'm gowned.
I have a mask.
Can you all please stop coddling me and treat me like any other sub-I? No, because you aren't any other sub-I.
This has gone on long enough.
Please leave.
Now.
Dr.
Feldman's right.
I'll come find you when I'm done here.
Right lower lobe infiltrate, and her white blood cell count and procalcitonin are up.
I'm afraid she might have developed a bacterial pneumonia.
Oh, God, I'm so sorry.
What did I do? Even with continuous nebs, her respiratory rate is still in the 40s.
We might need to intubate.
Let's get her on IV ceftriaxone and azithro, and let's get her to the PICU now.
What? So, it looks like RSV plus a bacterial pneumonia.
Probably strep, if I were to put my money on it.
The most common bacterial pathogen - in children her age.
- Not bad.
You know your stuff.
My expertise in infection control is only surpassed by my encyclopedic knowledge - of lung disease.
- Cystic fibrosis will do that.
Sure will.
Some of your antirejection meds will cause that tremor.
Goes away over time.
Shouldn't be a problem by intern year.
Look, I'm sorry that Dr.
Feldman was harsh back there, but it is our job to keep you safe.
This is my body and my life.
I'm not anybody's kid to protect.
Safety isn't my main priority.
I go white water rafting every chance I get.
I even go skydiving.
You're not scared? Course I'm scared.
Every time I cough, I think about rejection.
But I want to live, and that means risk.
What you all need to remember is I'm a doctor in training now, not your patient.
I couldn't understand what was going on in the ER.
What's wrong? I promise you she's in great hands.
She has RSV and bacterial pneumonia.
She needs oxygen, antibiotics - and fluids.
- I can't believe I let it get this bad.
- If only I - It's not your fault.
You were put in an impossible situation.
The system is broken.
Yeah.
- You the mom? - Yeah.
You can come in now.
She's doing better.
Thank you.
Hmm.
If the clinic were still open, we could have treated her daughter with antibiotics and avoided all of this.
Red Rock cut the funding.
You can't run a clinic without money.
Mm-hmm.
But if you came back, we could find the money.
One way or another.
I can't do it alone, but we can together, Nic.
Yeah, it's palinopsia.
She's continuing to see something after it's no longer there.
Very common after head trauma.
Don't tell me we got this woman through a fire, an explosion and a life-threatening injury only to find out she has a brain tumor.
I just heard.
Annie has a brain tumor? I'm so sorry.
How bad is it? Well, she has a posterior cortical lesion, a small hemorrhagic component and edema.
That accounts for her new symptoms.
No signs of cancer anywhere else.
Yet.
So it might not be metastatic.
The radiologist couldn't be certain.
We need to see the pathology report.
Cain is certain he can remove all of it.
What? He can't know that until he's actually in there.
Dibs.
Would you like me to start your playlist, Dr.
Cain? You know it.
Oh, oh, oh, oh Texas born and bred.
Yeah, I'm gonna take my horse To the old town road I'm gonna ride till I can't no more Probe.
To the old town road - I'm gonna ride - Kio - Till I can't no more - Kio I got the horses in the back Horse tack is attached Hat is matte black Got the boots that's black to match Ridin' on a horse, ha You can whip your Porsche I been in the valley You ain't been up off that porch, now Can't nobody tell me nothin' You can't tell me nothin' Can't nobody tell me nothin' You can't tell me nothin' My life is a movie Bull ridin' and boobies Cowboy hat from Gucci Wrangler on my booty Forceps.
Can't nobody tell me nothin' You can't tell me nothin' Can't nobody tell me nothin' You can't tell me nothin' Yeah, I'm gonna take my horse to the old town road I'm gonna ride till I can't no more I'm gonna take my horse to the old town road I can promise the margins will be clean.
That's one for the win column.
Send that to pathology.
Close it up.
- Cain did that in under five minutes.
- Yeah, but can we be sure he got it all and left her intact? Haste usually isn't a virtue in surgery.
Especially on the brain.
He's trusting a resident he's never met to close, unsupervised.
I wonder if he even cares about the pathology report.
His job is done, guys.
Is that thing in my head? You know none of this would've happened if you hadn't run away from me in the ER in the first place, right? You have to promise me you will never do that again, okay? This is a bummer.
I know, but the good news is you'll make a full recovery and be as good as new.
Thanks to Dr.
Voss.
Thank you so much.
Oh.
You're welcome.
That was fine work.
I fully admit I live for days like this.
It's why I love my job.
So Dr.
Cain is throwing a private party this Saturday.
I heard.
Just for our top doctors.
How lovely for you all.
- You're invited.
- No, I'm not.
I'm inviting you now.
I want you to meet Cain and get to know him.
Do you like him? He's impressive by any measure.
So far, I like him very much.
I just I want him beside me as your advocate.
I need an advocate? Yes.
Because I don't bill enough.
If It doesn't matter what the reason is.
I know your value as a doctor and as a friend.
And your place at Chastain will always be secure as long as I'm CEO.
I would just like you to have this man as an ally.
I'll pick you up at 6:00.
Looking very distinguished with your cane.
Thank you.
Small consolation on a rough day.
What did Annie's pathology report say? It's melanoma.
Which means Annie probably has Stage IV cancer.
God, I'm so sorry.
Not exactly one for the win column.
Cain already broke the news that she has a terminal diagnosis.
I'll at least give the guy credit for doing that.
Annie.
Mm-hmm.
It is so good to see you.
This is Nic Nevin.
She's been with me, following your case throughout the day.
I just wanted to say thank you so much for everything you did during the fire.
Oh, it's nothing that you wouldn't have done in my place.
Is there anything that we can do for you? How are your spirits? That's what we want to know.
It's crazy, but my spirits are really good.
You know, after talking to Dr.
Cain, I feel like the luckiest unlucky person ever.
- What did he say? - Well, he said if I hadn't have been in the basement and gotten injured, it's possible they might not have caught my cancer in time.
What did Dr.
Cain say about what's ahead? Well, if this was a few years ago, he would've been arranging hospice care.
But today, with all the drugs for melanoma, I could be around for decades to come.
That's true.
Immunotherapy has had great success with melanoma, and they're always coming out with new things.
And Dr.
Cain said I just need to be positive.
- Fight through it, right? - Right.
I don't want to think about death any more than I already have.
Conrad told me you lost your son.
I'm very sorry.
Yeah.
That's when I stopped racing.
I see it was a big mistake now.
Y-You can't stop living your life just 'cause someone you love has lost theirs.
You got to remember the good times.
Get rid of the bad times and go on.
I'm gonna compete again real soon.
I'm just gonna fight to get well and fight through the chemo.
And you know who's gonna be with me right through it? My son.
Because, you see, he he never really left me.
He just came to live here, in my heart.
Let's make it last forever 'Cause the night's still young It's true, I feel the pressure Every time you're gone Wow.
His office has a better view than mine.
And what does that tell you? That he bills 80 million a year.
You're kidding.
You didn't tell me that.
Well, if I had, you wouldn't be here.
You know as well as I do that anyone - who bills that much runs multiple ORs - Shh, shh.
- At the same time, overtreats, - Okay.
Okay.
Has side deals with device companies.
Okay, okay.
So I shouldn't have told you, just don't start.
This-this is the reality of health care today.
We'll fight it when necessary, we'll accommodate when possible, and we'll deal with it to survive.
Barrett.
I would like you to meet our very best orthopedic surgeon and my good friend, Dr.
Kit Voss.
I'm glad to finally meet you.
What you pulled off saving a child who suffered an internal decapitation - that was miraculous.
- Oh, thank you.
Flattery will get you everywhere with anyone but me.
A word, Randolph.
- When you get a minute.
- Absolutely.
Pleasure.
Why'd you do that? W-What is the point of alienating the man? What is the point of making nice when I know who he is? I am still trying to wrap my head around the fact that you hired someone who so obviously has an ego the size of Texas.
I Red Rock Mountain Medical hired him, and I understand why they did.
Health care is a business.
I'm a realist.
This is what's happening from coast to coast.
They're recruiting guys like Cain.
It's everywhere.
And doctors like me, who put our patients first, - are collateral damage.
- No.
I'll start interviewing elsewhere immediately.
- No.
K-Kit.
Please, don't.
Don't.
- I'm sorry.
But I don't belong here.
I see your, uh, your companion left.
- Yeah.
- You know what, I don't want you to spend this evening alone.
See that young lady right there? I can introduce you.
I'm telling you, Randolph, stick with me and we'll rise together.
The sky's the limit for men like us.
Ladies, thank you for coming.
Silent soldier in the night I need you to help me with something.
I, uh, I can't rest.
I can't let Jessie go without knowing what really happened.
Please, just take a look at this.
It's Jessie's medical records.
I just-I just want to know that nothing terrible happened, everything was done right.
You know how Nic feels about this.
This isn't about a lawsuit.
I gave that up.
I just want the truth.
I must have the truth.
For Jessie.
Mwah.
Think I'm ready.
I know.
Peace will find the restless ones Find me Thank you.
I love you.
You were I love you, too, Jessie.
Born to fly Fly To fly Fly Born to fly.