The Resident (2018) s03e07 Episode Script
Woman Down
1 Previously on The Resident Hey, Cindy.
You're exhausted.
Red Rock can schedule more operations and make more money.
I'm pulling rank.
Go home.
There's got to be someone - who can swap with you.
- Me.
I got you covered.
You just finished back-to-back surgeries, too.
Well, then I'll be in back-to-back-to-back surgeries.
They are still working on my request for Hemopleatin data.
The more time, the more patients could die.
We need help with something.
We're doing a little research on a drug.
An exclusive with DiaCure renal services would help us all out.
Chastain uses the drug Hemopleatin to treat anemia.
Nic's sister, Jessie she was on it.
She died of a massive pulmonary embolism, just like five more of our patients on Hemopleatin.
I think this drug is causing these fatal blood clots.
Get to the point.
I have a busy day.
Well, you're familiar with the company DiaCure? The biggest dialysis provider in the country.
- Yeah.
- Yeah.
I-I met their CEO at their annual shareholders' meeting last night.
He agreed to give us access to all their patient records in exchange for an exclusive deal with Chastain.
Since when did you start doing business deals? I didn't agree to anything, obviously.
- Well - Yeah, it's your call.
But bottom line, if Hemopleatin is killing people, and Chastain can prove it, - we're saving lives.
- I'm, uh I'm not gonna go into business with anyone on the basis of your wild hunches.
Take my wild hunch out of the equation.
DiaCure is still an excellent partner for Chastain, regardless.
It's Jessica.
Car versus tree.
GCS 7 on arrival.
Head trauma with positive seat belt sign.
- BP 60 over palp.
- Okay.
How long was she out there? Took an hour to extricate her.
Not sure how long Jessica was waiting before she was found.
Oh, my God.
Jess.
Jess! - Oh, my God.
- You're home now, sweetie.
Jess! - How is she? - We don't know yet, but we got her.
Unhook her.
Let's move her.
And on my count, let's go.
One, two, three.
- What happened? - Don't know.
Nobody around, no skid marks.
Might have fallen asleep at the wheel.
Oh, my God.
What's her access? She needs volume now.
One 22-gauge in her thumb.
We're trying to get a bigger peripheral, but her veins are all collapsed.
She was tired.
She was coming off a double shift.
You need to leave, Dr.
Feldman.
Give me an introducer.
I will get access.
Nurse, hold her C-spine.
Abdomen's soft.
I got the FAST.
I'll do it.
I have to do something.
- You need to let us take care of her.
- What? You need to let us take care of her.
We got this.
We got it.
No.
- Pravesh, Pravesh.
Pravesh! - No! - Whoa, whoa.
- Pravesh, get him out of here! - Get him out of here now! - No! Get off of me! - Go.
- No! Get your hands off of me! - Wait.
Wait.
- Let me stay! I want to stay in the room.
I've got to stay in the room.
Now anything? - Wait.
Wait, wait, wait.
- She's been down too long.
- How much more time?! - Another 20 seconds.
- Where's that introducer? - Happening as fast - as superhumanly possible.
- Ah.
Come on.
All right, and we are in.
Get that blood in her now and add an amp of bicarb.
Two minutes.
Pulse check.
- -I got a pulse.
We got a pulse.
- All right.
All right.
All right.
All right.
- It's thready, but it's there.
Jess? - Okay.
All right.
- It's thready, but it's there.
- Here we go.
Jess.
Jess, welcome back.
Now stay with me.
Stay with me! Okay, come on.
All right.
Abdomen's not so soft now.
Come on.
It's full of blood.
It's full of blood.
We got to find the bleeding and stop it now.
Hundley, call the OR.
Hundley! - Page Neuro.
- How are the pupils? They're reactive, but We need Neuro.
Let's go.
Come on.
Come on, come on, come on, come on.
Let's go, let's go, let's go.
How is she? Massive intra-abdominal hemorrhage.
- She's in good hands now.
- I got the page.
What's with the audience? She's one of your scrub nurses Jessica Moore.
She's been in nearly half of your surgeries.
She needs a head CT.
No time.
She'll bleed out on the CT table.
- We do this now.
- I'll just put in an extraventricular drain to measure pressure and control the swelling.
- I can do that blind.
- Well, that's quite reassuring.
My job isn't to reassure you.
So, that's where we are.
Thanks for checking in.
- I'll keep you posted.
- Dr.
Bell? - Yeah? - How is she? They're taking her for an emergency ex-lap.
This is on Red Rock.
- I - They cut staff, overscheduled the OR, and now Jessica's paying for it.
- We need more nurses.
- Can we just talk about this later? No! We lost some of our best due to the hours and salary cuts that Red Rock instituted.
- Uh - I have people working a double shift right now.
- Do you want more Jessicas? - No, of course not.
I'm devastated by this.
I You have you have any idea how many hours I've spent in an OR with Jessica? How many times she's had my back in a tough surgery? Don't suggest that I don't care what's happening to her.
She's not just a member of my team.
She's like She's family to me.
Look I have one nurse today, and she's a student.
Even if she was fully trained, that's not nearly enough.
We can't keep doing this.
We need help.
I'll see what I can do about getting more nurses.
Okay.
Hey.
Hey, how is she? Cain and Raptor are just getting started.
Did you get ahold of her parents? They're on their way.
From Europe.
They go twice a year Bordeaux and Tuscany.
This is their, uh, Bordeaux trip.
Apparently, they're really into wine.
She was going to introduce me to them at Thanksgiving.
Um they're getting on a plane right now.
No contact for several hours.
Have they designated a health care proxy until they get here? Yes.
Me.
Good.
Good choice.
You're a doctor.
Let me help you start that paperwork, okay? No.
No, no, no, no.
I'm not leaving her.
Irving, I know that you are scared.
Scared? Scared does not cover it.
This is all my fault.
How is this your fault? She's been pulling doubles for days.
And then, we had that game night.
I knew she was exhausted.
And yesterday, she was heading out, and I Okay.
Five seconds of action, and then I'm on the road.
Oh.
Mmm.
Usually, it's at least - ten seconds.
- Well - You look tired.
- Thank you.
It's totally what a girl wants to hear from a guy whose scrubs she wants to get into.
No, no, no.
You know I always think you're beautiful.
- Mm-hmm.
- I'm just wondering if you need a ride home.
Okay, least sexy supply closet time ever.
I'm sorry.
- Okay.
Much better? - Mm-hmm.
I let her go.
No.
No.
You did not let her do anything.
This is not on you or her.
If you want to blame someone, blame Red Rock.
Assigning blame doesn't help Jessica.
Focus on what you can do now.
Okay? I will stay on the OR floor.
I will be right here to get updates.
I will let you know as soon as I hear anything.
I will meet up with you in the ICU.
Go.
Before we begin, a quick gut check.
One of our own is on the table.
Anyone too tired physically or emotionally should step out now.
Should I step out? I worked two 30-hour shifts this week.
Oh, wait.
I'm the brain surgeon.
I should probably stay.
It's important that we are all in tip-top shape for Jessica.
So again, are we good? Nurse, how many shifts have you had this week? Not as many as Jessica.
She, um She covered for me yesterday.
Then I'm going to have to ask you to step out.
For Jessica.
Okay.
That's a nice plan.
Now we're down a scrub nurse without enough time to replace her.
- I'll do it.
- Aren't you a resident? I'm a surgeon.
Surely I can handle scrub nurse duties.
Well, then it's settled.
Nurse/Doctor Mina Okafor is on the case.
Let's go.
How long have you been in nursing school? Uh, two years.
I'm so excited to finally be here in a real hospital.
Can't wait to get into the trenches, you know.
Really start practicing medicine.
Good, 'cause you're about to hit the ground running.
We're working general medicine and the ICU today.
Wow.
Is that, is that normal? No.
It's a disaster.
We're shorthanded, and we're down one very important woman.
I heard about the scrub nurse while I was filling out my paperwork.
- I'm sorry.
I hope she's okay.
- Me, too.
I'll be going between our patients and checking on Jessica today, so I need you to keep up with me.
Oh, yeah.
I'll try.
- Oh, my God.
- Dad.
Ah.
Oh, I heard there was an accident, a Chastain nurse.
I was terrified.
Well, I'm fine.
Okay, you can let go now.
All right.
I'm okay.
Uh, this is, uh, Clara.
She's our student nurse.
- Hi.
- That's my dad, Kyle Nevin.
I will update you on Jessica later, but right now I got to go.
Hey, hey, hey.
I can help.
Uh Isn't it pretty great? First day on the job as a volunteer.
Well, I guess I will be training you both simultaneously.
Go Team Nevin.
Thank you.
Thank you.
Hi.
How is she? Um she had massive internal injuries from the accident.
But Austin and Mina were able to repair everything - in her abdomen.
- It's her brain that's the issue.
She was showing signs of increased intracranial pressure, so Cain put a drain in.
Have they done a post-op CT? Yeah, and there was no bleed.
That's good news.
But there are signs of swelling.
Keeping an eye on her.
And being positive.
Here, let me do that.
I'm her health care proxy and a doctor, so I'm responsible.
We're all here for you.
So we're all responsible.
No matter how busy it gets, Jessica is the priority.
Right.
Good.
The post-op labs.
- I got to check to see if they're back.
- Yep.
I'm on them.
You stay here with Jessica.
We'll all be here as much as we can.
You're gonna be sick of seeing our faces.
Thank you.
Both of you.
Can I help you? You must be Dr.
Bell.
Yeah, that's the name on the door.
You are? Logan Kim.
Exec VP of Red Rock.
You left a message with my office.
I left a message with Emma O'Neil.
Emma is head of Red Rock's transition team.
Transition's over.
I'll be overseeing the day-to-day operations of the hospital now.
I oversee the day-to-day.
It's a partnership.
No.
We have distinct duties.
You make payroll.
I'm CEO.
Let-Let's avoid a-a pissing contest, shall we? Sorry.
Yeah.
Um we've had a rough morning.
One of our best nurses fell asleep at the wheel, and her life is hanging by a thread.
She's she's working double shifts due to our nursing shortage.
Let's-let's walk that back, uh, immediately.
A single car accident doesn't mean that she was asleep at the wheel.
Could have been a suicide attempt.
Maybe she was texting.
Well, when she wakes up, we'll Well, if she wakes up.
If she doesn't, we may never know for sure.
Did PR feed you that? I know exactly what happened.
She was overworked.
She was exhausted.
She had a long drive home, and she fell asleep at the wheel.
You could spin it that way, which might lead the press to investigate other overworked employees, like a resident who fell through a skylight on your watch.
I-I'm not pointing any fingers, and I hope no one else will, but one CEO could easily be made a scapegoat for both incidents.
Are you threatening me? Absolutely not.
But I'm trying to make you see how much smoother things will run if we're both playing for the same team: the shareholders of Red Rock Mountain Medical.
Anything? Post-op blood tests aren't back yet.
Yeah.
Come on.
I take it all that optimism was for Irving's sake.
I'm scared to death.
For both of them.
If something happens to her Don't even say it.
If it had been you, I would be - I have no idea what I'd be.
- Hey.
I'm fine.
Okay? But we have to do something.
This is on Red Rock.
Jessica was overworked.
We're all overworked.
It's this system.
It's not right.
What do you want to do? Today, we focus on Jessica.
We make sure she's okay.
We make sure Irving's okay.
But tomorrow? Tomorrow we keep fighting.
Oh, sorry.
I was just looking for an extra pillow.
Jessica.
Top shelf, Dad.
Yeah.
Sorry.
Why don't you figure this out.
- Look at the - I-I'm sorry, sir.
- I don't know anything about the TV.
- I'm gonna take this to 921.
Hey.
Hey! Hey, how do you how do you change the channel? Because the-the TV's just showing birds.
Well, that's a nature channel.
I think - it's meant to keep you calm.
- Yeah, well-well, I hate birds, and it's driving me crazy.
Uh, see, I'll just, uh I'll just I'll get a new one.
Thank you.
Her ICP has been increasing over the last few hours.
We need to get her back into surgery to control the swelling.
Well, she's still recovering from the last surgery.
I'd advise we go forward with nonsurgical care - while she's still fragile.
- We've already been doing that.
Medical management is not cutting it.
We need to move on to surgical options.
Now, you want her to have irreversible brain damage? Hey.
A little sensitivity.
The next step is a decompressive hemicraniectomy.
Temporarily pop off a piece of her skull and allow her brain room to expand.
She's febrile.
In renal failure.
And have you seen her post-op CBC? Her platelets are critically low, which makes a craniectomy far riskier.
I think we still have time left to optimize her the best we can before going back in for another surgery.
All right, so, everyone listen to the third-year resident and follow him anywhere.
- I'm the attending.
- I'm also the attending, and Irving asked Conrad to coordinate care.
All right, so why don't we just go find the nursing student who's been bumbling around the floor somewhere? Maybe she would like a say, as well.
Conrad has the last word.
Right, Irving? He's making the call.
Let's get this straight.
I'm a neurosurgeon.
This woman is in need of neurosurgery.
If her brain continues to swell, she's gonna herniate.
She's either gonna die or have zero chances of waking up tomorrow as anything more than why don't we all say this one together a vegetable.
We can place her in a barbiturate coma.
That'll give us a chance to control the swelling while she recovers from the trauma of the surgery she just went through.
Look, we've all been here before in medicine where there is no clear-cut answer.
- We need to work together - Now an intern speaks.
Really? Why don't we just poll all of Atlanta.
Maybe everyone should have a voice at Chastain.
Jessica's only in this situation because you - overworked her for weeks.
- Oh, right.
So now I'm responsible for a nurse who didn't know enough to call an Uber.
No.
But you will be responsible if she arrests on the table because her body can't handle another invasive surgery.
Conrad makes this call.
Some medical proxy you are.
When she dies, it's gonna be on you.
Look, I didn't want to contradict you in front of Cain, but I'm not 100% about waiting to address Jessica's intracranial pressure.
I know.
I feel the same way.
But it is a judgment call, and I don't want to send her back to the OR with a dropping platelet count that we can't explain when there are other medical options.
Are you sure that continuing with conservative management is gonna help her ICP? It's worth a try, particularly in this case.
If she doesn't clot in surgery, she dies.
Okay, I'm on board.
But a word of caution.
You know Cain has the juice with Red Rock, right? You know he is their cash register, Hawkins.
I am well aware.
Since he came here, invasive brain and spine surgeries are up 49%.
Now, you ask yourself, how many of those are necessary? Cain cuts when no one else would.
So, you think he might be doing it again with Jessica? I think he's a cowboy.
I love surgeons with attitude - and even a healthy ego.
- Hmm.
If they put patients first, like you do.
Well, I don't mind residents with cojones.
But you tread lightly.
You just made a dangerous enemy.
How-how about bald but still banging with the best of them.
Hey, Nic.
Hi.
Uh, this is my daughter.
She's a nurse practitioner here.
Nic, this is Jackie, a 70-year-old woman with congestive heart failure here for IV diuretics, which requires monitoring throughout the day.
Well done, Dad, but I know.
Jackie's my patient.
Did you know that Jackie and her daughter Leslie here have a business together? They cross-stitch pillows with risqué phrases on them.
- Mm, I did not.
- Did you know that? - I did not.
I need one of those.
- Oh.
- Um, did you get Jackie's lunch? - Uh I came to take her order.
We got to talking.
I'm-I'm on it.
Uh, does he like older women? Mom.
What? He's adorable.
Okay, this isn't the bar.
This is Clara.
She'll be starting your IV today.
Have you ever done this before? On a, uh, mannequin.
But I always won when we did IV races in class.
- Clara's in training.
- Ow.
Nic, she's gonna kill me.
She's not gonna kill you.
Listen to your patient.
The band's too tight.
Got it.
Oh, pro tip, girlie.
Real people feel more pain than mannequins.
She's stable.
She's resting.
Buddy, you need to eat something.
- I'm not leaving her.
- You need to take care of yourself in order to take care of Jessica.
Come to the cafeteria.
We're gonna get you some food.
Conrad ordered more labs.
I'm waiting until they come back.
They're not gonna be back for another hour.
Come on.
It's tri-tip sandwich day.
You love tri-tip sandwich day.
I'm not hungry.
You need to eat anyway.
Don't make us drag you.
Dr.
Feldman.
I'd like to spend a few minutes with Jessica, if that's all right.
See? She's not gonna be alone.
Everyone loves her.
I think she'd be honored, Dr.
Bell.
I know how much she respects you.
All right.
Hey.
What can I get you, Dr.
Feldman? Uh, his usual.
Tri-tip sandwich coming up.
You don't look so good.
Go sit.
Grab that free table, okay? We may need to get a social worker to come talk to him.
Get him something for his anxiety.
He needs to keep a clear head.
Let's get some food in him.
We're out of tri-tip.
Tuna salad? It's tri-tip day.
The man needs a tri-tip sandwich.
He doesn't like tuna salad.
Do you understand? So go back there and get some tri-tip! We're all having a bad day.
That was uncalled for.
I'm sorry.
It's okay.
I heard about Jessica.
I understand.
We're all in it together.
What's going on? Got more labs back.
Platelets are still falling, and now she's anemic, so I paged Austin.
That doesn't make any sense.
She's gotten over 20 units PRBCs, 15 FFPs, ten units of platelets Yeah, well, you better keep 'em coming.
You think she's still bleeding? I don't see anything in her chest.
Her belly's nice and soft.
Well, where's all the blood going? We're working on that.
You're sure you didn't miss a bleed somewhere? Maybe the retroperitoneum or pleural cavities? No, I didn't miss anything.
You can't know that.
Maybe, this time, you missed something and that's why Jessica's still too sick for surgery.
And now she's running out of time.
Hey.
Remember, we are on the same side.
I'll take her for another CT, just to make sure we're not missing anything.
I didn't miss anything.
But let's get another CT, so we can be certain.
I'm sorry I left you, babe.
I'm sorry.
What's going on? She's still anemic and thrombocytopenic despite multiple transfusions.
- Why? - I'm working on it.
Honestly, I don't know.
There's nothing on the CT? No.
I called the CEO of DiaCure.
We made a deal.
We're gonna use their dialysis equipment exclusively.
You can get the data you need.
I-I just, uh just felt like I had to do something positive.
J-Jessica's She's my favorite of the OR nurses.
You know, she's a she's a pistol.
You know.
And sweet.
And a lady.
So this one's for her.
Wish it were more.
It's all I got.
Thank you.
Your dressing needs to be changed.
Get me a real nurse.
He's been picking at his cellulitis.
Yeah, bec I can't help it, because it itches.
All right? So why don't why don't you give me something in-instead of getting in my face? That sounds like drug seeking to me, and - Sir, you can't-can't do that.
- Steve.
Sir.
- Sir - You need to get back in bed.
Hey, hey.
Steve, come on.
You got to get back in bed.
Nic! The meth head is trying to kill your father! The meth head is trying to kill your father! Help! Hey, hey, hey! Code gray! - Hey, hey.
- Hey, hey, hey.
- Ow! Oh! - Hey! Hey! Ow! Ow! Ow, ow! Ow, ow, ow! Hold him down! Let go of me! - Dad, are you okay? - Yeah.
He bit me.
Is that bad? He didn't break the skin, but we'll take a look at it, just in case.
- It's okay.
- Oh, it's a good it was a good thing I was here.
Right place at the right time.
He could've hurt uh, Clara.
Clara, I'm sorry.
I shouldn't have left you alone.
- Are you okay? - Yeah.
Yeah, I'm fine.
Ooh, ooh.
He s-spit on me.
Oh, God.
You okay? Yeah, it's fine.
I'm fine.
It's okay not to be fine.
Nursing school doesn't prepare you for a day like this.
I quit.
You can't.
I'm sorry.
I'm short of nurses, and I need everybody that I can get.
Plus you can do this.
I don't want to.
I mean it was one thing when it was on paper.
What are the warning signs of heart failure? How many milliliters? I liked studying medicine.
But when it comes to this Look, you've had a seriously difficult first day.
But, hey, at least no one threw up on you.
No one pulled a chunk of hair out of your head.
That happened to you? First day.
God, why do you do this? Look, we don't have to like all of our patients.
But we do have to take care of them.
Because, whoever they are, they're sick and in pain.
And it's our job to deal with it.
And sometimes, yes, it is so hard.
But not many people get a chance to make a difference.
A good nurse can.
You've invested two years in this? Student debt, I imagine? You can always quit on your second day.
Come on.
You got this.
Let's go.
You figure out what's going on with her blood counts? - No.
- Her ICP keeps going up.
We don't have any more time.
You delayed this surgery for no good reason.
You failed.
Self-important neophyte, you don't even know how much you don't know.
I'm gonna remove the pressure from her brain and hope it's not too late.
So, congratulations.
Your narcissism almost killed your patient.
Saw to me.
Are you sure you're okay to be here? This is the last place on earth I want to be, and I won't be anywhere else.
Scalpel.
Lap pads.
Cautery.
- There's too much blood.
- Get suction in, damn it.
Suction.
Oh, my God.
No.
This is exactly what Conrad said would happen.
Why isn't she clotting? Hey, man, we didn't have a choice anymore.
When you wait too long, her brain swells and she dies.
You go back in there without correcting her coagulopathy, she bleeds out.
It was my job to figure it out.
Maybe we still can.
Let's work on the differential.
Together.
Okay.
All right, she's bleeding.
It won't stop.
Why? And where does the blood go? Into the body or onto the floor.
In this case, neither.
Jessica's not losing platelets.
Her body is destroying them.
Hemolysis, low platelets, renal dysfunction, fever.
- It's got to be TTP.
- Oh, God.
If she has TTP, her platelet count will just keep dropping.
She'll never clot.
This surgery is going to kill her, and I gave the okay to go ahead with it.
Now that we know what it is, we can treat it.
So you're gonna start plasmapheresis while she's in surgery? Hell yeah, he is.
Move faster.
Get that bleeder.
I'm moving as fast as I can.
It's oozing everywhere.
Keep hanging those platelets.
Get out of my OR! Now! I'm chief of surgery.
Every OR in Chastain is my OR.
Hawkins stays.
- What's happening? - Jessica has TTP.
- Giving her more platelets won't help.
- Scrub nurse, ignore him.
- I need you with me on this cautery.
- All you.
- Conrad, I'll get access.
- Thank you.
You can do that plasmapheresis when I'm done.
You have no idea even if you're right, let alone if it's gonna help.
Okay, now we can cauterize.
Now she has a chance.
Dr.
Bell, just wanted to congratulate you.
What for? Heard you made a very lucrative deal today.
- DiaCure Dialysis Centers.
- Yeah.
They gave us a great price for exclusivity.
That deserves an "attaboy" from the new veep.
What kind of kickback did they offer us for the contract? Some data we required for patient safety, and they committed to help us with the money we need - to fill out our nursing staff.
- Whoa.
Punching above your weight there.
I'll make the call on where the money goes.
I'm thinking Neuro.
Barrett's got a laundry list of line items.
Barrett? You on a first-name basis with Dr.
Cain? We go way back.
He's the one who got me this job.
Lured me away from a hedge fund on the West Coast.
You have no background in health care.
I have a background in profits.
Well, this profit goes for more nurses.
It's it's part of the agreement.
It can't be undone.
No more deals like this again without my input.
Hey.
I'm just gonna change the dressing.
All right, let's see what we have.
There isn't very much blood around the incision.
It's starting to clot.
We'll get another CBC.
Yeah, well, we can send it in, but this is good news.
The plasmapheresis is working.
She still might not wake up.
And if she does, we have no idea what kind of shape she'll be in.
We'll know more in 24 hours.
- Hey, Dad, wait.
- Oh, Nic.
I just finished my shift.
- You need something? - Look, um Thanks for being here today.
I love volunteering.
I know you were scared that it was me when you heard about the accident this morning.
I brushed you off.
I'm sorry I did that.
You're all I got, kid.
We're Team Nevin now.
Still no change in Jessica.
What's this? DiaCure records.
You got them.
Yeah.
It's worse than we thought.
20% higher complication rate with Hemopleatin.
Look at all these PEs.
This drug is probably what killed Jessie.
I think so.
What do you think the next step is? Tomorrow I go in to see Bell and Red Rock, and get this drug pulled off the shelves.
Permanently.
You know how dangerous that is, Conrad? Big Pharma is ruthless.
They could go after you.
They always like to discredit the messenger.
The numbers don't lie.
We'll make sure what happened to Jessie doesn't happen to anyone else.
Her death could save lives.
As awful as this is, I learned something today.
I really love her.
I don't think I realized how much until I thought I might lose her.
If she comes back to me, I'll tell her.
Please come back to me.
We all see how much you guys love each other.
You know, I beat myself up about leaving Priya at the altar.
But now I know it was right.
Because what we had it wasn't this.
Don't make this about you, Pravesh.
Hey.
Thank you.
Oh! - Um, okay.
- It's happening.
Give into it.
- Oh, that's tight.
But - Yeah.
Come on.
There you go.
Oh, buddy.
Hmm, you're certain you have enough patient information to prove that Hemopleatin is causing sudden death in a significant number of patients? Yes.
We need to pull it immediately and warn the FDA.
No, I've looked over the data; Dr.
Hawkins is right.
The complication rate is off the charts.
I'll-I'll have my people go over the figures, and if this checks out, we'll use it to make a PR splash.
Chastain catches a deadly drug - and saves patients.
- And in the meantime, we can go back to using an older drug that we know to be safe.
And, more good news, it's actually cheaper.
Well, that's a huge win on all fronts.
- Really nice work.
- All right.
Thank you.
That info was part of the DiaCure deal.
So you helped him? Yeah.
Yeah.
But I'm happy to let the hospital take the credit.
Okay.
Wake up.
Me or her? Both, I think.
- Mm.
- Jess? Honey? - Jess? - Mm.
Can you hear me? Mm.
- Can you hear me? - Hey.
Hey.
- Hey.
Hey, hey.
Whoa, whoa, whoa.
- Careful, careful.
Shh, shh.
No, don't do that.
- You're okay.
Hey.
- Hey, Jess.
Honey.
Hey.
You're okay.
You're fine.
You're fine.
It's a long story, but everything's gonna be just fine.
Okay.
Here we go.
Here we go.
You could use some vittles in ya.
All right.
I'll eat now.
- This is a mess.
- Do the honors.
- This looks good.
- Yeah, this is not from the cafeteria.
Okay, I want the little baby one over here.
I heard the good news.
- Dr.
Hawkins, a word? - Yeah, sure thing.
I just want to say, I, uh, appreciate what you did, and I actually regret that we had words.
It-it was an emotional day for all of us.
No doubt.
No doubt.
But don't ever question my decision again.
Well, when I'm wrong, I've learned to listen to my colleagues.
You're not a colleague.
You're a subordinate and I don't give a damn what your process is.
You're not invincible, you know.
No one is.
You sure about that? We on the same page? You tell me.
Hawkins is a whistleblower.
My concern is him deciding in his self-righteous way that Red Rock is doing something he doesn't like.
That's not something I can live with.
Then there's our answer.
He's a threat to the hospital.
I'll handle it.
You're exhausted.
Red Rock can schedule more operations and make more money.
I'm pulling rank.
Go home.
There's got to be someone - who can swap with you.
- Me.
I got you covered.
You just finished back-to-back surgeries, too.
Well, then I'll be in back-to-back-to-back surgeries.
They are still working on my request for Hemopleatin data.
The more time, the more patients could die.
We need help with something.
We're doing a little research on a drug.
An exclusive with DiaCure renal services would help us all out.
Chastain uses the drug Hemopleatin to treat anemia.
Nic's sister, Jessie she was on it.
She died of a massive pulmonary embolism, just like five more of our patients on Hemopleatin.
I think this drug is causing these fatal blood clots.
Get to the point.
I have a busy day.
Well, you're familiar with the company DiaCure? The biggest dialysis provider in the country.
- Yeah.
- Yeah.
I-I met their CEO at their annual shareholders' meeting last night.
He agreed to give us access to all their patient records in exchange for an exclusive deal with Chastain.
Since when did you start doing business deals? I didn't agree to anything, obviously.
- Well - Yeah, it's your call.
But bottom line, if Hemopleatin is killing people, and Chastain can prove it, - we're saving lives.
- I'm, uh I'm not gonna go into business with anyone on the basis of your wild hunches.
Take my wild hunch out of the equation.
DiaCure is still an excellent partner for Chastain, regardless.
It's Jessica.
Car versus tree.
GCS 7 on arrival.
Head trauma with positive seat belt sign.
- BP 60 over palp.
- Okay.
How long was she out there? Took an hour to extricate her.
Not sure how long Jessica was waiting before she was found.
Oh, my God.
Jess.
Jess! - Oh, my God.
- You're home now, sweetie.
Jess! - How is she? - We don't know yet, but we got her.
Unhook her.
Let's move her.
And on my count, let's go.
One, two, three.
- What happened? - Don't know.
Nobody around, no skid marks.
Might have fallen asleep at the wheel.
Oh, my God.
What's her access? She needs volume now.
One 22-gauge in her thumb.
We're trying to get a bigger peripheral, but her veins are all collapsed.
She was tired.
She was coming off a double shift.
You need to leave, Dr.
Feldman.
Give me an introducer.
I will get access.
Nurse, hold her C-spine.
Abdomen's soft.
I got the FAST.
I'll do it.
I have to do something.
- You need to let us take care of her.
- What? You need to let us take care of her.
We got this.
We got it.
No.
- Pravesh, Pravesh.
Pravesh! - No! - Whoa, whoa.
- Pravesh, get him out of here! - Get him out of here now! - No! Get off of me! - Go.
- No! Get your hands off of me! - Wait.
Wait.
- Let me stay! I want to stay in the room.
I've got to stay in the room.
Now anything? - Wait.
Wait, wait, wait.
- She's been down too long.
- How much more time?! - Another 20 seconds.
- Where's that introducer? - Happening as fast - as superhumanly possible.
- Ah.
Come on.
All right, and we are in.
Get that blood in her now and add an amp of bicarb.
Two minutes.
Pulse check.
- -I got a pulse.
We got a pulse.
- All right.
All right.
All right.
All right.
- It's thready, but it's there.
Jess? - Okay.
All right.
- It's thready, but it's there.
- Here we go.
Jess.
Jess, welcome back.
Now stay with me.
Stay with me! Okay, come on.
All right.
Abdomen's not so soft now.
Come on.
It's full of blood.
It's full of blood.
We got to find the bleeding and stop it now.
Hundley, call the OR.
Hundley! - Page Neuro.
- How are the pupils? They're reactive, but We need Neuro.
Let's go.
Come on.
Come on, come on, come on, come on.
Let's go, let's go, let's go.
How is she? Massive intra-abdominal hemorrhage.
- She's in good hands now.
- I got the page.
What's with the audience? She's one of your scrub nurses Jessica Moore.
She's been in nearly half of your surgeries.
She needs a head CT.
No time.
She'll bleed out on the CT table.
- We do this now.
- I'll just put in an extraventricular drain to measure pressure and control the swelling.
- I can do that blind.
- Well, that's quite reassuring.
My job isn't to reassure you.
So, that's where we are.
Thanks for checking in.
- I'll keep you posted.
- Dr.
Bell? - Yeah? - How is she? They're taking her for an emergency ex-lap.
This is on Red Rock.
- I - They cut staff, overscheduled the OR, and now Jessica's paying for it.
- We need more nurses.
- Can we just talk about this later? No! We lost some of our best due to the hours and salary cuts that Red Rock instituted.
- Uh - I have people working a double shift right now.
- Do you want more Jessicas? - No, of course not.
I'm devastated by this.
I You have you have any idea how many hours I've spent in an OR with Jessica? How many times she's had my back in a tough surgery? Don't suggest that I don't care what's happening to her.
She's not just a member of my team.
She's like She's family to me.
Look I have one nurse today, and she's a student.
Even if she was fully trained, that's not nearly enough.
We can't keep doing this.
We need help.
I'll see what I can do about getting more nurses.
Okay.
Hey.
Hey, how is she? Cain and Raptor are just getting started.
Did you get ahold of her parents? They're on their way.
From Europe.
They go twice a year Bordeaux and Tuscany.
This is their, uh, Bordeaux trip.
Apparently, they're really into wine.
She was going to introduce me to them at Thanksgiving.
Um they're getting on a plane right now.
No contact for several hours.
Have they designated a health care proxy until they get here? Yes.
Me.
Good.
Good choice.
You're a doctor.
Let me help you start that paperwork, okay? No.
No, no, no, no.
I'm not leaving her.
Irving, I know that you are scared.
Scared? Scared does not cover it.
This is all my fault.
How is this your fault? She's been pulling doubles for days.
And then, we had that game night.
I knew she was exhausted.
And yesterday, she was heading out, and I Okay.
Five seconds of action, and then I'm on the road.
Oh.
Mmm.
Usually, it's at least - ten seconds.
- Well - You look tired.
- Thank you.
It's totally what a girl wants to hear from a guy whose scrubs she wants to get into.
No, no, no.
You know I always think you're beautiful.
- Mm-hmm.
- I'm just wondering if you need a ride home.
Okay, least sexy supply closet time ever.
I'm sorry.
- Okay.
Much better? - Mm-hmm.
I let her go.
No.
No.
You did not let her do anything.
This is not on you or her.
If you want to blame someone, blame Red Rock.
Assigning blame doesn't help Jessica.
Focus on what you can do now.
Okay? I will stay on the OR floor.
I will be right here to get updates.
I will let you know as soon as I hear anything.
I will meet up with you in the ICU.
Go.
Before we begin, a quick gut check.
One of our own is on the table.
Anyone too tired physically or emotionally should step out now.
Should I step out? I worked two 30-hour shifts this week.
Oh, wait.
I'm the brain surgeon.
I should probably stay.
It's important that we are all in tip-top shape for Jessica.
So again, are we good? Nurse, how many shifts have you had this week? Not as many as Jessica.
She, um She covered for me yesterday.
Then I'm going to have to ask you to step out.
For Jessica.
Okay.
That's a nice plan.
Now we're down a scrub nurse without enough time to replace her.
- I'll do it.
- Aren't you a resident? I'm a surgeon.
Surely I can handle scrub nurse duties.
Well, then it's settled.
Nurse/Doctor Mina Okafor is on the case.
Let's go.
How long have you been in nursing school? Uh, two years.
I'm so excited to finally be here in a real hospital.
Can't wait to get into the trenches, you know.
Really start practicing medicine.
Good, 'cause you're about to hit the ground running.
We're working general medicine and the ICU today.
Wow.
Is that, is that normal? No.
It's a disaster.
We're shorthanded, and we're down one very important woman.
I heard about the scrub nurse while I was filling out my paperwork.
- I'm sorry.
I hope she's okay.
- Me, too.
I'll be going between our patients and checking on Jessica today, so I need you to keep up with me.
Oh, yeah.
I'll try.
- Oh, my God.
- Dad.
Ah.
Oh, I heard there was an accident, a Chastain nurse.
I was terrified.
Well, I'm fine.
Okay, you can let go now.
All right.
I'm okay.
Uh, this is, uh, Clara.
She's our student nurse.
- Hi.
- That's my dad, Kyle Nevin.
I will update you on Jessica later, but right now I got to go.
Hey, hey, hey.
I can help.
Uh Isn't it pretty great? First day on the job as a volunteer.
Well, I guess I will be training you both simultaneously.
Go Team Nevin.
Thank you.
Thank you.
Hi.
How is she? Um she had massive internal injuries from the accident.
But Austin and Mina were able to repair everything - in her abdomen.
- It's her brain that's the issue.
She was showing signs of increased intracranial pressure, so Cain put a drain in.
Have they done a post-op CT? Yeah, and there was no bleed.
That's good news.
But there are signs of swelling.
Keeping an eye on her.
And being positive.
Here, let me do that.
I'm her health care proxy and a doctor, so I'm responsible.
We're all here for you.
So we're all responsible.
No matter how busy it gets, Jessica is the priority.
Right.
Good.
The post-op labs.
- I got to check to see if they're back.
- Yep.
I'm on them.
You stay here with Jessica.
We'll all be here as much as we can.
You're gonna be sick of seeing our faces.
Thank you.
Both of you.
Can I help you? You must be Dr.
Bell.
Yeah, that's the name on the door.
You are? Logan Kim.
Exec VP of Red Rock.
You left a message with my office.
I left a message with Emma O'Neil.
Emma is head of Red Rock's transition team.
Transition's over.
I'll be overseeing the day-to-day operations of the hospital now.
I oversee the day-to-day.
It's a partnership.
No.
We have distinct duties.
You make payroll.
I'm CEO.
Let-Let's avoid a-a pissing contest, shall we? Sorry.
Yeah.
Um we've had a rough morning.
One of our best nurses fell asleep at the wheel, and her life is hanging by a thread.
She's she's working double shifts due to our nursing shortage.
Let's-let's walk that back, uh, immediately.
A single car accident doesn't mean that she was asleep at the wheel.
Could have been a suicide attempt.
Maybe she was texting.
Well, when she wakes up, we'll Well, if she wakes up.
If she doesn't, we may never know for sure.
Did PR feed you that? I know exactly what happened.
She was overworked.
She was exhausted.
She had a long drive home, and she fell asleep at the wheel.
You could spin it that way, which might lead the press to investigate other overworked employees, like a resident who fell through a skylight on your watch.
I-I'm not pointing any fingers, and I hope no one else will, but one CEO could easily be made a scapegoat for both incidents.
Are you threatening me? Absolutely not.
But I'm trying to make you see how much smoother things will run if we're both playing for the same team: the shareholders of Red Rock Mountain Medical.
Anything? Post-op blood tests aren't back yet.
Yeah.
Come on.
I take it all that optimism was for Irving's sake.
I'm scared to death.
For both of them.
If something happens to her Don't even say it.
If it had been you, I would be - I have no idea what I'd be.
- Hey.
I'm fine.
Okay? But we have to do something.
This is on Red Rock.
Jessica was overworked.
We're all overworked.
It's this system.
It's not right.
What do you want to do? Today, we focus on Jessica.
We make sure she's okay.
We make sure Irving's okay.
But tomorrow? Tomorrow we keep fighting.
Oh, sorry.
I was just looking for an extra pillow.
Jessica.
Top shelf, Dad.
Yeah.
Sorry.
Why don't you figure this out.
- Look at the - I-I'm sorry, sir.
- I don't know anything about the TV.
- I'm gonna take this to 921.
Hey.
Hey! Hey, how do you how do you change the channel? Because the-the TV's just showing birds.
Well, that's a nature channel.
I think - it's meant to keep you calm.
- Yeah, well-well, I hate birds, and it's driving me crazy.
Uh, see, I'll just, uh I'll just I'll get a new one.
Thank you.
Her ICP has been increasing over the last few hours.
We need to get her back into surgery to control the swelling.
Well, she's still recovering from the last surgery.
I'd advise we go forward with nonsurgical care - while she's still fragile.
- We've already been doing that.
Medical management is not cutting it.
We need to move on to surgical options.
Now, you want her to have irreversible brain damage? Hey.
A little sensitivity.
The next step is a decompressive hemicraniectomy.
Temporarily pop off a piece of her skull and allow her brain room to expand.
She's febrile.
In renal failure.
And have you seen her post-op CBC? Her platelets are critically low, which makes a craniectomy far riskier.
I think we still have time left to optimize her the best we can before going back in for another surgery.
All right, so, everyone listen to the third-year resident and follow him anywhere.
- I'm the attending.
- I'm also the attending, and Irving asked Conrad to coordinate care.
All right, so why don't we just go find the nursing student who's been bumbling around the floor somewhere? Maybe she would like a say, as well.
Conrad has the last word.
Right, Irving? He's making the call.
Let's get this straight.
I'm a neurosurgeon.
This woman is in need of neurosurgery.
If her brain continues to swell, she's gonna herniate.
She's either gonna die or have zero chances of waking up tomorrow as anything more than why don't we all say this one together a vegetable.
We can place her in a barbiturate coma.
That'll give us a chance to control the swelling while she recovers from the trauma of the surgery she just went through.
Look, we've all been here before in medicine where there is no clear-cut answer.
- We need to work together - Now an intern speaks.
Really? Why don't we just poll all of Atlanta.
Maybe everyone should have a voice at Chastain.
Jessica's only in this situation because you - overworked her for weeks.
- Oh, right.
So now I'm responsible for a nurse who didn't know enough to call an Uber.
No.
But you will be responsible if she arrests on the table because her body can't handle another invasive surgery.
Conrad makes this call.
Some medical proxy you are.
When she dies, it's gonna be on you.
Look, I didn't want to contradict you in front of Cain, but I'm not 100% about waiting to address Jessica's intracranial pressure.
I know.
I feel the same way.
But it is a judgment call, and I don't want to send her back to the OR with a dropping platelet count that we can't explain when there are other medical options.
Are you sure that continuing with conservative management is gonna help her ICP? It's worth a try, particularly in this case.
If she doesn't clot in surgery, she dies.
Okay, I'm on board.
But a word of caution.
You know Cain has the juice with Red Rock, right? You know he is their cash register, Hawkins.
I am well aware.
Since he came here, invasive brain and spine surgeries are up 49%.
Now, you ask yourself, how many of those are necessary? Cain cuts when no one else would.
So, you think he might be doing it again with Jessica? I think he's a cowboy.
I love surgeons with attitude - and even a healthy ego.
- Hmm.
If they put patients first, like you do.
Well, I don't mind residents with cojones.
But you tread lightly.
You just made a dangerous enemy.
How-how about bald but still banging with the best of them.
Hey, Nic.
Hi.
Uh, this is my daughter.
She's a nurse practitioner here.
Nic, this is Jackie, a 70-year-old woman with congestive heart failure here for IV diuretics, which requires monitoring throughout the day.
Well done, Dad, but I know.
Jackie's my patient.
Did you know that Jackie and her daughter Leslie here have a business together? They cross-stitch pillows with risqué phrases on them.
- Mm, I did not.
- Did you know that? - I did not.
I need one of those.
- Oh.
- Um, did you get Jackie's lunch? - Uh I came to take her order.
We got to talking.
I'm-I'm on it.
Uh, does he like older women? Mom.
What? He's adorable.
Okay, this isn't the bar.
This is Clara.
She'll be starting your IV today.
Have you ever done this before? On a, uh, mannequin.
But I always won when we did IV races in class.
- Clara's in training.
- Ow.
Nic, she's gonna kill me.
She's not gonna kill you.
Listen to your patient.
The band's too tight.
Got it.
Oh, pro tip, girlie.
Real people feel more pain than mannequins.
She's stable.
She's resting.
Buddy, you need to eat something.
- I'm not leaving her.
- You need to take care of yourself in order to take care of Jessica.
Come to the cafeteria.
We're gonna get you some food.
Conrad ordered more labs.
I'm waiting until they come back.
They're not gonna be back for another hour.
Come on.
It's tri-tip sandwich day.
You love tri-tip sandwich day.
I'm not hungry.
You need to eat anyway.
Don't make us drag you.
Dr.
Feldman.
I'd like to spend a few minutes with Jessica, if that's all right.
See? She's not gonna be alone.
Everyone loves her.
I think she'd be honored, Dr.
Bell.
I know how much she respects you.
All right.
Hey.
What can I get you, Dr.
Feldman? Uh, his usual.
Tri-tip sandwich coming up.
You don't look so good.
Go sit.
Grab that free table, okay? We may need to get a social worker to come talk to him.
Get him something for his anxiety.
He needs to keep a clear head.
Let's get some food in him.
We're out of tri-tip.
Tuna salad? It's tri-tip day.
The man needs a tri-tip sandwich.
He doesn't like tuna salad.
Do you understand? So go back there and get some tri-tip! We're all having a bad day.
That was uncalled for.
I'm sorry.
It's okay.
I heard about Jessica.
I understand.
We're all in it together.
What's going on? Got more labs back.
Platelets are still falling, and now she's anemic, so I paged Austin.
That doesn't make any sense.
She's gotten over 20 units PRBCs, 15 FFPs, ten units of platelets Yeah, well, you better keep 'em coming.
You think she's still bleeding? I don't see anything in her chest.
Her belly's nice and soft.
Well, where's all the blood going? We're working on that.
You're sure you didn't miss a bleed somewhere? Maybe the retroperitoneum or pleural cavities? No, I didn't miss anything.
You can't know that.
Maybe, this time, you missed something and that's why Jessica's still too sick for surgery.
And now she's running out of time.
Hey.
Remember, we are on the same side.
I'll take her for another CT, just to make sure we're not missing anything.
I didn't miss anything.
But let's get another CT, so we can be certain.
I'm sorry I left you, babe.
I'm sorry.
What's going on? She's still anemic and thrombocytopenic despite multiple transfusions.
- Why? - I'm working on it.
Honestly, I don't know.
There's nothing on the CT? No.
I called the CEO of DiaCure.
We made a deal.
We're gonna use their dialysis equipment exclusively.
You can get the data you need.
I-I just, uh just felt like I had to do something positive.
J-Jessica's She's my favorite of the OR nurses.
You know, she's a she's a pistol.
You know.
And sweet.
And a lady.
So this one's for her.
Wish it were more.
It's all I got.
Thank you.
Your dressing needs to be changed.
Get me a real nurse.
He's been picking at his cellulitis.
Yeah, bec I can't help it, because it itches.
All right? So why don't why don't you give me something in-instead of getting in my face? That sounds like drug seeking to me, and - Sir, you can't-can't do that.
- Steve.
Sir.
- Sir - You need to get back in bed.
Hey, hey.
Steve, come on.
You got to get back in bed.
Nic! The meth head is trying to kill your father! The meth head is trying to kill your father! Help! Hey, hey, hey! Code gray! - Hey, hey.
- Hey, hey, hey.
- Ow! Oh! - Hey! Hey! Ow! Ow! Ow, ow! Ow, ow, ow! Hold him down! Let go of me! - Dad, are you okay? - Yeah.
He bit me.
Is that bad? He didn't break the skin, but we'll take a look at it, just in case.
- It's okay.
- Oh, it's a good it was a good thing I was here.
Right place at the right time.
He could've hurt uh, Clara.
Clara, I'm sorry.
I shouldn't have left you alone.
- Are you okay? - Yeah.
Yeah, I'm fine.
Ooh, ooh.
He s-spit on me.
Oh, God.
You okay? Yeah, it's fine.
I'm fine.
It's okay not to be fine.
Nursing school doesn't prepare you for a day like this.
I quit.
You can't.
I'm sorry.
I'm short of nurses, and I need everybody that I can get.
Plus you can do this.
I don't want to.
I mean it was one thing when it was on paper.
What are the warning signs of heart failure? How many milliliters? I liked studying medicine.
But when it comes to this Look, you've had a seriously difficult first day.
But, hey, at least no one threw up on you.
No one pulled a chunk of hair out of your head.
That happened to you? First day.
God, why do you do this? Look, we don't have to like all of our patients.
But we do have to take care of them.
Because, whoever they are, they're sick and in pain.
And it's our job to deal with it.
And sometimes, yes, it is so hard.
But not many people get a chance to make a difference.
A good nurse can.
You've invested two years in this? Student debt, I imagine? You can always quit on your second day.
Come on.
You got this.
Let's go.
You figure out what's going on with her blood counts? - No.
- Her ICP keeps going up.
We don't have any more time.
You delayed this surgery for no good reason.
You failed.
Self-important neophyte, you don't even know how much you don't know.
I'm gonna remove the pressure from her brain and hope it's not too late.
So, congratulations.
Your narcissism almost killed your patient.
Saw to me.
Are you sure you're okay to be here? This is the last place on earth I want to be, and I won't be anywhere else.
Scalpel.
Lap pads.
Cautery.
- There's too much blood.
- Get suction in, damn it.
Suction.
Oh, my God.
No.
This is exactly what Conrad said would happen.
Why isn't she clotting? Hey, man, we didn't have a choice anymore.
When you wait too long, her brain swells and she dies.
You go back in there without correcting her coagulopathy, she bleeds out.
It was my job to figure it out.
Maybe we still can.
Let's work on the differential.
Together.
Okay.
All right, she's bleeding.
It won't stop.
Why? And where does the blood go? Into the body or onto the floor.
In this case, neither.
Jessica's not losing platelets.
Her body is destroying them.
Hemolysis, low platelets, renal dysfunction, fever.
- It's got to be TTP.
- Oh, God.
If she has TTP, her platelet count will just keep dropping.
She'll never clot.
This surgery is going to kill her, and I gave the okay to go ahead with it.
Now that we know what it is, we can treat it.
So you're gonna start plasmapheresis while she's in surgery? Hell yeah, he is.
Move faster.
Get that bleeder.
I'm moving as fast as I can.
It's oozing everywhere.
Keep hanging those platelets.
Get out of my OR! Now! I'm chief of surgery.
Every OR in Chastain is my OR.
Hawkins stays.
- What's happening? - Jessica has TTP.
- Giving her more platelets won't help.
- Scrub nurse, ignore him.
- I need you with me on this cautery.
- All you.
- Conrad, I'll get access.
- Thank you.
You can do that plasmapheresis when I'm done.
You have no idea even if you're right, let alone if it's gonna help.
Okay, now we can cauterize.
Now she has a chance.
Dr.
Bell, just wanted to congratulate you.
What for? Heard you made a very lucrative deal today.
- DiaCure Dialysis Centers.
- Yeah.
They gave us a great price for exclusivity.
That deserves an "attaboy" from the new veep.
What kind of kickback did they offer us for the contract? Some data we required for patient safety, and they committed to help us with the money we need - to fill out our nursing staff.
- Whoa.
Punching above your weight there.
I'll make the call on where the money goes.
I'm thinking Neuro.
Barrett's got a laundry list of line items.
Barrett? You on a first-name basis with Dr.
Cain? We go way back.
He's the one who got me this job.
Lured me away from a hedge fund on the West Coast.
You have no background in health care.
I have a background in profits.
Well, this profit goes for more nurses.
It's it's part of the agreement.
It can't be undone.
No more deals like this again without my input.
Hey.
I'm just gonna change the dressing.
All right, let's see what we have.
There isn't very much blood around the incision.
It's starting to clot.
We'll get another CBC.
Yeah, well, we can send it in, but this is good news.
The plasmapheresis is working.
She still might not wake up.
And if she does, we have no idea what kind of shape she'll be in.
We'll know more in 24 hours.
- Hey, Dad, wait.
- Oh, Nic.
I just finished my shift.
- You need something? - Look, um Thanks for being here today.
I love volunteering.
I know you were scared that it was me when you heard about the accident this morning.
I brushed you off.
I'm sorry I did that.
You're all I got, kid.
We're Team Nevin now.
Still no change in Jessica.
What's this? DiaCure records.
You got them.
Yeah.
It's worse than we thought.
20% higher complication rate with Hemopleatin.
Look at all these PEs.
This drug is probably what killed Jessie.
I think so.
What do you think the next step is? Tomorrow I go in to see Bell and Red Rock, and get this drug pulled off the shelves.
Permanently.
You know how dangerous that is, Conrad? Big Pharma is ruthless.
They could go after you.
They always like to discredit the messenger.
The numbers don't lie.
We'll make sure what happened to Jessie doesn't happen to anyone else.
Her death could save lives.
As awful as this is, I learned something today.
I really love her.
I don't think I realized how much until I thought I might lose her.
If she comes back to me, I'll tell her.
Please come back to me.
We all see how much you guys love each other.
You know, I beat myself up about leaving Priya at the altar.
But now I know it was right.
Because what we had it wasn't this.
Don't make this about you, Pravesh.
Hey.
Thank you.
Oh! - Um, okay.
- It's happening.
Give into it.
- Oh, that's tight.
But - Yeah.
Come on.
There you go.
Oh, buddy.
Hmm, you're certain you have enough patient information to prove that Hemopleatin is causing sudden death in a significant number of patients? Yes.
We need to pull it immediately and warn the FDA.
No, I've looked over the data; Dr.
Hawkins is right.
The complication rate is off the charts.
I'll-I'll have my people go over the figures, and if this checks out, we'll use it to make a PR splash.
Chastain catches a deadly drug - and saves patients.
- And in the meantime, we can go back to using an older drug that we know to be safe.
And, more good news, it's actually cheaper.
Well, that's a huge win on all fronts.
- Really nice work.
- All right.
Thank you.
That info was part of the DiaCure deal.
So you helped him? Yeah.
Yeah.
But I'm happy to let the hospital take the credit.
Okay.
Wake up.
Me or her? Both, I think.
- Mm.
- Jess? Honey? - Jess? - Mm.
Can you hear me? Mm.
- Can you hear me? - Hey.
Hey.
- Hey.
Hey, hey.
Whoa, whoa, whoa.
- Careful, careful.
Shh, shh.
No, don't do that.
- You're okay.
Hey.
- Hey, Jess.
Honey.
Hey.
You're okay.
You're fine.
You're fine.
It's a long story, but everything's gonna be just fine.
Okay.
Here we go.
Here we go.
You could use some vittles in ya.
All right.
I'll eat now.
- This is a mess.
- Do the honors.
- This looks good.
- Yeah, this is not from the cafeteria.
Okay, I want the little baby one over here.
I heard the good news.
- Dr.
Hawkins, a word? - Yeah, sure thing.
I just want to say, I, uh, appreciate what you did, and I actually regret that we had words.
It-it was an emotional day for all of us.
No doubt.
No doubt.
But don't ever question my decision again.
Well, when I'm wrong, I've learned to listen to my colleagues.
You're not a colleague.
You're a subordinate and I don't give a damn what your process is.
You're not invincible, you know.
No one is.
You sure about that? We on the same page? You tell me.
Hawkins is a whistleblower.
My concern is him deciding in his self-righteous way that Red Rock is doing something he doesn't like.
That's not something I can live with.
Then there's our answer.
He's a threat to the hospital.
I'll handle it.