The Resident (2018) s03e14 Episode Script
The Flea
1 - Previously on The Resident - Today is the day we introduce 3B Life to the American public.
So you are Bell and Cain's new partner? They're the new partners.
I'm the founder.
- You should call me.
- Okay.
I've just been hired as the new team doctor for Georgia FC.
This will remain at St.
John's unless there's another hospital I decide to call home.
What would be the terms? Chief resident.
- Good to have you back.
- Cheers.
(NIC VOMITING) I told you the table-side Caesar was a bad idea.
(TOILET FLUSHING) You know that little asterisk they put on the menu? "This contains raw egg"? Why did I ignore it? 'Cause you love to live life on the edge.
Like me.
I really wanted to be with you your first day back at Chastain.
I know, but it's only one day.
And we have so many more to come.
Unless you continue to ignore the asterisk.
(LAUGHS) All right.
Kitchen's stocked.
Bananas - rice - Applesauce, toast.
Yes, I'm well aware of the BRAT diet.
Have a good first day back.
Be with you in spirit.
- All right.
I love you.
- (STAMMERS) Oh, nice.
My little BRAT.
Now go.
I'm gonna be sick again.
- Stay out of trouble.
- Call me if you need anything.
I want what I want, not what I need Even if it kills me, I'll be free I want what I want, not what I need The American dream I want what I want, not what I need Even if it kills me, I'll be free What I want is just what I want The American dream - Hey, Pravesh? - Hmm? - Does that guy look familiar to you? - Oh, no.
No, no, no.
- Why? - I don't know, I I think he used to work here.
You know, it's just really hard to remember, you know, with all these faces just coming and going around here.
Oh, yeah, yeah.
You boys done? - Hmm? - Oh, wait.
I do remember that voice.
Dr.
Conrad Hawkins.
The man who went up against Red Rock and lived to tell the tale.
Oh.
Oh! Oh.
You miss all this? You have no idea.
How do you feel about getting your footsies wet in the ER? - We could use the help.
- Ah! - Wet footsies.
I'm in.
- (PAGER BEEPS) Psst.
(LAUGHS) Good to see you, darling.
CAIN: Dr.
Hawkins.
Welcome back.
Thank you.
Nice to be back.
Let's go.
Brought Hawkins back? Uh, hey, let me call you back.
He signed a lucrative deal with a national sports franchise.
- He's still a whistleblower.
- I'm aware.
Risk versus reward.
I made the call.
(SMACKS LIPS) It's insanity.
Turns out he's a rainmaker.
And Red Rock likes the rain.
Yeah, I'm well aware.
Remember who you're talking to? Now, careful now Barrett.
Proceed with caution.
I should have been informed.
Leaving me out of the loop on Hawkins is a sign of disrespect to the surgeon who's made more rain for you and Red Rock than anyone else.
Not as much as you used to.
Your billing is moving in the wrong direction.
Pair that with the expensive neuro center we're building on your behalf, by my assessment I'd say you got to hustle up.
Hustle up? What exactly are you implying? Everyone has an expiration date.
Everyone.
(EASY LISTENING MUSIC PLAYING) I'm game.
ANDREA: I'm game, too.
Even though most people don't normally do it this way.
That's true.
When most people start out, they only show each other their best qualities.
And hide their worst, pretend to be someone they're not.
It could be months before you find out who you're really with.
Years.
We will lay it all on the table next to these inedible eggs and DOA flapjacks.
- (LAUGHS) - A breakfast interrogation.
Won't be my first time on the witness stand.
- Oh.
- Mm-hmm.
- Well, let's start there, why don't we? - Okay.
Oh, hey, uh (CLEARS THROAT) Just checked on that outside hospital hernia transfer.
His incision was oozing.
I interrupt something? Enjoy your meal.
Uh where were we? I was about to ask you about your worst breakup.
Yeah.
No.
No, we're-we're not going there.
- What?! We're just - N-No.
Sorry.
Not-not a chance.
The - (BUZZING) - I-Is ? Whoa.
Is that my pager? I think Oh, look at that.
Saved by the pager.
- Did you just page yourself? - Excuse me? - What? Huh? - What do you mean? Who does that? - (STAMMERS) Okay.
- Listen, got to go.
- Catch you later.
- (LAUGHS) Incoming Bay Six.
- Hmm.
- All right, let's do this.
Doug, I'm Dr.
Hawkins.
So what's going on? Uh it was Taco Tuesday.
I do it up real nice for the kids.
Queso, green chilis.
I was cleaning the table off, and I looked down, and that's when I saw it.
BOTH: Saw what? Drool.
I was in the middle of a photo shoot when it got real bad.
Well, it's not uncommon for flashing lights to trigger a headache.
Your pupils are pinpoint.
That means smaller than normal.
I know what pinpoint means, thank you.
How long will it take me to get normal? I'm tip-top from top to tail, baby.
- Then why are you here, Raj? - (CLEARS THROAT) Look, I get the runs, like, every 20 minutes.
All right, I was on a date last night.
Had to get off to the john before the food even arrived.
We were supposed to go see a movie after.
(SCOFFS) Forget it.
We might as well watch it on my phone in the bathroom.
CONRAD: All right.
- (LAUGHTER) - All right.
So you pull me into the ER for what appears to be a drooler, a headache, and diarrhea.
So we threw you some softball cases.
We just don't want to lose you again.
Don't fly too close to the sun on your first day back.
- Mm-hmm.
- (PAGERS RINGING AND BUZZING) I could use a little sun.
Mind if I join? Hawkins is back in action.
(LAUGHS) What a lovely sight.
They should be landing soon.
54-year-old woman, Jet Ski collision with a motorboat.
Propeller lodged in pelvis.
Pulse: 126.
Got it.
Voss, you're with me.
Careful not to disrupt the propeller blade.
Roger that.
- What's her name? - Becky Copple.
Becky, we're gonna take care of you, okay? What have we got? 55-year-old male, same accident.
Hit his head on the deck.
No LOC.
GCS 14 on scene for confusion.
I'm fine.
Just please save my wife.
Becky, do you know where you are? Hospital.
BP's 75/40, pulse in the 140s, 02 sat 99%.
She's cold and clamped down, going into shock.
No, she's in shock.
Hang two units of O neg now and activate massive transfusion protocol.
Dr.
Feldman, can you put in a central line? (RHYTHMIC BEEPING) Oh, there's blood in her pelvis.
KIT: The propeller could be tamponading a more catastrophic bleed.
Becky, can you wiggle your left toes? Great.
How about your right? I I can't move my leg.
What's going on? Ah, pupils are equal and reactive.
This shouldn't need stitches.
How you feeling? Ah, just-just a headache.
Maybe my eyes are a little bit blurry.
Okay, possible concussion.
We'll run some tests.
- (PAGER RINGING) - Hey, I got another patient.
- I got to go.
You good? - Good.
- Sure? - Mm.
- John? - Mm.
- Squeeze my fingers.
- Ah.
Squeeze my fingers.
Good.
Good.
So you live here in Atlanta? Yeah, we do, but we spend most of our time on the road.
(MUFFLED CHATTER) - Oh, yeah, why's that? - Uh, well, Becky and I started the Copple Foundation about 15 years ago.
All right, push on the gas.
Push on the gas.
That's good.
Yeah, we, uh, serve the causes that we're most passionate about.
Health care is one of them.
And that is why we know this man so well.
- John.
- (SIGHS) I'm so sorry to hear about the accident.
Thank you, Logan.
I'm, uh (SWALLOWS) Becky's hurt really bad.
I assure you she-she's in the hands of our absolute best.
As are you.
Thank you.
- (GROANS SOFTLY) - I'll be right back.
KIM: John and Becky Copple are among the biggest donors to Red Rock.
Most notably, our new neuro center.
You gave me a reason to bring you back.
Let's make sure that I continue to feel good about my decision.
Okay? BP's up to 100/60.
Pulse has come down to the 90s.
This is our window to move her.
Hang another unit of blood and let's bring the cooler with us to CT.
And then to the OR to remove the propeller.
Come on, people, let's move.
Wait, wait.
Wh-Wh-Where-where are they taking her? Imaging.
Just part of the process.
(SIGHS) It was my idea to go Jet Skiing.
Becky loves the outdoors.
I hate the sun.
It's one of the few things we don't have in common.
But this boat came out of nowhere.
And we crashed at full speed.
I just wish I had gotten the worst of it and not her.
I can't lose her.
I just I-I don't even know what my life looks like without Becky.
I understand.
But if we don't take care of you, then you can't take care of Becky, so how about we focus on you for a minute? Deal? - Deal.
- All right.
I'm seeing on your medical record you had a brain tumor removed eight years ago? I did.
Yes.
It was a benign growth.
- Hmm.
- Why? Just want to get a CT to make sure everything's okay.
- Sound good? - Let's do it.
ANDREA: So, thanks to ads, point of sale displays, strategic partnerships Oh, Randy, there you are.
Have a seat.
The lovely Andrea just came to the interesting part.
You gentlemen remember our first quarter projections.
Well, this is our actual revenue.
50,000 units sold in the first month.
100 last week alone.
- Those are real numbers? - Mm-hmm.
I mean, I knew we were doing well, but We can barely keep up with demand.
Well, then, I say we increase production, with a larger facility.
- We could expand to other regions.
- Mm-hmm.
BELL: You know, we should put some cash into R&D and lay the foundation for a whole new line.
You'll all be parking your yachts next to mine before the year's out.
You know, maybe you can quit teaching Pilates.
Or, hell, she could buy the studio.
Hell, she could buy Pilates.
I don't think that's possible.
Uh, with the fortunes we're gonna make, it is.
- (EXHALES) - L-Listen, listen.
I-I-I have been here before.
All right? I mean, we are playing with the big boys now.
And with profits this promising, competitors will be trying to buy us for a nickel and a rubdown.
But I think we can all agree that the real winning formula is not just what's in this little bottle.
No, no, no.
No, it's-it's the people in this room.
All y'all, the-the men and brilliant lady right here, united, working together.
We have struck gold, my friends, and I don't know, but anybody here want to let 'em take away our gold? - (PAGER BEEPING) - I'd like to see 'em try it.
That is one enormous fracture.
KIT: The propeller sliced through her sacroiliac joint.
Explains why she can't move her leg.
Her pelvis has been completely separated from her spine.
AUSTIN: And it's torn through her internal iliac artery.
The damage is so extensive - because this propeller is cupped.
- KIT: So, the plan is, we remove the propeller, stop the bleeding before she exsanguinates.
Then, if we succeed, reattaching her pelvis to her spine will not be a walk in the park.
I'll prep the OR.
(DOOR OPENS) CAIN: What's the story? TBI.
History of a benign brain tumor that was successfully removed, but it's regrown.
CAIN: Well, hopefully it's still benign.
I'll send it to pathology when I take it out.
I'm gonna need to review his prior scans and path reports.
- Mm-hmm.
- There's also an associated hemorrhage.
- Is he symptomatic? - Headache, blurry vision.
And it's only gonna get worse the longer we wait.
We're gonna have to operate soon.
Any there any issues - that might complicate his surgery? - Eh, mild hyponatremia.
That's likely related to dehydration.
Otherwise, labs were unremarkable.
All right.
I'll take him to my OR.
(DEVON SPEAKING INDISTINCTLY) (GROANING) Sir, you need to stay in your bed.
And keep your pants on.
L-Look.
IRVING: Fasciculations? - When did it start? - A few minutes ago.
- Let's get another full set of labs.
- Right.
We'll check for any electrolyte abnormalities.
Should I, uh, cancel Waffle Wednesday? Maybe just reschedule till next week.
HUNDLEY: A little help over here! Respiratory distress, Bay Eight.
- IRVING: Pravesh.
- Stay there.
Get me an intubation kit.
She started to wheeze and couldn't clear her secretions.
We tried BiPap and she became altered and we couldn't get her sats over 72%.
(MONITOR BEEPING RHYTHMICALLY) (BEEPING) Mild crackles bilaterally.
Increase the PEEP.
PEEP is up to 15.
Okay, that bought us some room.
But she's still skimming the treetops.
All right, let's get a blood gas and a chest X-ray.
And write her for broad-spectrum antibiotics with cultures first.
Once we get the gas, we'll put her on ARDSNet protocol.
If her oxygenation is still tenuous, we'll start inhaled epo.
IRVING: Good plan.
But this is strange.
I mean, she came in with a headache, for God's sake.
And now she's very close to max vent settings.
We need to figure this out.
And fast.
Can I talk to my wife? We need to get you both in ORs ASAP.
No, no, please.
I just - I need a sec.
- We have to be quick, though.
Hold up, hold up.
I know what you're gonna say.
We're in good hands.
We're both gonna be fine.
You love me.
I was gonna lead with "I love you".
But, yes, all of that.
Then I'll see you tonight.
Make sure we're in a recovery room together.
In our 20 years of marriage, we've never spent a night apart.
KIT: We wouldn't want to break a streak like that.
AUSTIN: Well, you've got two softies who'll do our best to make it happen, but right now we got to go.
JOHN: I love you.
- I love you.
- I love you.
(PHONE RINGING) Hey.
CONRAD: How you feeling? Better.
Thank you.
It's so quiet.
Where are you? Our supply closet.
Oh, it's our supply closet now? Well, we-we share it with Jess and Irving, but it's mostly ours.
(SIGHS) You okay? Nic, I just I just want to say thank you for for being there and for, for never doubting that I would be okay and for helping me.
Helping me find my way back here.
You don't need to thank me.
Yes.
I do.
Hey.
You'd do the same for me.
But you need to get back to work.
People are gonna think you lost your mind, talking to yourself alone in a supply closet on your first day back.
(CHUCKLING) That's fair.
That's fair.
I'll get home as soon as I can.
I know you will.
I'll see you tonight.
(PHONE BEEPS) (GROANING) Again? Unfortunately, Raj's bathroom situation has escalated.
But all of his stool studies have come back negative.
Mr.
Corson's pants are back on, but he's still having fasciculations, and he's started to act confused.
What? Pravesh.
What's up? MUDDLES.
I haven't heard that term since I was in medical school.
Meiosis, urination Diarrhea, diaphoresis Lacrimation, excitation of the central nervous system, salivation.
Yeah, so, if you add Doug, Cynthia and Raj's symptoms together, it is textbook organophosphate poisoning.
How do three patients who have nothing in common get exposed to a toxin that's only found - in pesticides and chemical weapons? - I don't know.
But they're all showing different signs of exposure.
(IRVING EXHALES) If it is, we need to treat them fast.
Organophosphate poisoning can progress rapidly.
Hundley, push atropine and one gram of 2-PAM - for all three of them.
- On it.
KIT: Dr.
Okafor, why don't you give that propeller blade a nice, big tug.
MINA: It's not budging.
KIT: It's stuck in the SI joint.
You have to pull with more force.
Put your back into it, dear.
(MINA GRUNTS) Okay, it's not working.
AUSTIN: Step aside.
I've got Excalibur.
(GRUNTING) Damn.
- It won't come out.
- MINA: Mm-hmm.
KIT: Allow me.
Ortho isn't just about brute strength.
Sometimes you have to think outside of the box.
Hammer, please? And then use brute strength.
Get ready.
- (ALARM BEEPING) - MINA: Suction.
- KIT: Retractors.
- AUSTIN: Sutures.
What are the odds a benign brain tumor regrows? Well, it's rare, but it can happen.
Don't worry.
I'm here to deal with that.
We're gonna proceed with the craniotomy - to remove the tumor.
- Copy that.
CAIN: I'll get scrubbed up.
Thank you, Dr.
Cain.
CAIN: You're welcome.
John, I'm gonna administer the propofol now.
Start counting backwards for me from ten.
(GROANING) - Just breathe.
- (GROANING CONTINUES) (MONITOR BEEPING) What'd you give him? Just relax.
Just breathe.
What did you give him? I haven't given him anything yet.
CAIN: You must have done something.
He's tach'ing away in the 150s.
His BP shot up to 180s.
- (GROANING) It hurts! - CAIN: What? Where do you Where does it hurt? - Tell me what hurts.
- It hurts! - What's-what's hurt? What hurts? - My stomach! - Your stomach? - (SHOUTING) Abort the surgery! (MOANING, COUGHING) KIT: Dr.
Austin, you're on the left pelvis.
Dr.
Okafor, you're on the right.
Fasten this obtrusive instrument on each side.
Now for the most critical part of the surgery.
We must bring her pelvis and spine back into alignment.
- AUSTIN: We're gonna reduce her SI joint? - Correct.
You will both push your side of the pelvis towards one another.
How hard do we push? It must be equal pressure.
And what if one pushes harder than the other? Then her pelvis will be misaligned from her spine.
We could crush her sacral nerves and leave her paralyzed.
You must be perfectly in sync.
I know I can count on you both.
AUSTIN: We got this.
MINA: On three? One, two, three.
KIT: Slowly.
A little more pressure from you both.
(CLICKING) Feeling some resistance.
AUSTIN: I'll adjust.
Stop.
MINA: How did we do? That's anatomic.
I've never seen a more perfect alignment.
(CHUCKLES) Game, set Match.
(KEYS CLACKING) My patient is stagnating in the ICU after an aborted surgery because something you missed.
We don't know that yet.
Then what do you know? - You're the internist here, right? - Mm-hmm.
In the great ecosystem of this hospital, a flea.
You had one job: to make sure my patient was tuned up for surgery.
So let me give you some advice upon your fresh return to this hospital.
Go do your one job so my patient doesn't die.
What the hell happened in there? I'm replaying it in my head.
This, uh, acute abdominal pain with nausea and hemodynamic instability in the OR but with absolutely no prodrome.
Could he have thrown a clot to his bowel? I thought about that, but nothing on imaging.
And his lactate is flat.
So what's your plan? Uh, reexamine head to toe.
Rerun labs.
Get to the bottom of this.
(EXHALES) (QUIETLY): Listen, let me know how I can help you.
They-they took your head.
You figured out how to grow another one.
But don't think for a second they're not looking for any reason to bring the ax down again.
Who's "they"? Kim did the firing, but he and Cain are a team.
There's no way Cain didn't have a hand in it.
And Cain doesn't care that you brought in Georgia FC.
For him, getting rid of you is personal.
Be careful.
Buy you coffee? No.
Please? Thank you.
Fine.
Uh, one almond milk latte and one - Large coffee.
- Thanks.
What do you want to know about him? AJ seems amazing, but I have been conned before.
So, woman-to-woman, off the record, jump in or run like hell? (SIRENS WAILING) - (ELEVATOR DINGS) - All three patients have stabilized.
Cynthia just got extubated.
- So you were right.
- Yeah.
But how do three people with no connection end up with the same rare poison in their system? First, we find out.
Then we call County Public Health and stop whatever caused this.
So, you live nearby in ? - Savannah.
- Chamblee.
(HOARSELY): Sandy Springs.
Any recent exposure to chemicals? - No.
- No.
I bought a can of body spray.
Has anyone sprayed insecticides near your home or your garden? I don't have a garden.
Not that I'm aware of.
(SCOFFS) No.
Any vitamins or supplements? Yeah.
Yeah, I just picked up a new one.
Um 3, uh 3B something.
3B Life.
That's it.
Hey, fingers crossed, I look just as good as that doctor on the label when I'm his age, right? - (CHUCKLES) - (FORCED CHUCKLE) Three different patients All with organophosphate poisoning.
All on 3B Life.
Well, maybe they use the same cleaning supplies or pesticides.
We did extensive patient histories.
You can't possibly know everything that they came in contact with Yes, but, right now, the only link that we do have is your supplement.
- How widely was it distributed? - Wide.
Okay.
We need to call Public Health and warn them about it.
That's ridiculously premature.
You can't call the CDC on three patients.
Dr.
Bell, I know that you have a personal stake in this, - but we have to - Okay.
Maybe, maybe they have other things in common.
And if we act too quickly, we'll destroy the reputation of a good product that is helping people, not to mention me.
Yeah, but if we wait, people could die.
So, beyond an acute cholinergic crisis, people could have serious long-term disabilities I don't need to be educated on the effects of organophosphates.
Okay, Dr.
Bell, we just need to do the right thing.
(PANTING) I can only see you when I turn to look at you.
When you stand to the right of me, I can't see you at all.
Must be because of the tumor.
The bleeding is causing some swelling, and that is what's affecting your vision.
Well, will it get better? I-I can't go blind.
We're giving you some steroids.
We're gonna decrease the swelling.
Now, if we can get that tumor out soon, - then you should regain your vision.
- "If"? - Let's get it out now.
- Yes, I know.
I am of the same mind.
But your labile blood pressure and heart rate haven't been responding to the treatments.
- (SIGHS) - And I can't risk sending you back into surgery unless Dr.
Hawkins can come up with a plan to make sure that you're safe in the OR.
- JOHN: What's the plan? - Yes, Dr.
Hawkins.
What is the plan? John, I know you've been scanned and examined up and down, but do you mind if I take one more look? (CHUCKLES) (HISSES) (GROANING SOFTLY) Did that start to hurt after the accident? No, actually.
(HISSES) That pain has been on and off for a while.
Sometimes it hurts so bad, I feel like it's gonna rip right through me.
Like today in the OR.
And then all of a sudden, it gets better.
Now I'm gonna untie your gown so I can get a good listen to your lungs.
What? (STAMMERS) What's wrong? There are blisters on your shoulder.
I did not see that earlier.
CAIN: Why the hell didn't you see that earlier? That's your job.
Didn't you do a full physical examination? They-they weren't there this morning.
I'm sure.
I would know.
I've had them in the past.
That's why I hate the sun.
And when we were outside, I was covered from head to toe.
Hyponatremia.
Recurrent abdominal pain.
Blistering skin lesions.
Blistering.
Blistering, blistering, blistering skin lesions.
(CHUCKLES) I need a urine sample.
Right now.
ANDREA: There's got to be a mistake.
I don't know.
It doesn't make sense.
We ship out hundreds of thousands of units - and only three people get sick? - Well, it's not just three.
No, I just found out that two more patients have been diagnosed with organophosphate poisoning - over at Atlanta General.
- Oh, my God.
They're stable.
They're getting treatment, just like the ones here at Chastain.
Are they on 3B? They're on supplements.
But if I ask for specifics, the doctors there will make the same connection that we did.
Then we test the facility, - we prove it's not us.
- (STAMMERS) Agreed, but (EXHALES) Zip is gonna start talking about an exit strategy.
- Wait, what? It's too soon.
- No, Andrea, there's a chance, no matter what the percentage, that 3B is the culprit and that we're dead in the water.
- (SIGHS) - I can't believe this is happening.
I-I I have to call the partners.
Your post-op CBC is stable.
No more bleeding.
Distal pulses are strong.
Becky, can you wiggle your toes? Looks good.
(CHUCKLES) Recovering from major surgery is challenging, so we will be monitoring you closely.
Thank you.
(EXHALES) And what about John? He didn't have surgery yet.
Why? We don't know.
But we do know his doctors are working on it.
What does that mean? Will he be okay? Can I be with him? First, you must get well.
Then you can be strong for him.
When he had brain surgery eight years ago, I held his hand all night.
Like I could keep him with me, just by physically holding on.
And it worked.
Well, as soon as we can, we'll get you two back together again.
And now we have urine in the sun.
Dr.
Hawkins, I'm starting to lose my patience.
Just wait.
(QUIETLY): I am not gonna stand here and stare at another man's urine with you while John's tumor continues to swell.
We don't have time for this.
It was time well spent.
What-What's happening? John, this urine changed color.
That explains what happened in the OR and gives us a diagnosis: porphyria.
Porphyria's when you have an excess of the chemical porphyrin and it builds up in your organs, and when that happens, certain stressors, like the intense lighting in the OR, triggers a crisis that causes things like blisters, stomach pain, and even organ damage.
You got all that from my pee? CONRAD (CHUCKLES): Combined with your exam and history of previous stomach pain and skin blisters.
But yes, when the porphyrins turned your urine dark in the sun, my clinical suspicion was confirmed.
So I've had this my whole life? Incredibly rare, easily missed, but the good news is we can treat you.
We'll be sending confirmatory labs of course, but I am confident you will be back in the OR soon.
Which Dr.
Cain and I will be prepping for you.
- (JOHN SIGHS) - CONRAD: I made a list of all the meds that can be fatal to a porphyria patient.
Avoid these at all costs.
I haven't had a porphyria patient since residency.
Yep, this is a unique case.
That's exactly why I made a list for everyone.
Propofol for anesthesia, that's safe.
Morphine's okay.
Just let me know before you give - any antibiotics.
- CAIN: Dr.
Hawkins is right.
We all need to review the drug list.
CONRAD: And the reason John crashed in the OR before was because of these intense lights, so we got these filters.
CAIN: We'll still be able to see, but they change the wavelength of the light that hits John's body.
CONRAD: Avoiding a porphyric crisis.
(MONITOR BEEPING RAPIDLY) What the hell happened? KIT: She came out fine after the surgery, then she went into V tach and lost her pressure.
Hold compressions.
Checking a rhythm.
Damn, she's still in V fib.
We need to shock again.
Charging to 200.
Clear.
AUSTIN: Restart compressions.
I'll take over.
KIT: Code labs are back.
Hemoglobin is stable.
She's not losing blood.
But her calcium is under five.
That's not doing her heart any favors.
Okay, we need more calcium.
One gram of calcium chloride, now.
We ordered it hours ago.
There's a calcium chloride shortage.
Take it from the crash cart.
She should have received more calcium with her blood transfusions.
This is what happens when drug companies discontinue products that save lives but don't make money.
Calcium chloride is in.
AUSTIN: Continue compressions.
30 seconds to the next pulse check.
Hope this works.
CAIN: Bull's-eye.
Time to remove the tumor.
How are the lights? Sufficient.
My patient's hemodynamic instability is no longer distracting me.
You might want to follow that lead.
(SCOFFS SOFTLY) Forceps.
His wife Becky just coded.
They're still working on her.
Get this to path.
It's been hours why is he just getting to the tumor now? It's a delicate surgery.
Dr.
Cain is in the middle of a very complicated surgery, and with the added precautions for the porphyria John's a lucky guy.
(JOHN SIGHING) I can see you.
(CHUCKLES): All of you.
Surgery went well.
Your tumor's gone, and your preliminary path looks benign.
And we have a plan to manage your porphyria moving forward.
Today you received Chastain's finest, as promised.
JOHN: But Becky where is she? She sustained serious injuries in the crash, but, like you said before, John, your wife she is strong enough for both of you.
She survived a very grueling surgery.
But hey, don't worry, we will make sure you do not spend tonight apart.
Your streak will be intact.
So now what? I don't want to give up.
What if I'm wrong? What if my supplements are hurting people? Look you and I don't know each other well, but you have shown me so far a woman who doesn't half-ass anything.
So I believe that you know your stuff.
And I believe that you will do the right thing.
ANDREA: I know it's not the 3B.
- I know it.
- Actually, you don't.
I see a future buried in lawsuits.
Oh, please, do not use the "L" word.
Okay, once we test the manufacturing facility We'll already be on 60 Minutes by then.
I know you're both concerned about your own liability.
- If - We poisoned people? Yeah, I think we might be a little bit concerned about that.
Okay, but let's remember that I'm the reason that we're here.
My product, my skill, my judgment, that's that's what got us this far.
So I ask that you trust me to see us through this.
Please.
(CAIN SIGHS) How many units have we sold? Enough that a recall costs us millions more.
All to protect a brand that we don't even know will be worth anything when this whole thing is done.
It's time to walk away from the table.
I agree, I agree.
We got to protect ourselves, cut our losses.
I-I think we should declare bankruptcy.
CAIN: Liquidate the assets, make sure there's nothing left to sue for.
Okay, everything I have is in this company don't do this.
It's over.
Okay? I'm sorry.
Maybe next time, don't make your supplements out of fertilizer.
You have no idea what you're talking about.
You're just a fat cat who came along for the ride.
And I appreciate the cash, but do not speak to me like that again.
I am just fine to go it alone, if that's what I'm up against.
There's another way.
I'll buy you out.
- Both of you.
- (CHUCKLES) Take on all the liability myself.
You sure you have the cash for that suicide mission? I'll figure it out.
(STAMMERS) 50 cents on the dollar for all your shares.
Hell, I mean, if I can get some of my money back and, uh, dodge this bullet, I don't care how you do it.
I'm sold.
Okay.
But make it fast.
(BELL EXHALES) (WHISPERS): Why did you - (CHUCKLES) - Why why did (SIGHS) Well, because, at this point, they think it's a coin toss that 3B's at fault.
They're panicking.
And I think the odds are slightly better than that.
You know, yeah, it's kind of betting the farm, but it's a chance to get full ownership back for the two people I care most about.
(SOFTLY): Wow.
Thank you.
No, don't thank me.
Just (SIGHS) Just pray we're not wrong.
(SIGHS) Otherwise, I just made the biggest mistake of my life.
And we're both ruined.
Where's your friend? She's going through some things right now.
Hmm.
Are you looking for her red flags? Well, it's early.
You know? She's looking for your red flags.
What'd you tell her? You mean what didn't I tell her.
(AUSTIN CHUCKLES) You know, you are enjoying this a little too much.
(GIGGLES): Mm-hmm.
I led with "compassionate".
Closed with "brilliant".
That she would be wise to hold on and not let go.
We're gonna rise, hear the calling And I told her about your cats.
All five of them.
The woman deserved a warning.
We're gonna rise above (LAUGHS) We're gonna rise, hear the calling We're gonna find that we belong We're gonna rise above where we've fallen We're gonna rise - Hey.
(CLEARS THROAT) - (CONRAD SIGHS) Ah Mm You do not look or smell like a 12-hour shift.
My new office has a shower.
Ooh.
I remember that shower.
How are you feeling? So much better.
You survived.
Yeah, and my patients did, too.
- Really? - (CHUCKLING) This amazing couple, 20 years together, never spent a single night apart.
Wow.
That is amazing.
Something to aspire to.
(SIGHS) No way.
- No way, right? - No.
I mean, I love you, but time apart is healthy.
We've got, like, a thing that works for us.
- It works beautifully.
- Mm-hmm.
Which requires the occasional night apart.
Handful of nights; rare exceptions.
Mm, a few handfuls.
- Easy, now.
- (CHUCKLES) Tonight is not one of those nights.
We're gonna rise, hear the calling We're gonna find How many handfuls? We're gonna rise above - I know you're not asleep.
- (LAUGHS) We're gonna rise
So you are Bell and Cain's new partner? They're the new partners.
I'm the founder.
- You should call me.
- Okay.
I've just been hired as the new team doctor for Georgia FC.
This will remain at St.
John's unless there's another hospital I decide to call home.
What would be the terms? Chief resident.
- Good to have you back.
- Cheers.
(NIC VOMITING) I told you the table-side Caesar was a bad idea.
(TOILET FLUSHING) You know that little asterisk they put on the menu? "This contains raw egg"? Why did I ignore it? 'Cause you love to live life on the edge.
Like me.
I really wanted to be with you your first day back at Chastain.
I know, but it's only one day.
And we have so many more to come.
Unless you continue to ignore the asterisk.
(LAUGHS) All right.
Kitchen's stocked.
Bananas - rice - Applesauce, toast.
Yes, I'm well aware of the BRAT diet.
Have a good first day back.
Be with you in spirit.
- All right.
I love you.
- (STAMMERS) Oh, nice.
My little BRAT.
Now go.
I'm gonna be sick again.
- Stay out of trouble.
- Call me if you need anything.
I want what I want, not what I need Even if it kills me, I'll be free I want what I want, not what I need The American dream I want what I want, not what I need Even if it kills me, I'll be free What I want is just what I want The American dream - Hey, Pravesh? - Hmm? - Does that guy look familiar to you? - Oh, no.
No, no, no.
- Why? - I don't know, I I think he used to work here.
You know, it's just really hard to remember, you know, with all these faces just coming and going around here.
Oh, yeah, yeah.
You boys done? - Hmm? - Oh, wait.
I do remember that voice.
Dr.
Conrad Hawkins.
The man who went up against Red Rock and lived to tell the tale.
Oh.
Oh! Oh.
You miss all this? You have no idea.
How do you feel about getting your footsies wet in the ER? - We could use the help.
- Ah! - Wet footsies.
I'm in.
- (PAGER BEEPS) Psst.
(LAUGHS) Good to see you, darling.
CAIN: Dr.
Hawkins.
Welcome back.
Thank you.
Nice to be back.
Let's go.
Brought Hawkins back? Uh, hey, let me call you back.
He signed a lucrative deal with a national sports franchise.
- He's still a whistleblower.
- I'm aware.
Risk versus reward.
I made the call.
(SMACKS LIPS) It's insanity.
Turns out he's a rainmaker.
And Red Rock likes the rain.
Yeah, I'm well aware.
Remember who you're talking to? Now, careful now Barrett.
Proceed with caution.
I should have been informed.
Leaving me out of the loop on Hawkins is a sign of disrespect to the surgeon who's made more rain for you and Red Rock than anyone else.
Not as much as you used to.
Your billing is moving in the wrong direction.
Pair that with the expensive neuro center we're building on your behalf, by my assessment I'd say you got to hustle up.
Hustle up? What exactly are you implying? Everyone has an expiration date.
Everyone.
(EASY LISTENING MUSIC PLAYING) I'm game.
ANDREA: I'm game, too.
Even though most people don't normally do it this way.
That's true.
When most people start out, they only show each other their best qualities.
And hide their worst, pretend to be someone they're not.
It could be months before you find out who you're really with.
Years.
We will lay it all on the table next to these inedible eggs and DOA flapjacks.
- (LAUGHS) - A breakfast interrogation.
Won't be my first time on the witness stand.
- Oh.
- Mm-hmm.
- Well, let's start there, why don't we? - Okay.
Oh, hey, uh (CLEARS THROAT) Just checked on that outside hospital hernia transfer.
His incision was oozing.
I interrupt something? Enjoy your meal.
Uh where were we? I was about to ask you about your worst breakup.
Yeah.
No.
No, we're-we're not going there.
- What?! We're just - N-No.
Sorry.
Not-not a chance.
The - (BUZZING) - I-Is ? Whoa.
Is that my pager? I think Oh, look at that.
Saved by the pager.
- Did you just page yourself? - Excuse me? - What? Huh? - What do you mean? Who does that? - (STAMMERS) Okay.
- Listen, got to go.
- Catch you later.
- (LAUGHS) Incoming Bay Six.
- Hmm.
- All right, let's do this.
Doug, I'm Dr.
Hawkins.
So what's going on? Uh it was Taco Tuesday.
I do it up real nice for the kids.
Queso, green chilis.
I was cleaning the table off, and I looked down, and that's when I saw it.
BOTH: Saw what? Drool.
I was in the middle of a photo shoot when it got real bad.
Well, it's not uncommon for flashing lights to trigger a headache.
Your pupils are pinpoint.
That means smaller than normal.
I know what pinpoint means, thank you.
How long will it take me to get normal? I'm tip-top from top to tail, baby.
- Then why are you here, Raj? - (CLEARS THROAT) Look, I get the runs, like, every 20 minutes.
All right, I was on a date last night.
Had to get off to the john before the food even arrived.
We were supposed to go see a movie after.
(SCOFFS) Forget it.
We might as well watch it on my phone in the bathroom.
CONRAD: All right.
- (LAUGHTER) - All right.
So you pull me into the ER for what appears to be a drooler, a headache, and diarrhea.
So we threw you some softball cases.
We just don't want to lose you again.
Don't fly too close to the sun on your first day back.
- Mm-hmm.
- (PAGERS RINGING AND BUZZING) I could use a little sun.
Mind if I join? Hawkins is back in action.
(LAUGHS) What a lovely sight.
They should be landing soon.
54-year-old woman, Jet Ski collision with a motorboat.
Propeller lodged in pelvis.
Pulse: 126.
Got it.
Voss, you're with me.
Careful not to disrupt the propeller blade.
Roger that.
- What's her name? - Becky Copple.
Becky, we're gonna take care of you, okay? What have we got? 55-year-old male, same accident.
Hit his head on the deck.
No LOC.
GCS 14 on scene for confusion.
I'm fine.
Just please save my wife.
Becky, do you know where you are? Hospital.
BP's 75/40, pulse in the 140s, 02 sat 99%.
She's cold and clamped down, going into shock.
No, she's in shock.
Hang two units of O neg now and activate massive transfusion protocol.
Dr.
Feldman, can you put in a central line? (RHYTHMIC BEEPING) Oh, there's blood in her pelvis.
KIT: The propeller could be tamponading a more catastrophic bleed.
Becky, can you wiggle your left toes? Great.
How about your right? I I can't move my leg.
What's going on? Ah, pupils are equal and reactive.
This shouldn't need stitches.
How you feeling? Ah, just-just a headache.
Maybe my eyes are a little bit blurry.
Okay, possible concussion.
We'll run some tests.
- (PAGER RINGING) - Hey, I got another patient.
- I got to go.
You good? - Good.
- Sure? - Mm.
- John? - Mm.
- Squeeze my fingers.
- Ah.
Squeeze my fingers.
Good.
Good.
So you live here in Atlanta? Yeah, we do, but we spend most of our time on the road.
(MUFFLED CHATTER) - Oh, yeah, why's that? - Uh, well, Becky and I started the Copple Foundation about 15 years ago.
All right, push on the gas.
Push on the gas.
That's good.
Yeah, we, uh, serve the causes that we're most passionate about.
Health care is one of them.
And that is why we know this man so well.
- John.
- (SIGHS) I'm so sorry to hear about the accident.
Thank you, Logan.
I'm, uh (SWALLOWS) Becky's hurt really bad.
I assure you she-she's in the hands of our absolute best.
As are you.
Thank you.
- (GROANS SOFTLY) - I'll be right back.
KIM: John and Becky Copple are among the biggest donors to Red Rock.
Most notably, our new neuro center.
You gave me a reason to bring you back.
Let's make sure that I continue to feel good about my decision.
Okay? BP's up to 100/60.
Pulse has come down to the 90s.
This is our window to move her.
Hang another unit of blood and let's bring the cooler with us to CT.
And then to the OR to remove the propeller.
Come on, people, let's move.
Wait, wait.
Wh-Wh-Where-where are they taking her? Imaging.
Just part of the process.
(SIGHS) It was my idea to go Jet Skiing.
Becky loves the outdoors.
I hate the sun.
It's one of the few things we don't have in common.
But this boat came out of nowhere.
And we crashed at full speed.
I just wish I had gotten the worst of it and not her.
I can't lose her.
I just I-I don't even know what my life looks like without Becky.
I understand.
But if we don't take care of you, then you can't take care of Becky, so how about we focus on you for a minute? Deal? - Deal.
- All right.
I'm seeing on your medical record you had a brain tumor removed eight years ago? I did.
Yes.
It was a benign growth.
- Hmm.
- Why? Just want to get a CT to make sure everything's okay.
- Sound good? - Let's do it.
ANDREA: So, thanks to ads, point of sale displays, strategic partnerships Oh, Randy, there you are.
Have a seat.
The lovely Andrea just came to the interesting part.
You gentlemen remember our first quarter projections.
Well, this is our actual revenue.
50,000 units sold in the first month.
100 last week alone.
- Those are real numbers? - Mm-hmm.
I mean, I knew we were doing well, but We can barely keep up with demand.
Well, then, I say we increase production, with a larger facility.
- We could expand to other regions.
- Mm-hmm.
BELL: You know, we should put some cash into R&D and lay the foundation for a whole new line.
You'll all be parking your yachts next to mine before the year's out.
You know, maybe you can quit teaching Pilates.
Or, hell, she could buy the studio.
Hell, she could buy Pilates.
I don't think that's possible.
Uh, with the fortunes we're gonna make, it is.
- (EXHALES) - L-Listen, listen.
I-I-I have been here before.
All right? I mean, we are playing with the big boys now.
And with profits this promising, competitors will be trying to buy us for a nickel and a rubdown.
But I think we can all agree that the real winning formula is not just what's in this little bottle.
No, no, no.
No, it's-it's the people in this room.
All y'all, the-the men and brilliant lady right here, united, working together.
We have struck gold, my friends, and I don't know, but anybody here want to let 'em take away our gold? - (PAGER BEEPING) - I'd like to see 'em try it.
That is one enormous fracture.
KIT: The propeller sliced through her sacroiliac joint.
Explains why she can't move her leg.
Her pelvis has been completely separated from her spine.
AUSTIN: And it's torn through her internal iliac artery.
The damage is so extensive - because this propeller is cupped.
- KIT: So, the plan is, we remove the propeller, stop the bleeding before she exsanguinates.
Then, if we succeed, reattaching her pelvis to her spine will not be a walk in the park.
I'll prep the OR.
(DOOR OPENS) CAIN: What's the story? TBI.
History of a benign brain tumor that was successfully removed, but it's regrown.
CAIN: Well, hopefully it's still benign.
I'll send it to pathology when I take it out.
I'm gonna need to review his prior scans and path reports.
- Mm-hmm.
- There's also an associated hemorrhage.
- Is he symptomatic? - Headache, blurry vision.
And it's only gonna get worse the longer we wait.
We're gonna have to operate soon.
Any there any issues - that might complicate his surgery? - Eh, mild hyponatremia.
That's likely related to dehydration.
Otherwise, labs were unremarkable.
All right.
I'll take him to my OR.
(DEVON SPEAKING INDISTINCTLY) (GROANING) Sir, you need to stay in your bed.
And keep your pants on.
L-Look.
IRVING: Fasciculations? - When did it start? - A few minutes ago.
- Let's get another full set of labs.
- Right.
We'll check for any electrolyte abnormalities.
Should I, uh, cancel Waffle Wednesday? Maybe just reschedule till next week.
HUNDLEY: A little help over here! Respiratory distress, Bay Eight.
- IRVING: Pravesh.
- Stay there.
Get me an intubation kit.
She started to wheeze and couldn't clear her secretions.
We tried BiPap and she became altered and we couldn't get her sats over 72%.
(MONITOR BEEPING RHYTHMICALLY) (BEEPING) Mild crackles bilaterally.
Increase the PEEP.
PEEP is up to 15.
Okay, that bought us some room.
But she's still skimming the treetops.
All right, let's get a blood gas and a chest X-ray.
And write her for broad-spectrum antibiotics with cultures first.
Once we get the gas, we'll put her on ARDSNet protocol.
If her oxygenation is still tenuous, we'll start inhaled epo.
IRVING: Good plan.
But this is strange.
I mean, she came in with a headache, for God's sake.
And now she's very close to max vent settings.
We need to figure this out.
And fast.
Can I talk to my wife? We need to get you both in ORs ASAP.
No, no, please.
I just - I need a sec.
- We have to be quick, though.
Hold up, hold up.
I know what you're gonna say.
We're in good hands.
We're both gonna be fine.
You love me.
I was gonna lead with "I love you".
But, yes, all of that.
Then I'll see you tonight.
Make sure we're in a recovery room together.
In our 20 years of marriage, we've never spent a night apart.
KIT: We wouldn't want to break a streak like that.
AUSTIN: Well, you've got two softies who'll do our best to make it happen, but right now we got to go.
JOHN: I love you.
- I love you.
- I love you.
(PHONE RINGING) Hey.
CONRAD: How you feeling? Better.
Thank you.
It's so quiet.
Where are you? Our supply closet.
Oh, it's our supply closet now? Well, we-we share it with Jess and Irving, but it's mostly ours.
(SIGHS) You okay? Nic, I just I just want to say thank you for for being there and for, for never doubting that I would be okay and for helping me.
Helping me find my way back here.
You don't need to thank me.
Yes.
I do.
Hey.
You'd do the same for me.
But you need to get back to work.
People are gonna think you lost your mind, talking to yourself alone in a supply closet on your first day back.
(CHUCKLING) That's fair.
That's fair.
I'll get home as soon as I can.
I know you will.
I'll see you tonight.
(PHONE BEEPS) (GROANING) Again? Unfortunately, Raj's bathroom situation has escalated.
But all of his stool studies have come back negative.
Mr.
Corson's pants are back on, but he's still having fasciculations, and he's started to act confused.
What? Pravesh.
What's up? MUDDLES.
I haven't heard that term since I was in medical school.
Meiosis, urination Diarrhea, diaphoresis Lacrimation, excitation of the central nervous system, salivation.
Yeah, so, if you add Doug, Cynthia and Raj's symptoms together, it is textbook organophosphate poisoning.
How do three patients who have nothing in common get exposed to a toxin that's only found - in pesticides and chemical weapons? - I don't know.
But they're all showing different signs of exposure.
(IRVING EXHALES) If it is, we need to treat them fast.
Organophosphate poisoning can progress rapidly.
Hundley, push atropine and one gram of 2-PAM - for all three of them.
- On it.
KIT: Dr.
Okafor, why don't you give that propeller blade a nice, big tug.
MINA: It's not budging.
KIT: It's stuck in the SI joint.
You have to pull with more force.
Put your back into it, dear.
(MINA GRUNTS) Okay, it's not working.
AUSTIN: Step aside.
I've got Excalibur.
(GRUNTING) Damn.
- It won't come out.
- MINA: Mm-hmm.
KIT: Allow me.
Ortho isn't just about brute strength.
Sometimes you have to think outside of the box.
Hammer, please? And then use brute strength.
Get ready.
- (ALARM BEEPING) - MINA: Suction.
- KIT: Retractors.
- AUSTIN: Sutures.
What are the odds a benign brain tumor regrows? Well, it's rare, but it can happen.
Don't worry.
I'm here to deal with that.
We're gonna proceed with the craniotomy - to remove the tumor.
- Copy that.
CAIN: I'll get scrubbed up.
Thank you, Dr.
Cain.
CAIN: You're welcome.
John, I'm gonna administer the propofol now.
Start counting backwards for me from ten.
(GROANING) - Just breathe.
- (GROANING CONTINUES) (MONITOR BEEPING) What'd you give him? Just relax.
Just breathe.
What did you give him? I haven't given him anything yet.
CAIN: You must have done something.
He's tach'ing away in the 150s.
His BP shot up to 180s.
- (GROANING) It hurts! - CAIN: What? Where do you Where does it hurt? - Tell me what hurts.
- It hurts! - What's-what's hurt? What hurts? - My stomach! - Your stomach? - (SHOUTING) Abort the surgery! (MOANING, COUGHING) KIT: Dr.
Austin, you're on the left pelvis.
Dr.
Okafor, you're on the right.
Fasten this obtrusive instrument on each side.
Now for the most critical part of the surgery.
We must bring her pelvis and spine back into alignment.
- AUSTIN: We're gonna reduce her SI joint? - Correct.
You will both push your side of the pelvis towards one another.
How hard do we push? It must be equal pressure.
And what if one pushes harder than the other? Then her pelvis will be misaligned from her spine.
We could crush her sacral nerves and leave her paralyzed.
You must be perfectly in sync.
I know I can count on you both.
AUSTIN: We got this.
MINA: On three? One, two, three.
KIT: Slowly.
A little more pressure from you both.
(CLICKING) Feeling some resistance.
AUSTIN: I'll adjust.
Stop.
MINA: How did we do? That's anatomic.
I've never seen a more perfect alignment.
(CHUCKLES) Game, set Match.
(KEYS CLACKING) My patient is stagnating in the ICU after an aborted surgery because something you missed.
We don't know that yet.
Then what do you know? - You're the internist here, right? - Mm-hmm.
In the great ecosystem of this hospital, a flea.
You had one job: to make sure my patient was tuned up for surgery.
So let me give you some advice upon your fresh return to this hospital.
Go do your one job so my patient doesn't die.
What the hell happened in there? I'm replaying it in my head.
This, uh, acute abdominal pain with nausea and hemodynamic instability in the OR but with absolutely no prodrome.
Could he have thrown a clot to his bowel? I thought about that, but nothing on imaging.
And his lactate is flat.
So what's your plan? Uh, reexamine head to toe.
Rerun labs.
Get to the bottom of this.
(EXHALES) (QUIETLY): Listen, let me know how I can help you.
They-they took your head.
You figured out how to grow another one.
But don't think for a second they're not looking for any reason to bring the ax down again.
Who's "they"? Kim did the firing, but he and Cain are a team.
There's no way Cain didn't have a hand in it.
And Cain doesn't care that you brought in Georgia FC.
For him, getting rid of you is personal.
Be careful.
Buy you coffee? No.
Please? Thank you.
Fine.
Uh, one almond milk latte and one - Large coffee.
- Thanks.
What do you want to know about him? AJ seems amazing, but I have been conned before.
So, woman-to-woman, off the record, jump in or run like hell? (SIRENS WAILING) - (ELEVATOR DINGS) - All three patients have stabilized.
Cynthia just got extubated.
- So you were right.
- Yeah.
But how do three people with no connection end up with the same rare poison in their system? First, we find out.
Then we call County Public Health and stop whatever caused this.
So, you live nearby in ? - Savannah.
- Chamblee.
(HOARSELY): Sandy Springs.
Any recent exposure to chemicals? - No.
- No.
I bought a can of body spray.
Has anyone sprayed insecticides near your home or your garden? I don't have a garden.
Not that I'm aware of.
(SCOFFS) No.
Any vitamins or supplements? Yeah.
Yeah, I just picked up a new one.
Um 3, uh 3B something.
3B Life.
That's it.
Hey, fingers crossed, I look just as good as that doctor on the label when I'm his age, right? - (CHUCKLES) - (FORCED CHUCKLE) Three different patients All with organophosphate poisoning.
All on 3B Life.
Well, maybe they use the same cleaning supplies or pesticides.
We did extensive patient histories.
You can't possibly know everything that they came in contact with Yes, but, right now, the only link that we do have is your supplement.
- How widely was it distributed? - Wide.
Okay.
We need to call Public Health and warn them about it.
That's ridiculously premature.
You can't call the CDC on three patients.
Dr.
Bell, I know that you have a personal stake in this, - but we have to - Okay.
Maybe, maybe they have other things in common.
And if we act too quickly, we'll destroy the reputation of a good product that is helping people, not to mention me.
Yeah, but if we wait, people could die.
So, beyond an acute cholinergic crisis, people could have serious long-term disabilities I don't need to be educated on the effects of organophosphates.
Okay, Dr.
Bell, we just need to do the right thing.
(PANTING) I can only see you when I turn to look at you.
When you stand to the right of me, I can't see you at all.
Must be because of the tumor.
The bleeding is causing some swelling, and that is what's affecting your vision.
Well, will it get better? I-I can't go blind.
We're giving you some steroids.
We're gonna decrease the swelling.
Now, if we can get that tumor out soon, - then you should regain your vision.
- "If"? - Let's get it out now.
- Yes, I know.
I am of the same mind.
But your labile blood pressure and heart rate haven't been responding to the treatments.
- (SIGHS) - And I can't risk sending you back into surgery unless Dr.
Hawkins can come up with a plan to make sure that you're safe in the OR.
- JOHN: What's the plan? - Yes, Dr.
Hawkins.
What is the plan? John, I know you've been scanned and examined up and down, but do you mind if I take one more look? (CHUCKLES) (HISSES) (GROANING SOFTLY) Did that start to hurt after the accident? No, actually.
(HISSES) That pain has been on and off for a while.
Sometimes it hurts so bad, I feel like it's gonna rip right through me.
Like today in the OR.
And then all of a sudden, it gets better.
Now I'm gonna untie your gown so I can get a good listen to your lungs.
What? (STAMMERS) What's wrong? There are blisters on your shoulder.
I did not see that earlier.
CAIN: Why the hell didn't you see that earlier? That's your job.
Didn't you do a full physical examination? They-they weren't there this morning.
I'm sure.
I would know.
I've had them in the past.
That's why I hate the sun.
And when we were outside, I was covered from head to toe.
Hyponatremia.
Recurrent abdominal pain.
Blistering skin lesions.
Blistering.
Blistering, blistering, blistering skin lesions.
(CHUCKLES) I need a urine sample.
Right now.
ANDREA: There's got to be a mistake.
I don't know.
It doesn't make sense.
We ship out hundreds of thousands of units - and only three people get sick? - Well, it's not just three.
No, I just found out that two more patients have been diagnosed with organophosphate poisoning - over at Atlanta General.
- Oh, my God.
They're stable.
They're getting treatment, just like the ones here at Chastain.
Are they on 3B? They're on supplements.
But if I ask for specifics, the doctors there will make the same connection that we did.
Then we test the facility, - we prove it's not us.
- (STAMMERS) Agreed, but (EXHALES) Zip is gonna start talking about an exit strategy.
- Wait, what? It's too soon.
- No, Andrea, there's a chance, no matter what the percentage, that 3B is the culprit and that we're dead in the water.
- (SIGHS) - I can't believe this is happening.
I-I I have to call the partners.
Your post-op CBC is stable.
No more bleeding.
Distal pulses are strong.
Becky, can you wiggle your toes? Looks good.
(CHUCKLES) Recovering from major surgery is challenging, so we will be monitoring you closely.
Thank you.
(EXHALES) And what about John? He didn't have surgery yet.
Why? We don't know.
But we do know his doctors are working on it.
What does that mean? Will he be okay? Can I be with him? First, you must get well.
Then you can be strong for him.
When he had brain surgery eight years ago, I held his hand all night.
Like I could keep him with me, just by physically holding on.
And it worked.
Well, as soon as we can, we'll get you two back together again.
And now we have urine in the sun.
Dr.
Hawkins, I'm starting to lose my patience.
Just wait.
(QUIETLY): I am not gonna stand here and stare at another man's urine with you while John's tumor continues to swell.
We don't have time for this.
It was time well spent.
What-What's happening? John, this urine changed color.
That explains what happened in the OR and gives us a diagnosis: porphyria.
Porphyria's when you have an excess of the chemical porphyrin and it builds up in your organs, and when that happens, certain stressors, like the intense lighting in the OR, triggers a crisis that causes things like blisters, stomach pain, and even organ damage.
You got all that from my pee? CONRAD (CHUCKLES): Combined with your exam and history of previous stomach pain and skin blisters.
But yes, when the porphyrins turned your urine dark in the sun, my clinical suspicion was confirmed.
So I've had this my whole life? Incredibly rare, easily missed, but the good news is we can treat you.
We'll be sending confirmatory labs of course, but I am confident you will be back in the OR soon.
Which Dr.
Cain and I will be prepping for you.
- (JOHN SIGHS) - CONRAD: I made a list of all the meds that can be fatal to a porphyria patient.
Avoid these at all costs.
I haven't had a porphyria patient since residency.
Yep, this is a unique case.
That's exactly why I made a list for everyone.
Propofol for anesthesia, that's safe.
Morphine's okay.
Just let me know before you give - any antibiotics.
- CAIN: Dr.
Hawkins is right.
We all need to review the drug list.
CONRAD: And the reason John crashed in the OR before was because of these intense lights, so we got these filters.
CAIN: We'll still be able to see, but they change the wavelength of the light that hits John's body.
CONRAD: Avoiding a porphyric crisis.
(MONITOR BEEPING RAPIDLY) What the hell happened? KIT: She came out fine after the surgery, then she went into V tach and lost her pressure.
Hold compressions.
Checking a rhythm.
Damn, she's still in V fib.
We need to shock again.
Charging to 200.
Clear.
AUSTIN: Restart compressions.
I'll take over.
KIT: Code labs are back.
Hemoglobin is stable.
She's not losing blood.
But her calcium is under five.
That's not doing her heart any favors.
Okay, we need more calcium.
One gram of calcium chloride, now.
We ordered it hours ago.
There's a calcium chloride shortage.
Take it from the crash cart.
She should have received more calcium with her blood transfusions.
This is what happens when drug companies discontinue products that save lives but don't make money.
Calcium chloride is in.
AUSTIN: Continue compressions.
30 seconds to the next pulse check.
Hope this works.
CAIN: Bull's-eye.
Time to remove the tumor.
How are the lights? Sufficient.
My patient's hemodynamic instability is no longer distracting me.
You might want to follow that lead.
(SCOFFS SOFTLY) Forceps.
His wife Becky just coded.
They're still working on her.
Get this to path.
It's been hours why is he just getting to the tumor now? It's a delicate surgery.
Dr.
Cain is in the middle of a very complicated surgery, and with the added precautions for the porphyria John's a lucky guy.
(JOHN SIGHING) I can see you.
(CHUCKLES): All of you.
Surgery went well.
Your tumor's gone, and your preliminary path looks benign.
And we have a plan to manage your porphyria moving forward.
Today you received Chastain's finest, as promised.
JOHN: But Becky where is she? She sustained serious injuries in the crash, but, like you said before, John, your wife she is strong enough for both of you.
She survived a very grueling surgery.
But hey, don't worry, we will make sure you do not spend tonight apart.
Your streak will be intact.
So now what? I don't want to give up.
What if I'm wrong? What if my supplements are hurting people? Look you and I don't know each other well, but you have shown me so far a woman who doesn't half-ass anything.
So I believe that you know your stuff.
And I believe that you will do the right thing.
ANDREA: I know it's not the 3B.
- I know it.
- Actually, you don't.
I see a future buried in lawsuits.
Oh, please, do not use the "L" word.
Okay, once we test the manufacturing facility We'll already be on 60 Minutes by then.
I know you're both concerned about your own liability.
- If - We poisoned people? Yeah, I think we might be a little bit concerned about that.
Okay, but let's remember that I'm the reason that we're here.
My product, my skill, my judgment, that's that's what got us this far.
So I ask that you trust me to see us through this.
Please.
(CAIN SIGHS) How many units have we sold? Enough that a recall costs us millions more.
All to protect a brand that we don't even know will be worth anything when this whole thing is done.
It's time to walk away from the table.
I agree, I agree.
We got to protect ourselves, cut our losses.
I-I think we should declare bankruptcy.
CAIN: Liquidate the assets, make sure there's nothing left to sue for.
Okay, everything I have is in this company don't do this.
It's over.
Okay? I'm sorry.
Maybe next time, don't make your supplements out of fertilizer.
You have no idea what you're talking about.
You're just a fat cat who came along for the ride.
And I appreciate the cash, but do not speak to me like that again.
I am just fine to go it alone, if that's what I'm up against.
There's another way.
I'll buy you out.
- Both of you.
- (CHUCKLES) Take on all the liability myself.
You sure you have the cash for that suicide mission? I'll figure it out.
(STAMMERS) 50 cents on the dollar for all your shares.
Hell, I mean, if I can get some of my money back and, uh, dodge this bullet, I don't care how you do it.
I'm sold.
Okay.
But make it fast.
(BELL EXHALES) (WHISPERS): Why did you - (CHUCKLES) - Why why did (SIGHS) Well, because, at this point, they think it's a coin toss that 3B's at fault.
They're panicking.
And I think the odds are slightly better than that.
You know, yeah, it's kind of betting the farm, but it's a chance to get full ownership back for the two people I care most about.
(SOFTLY): Wow.
Thank you.
No, don't thank me.
Just (SIGHS) Just pray we're not wrong.
(SIGHS) Otherwise, I just made the biggest mistake of my life.
And we're both ruined.
Where's your friend? She's going through some things right now.
Hmm.
Are you looking for her red flags? Well, it's early.
You know? She's looking for your red flags.
What'd you tell her? You mean what didn't I tell her.
(AUSTIN CHUCKLES) You know, you are enjoying this a little too much.
(GIGGLES): Mm-hmm.
I led with "compassionate".
Closed with "brilliant".
That she would be wise to hold on and not let go.
We're gonna rise, hear the calling And I told her about your cats.
All five of them.
The woman deserved a warning.
We're gonna rise above (LAUGHS) We're gonna rise, hear the calling We're gonna find that we belong We're gonna rise above where we've fallen We're gonna rise - Hey.
(CLEARS THROAT) - (CONRAD SIGHS) Ah Mm You do not look or smell like a 12-hour shift.
My new office has a shower.
Ooh.
I remember that shower.
How are you feeling? So much better.
You survived.
Yeah, and my patients did, too.
- Really? - (CHUCKLING) This amazing couple, 20 years together, never spent a single night apart.
Wow.
That is amazing.
Something to aspire to.
(SIGHS) No way.
- No way, right? - No.
I mean, I love you, but time apart is healthy.
We've got, like, a thing that works for us.
- It works beautifully.
- Mm-hmm.
Which requires the occasional night apart.
Handful of nights; rare exceptions.
Mm, a few handfuls.
- Easy, now.
- (CHUCKLES) Tonight is not one of those nights.
We're gonna rise, hear the calling We're gonna find How many handfuls? We're gonna rise above - I know you're not asleep.
- (LAUGHS) We're gonna rise