Saving Hope (2012) s04e07 Episode Script
Can't You Hear Me Knocking?
Two regulars please.
Okay, so our son has been invited to three birthday parties this weekend.
You know, he can barely walk, and he has a busier social life than we do.
Please tell me at least one of them is a drop-off.
Mnh-mnh.
Hey.
"In lieu of presents, please make a donation" "to save the giant sequoia tree fund.
" I do so hope to see Athena, my cat.
She died nine years ago.
I just think that a kid would prefer to have a toy over saving a giant tree.
That's all I'm saying.
Do cats go to the same place as people? I'm not sure.
Charlie, is everything okay? Yeah, yeah, just, uh We're not alone.
Right, well, could you turn it off for a minute, just tell them that your girlfriend's talking to you? Oh, trust me, if I could turn it off for good, I would.
Oh, look, and now duty calls.
I love you.
Oh, would you like a coffee? Yes, thank you.
- Mm.
- So, how is resident life treating you? Oh, I don't know if I'd call it a life, but it's great.
You know, I remember, I was so tired once that I forgot my name in front of a patient.
Last week, I wore my scrubs backwards twice.
Ladies, the acceptable amount of caffeine for surgeons is 200 milligrams a day.
Says who? Says a recent study out of Johns Hopkins.
And, since Dawn is on leave, your new interim chief of surgery.
Are you talking about yourself in the third person? There'll be no finger tremors during anastomosis.
Not under Hamza's watch.
Hey, I'm gonna lodge a formal complaint.
Hon, take it up with the chief.
Zach, what do we got? We got a 44-year-old male, Cal Nedman, possible posterior sternoclavicular dislocation.
Took a hit from a 300-pound lineman.
Whoa, no padding? Looks like he was hit by a truck.
- Yeah.
- Is he the coach? Yeah.
And my dad.
Okay, son, you're gonna have to wait out in the, uh, in the waiting area, okay? I can't get an airway.
- Is he gonna be okay? - He's in good hands.
Could you show him where to wait, please? Yeah, follow me.
He's choking out, guys.
Clavicle's pressing on the windpipe.
Uh towel clip.
You gonna shoehorn him? That's usually done in the O.
R.
Yeah, no time.
Uh, let's have cardiac on the standby, please.
Okay.
Ready? - Do it.
- One, two, three.
No, he's still in trouble.
Tracheal deviation? Chest tube.
Give me a 16-gauge.
There we go.
Okay.
Tube's in.
- Whoa, whoa, whoa, whoa.
- That's a lot of blood.
Okay.
The bone's lacerated something.
- Innominate vein? - Okay, clamp that tube.
We need to get him to the O.
R.
before he bleeds out.
Let's go, guys.
Let's hurry.
Sorry.
Let's go.
Well, that was a hell of a mess.
Okay, both ends of the vein are clamped.
Just a couple of more stitches in the graft.
Yeah, this guy has officially dodged a bullet.
Watch the clavicle.
The edge is still jagged.
Yep.
Suction.
Oxygen sats at 80.
B.
P.
71 over 45.
I'm reading that Shahir has you as lead on 13 surgeries this week.
The milk in my fridge is going to walk away before I get home.
Feels good to be quarterback, though, right? Sure.
You ever play football? Yep, in college.
I could never figure out the difference between a fullback and a halfback.
About 50 pounds.
Huh.
Okay, clamp coming off.
Aw, damn it! Dr.
Lin.
I'm okay.
At least I'm in the O.
R.
Jackson.
Elizabeth Grant here for her final appointment.
Exam room 3.
Oh, and had a cake sent in, I take it.
Yeah, caramel ripple the way to a nurse's heart.
Mmm.
Hey, how's everything going with the radiation? Splendid.
That's it? That's it.
So, they zapped all the spots? Mm-hmm, mm-hmm.
Just waiting on the C.
T.
results.
Have you told anyone else yet? No, I have not, because I don't want to worry anyone until I get the call.
So, with any luck, this little hiccup just stays between the two of us.
Mm-hmm.
You sound hopeful.
I am.
I am really hopeful that things can get back to normal and you can stop being so nice to me.
Oh, please.
I'm nice to everyone.
Doesn't Dr.
Hamza have a rule about that much caffeine? He does, but I was chief once, too, you know.
Great.
So, Dixie, why don't you tell us more about what's brought you in here today? It's like the perma-flu.
It's constant nausea, this nagging headache.
Well, the C.
T.
you had in emergency shows nothing unusual going on in your belly.
Great, so, some grade-A painkillers should take care of it, if you could just write that up.
What's the rush? Oh, it's my gido.
He's been living with me since my baba passed, and it's almost time for his lunch pills, so Whoa! Okay, take it easy.
Have you been getting enough rest? Um, probably not.
Between taking gido to his appointments and making sure he's eating, putting him to bed, that kind of thing.
- That's a full plate.
- Yeah.
I could write a prescription, something to help you sleep.
Oh, you are a goddess.
Thank you guys Listen, Dixie, I know that you're in a hurry to get home, but I really do need you to stick around for a couple more tests.
Well, what about gido? I could send a mobile nurse to give him his pills.
Think of it this way, it's a chance for you to lay down.
Hey.
Ah, we're just trading recipes.
Yeah, I swapped my famous summer berry tarts for his lemon cheesecake.
I didn't know you baked.
It relaxes me.
Guy's got to eat.
We're gonna miss having you around here.
But nice to finally be going home, I bet.
Yeah, it is.
Okay, let's take a look.
Yeah, those skin grafts are healing nicely.
Do you have enough cream? Only about two years' worth.
Let's see those arms.
Good.
Can you touch your thumb to your pinky finger? Any pain? No pain.
Okay, press against my hand for me.
There you go, nicely done.
Not a lot of contracture, skin is moist.
You've obviously been keeping up with your physio.
All Dr.
Kinney has to do is fit you for some compression garments.
And then you are officially cleared to go home.
That's great.
Yeah, that's great.
How's he doing? Still no change.
He's in recovery, but you should be able to see him soon.
Is he going to be okay? He took a pretty hard hit, but he pulled through.
You know what's weird? This won't turn my dad off football.
He'll still be obsessed with it even though it almost killed him.
He played in college, but his knee gave out.
That's a pretty tough pill to swallow.
He's a really good coach, though.
Sent five kids off to the pros already.
I'll probably make the college team, too.
That's great.
I'm trying my best to re-live his glory, you know? Yeah, well, I'll, uh I'll let you know when he's up for a visit.
Thanks.
Which could be a while.
You want me to find you something a little less padded to wear? That'd be nice.
You bet.
Hello.
Can I help you with something? Questions, directions, that sort of thing? I'm so pretty.
Okay.
It's a huge malignant glioma, probably a glioblastoma.
Explains the headaches, the nausea.
And the slurred words.
Can we operate? No.
See here? The tumor's invading the cerebral peduncle.
You can't resect it without leaving her with a deficit.
What about PEVAC? Maybe.
Either way, she's only got a couple months to live.
These tumors are a death sentence.
Okay, I guess we have to tell her.
Let me do it.
It's the worst part of the job, hands down.
I know.
I-I don't want to shy away from that.
Are you sure? I'm sure.
All right.
I have brain cancer? How? These type of tumors grow quickly.
By the time they're discovered, they can be quite advanced.
Um Gido needs a, uh, a driver and a nurse for his pills.
I mean, those retirement places, they have waiting lists of, like, two years.
How long do I have? Tell me everything.
You could start losing cognitive function within weeks.
You likely have no more than six months.
Doctor, is that true? Every tumor is different, and this is very serious, yes.
Then, um, I have to go.
Um, I have so much to do.
I have to Dixie.
Just wait.
There could be an option.
What do you mean? What kind of option? Have you heard of viral therapy? No.
Dr.
Reid? It's very new.
And it's still in the experimental stage.
Okay, but, what? So you're saying that I could I could live.
I'm saying that it's a long shot, but it's a possibility.
So, please, just stay, and we will discuss a treatment plan.
All right.
But gido needs to be here, okay? Because he really needs me.
All right.
Okay.
You were a little blunt in there.
I thought she should make decisions based on facts.
Well, now she's making them based on fear.
She said she wanted to know everything.
People say they want to know everything, Cassie, but that doesn't mean they're actually ready to hear it.
I don't understand.
With news like this, it's all about timing.
Okay, but you straight-up lied to her.
You said there was an option.
Viral therapy is an option.
It's experimental.
True.
And Hope Zion's not even approved.
Also true, but luckily, I have an in with the interim chief.
Shahir is my guy.
Your guy? Yeah, I know him.
He will not pass on an opportunity like this, trust me.
The smoking cessation subcommittee wants $2,000 for new posters, and the surgical recovery ward is threatening to protest if the vending machines don't go vegan.
Well I will see you in a minute.
I can come back.
No, I love this.
Come in.
How much have you heard about this? Phase one study, Dr.
Friedman, Duke University.
On glioblastomas and polio.
Mm-hmm.
The tumor is injected with re-engineered polio, and the immune system fights the virus.
And the cancer at the same time.
It's in its early days, but intriguing work.
I knew you'd be as excited as I am, and if anybody can fast track this for my patient, the board loves you.
Alex, absolutely not.
Shahir, we can do this.
You're asking me to throw my weight around for a study that is in its infancy.
And we don't even know the effectiveness of it long term.
It's been successful in 11 patients.
And unsuccessful in just as many.
And those patients died horrible deaths paralysis, blindness.
Duke is adjusting the dosages.
Alex.
If Dawn was still chief, you wouldn't have gone to her with this.
Well, then, lucky for me, Dawn isn't.
You're asking me to risk my reputation.
No, I'm asking you to help me save a 28-year-old woman who has inoperable brain cancer.
I can't think of just one patient.
I have the whole hospital to consider.
The answer is no.
Oh, sorry.
No, no, it's okay.
It's sports.
I wanted the art section, anyway.
Athena was a korat, an ancient cat of Siam.
Not now.
Did you want to be alone? Uh what? I mean, I could eat while staring off into space, but I'd way rather talk to someone.
I'm Kristine.
Charlie.
Surprised we've never crossed paths.
I-I work up on the eighth floor.
Palliative care.
Yeah.
End of life is kind of my thing.
That's a tough job.
Yeah, but somebody's got to do it, right? Do you think they have chicken livers on-on the other side, I mean? You know what? Uh, I would love to stay and chat, but I just remembered, I have a surgery, so got to eat and read on the run, you know? Well, it was nice to meet you.
Yeah, you too.
C-could you just tell me if I'll see Athena again? I'll, uh, I'll see you later.
Yeah, shouldn't keep an old cat lady waiting, right? Okay, Louise, here's the thing.
Maybe the cats go to the same place, maybe they don't, but you won't find out for sure until you get there.
Oh.
Well, why didn't you say so? Wrist circumference, 4.
2 inches.
Radial forearm length, 11.
4.
Do I have to wear these all the time? Yikes.
You can get them in different colors.
You know, coordinate your work ensemble.
Yeah, I'm not too worried about that.
Well, I guess social worker beige does go with everything.
No, it's not that.
I'm not going back to work.
I've already notified my agency.
What? Why? You love your job.
I did.
Those kids are the only thing you have talked about since you have been here.
It's just different now.
Okay, um Sorry, I have to take this, but you and me, we're not done here.
Hey.
What is it? Oh, your test results.
Please.
Don't touch me.
What's going on? Are you all right? Yeah.
Take this to the resource center for me, please.
Hey, uh, do you do you have a second? I need to talk to you about something.
- Yeah, me, too.
- Ah.
You know, you think you know somebody.
More trouble on Mars? No, it's Shahir.
We have a chance to do something really great for a patient, but he won't do it because he's too concerned about the hospital.
Well, that's his job now.
See the big picture, protect the hospital's interests.
Ahead of the patient? No, in addition to.
Well, it's not the Shahir I know.
Well, I don't know.
Maybe you can show him how he can help the patient and the hospital at the same time.
I-I mean, the Shahir you know is still in there, I promise.
He's probably just drowning in paperwork.
You're right.
You're always right.
- Well - I'm sorry.
You said you wanted to talk about something.
Oh, um, no.
It can wait.
Great, catch you later.
Dr.
Friedman has worked out a dosage for the polio that will minimize complications.
Why are we still talking about this? Because I'm trying to do what's right for my patient.
And I need to do what's best for the hospital.
Well, this could be great for the hospital, Shahir.
Think about it, "Hope Zion spearheads an innovative new treatment.
" You know, Charlie told me once that your grandmother used to put your grandfather's slippers in the oven to warm them up.
Is that true? Yes, she almost burnt the house down.
It's not a recommended practice.
And she used to wash his hair in the sink when he couldn't wash it for himself anymore.
Until the day he died, mm-hmm.
Now she has Alzheimer's.
What if she'd gotten sick first? I know what you're trying to do, Alex.
Then come with me.
Okay.
So, here's some water.
Wash it down.
Thank you, Kohana.
Hello.
There's someone I'd like both of you to meet.
Dr.
Hamza, this is Dixie and gido.
Nice to meet you.
Have you eaten anything? I'm not so hungry.
Gido, you need to eat.
You're cold.
You'd think they could afford to keep the heat up in these places.
Can she have this, or is there some rule? No rule against Mountain Dew, no.
Thank you.
I thought of a few things.
Like, uh skunking you.
That sounds like a plan.
So, Shahir, what do you think? I think it's manipulative.
But look at them.
He needs her.
If it wasn't a desperate situation, I wouldn't consider the treatment, either.
Okay.
Dixie, we do need to talk.
About your news? It's not good news, gido.
But there may be an option.
I'll speak to the board.
Thank you.
I thought you said he was gonna be okay.
Look at him.
Yeah, I know he looks a little rough, but, uh, he's gonna come back, kind of like a pick-6, no time left on the clock, you know what I mean? Can we not talk about football? Uh, yeah, just trying to take your mind off things.
Honestly I hate it.
Listen, Ty, I know you feel that way right now, but I never liked it.
Then why play? My dad loves it.
I played for him.
Why didn't you ever say anything? Uh he can't see you or hear you.
But you can.
Yep.
It's kind of my thing.
If he didn't want to play football, he should have just said something.
Wait a second.
You know that guy? I am that guy.
Ty has no idea, and it has to stay that way.
You understand.
Not completely.
He's not ready.
From everything I've seen, he's pretty tough, Cal.
Please, call me Caroline.
Okay, Caroline.
He pretends to be tough, but he is a gentle soul.
He is not mature enough to handle everything that goes along with this yet.
So, you lie to him? Sometimes you have to hide the truth.
Otherwise, you end up hurting the people you love the most.
Okay.
I'll-I'll talk to you later, then.
Okay, thanks, bye.
Sorry about that.
Old school, I love it.
Uh sorry, what? The phone thing, works great until someone actually calls.
I've had to squirm my way out of that one a few times.
I don't know what you're talking about.
Really? Really.
Well, I thought when I saw you earlier at the coffee place, you were talking to myself.
I was I was talking to myself.
No, I-I do that.
I'm, you know, just an eccentric surgeon.
Oh, I-I guess I was wrong.
- Sorry.
- It's okay.
I'll see you around.
Sure.
The polio attacks the cancer.
Sounds like you're replacing one disease with another disease.
I know that it's really difficult to wrap your head around.
You're young.
You have no memory of this, but my best friend got polio when we were kids.
His whole body stopped working.
He choked to death.
Awful.
I can't let my granddaughter go through that.
There are risks.
We'll do what we can to shield Dixie from any complications.
The hell you will.
Gido.
I know this sounds crazy.
It is crazy.
The truth is, regardless of the risks, this is our only chance.
Gido, I'm I'm dying.
I can't live without my Kohana.
Do what you need to do.
The path will help guide the polio to the tumor? Yes, and it needs to be exact.
The catheter needs to land right in the center of the mass.
Like a sniper's bullet.
Precisely, and if we miss by one millimeter Then she will be paralyzed.
That's the best possible outcome.
Well, then, let's not let that happen.
Mm.
Dixie's lucky to have you.
And so am I.
Please, I need to concentrate.
Right.
White blood cell count is good.
Something's wrong! Okay, B.
P.
is 70 over 40.
What's happening, Maggie? He could be suffering a major M.
I.
or thrown an embolus.
Ty, did your dad take any medication of any kind? Daily aspirin, anything? I don't know.
Check his bag for me, please.
No! No, he can't he can't look in there.
I-I started taking hormones.
They're in my bag.
Dr.
Harris, I-I found some pills.
Please! He cannot find out this way.
Get him up for a C.
T.
angiogram.
Page interventional radiology.
If it is a P.
E.
, I'm gonna need help with that thrombolysis.
And run a full blood panel.
On it.
Were those pills steroids? We're not sure.
My dad drilled into us about playing clean.
Said a real man builds up his own strength.
Look, um, why don't you go get some rest? These test results are gonna take some time, okay? Okay.
You should have told me about this.
It's only been a few weeks.
I didn't think it mattered.
H.
R.
T.
increases risk of clotting, okay? Patients need to be weaned off of this before surgery.
This could have cost you your life.
Thank you for not telling him.
All Ty knows for sure is that you're very sick.
Let's keep it that way.
He'll be none the wiser.
He's gonna find out, Caroline, one way or the other.
He may be ready.
Maybe he is.
But I'm not.
We're two and two.
Rubber match.
How is everything feeling? Like I've been abducted by aliens.
I mean, are you sure it's working? It's a slow infusion.
Half a teaspoon of the virus directly into the tumor.
How many times does she have to do this? Once.
That's it.
It seems so peaceful.
Well, best case scenario, everything stays just as it is, except for the tumor, of course, which will eventually shrink and disappear.
Seems like voodoo to me.
Well what's happening? What is it, Dixie? The the cards, they're-they're blurry.
Doctor.
Okay, I-I'm stopping the infusion.
It's getting worse.
- I'll page radiology.
- Is it the polio? Is it inside her? Oh, my god.
Oh, my god, I-I-I can't see! I can't see! The tumor's expanded.
It's compressing against her optic tract.
Let's bring down the swelling.
Dr.
Sharpe, 20 of dex and bolus 200 cc's of mannitol.
Mm-hmm.
Even with the decompression, the loss of vision could be permanent.
Is it possible that the polio breached the path to the tumor? No, it's not.
With the parameters we set Alex, I can't even entertain this notion right now.
If I do, that means Dixie's life is over, our careers, the hospital.
Dr.
Sharpe, is she stabilizing? Not yet.
Pressure's still sky high.
Damn it.
I shouldn't have brought you in on this.
Okay, that doesn't even matter right now.
What matters is figuring out how to get Dixie out of this alive.
Wow, that's a great picture.
The woman in it looks really happy.
That's because she was.
Her life was normal.
Okay, stop me if you've heard this before.
But there is no black-and-white definition of normal.
Normal is subjective.
It's a messy, inconsistent, silly, hopeful version of how we feel most at home in our lives.
Did you just make that up? No.
It was Tori Spelling.
What? I know, right? So, I guess now I have to admit that I'm a reality TV junkie.
Me too.
- Are you? - Yes.
I knew I liked you.
Look, I know it's hard for you to put yourself out there.
But you just have to do it.
'Cause I'm scared to think of what's gonna happen to you if you don't.
Nothing's gonna happen.
No, that's the thing about reality.
The one minute, you're fine.
The next, you're not.
Nothing changes.
Nothing stops.
We affect nothing.
Well, that's a little more Nietzsche than Tori Spelling.
Anyway, we are officially done here, so come on, let me walk you out.
Just because you're getting out of here doesn't mean you're getting rid of me.
Don't worry.
I have my next follow-up in the next two weeks.
Miss Would you be so kind as to allow me to accompany you the rest of the way? I'd be honored.
Bye, honey.
Bye.
He's staring at me.
You should be staring at him.
White socks, black shoes? Please.
Oh, my god.
I'm so sorry.
Hold up.
Hey.
Is that your mom in there? I'm gonna get someone to look after you, okay? Are you all right? Yeah.
Is everything okay? Did your mom get burned, too? She spilled a pot of boiling water on herself.
She needs an operation.
It's got to be pretty scary seeing her like that.
Is she gonna look like that? It's all right.
It's just skin.
Do you want to touch it? Feels a little bit like play-doh.
Yes, it does.
This is pretty.
Thanks.
You know, even though your mom is gonna look different, she's-she's gonna go back to being your mom in no time.
How do you know? Because that's what happens when we get sick.
It doesn't change who we are.
It just makes us stronger.
I hope so.
Here.
This is for your mom.
How's coach? Fed in the catheter and blasted the clot.
He's stable.
Nice work.
Thanks.
I'm going to live.
Yep, looks that way.
That means I have to go back.
I guess.
To being someone I'm not.
For the first time in my life, I feel like me.
And it's better than I ever imagined.
What are you gonna tell Ty? The truth.
I don't want to cause any more damage to me or to him.
I think we're both ready.
The blindness was caused by swelling in the brain.
From the polio? Not the polio, her brain's inflammatory response to it.
Her immune system is attacking the tumor.
Will she see again? Now that pressure is off her optic nerve, it's likely that her vision will be restored.
And the cancer? We won't know for a few weeks if the growth has slowed.
Gido.
Kohana.
Can you see me? I can see you.
Hm, that's very good news.
Good news? It's great news! Okay.
Dixie will need constant care and monitoring.
It's my turn.
Hey.
What a day, but now I'm all yours.
What's up? Hey, is this about earlier in the hall? With Cassie? Is she okay? Yeah.
Yeah, yeah.
Uh But, um, uh I'm-I'm not.
It's, um it's back, Alex.
Cancer's back.
Oh, my god.
Yeah.
Um What can I do? I know what you can't do.
You can't give me that look, the "oh, you have cancer" look.
It's still me.
I'm still me, okay? Okay.
Does Molly know? No, not-not yet.
Okay.
Hey.
What did I just tell you about that look? Right.
Sorry.
It's it's gone.
See? All gone.
And one more thing, please? Don't tell anyone, okay? You know Cassie knows, but that's it.
And, uh I just need a couple of days to, um just to get my head around it.
Of course.
Hey.
Whatever you need.
Great.
Good.
Okay.
Ah.
When he wakes up, he's gonna need oxy for the pain and docusate for the constipation, and then I get to go home.
And I get to scrub up for my third bowel resection.
But you're back in the O.
R.
Code blue, I.
C.
U.
, room 4.
- Code blue, ICU, room 4.
- Is that Cal? Yes.
Maggie, bag him.
Yep.
Where's that crash cart? Switch out.
Switch out.
And clear.
I got nothing.
Going again.
And clear.
Still no pulse.
Going again.
Clear.
Time of death, 6:32.
Charlie.
I'm sorry.
It's all my fault.
He's dead because of me.
What? If I hadn't kept it a secret about hating football, we wouldn't have been out on that field.
Ty He would still be here.
My sweet boy.
I never got to explain.
Now I won't be there for you.
I won't be able to protect you.
I should have just told him the truth.
You were protecting your dad's feelings.
We do that for the people we love.
Those pills they weren't steroids, were they? No.
No, they weren't.
I guess it was hard for him to tell me the truth, too.
I loved him so much.
Knock knock.
I have a stack of RFPs to review before 8:00 A.
M.
Don't tell anyone, okay? Oh, your secret is safe with me, chief.
We made a pretty good team in there today.
Hmm.
Plus ça change, plus c'est pareil.
Well, the weight of the world is about to be lifted off your shoulders.
You know, I'm gonna miss this job, Alex.
I like the added responsibility.
It's a lot to worry about.
Well, you have Charlie and Luke.
Who you haven't visited in a few weeks, by the way.
Yeah, I suppose it's time to teach him some chess.
So, we're good? Oh, we're better than good.
We're team Shalex.
Thank you.
Come on.
I think that's probably the greatest thing I've seen all day.
Can you help me, please? There you are.
Hello, handsome.
Hi, beautiful.
Mm.
Mm, wait, wait, wait, wait.
Oh! Ooh! Ooh! I'm feeling the remnants of a hard day in there.
It's nothing.
Yeah, kind of had one myself.
Want to get out of here? Yeah, just got some paperwork to take care of.
Oh.
Well, I love you.
I love you.
See you at home.
Okay.
Hey.
Hey.
Working a double? Yes, I am.
And if I don't get more than I'm going to bite someone's head off.
Well, I have it on pretty good authority that cappuccinos aren't considered part of the deal.
Oh, I will quote you on that if I'm caught.
Cassie, in the hallway earlier with Dana, I'm really glad that she had you to lean on.
Now she has both of us.
Yes, she does.
Good night.
Good night.
You're still here.
Yeah.
Yeah.
You too.
Hard day? You could say that, yeah.
You want to talk about it? Okay, here goes.
I see ghosts, and I know you do, too.
Now do you want to talk about it? So you were saying it was a hard day Because of the cat lady? No.
No, it wasn't because of the, uh cat lady.
Another one.
What was his name? Her name.
Her name was Caroline.
Okay, so our son has been invited to three birthday parties this weekend.
You know, he can barely walk, and he has a busier social life than we do.
Please tell me at least one of them is a drop-off.
Mnh-mnh.
Hey.
"In lieu of presents, please make a donation" "to save the giant sequoia tree fund.
" I do so hope to see Athena, my cat.
She died nine years ago.
I just think that a kid would prefer to have a toy over saving a giant tree.
That's all I'm saying.
Do cats go to the same place as people? I'm not sure.
Charlie, is everything okay? Yeah, yeah, just, uh We're not alone.
Right, well, could you turn it off for a minute, just tell them that your girlfriend's talking to you? Oh, trust me, if I could turn it off for good, I would.
Oh, look, and now duty calls.
I love you.
Oh, would you like a coffee? Yes, thank you.
- Mm.
- So, how is resident life treating you? Oh, I don't know if I'd call it a life, but it's great.
You know, I remember, I was so tired once that I forgot my name in front of a patient.
Last week, I wore my scrubs backwards twice.
Ladies, the acceptable amount of caffeine for surgeons is 200 milligrams a day.
Says who? Says a recent study out of Johns Hopkins.
And, since Dawn is on leave, your new interim chief of surgery.
Are you talking about yourself in the third person? There'll be no finger tremors during anastomosis.
Not under Hamza's watch.
Hey, I'm gonna lodge a formal complaint.
Hon, take it up with the chief.
Zach, what do we got? We got a 44-year-old male, Cal Nedman, possible posterior sternoclavicular dislocation.
Took a hit from a 300-pound lineman.
Whoa, no padding? Looks like he was hit by a truck.
- Yeah.
- Is he the coach? Yeah.
And my dad.
Okay, son, you're gonna have to wait out in the, uh, in the waiting area, okay? I can't get an airway.
- Is he gonna be okay? - He's in good hands.
Could you show him where to wait, please? Yeah, follow me.
He's choking out, guys.
Clavicle's pressing on the windpipe.
Uh towel clip.
You gonna shoehorn him? That's usually done in the O.
R.
Yeah, no time.
Uh, let's have cardiac on the standby, please.
Okay.
Ready? - Do it.
- One, two, three.
No, he's still in trouble.
Tracheal deviation? Chest tube.
Give me a 16-gauge.
There we go.
Okay.
Tube's in.
- Whoa, whoa, whoa, whoa.
- That's a lot of blood.
Okay.
The bone's lacerated something.
- Innominate vein? - Okay, clamp that tube.
We need to get him to the O.
R.
before he bleeds out.
Let's go, guys.
Let's hurry.
Sorry.
Let's go.
Well, that was a hell of a mess.
Okay, both ends of the vein are clamped.
Just a couple of more stitches in the graft.
Yeah, this guy has officially dodged a bullet.
Watch the clavicle.
The edge is still jagged.
Yep.
Suction.
Oxygen sats at 80.
B.
P.
71 over 45.
I'm reading that Shahir has you as lead on 13 surgeries this week.
The milk in my fridge is going to walk away before I get home.
Feels good to be quarterback, though, right? Sure.
You ever play football? Yep, in college.
I could never figure out the difference between a fullback and a halfback.
About 50 pounds.
Huh.
Okay, clamp coming off.
Aw, damn it! Dr.
Lin.
I'm okay.
At least I'm in the O.
R.
Jackson.
Elizabeth Grant here for her final appointment.
Exam room 3.
Oh, and had a cake sent in, I take it.
Yeah, caramel ripple the way to a nurse's heart.
Mmm.
Hey, how's everything going with the radiation? Splendid.
That's it? That's it.
So, they zapped all the spots? Mm-hmm, mm-hmm.
Just waiting on the C.
T.
results.
Have you told anyone else yet? No, I have not, because I don't want to worry anyone until I get the call.
So, with any luck, this little hiccup just stays between the two of us.
Mm-hmm.
You sound hopeful.
I am.
I am really hopeful that things can get back to normal and you can stop being so nice to me.
Oh, please.
I'm nice to everyone.
Doesn't Dr.
Hamza have a rule about that much caffeine? He does, but I was chief once, too, you know.
Great.
So, Dixie, why don't you tell us more about what's brought you in here today? It's like the perma-flu.
It's constant nausea, this nagging headache.
Well, the C.
T.
you had in emergency shows nothing unusual going on in your belly.
Great, so, some grade-A painkillers should take care of it, if you could just write that up.
What's the rush? Oh, it's my gido.
He's been living with me since my baba passed, and it's almost time for his lunch pills, so Whoa! Okay, take it easy.
Have you been getting enough rest? Um, probably not.
Between taking gido to his appointments and making sure he's eating, putting him to bed, that kind of thing.
- That's a full plate.
- Yeah.
I could write a prescription, something to help you sleep.
Oh, you are a goddess.
Thank you guys Listen, Dixie, I know that you're in a hurry to get home, but I really do need you to stick around for a couple more tests.
Well, what about gido? I could send a mobile nurse to give him his pills.
Think of it this way, it's a chance for you to lay down.
Hey.
Ah, we're just trading recipes.
Yeah, I swapped my famous summer berry tarts for his lemon cheesecake.
I didn't know you baked.
It relaxes me.
Guy's got to eat.
We're gonna miss having you around here.
But nice to finally be going home, I bet.
Yeah, it is.
Okay, let's take a look.
Yeah, those skin grafts are healing nicely.
Do you have enough cream? Only about two years' worth.
Let's see those arms.
Good.
Can you touch your thumb to your pinky finger? Any pain? No pain.
Okay, press against my hand for me.
There you go, nicely done.
Not a lot of contracture, skin is moist.
You've obviously been keeping up with your physio.
All Dr.
Kinney has to do is fit you for some compression garments.
And then you are officially cleared to go home.
That's great.
Yeah, that's great.
How's he doing? Still no change.
He's in recovery, but you should be able to see him soon.
Is he going to be okay? He took a pretty hard hit, but he pulled through.
You know what's weird? This won't turn my dad off football.
He'll still be obsessed with it even though it almost killed him.
He played in college, but his knee gave out.
That's a pretty tough pill to swallow.
He's a really good coach, though.
Sent five kids off to the pros already.
I'll probably make the college team, too.
That's great.
I'm trying my best to re-live his glory, you know? Yeah, well, I'll, uh I'll let you know when he's up for a visit.
Thanks.
Which could be a while.
You want me to find you something a little less padded to wear? That'd be nice.
You bet.
Hello.
Can I help you with something? Questions, directions, that sort of thing? I'm so pretty.
Okay.
It's a huge malignant glioma, probably a glioblastoma.
Explains the headaches, the nausea.
And the slurred words.
Can we operate? No.
See here? The tumor's invading the cerebral peduncle.
You can't resect it without leaving her with a deficit.
What about PEVAC? Maybe.
Either way, she's only got a couple months to live.
These tumors are a death sentence.
Okay, I guess we have to tell her.
Let me do it.
It's the worst part of the job, hands down.
I know.
I-I don't want to shy away from that.
Are you sure? I'm sure.
All right.
I have brain cancer? How? These type of tumors grow quickly.
By the time they're discovered, they can be quite advanced.
Um Gido needs a, uh, a driver and a nurse for his pills.
I mean, those retirement places, they have waiting lists of, like, two years.
How long do I have? Tell me everything.
You could start losing cognitive function within weeks.
You likely have no more than six months.
Doctor, is that true? Every tumor is different, and this is very serious, yes.
Then, um, I have to go.
Um, I have so much to do.
I have to Dixie.
Just wait.
There could be an option.
What do you mean? What kind of option? Have you heard of viral therapy? No.
Dr.
Reid? It's very new.
And it's still in the experimental stage.
Okay, but, what? So you're saying that I could I could live.
I'm saying that it's a long shot, but it's a possibility.
So, please, just stay, and we will discuss a treatment plan.
All right.
But gido needs to be here, okay? Because he really needs me.
All right.
Okay.
You were a little blunt in there.
I thought she should make decisions based on facts.
Well, now she's making them based on fear.
She said she wanted to know everything.
People say they want to know everything, Cassie, but that doesn't mean they're actually ready to hear it.
I don't understand.
With news like this, it's all about timing.
Okay, but you straight-up lied to her.
You said there was an option.
Viral therapy is an option.
It's experimental.
True.
And Hope Zion's not even approved.
Also true, but luckily, I have an in with the interim chief.
Shahir is my guy.
Your guy? Yeah, I know him.
He will not pass on an opportunity like this, trust me.
The smoking cessation subcommittee wants $2,000 for new posters, and the surgical recovery ward is threatening to protest if the vending machines don't go vegan.
Well I will see you in a minute.
I can come back.
No, I love this.
Come in.
How much have you heard about this? Phase one study, Dr.
Friedman, Duke University.
On glioblastomas and polio.
Mm-hmm.
The tumor is injected with re-engineered polio, and the immune system fights the virus.
And the cancer at the same time.
It's in its early days, but intriguing work.
I knew you'd be as excited as I am, and if anybody can fast track this for my patient, the board loves you.
Alex, absolutely not.
Shahir, we can do this.
You're asking me to throw my weight around for a study that is in its infancy.
And we don't even know the effectiveness of it long term.
It's been successful in 11 patients.
And unsuccessful in just as many.
And those patients died horrible deaths paralysis, blindness.
Duke is adjusting the dosages.
Alex.
If Dawn was still chief, you wouldn't have gone to her with this.
Well, then, lucky for me, Dawn isn't.
You're asking me to risk my reputation.
No, I'm asking you to help me save a 28-year-old woman who has inoperable brain cancer.
I can't think of just one patient.
I have the whole hospital to consider.
The answer is no.
Oh, sorry.
No, no, it's okay.
It's sports.
I wanted the art section, anyway.
Athena was a korat, an ancient cat of Siam.
Not now.
Did you want to be alone? Uh what? I mean, I could eat while staring off into space, but I'd way rather talk to someone.
I'm Kristine.
Charlie.
Surprised we've never crossed paths.
I-I work up on the eighth floor.
Palliative care.
Yeah.
End of life is kind of my thing.
That's a tough job.
Yeah, but somebody's got to do it, right? Do you think they have chicken livers on-on the other side, I mean? You know what? Uh, I would love to stay and chat, but I just remembered, I have a surgery, so got to eat and read on the run, you know? Well, it was nice to meet you.
Yeah, you too.
C-could you just tell me if I'll see Athena again? I'll, uh, I'll see you later.
Yeah, shouldn't keep an old cat lady waiting, right? Okay, Louise, here's the thing.
Maybe the cats go to the same place, maybe they don't, but you won't find out for sure until you get there.
Oh.
Well, why didn't you say so? Wrist circumference, 4.
2 inches.
Radial forearm length, 11.
4.
Do I have to wear these all the time? Yikes.
You can get them in different colors.
You know, coordinate your work ensemble.
Yeah, I'm not too worried about that.
Well, I guess social worker beige does go with everything.
No, it's not that.
I'm not going back to work.
I've already notified my agency.
What? Why? You love your job.
I did.
Those kids are the only thing you have talked about since you have been here.
It's just different now.
Okay, um Sorry, I have to take this, but you and me, we're not done here.
Hey.
What is it? Oh, your test results.
Please.
Don't touch me.
What's going on? Are you all right? Yeah.
Take this to the resource center for me, please.
Hey, uh, do you do you have a second? I need to talk to you about something.
- Yeah, me, too.
- Ah.
You know, you think you know somebody.
More trouble on Mars? No, it's Shahir.
We have a chance to do something really great for a patient, but he won't do it because he's too concerned about the hospital.
Well, that's his job now.
See the big picture, protect the hospital's interests.
Ahead of the patient? No, in addition to.
Well, it's not the Shahir I know.
Well, I don't know.
Maybe you can show him how he can help the patient and the hospital at the same time.
I-I mean, the Shahir you know is still in there, I promise.
He's probably just drowning in paperwork.
You're right.
You're always right.
- Well - I'm sorry.
You said you wanted to talk about something.
Oh, um, no.
It can wait.
Great, catch you later.
Dr.
Friedman has worked out a dosage for the polio that will minimize complications.
Why are we still talking about this? Because I'm trying to do what's right for my patient.
And I need to do what's best for the hospital.
Well, this could be great for the hospital, Shahir.
Think about it, "Hope Zion spearheads an innovative new treatment.
" You know, Charlie told me once that your grandmother used to put your grandfather's slippers in the oven to warm them up.
Is that true? Yes, she almost burnt the house down.
It's not a recommended practice.
And she used to wash his hair in the sink when he couldn't wash it for himself anymore.
Until the day he died, mm-hmm.
Now she has Alzheimer's.
What if she'd gotten sick first? I know what you're trying to do, Alex.
Then come with me.
Okay.
So, here's some water.
Wash it down.
Thank you, Kohana.
Hello.
There's someone I'd like both of you to meet.
Dr.
Hamza, this is Dixie and gido.
Nice to meet you.
Have you eaten anything? I'm not so hungry.
Gido, you need to eat.
You're cold.
You'd think they could afford to keep the heat up in these places.
Can she have this, or is there some rule? No rule against Mountain Dew, no.
Thank you.
I thought of a few things.
Like, uh skunking you.
That sounds like a plan.
So, Shahir, what do you think? I think it's manipulative.
But look at them.
He needs her.
If it wasn't a desperate situation, I wouldn't consider the treatment, either.
Okay.
Dixie, we do need to talk.
About your news? It's not good news, gido.
But there may be an option.
I'll speak to the board.
Thank you.
I thought you said he was gonna be okay.
Look at him.
Yeah, I know he looks a little rough, but, uh, he's gonna come back, kind of like a pick-6, no time left on the clock, you know what I mean? Can we not talk about football? Uh, yeah, just trying to take your mind off things.
Honestly I hate it.
Listen, Ty, I know you feel that way right now, but I never liked it.
Then why play? My dad loves it.
I played for him.
Why didn't you ever say anything? Uh he can't see you or hear you.
But you can.
Yep.
It's kind of my thing.
If he didn't want to play football, he should have just said something.
Wait a second.
You know that guy? I am that guy.
Ty has no idea, and it has to stay that way.
You understand.
Not completely.
He's not ready.
From everything I've seen, he's pretty tough, Cal.
Please, call me Caroline.
Okay, Caroline.
He pretends to be tough, but he is a gentle soul.
He is not mature enough to handle everything that goes along with this yet.
So, you lie to him? Sometimes you have to hide the truth.
Otherwise, you end up hurting the people you love the most.
Okay.
I'll-I'll talk to you later, then.
Okay, thanks, bye.
Sorry about that.
Old school, I love it.
Uh sorry, what? The phone thing, works great until someone actually calls.
I've had to squirm my way out of that one a few times.
I don't know what you're talking about.
Really? Really.
Well, I thought when I saw you earlier at the coffee place, you were talking to myself.
I was I was talking to myself.
No, I-I do that.
I'm, you know, just an eccentric surgeon.
Oh, I-I guess I was wrong.
- Sorry.
- It's okay.
I'll see you around.
Sure.
The polio attacks the cancer.
Sounds like you're replacing one disease with another disease.
I know that it's really difficult to wrap your head around.
You're young.
You have no memory of this, but my best friend got polio when we were kids.
His whole body stopped working.
He choked to death.
Awful.
I can't let my granddaughter go through that.
There are risks.
We'll do what we can to shield Dixie from any complications.
The hell you will.
Gido.
I know this sounds crazy.
It is crazy.
The truth is, regardless of the risks, this is our only chance.
Gido, I'm I'm dying.
I can't live without my Kohana.
Do what you need to do.
The path will help guide the polio to the tumor? Yes, and it needs to be exact.
The catheter needs to land right in the center of the mass.
Like a sniper's bullet.
Precisely, and if we miss by one millimeter Then she will be paralyzed.
That's the best possible outcome.
Well, then, let's not let that happen.
Mm.
Dixie's lucky to have you.
And so am I.
Please, I need to concentrate.
Right.
White blood cell count is good.
Something's wrong! Okay, B.
P.
is 70 over 40.
What's happening, Maggie? He could be suffering a major M.
I.
or thrown an embolus.
Ty, did your dad take any medication of any kind? Daily aspirin, anything? I don't know.
Check his bag for me, please.
No! No, he can't he can't look in there.
I-I started taking hormones.
They're in my bag.
Dr.
Harris, I-I found some pills.
Please! He cannot find out this way.
Get him up for a C.
T.
angiogram.
Page interventional radiology.
If it is a P.
E.
, I'm gonna need help with that thrombolysis.
And run a full blood panel.
On it.
Were those pills steroids? We're not sure.
My dad drilled into us about playing clean.
Said a real man builds up his own strength.
Look, um, why don't you go get some rest? These test results are gonna take some time, okay? Okay.
You should have told me about this.
It's only been a few weeks.
I didn't think it mattered.
H.
R.
T.
increases risk of clotting, okay? Patients need to be weaned off of this before surgery.
This could have cost you your life.
Thank you for not telling him.
All Ty knows for sure is that you're very sick.
Let's keep it that way.
He'll be none the wiser.
He's gonna find out, Caroline, one way or the other.
He may be ready.
Maybe he is.
But I'm not.
We're two and two.
Rubber match.
How is everything feeling? Like I've been abducted by aliens.
I mean, are you sure it's working? It's a slow infusion.
Half a teaspoon of the virus directly into the tumor.
How many times does she have to do this? Once.
That's it.
It seems so peaceful.
Well, best case scenario, everything stays just as it is, except for the tumor, of course, which will eventually shrink and disappear.
Seems like voodoo to me.
Well what's happening? What is it, Dixie? The the cards, they're-they're blurry.
Doctor.
Okay, I-I'm stopping the infusion.
It's getting worse.
- I'll page radiology.
- Is it the polio? Is it inside her? Oh, my god.
Oh, my god, I-I-I can't see! I can't see! The tumor's expanded.
It's compressing against her optic tract.
Let's bring down the swelling.
Dr.
Sharpe, 20 of dex and bolus 200 cc's of mannitol.
Mm-hmm.
Even with the decompression, the loss of vision could be permanent.
Is it possible that the polio breached the path to the tumor? No, it's not.
With the parameters we set Alex, I can't even entertain this notion right now.
If I do, that means Dixie's life is over, our careers, the hospital.
Dr.
Sharpe, is she stabilizing? Not yet.
Pressure's still sky high.
Damn it.
I shouldn't have brought you in on this.
Okay, that doesn't even matter right now.
What matters is figuring out how to get Dixie out of this alive.
Wow, that's a great picture.
The woman in it looks really happy.
That's because she was.
Her life was normal.
Okay, stop me if you've heard this before.
But there is no black-and-white definition of normal.
Normal is subjective.
It's a messy, inconsistent, silly, hopeful version of how we feel most at home in our lives.
Did you just make that up? No.
It was Tori Spelling.
What? I know, right? So, I guess now I have to admit that I'm a reality TV junkie.
Me too.
- Are you? - Yes.
I knew I liked you.
Look, I know it's hard for you to put yourself out there.
But you just have to do it.
'Cause I'm scared to think of what's gonna happen to you if you don't.
Nothing's gonna happen.
No, that's the thing about reality.
The one minute, you're fine.
The next, you're not.
Nothing changes.
Nothing stops.
We affect nothing.
Well, that's a little more Nietzsche than Tori Spelling.
Anyway, we are officially done here, so come on, let me walk you out.
Just because you're getting out of here doesn't mean you're getting rid of me.
Don't worry.
I have my next follow-up in the next two weeks.
Miss Would you be so kind as to allow me to accompany you the rest of the way? I'd be honored.
Bye, honey.
Bye.
He's staring at me.
You should be staring at him.
White socks, black shoes? Please.
Oh, my god.
I'm so sorry.
Hold up.
Hey.
Is that your mom in there? I'm gonna get someone to look after you, okay? Are you all right? Yeah.
Is everything okay? Did your mom get burned, too? She spilled a pot of boiling water on herself.
She needs an operation.
It's got to be pretty scary seeing her like that.
Is she gonna look like that? It's all right.
It's just skin.
Do you want to touch it? Feels a little bit like play-doh.
Yes, it does.
This is pretty.
Thanks.
You know, even though your mom is gonna look different, she's-she's gonna go back to being your mom in no time.
How do you know? Because that's what happens when we get sick.
It doesn't change who we are.
It just makes us stronger.
I hope so.
Here.
This is for your mom.
How's coach? Fed in the catheter and blasted the clot.
He's stable.
Nice work.
Thanks.
I'm going to live.
Yep, looks that way.
That means I have to go back.
I guess.
To being someone I'm not.
For the first time in my life, I feel like me.
And it's better than I ever imagined.
What are you gonna tell Ty? The truth.
I don't want to cause any more damage to me or to him.
I think we're both ready.
The blindness was caused by swelling in the brain.
From the polio? Not the polio, her brain's inflammatory response to it.
Her immune system is attacking the tumor.
Will she see again? Now that pressure is off her optic nerve, it's likely that her vision will be restored.
And the cancer? We won't know for a few weeks if the growth has slowed.
Gido.
Kohana.
Can you see me? I can see you.
Hm, that's very good news.
Good news? It's great news! Okay.
Dixie will need constant care and monitoring.
It's my turn.
Hey.
What a day, but now I'm all yours.
What's up? Hey, is this about earlier in the hall? With Cassie? Is she okay? Yeah.
Yeah, yeah.
Uh But, um, uh I'm-I'm not.
It's, um it's back, Alex.
Cancer's back.
Oh, my god.
Yeah.
Um What can I do? I know what you can't do.
You can't give me that look, the "oh, you have cancer" look.
It's still me.
I'm still me, okay? Okay.
Does Molly know? No, not-not yet.
Okay.
Hey.
What did I just tell you about that look? Right.
Sorry.
It's it's gone.
See? All gone.
And one more thing, please? Don't tell anyone, okay? You know Cassie knows, but that's it.
And, uh I just need a couple of days to, um just to get my head around it.
Of course.
Hey.
Whatever you need.
Great.
Good.
Okay.
Ah.
When he wakes up, he's gonna need oxy for the pain and docusate for the constipation, and then I get to go home.
And I get to scrub up for my third bowel resection.
But you're back in the O.
R.
Code blue, I.
C.
U.
, room 4.
- Code blue, ICU, room 4.
- Is that Cal? Yes.
Maggie, bag him.
Yep.
Where's that crash cart? Switch out.
Switch out.
And clear.
I got nothing.
Going again.
And clear.
Still no pulse.
Going again.
Clear.
Time of death, 6:32.
Charlie.
I'm sorry.
It's all my fault.
He's dead because of me.
What? If I hadn't kept it a secret about hating football, we wouldn't have been out on that field.
Ty He would still be here.
My sweet boy.
I never got to explain.
Now I won't be there for you.
I won't be able to protect you.
I should have just told him the truth.
You were protecting your dad's feelings.
We do that for the people we love.
Those pills they weren't steroids, were they? No.
No, they weren't.
I guess it was hard for him to tell me the truth, too.
I loved him so much.
Knock knock.
I have a stack of RFPs to review before 8:00 A.
M.
Don't tell anyone, okay? Oh, your secret is safe with me, chief.
We made a pretty good team in there today.
Hmm.
Plus ça change, plus c'est pareil.
Well, the weight of the world is about to be lifted off your shoulders.
You know, I'm gonna miss this job, Alex.
I like the added responsibility.
It's a lot to worry about.
Well, you have Charlie and Luke.
Who you haven't visited in a few weeks, by the way.
Yeah, I suppose it's time to teach him some chess.
So, we're good? Oh, we're better than good.
We're team Shalex.
Thank you.
Come on.
I think that's probably the greatest thing I've seen all day.
Can you help me, please? There you are.
Hello, handsome.
Hi, beautiful.
Mm.
Mm, wait, wait, wait, wait.
Oh! Ooh! Ooh! I'm feeling the remnants of a hard day in there.
It's nothing.
Yeah, kind of had one myself.
Want to get out of here? Yeah, just got some paperwork to take care of.
Oh.
Well, I love you.
I love you.
See you at home.
Okay.
Hey.
Hey.
Working a double? Yes, I am.
And if I don't get more than I'm going to bite someone's head off.
Well, I have it on pretty good authority that cappuccinos aren't considered part of the deal.
Oh, I will quote you on that if I'm caught.
Cassie, in the hallway earlier with Dana, I'm really glad that she had you to lean on.
Now she has both of us.
Yes, she does.
Good night.
Good night.
You're still here.
Yeah.
Yeah.
You too.
Hard day? You could say that, yeah.
You want to talk about it? Okay, here goes.
I see ghosts, and I know you do, too.
Now do you want to talk about it? So you were saying it was a hard day Because of the cat lady? No.
No, it wasn't because of the, uh cat lady.
Another one.
What was his name? Her name.
Her name was Caroline.