Transplant (2020) s04e07 Episode Script

1
So you got a basic kitchen,
bathroom. The TV works.
There's two or three positions each year
where practising surgeons
will take on foreign doctors.
Disappearing from your life,
that was me being scared
that I'd never be
able to build anything.
I'm thinking about having a kid.
And if I do something
that crazy by myself,
I need to know that my
work environment is stable.
It's been decided that he's gonna
be transitioning out of Trauma OR
and no longer connected to
the emergency department.
Dr. Devi, I appreciate your faith
in me, and I plan to earn it.
Hydromorphone? Mags, what is this?
If you have pain, Claire,
that pain should be managed.
They'll be retrieving the
donor heart late tonight.
First thing in the
morning, we'll get going.
I can't see a future
unless you're in it.
This is real, Mags.
(OPENING THEME)
(HONKING)
(DOOR OPENS)
(DOOR SHUTS)
Hey (BASHIR MOANS)
It's 6:30.
How long have you been out?
(SIGHING)
About an hour.
Was Amira awake when you left?
No, but I left her a
note and made her lunch.
It's weirdly quiet
out there for a Monday.
Oh, and I brought your fancy clothes.
Thank you.
Are you nervous?
Dr. Robitaille says he wants
me to meet the whole team.
Whatever that means.
It means he wants to make you an offer.
Just make sure it's
got extended medical.
It'd cover Amira's braces.
Me saying that doesn't
mean it's not gonna happen.
(SIGHING)
The broker came back with
some options, but also,
June says I can keep my
room if we want a slow burn.
Just tell the broker
we need two bathrooms
because you and Amira refuse
to hang up your towels.
Hey, we have a system, alright?
(CHUCKLING)
Hey, remember when HR
called me as I was working
into the hospital to tell me
the position had been filled?
That happened only one
time at a different house
(RUMBLING)
The bed shook!
Every time my arm moves
even an inch, it kills.
Yeah, I don't know what that was.
Anyway, I think it's over.
- (INDISTINCT PA ANNOUNCEMENT)
- Um Okay.
Charlotte, tell me about your elbow.
I fell off the curb. It was 5:30
this morning and I was fast-walking.
Exercising? Can you bend it a little?
While studying for midterms.
University applications are soon.
Yes, I know my skin is dry.
You know which school you want to go to?
There's five on my list
with good pre-med tracks.
Not like when you were
applying and every nice guy
with a B average got in.
"Nice guy, B average."
Charlotte, I don't think
I've ever been summed up so astutely.
I didn't mean to It's just stressful.
Okay.
Were you dizzy?
Alright, well, I'm gonna
get you on IV fluids
because you are a bit dehydrated.
- When was your last period?
- Why?
Well, it's just one of the
standard questions we ask.
And you'll probably get
asked again at X-ray.
I don't really get them.
Do you know why?
Because sometimes
stress or change in diet
can cause cycles to stop for a while.
Actually, can you go now?
If I have to wait here, I should study.
Earthquakes in Toronto?
Is that even a thing?
Closest fault lines are Quebec and
western New York, but we do get tremors.
Just nobody usually feels them.
Well, apparently, this one
was big enough to shake loose
one of those giant lit
billboards over Yonge.
That's "act of God" scary.
More like "we ruined the planet" scary.
Actually, earthquakes are not influenced
by climate change
"Shut up, Arnold," got it.
Hey, Claire, remember a few years back
when a chunk of the overpass collapsed?
People were more scared than injured
so you got that place
to send free pizza?
Set up for worst-case
scenario, clear the curtains.
Anything non-urgent,
boot it to the hallway.
Alright, let's make sure we're
ready with fresh frozen plasma.
And packed red cells and platelets.
I'll meet you in there.
(JUNE SIGHS)
June, let's go!
Yeah, I'm coming.
- What'd he say?
- Who?
Singh, about staying on
in Trauma OR, full-time?
- Mags
- You said if the line
was still there today, you'd ask him
because the random rotation
of bosses you're saddled with
won't work with getting
your life organized.
Yeah, just chill out. I've
been here for two minutes.
- 22, and you're stalling.
- Oh, my God, I'm not stalling.
It's just, like, being
a few weeks late.
It's not a big deal.
Remember two months ago?
Do you remember two months before that?
Yeah, those times you were
only late three or four days.
- Oh, look, my abdo trauma.
- June
Natalia Bury, 51. BP's holding
at 105 over 75, heart rate's 170.
Left upper quadrant pain. She was
right underneath it when it fell.
- When the cloud fell.
- Okay, Natalia, look at me.
- Can you tell me where it hurts?
- Please, find Danny.
Is Danny a loved one?
Did she just say the cloud fell on her?
She means the billboard. The mechanical
sky diorama thing around the corner.
It's okay, Natalia, I'll
get somebody to find Danny.
Bashir?
I can reschedule if you need all hands.
We'll be fine. But I got
a call from public health.
Out of province this time.
Some kind of chemical spill,
and they asked if you'd
call the doctor there
since there's overlap
with your experience.
Okay, I'll get in touch.
Good luck at St. Agnes today.
Three lacerations from
shattered glass, four fractures,
and the guy in five
has electrical burns.
Hopefully, this ends as
quickly as it started.
Uh, displaced elbow needs
imaging and fluids, Rhoda.
If you're swamped, I can do both.
- Thanks, Theo.
- Fluids for a displaced elbow?
Well, she's 17, and I think
struggling with an eating disorder.
And you want her admitted for it?
Hard to know. I saw lanugo,
dry skin, her cycle stopped.
I tried getting her talking,
but she stonewalled pretty hard.
Maybe send in the
adolescence psychiatrist.
Someone more suited to tactfully
break through that stone wall.
- Uh, sure, if you think that's best.
- Great!
Dr. Hamed? Jay Penney.
I'm a doctor in the north of Labrador,
and the provincial health officer
said you have some expertise here?
- Dr. Penney, are you alright?
- Thing is, I don't know.
We had a truck crash
about four hours ago, okay?
The driver was dead. At first,
we figured it was just trauma,
but eventually, we realized
he was hauling pesticides
which shared properties with sarin.
Is that something you know about?
I have experience there, yes.
Uh, how large is the exposure area?
Are you seeing people with symptoms?
I started seeing patients
with respiratory problems.
Okay, you need a decontamination team.
Um, do you know the exact
name of the chemical?
Uh, I'll find out.
I'm told they're coming,
but you can't easily get to us.
And I'm two years out of residency
and the only doctor for 500 kilometres.
I need somebody to talk me
through it and help these folks.
He's dead! I think he's dead!
Carmen, grab a crash cart.
- Oh, my God, Dad, no!
- What happened, ma'am?
We've been here all night. I just left
for an hour to take my kid to school.
No, no, he didn't want that.
Is he
I'm very sorry, ma'am.
He came to you for help.
How could you let him die
in the hall like a piece
of garbage? Shame on you!
All the guy has up there is a
part-time nurse and some volunteers.
He needs mitigation strategies.
I'm away for what, like a fortnight?
And already the guy's got a side hustle?
Dr. Novak, you left Trauma OR
to go back to ICU six months ago.
Has it been that long? No wonder
I'm so charmingly refreshed.
- How many people were exposed?
- They don't know.
The truck crashed
downwind of a small town.
Houses, local business,
and a K through 12 school.
It's blocking the only road out of town.
Organophosphate pesticides cause
everything from resp
distress to paralysis.
I'd recommend a full-scale evacuation
of half a mile in every direction,
but they're so remote that medevac and
decontamination teams
are still hours away.
A vapour is gonna get into the low-line
areas so higher ground is better.
Yeah, large exposure,
it'll start interacting
with the nervous system
within 10 minutes.
If it's inhaled, I told them to look out
for pin-point pupils, runny
nose, broncho-constrictions
Fluid accumulation in the
airways of the lungs. Dyspnea.
Do they have any pralidoxime?
And a small amount of atropine.
- Theo, for pediatric dose?
- I can get you a crib sheet by weight.
Can you both compile
some detailed instructions
and text them to me? I'll call
them on the way to my interview.
- Sure.
- What interview?
- St. Agnes.
- When does your residency end?
- Three weeks.
- Huh.
That place is barely a
notch above urgent care.
It's not really your tempo. Is
it Is it really what you want?
Of the EDs looking, they're
the ones I found traction with.
Oh. Whatever, just go, and then
when it gets intolerable, move on.
No, not everyone is as comfortable
with that kind of transience.
Coming from a man whose content to work
for a chief who loathes
him and always will.
I mean, welcome to the club,
the loathing part, but the content part?
- That's all you.
- Yeah, well, we may have started off a little rocky,
but you know, at least
I'm trying to fix it.
Aw, denial looks good on ya.
Text me those dosing
instructions when you can.
Yeah
He was in late-stage cancer.
Admitting was trying to find him
and move him to palliative. And his
daughter was upset because he was alone.
- Which nurse found him?
- Rhoda.
- Carmen said she needed five.
- Rhoda?
- Needed more than five. She quit.
- Because of this?
Because nothing works
here and she's fed up.
That isn't fair. You
know I've made the point
our nurses need more
support so many times.
Admin doesn't even hear it anymore.
- You didn't return my texts.
- What's there to say?
The doctor you referred me to while
you were away says I need to taper off.
- That's fine.
- Well, if you're not
and you need help doing
that or aren't ready to,
- I still want to help.
- I said I'm fine.
Well, we talked about accountability
Oh, Bishop used to laugh
at wide-eyed idealist Mags.
He said, one of these
days, we're all gonna be
working for you. (SCOFFS)
After everything you've been through,
I don't understand why'd you
even come back to this place.
Natalia Bury, 51 years
old, earthquake victim.
They're saying it was
a magnitude of 4.1.
CT's saying grade 5 shattered spleen.
- So it's coming out.
- Laparoscopic for blunt trauma?
Bold. How'd she take the news?
By the time we were done imagining,
she wasn't cogent enough to consent.
She was asking for Danny,
but Danny's not here.
So If we don't go now
- There won't be anywhere to go.
- Exactly. Pen.
- (JUNE WINCES)
- She been tacky the whole time?
Just a couple of fluctuations. Scalpel.
Uh, I don't think I see sinus.
You think she's having
a heart attack on the table?
- Have you seen that before?
- Once.
We draped and echoed to assess it
was truly a wall-motion abnormality.
Which is how I suggest
we play this one, too.
I, uh Dr. Singh, I don't know.
June, what are you saying?
I, uh Okay, I'll just finish
with the ports, and then we can stop.
You don't sound convinced.
I'm worried about her hemorrhaging.
I would prioritize the spleen.
If this is an MI, there's a good chance
they would treat conservatively.
What Dr. Curtis said. Then put her
on a 12-lead ECG for visibility.
Dr. Singh, that's not what I meant.
- I was just trying
- Oh, c'mon, June.
As soon as the words
were out of your mouth,
we both knew I'd been schooled.
Five millimetres trocar here.
- (JUNE EXHALES)
- Since when do you not speak up
when you disagree with me, June?
I, uh think I'm gonna go loop
cardiology in myself just to be sure.
- You got this?
- I do.
I'd like heart rate updates
every minute, please.
(GROANS)
- You said "no milk," right?
- Yes, yes. Thank you.
So You've toured
the department again.
Met our whole team.
- Thoughts?
- It seems great. And efficient.
I know it's not the level one
trauma centre that you're used to,
but most docs prefer our saner pace.
Everyone is very excited about
your skills and experience.
You're exactly what we've
been looking for, Dr. Hamed.
And you know how hard it is to
get doctors to agree on anything.
I do. Yes
On that note, I am thrilled
to offer you a four-year
contract here at St. Agnes.
Starting as soon as your residency ends.
(SOFT MUSIC)
I'm sorry, Dr. Robitaille,
but I can't accept.
(SIRENS WAILING)
(PHONE VIBRATING)
(SIGHING)
Uh, Dr. Curtis, hi!
They said you're the doctor
surgeon-person responsible for her.
One of them, yeah, but what do you need?
Well, I need to know
what the hell happened?
I mean, I get out of class
to find out she had surgery
- and a heart attack.
- Oh, you're Danny.
Right, uh Our cardiac team
is assessing how much damage,
- if any, was caused by the MI.
- Okay, and her spleen?
Like, does she even know?
Aren't you supposed to check
before you rip something out of a
- Is that her stuff?
- No, no. Look,
a billboard collapsed on your
mother triggering this chain of events.
She's my girlfriend! Not my mother.
You should know better than to assume.
I gotta go.
(SIGHING)
- How did this happen?
- Hold on, I'm almost done.
He said it was a small explosion in a
shed or a garage during the earthquake.
Paramedics said he was hemo unstable
so they gave him a bolus of fluid.
(INDISTINCT CHATTER)
(WINCING)
- Okay, how many fingers?
- No idea!
Take this, it's everything
you need to find the girl.
- BPs 90 over 60.
- What girl?
Uh, I was looking for my cat.
He got out when I heard a rattling
in a laneway garage so I went in.
Then the ground started
shaking, rumbling, then
I think there was an explosion, but
But before I blacked out, I saw her.
- Your cat?
- No!
A girl, she looked about
16, tied to a drain pipe.
I remember thinking, "Why
would a shed have plumbing?"
Arnold, let's start another
line. Let's get it fast!
And, uh, 50 milligrams dimenhydrinate.
You need to find her. I tried
telling the paramedics, but
- Gauze, Carmen.
- Yup.
There's internal bleeding, then
there's risk of losing more.
- Yeah.
- She was terrified.
You have to move faster
than that, Carmen.
- Yeah, I'm trying!
- Arnold, we need morphine, tetanus, and ceftriaxone.
Got it, and I already paged optho.
- Thank you.
- Hey! The girl is in danger,
- you need to call the cops! Now!
- BPs down to 65 over 35.
He's in hypovolemic shock. Activate MTP.
- Prep two rounds of epi.
- No, no epi.
Let me call it, Carmen. We need two
milligrams of lorazepam,
two grams of TXA.
- Blood's ready.
- What if the seizure dislodges
- the thing in his eye?
- We just need to get him stable
and hope for the best.
(SIGHING)
- Pressure's coming back up.
- OR for a lap?
No, CT. We need to see
how deep his eye injury is.
Um, Dr. Hamed, I get that maybe
a code isn't the best time,
but I need to learn. So anytime
there's anything you need me to do
Yeah, I'll keep that
in mind, Carmen, thanks.
Hey, Shawn, I'll call about
the girl. Okay? I promise.
I just need to make sure she's okay.
(TENSE MUSIC)
(KIDS PLAYING)
Amira!
Amira! (IN ARABIC)
Are you the father? You can't leave
a kid her age in the park alone.
I understand that, I just got held up.
Anyway, I'm here now.
Thank you for your concern.
You can tell me if you need help.
Are you okay, honey?
I think I'm gonna call the police.
No, no, no. Please,
please, don't do that.
Look, I work at the restaurant
just down the street.
You can go ask them. I had a
phone interview for another job.
I'm really a doctor.
My shift ran late so I had
to take the call from work.
Please.
He's my brother.
(IN ARABIC)
But did they tell you that I
am 43 and that my father died
of a stroke at that age,
and his father did, too?
Well, with a family history like that,
it makes sense that
you would be worried.
But can you please sit down, Harper?
I eat healthy, I exercise.
I don't smoke like they did.
I have done everything I
could to avoid their fate.
- Harper
- But it's just been like this cloud on the horizon.
And, you know, I guess there's just
nothing I could've done to stop it.
Harper! You are not having a stroke.
- How do you know that?
- Well, the night doctor
sent you for a CT-angio
as a code stroke,
and there is no clot or
bleeding in your brain.
We had an influx of urgent
patients this morning
because of the earthquake. So it took
a while to get your results back, but
That stuff, though, it
rules out a stroke? 100%?
Together with the clinical
exam and the negative CTA,
it's the tool we have, I'm confident.
That's not good enough,
my arm is still tingling.
That could be for a
number of minor reasons.
Viral, stress, a pinched nerve.
What gets us the rest of the way?
I could ask for an MRI or
have neurology come down,
but I'm telling you
it's gonna be non-urgent.
Please, it's been too long
thinking this is coming
to just accept that it isn't
without doing everything
that I can to make sure that it's not.
Okay, Harper. Just settle
in for that wait, alright?
I texted like five times, what the hell?
Yeah, I know, I just, uh Thanks.
- They made me an offer.
- Okay.
- I turned it down.
- What?
I know. Obviously, it
was stupid, but I
I don't know what I was thinking.
I'm trying to understand why I did it.
Okay, hold on. I just was not
expecting you to say that, but
Bash? They took Shawn to image his head,
but you'll want to hear what the
cops said about the girl he found.
Okay.
- Go.
- Thanks.
I wanna know what you're gonna do
to make sure no one else
ever has to go through this.
And if you can't tell me,
I'm going to the press,
so people can find out
what kind of tragic,
irresponsible operation you're
running and something changes.
Are you okay?
Did you need something?
Uh, actually, I just came to check
in on how things have been going,
but it seems like a bad time, I
Um
Look, I have personally felt that
my performance has been solid.
- Uh-huh.
- Good.
And, um, I'm aware of the
ground I had to cover to
to build trust between us.
You've certainly been
making a concerted effort.
Okay, just
I mean, you say that,
but it sounds like
For example, earlier today,
you suggested that I bring
psych in on my eating disorder patient?
You agreed that was a good idea.
Except, I am actually capable
of talking to my patients
about sensitive issues. I
have been doing it successfully
for a long time.
You want to hear me say that
I am aware of that, Theo?
- Fine. I'm aware.
- I'm a nice guy, Dr. Devi.
If you can't see that,
maybe the problem is you.
Maybe it is.
Huh. Took an earthquake
for everyone in ED to
realize that they miss me, eh?
Can we talk?
Yeah.
So I noticed Singh covering Trauma OR.
I'm guessing you're wanting him
to take over for me full-time.
Yeah. I do.
He's a reliable choice, that's
what you said you needed.
What I need is for you to write
me a script for misoprostol.
Oh. Ulcer prevention or ?
- The other thing.
- Did you change your mind about having a kid?
Uh, just that circumstance
affects dosage.
My body changed it for
me. So I think 600 mcg.
I wasn't that far along.
Already self-assessed.
I don't want to do the
watchful waiting thing.
I just wanna put it behind me.
- June
- Please, don't.
I came to you because you're the
one person who won't make me do that.
Okay.
I'll put it through for you right away.
Hey, Jay, it's Dr. Bashir Hamed.
I'm told evac teams are navigating
their way around highway closures,
but they are on their way. Call me or
text me if you need anything, alright?
Hey, Shawn. So how are you feeling?
It's getting a little
uncomfortable, not turning my head.
I bet. But they needed to
make sure that you're bleeding
was stable before operating on your eye.
Did they find her? The girl?
Uh, about that, we spoke to the
police, they checked out the garage.
Uh, Shawn, there is no girl.
What do you mean? She escaped?
No, there never was one.
The garage that you went to
was owned by an elderly couple,
who feel terrible about the
compressor which had been rattling.
The husband is a handyman, and
Because they're an elderly
couple, there's no girl?
Maybe they moved her
from the drain pipe.
They checked. There are
no pipes in this place.
And the security camera confirms this.
I saw her.
I can see her so clearly,
right now in my mind.
You're saying this is a delusion?
Likely a hallucination
due to brain injury.
Why would my mind even
Sometimes we project.
I mean, do you think there could
be anything else that might
You said you lost your cat.
Yeah, but he gets out all the time.
I'm home a lot, in
between jobs right now.
I think he kind of
hates me and needs space.
Wait I invented a girl to save
because my cat doesn't need me?
The good news is you can now
focus on the things you need.
Which means letting your
body heal from this trauma.
Heard you were looking
for me. How's the elbow?
Why'd you pawn me off on a psychiatrist?
You brought me here to complain.
Yet, you didn't seem to really
want to talk to me earlier.
I don't wanna talk to anyone.
Now I'm admitted and trapped here.
I'll miss exams and everything
I'm working for is ruined.
I get you're upset. But Charlotte,
this isn't something you can ignore.
I worked out a system.
Restrict to stay focused,
then after every exam, eat
enough to start all over.
And what did the psychiatrist say?
That it's perfectionism,
or anxiety, or OCD,
and I suck at dealing.
That's all they ever say.
This is why I want to be a doctor,
to think outside the stupid box.
Well, then, start
now. What do you think?
I think you guys always
need something to fix.
And when you can't or I can't or
there isn't, the cycle just restarts.
- And do your parents know?
- Since I was 12.
They watch me get better then worse.
It kills me every time I let them down.
I was hoping you'd call for me.
So I'm not only here
for you to yell at me.
I just like how you didn't push.
Have you ever heard of
family-based treatment?
It means your mom and
dad keep you accountable,
and it decouples eating disorders
from psychological causes.
Why hasn't anyone suggested it?
Because not everyone subscribes to it.
And your family really has to want
to be an active part of the process.
They do.
Only it's kind of too late
since I'm stuck in inpatient jail.
How often are they checking on you?
Maybe it was something that
Novak said about St. Agnes
being low stakes that's
just rattling in my
Okay, just pause. Just
Tell me what happened.
They offered me everything.
Everything I've worked
for since I came here.
Just here you go.
And then I got this
feeling that it wasn't for me.
And I should know better than
to listen to these impulses.
- It was selfish and, and stupid.
- No, so what, though?
Why do you keep punishing yourse
- Hey, guys! Mags
- Yes.
Echo looks good, bloods are good.
- Stress test, too.
- Great.
Great because I feel good.
Energy levels, everything.
- Nice.
- Did you still want to do
- the endomyocardial biopsy today?
- What time is your shift over?
- At seven.
- But if you can squeeze it in earlier,
- I'll take over her patients.
- I love the way you two
attack this as a team.
All my post-ops should be so lucky.
Let's do it after your shift.
I can have you out fast.
- Okay.
- Dr. Zhang.
She's had four biopsies in six months.
At what point can we stop
worrying about rejection?
Now, at every point.
Easier said than done.
But try not to worry about
something you can't control.
- Is that even
- I'm trying, I really am.
- You were saying?
- I was asking you
why you keep punishing yourself.
Five years ago, I made us leave Elliot's
because I was frustrated
and acted impulsively.
We were between places.
- Where were you sleeping?
- Khaled lent us his couch.
Amira was at a playground one day
and a job interview ran long, and
a stranger accused me of
being a negligent parent.
That is the last thing
you could ever be called.
It was that day I realized
I couldn't requalify
and keep a roof over our
heads so I went full-time
at the restaurant and gave up
any hopes of being a doctor again.
I'm having just come
through a heart attack myself.
You'll feel tired, shortness of breath.
She's gonna need help, Danny.
How long until she's her regular self?
Couple of months. Post-surgery,
you'll want to take it easy.
You said shortness of breath, is that
why I'm having trouble breathing now?
Uh, can you just turn
your head the other way?
It looks like, uh Are those hives?
She may be reacting to the medication?
When you say she needs help,
like, uh getting dressed?
Like, she, I mean, she can
go to the bathroom
by herself, I imagine.
She's barely 50, nobody's
suggesting she'll be incontinent.
I look out for you all the time, Danny.
Is it really that horrific to
have to look after me for a month?
Didn't say that. Don't get mad at me.
Yeah, did you know you
were allergic to bee stings?
Yeah, why? Is that
It's like, how did you
not feel the stinger?
This is why you had the heart attack.
Are you saying this is my fault?
Uh, what June means
is that in rare cases,
these things can cause Kounis syndrome
which leads to the release
of inflammatory cytokines
and can cause coronary artery vasospasm.
So while the billboard
fell, a bee also stung me?
I mean, like, whoa, what?
- So weird
- Just get out, Danny.
No, I didn't do it. Nah,
I didn't do anything.
- Leave! Just go.
- C'mon.
You don't have to do this.
Hey, I figured you
bailed right after you
Quit in a fiery rage?
I hope I didn't screw you guys
with the earthquake fallout.
No, it blew over pretty quickly, but
Look, I know it sucks.
The man who died
It's not that. I quit because of Claire.
Look, every few months, this place gets
to be too much and I say I'm leaving.
And Claire always talks me down.
This time, she didn't even blink.
I know she hasn't been herself lately.
It's because of the drugs, Mags.
I hate to betray her,
but you should know.
I did. Right before my surgery,
I offered to help with pain management.
Well, right now, it's out of control.
I'm really sorry, Mags.
Harper's MRI came back clean
and I know you said
to prep for discharge.
My arm is still tingling.
So if you can't redo
those tests tonight, I
can come back tomorrow.
- Or you could refer me, I
- No. It's a pinched nerve.
If you want a follow-up, ask your GP.
I know it's hard, but
you have to try to accept
the fact that there is no
cloud on the horizon, Harper.
So what's going on here?
- Mags knows about Claire.
- Oh.
The thing is, is that she
never actually told us.
She has this witness medication
wastage a few times a week.
But in the morning, the
count is always wrong.
- So she's stealing painkillers?
- It's not like we've caught her
high or messing with patients, but
- She's so lost.
- Okay, um
Well, if there's any good news here
is that you don't
really wanna quit, right?
No. But
If Claire is prepared to let me,
what's that say about where
this place is right now?
- (PHONE CHIMING)
- Hey, Jay, how's it going?
A makeshift quarantine in
the church has 14 patients
using all the rebreather masks I've got.
Oh, uh, last time we spoke,
18 people needed your help.
Well, a few stabilized.
Volunteers are knocking on doors
and I'm hoping that's it for new cases.
But also, because we've used
all the atropine we have.
Okay, but you haven't lost anyone?
- (INDISTINCT)
- Jay?
This 14-year-old boy has dyspnea,
then suddenly pericardial effusion,
just not in a way I've ever seen before.
Meds didn't work.
Okay, so effusion didn't
connect to the antidote
or the toxin, but if you're
worried about tamponade
The thing is, Bash, his heart
isn't where it should be.
- What's that supposed to mean?
- I don't know
- (CALL DROPPING)
- Now! Now! I want it out now!
- Turn that off!
- Hey, what's going on?
- Get him some lorazepam.
- Don't come closer, Dr. Hamed.
- Shawn, what are you doing?
- No, they're saying
it could be all night before
I'm stable enough for surgery.
They're still monitoring
your abdominal bleeding.
No, I need this out of my eye now!
Look, I understand it's uncomfortable,
but if you could just hold
on a little bit longer
No, it's not that, it's the girl!
- Shawn, we've talked about
- No! I'm serious.
No, I get you're saying
she's not real, and I
I believe you or I want to believe you.
But it feels so real.
And that feeling is
more intense than any
pain I've ever known.
Look, Shawn, if you do
this, honestly, I don't know
what's going to happen medically,
but there will be a lot of bleeding,
possibly in your brain which could lead
to hemorrhagic stroke,
shock infection, blindness.
Every second's torture. I
can see her terrified face.
- I need it to go away.
- There's no guarantee
that removing it will
take that feeling away.
It will. I know it, it has to.
You have a brain injury, Shawn.
You're not thinking clearly.
Just please
(SIGHING)
Thank you, I'll find the nurse.
- (SHAWN SCREAMS)
- Hey, no, no!
Hey, Shawn, Shawn!
Hey, hey!
(SIRENS WAILING)
I'm so glad you're
sticking around, Rhoda.
What happened today was not fair to you.
Hey, it's not your fault.
I know you're trying.
I don't want to hide from
reality or make excuses.
Wait times are the same as they were
two years ago when I started this job.
Staff to patient ratios, same deal.
This isn't self-pity, it's
just a dose of radical honesty.
Claire, thank you for
coming. Take a seat.
- What is this?
- I'm sorry, okay,
but we're just worried about you.
We love you, Claire. You know we do.
- It's just
- Stop.
- Claire!
- Dr. Devi, let me try.
- Claire!
- (SIGHS)
How could you, Mags?
They knew already. Or
Arnold and Rhoda did.
Yeah, so you decided to blindside
me with some pointless intervention.
I promised that I'd be there
for you, and then I disappeared.
But we can work on this
and get you back on track.
For what? You are still that naive
- little girl clinging to a lie.
- Alright, then quit!
If you believe that,
then you should quit
instead of poisoning
the people around you.
But I don't I don't think you do.
If you keep stealing
pills, Devi will alert legal
and you won't be able to see patients.
That's what I came out here to say.
(SINGH KNOCKS)
I think we just broke that couple up.
- I blame the bee.
- (SINGH CHUCKLES)
Uh, I know you're looking for
a full-time Trauma OR body.
Uh, yeah, I wanted to
talk to you about
I'm going back upstairs.
- Did I do something wrong?
- No.
One, it's not what I want.
I'm a general surgeon
and that's what I love.
And two, you don't need some
blowhard lording over you.
That's not the way
management's going to see it.
Which is why I'm gonna make
the case that they should.
You earned it, June.
Thanks.
Okay
You good?
Yeah.
Hey, you paged me about Jay Penney?
- How's he doing?
- Save one more coronal image,
- and then we're good.
- What happened to Carmen?
- Nothing, I'm a lab rat.
- Technically, she volunteered.
But now I know what a C
with contrast feels like,
which can only be an asset
to my level of patient care.
What's the deal here?
Have you ever heard of situs inversus?
Uh, when organs are in the mirror
image position where they should be.
Your doctor in Labrador has a
kid who needs pericardiocentesis,
but they found out the hard way
that his heart's in the wrong place.
Since they don't have
much access to imaging,
they'll need you to talk
him through what to do.
- And your organs are the map?
- The software inverts
the image, and then we can
help Jay visualize the anatomy
to make sure his landmarks are correct.
- Thanks, Carmen.
- Yeah.
Right, so Jay can drain the
fluid around the kid's heart
- before he dies.
- (PHONE RINGING)
Okay, let's go.
Okay, you'll need a 30cc
syringe, spinal needle,
a guide wire, pigtail
or closest you can find.
I'm set up, Bash.
Okay, you're gonna to run your fingers
down his sternum until
you hit a bony notch.
How old did you say this patient is?
- 14, male, 50 kilos.
- Alright, with no imaging,
he should be going
subxiphoidal with a 7F pigtail.
That way you can aspirate
even clotted blood.
And then aim for the right shoulder.
- The right shoulder?
- Jay, does that make sense?
- Hang in there, buddy.
- Jay, do you hear us?
Talk to us, man, what's going on?
Sorry, trying to mark
the puncture point.
How far? If I miss, I pierce a lung.
I'd say about the width of
one finger on a kid this age.
And make sure you
continuously check pressure.
Jay, you good?
Little guy's name is Paul.
I don't I don't know if
I'm doing this right, guys
Hey, it's okay. How many of
these have you done the easy way?
One. Since residency.
Paul's mom didn't have an
ultrasound while she was pregnant
so we didn't know about his
irregular anatomy. Crap
What's wrong? What happened?
- No breath sounds.
- What's his heart rate?
I don't know.
You want me to stop for a pulse?
No, no, no! You need
to puncture right away.
Okay, don't think. Just go hard
so you perforate the pericardium.
Okay.
(HANGING UP)
Damn it. I'll get him back.
Theo, our guy from adolescence
psych wants to talk to you.
Uh, yeah, leave that with
me, Arnold. Thank you.
I did something, uh, risky.
I busted this patient out of here
before confirming with her doctors.
I mean, her parents were relieved
when they came and got her.
And I got her a great team,
it's just somewhere else.
You know, Novak was right about Devi.
C'mon, Jay, pick up.
Bash, I'm trying to tell you something.
- Theo, are you okay?
- No!
No, I haven't been for a long while.
Because you discharged someone
No, because I keep doing
some version of the same thing
over and over, and and
making the same mistakes.
I know you have a lot going on.
Alright, with residency
ending, and Mags, and Amira.
She's going to England for a month
on this STEM exchange trip, but
But you still see her
as a nine-year-old.
Well, you know I get
this kind of thing, right?
It's just that my therapist
told me that I keep putting
this pressure on the men in my life.
You know, expecting them to
be fathers or brothers, and
Maybe I reacted by pulling away and
(PHONE VIBRATES)
"No signal for voice call.
Got the needle in,
seems to be draining."
This was impressive.
Hey, Theo.
What if there's an
infection or a complication?
- How will we know if we can't see him?
- Bash
he's okay.
Can I come in?
So I just spoke with cardiology again.
And they said that you're
recovering really well.
There's no reason for you
not to be home tomorrow.
You must think I'm an absolute idiot.
Uh, don't I mean,
a billboard fell on you.
Danny, and that whole thing.
I thought he was
It is just so hard to meet people.
(SIGHS) What was I thinking?
That you don't deserve to be alone.
Didn't they ask you to stay lying back?
Hey Yeah.
I wanted to see if I could
sit up on my own, though.
Your internal bleeding's managed.
Your ophthalmologist says there's
no medical precedent for it,
but your vision is
starting to return and
if it continues,
you should recover fully.
So I'm told.
And the girl?
Soon as I woke up, it was
like she was a dream, man.
So you just forgot about her?
Now she's a fading memory.
You have no idea what
kind of relief that is.
I've got to be honest, Shawn,
I was not expecting
this one to go smoothly.
Right?
Also, my neighbour called,
my cat's been waiting
at my door all day.
(BASHIR EXHALES)
(DOOR SHUTS)
- Hi.
- Hey
(SIGHING)
(SIGHING)
- I'm sorry I missed your biopsy.
- It's okay. It was fine.
- How's the kid?
- Which one?
The kid who never existed or the kid
whose organs were on the wrong side?
- They're both fine, actually.
- Good.
Have you seen Claire
since our little throwdown?
Maybe she just needs some time.
I'm coming off sedatives or
maybe I'd feel worse about it.
(BASHIR CHUCKLES)
I'm glad that you didn't take
that job if it's not right for you.
What kind of sedatives
do they have you on?
It's just
You said that it was
stupid and selfish and
I understand that you've trained
yourself to feel that way, but
maybe you're allowed to be those things.
Just like the rest of us.
(BASHIR EXHALES)
I'm trying.
I know.
What?
- Nothing.
- Liar.
Claire told me that she
and Bishop used to mock me
for being a naive little idiot.
Well, I fell in love with that idiot.
I guess that makes you an idiot, too.
I guess so.
(GENTLE MUSIC)
(♪♪)