The Resident (2018) s05e15 Episode Script
In For a Penny
Previously on The Resident
Palliative care doctors will
treat your symptoms
and make sure you live your best life.
And this will give us more time to do the things that we love together.
I've been short-listed for a seat at the state medical board.
That's wonderful, Randolph.
I want this baby to be 100% me.
And since we're identical twins, I was wondering, would you give me one of your eggs? - Are you in trouble? - No.
I'm fully in control of my past, present, and to some extent my future.
First we sterilize the tweezers.
Don't burn yourself, Mr.
Soriano.
Ever inspired by your confidence, Jordan.
Now we use our sterilized tweezer to place four different antibiotics.
Bingo.
It'll take at least 24 hours for us to see which antibiotics fights off the bacteria.
And that is just like a real clinical trial.
Progress is incremental.
But that's the only way for us to figure out which treatments work to heal people.
Like me.
So you're the petri dish? - Ew.
Gross.
- No, no, Jordan is right, isn't he, Dr.
Pravesh? Well, we have more scientific terms for it, but, yeah, your teacher is a straight-up petri dish.
But a very brave one.
The risks are high, but just think of the potential rewards.
Scurvy, polio, diabetes.
All of those are treatable, even curable because of clinical trials.
So today, class, please listen to your sub, read chapter four while I will go to Chastain Memorial Hospital so Dr.
Pravesh can give me my first infusion of a potentially life-saving drug for my lung cancer.
It could be a cure or it could be something else.
That is the beauty of experimentation.
We only know once we've taken a chance.
All right, let's chase that last dose of epi with another amp of bicarb.
Pushing bicarb now.
How long have we been coding him? 30 minutes by my watch.
But since EMS found him at the scene, it's probably closer to an hour.
He's been asystolic the last three pulse checks, maxed out on meds.
Fixed and dilated.
All right, it's time.
Stop compressions.
Time of death 9:34 a.
m.
He's too young.
And alone.
EMS couldn't find a wallet or phone on him.
Olanzapine.
Aripiprazole.
Antipsychotics? Unusual.
Explains why the Narcan didn't work.
If you take enough of this, you can still get high.
These doses are What? These doses are what? Then the unicorns have a party, but the kitty has disappeared.
They have to save her, so they call in Happy the bloodhound, 'cause he has a great nose and he's a famous detective.
Whoa, whoa, whoa, don't tell me any more, you'll ruin it for me.
Hi, Tisha.
Can we read together, Daddy, and you do all the funny voices the way you do? Yes, of course.
Right after work, okay? What is it, Daddy? Have a great day at school, Bubble.
Love you.
- Bye, Daddy.
- Bye.
Where you going? To the pharmacy that filled these prescriptions.
I've never heard of this patient and I didn't prescribe these.
That's not what you do.
You have to go straight to the FBI.
Okay.
And how do you know that? I just do.
There's an office downtown.
I can give you a name.
Oh, perfect.
You can give me the name of an FBI agent.
That's-that's great.
His name is Todd Barker.
I'll call him and let him know that someone is using your name and NPI number to prescribe drugs, - and he'll take it from there.
- Whoa, whoa, slow your roll.
What?! Irving is paging me.
I got to go.
Hold on.
Hey.
Dr.
Hawkins told me that Grace likes the comfy chairs from the fourth floor, so I got you one.
And by "got" I mean stole.
- Just don't tell.
- Thank you.
Where is Dr.
Hawkins, by the way? He was with us through all the chemo.
Yeah, he'll still check in on you, I promise.
Dr.
Pravesh is our doctor now.
He's the clinical trial specialist.
So, it doesn't look like much, - but - My TILs.
This is Albert's first dose of tumor-infiltrating lymphocytes.
The cells that we harvested last month from your lung biopsy are now primed to target your specific cancer.
- Pretty amazing, right? - It's awesome.
As in the true meaning of the word, inspiring awe.
Like the way I feel about black holes and atomic vibration.
You two are such nerds.
Damn right.
So you will get one dose every few hours, six in total.
It'll be some time before we know if you respond.
But this is the first step.
Science never sounded so easy.
So I want you to be realistic.
This will likely make you feel sicker before you get better.
So expect flu-like symptoms, maybe worse.
How much worse? Hey, don't worry.
I could handle whatever comes.
This is my lifeline.
My last best chance.
All right, then, here we go.
Oh, Dr.
Feldman, wait.
Can you cover for me for a few hours? No.
My shift is over.
You're taking over for me so I can have a life outside these walls.
Yeah, totally.
So you can cover for me? - No.
- Thank you.
I suppose I can't ask you where you're going, but where are you going? 12 hours on my feet, what's another 12 to 13? This is doctor abuse.
Mariana, 36 years old, respiratory distress.
No breath sounds on the right.
Likely a collapsed lung.
Where do you want us? Bay 11.
Do you have a set of vitals? Heart rate 120.
BP 80/palp.
90%, 92% on oxygen.
All right.
Page Dr.
Austin.
Dr.
Austin is on his way out of here, but feel free to page Dr.
Devi.
- You're leaving, too? Unfair.
- Yes, sir.
If I have to stay, everyone else should stay! - I'm here.
You leaving? - I have to visit my mother.
And Irving is whining like a puppy dog in pain.
- You go.
I got this.
- On my count.
- One, two, three.
- What do you need? How do you feel about a pneumothorax? - Psyched.
- This is Mariana.
You live in my ER now, Devi.
Mariana, we're first gonna take a listen to your lungs, okay? Hundley, can I get a chest tube kit, please? Mm-hmm.
Your right lung has collapsed.
I need to do a decompression to help you breathe better, okay? We're gonna numb you first.
This may hurt a bit.
Chest tube to me.
Mm-hmm.
Take a deep breath in.
All right, we're in place.
Pleur-evac.
I felt like I was about to die.
Well, you were, dear.
But Dr.
Devi just saved you like the boss she is.
Thank you.
Here we go, milady.
Back to its rightful owner.
You were only CEO for a few days.
Wait, did you move my plant? Yeah, it has better light over there.
I have my first meeting as a member of the state medical board today, so I can start a chapter in my new life and I can hand you a smoothly running hospital.
Huh.
Looks like Trevor Daniels - didn't show up for work again today.
- He's been AWOL since speaking out on Billie's behalf.
She's trying to find him.
And Dr.
Hawkins called to say he's on his way to the FBI.
The FBI? Oh.
And our new ER doc just took off in the middle of her shift.
What were you saying about a smoothly running hospital? That in your capable hands, it'll soon be silk.
You look very sharp in that suit, by the way.
I know.
Okay, um, your own sister being the biological mother of your child is It's a little weird, right? Am I allowed to say that? Lots of women donate their eggs to their sisters.
True, but Devon has a point.
Giving you one of my eggs is complicated.
We have to be honest about this, right? You both would be the baby's mother, technically.
No.
I'd be the baby's mother.
I will give birth and raise my child.
Leela's responsibility ends with the donation of the egg.
Yes, but you are identical twins with identical DNA.
If I could have a child with my own egg that's identical to hers, you wouldn't think of my baby as Leela's, - would you? - But who will be the father? A sperm donor.
Okay, but who? That's my call.
Just give me some time to think about it.
I know I don't really have a say here, - but I - No, you don't, sweets.
My body.
My sister.
My egg.
Dr.
Hawkins.
We spoke on the phone.
Agent Barker.
Sorry for the delay.
We were waiting on someone.
Follow me.
Dr.
Sullivan.
Agent Barker.
Always a pleasure.
Glad you could make it.
Things go smoother when you're around.
I realized I shouldn't leave you alone to navigate this.
And what exactly are we navigating? - Mom? - In the kitchen! Ah.
I know that smell.
That brings me back to sixth grade, after school, racing home so I could get my hands on double banana nut muffins.
Yes.
With the streusel.
Well, my store-bought scones are ashamed to be in your presence.
Nonsense.
We need something to feed the birds.
Honestly, Mom, when was the last time you baked? - Chemo Carol is history.
- Mm.
Palliative care Carol is rocking - this kitchen.
- Yeah, I can see that.
I have the incentive now that I can enjoy food again.
Mm.
Doreen and I are visiting the botanical gardens this afternoon, so what can I do for you, baby boy? Nothing.
Just seeing you like this is all I need.
Thank you.
AJ.
I want you to know I understand my days are numbered, but I'm truly living them.
I can see that, Mom.
And that makes me so happy.
Mmm.
Albert.
Talk to me, man.
What's going on? It's just, um, some chills.
He's complaining of nausea and muscle aches, as well.
Yeah, it's just like the flu, right? Okay, you're spiking a fever.
I'll order you some meds - and a cooling blanket, all right? - It's hard to breathe.
- What's happening? - Probably has some fluid in his lungs.
I'll put him on oxygen.
This isn't like the flu.
It's getting harder really fast, Dr.
Pravesh.
It's quicker than I expected.
This is the only hope to get you better, right? I'm here for you every step of the way.
You still with me? Okay.
Just breathe.
163 antipsychotic prescriptions written in your name in the last two months at six different clinics in addition to high-priced asthma meds and antihypertensives.
Well, I didn't do this.
No one's breaking out the handcuffs, Dr.
Hawkins.
We think you're a small part of a much bigger case we've been tracking for a year.
These are all brand-name drugs.
Highly reimbursed medications.
Medicare fraud.
Yes.
Kickbacks.
Drug diversion.
We think it's a pill mill.
A big one.
At least six clinics involved.
Probably busing people in.
You have a pole camera up yet? A warrant just came through.
Classic mob operation.
The Mafia is often involved in Medicare fraud.
There's little oversight, scant punishment and big rewards.
And we now have mob levels of violence.
Federal investigators, informants, even doctors who assist in our investigations have been murdered.
Which is why we're keeping an eye on Dr.
Sullivan as best we can.
Nice to know you've been working with the FBI.
How did they get - Dr.
Hawkins' name and numbers? - Few years ago, there was a ransomware attack on Chastain.
They were just idiots in some basement.
Yeah, well, typically these idiots sell your identities, DEA, NPI numbers to larger criminal organizations.
So, what do I do about it? You go back to Chastain, leave this to us.
If you don't, it could be your life in danger.
I think we've heard enough to understand.
Not nearly.
That's all I can tell you right now.
And we have to get back to work.
Great seeing you again.
Talk soon.
Dr.
Hawkins.
You and I need to have a little chat.
Mariana, how are you feeling? Better.
Very well, actually.
Oh, glad to hear it.
I can't believe this happened again.
Wait, your lung's collapsed before? Yes.
My doctor wasn't too worried.
He said I was young, healthy.
Is it possible this is just a coincidence? It's unlikely.
We're going to have to keep you here to figure this out.
No, I have an important meeting with a client later.
Cancel it.
Can you elaborate? I'm sorry.
I did not mean to sound so blunt.
I'm a surgeon, so most of the patients I deal with are unconscious.
My bedside manner gets a little rusty.
But that's no excuse.
I'd be more concerned if your scalpel was rusty.
And you do not need to apologize.
Would a male surgeon apologize? It's unlikely.
I've told my team to shoot me if I ever apologize to a client.
Makes them trust you less.
What do you do? I'm an architect.
My uncle's an architect.
He's never apologized for anything.
Frank Lloyd Wright said, "Early in life, I had to choose" "between honest arrogance and hypocritical humility.
I chose honest arrogance.
" Well, I vote for honest humility.
And on that note, your lung should not collapse twice.
We'll have to consult a specialist, okay? I'll be back to check on you later.
- Breathing better? - Mm-hmm.
See? Everything's fine.
If he's this bad after a first dose, what will happen next? He's got five more to go.
Everybody reacts differently.
We won't know until we proceed.
That's just how it works.
Grace, you haven't eaten all day.
Why don't you go to the cafeteria for a bit? I'll be fine.
Okay.
I've tried to talk her through this, explain the science.
I gave her a book on Marie Curie.
Big mistake, since Curie died experimenting on herself.
Yeah, still walking that one back.
Albert, it's time for your second dose.
I figured.
That's why I asked her to step out.
You sure? Yes.
I'll be back.
The Lord is my shepherd, I shall not want Well, I don't think we've seen anything too concerning today.
Certainly nothing requiring punitive action.
Uh, actually, there is one case we haven't discussed that's alarming.
Emily Benesch, 32 years old.
Ms.
Benesch had, uh, an anterior cervical discectomy and fusion.
Dr.
Elkins, you're a neurosurgeon.
Did you see this complaint? I did.
As I recall, the patient had complications post-op.
The surgeon damaged her spinal cord.
Now Ms.
Benesch is a paraplegic.
Spinal surgery always has risks.
Well, uh, after the operation, she felt something was wrong, she asked her surgeon Dr.
Keith Bosley for a follow-up, and he "brushed her off.
" I know Dr.
Bosley personally.
I-I doubt he brushed her off.
Well, I found several other complaints against him.
So wouldn't, uh, multiple complaints be a red flag? I think we should dig into Dr.
Bosley's patient outcomes and give Ms.
Benesch a fair hearing.
Stories like this flood our office.
Patients get emotional when complications occur and look to place blame.
This patient isn't emotional, she's a paraplegic.
We can't fix every patient's problem or guarantee everyone a perfect outcome.
No, I understand that.
But isn't it the job of this board to hear our patients' problems, particularly when there are repeat complaints? Dr.
Elkins, will you delve into this more deeply? Should a close friend of Dr.
Bosley's be the one to lead his investigation? State medical boards are staffed by doctors precisely because we are the best people to judge our own colleagues.
So let's just simmer down.
Just watch, and learn how we operate.
Oh, I-I think I'm getting a pretty good sense of how you operate.
When you wouldn't answer questions about your past, I didn't push.
I respected your privacy, but that's off the table now.
Talk to me.
It started with a phone call back when I was a resident.
I was employed by a big hospital system in Chicago that took a lot of Medicare patients.
They were overtreating, doing unnecessary surgeries, and ripping off Medicare for millions of dollars.
That's almost standard operational procedure in some hospitals these days.
I couldn't let it stand.
I see a problem I try to fix it.
I get that.
So I called a Medicare fraud tip line, and the DOJ got involved.
Long story short, I ended up wearing a wire and collecting documents to help them get the proof they needed.
You were hooked.
Yeah.
So when the FBI approached me to keep working with them I was all in.
They need doctors to understand medically what's fraud and what isn't, and to work undercover.
Soon, we went after the biggest fish.
The Mafia.
It was a much tougher world.
Lot of risk.
Eventually, I was identified as an FBI operative, and there was an attempt on my life.
- Are you safe now? - It's been two years.
But the Mafia makes a practice of punishing its enemies.
I never know who I can trust, so I say as little as possible about my past, and I don't stay long in one place.
You should have told me.
I get that you're in a tough spot.
Here's the thing.
I like you.
And I like you.
But it ends there.
I don't get involved with anyone, Conrad.
And no one should get involved with me, for a number of reasons, but the main one is that I will disappear.
Well, maybe you should stop running.
Trust me on this.
You take care of people.
You want to take care of me.
But you can't.
I take care of myself.
I'll see you at Chastain.
Dr.
Pravesh, what's going on? His pressure is plummeting and he's spiking a fever again.
He still has three doses left.
More fluids should bring up the pressure.
I- I don't think he can handle the trial.
I don't think I can, either.
- I want it to stop.
- When Albert is stable, we will discuss it, but right now we don't even know if the trial is to blame.
It could be an infection, and I don't want to deprive him of a cure for the wrong reasons.
How are you gonna figure it out? Grace.
You have to trust me and this process.
You two and your scientific method.
I don't trust this "process.
" Look at him.
Whatever you're doing is making him worse.
If this protocol's gonna work, it's gonna take time.
Let's get him to the ICU so we can stabilize him and monitor him, and I promise you that all options will be available to the both of you.
Fine, and thank you, but I'd like to call in Dr.
Hawkins for a second opinion.
I've already paged him for a consult.
He's on his way.
Albert? I am right here.
It's gonna be okay.
I'm fine.
Yes.
Yes.
Don't worry.
Uh The doctor's walking in.
I love you, too.
Bye.
My husband.
Also an architect.
Which is why he isn't here.
He's on-site of a new project in Memphis.
Dual-career marriage.
I know all about that.
And the people who do it with children? Boggles the mind.
Agreed.
My career is all-consuming.
And I'm a perfectionist.
It's a compulsion.
Cough sounds bad.
Let me take a listen.
Hey, what's going on? Hemoptysis in our pneumothorax patient.
Her lungs sounded clear, but now There's still an air leak.
And there's no blood in the chest tube.
Mariana, we're gonna confer for a minute, okay? Okay, so something more serious is going on.
All right, well, give me the differential.
It could be an abscess, bronchiectasis or even cancer.
- A CT should help.
- All right.
Well, let's get her in the magic box right now.
And then this Dr.
Abernathy dismisses the case as though it was nothing.
Do you think the neurosurgeon's really culpable? Well, I'm not gonna condemn him without solid consideration, but they refused to give it any air.
What? - Does any of this really surprise you? - No.
This is why I wanted the job in the first place.
So what will you do? Hello? Hello, is this Ms.
Benesch? Yes, who's calling? This is Dr.
Randolph Bell from the state medical board.
I'd like to talk with you about Dr.
Bosley.
Finally.
I'd given up hope.
Got your page.
I came as quickly as I could.
Is your emergency handled? Hard to tell.
How's Albert doing? Well, we're four doses in.
I've had to give him broad-spectrum antibiotics and three liters of fluids, and he's getting sicker.
I had to start him on norepi.
- You think it's the trial drug? - I do.
His blood cultures came back negative, there's no sign of infection.
And it's time for his next dose.
Ah, that's a tough call.
He's already on a non-rebreather with a borderline blood gas.
With another dose, you may have to intubate.
Which could be fatal for Albert.
A ventilator-associated pneumonia, with his immune system? God, and his poor wife.
And the trial? An intubation would be an unexpected adverse event, which could get the trial paused or stopped altogether.
But if he doesn't finish the protocol, and his cancer only gets worse So if I give him the dose, it could kill him.
And if I hold it, then everything he's gone through up until this point would be completely useless.
There's no good answer.
And Albert's wife, she doesn't trust me, she trusts you.
Yeah, I'll talk to her, but let's be clear: you make the call.
No.
Neither of us will.
Albert should decide.
So, your CT was clear.
Which means it's not an abscess, inflammation or cancer.
Okay, so what's next? It's good to rule things out.
I am going to circle back with Dr.
Austin, and I Are you still in pain? Is it your chest? It's just, it's just cramps.
The same every month.
Ooh, they're excruciating sometimes.
Have they always been this bad? As long as I can remember.
Sometimes I even get a nosebleed.
It's a real thrill, being a woman.
The last time your lung collapsed, were you also on your period? Uh, a-as a matter of fact I was.
I Yeah.
I-I remember I had to ask for pain meds while I was here.
Why? Sit tight, I will be right back.
I promise.
Endometriosis? Really? Her pneumothorax coincides with her periods, which are abnormally painful.
Isn't it possible that aberrant endometrial tissue from her pelvis traveled through tiny defects in her diaphragm up into her chest, where Where it continues to respond to the hormones of her menstrual cycle, thus wreaking havoc.
Yeah, it's definitely possible, but, Devi, that's - extremely rare.
- So is having repeated episodes of pneumothorax with no discernible cause on imaging.
What if these aren't random? What if this is evidence of a problem her body's been trying to hide this entire time? Well, we could get an MRI for a better look, but ultimately the only way to confirm a catamenial pneumo is with surgery.
That's thoracic and abdominal.
And if we find what you think we will, - that could be a hell of a procedure.
- That can cure her.
I'm ready for this.
Oh, I know you are.
Devi, you just pulled off a Conrad Hawkins-level diagnosis.
Let's get your patient ready and scrub in.
Tell him we can stop, Dr.
Hawkins, please.
Of course we can.
- I've always said that.
- We can't quit an experiment halfway through.
I tell my students all the time.
This is your life.
You get to be selfish.
You don't have to think about the greater good.
I am being selfish.
Without the trial, I die.
But you may die sooner with it.
I can't lose you.
Do you think I'm not scared? I am.
But this is what I want to do.
I'm willing to suffer for the science, just for a chance, however slim, to survive this cancer.
I just need you to support me, please.
- But, Albert - Listen, listen.
We're a team, right? Don't fight Dr.
Pravesh.
Just trust him.
And trust me and honor what I want and believe.
Okay.
I've decided, Dr.
Pravesh.
Please give me the next dose.
I hope this isn't an imposition.
More like a surprise.
I thought the state medical board had lost all interest in my case.
My lawyer certainly has.
Well, I'm sorry to hear that.
Thank you.
I don't blame her.
She took me on pro bono.
When we couldn't get any traction with the board, there wasn't any way forward.
Are you looking for a financial settlement? No, I'm looking for accountability.
He nicked the artery in my spine.
There was massive bleeding.
My spinal cord was damaged.
I did not have to end up like this.
I don't want future patients of Dr.
Bosley to, either.
Hey, your case file says that you received a second and third opinion about your outcome.
And that a post-op MRI would have caught the damage, and then a second emergency surgery could have repaired it.
Yes.
I might still be walking today if Dr.
Bosley had listened to me.
He didn't.
So he says you pushed hard for the surgery, That's not the point.
The harm I suffered during the operation could have been prevented.
I want the board to do something.
Will they? Honestly? Probably not.
But I will do something.
I'm maxed out on norepi, adding vasopressin.
I hear crackles halfway up, and he's losing consciousness.
Albert.
Can you hear me? - We're gonna need to intubate.
- No, not intubation.
He's struggling to breathe, Grace.
It may be the only thing to help keep him alive.
I'll grab an intubation tray.
I knew we should have stopped.
My husband, him I understand.
He'll never quit.
But you? You're doctors.
You know.
You're supposed to know better.
Why couldn't you stop him? Grace, you know I respect you and your husband.
He didn't want to stop, we have to honor that.
And Dr.
Pravesh has my total support.
I'll be right back.
Add a dialysis line.
His kidneys are shutting down.
Yeah.
Just let me know, please.
Albert's stable for now.
Yeah, well, it doesn't change the fact that he walked in here in decent shape and now he's on dialysis and he's being intubated.
Did you call the study sponsors? I had to notify them of the toxicity of the drug, and now they're deciding if they're gonna put the trial on hold.
Grace was right, I knew the dangers, I knew the odds for Albert were getting longer every single hour.
I shouldn't have listened to him, except I know that I should have.
You followed the patient's wishes.
It was the right move.
Albert knew exactly what he was doing.
I feel like a general who's sending my soldiers out into the battlefield to face a line of machine guns while I stand in safety.
All wars have casualties.
And they also have triumphs.
It's the same with clinical trials.
I want Albert to survive.
I want him to teach his kids for years to come.
So they can visit him in his happy retirement.
He deserves that.
This isn't over.
The intubation bought him time.
So next steps.
All right, what we know now is that he's battling massive inflammation from the trial drug.
So, if we treat the inflammation I hesitated to give him steroids because I thought he was infected, but We should go for it plus toci.
If all his cultures have been negative, yeah.
It could help more than it could hurt him.
Let's do it.
Endometriosis fits your symptoms.
You check all the boxes.
You know, most doctors don't ask women the right question to make these connections.
That's why it can take years to diagnose.
But if we're right, we can fix this.
But we do need to be clear about what this means for you.
This condition can affect your fertility.
Now, with surgery, you should end up pain-free, but if we find extensive damage, you are aware that you may not be able to have children, right? I discussed it with my husband.
He's flying in to be with me.
He's okay with never having children.
And you? W-We're on the same page.
We're focused on each other, and our careers.
And there's nothing wrong with that.
You're absolutely right.
His MAPs are solid.
I'm gonna titrate down the norepi.
- That's an improvement.
- Not enough.
What do the labs say? Just tell me.
Look for yourself.
His blood gas looks good.
We can turn down his oxygen to 40%.
And his liver function is normalizing.
He's turning around.
He's gonna be okay.
Yes.
Yes.
Albert will make it through this trial.
You have given him a chance to survive.
You did it.
He's looking better, right? He already wants to send a video to his students.
I tell them every day, record even the most incremental progress in your experiments.
This is more than incremental.
When you're ready, I'll set up a transfer back to the room with the comfy chair.
Albert, I owe you an apology.
Grace, you, too.
I just had no idea it was gonna get this bad.
You were doing your job.
I'm sorry I got so angry.
Oh, stop, both of you.
I was a willing guinea pig, remember? A human petri dish.
Besides, it worked.
Well, we know you can get through the doses.
But we don't actually know if it's gonna help your cancer yet.
But I have a chance.
More than I had before.
See? I told you to trust Dr.
Pravesh.
- You were right.
- Mm.
Like two peas in a pod, you science nerds.
That's right.
Now, here's the real question.
Who can recite the periodic table faster? - Did you just challenge me? - Yes, I did.
No Actually, no, y-you need to get some rest.
Hydrogen, helium, lithium Okay, okay, okay.
You win.
You win.
Imaging, please dial 2732 Oh, well, well, well, if it isn't the queen of Chastain.
Hey.
Ah - Oh.
Nice.
- You like that, right? Hey, man, I heard Devon's clinical trial passed the first test.
Yeah, barely.
The protocol was worse than anyone imagined.
Your mom wouldn't have survived it, AJ.
Well, we have no regrets.
You know what she did today? She made three different kind of muffins and she took a walk through the botanical gardens.
Telling you, brother, palliative care was a good call.
So, uh do we need to talk about the new ER doc? - Okay.
- Yeah.
Look, I'm just saying, I like her.
No BS, no sugarcoating.
Uh, she's definitely an interesting case.
"Interesting.
" That sounds mysterious.
Come on, man.
Give up the backstory.
No, do not go there.
You know something I don't? I thought you two might have something going on.
- Just colleagues.
- Yeah, for now.
No.
I already have one lady in my life.
Me.
- I'll catch you tomorrow.
- All right.
See you later, cutie-pie.
Bye.
The unicorn book, you promised.
What? Unicorn book? I don't know what you're talking about.
- Daddy.
- I didn't forget, sweetheart.
Happy the Bloodhound is coming right up.
I'm so proud of you.
And I'm proud of you.
You made a tough diagnosis most doctors would miss.
And you got your patient through a very rough surgery, Leela.
Well, I really admire Mariana.
And I'm really glad I got to know her a bit.
She's a successful businesswoman, and an unapologetic control freak, with a very successful husband in the same business.
Sounds familiar.
And she wasn't at all afraid of a condition that could make her infertile, because she doesn't want kids.
I mean, there are people like that.
I'm just not one of them.
I want to have a family one day.
With you.
We need to talk about this.
I don't know if I want kids.
At least not right now.
I could not manage surgical residency and a family.
Yeah, I get that.
And it can wait.
We have plenty of time.
Devon, it could be a long while.
Leela, all kinds of doctors manage it.
I mean, there are work-arounds.
I believe that, I just I don't know if it'll ever be the right thing for me.
Which is why I-I realized that what Padma wants can help us both.
I can give her the egg she so desperately wants, so she can have a baby, and at the same time, I can freeze some for me.
For us.
For the future.
Yes.
Just to give me time to think about it.
But that's all I can promise right now.
Can you live with that?
And this will give us more time to do the things that we love together.
I've been short-listed for a seat at the state medical board.
That's wonderful, Randolph.
I want this baby to be 100% me.
And since we're identical twins, I was wondering, would you give me one of your eggs? - Are you in trouble? - No.
I'm fully in control of my past, present, and to some extent my future.
First we sterilize the tweezers.
Don't burn yourself, Mr.
Soriano.
Ever inspired by your confidence, Jordan.
Now we use our sterilized tweezer to place four different antibiotics.
Bingo.
It'll take at least 24 hours for us to see which antibiotics fights off the bacteria.
And that is just like a real clinical trial.
Progress is incremental.
But that's the only way for us to figure out which treatments work to heal people.
Like me.
So you're the petri dish? - Ew.
Gross.
- No, no, Jordan is right, isn't he, Dr.
Pravesh? Well, we have more scientific terms for it, but, yeah, your teacher is a straight-up petri dish.
But a very brave one.
The risks are high, but just think of the potential rewards.
Scurvy, polio, diabetes.
All of those are treatable, even curable because of clinical trials.
So today, class, please listen to your sub, read chapter four while I will go to Chastain Memorial Hospital so Dr.
Pravesh can give me my first infusion of a potentially life-saving drug for my lung cancer.
It could be a cure or it could be something else.
That is the beauty of experimentation.
We only know once we've taken a chance.
All right, let's chase that last dose of epi with another amp of bicarb.
Pushing bicarb now.
How long have we been coding him? 30 minutes by my watch.
But since EMS found him at the scene, it's probably closer to an hour.
He's been asystolic the last three pulse checks, maxed out on meds.
Fixed and dilated.
All right, it's time.
Stop compressions.
Time of death 9:34 a.
m.
He's too young.
And alone.
EMS couldn't find a wallet or phone on him.
Olanzapine.
Aripiprazole.
Antipsychotics? Unusual.
Explains why the Narcan didn't work.
If you take enough of this, you can still get high.
These doses are What? These doses are what? Then the unicorns have a party, but the kitty has disappeared.
They have to save her, so they call in Happy the bloodhound, 'cause he has a great nose and he's a famous detective.
Whoa, whoa, whoa, don't tell me any more, you'll ruin it for me.
Hi, Tisha.
Can we read together, Daddy, and you do all the funny voices the way you do? Yes, of course.
Right after work, okay? What is it, Daddy? Have a great day at school, Bubble.
Love you.
- Bye, Daddy.
- Bye.
Where you going? To the pharmacy that filled these prescriptions.
I've never heard of this patient and I didn't prescribe these.
That's not what you do.
You have to go straight to the FBI.
Okay.
And how do you know that? I just do.
There's an office downtown.
I can give you a name.
Oh, perfect.
You can give me the name of an FBI agent.
That's-that's great.
His name is Todd Barker.
I'll call him and let him know that someone is using your name and NPI number to prescribe drugs, - and he'll take it from there.
- Whoa, whoa, slow your roll.
What?! Irving is paging me.
I got to go.
Hold on.
Hey.
Dr.
Hawkins told me that Grace likes the comfy chairs from the fourth floor, so I got you one.
And by "got" I mean stole.
- Just don't tell.
- Thank you.
Where is Dr.
Hawkins, by the way? He was with us through all the chemo.
Yeah, he'll still check in on you, I promise.
Dr.
Pravesh is our doctor now.
He's the clinical trial specialist.
So, it doesn't look like much, - but - My TILs.
This is Albert's first dose of tumor-infiltrating lymphocytes.
The cells that we harvested last month from your lung biopsy are now primed to target your specific cancer.
- Pretty amazing, right? - It's awesome.
As in the true meaning of the word, inspiring awe.
Like the way I feel about black holes and atomic vibration.
You two are such nerds.
Damn right.
So you will get one dose every few hours, six in total.
It'll be some time before we know if you respond.
But this is the first step.
Science never sounded so easy.
So I want you to be realistic.
This will likely make you feel sicker before you get better.
So expect flu-like symptoms, maybe worse.
How much worse? Hey, don't worry.
I could handle whatever comes.
This is my lifeline.
My last best chance.
All right, then, here we go.
Oh, Dr.
Feldman, wait.
Can you cover for me for a few hours? No.
My shift is over.
You're taking over for me so I can have a life outside these walls.
Yeah, totally.
So you can cover for me? - No.
- Thank you.
I suppose I can't ask you where you're going, but where are you going? 12 hours on my feet, what's another 12 to 13? This is doctor abuse.
Mariana, 36 years old, respiratory distress.
No breath sounds on the right.
Likely a collapsed lung.
Where do you want us? Bay 11.
Do you have a set of vitals? Heart rate 120.
BP 80/palp.
90%, 92% on oxygen.
All right.
Page Dr.
Austin.
Dr.
Austin is on his way out of here, but feel free to page Dr.
Devi.
- You're leaving, too? Unfair.
- Yes, sir.
If I have to stay, everyone else should stay! - I'm here.
You leaving? - I have to visit my mother.
And Irving is whining like a puppy dog in pain.
- You go.
I got this.
- On my count.
- One, two, three.
- What do you need? How do you feel about a pneumothorax? - Psyched.
- This is Mariana.
You live in my ER now, Devi.
Mariana, we're first gonna take a listen to your lungs, okay? Hundley, can I get a chest tube kit, please? Mm-hmm.
Your right lung has collapsed.
I need to do a decompression to help you breathe better, okay? We're gonna numb you first.
This may hurt a bit.
Chest tube to me.
Mm-hmm.
Take a deep breath in.
All right, we're in place.
Pleur-evac.
I felt like I was about to die.
Well, you were, dear.
But Dr.
Devi just saved you like the boss she is.
Thank you.
Here we go, milady.
Back to its rightful owner.
You were only CEO for a few days.
Wait, did you move my plant? Yeah, it has better light over there.
I have my first meeting as a member of the state medical board today, so I can start a chapter in my new life and I can hand you a smoothly running hospital.
Huh.
Looks like Trevor Daniels - didn't show up for work again today.
- He's been AWOL since speaking out on Billie's behalf.
She's trying to find him.
And Dr.
Hawkins called to say he's on his way to the FBI.
The FBI? Oh.
And our new ER doc just took off in the middle of her shift.
What were you saying about a smoothly running hospital? That in your capable hands, it'll soon be silk.
You look very sharp in that suit, by the way.
I know.
Okay, um, your own sister being the biological mother of your child is It's a little weird, right? Am I allowed to say that? Lots of women donate their eggs to their sisters.
True, but Devon has a point.
Giving you one of my eggs is complicated.
We have to be honest about this, right? You both would be the baby's mother, technically.
No.
I'd be the baby's mother.
I will give birth and raise my child.
Leela's responsibility ends with the donation of the egg.
Yes, but you are identical twins with identical DNA.
If I could have a child with my own egg that's identical to hers, you wouldn't think of my baby as Leela's, - would you? - But who will be the father? A sperm donor.
Okay, but who? That's my call.
Just give me some time to think about it.
I know I don't really have a say here, - but I - No, you don't, sweets.
My body.
My sister.
My egg.
Dr.
Hawkins.
We spoke on the phone.
Agent Barker.
Sorry for the delay.
We were waiting on someone.
Follow me.
Dr.
Sullivan.
Agent Barker.
Always a pleasure.
Glad you could make it.
Things go smoother when you're around.
I realized I shouldn't leave you alone to navigate this.
And what exactly are we navigating? - Mom? - In the kitchen! Ah.
I know that smell.
That brings me back to sixth grade, after school, racing home so I could get my hands on double banana nut muffins.
Yes.
With the streusel.
Well, my store-bought scones are ashamed to be in your presence.
Nonsense.
We need something to feed the birds.
Honestly, Mom, when was the last time you baked? - Chemo Carol is history.
- Mm.
Palliative care Carol is rocking - this kitchen.
- Yeah, I can see that.
I have the incentive now that I can enjoy food again.
Mm.
Doreen and I are visiting the botanical gardens this afternoon, so what can I do for you, baby boy? Nothing.
Just seeing you like this is all I need.
Thank you.
AJ.
I want you to know I understand my days are numbered, but I'm truly living them.
I can see that, Mom.
And that makes me so happy.
Mmm.
Albert.
Talk to me, man.
What's going on? It's just, um, some chills.
He's complaining of nausea and muscle aches, as well.
Yeah, it's just like the flu, right? Okay, you're spiking a fever.
I'll order you some meds - and a cooling blanket, all right? - It's hard to breathe.
- What's happening? - Probably has some fluid in his lungs.
I'll put him on oxygen.
This isn't like the flu.
It's getting harder really fast, Dr.
Pravesh.
It's quicker than I expected.
This is the only hope to get you better, right? I'm here for you every step of the way.
You still with me? Okay.
Just breathe.
163 antipsychotic prescriptions written in your name in the last two months at six different clinics in addition to high-priced asthma meds and antihypertensives.
Well, I didn't do this.
No one's breaking out the handcuffs, Dr.
Hawkins.
We think you're a small part of a much bigger case we've been tracking for a year.
These are all brand-name drugs.
Highly reimbursed medications.
Medicare fraud.
Yes.
Kickbacks.
Drug diversion.
We think it's a pill mill.
A big one.
At least six clinics involved.
Probably busing people in.
You have a pole camera up yet? A warrant just came through.
Classic mob operation.
The Mafia is often involved in Medicare fraud.
There's little oversight, scant punishment and big rewards.
And we now have mob levels of violence.
Federal investigators, informants, even doctors who assist in our investigations have been murdered.
Which is why we're keeping an eye on Dr.
Sullivan as best we can.
Nice to know you've been working with the FBI.
How did they get - Dr.
Hawkins' name and numbers? - Few years ago, there was a ransomware attack on Chastain.
They were just idiots in some basement.
Yeah, well, typically these idiots sell your identities, DEA, NPI numbers to larger criminal organizations.
So, what do I do about it? You go back to Chastain, leave this to us.
If you don't, it could be your life in danger.
I think we've heard enough to understand.
Not nearly.
That's all I can tell you right now.
And we have to get back to work.
Great seeing you again.
Talk soon.
Dr.
Hawkins.
You and I need to have a little chat.
Mariana, how are you feeling? Better.
Very well, actually.
Oh, glad to hear it.
I can't believe this happened again.
Wait, your lung's collapsed before? Yes.
My doctor wasn't too worried.
He said I was young, healthy.
Is it possible this is just a coincidence? It's unlikely.
We're going to have to keep you here to figure this out.
No, I have an important meeting with a client later.
Cancel it.
Can you elaborate? I'm sorry.
I did not mean to sound so blunt.
I'm a surgeon, so most of the patients I deal with are unconscious.
My bedside manner gets a little rusty.
But that's no excuse.
I'd be more concerned if your scalpel was rusty.
And you do not need to apologize.
Would a male surgeon apologize? It's unlikely.
I've told my team to shoot me if I ever apologize to a client.
Makes them trust you less.
What do you do? I'm an architect.
My uncle's an architect.
He's never apologized for anything.
Frank Lloyd Wright said, "Early in life, I had to choose" "between honest arrogance and hypocritical humility.
I chose honest arrogance.
" Well, I vote for honest humility.
And on that note, your lung should not collapse twice.
We'll have to consult a specialist, okay? I'll be back to check on you later.
- Breathing better? - Mm-hmm.
See? Everything's fine.
If he's this bad after a first dose, what will happen next? He's got five more to go.
Everybody reacts differently.
We won't know until we proceed.
That's just how it works.
Grace, you haven't eaten all day.
Why don't you go to the cafeteria for a bit? I'll be fine.
Okay.
I've tried to talk her through this, explain the science.
I gave her a book on Marie Curie.
Big mistake, since Curie died experimenting on herself.
Yeah, still walking that one back.
Albert, it's time for your second dose.
I figured.
That's why I asked her to step out.
You sure? Yes.
I'll be back.
The Lord is my shepherd, I shall not want Well, I don't think we've seen anything too concerning today.
Certainly nothing requiring punitive action.
Uh, actually, there is one case we haven't discussed that's alarming.
Emily Benesch, 32 years old.
Ms.
Benesch had, uh, an anterior cervical discectomy and fusion.
Dr.
Elkins, you're a neurosurgeon.
Did you see this complaint? I did.
As I recall, the patient had complications post-op.
The surgeon damaged her spinal cord.
Now Ms.
Benesch is a paraplegic.
Spinal surgery always has risks.
Well, uh, after the operation, she felt something was wrong, she asked her surgeon Dr.
Keith Bosley for a follow-up, and he "brushed her off.
" I know Dr.
Bosley personally.
I-I doubt he brushed her off.
Well, I found several other complaints against him.
So wouldn't, uh, multiple complaints be a red flag? I think we should dig into Dr.
Bosley's patient outcomes and give Ms.
Benesch a fair hearing.
Stories like this flood our office.
Patients get emotional when complications occur and look to place blame.
This patient isn't emotional, she's a paraplegic.
We can't fix every patient's problem or guarantee everyone a perfect outcome.
No, I understand that.
But isn't it the job of this board to hear our patients' problems, particularly when there are repeat complaints? Dr.
Elkins, will you delve into this more deeply? Should a close friend of Dr.
Bosley's be the one to lead his investigation? State medical boards are staffed by doctors precisely because we are the best people to judge our own colleagues.
So let's just simmer down.
Just watch, and learn how we operate.
Oh, I-I think I'm getting a pretty good sense of how you operate.
When you wouldn't answer questions about your past, I didn't push.
I respected your privacy, but that's off the table now.
Talk to me.
It started with a phone call back when I was a resident.
I was employed by a big hospital system in Chicago that took a lot of Medicare patients.
They were overtreating, doing unnecessary surgeries, and ripping off Medicare for millions of dollars.
That's almost standard operational procedure in some hospitals these days.
I couldn't let it stand.
I see a problem I try to fix it.
I get that.
So I called a Medicare fraud tip line, and the DOJ got involved.
Long story short, I ended up wearing a wire and collecting documents to help them get the proof they needed.
You were hooked.
Yeah.
So when the FBI approached me to keep working with them I was all in.
They need doctors to understand medically what's fraud and what isn't, and to work undercover.
Soon, we went after the biggest fish.
The Mafia.
It was a much tougher world.
Lot of risk.
Eventually, I was identified as an FBI operative, and there was an attempt on my life.
- Are you safe now? - It's been two years.
But the Mafia makes a practice of punishing its enemies.
I never know who I can trust, so I say as little as possible about my past, and I don't stay long in one place.
You should have told me.
I get that you're in a tough spot.
Here's the thing.
I like you.
And I like you.
But it ends there.
I don't get involved with anyone, Conrad.
And no one should get involved with me, for a number of reasons, but the main one is that I will disappear.
Well, maybe you should stop running.
Trust me on this.
You take care of people.
You want to take care of me.
But you can't.
I take care of myself.
I'll see you at Chastain.
Dr.
Pravesh, what's going on? His pressure is plummeting and he's spiking a fever again.
He still has three doses left.
More fluids should bring up the pressure.
I- I don't think he can handle the trial.
I don't think I can, either.
- I want it to stop.
- When Albert is stable, we will discuss it, but right now we don't even know if the trial is to blame.
It could be an infection, and I don't want to deprive him of a cure for the wrong reasons.
How are you gonna figure it out? Grace.
You have to trust me and this process.
You two and your scientific method.
I don't trust this "process.
" Look at him.
Whatever you're doing is making him worse.
If this protocol's gonna work, it's gonna take time.
Let's get him to the ICU so we can stabilize him and monitor him, and I promise you that all options will be available to the both of you.
Fine, and thank you, but I'd like to call in Dr.
Hawkins for a second opinion.
I've already paged him for a consult.
He's on his way.
Albert? I am right here.
It's gonna be okay.
I'm fine.
Yes.
Yes.
Don't worry.
Uh The doctor's walking in.
I love you, too.
Bye.
My husband.
Also an architect.
Which is why he isn't here.
He's on-site of a new project in Memphis.
Dual-career marriage.
I know all about that.
And the people who do it with children? Boggles the mind.
Agreed.
My career is all-consuming.
And I'm a perfectionist.
It's a compulsion.
Cough sounds bad.
Let me take a listen.
Hey, what's going on? Hemoptysis in our pneumothorax patient.
Her lungs sounded clear, but now There's still an air leak.
And there's no blood in the chest tube.
Mariana, we're gonna confer for a minute, okay? Okay, so something more serious is going on.
All right, well, give me the differential.
It could be an abscess, bronchiectasis or even cancer.
- A CT should help.
- All right.
Well, let's get her in the magic box right now.
And then this Dr.
Abernathy dismisses the case as though it was nothing.
Do you think the neurosurgeon's really culpable? Well, I'm not gonna condemn him without solid consideration, but they refused to give it any air.
What? - Does any of this really surprise you? - No.
This is why I wanted the job in the first place.
So what will you do? Hello? Hello, is this Ms.
Benesch? Yes, who's calling? This is Dr.
Randolph Bell from the state medical board.
I'd like to talk with you about Dr.
Bosley.
Finally.
I'd given up hope.
Got your page.
I came as quickly as I could.
Is your emergency handled? Hard to tell.
How's Albert doing? Well, we're four doses in.
I've had to give him broad-spectrum antibiotics and three liters of fluids, and he's getting sicker.
I had to start him on norepi.
- You think it's the trial drug? - I do.
His blood cultures came back negative, there's no sign of infection.
And it's time for his next dose.
Ah, that's a tough call.
He's already on a non-rebreather with a borderline blood gas.
With another dose, you may have to intubate.
Which could be fatal for Albert.
A ventilator-associated pneumonia, with his immune system? God, and his poor wife.
And the trial? An intubation would be an unexpected adverse event, which could get the trial paused or stopped altogether.
But if he doesn't finish the protocol, and his cancer only gets worse So if I give him the dose, it could kill him.
And if I hold it, then everything he's gone through up until this point would be completely useless.
There's no good answer.
And Albert's wife, she doesn't trust me, she trusts you.
Yeah, I'll talk to her, but let's be clear: you make the call.
No.
Neither of us will.
Albert should decide.
So, your CT was clear.
Which means it's not an abscess, inflammation or cancer.
Okay, so what's next? It's good to rule things out.
I am going to circle back with Dr.
Austin, and I Are you still in pain? Is it your chest? It's just, it's just cramps.
The same every month.
Ooh, they're excruciating sometimes.
Have they always been this bad? As long as I can remember.
Sometimes I even get a nosebleed.
It's a real thrill, being a woman.
The last time your lung collapsed, were you also on your period? Uh, a-as a matter of fact I was.
I Yeah.
I-I remember I had to ask for pain meds while I was here.
Why? Sit tight, I will be right back.
I promise.
Endometriosis? Really? Her pneumothorax coincides with her periods, which are abnormally painful.
Isn't it possible that aberrant endometrial tissue from her pelvis traveled through tiny defects in her diaphragm up into her chest, where Where it continues to respond to the hormones of her menstrual cycle, thus wreaking havoc.
Yeah, it's definitely possible, but, Devi, that's - extremely rare.
- So is having repeated episodes of pneumothorax with no discernible cause on imaging.
What if these aren't random? What if this is evidence of a problem her body's been trying to hide this entire time? Well, we could get an MRI for a better look, but ultimately the only way to confirm a catamenial pneumo is with surgery.
That's thoracic and abdominal.
And if we find what you think we will, - that could be a hell of a procedure.
- That can cure her.
I'm ready for this.
Oh, I know you are.
Devi, you just pulled off a Conrad Hawkins-level diagnosis.
Let's get your patient ready and scrub in.
Tell him we can stop, Dr.
Hawkins, please.
Of course we can.
- I've always said that.
- We can't quit an experiment halfway through.
I tell my students all the time.
This is your life.
You get to be selfish.
You don't have to think about the greater good.
I am being selfish.
Without the trial, I die.
But you may die sooner with it.
I can't lose you.
Do you think I'm not scared? I am.
But this is what I want to do.
I'm willing to suffer for the science, just for a chance, however slim, to survive this cancer.
I just need you to support me, please.
- But, Albert - Listen, listen.
We're a team, right? Don't fight Dr.
Pravesh.
Just trust him.
And trust me and honor what I want and believe.
Okay.
I've decided, Dr.
Pravesh.
Please give me the next dose.
I hope this isn't an imposition.
More like a surprise.
I thought the state medical board had lost all interest in my case.
My lawyer certainly has.
Well, I'm sorry to hear that.
Thank you.
I don't blame her.
She took me on pro bono.
When we couldn't get any traction with the board, there wasn't any way forward.
Are you looking for a financial settlement? No, I'm looking for accountability.
He nicked the artery in my spine.
There was massive bleeding.
My spinal cord was damaged.
I did not have to end up like this.
I don't want future patients of Dr.
Bosley to, either.
Hey, your case file says that you received a second and third opinion about your outcome.
And that a post-op MRI would have caught the damage, and then a second emergency surgery could have repaired it.
Yes.
I might still be walking today if Dr.
Bosley had listened to me.
He didn't.
So he says you pushed hard for the surgery, That's not the point.
The harm I suffered during the operation could have been prevented.
I want the board to do something.
Will they? Honestly? Probably not.
But I will do something.
I'm maxed out on norepi, adding vasopressin.
I hear crackles halfway up, and he's losing consciousness.
Albert.
Can you hear me? - We're gonna need to intubate.
- No, not intubation.
He's struggling to breathe, Grace.
It may be the only thing to help keep him alive.
I'll grab an intubation tray.
I knew we should have stopped.
My husband, him I understand.
He'll never quit.
But you? You're doctors.
You know.
You're supposed to know better.
Why couldn't you stop him? Grace, you know I respect you and your husband.
He didn't want to stop, we have to honor that.
And Dr.
Pravesh has my total support.
I'll be right back.
Add a dialysis line.
His kidneys are shutting down.
Yeah.
Just let me know, please.
Albert's stable for now.
Yeah, well, it doesn't change the fact that he walked in here in decent shape and now he's on dialysis and he's being intubated.
Did you call the study sponsors? I had to notify them of the toxicity of the drug, and now they're deciding if they're gonna put the trial on hold.
Grace was right, I knew the dangers, I knew the odds for Albert were getting longer every single hour.
I shouldn't have listened to him, except I know that I should have.
You followed the patient's wishes.
It was the right move.
Albert knew exactly what he was doing.
I feel like a general who's sending my soldiers out into the battlefield to face a line of machine guns while I stand in safety.
All wars have casualties.
And they also have triumphs.
It's the same with clinical trials.
I want Albert to survive.
I want him to teach his kids for years to come.
So they can visit him in his happy retirement.
He deserves that.
This isn't over.
The intubation bought him time.
So next steps.
All right, what we know now is that he's battling massive inflammation from the trial drug.
So, if we treat the inflammation I hesitated to give him steroids because I thought he was infected, but We should go for it plus toci.
If all his cultures have been negative, yeah.
It could help more than it could hurt him.
Let's do it.
Endometriosis fits your symptoms.
You check all the boxes.
You know, most doctors don't ask women the right question to make these connections.
That's why it can take years to diagnose.
But if we're right, we can fix this.
But we do need to be clear about what this means for you.
This condition can affect your fertility.
Now, with surgery, you should end up pain-free, but if we find extensive damage, you are aware that you may not be able to have children, right? I discussed it with my husband.
He's flying in to be with me.
He's okay with never having children.
And you? W-We're on the same page.
We're focused on each other, and our careers.
And there's nothing wrong with that.
You're absolutely right.
His MAPs are solid.
I'm gonna titrate down the norepi.
- That's an improvement.
- Not enough.
What do the labs say? Just tell me.
Look for yourself.
His blood gas looks good.
We can turn down his oxygen to 40%.
And his liver function is normalizing.
He's turning around.
He's gonna be okay.
Yes.
Yes.
Albert will make it through this trial.
You have given him a chance to survive.
You did it.
He's looking better, right? He already wants to send a video to his students.
I tell them every day, record even the most incremental progress in your experiments.
This is more than incremental.
When you're ready, I'll set up a transfer back to the room with the comfy chair.
Albert, I owe you an apology.
Grace, you, too.
I just had no idea it was gonna get this bad.
You were doing your job.
I'm sorry I got so angry.
Oh, stop, both of you.
I was a willing guinea pig, remember? A human petri dish.
Besides, it worked.
Well, we know you can get through the doses.
But we don't actually know if it's gonna help your cancer yet.
But I have a chance.
More than I had before.
See? I told you to trust Dr.
Pravesh.
- You were right.
- Mm.
Like two peas in a pod, you science nerds.
That's right.
Now, here's the real question.
Who can recite the periodic table faster? - Did you just challenge me? - Yes, I did.
No Actually, no, y-you need to get some rest.
Hydrogen, helium, lithium Okay, okay, okay.
You win.
You win.
Imaging, please dial 2732 Oh, well, well, well, if it isn't the queen of Chastain.
Hey.
Ah - Oh.
Nice.
- You like that, right? Hey, man, I heard Devon's clinical trial passed the first test.
Yeah, barely.
The protocol was worse than anyone imagined.
Your mom wouldn't have survived it, AJ.
Well, we have no regrets.
You know what she did today? She made three different kind of muffins and she took a walk through the botanical gardens.
Telling you, brother, palliative care was a good call.
So, uh do we need to talk about the new ER doc? - Okay.
- Yeah.
Look, I'm just saying, I like her.
No BS, no sugarcoating.
Uh, she's definitely an interesting case.
"Interesting.
" That sounds mysterious.
Come on, man.
Give up the backstory.
No, do not go there.
You know something I don't? I thought you two might have something going on.
- Just colleagues.
- Yeah, for now.
No.
I already have one lady in my life.
Me.
- I'll catch you tomorrow.
- All right.
See you later, cutie-pie.
Bye.
The unicorn book, you promised.
What? Unicorn book? I don't know what you're talking about.
- Daddy.
- I didn't forget, sweetheart.
Happy the Bloodhound is coming right up.
I'm so proud of you.
And I'm proud of you.
You made a tough diagnosis most doctors would miss.
And you got your patient through a very rough surgery, Leela.
Well, I really admire Mariana.
And I'm really glad I got to know her a bit.
She's a successful businesswoman, and an unapologetic control freak, with a very successful husband in the same business.
Sounds familiar.
And she wasn't at all afraid of a condition that could make her infertile, because she doesn't want kids.
I mean, there are people like that.
I'm just not one of them.
I want to have a family one day.
With you.
We need to talk about this.
I don't know if I want kids.
At least not right now.
I could not manage surgical residency and a family.
Yeah, I get that.
And it can wait.
We have plenty of time.
Devon, it could be a long while.
Leela, all kinds of doctors manage it.
I mean, there are work-arounds.
I believe that, I just I don't know if it'll ever be the right thing for me.
Which is why I-I realized that what Padma wants can help us both.
I can give her the egg she so desperately wants, so she can have a baby, and at the same time, I can freeze some for me.
For us.
For the future.
Yes.
Just to give me time to think about it.
But that's all I can promise right now.
Can you live with that?