Chicago Med (2015) s10e13 Episode Script
Take a Look in the Mirror
1
Just because Carl is
going for full custody
does not mean he's gonna get it.
He's gonna use my psych hold against me.
I'm really glad to
have you in my corner.
It means more than you know.
[TENSE MUSIC]
I'm seeing my attacker
whenever I'm in my office.
In my experience,
when you try to run away
from your demons, they chase you.
You never made it back
to my place last night.
I'm worried you're trying
to numb your grief.
- Watch where you're going!
- Get out of my face.
[GRUNTING]
[GROANS]
[DISTANT SIRENS WAILING] [DOG BARKING]
[SOFT TENSE MUSIC]
That's right. Stay down.
[PANTING]
Where's that smart mouth now?
- [GRUNTS]
- [GROANING]
[SIRENS APPROACHING]
♪
Well, it sounds to me, anyway,
like you're feeling
a lot closer to normal,
and that makes me happy.
Well, I don't know about normal,
but I now know the value
of a good therapist.
Does that mean I'm gonna
get a big, fat raise?
No.
Okay, well, I'm still happy
you're feeling better, I guess.
- [CHUCKLES]
- Is that Jackie?
- Hey, good morning.
- Good morning, Jackie.
Ms. Goodwin, good morning.
Good morning, Dr. Charles.
- How're you doing?
- Good, good.
Ah, you know, this is
gonna take forever.
I'm just gonna head
back to the ED, I think.
Why don't you give us your order?
- I'll bring it up.
- Oh, no.
- No, no, it's fine.
- You sure?
Yeah, yeah, I'll see you in there.
What was that all about?
Oh, I don't know, man.
That was very
that was weird, wasn't it?
Okay.
What?
[CHUCKLES]
That looks good.
Where am I?
Martin, I told you,
we're at the hospital.
Okay, so how did this happen?
Someone turned off
the TV he was watching,
and he got mad and smashed a lamp.
He's been getting pretty worked up
- over that kind of thing lately.
- Got it.
Any history of bleeding
disorder or, uh, diabetes?
I'm really not sure.
Okay. Any family we can contact?
Unfortunately, no.
All we know is that he was living alone
until he set his stovetop on fire.
CFD turned him over to the state,
and when a cognitive eval
tagged dementia,
he ended up at our facility.
All right, I see bedsores,
and he's pretty thin.
When's the last time he took a bath?
Look, there's only three of us
on the entire memory care floor
trying to rotate through all the rooms.
How long is this gonna take?
Martin's not my only patient.
I need to get back to the facility.
Well, you're gonna have to
hang tight because Dr. Archer
wants occupational therapy
to examine Martin's hand
before he's released.
Where am I?
You are right here with me, Martin.
[INAUDIBLE]
- Uh
- What is it?
Uh, uh.
[SOBBING]
Okay.
Listen to me.
We're gonna figure this out.
I'm gonna take good care of you, Martin.
You hear me? I promise.
♪
What happened to your lip?
- [CLEARS THROAT]
- I'm fine.
You got in a fight
last night, didn't you?
Yeah, let's not do this again.
You, uh you made your feelings
perfectly clear last night.
Could use you in T6.
Patient's complaining of back pains,
but there's there's no rush.
Okay, I'll be there in a moment.
Oh, Ms. Copeland, this is Dr. Asher.
You can call me Eva.
Hi, Eva.
I heard you've got some back pain.
Can you show me where it hurts?
Okay, any chance you could be pregnant?
- No.
- Are you sexually active?
My fiancé and I, we've been
saving ourselves for marriage.
Okay, so when did your back pain start?
When I woke up this morning.
I'm a bit of a wild sleeper.
Oh, I am the same way.
My poor fiancé has
no idea what he's in for.
- Ow!
- Ooh.
All right, I'm gonna lie you back.
- Okay?
- [GROANING]
Ow!
Okay, I am done torturing you, Eva.
Let's get a CBC and a BMP.
You got it.
We'll be right back.
- And an ultrasound?
- And a pregnancy test.
Victor Tullman, 52 years old.
Was ejected when his motorcycle
hit a retaining wall.
Got lodged in the fence line.
CFD extracted him at the scene.
Oh, it hurts so bad.
All right, we're gonna
get you fixed up, Victor.
All right, come on. Put him in here.
You know, we're gonna keep
this here for a moment, yeah?
All right, push one of Dilaudid
and a tetanus shot.
Copy that.
It's embedded in the chest wall.
All right, and the other's anterior.
You stabilize while I
dissect the barbs one by one.
Give me a heavy clamp and a
pair of wire cutters, please.
[GROANS]
- Careful.
- Dilaudid's on board.
- Tetanus is up next.
- Okay, good. Let's clamp.
All right, let me get this
out of the way first.
All right.
- [GROANING]
- You in?
Yeah.
Got it. One down, one to go.
Irrigate to make sure there's
no retained foreign bodies.
Now this one is deep.
[TENSE MUSIC]
Yeah. Yeah.
- Okay.
- All right.
It's out.
All right, good job.
- [COUGHING]
- All right, let's get him a
Oh!
Is that what I think it is?
That is his lung.
♪
Eviscerated lung. I've read about them.
Multiple rib fractures
created instability
in the chest, allowed the lung
to herniate through the chest wall.
Pressure from his cough
forced it through the opening.
So what's our plan of attack,
Ms. Howard?
Immediate surgery to reduce the lung
and reconstruct the chest wall.
Yes.
And what else?
Um
His EKG showed low-voltage
conduction disturbances.
He has a weakened heart muscle.
Before he gets anesthesia,
it's a good idea to make sure
it doesn't kill him.
Right, of course.
Let's page Dr. Hayes for a
cardiothoracic consult before surgery.
[SOFT DRAMATIC MUSIC]
- She's had enough hand-holding.
- Oh, please, I get it.
Yeah, yeah, but what concerns me
is that you're getting
into her head too much.
I hope I am.
Naomi has to learn not
to buckle under pressure,
or she's gonna spend her entire
career threading catheters.
Naomi's going to match very soon.
I want to make sure she's ready.
♪
[CHUCKLES]
You finally getting
that first cup of coffee?
- Yep.
- [BOTH CHUCKLE]
Hey, look, um
I wanted to ask you or just, uh,
make sure that we're
we're okay, I mean, after
that whatever happened,
or rather, didn't happen last night.
Yeah, of course.
It was just a weird moment, I think.
Yes, definitely.
Um, so you have your
you got your your custody
hearing this afternoon.
How you doing with that?
Yeah, I'm gonna leave here in an hour.
I'm gonna go change and head over.
I gotta find a perfect outfit
that says I am capable
of caring for my child.
Please don't do that to yourself.
How can I not?
Carl's lawyer, she's
she's going after me.
She's got a child psychologist.
She's got an expert in self-harm.
[SOFT APPREHENSIVE MUSIC]
She's even got somebody
from the psych ward coming in.
From here? From Gaffney?
Yeah, Dr. Nemic. Do you know him?
Yeah.
Good doc.
I mean, at least he'll he'll
play it straight, you know?
But can I just give you
a little piece of advice,
if you'll allow me?
Just try and stay out of,
oh, what are they gonna do?
What are they not gonna do, you know,
and focus on the stuff
that you can control.
Yeah, well, that's the thing.
I don't feel like
I can control anything.
Looks like he has an underlying
constrictive cardiomyopathy.
- Thank you, Doris.
- Thank you, Dr. Hayes.
Repairing his heart is my priority.
Let's get him upstairs ASAP.
Respectfully, I disagree.
Oh?
We have to repair
the exposed lung first.
Every second we wait increases
his risk of deadly infection.
I hear you, Dr. Lenox, but
there's significant thickening
of the pericardium.
It's impeding perfusion.
A repaired lung is not gonna
do much good if his heart
gives out on the table.
Well, what if we take
a thoracoscopic approach,
fix the heart and lung simultaneously?
Bold but riskier approach.
But we could limit his time
under anesthesia,
which minimizes the risk of a stroke
and cardiac arrest during surgery.
Interesting.
But we'd have to drop the
left lung to reach the heart.
If there's an air leak on the right,
we won't be able to ventilate.
He dies on the table.
Well, I'm not concerned about that.
We can protect the eviscerated
lung and secure the opening.
I'll have my team prep the OR.
Excellent idea, Ms. Howard.
Would you like to scrub in with us?
- That would be amazing.
- Great.
See you both up there.
[SOFT TENSE MUSIC]
♪
What you have is called
an ectopic pregnancy.
I'm pregnant?
Not in the traditional sense.
See, your egg became fertilized
in the fallopian tube,
which is normal, but it got stuck there,
and it never traveled to the uterus.
That's what's causing
your abdomen and back pain.
But if the tube ruptured,
it could quickly turn life-threatening.
Well, what happens now?
Now we need to remove the pregnancy.
Fortunately, this is a routine
laparoscopic procedure,
and you'll be back
on your feet in a week.
Eva, your fiancé just
checked into the waiting room.
Can I let him come in?
He can't know.
I can't tell him
if you don't want me to,
but wouldn't he want to know?
It's not his.
Please. He'll leave me.
♪
- Sharon?
- Yeah?
- You got a minute?
- Of course. What's up?
I got a patient that was brought in
from a state dementia care
facility with a hand injury.
Nothing serious, but I've been
slow playing his treatment.
So what's your concern?
He's underweight, hasn't bathed.
And I was checking out
his medication history,
and it's all over the place.
They had him on statins
and took him off.
And then they had him on levothyroxine,
and they discontinued that too.
So you think it's neglect?
Yes.
These facilities can be dumping grounds
for insurance companies.
Well, what about family, friends?
No family, and I checked out
last-known address,
and no one's heard of Martin.
He must have been a bit of a shut-in.
So you want to know if we should report?
I don't want to sound
the alarm unnecessarily,
but I can't help but feeling
that Martin's trying to tell me
something important but can't.
You know, Bert exhales
and groans a little
when he doesn't like something
and can't find the words.
Dementia patients have small signs
that are language
that we have to understand.
You need more time to know Martin's.
- All right, what have we got?
- 34-year-old male.
GCS 12.
Hypotensive with an oxygen level of 90.
Came home drunk last night
and passed out.
When his wife tried to
wake him up this morning,
he could barely keep his eyes open.
- Oxygen's down to 88.
- Please help him.
Did he take anything unusual?
A new medication that doesn't
mix well with alcohol?
I don't know.
He went out last night
to meet some friends.
He's got some bruising here on the ribs.
Did he say how that happened?
He mentioned falling down stairs, but
You think he got into a fight?
I love him, but he's a hothead.
Stethoscope?
When did he start having
difficulty breathing?
In the car on the way here.
Okay, let's intubate.
20 of etomidate, 100 of sux.
On it.
[MONITOR BEEPING]
[TENSE MUSIC]
Where's that smart mouth now?
Meds are in.
Ripley? You cool?
Yeah.
All good.
♪
Oxygen at 94 and climbing.
No free fluid in his abdomen.
No sign of any traumatic injury.
Maybe it's a retroperitoneal bleed.
His kidneys look normal
in the ultrasound.
Yeah, but if he took a flank shot,
there's a possibility it could
have opened a slow bleed
that wouldn't necessarily
show up on a scan right away.
Fair call.
Graysen, let's order a C
of his posterior abdomen and pelvis,
- and then we'll go from there.
- Copy.
Okay.
Thanks for the assist.
Yeah.
Keep me in the loop.
I can't believe you called
protective services.
It's my job to ensure that all patients
are properly cared for.
Well, it's a colossal waste of time.
Well, I'm sorry I held you up.
[SIGHS] Not this again.
Martin, lift your feet.
Where did I go?
Come on, Martin, we gotta go home.
Wait, stop.
It's okay, Martin.
Why don't you come with me?
[SUSPENSEFUL MUSIC]
Where am I?
You don't see yourself.
Where did I go?
Bri, you said that
Martin would get upset
every time you turned the TV off?
That's right. He'd freak out.
Didn't want to miss his game shows.
- What would he say?
- Same thing as now.
Where am I? Where did I go?
Over and over.
He wasn't upset you turned the TV off.
He was upset at his own
reflection on the empty screen.
Okay, Martin.
Why don't you sit down?
Okay.
I am not discharging him.
Stay put.
You were right.
Slow bleed from the right kidney
that's leaking into
the perinephric space.
I didn't want to be right.
I'm giving him
a couple of units of blood.
I already spoke to trauma,
and once an OR is available,
I'm gonna get him upstairs for surgery.
You want to remove his kidney?
Well, I'm afraid we have no choice.
Well, we could take him to
angio and embolize the bleed.
I wish we could, but it looks like
the bleed's coming off the vena cava,
so kidney has to come out.
I'd go more conservative.
Look, this is a young guy
who got in a fight.
I'd rather I'd rather he
didn't have to lose a kidney
over one bad decision.
So I'm just sort of surprised
that you want to embolize
when he came in hypotensive.
We'd be risking his life for
Neither of us want that, obviously.
But I'm surprised you jumped
to such an extreme measure
when there are other options
that don't involve removing a kidney.
He'll still have another one,
and we're not talking about
a lifetime on dialysis here.
[SIGHS]
Dude, are you okay?
Don't worry about me.
Just cancel the OR.
Schedule the embolization.
[SCOFFS] Okay, so you're
just pulling rank, then?
Yeah, I guess so.
[FAUCET WHOOSHING]
I feel like you're angry with me.
I disagree with you.
There's a difference.
You think I overstepped with Dr. Hayes?
I think you blurted out the
first idea that came to mind
to impress a world-renowned
cardiothoracic surgeon.
No, I actually believe in this approach.
But did you think it through first?
Because I see endless
potential for error.
And when it comes to surgery,
you have to think three steps ahead.
You told me to find my voice,
to speak my mind.
Now I have, and you're still unhappy?
- So which is it?
- It's both.
You have to pick your moments
because everything
you do between now and match day
can have a significant impact
on your career.
I'm sorry you're angry
he preferred my idea to yours
That's not what this is about.
Are you sure?
- Yes.
- [SCOFFS]
Dr. Hayes liked your idea,
and I know that feels good.
But if this surgery goes south,
the only thing he's going
to remember is the failure.
And he won't punish himself for that.
He will punish you.
And all your match
opportunities will vanish.
And then where will you be?
I'm a big girl.
[TENSE MUSIC]
OR is prepped. Is the patient ready?
What's up?
I think it might be best
if I sit this out.
May I ask why?
I'm not on board with the surgical plan.
You still object
to deflating the good lung
in order to reach the heart?
Yes.
And if he crumps, his trauma injuries
prevent us from administering
heparin to put him on bypass.
I don't want my doubts to
negatively impact the outcome.
Understood.
Ms. Howard and I will take it from here.
♪
And to be clear,
you don't feel that Penny
is safe with your wife?
No, I don't.
And why is that?
Jackie's been prone
to depression for years,
and it got a lot worse leading
up to her suicide attempt.
Look, I don't want to be here
trying to take custody
away from my wife.
That's Penny's mother.
This is killing me.
Then why are you doing it?
[TENSE MUSIC]
I don't feel I have a choice.
I've seen my wife go to a place
where she can't see anything
else but her own pain.
And God forbid,
if she chose to do something
to herself again and hurt Penny,
I'd never forgive myself.
[MONITOR BEEPING]
Hi, Eva.
So I'd like to go over your
procedure again with you.
I will make a small incision
near your navel,
and from there, I will go in and remove
the ectopic pregnancy and
the affected fallopian tube.
Okay, we're gonna give you
a little bit of Versed
to take some of the edge off
before going to the OR, okay?
Yeah. Okay.
Do you think I'm a horrible person?
No.
I love Caleb so much.
He helped get me on the path.
I just can't stand the thought
of disappointing him.
My eyelids feel so heavy.
Yeah, that's the Versed kicking in.
[BOTH CHUCKLE]
I just
I never meant for any of this to happen.
I told him. I told him not to.
I said no.
Please, no, no, no.
Please stop.
Don't do this.
It hurts.
♪
I'm through the pleura.
Marty, can we drop
the left lung, please?
On it.
Lung's deflated.
Vitals holding steady.
Perfect. You're doing fine, Ms. Howard.
Just keep holding
that angle on the scope.
I'll cut the scar tissue away,
and then we can reduce the lung
and reconstruct the chest wall.
Sound like a good plan to you?
Yes, Dr. Hayes.
You got benched?
I benched myself.
Why is that?
Dr. Hayes and I couldn't reach consensus
on a surgical approach,
so I thought it best to remove myself.
Sure.
I'm gonna go out on a limb and say
that the Caitlin Lenox
that I've dealt with
would never just remove herself.
This is about Naomi.
A thoracoscopic dual repair
seems like an impressive pull
for a med student,
especially when it was
said medical student's idea.
Oh, and you're worried
that it would backfire?
I tried to throw her a life jacket,
and she accused me of jealousy.
Oh, I see.
It was disrespectful and reckless.
Neither of us should throw stones
on that particular point.
But she stood up to you.
I would call that progress.
[PENSIVE MUSIC]
Med students take what you teach them
and eventually use it against you.
That's right, and they
become the competition,
whether we want to admit that or not.
I hate this feeling.
I did too.
Did?
Yeah, well, I learned
to love that feeling.
It means I've done my job as a mentor.
You know what?
Naomi's only in there
right now because of you.
You should be proud of that.
[ALARM BEEPING]
Sats are falling.
What do you think?
Put him on bypass.
He'll bleed out from heparin.
[BEEPING]
You prepped the femorals.
I figured I'd have it ready
in case we needed central line
access or to put him on bypass.
Impressive call.
You're thinking three steps ahead.
Well done.
♪
She's a transgender woman.
- Name is Loretta.
- Because of the dementia,
she didn't recognize her own reflection.
And you were right.
She was trying to tell you something.
Mm-hmm.
All the neighbors I contacted
from her last known address
had no idea who Martin was.
So as a last Hail Mary,
I sent them a photo.
If the name didn't ring a bell,
maybe a face would.
Mm-hmm.
One of them sent me this photo
and said that Loretta was
kind, warm, and gregarious.
Hmm.
She was getting
hormone replacement therapy.
She must have fallen behind
on her injections
when the dementia took hold.
Yeah, by the time the state took her in,
she was no longer presenting as a woman.
Mm-hmm.
And I know this is different, obviously,
but that pain in her eyes,
I recognized it.
Loretta deserves better than
the care that she's getting.
- Yeah, agreed.
- She needs the proper resources.
You know, there's a new
LGBTQ+ memory care center
that recently opened a wing
dedicated to transgender patients.
The administrator owes me a favor.
Thanks, Sharon.
I'm sorry. You were right.
I should have taken the time
to pay closer attention.
I just wish there was
something I could do.
There is something.
[TENSE MUSIC]
- He's bradying down.
- What's happening to him?
The embolization
failed to stop the bleed.
Call the OR.
No, he won't make it up there.
His heart's bottoming out.
We need to open up his chest right here
and cross-clamp the aorta.
- I'll do it.
- No, you've done enough.
What the hell are you doing?
He's hypotensive.
Heart rate's down to 32.
Please, somebody help him.
Trigger the MTP and hand me a scalpel.
I'm opening him up now.
Dr. Ripley, step aside.
I don't what's going on with you,
but you're out of line
and out of control.
- I need to do this.
- Step aside now.
- It has to be me.
- Why?
Because I did this to him!
[ALARM BLARES]
He's in asystole.
Oh, my God, do something!
Get out. You can't be here right now.
Get out. Prep.
Come on.
[ALARM BEEPING]
Scalpel.
Hold compressions.
♪
Okay, give me an aortic clamp
and prep one milligram
intracardiac epinephrine.
What is Adam O'Rourke's condition?
Right now, you should be
a little more concerned about yourself.
Please.
He's in surgery to repair the vena cava
and remove his kidney.
He's expected to make a full recovery.
Good. No, no.
Saving him does not save you.
His wife is planning to sue,
one way or another.
I'm afraid your presence in
the ED has become a liability.
Look, whatever you have to do,
I understand.
I'm suspending you without
pay effective immediately
until further notice.
There will be a formal investigation,
hearing, and judgment.
I don't intend to
fight you or the board,
to blame anyone else, or make excuses.
I I brought this on myself.
[APPREHENSIVE MUSIC]
I'm deeply sorry for the trouble
I have caused this hospital.
Full disclosure,
I'm recommending that
the board terminate you.
♪
I appreciate your honesty.
You have left me no choice, Dr. Ripley.
Just go home.
♪
Hey, Eva.
You did so good.
How are you feeling?
Good. I'm a little tired.
Where's Caleb?
He'll be here soon. I just
I wanted to talk to you
about something first.
Okay.
Eva, do you remember what you said
before you went into surgery,
right before you went under?
No, I don't remember anything.
Eva, did someone hurt you?
Please, can you get Caleb?
Nothing that we discuss in here
will ever leave this room,
unless you want it to.
Um
a few months ago,
I went to stay with
my best friend, Athena,
and her family on the lake.
Caleb wasn't there.
He had to work.
So Athena broke out the champagne
to celebrate my engagement.
And we drank some wine.
Her cousin was there.
When I went to bed,
he, uh
he came in my room, and
I told him to stop, but he wouldn't.
And I was just so drunk
that I went numb,
like I wasn't even in my body.
He raped you.
I think I'd been
sending him mixed signals.
Like, I'd been really
sweet to him all night.
Hey, hey, don't you think for a second
that being sweet justifies his behavior.
It doesn't.
This was not your fault.
You said no. End of discussion.
Yeah, I know.
I am so sorry that
this happened to you, Eva.
And I am here to help you,
however you want.
[APPREHENSIVE MUSIC]
Do you think I should tell Caleb?
♪
I think that that's up to you.
Can you be there when I tell him?
Of course, I will.
[SOBBING]
♪
Ms. Embry, your next witness.
Actually, um, sorry, Your Honor.
We might want to adjust slightly.
We're still waiting on
a representative from Gaffney,
Dr. Orson Nemic.
Um, Dr. Nemic, uh, had an emergency.
He asked me to step in. I'm Dan Charles.
I'm the, um, head of psychiatry
at Gaffney.
You're familiar with Ms. Nelson's case?
I am, Your Honor.
I'm actually the doctor
who committed her last year.
Okay.
I'm okay with it,
so long as both sides agree.
♪
It's fine with us.
Ms. Embry?
We're good, Your Honor.
Then please take the stand, Dr. Charles.
You placed Mrs. Nelson
on a psychiatric hold
because you considered her
a threat to herself, correct?
Yes.
That's actually a core criteria
for placing somebody on a 5150.
And in a state like that,
is someone capable
of properly considering
the health and safety
- of others around them?
- No.
And let's be crystal clear
about the state
Mrs. Nelson was in.
She was found bleeding
on the bathroom floor
after cutting herself, correct?
That's correct.
And why do you think that happened?
Well, at that point, Mrs. Nelson
had been working in the
burn unit for over 10 years.
And in my opinion, she was
suffering from severe PTSD.
Isn't PTSD a chronic,
difficult-to-treat condition?
Well, the biggest challenge
in addressing PTSD
isn't treating it.
It's getting the sufferer to acknowledge
that they need help.
And once this crisis broke
through Mrs. Nelson's denial,
she threw herself into her recovery.
She took a two-month leave of absence,
underwent intensive psychotherapy.
She's doing everything
that you're supposed to do
to prevent a relapse,
and in my opinion, anyway,
is no more of a threat
to her child than I am to mine.
A moment, Your Honor?
[WHISPERING INDISTINCTLY]
Dr. Charles, how would you describe
the nature of your relationship
with Mrs. Nelson now?
I'm sorry, I don't
understand the question.
Well, you seem to know
a lot about someone
who isn't under your direct care.
Well, we're we're colleagues.
We work together.
Friends?
In a professional context, anyway.
And are you romantically
involved with Jackie Nelson?
Objection.
Your Honor, this is
wildly inappropriate.
Isn't this your witness, counselor?
This is a replacement for my witness,
and I believe he might
have a certain bias.
Make it quick, Ms. Embry.
Dr. Charles, are you now
or have you ever been
romantically involved
- with Jackie Nelson?
- Absolutely not.
[TENSE MUSIC]
And do you have romantic
feelings for Mrs. Nelson?
No, I do not.
No more questions, Your Honor.
♪
[MONITOR BEEPING]
Ms. Howard just went downstairs,
if that's who you're looking for.
He seems to be recovering nicely.
In no small part thanks to Naomi.
As you can imagine,
I have worked with
a lot of med students.
She is one of the best
and brightest I've seen.
She speaks her mind.
And that's a testament
to your mentorship.
I appreciate that.
I appreciated your honesty today
and how you removed yourself
from a procedure
that you didn't agree with.
That is integrity.
Thank you, but you clearly
had everything under control.
Did I?
We so often discuss
and debate and consider
all possible options, but at some point,
you just got to take a leap of faith.
I don't agree.
I'm not surprised.
Faith is a roll of the dice,
and life is random enough.
So I prefer to game out
possible outcomes
and stress test the merits and dangers
and determine which is
the strongest path.
I prefer solid ground under my feet.
Can I buy you dinner, Caitlin?
You haven't been listening.
[SOFT MUSIC]
I'll see you tomorrow, Dr. Hayes.
Good night, Dr. Lenox.
Tell me what?
I, um
I wasn't being completely
honest with you earlier
about my surgery.
Okay.
Well, be honest now.
Dr. Asher didn't remove a cyst.
She removed an ectopic pregnancy.
Pregnancy?
When I was up at Athena's
cabin, her cousin, he
he came into my bed that night.
And he raped me.
Caleb, please don't hate me.
[SOFT TENSE MUSIC]
♪
[SIGHS]
I could never hate you.
I love you.
I love you too.
It's gonna be all right, Eva.
God is merciful. He forgives you.
[SNIFFLES]
And eventually,
I will too.
Eva has nothing to apologize for.
Excuse me?
She was assaulted.
She doesn't need your forgiveness.
- She needs your support.
- Dr. Asher.
There is only one judgment
that matters to me,
and it is definitely not yours.
She didn't deserve for this to happen.
She said no and was forced
against her will.
Eva?
I appreciate your support, Dr. Asher.
I really do.
But now this is between
me, Caleb, and God.
Eva, you don't
♪
Okay.
And one more thing.
There you go.
[SOFT MUSIC]
♪
[GASPS]
It's me.
[CHUCKLES]
Beautiful.
Hello, Loretta.
Great news.
The memory care center
has a bed available.
They can pick up Loretta tonight.
♪
Thank you.
Prepping for your USLME exam?
I'm making my way
through your checklist.
Good.
You did excellent work today.
Dr. Hayes was impressed with you.
And so was I.
Thank you.
Look, I'm I'm sorry for
the way I talked to you.
You were honest, and I would
never fault anyone for that.
The first time I saw you,
you diagnosed and reduced
a man's dislocated hip
in under 20 seconds.
I instantly knew
I wanted to learn from you.
And it definitely hasn't been easy.
But if it makes me the doctor you are,
I don't regret a second of it.
♪
What you did today was also badass.
- [LAUGHS]
- Thank you.
So let's get you prepped.
[KNOCKING]
- Hey.
- Hello, there.
I thought you'd like to know
that the judge granted me
joint custody and full parental rights.
- Congratulations.
- Thank you.
And, um, sorry it got so personal.
Hey, at least we got that
stuff figured out this morning.
Yeah, except I lied.
- How do you mean?
- I was embarrassed.
And, um,
I'm just not gonna pretend like
there's not something here.
Yeah, me, neither.
But you know what?
I'm not so sure that this
is a really good idea
for me right now.
Why not?
Nemic didn't have an emergency today.
I cooked up an excuse for him
to stay at the hospital
and sped over to the courtroom
and jumped up on the stand
and perjured myself.
I'm really worried that
this is not starting out
in a very healthy place for me.
Daniel.
Look, something that
I've come to realize is that
when it comes to the relationships
that really matter to me,
I'm just not very good
at figuring out where, you know,
the shrink ends and I begin.
- [SCOFFS]
- Wow.
You're so full of it, you know that?
It's not that you can't
turn the shrink off.
It's that you don't want to
because you like it
because it keeps you in control.
I'm not so sure you're right about that.
You know, Daniel,
you deserve to be happy.
- I know I do.
- No, you don't.
But I sincerely hope someday you do.
[DOOR SLAMS]
♪
Goodwin suspended you?
Hannah, I
Don't.
I swear to you.
I wasn't looking for a fight.
This guy, he just
he wanted trouble.
And you just gave it to him?
If I'm trying to walk away
and someone throws a punch,
I'm gonna defend myself, yeah.
Anyone would.
[APPREHENSIVE MUSIC]
You don't
you don't see the irony at all.
Irony?
What what irony?
A few months ago, you were
accused of assaulting Pavel.
- Falsely accused.
- That's right.
And now you're back here again.
Except this time, you did it.
♪
I think that's incredibly unfair
You nearly killed a man.
But I I helped save him. I fixed it.
Really? That's your takeaway? That's
I don't even know what
to say to you anymore.
Or why you are so hell bent
on throwing this life away
that you fought so hard to have.
♪
Just because Carl is
going for full custody
does not mean he's gonna get it.
He's gonna use my psych hold against me.
I'm really glad to
have you in my corner.
It means more than you know.
[TENSE MUSIC]
I'm seeing my attacker
whenever I'm in my office.
In my experience,
when you try to run away
from your demons, they chase you.
You never made it back
to my place last night.
I'm worried you're trying
to numb your grief.
- Watch where you're going!
- Get out of my face.
[GRUNTING]
[GROANS]
[DISTANT SIRENS WAILING] [DOG BARKING]
[SOFT TENSE MUSIC]
That's right. Stay down.
[PANTING]
Where's that smart mouth now?
- [GRUNTS]
- [GROANING]
[SIRENS APPROACHING]
♪
Well, it sounds to me, anyway,
like you're feeling
a lot closer to normal,
and that makes me happy.
Well, I don't know about normal,
but I now know the value
of a good therapist.
Does that mean I'm gonna
get a big, fat raise?
No.
Okay, well, I'm still happy
you're feeling better, I guess.
- [CHUCKLES]
- Is that Jackie?
- Hey, good morning.
- Good morning, Jackie.
Ms. Goodwin, good morning.
Good morning, Dr. Charles.
- How're you doing?
- Good, good.
Ah, you know, this is
gonna take forever.
I'm just gonna head
back to the ED, I think.
Why don't you give us your order?
- I'll bring it up.
- Oh, no.
- No, no, it's fine.
- You sure?
Yeah, yeah, I'll see you in there.
What was that all about?
Oh, I don't know, man.
That was very
that was weird, wasn't it?
Okay.
What?
[CHUCKLES]
That looks good.
Where am I?
Martin, I told you,
we're at the hospital.
Okay, so how did this happen?
Someone turned off
the TV he was watching,
and he got mad and smashed a lamp.
He's been getting pretty worked up
- over that kind of thing lately.
- Got it.
Any history of bleeding
disorder or, uh, diabetes?
I'm really not sure.
Okay. Any family we can contact?
Unfortunately, no.
All we know is that he was living alone
until he set his stovetop on fire.
CFD turned him over to the state,
and when a cognitive eval
tagged dementia,
he ended up at our facility.
All right, I see bedsores,
and he's pretty thin.
When's the last time he took a bath?
Look, there's only three of us
on the entire memory care floor
trying to rotate through all the rooms.
How long is this gonna take?
Martin's not my only patient.
I need to get back to the facility.
Well, you're gonna have to
hang tight because Dr. Archer
wants occupational therapy
to examine Martin's hand
before he's released.
Where am I?
You are right here with me, Martin.
[INAUDIBLE]
- Uh
- What is it?
Uh, uh.
[SOBBING]
Okay.
Listen to me.
We're gonna figure this out.
I'm gonna take good care of you, Martin.
You hear me? I promise.
♪
What happened to your lip?
- [CLEARS THROAT]
- I'm fine.
You got in a fight
last night, didn't you?
Yeah, let's not do this again.
You, uh you made your feelings
perfectly clear last night.
Could use you in T6.
Patient's complaining of back pains,
but there's there's no rush.
Okay, I'll be there in a moment.
Oh, Ms. Copeland, this is Dr. Asher.
You can call me Eva.
Hi, Eva.
I heard you've got some back pain.
Can you show me where it hurts?
Okay, any chance you could be pregnant?
- No.
- Are you sexually active?
My fiancé and I, we've been
saving ourselves for marriage.
Okay, so when did your back pain start?
When I woke up this morning.
I'm a bit of a wild sleeper.
Oh, I am the same way.
My poor fiancé has
no idea what he's in for.
- Ow!
- Ooh.
All right, I'm gonna lie you back.
- Okay?
- [GROANING]
Ow!
Okay, I am done torturing you, Eva.
Let's get a CBC and a BMP.
You got it.
We'll be right back.
- And an ultrasound?
- And a pregnancy test.
Victor Tullman, 52 years old.
Was ejected when his motorcycle
hit a retaining wall.
Got lodged in the fence line.
CFD extracted him at the scene.
Oh, it hurts so bad.
All right, we're gonna
get you fixed up, Victor.
All right, come on. Put him in here.
You know, we're gonna keep
this here for a moment, yeah?
All right, push one of Dilaudid
and a tetanus shot.
Copy that.
It's embedded in the chest wall.
All right, and the other's anterior.
You stabilize while I
dissect the barbs one by one.
Give me a heavy clamp and a
pair of wire cutters, please.
[GROANS]
- Careful.
- Dilaudid's on board.
- Tetanus is up next.
- Okay, good. Let's clamp.
All right, let me get this
out of the way first.
All right.
- [GROANING]
- You in?
Yeah.
Got it. One down, one to go.
Irrigate to make sure there's
no retained foreign bodies.
Now this one is deep.
[TENSE MUSIC]
Yeah. Yeah.
- Okay.
- All right.
It's out.
All right, good job.
- [COUGHING]
- All right, let's get him a
Oh!
Is that what I think it is?
That is his lung.
♪
Eviscerated lung. I've read about them.
Multiple rib fractures
created instability
in the chest, allowed the lung
to herniate through the chest wall.
Pressure from his cough
forced it through the opening.
So what's our plan of attack,
Ms. Howard?
Immediate surgery to reduce the lung
and reconstruct the chest wall.
Yes.
And what else?
Um
His EKG showed low-voltage
conduction disturbances.
He has a weakened heart muscle.
Before he gets anesthesia,
it's a good idea to make sure
it doesn't kill him.
Right, of course.
Let's page Dr. Hayes for a
cardiothoracic consult before surgery.
[SOFT DRAMATIC MUSIC]
- She's had enough hand-holding.
- Oh, please, I get it.
Yeah, yeah, but what concerns me
is that you're getting
into her head too much.
I hope I am.
Naomi has to learn not
to buckle under pressure,
or she's gonna spend her entire
career threading catheters.
Naomi's going to match very soon.
I want to make sure she's ready.
♪
[CHUCKLES]
You finally getting
that first cup of coffee?
- Yep.
- [BOTH CHUCKLE]
Hey, look, um
I wanted to ask you or just, uh,
make sure that we're
we're okay, I mean, after
that whatever happened,
or rather, didn't happen last night.
Yeah, of course.
It was just a weird moment, I think.
Yes, definitely.
Um, so you have your
you got your your custody
hearing this afternoon.
How you doing with that?
Yeah, I'm gonna leave here in an hour.
I'm gonna go change and head over.
I gotta find a perfect outfit
that says I am capable
of caring for my child.
Please don't do that to yourself.
How can I not?
Carl's lawyer, she's
she's going after me.
She's got a child psychologist.
She's got an expert in self-harm.
[SOFT APPREHENSIVE MUSIC]
She's even got somebody
from the psych ward coming in.
From here? From Gaffney?
Yeah, Dr. Nemic. Do you know him?
Yeah.
Good doc.
I mean, at least he'll he'll
play it straight, you know?
But can I just give you
a little piece of advice,
if you'll allow me?
Just try and stay out of,
oh, what are they gonna do?
What are they not gonna do, you know,
and focus on the stuff
that you can control.
Yeah, well, that's the thing.
I don't feel like
I can control anything.
Looks like he has an underlying
constrictive cardiomyopathy.
- Thank you, Doris.
- Thank you, Dr. Hayes.
Repairing his heart is my priority.
Let's get him upstairs ASAP.
Respectfully, I disagree.
Oh?
We have to repair
the exposed lung first.
Every second we wait increases
his risk of deadly infection.
I hear you, Dr. Lenox, but
there's significant thickening
of the pericardium.
It's impeding perfusion.
A repaired lung is not gonna
do much good if his heart
gives out on the table.
Well, what if we take
a thoracoscopic approach,
fix the heart and lung simultaneously?
Bold but riskier approach.
But we could limit his time
under anesthesia,
which minimizes the risk of a stroke
and cardiac arrest during surgery.
Interesting.
But we'd have to drop the
left lung to reach the heart.
If there's an air leak on the right,
we won't be able to ventilate.
He dies on the table.
Well, I'm not concerned about that.
We can protect the eviscerated
lung and secure the opening.
I'll have my team prep the OR.
Excellent idea, Ms. Howard.
Would you like to scrub in with us?
- That would be amazing.
- Great.
See you both up there.
[SOFT TENSE MUSIC]
♪
What you have is called
an ectopic pregnancy.
I'm pregnant?
Not in the traditional sense.
See, your egg became fertilized
in the fallopian tube,
which is normal, but it got stuck there,
and it never traveled to the uterus.
That's what's causing
your abdomen and back pain.
But if the tube ruptured,
it could quickly turn life-threatening.
Well, what happens now?
Now we need to remove the pregnancy.
Fortunately, this is a routine
laparoscopic procedure,
and you'll be back
on your feet in a week.
Eva, your fiancé just
checked into the waiting room.
Can I let him come in?
He can't know.
I can't tell him
if you don't want me to,
but wouldn't he want to know?
It's not his.
Please. He'll leave me.
♪
- Sharon?
- Yeah?
- You got a minute?
- Of course. What's up?
I got a patient that was brought in
from a state dementia care
facility with a hand injury.
Nothing serious, but I've been
slow playing his treatment.
So what's your concern?
He's underweight, hasn't bathed.
And I was checking out
his medication history,
and it's all over the place.
They had him on statins
and took him off.
And then they had him on levothyroxine,
and they discontinued that too.
So you think it's neglect?
Yes.
These facilities can be dumping grounds
for insurance companies.
Well, what about family, friends?
No family, and I checked out
last-known address,
and no one's heard of Martin.
He must have been a bit of a shut-in.
So you want to know if we should report?
I don't want to sound
the alarm unnecessarily,
but I can't help but feeling
that Martin's trying to tell me
something important but can't.
You know, Bert exhales
and groans a little
when he doesn't like something
and can't find the words.
Dementia patients have small signs
that are language
that we have to understand.
You need more time to know Martin's.
- All right, what have we got?
- 34-year-old male.
GCS 12.
Hypotensive with an oxygen level of 90.
Came home drunk last night
and passed out.
When his wife tried to
wake him up this morning,
he could barely keep his eyes open.
- Oxygen's down to 88.
- Please help him.
Did he take anything unusual?
A new medication that doesn't
mix well with alcohol?
I don't know.
He went out last night
to meet some friends.
He's got some bruising here on the ribs.
Did he say how that happened?
He mentioned falling down stairs, but
You think he got into a fight?
I love him, but he's a hothead.
Stethoscope?
When did he start having
difficulty breathing?
In the car on the way here.
Okay, let's intubate.
20 of etomidate, 100 of sux.
On it.
[MONITOR BEEPING]
[TENSE MUSIC]
Where's that smart mouth now?
Meds are in.
Ripley? You cool?
Yeah.
All good.
♪
Oxygen at 94 and climbing.
No free fluid in his abdomen.
No sign of any traumatic injury.
Maybe it's a retroperitoneal bleed.
His kidneys look normal
in the ultrasound.
Yeah, but if he took a flank shot,
there's a possibility it could
have opened a slow bleed
that wouldn't necessarily
show up on a scan right away.
Fair call.
Graysen, let's order a C
of his posterior abdomen and pelvis,
- and then we'll go from there.
- Copy.
Okay.
Thanks for the assist.
Yeah.
Keep me in the loop.
I can't believe you called
protective services.
It's my job to ensure that all patients
are properly cared for.
Well, it's a colossal waste of time.
Well, I'm sorry I held you up.
[SIGHS] Not this again.
Martin, lift your feet.
Where did I go?
Come on, Martin, we gotta go home.
Wait, stop.
It's okay, Martin.
Why don't you come with me?
[SUSPENSEFUL MUSIC]
Where am I?
You don't see yourself.
Where did I go?
Bri, you said that
Martin would get upset
every time you turned the TV off?
That's right. He'd freak out.
Didn't want to miss his game shows.
- What would he say?
- Same thing as now.
Where am I? Where did I go?
Over and over.
He wasn't upset you turned the TV off.
He was upset at his own
reflection on the empty screen.
Okay, Martin.
Why don't you sit down?
Okay.
I am not discharging him.
Stay put.
You were right.
Slow bleed from the right kidney
that's leaking into
the perinephric space.
I didn't want to be right.
I'm giving him
a couple of units of blood.
I already spoke to trauma,
and once an OR is available,
I'm gonna get him upstairs for surgery.
You want to remove his kidney?
Well, I'm afraid we have no choice.
Well, we could take him to
angio and embolize the bleed.
I wish we could, but it looks like
the bleed's coming off the vena cava,
so kidney has to come out.
I'd go more conservative.
Look, this is a young guy
who got in a fight.
I'd rather I'd rather he
didn't have to lose a kidney
over one bad decision.
So I'm just sort of surprised
that you want to embolize
when he came in hypotensive.
We'd be risking his life for
Neither of us want that, obviously.
But I'm surprised you jumped
to such an extreme measure
when there are other options
that don't involve removing a kidney.
He'll still have another one,
and we're not talking about
a lifetime on dialysis here.
[SIGHS]
Dude, are you okay?
Don't worry about me.
Just cancel the OR.
Schedule the embolization.
[SCOFFS] Okay, so you're
just pulling rank, then?
Yeah, I guess so.
[FAUCET WHOOSHING]
I feel like you're angry with me.
I disagree with you.
There's a difference.
You think I overstepped with Dr. Hayes?
I think you blurted out the
first idea that came to mind
to impress a world-renowned
cardiothoracic surgeon.
No, I actually believe in this approach.
But did you think it through first?
Because I see endless
potential for error.
And when it comes to surgery,
you have to think three steps ahead.
You told me to find my voice,
to speak my mind.
Now I have, and you're still unhappy?
- So which is it?
- It's both.
You have to pick your moments
because everything
you do between now and match day
can have a significant impact
on your career.
I'm sorry you're angry
he preferred my idea to yours
That's not what this is about.
Are you sure?
- Yes.
- [SCOFFS]
Dr. Hayes liked your idea,
and I know that feels good.
But if this surgery goes south,
the only thing he's going
to remember is the failure.
And he won't punish himself for that.
He will punish you.
And all your match
opportunities will vanish.
And then where will you be?
I'm a big girl.
[TENSE MUSIC]
OR is prepped. Is the patient ready?
What's up?
I think it might be best
if I sit this out.
May I ask why?
I'm not on board with the surgical plan.
You still object
to deflating the good lung
in order to reach the heart?
Yes.
And if he crumps, his trauma injuries
prevent us from administering
heparin to put him on bypass.
I don't want my doubts to
negatively impact the outcome.
Understood.
Ms. Howard and I will take it from here.
♪
And to be clear,
you don't feel that Penny
is safe with your wife?
No, I don't.
And why is that?
Jackie's been prone
to depression for years,
and it got a lot worse leading
up to her suicide attempt.
Look, I don't want to be here
trying to take custody
away from my wife.
That's Penny's mother.
This is killing me.
Then why are you doing it?
[TENSE MUSIC]
I don't feel I have a choice.
I've seen my wife go to a place
where she can't see anything
else but her own pain.
And God forbid,
if she chose to do something
to herself again and hurt Penny,
I'd never forgive myself.
[MONITOR BEEPING]
Hi, Eva.
So I'd like to go over your
procedure again with you.
I will make a small incision
near your navel,
and from there, I will go in and remove
the ectopic pregnancy and
the affected fallopian tube.
Okay, we're gonna give you
a little bit of Versed
to take some of the edge off
before going to the OR, okay?
Yeah. Okay.
Do you think I'm a horrible person?
No.
I love Caleb so much.
He helped get me on the path.
I just can't stand the thought
of disappointing him.
My eyelids feel so heavy.
Yeah, that's the Versed kicking in.
[BOTH CHUCKLE]
I just
I never meant for any of this to happen.
I told him. I told him not to.
I said no.
Please, no, no, no.
Please stop.
Don't do this.
It hurts.
♪
I'm through the pleura.
Marty, can we drop
the left lung, please?
On it.
Lung's deflated.
Vitals holding steady.
Perfect. You're doing fine, Ms. Howard.
Just keep holding
that angle on the scope.
I'll cut the scar tissue away,
and then we can reduce the lung
and reconstruct the chest wall.
Sound like a good plan to you?
Yes, Dr. Hayes.
You got benched?
I benched myself.
Why is that?
Dr. Hayes and I couldn't reach consensus
on a surgical approach,
so I thought it best to remove myself.
Sure.
I'm gonna go out on a limb and say
that the Caitlin Lenox
that I've dealt with
would never just remove herself.
This is about Naomi.
A thoracoscopic dual repair
seems like an impressive pull
for a med student,
especially when it was
said medical student's idea.
Oh, and you're worried
that it would backfire?
I tried to throw her a life jacket,
and she accused me of jealousy.
Oh, I see.
It was disrespectful and reckless.
Neither of us should throw stones
on that particular point.
But she stood up to you.
I would call that progress.
[PENSIVE MUSIC]
Med students take what you teach them
and eventually use it against you.
That's right, and they
become the competition,
whether we want to admit that or not.
I hate this feeling.
I did too.
Did?
Yeah, well, I learned
to love that feeling.
It means I've done my job as a mentor.
You know what?
Naomi's only in there
right now because of you.
You should be proud of that.
[ALARM BEEPING]
Sats are falling.
What do you think?
Put him on bypass.
He'll bleed out from heparin.
[BEEPING]
You prepped the femorals.
I figured I'd have it ready
in case we needed central line
access or to put him on bypass.
Impressive call.
You're thinking three steps ahead.
Well done.
♪
She's a transgender woman.
- Name is Loretta.
- Because of the dementia,
she didn't recognize her own reflection.
And you were right.
She was trying to tell you something.
Mm-hmm.
All the neighbors I contacted
from her last known address
had no idea who Martin was.
So as a last Hail Mary,
I sent them a photo.
If the name didn't ring a bell,
maybe a face would.
Mm-hmm.
One of them sent me this photo
and said that Loretta was
kind, warm, and gregarious.
Hmm.
She was getting
hormone replacement therapy.
She must have fallen behind
on her injections
when the dementia took hold.
Yeah, by the time the state took her in,
she was no longer presenting as a woman.
Mm-hmm.
And I know this is different, obviously,
but that pain in her eyes,
I recognized it.
Loretta deserves better than
the care that she's getting.
- Yeah, agreed.
- She needs the proper resources.
You know, there's a new
LGBTQ+ memory care center
that recently opened a wing
dedicated to transgender patients.
The administrator owes me a favor.
Thanks, Sharon.
I'm sorry. You were right.
I should have taken the time
to pay closer attention.
I just wish there was
something I could do.
There is something.
[TENSE MUSIC]
- He's bradying down.
- What's happening to him?
The embolization
failed to stop the bleed.
Call the OR.
No, he won't make it up there.
His heart's bottoming out.
We need to open up his chest right here
and cross-clamp the aorta.
- I'll do it.
- No, you've done enough.
What the hell are you doing?
He's hypotensive.
Heart rate's down to 32.
Please, somebody help him.
Trigger the MTP and hand me a scalpel.
I'm opening him up now.
Dr. Ripley, step aside.
I don't what's going on with you,
but you're out of line
and out of control.
- I need to do this.
- Step aside now.
- It has to be me.
- Why?
Because I did this to him!
[ALARM BLARES]
He's in asystole.
Oh, my God, do something!
Get out. You can't be here right now.
Get out. Prep.
Come on.
[ALARM BEEPING]
Scalpel.
Hold compressions.
♪
Okay, give me an aortic clamp
and prep one milligram
intracardiac epinephrine.
What is Adam O'Rourke's condition?
Right now, you should be
a little more concerned about yourself.
Please.
He's in surgery to repair the vena cava
and remove his kidney.
He's expected to make a full recovery.
Good. No, no.
Saving him does not save you.
His wife is planning to sue,
one way or another.
I'm afraid your presence in
the ED has become a liability.
Look, whatever you have to do,
I understand.
I'm suspending you without
pay effective immediately
until further notice.
There will be a formal investigation,
hearing, and judgment.
I don't intend to
fight you or the board,
to blame anyone else, or make excuses.
I I brought this on myself.
[APPREHENSIVE MUSIC]
I'm deeply sorry for the trouble
I have caused this hospital.
Full disclosure,
I'm recommending that
the board terminate you.
♪
I appreciate your honesty.
You have left me no choice, Dr. Ripley.
Just go home.
♪
Hey, Eva.
You did so good.
How are you feeling?
Good. I'm a little tired.
Where's Caleb?
He'll be here soon. I just
I wanted to talk to you
about something first.
Okay.
Eva, do you remember what you said
before you went into surgery,
right before you went under?
No, I don't remember anything.
Eva, did someone hurt you?
Please, can you get Caleb?
Nothing that we discuss in here
will ever leave this room,
unless you want it to.
Um
a few months ago,
I went to stay with
my best friend, Athena,
and her family on the lake.
Caleb wasn't there.
He had to work.
So Athena broke out the champagne
to celebrate my engagement.
And we drank some wine.
Her cousin was there.
When I went to bed,
he, uh
he came in my room, and
I told him to stop, but he wouldn't.
And I was just so drunk
that I went numb,
like I wasn't even in my body.
He raped you.
I think I'd been
sending him mixed signals.
Like, I'd been really
sweet to him all night.
Hey, hey, don't you think for a second
that being sweet justifies his behavior.
It doesn't.
This was not your fault.
You said no. End of discussion.
Yeah, I know.
I am so sorry that
this happened to you, Eva.
And I am here to help you,
however you want.
[APPREHENSIVE MUSIC]
Do you think I should tell Caleb?
♪
I think that that's up to you.
Can you be there when I tell him?
Of course, I will.
[SOBBING]
♪
Ms. Embry, your next witness.
Actually, um, sorry, Your Honor.
We might want to adjust slightly.
We're still waiting on
a representative from Gaffney,
Dr. Orson Nemic.
Um, Dr. Nemic, uh, had an emergency.
He asked me to step in. I'm Dan Charles.
I'm the, um, head of psychiatry
at Gaffney.
You're familiar with Ms. Nelson's case?
I am, Your Honor.
I'm actually the doctor
who committed her last year.
Okay.
I'm okay with it,
so long as both sides agree.
♪
It's fine with us.
Ms. Embry?
We're good, Your Honor.
Then please take the stand, Dr. Charles.
You placed Mrs. Nelson
on a psychiatric hold
because you considered her
a threat to herself, correct?
Yes.
That's actually a core criteria
for placing somebody on a 5150.
And in a state like that,
is someone capable
of properly considering
the health and safety
- of others around them?
- No.
And let's be crystal clear
about the state
Mrs. Nelson was in.
She was found bleeding
on the bathroom floor
after cutting herself, correct?
That's correct.
And why do you think that happened?
Well, at that point, Mrs. Nelson
had been working in the
burn unit for over 10 years.
And in my opinion, she was
suffering from severe PTSD.
Isn't PTSD a chronic,
difficult-to-treat condition?
Well, the biggest challenge
in addressing PTSD
isn't treating it.
It's getting the sufferer to acknowledge
that they need help.
And once this crisis broke
through Mrs. Nelson's denial,
she threw herself into her recovery.
She took a two-month leave of absence,
underwent intensive psychotherapy.
She's doing everything
that you're supposed to do
to prevent a relapse,
and in my opinion, anyway,
is no more of a threat
to her child than I am to mine.
A moment, Your Honor?
[WHISPERING INDISTINCTLY]
Dr. Charles, how would you describe
the nature of your relationship
with Mrs. Nelson now?
I'm sorry, I don't
understand the question.
Well, you seem to know
a lot about someone
who isn't under your direct care.
Well, we're we're colleagues.
We work together.
Friends?
In a professional context, anyway.
And are you romantically
involved with Jackie Nelson?
Objection.
Your Honor, this is
wildly inappropriate.
Isn't this your witness, counselor?
This is a replacement for my witness,
and I believe he might
have a certain bias.
Make it quick, Ms. Embry.
Dr. Charles, are you now
or have you ever been
romantically involved
- with Jackie Nelson?
- Absolutely not.
[TENSE MUSIC]
And do you have romantic
feelings for Mrs. Nelson?
No, I do not.
No more questions, Your Honor.
♪
[MONITOR BEEPING]
Ms. Howard just went downstairs,
if that's who you're looking for.
He seems to be recovering nicely.
In no small part thanks to Naomi.
As you can imagine,
I have worked with
a lot of med students.
She is one of the best
and brightest I've seen.
She speaks her mind.
And that's a testament
to your mentorship.
I appreciate that.
I appreciated your honesty today
and how you removed yourself
from a procedure
that you didn't agree with.
That is integrity.
Thank you, but you clearly
had everything under control.
Did I?
We so often discuss
and debate and consider
all possible options, but at some point,
you just got to take a leap of faith.
I don't agree.
I'm not surprised.
Faith is a roll of the dice,
and life is random enough.
So I prefer to game out
possible outcomes
and stress test the merits and dangers
and determine which is
the strongest path.
I prefer solid ground under my feet.
Can I buy you dinner, Caitlin?
You haven't been listening.
[SOFT MUSIC]
I'll see you tomorrow, Dr. Hayes.
Good night, Dr. Lenox.
Tell me what?
I, um
I wasn't being completely
honest with you earlier
about my surgery.
Okay.
Well, be honest now.
Dr. Asher didn't remove a cyst.
She removed an ectopic pregnancy.
Pregnancy?
When I was up at Athena's
cabin, her cousin, he
he came into my bed that night.
And he raped me.
Caleb, please don't hate me.
[SOFT TENSE MUSIC]
♪
[SIGHS]
I could never hate you.
I love you.
I love you too.
It's gonna be all right, Eva.
God is merciful. He forgives you.
[SNIFFLES]
And eventually,
I will too.
Eva has nothing to apologize for.
Excuse me?
She was assaulted.
She doesn't need your forgiveness.
- She needs your support.
- Dr. Asher.
There is only one judgment
that matters to me,
and it is definitely not yours.
She didn't deserve for this to happen.
She said no and was forced
against her will.
Eva?
I appreciate your support, Dr. Asher.
I really do.
But now this is between
me, Caleb, and God.
Eva, you don't
♪
Okay.
And one more thing.
There you go.
[SOFT MUSIC]
♪
[GASPS]
It's me.
[CHUCKLES]
Beautiful.
Hello, Loretta.
Great news.
The memory care center
has a bed available.
They can pick up Loretta tonight.
♪
Thank you.
Prepping for your USLME exam?
I'm making my way
through your checklist.
Good.
You did excellent work today.
Dr. Hayes was impressed with you.
And so was I.
Thank you.
Look, I'm I'm sorry for
the way I talked to you.
You were honest, and I would
never fault anyone for that.
The first time I saw you,
you diagnosed and reduced
a man's dislocated hip
in under 20 seconds.
I instantly knew
I wanted to learn from you.
And it definitely hasn't been easy.
But if it makes me the doctor you are,
I don't regret a second of it.
♪
What you did today was also badass.
- [LAUGHS]
- Thank you.
So let's get you prepped.
[KNOCKING]
- Hey.
- Hello, there.
I thought you'd like to know
that the judge granted me
joint custody and full parental rights.
- Congratulations.
- Thank you.
And, um, sorry it got so personal.
Hey, at least we got that
stuff figured out this morning.
Yeah, except I lied.
- How do you mean?
- I was embarrassed.
And, um,
I'm just not gonna pretend like
there's not something here.
Yeah, me, neither.
But you know what?
I'm not so sure that this
is a really good idea
for me right now.
Why not?
Nemic didn't have an emergency today.
I cooked up an excuse for him
to stay at the hospital
and sped over to the courtroom
and jumped up on the stand
and perjured myself.
I'm really worried that
this is not starting out
in a very healthy place for me.
Daniel.
Look, something that
I've come to realize is that
when it comes to the relationships
that really matter to me,
I'm just not very good
at figuring out where, you know,
the shrink ends and I begin.
- [SCOFFS]
- Wow.
You're so full of it, you know that?
It's not that you can't
turn the shrink off.
It's that you don't want to
because you like it
because it keeps you in control.
I'm not so sure you're right about that.
You know, Daniel,
you deserve to be happy.
- I know I do.
- No, you don't.
But I sincerely hope someday you do.
[DOOR SLAMS]
♪
Goodwin suspended you?
Hannah, I
Don't.
I swear to you.
I wasn't looking for a fight.
This guy, he just
he wanted trouble.
And you just gave it to him?
If I'm trying to walk away
and someone throws a punch,
I'm gonna defend myself, yeah.
Anyone would.
[APPREHENSIVE MUSIC]
You don't
you don't see the irony at all.
Irony?
What what irony?
A few months ago, you were
accused of assaulting Pavel.
- Falsely accused.
- That's right.
And now you're back here again.
Except this time, you did it.
♪
I think that's incredibly unfair
You nearly killed a man.
But I I helped save him. I fixed it.
Really? That's your takeaway? That's
I don't even know what
to say to you anymore.
Or why you are so hell bent
on throwing this life away
that you fought so hard to have.
♪