The Elephant in the Room (2020) - full transcript

- Oh yes it's gonna
be another beautiful day.

Fortunately it looks
like we've gotten

through that
tremendous heat wave

with cooler temps expected this
afternoon into the evening.

And overnights are
gonna be downright cold

with highs expected in the
upper 60s until morning.

Right now traffic is
moving along fairly well

although if you're headed
south to Manhattan Beach

and beyond, you'll
wanna give yourself

plenty of additional
time due to an overturned

tractor trailer at the
number three and four lanes



at the 405 at El Segundo.

Cool, right, let's get back to

- To the rock
and roll retrospective

at Chanley Center where 10
of your favorite bands...

- Hey, learn to drive, asshole!

- Dr. Crawford,
please call reception.

Dr. Crawford, call
reception please.

- Thomas, go long.

Nice catch, going all state!

- Ah, jeez.

- Clinic Services,
St. Mary's Hospital.

- Dr. Chin, Dr. Chin

to the fourth floor
pediatric unit.

Dr. Chin, you're wanted on the
fourth floor pediatric unit.



- Good morning everyone.

First we have two new supportive
carefellows joining us.

Dr. Josh Little, a
pediatrician from UCLA.

And Dr. Adam Styfan, an
oncologist from Nebraska.

Let's start with introductions.

I am Dr. David Olson, the chair

of the Supportive
Care Department.

- Good morning, I'm Alex,
the Pharmacist for this unit.

- And I'm Anna, I'm
the neurologist.

- I'm Michael.

And it is definitely
not a good morning.

But I'm still a Nurse
Practitioner of the group.

I was up late.

- So my name's Valerie

and I'm the social
worker for the team.

And also the babysitter
for this guy.

- And for that we are
eternally grateful.

- Hi, I'm Nicole.

I'm the Chaplain for the group

and welcome to both of you.

- Good morning, I'm Astrid,

I'm the Psychiatrist
for our team.

- Wait a minute.

Did you say Little and Styfan?

How cool is that?

You should be urologists.

Get it?

Right, okay.

- On that note, good morning.

It's time to get started.

The meeting today will be
run by Dr. Astrid Adams.

- Thank you.

Welcome everyone to a new day.

I'd like to begin with
a little meditation,

taking a moment to clear
our heads and recharge.

I'd like to invite you
to close your eyes.

Don't talk.

And just let go of work
for the next three minutes.

Okay.

- Mhmm.

- All right, we will get started

with some general announcements.

We still need volunteers
to help with the survivor

celebration that's coming up.

And sadly, last night we lost

dear Mrs. Debra Urland.

Next on the list is
Danny Sorensen, age five.

- Danny's cancer is
rapidly progressing.

And he is experiencing
difficulty

breathing, severe headaches.

I'm worried about a seizure
or sudden head bleed

that can't be stopped.

Sadly I think we only
have hours to days left.

- Danny came to us originally to

be part of a phase
one clinical trial.

And he wasn't eligible.

So it was decided that he
would go home in hospice.

But his condition, it started
to deteriorate pretty quickly.

It wasn't safe to
transport him home

so we've decided to do
hospice here at the hospital

and let him spend the
remainder of his time

here under our care
with his mother.

- April has requested
that we make Danny's time

as special as possible.

So we've decided to
throw him a pajama party.

- All right.
- Nice.

- Yeah.

- Understandably, April
is grieving right now.

The best thing that we
can do for her as a team

is to be there with our
presence and our compassion.

- And please, always remember.

- The door is always open.

- Thank you very much.

Michael.

- Yeah?

- Would you take the
responsibility of introducing

our urol, excuse me,

Josh and Adam to meet Danny.

- Yes sir.

- Thank you, Michael.

- Hey, you let me know if
you need any help, okay?

- Okay.
- All right.

I gotta run.

I have a new consult
in the clinic.

- Let's meet up.

- I'd like to go up
to the third floor.

There's two patients up
there that I wanna see.

- Gentlemen.

- Alex, maybe you can go over
the comfort care medication.

- Sure, I can do that.

I'm just sorry I'm
not important enough

for everybody to stay.

- Aw, poor Alex.

Buddy, you know I love you.

But listen, I'm late for clinic.

Tell you what, I'll bring

makeup marshmallow
treats tomorrow

just to prove it to you.

- You better use
real marshmallows.

- No, use the whip.

Use the cream, use the
cream, use the cream.

- Dr. David
Olson, Dr. David Olson,

you're needed in clinic 7B.

Dr. David Olson to clinic 7B.

- Hi.

I'm Michael, the
Nurse Practitioner

with the Supportive Care Team.

- Hi, I'm Kelly Davis.

This is my father-in-law Oscar.

- Oscar.
- Pleased to meet you.

- What the hell are you doing?

- He's alive!

I'm sorry that you're in pain.

And you have every
right to be angry.

- What would you know about it?

- You're right.

I could never
really know what you

and your family
are going through.

But I know that everything
in your life has changed.

And you're in pain.

I wanna help get your
pain under control.

The problem is, pain
can be pretty complex.

Controlling pain, it's more
than just about giving drugs.

It's about me
getting to know you

and learning what's
important to you,

what your goals are.

And if you can beat me
in a wheelchair race.

How about we start over.

Hi, I'm Michael.

Are you gonna shake my hand

or should I just wave?

- I'm Cooper.

And I can already tell

you're gonna be
a pain in my ass.

- Don't worry, I
can fix that too.

- I'm so sorry this is
happening to you and Danny.

But you know what?

You're showing an amazing
amount of courage.

- He's being so brave.

I just don't want
him to see me upset.

I'm just not ready to lose him.

I don't know what else to do.

- You're doing everything
you're supposed

to be doing as a mother.

And now, we're gonna focus
on celebrating his life.

Let me get things ready
for the pajama party.

- Cooper's pain is
in his lower back

and it's pretty severe.

He can barely walk
and he can't sleep.

We are really
hoping you can help.

- Listen, I wish
that I could just

make this nightmare go
away for all of you.

Here's the plan.

I get you out of
pain, and we race.

Deal?

- You got a deal.

- All
those participating
in the pajama party

for young Danny Sorensen,

the party starts as 11 a.m.

- I love these pajamas.

Monkey ones, huh?

My girls would love these.

You look so alert today.

Does he know what
we're planning?

- Yeah, he knows.

I had to tell him earlier.

He was in so much pain.

I felt he needed a distraction.

- Okay.

- Let's show Valerie
your new look, okay?

- Oh my god, let me see you.

Look at you, you
cool little dude,

give me a high five!

Yay!

Let me go change, all right?

I'll be right back.

I've gotta go find
Michael too, okay?

- Okay.
- Okay.

- Dr. Frederick
Martin, Dr. Frederick Martin,

you have a visitor at reception.

- You guys look so awesome.

Thank you so much
for doing this.

Let me go get changed.

Okay, I've got the
whole floor in pajamas.

Everyone should be
here in just a sec.

- Huh, see?

This is what our
job is all about.

- Danny, Danny, what's wrong?

Oh no, someone please!
- What's wrong, April?

Come over here.

Let's let the doctor check him.

It's all right.

Come on, take a seat.

- And he was
doing so well today.

- It's okay, we've been here.

- Should I
order a Dilaudid IV push?

- No, hold off on that.

- Take a breath.

I know he was doing
well, but remember,

- He's declining very fast.

He doesn't have much left.

- I'm holding
on, I'm right here.

Right here is comfortable.

Right here.

- April.

Would you like to hold
Danny one more time?

- You said you wanted to.

It's time.

Now it's up to you, okay?

Take a breath.

April.

Your sweet little
Danny has died.

I'm so sorry.

- I can't stand
the thought of him

being carried out on a gurney.

Can I please just
carry him myself?

- Absolutely.

I will arrange that.

- I know this is tough, guys.

Everyone did the
best they could.

Danny's cancer was
just too aggressive.

We need to focus on
the difference you made

for Danny and his mom

during his last few days.

- Michael, you'd be a
little more convincing

if you weren't
wearing that sleeper.

- Ooh.

- Don't be ridiculous.

I do have clothes
on underneath this.

- I just didn't say how much.

- Thank you.

- Thanks Michael, we
needed that.

- Hey girls, do your homework

and listen to your Dad, please.

I've gotta go back
to the hospital.

Shit.

- Honey, honey.

What's wrong?

Oh.

Honey, he's not worth it.

- Would Gloria Desouza

please pick up the
courtesy phone.

Gloria Desouza please pick
up the courtesy phone.

- Well hello, Michael.

- Hello, Anna, I'm
so glad you're here.

Listen, I have Cooper
Davis on his way in

with pain out of control and

I was wondering if
you could see him

on counsel for me please?

- You sound really desperate.

- Yeah.
- Yeah.

Sure, I'll take a look at him.

- Thank you.

- You're welcome.

But it's gonna cost you.

- Okay.

- Mhmm.
- All right.

There will be a
steak dinner in it

and a show.

Your choice.

Oh and some cold beer.

- Ooh, yes.

- And me, I'll be there.

What do you say?

- So are the red footie
sleepers optional?

- Okay, thank you.

Obviously she heard
about the pajama party.

- Obviously, and I
think it's really sweet.

It's all these nurses
can talk about.

- Yeah well, I mean enough
about my jammy prowess.

- I'm on call, so I
can take a look at him

and I'll update you
tomorrow morning.

- Perfect.

One more thing.

You better be careful.

This could get serious.

- Do you want me to call HR?

- Marshmallow treats for all.

Help yourselves.

- What?

- Oh my god.

- What's this mess?

I thought it was
supposed to be homemade.

- Okay everyone.

It's time to start our
pre-meeting meditation.

If everyone could sit
down and settle in.

Research shows
that three minutes

is the minimum amount
of time it takes

to reset your minds

which allows us to be
holistically present

for our patients
and their families

and one another.

So, with that,
welcome to a new day.

I invite you to close your eyes.

No talking.

Let yourself be free from work

and any other stresses.

Thank you.

- Thank you, Astrid.

- Okay.

So the next case

on our agenda here

is... - It's Cooper.

Oh, darn, I have to go.

Hey, I did not plan this.

- Okay, that's fine, great.

- If anyone is wounded,

Alex. - No Micheal, that's fine.

- I have more marshmallow
treats in my car

and I'm not afraid to use them.

- Don't worry about us, Michael.

We'll take care of
things here as always.

- Hey, Adam.

You wanna go with me?

- Excuse me, guys.

- This way, hotshot.

Look, I know this
program can be rough

but I wanna show you
how we can really

compliment each other.

Oh, hey.

Psst, Thomas!

- Oh, son of a!

Jeez, dammit, sorry Michael.

This damn thing
just won't stay put.

- I don't think you should
swear while holding Mary.

Let's go.

We're still broom
buddies, for now.

This is Dr. Styfan,
a urol, oncologist

working with me today.

- Does that mean I'm so
bad I need two of you?

- No, actually we're
combining forces.

- Hey, what's going on?

- The pain in my right
groin is horrible.

I can't stand it!

- Hi, this is Michael.

I just entered a now
order for Dilaudid IV

to be given to Cooper
Davis in room six.

Will you please meet me in here?

Would you call Dr. Dracos
and fill him in on Cooper?

Thanks.

We're gonna move
over to the bed.

Could you hold that. - My god.

- There we go.

Big hug.

There we go, I got you.

- That should do.

- I just love the effect
I have on my patients.

- It just breaks
my heart to see him

go through so much pain.

I hate this.

- I know.

Well listen, Cooper, he's
comfortable now, okay?

I'm gonna ask the nurse
to keep an eye on you two

while I go speak with Anna.

- Thank you.

- Sweet dreams.

This is Michael.

- Hey Michael, I have
the MRI results for Cooper

and they are not good.

He has multiple compression
fractures of his spine

and a mass that looks
like it has gotten

into his spinal cord fluid.

Cooper needs surgery right away.

We confirm this in surgery,

his life expectancy is going
to be about three months.

In the meantime he
could have a stroke,

develop seizures and have
even more excruciating pain.

- Okay, Dr. Dracos
needs to know.

Could you call him and then
meet me in Cooper's room?

- I've already
got a page in for him

and for the
neurosurgeon on call.

See you in a few minutes.

- Change of plans.

Hi, Kelly.

I'm here with the
neurologist, Dr. Crawford

and Dr. Styfan who
you've already met.

We wanted to talk with
you about Cooper's MRI.

Cooper needs surgery as
soon as we can arrange it.

His cancer has caused some
bones in his spine to break

and push down on
his spinal cord.

And we also think
that there's a tumor

growing in his spine
that needs to be removed.

Now these two problems are
what's causing Cooper's pain.

So Dr. Sun, the neurosurgeon
wants to operate

as soon as possible to
prevent any permanent damage.

Okay?

- I'm so sorry this has to
happen so quickly, Kelly.

Here I have, it's just
a surgical release
and consent form

for you so you can sign.

Dr. Sun will be
doing the surgery.

- Cooper, I know
you're listening

because you stopped snoring.

- And she will place
and implant a pain pump

if necessary or possible, so,

- Do you wanna talk about this?

- I will do anything to stop
the pain from coming back.

- That's it.

Where do I sign?

- Okay.

So generally the logistics
is just talking about

before and how properly it
should be taken care of,

constantly we need
to be monitoring.

- I just realized something.

I was just thinking

how much you remind me
of my father right now.

- What the hell?

- Now hear me out.

With a bald head and
the blotchy skin.

Yeah.

You look just like my old man.

I mean I know you're
not old enough yet.

But wow, you could be twins.

- Are you for real?

- Could you just say,

"shut the hell up, you
dumb shit!" for me?

Come on, say it.

Come on, come on.

Say it.

- Shut the hell
up, you dumb shit!

Oh god, oh!

- Brings back so many memories.

- Great.

- Why are you being so rude?

- Oh he told me so.

- He's out on an IV.

All right, room 220, got it.

I'll go take a look at him.

Thanks, Doctor.

- My cardiologist told me

I just had another heart attack.

He doesn't wanna do
any more procedures

because my heart is too weak

so I guess this is it.

- I'm so sorry that you're going

through this, Mr. Brownrigg.

- Thank you.

You guys can call me Thomas.

We bonded.

The three of us, we
survived the near disaster

with my Mary statue.

- How long have you
been working here

at St. Mary's?

- Oh I've been in housekeeping

doing floorwork for
about two years.

I do it just to feel useful.

See, after my wife died,

I didn't want to just
wait around for my turn.

We were married for 35 years.

- So do you have
a designated will,

do you got someone to take
care of you if you can't?

I'm sorry, Thomas.

What Dr. Styfan means is
do you have any family

in the area that
can be here for you?

- Oh, I have a good friend.

His name is Louis.

He lives in town here.

I don't really have
anyone I'm close to

except for that Mary statue.

I guess I didn't let anyone
get too close, you know?

I mean my work filled the gaps.

Coworkers, the
wonderful staff here.

And the recent...

- Thomas, I'm sorry.

I need to go check on something.

Dr. Styfan will continue
with a few more questions

if you're up for it.

- Thomas, I wanna make
sure that you understand

what is happening to your heart.

- I'm dying.

My heart has had enough.

- Unfortunately you are right.

Thomas, your heart
is very tired.

And this latest attack
has got your heart

working even harder.

And we don't know how long
it will continue beating.

Now if it stops, we can
get it started again.

You know, with electrical
shocks, pushing on your chest,

and or medicine.

But it won't change the
fact how sick your heart is.

- Well if it's so sick,

why would you even bother?

- Well some people
just need more time.

But ultimately,
you need to tell us

what is important to you.

- Please call reception.

Dr. Crawford, call
reception please.

- Well being kept
alive on machines

is not my idea of living.

- Honestly, I would
like to see you take

what energy you have left

and spend it enjoying your life.

- Coming through,
watch out, heads up.

Ooh, this statue is heavy.

How in the world were
you able to catch it?

One, two, three.

Oh.

I think you need
Mary to be with you.

I'm sure she would
miss your attention.

Thomas, do you
need anything else?

- Dr. Styfan and
I had a good talk.

I would like to be
kept comfortable.

I don't want any machines.

You know I just wish there
was someway I could go home.

- Listen, I'm glad that
you were able to talk.

Now tell you what, I'll
notify your cardiologist,

I'll ring in some orders

and I'll see what I can do
about getting you out of here.

Okay?

In the meantime,

I'm going to ask the
nurses to medicate you

if you have any
pain or discomfort.

And I'd like to stop
all blood draws.

I'm also going to ask the nurses

to reposition you
only if you request.

And to let you eat
anything you want.

And the statue of
Mary is to be left

at Thomas Brownrigg's bedside.

Anyone wishing to
remove the statue

must contact Dr. Adam Styfan
for permission.

- So we can meet with
Barbara Shelley at three?

- Yeah, three to four.

- You asshole.

- Dad?

Oh, why Dr. Styfan.

Whatever could be the problem?

- The problem is you.

I got 12 phone calls
from nursing supervisors

and security personnel
insisting that I

bring back the statue of Mary?

They weren't buying
that a statue

was providing comfort
to a dying man.

I tried to convince
them that the statue

looked like Thomas' dead wife.

Then I went with he was lonely.

I even tried to
say that the statue

was a part of Thomas'
legacy where nothing worked.

I had to come back in, sleep
next to the statue of Mary

while reassuring
Thomas that no one

was going to touch her.

I don't think the nurses
like me very much.

- I wanna thank
you Adam, for a job

very excellently done.

Why don't you go home
now and get some sleep?

I'll take care of
things from here.

- Hey, Adam.

Wait up.

- Okay.

- You finally got this.

You finally got it.

He's a keeper.

Mr. Thomas Brownrigg
is a 68 year old male

with end stage cardiac disease.

He's a widow of two years.

Thomas works at St.
Mary's in housekeeping.

He is comfort measures only.

Thomas is very weak and
unable to care for himself.

- What do you think
of my cool commode?

- It is not a commode,
it's a wheelchair

so don't pee in
it, but I like it.

- Eh, wheelchair,
commode, same thing.

Ooh, ooh.

- What?

Ooh, yes, very intimidating.

Mhmm, very scary.

- Something tells
me I've been set up.

- Yeah, hey!

Oh, Michael, that's a nice ride.

You really went all out.

Nice balloons.

- These are supposed
to be gears.

- Look like balloons to me.

- These are my brakes.

- You know, I'm actually
a little nervous.

I think there's a good chance
you could beat my time.

- Okay.

- If I give you a
two hour head start!

- Okay!

Where are you going?

- You're in
trouble now, Michael.

Catch me if you can!

- Coop, wait up!

Get over here, you gotta
let me see this thing.

- It's been a long time since
I've seen him be this happy.

- You better get up.

You better get
Michael some oxygen.

Great teamwork, Dad.

I do believe that's mine.

- I surrender, sir.

- Yes!

Victory is mine!

- Hey, I gotta get
back to the meeting.

So, why don't you
stay, hang out,

take a ride on the chair
and I'll cover for you?

- Yeah?

- Yeah.

- You're the best.

I'll be there in a few minutes.

- Okay, yeah.

I'll see you, behave yourself,

bye bye. - Cooper!

I can stay!

- Thank you for taking the time

to join us, Michael.

- I have a good
excuse for being late.

I was actually busy getting
humiliated by Cooper.

I mean, you should have seen it.

It was amazing how
the race challenge

actually helped Cooper's morale.

He was just so
glowing with pride

when he showed this outrageous
machine to me, just,

I wasn't actually crazy
about my humiliation part.

- We all need to make
sacrifices, Michael.

I'm glad to hear Cooper
has recovered enough

from his surgery
to be more active.

I take it the pain
pump is working well.

I just hope we can
keep him out of pain

for a while longer.

Now is a good time to
have a goals of care

conversation with
him and his family.

- Yes, Michael I hate to
say this right now but

we have to be realistic
about where Cooper is.

- Michael, she's right.

We can't wait too long.

It's time.

- All right, I'll help
set up the family meeting.

- Okay.

- Thank you, sir.

- Thank you, Michael.

- Thank you everyone,
for coming today.

I think we all know each other,

so I'm gonna dispense
with introductions.

We're here today to talk
about how to support Cooper

and his family.

And we wanna establish
a good understanding

of what your values and
your wishes are, okay?

- First I wanna thank
all of you for having us.

I know it's unusual
to have the patient

come to one of these.

So I appreciate the opportunity.

So I'm dying.

You see, I know I'm dying.

I know my time is limited.

The cancer has gotten
into my spinal cord fluid.

- As your body becomes weaker,

we need to know, Cooper,

how aggressive
you want us to be.

- I don't wanna be kept
alive artificially.

I don't want machines, I
don't want feeding tubes.

I just want to spend what
time I have with my family,

and to have help
controlling the pain.

- What if the only way we
have of controlling your pain

is to keep you
sedated all the time?

You wouldn't be able to
interact with your family.

- I can't interact with them now

if I'm screaming and
writhing in pain.

So if it comes to that point,

then yes, I wanna be medicated.

- What we've described is
called palliative sedation.

We're not gonna
deeply sedate you

until all other pain medication
options are ineffective.

Cooper, once we do
deeply sedate you,

you won't be able to
eat or drink anymore.

- Cooper, this is true for all
patients who become this ill.

But this can be
especially hard on family.

So it's really important
that we help you

understand this process.

And that we know that
you're really making

the choice that you want here.

This is not the
route we wanna go

but we wanna make sure
that you're all informed.

- Actually, my greatest desire

is to have another
wheelchair race with Michael

so I can kick his ass again.

- I'd pay 20 bucks
to watch that.

- All I really
want is to go home

and be with my family.

- Dr. Melvin, please report

to the Trauma Center.

Dr. Melvin, you're requested
in the Trauma Center.

- Come on now!

Kablooey!

Dead man wheeling here!

- Hey, thank you Coop.

I needed that.

Let's go.

- Look out!

- Would a
valet operator please meet

a patient at the front entrance.

A valet operator to the
front entrance please.

- I think Cooper's cancer

is just progressing too rapidly.

Now it's starting to
get a little rough.

- Michael, I
know this is tough for you

but I know you're gonna
do the right thing.

- Hey guys.

So what's up?

- Dr. Roberts and I want
to check your pain pump.

And Valerie's here
to keep an eye on us.

This programmer has a
scanner attached to a cord

that is placed over
your pump reservoir

implanted under your skin.

The scanner can access
data from the pump,

print it out on the
programmer screen

and allow me to change
settings if I need to.

Now, pull up your gown.

- Aw, aren't you gonna at
least buy me dinner first?

You're doing one
hell of a job, Doc.

But could you speed it up a bit?

I'm kinda naked here.

- This is great.

Someone's finally giving
Michael a hard time.

- Let's pump up the
Dilaudid to five.

Everything else is maxed out.

- Just fix this here for you.

- Oh, that's real professional.

They teach you that
in nursing school?

Oh please, allow me to fix it.

I don't mind being abused.

I'm only dying here!

- Sorry I'm gonna miss
the rest of the show

but I have to get this.

- Sorry, Coop.

I know, I'm not acting
like my usual self lately.

Is there anything else
that you wanna talk about?

- Just try to keep me out
of pain as much as possible.

I don't want my family
to be any more upset

than they already are.

- We're hoping that the pain
pump will continue to work.

And you know if it doesn't,

unfortunately we're looking
at the deeper sedation

that we talked about.

- I know.

Just help them get through it.

- I will.

- Just help me get through
it with minimal pain

and support my family.

That's all I'm asking.

Well, maybe not all.

Actually, there
is one more thing.

- Anything, Coop.

You know I'll help
any way I can.

- I need you to
promise me, Michael.

I need you to promise that
when this thing happens,

you'll do something for me.

- Consider it done.

- I want you to sing to me!

- Oh man, I
walked right into that.

- Yes you did, buddy.

- A little birdy told me

that you used to sing in a band.

Heard you were pretty good too.

And I hope you know the
words to the theme song

from The Flinstones.

'Cause that's my favorite.

Yabba dabba do!

- Oh is that a picture of
the whole family there?

- Hey!

Patient abuse!

Come on!

Hey Doctor Dumbshit.

You working all night again?

- It's just starting
to roll off your tongue

a little too easy.

Actually, no, I'm
just on my way home.

Why, do you need me
to come tuck you in

and sing to you?

- Let me have a slice.

- I don't have...
- Come on, one slice.

And I promise to
keep my lips sealed

about you having the
hots for Dr. Crawford.

- What?

That's ridiculous.

I don't, where
did you hear that?

- Look, I may be sick
but I'm not blind.

Don't worry, I'll put
in a good word for ya.

Come on.

- The things I do.

- Mmm, mmm, mmm.

Listen, Romeo.

Life's a lot shorter
than you think.

Trust me, I know.

You spend all your time
here at the hospital

mainly just bothering me.

You need to make time
for something else.

Take it from me.

If you're lucky enough to
find that special someone

who supports you and loves you,

don't hold back.

Make the most of every
minute you have together.

Be a man!

Don't be afraid to
open up your heart

even if you think
there's a chance

it might get broken.

There's worse things
in this world.

- You getting all
sensitive on me now?

Okay.

I think it's time for me to go

before all my pizza's gone.

- Michael, look at me!

Go find that beautiful
girlfriend of yours

and hold on tight
and live your life

to the fullest.

Because if you don't,

then you really are a dumb shit.

- See?

Now you really do
remind me of my Dad.

- I love you too, buddy.

Now give me another slice

and get the hell outta here.

- All right.

This is Michael Lafata, NP

dictating a note to
chart on Cooper Davis.

Medical record number 34458.

Patient is a 52 year old
male with renal cancer.

Status post nephrectomy
and T5 tumor biopsy.

Confirmation of
leptomenangiomethasthesis,

on comfort measures only
with implanted pain pump.

Discharged home per patient's
request one month ago,

now at progressively
increasing right groin pain

unresponsive to
aggressive titration

of intrathecal pain pump.

Patient's wife was
advised to bring patient

into the ER for
further evaluation.

- So we're here today to
talk about what's going on.

- So as you both know,
your father is very sick

and in a lot of pain.

And the only way that we can
manage that pain right now

is just by putting
him deeply asleep,

almost like someone who's
about to have surgery.

It's the only way that we
can keep him comfortable.

- We know this is bad.

Dad warned us this could happen.

- I still feel like
everyone's giving up.

Isn't there anything
else you guys can do?

- No, there is nothing more
that we can medically do

in order to stop the
cancer that's spreading

from his spinal fluid
up into his brain.

It's causing him horrible pain.

And now we just wanna focus
on managing that pain.

- We're not giving
up on your father.

We know you care about
him deeply and love him.

And we care about
him deeply too.

- Then help him.

Don't just let him die!

- Your father has
fought so hard.

His body is tired.

This type of cancer
does not have a cure.

It will only progress and
his pain will get worse.

Right now we need to do
what is best for him.

- So what are you gonna do?

- We're going to keep
his pain pump settings

right where they are

and add an additionally IV
medication called Ativan.

The problem is, your father
will be in a deep sleep.

And he won't be able to
talk to you, eat or drink.

- And we want to make sure
everybody is comfortable

with this plan.

- So you're just
gonna kill him?!

- No, no.

Tiffany, unfortunately,
it is the cancer

that is killing your father.

This is the only thing we can do

to keep him from dying in pain.

A body cannot digest food

when someone as sick
as your father...

- Tiff!
- Tiffany!

- Tiffany.
- Tiffany!

- I got this.

- Tiffany.

- I wish there
was an easier way.

- We should get him
on the Ativan drip.

Can you order one and get the
drip hung as soon as possible?

- We can't find Tiffany,
what's going on?

- I'm not sure, he
just started writhing in pain.

- This is Michael, I need
another two milligrams

of Ativan, stat.

And please, call the pharmacy,

tell them I need the
Ativan drip right now!

- What's wrong?

What happened?

- We don't know yet.

- I believe Cooper has
had a massive stroke.

I don't know how much
time he has left.

- We gotta find Tiffany.

- I can't believe this
is finally happening.

I mean I knew it would.

I just hoped.

Oh my god, this is the
dumbest thing I've ever done.

I hope you're happy
in there, bud.

- Hey.

- You see officer, they
are killing my father.

- What's up, Michael, Valerie?

This young lady just caused
quite a scene out front.

She says you're
killing her father.

I thought the least I could
do is bring her back here.

- Thanks, Gary.

We'll take it from here.

- You two know each other?

Officer, I insist
you arrest them.

- It must be exhausting
to stay so angry.

You have so many people who
can help you through this

but you insist on
pushing them away.

All because you
need to stay angry.

- Whoah, I'm out of here.

She's all yours.

Give me a call if you need to.

- Thanks Gary.

Tell Mom I said hi.

- Great, you're all
related, perfect.

- I'm sorry I left.

I don't know what's
wrong with me.

- It's okay.

- Oh my god.

Even when Valerie's not
here, she's still bugging me.

- Go on, read it.

- Yeah.

Okay.

Don't believe the
pedestal you placed upon.

Well, that's dumb 'cause
I deserve my pedestal.

Of course now there's
a statue of Mary

bolted onto it.

A power greater than you

will determine your
patient's fate.

Yeah, usually
that's the surgeon.

Find comfort in knowing
you did your very best.

Review actions and
explore feelings daily.

I am.

I promise to stay in the present

and separate my personal issues
from what actually happened.

I haven't been
very good at that.

I promise not to fear

feelings of sadness or grief.

For it is when the
heart is broken

that it is most open
to growth and change.

What?

Who writes this stuff?

Well you know it's a good
thing I'm not suicidal.

'Cause that would have
been over with.

Michael, where are you?

Cooper just died.

Okay.

Yeah, okay, all right, okay.

- It's okay.

Hey. - Yeah.

- How can I love you
best, what can I do?

- You're doing it.

And you can give me some
pizza and some cold beer.

That's all I want.

- Sounds good.
- Right on.

I just wanna go home.

- I know.

- I'd like to order a
pizza to be delivered.

Yeah, my usual.

Thanks.

Wow.

- Hi Michael, how are you doing?

I hope you're better.

We're here for you, buddy.

Give me a call when
you feel up to it.

We love you.

You know I'm really glad
you're taking some time off.

Good for you.

I think it was a good idea.

You've dealt with
so much lately.

Call me.

- Hi, I'm calling
about that frisbee set

you had for sale.

Would you take 18
dollars instead of 20?

Or like I could go to 19.

All right let me know.

- Michael!

You jerk, pick up the phone

or I'm coming over there

and I'm gonna shove
it up your ass!

- Delivery for Michael Lafa...
- Lafata.

Yup, delete, delete.

Delete.

If only my life were that easy.

Hey, you're nasty, delete.

Hey, you're stupid, delete.

- Just don't yell at him, babe.

- Where the hell are you?

You're not the only one
going through grief.

I could have been there for you.

I could have helped you.

But no, you just go off and hide

as if nobody cares.

- Okay.

I suck at this.

I had too many days
with too little sleep.

- Look, Michael.

When Danny died,

I told myself I was done.

I was ready to walk
away from this job.

I was done.

I was thinking about
my girls too much.

And then I had to refocus

and shift and remain present

for Danny and his mom.

Do you think that
hurt any less for me?

You've gotta find something
that distracts you.

You gotta get lost in something.

You gotta find something
that gives you meaning

and purpose outside
of this kind of work.

You gotta fall in
love with something.

- Yeah, I...
- Like maybe art.

Or like journaling.

Or like music or
biking or something.

- What's with all the
doorbells and the knocking?

It smells like pizza in here.

- You dog.

Here we've been
trying to cheer you up

and you've got your own
special therapy going on.

I was gonna suggest getting
the band back together

but I see you already
found your joy.

- Anna's been so amazing
through all this.

- Thank you.

Actually I think that's
a really good idea.

I think you guys should
get the band back together.

- See, we should do it.

We should get the band
back together, man.

Rock and roll!

- You know what, it's
time for us to go.

- We could run a
couple on Saturday.

- No guys, you
do not need to leave.

You should stay.

- I gotta rescue my mom.

She's got my kids and you know,

sounds like you guys
are in good hands.

- Yeah he is.

- Come on, come on, let's go.

- No, but really,
this is really great.

And you have permission
to be in the band.

- What?

- Thanks?
- Way to go.

- Permission?

What do you mean
permission, that's so rude.

Who says that?

Come on.

Here we go.

- They're crazy.

- Let's never get married.

Mmm, thank you.

- Ah, you're welcome.

- I should have
seen that coming.

- Here you go.

- Why hello.

This is Dr. David Olson.

After the tone, please
leave a message.

- Hi, Dr. Olson, it's Michael.

Thank you for letting me
take some time off work.

Listen, I was wondering
if I could get involved

with the hospital Survivor
Celebration this year?

That's it, thank you again

and I will for sure
be back on Monday.

So if you take a
look at the program

you'll see we have some fun
things lined up for today.

This is yours if you'd like

and help yourself, find a seat.

- All right, thank you.

- You're welcome.

Hey.

- Hey.

- Thank you for helping
me with all of this.

- Yeah.

- You've been great.

Yeah I really just,

I think I lost sight of
patients that actually do well

and get better.

I don't see many of the
successes in my practice.

Or maybe it's just
I'm too focused on

the ones with complications
to even notice.

- I would like to call
upon everyone today.

- I'm really,
really, really happy

that you decided to participate.

- Yeah.

- Okay, I gotta go.

But, I will see you.

- Okay.

- Okay.

- I need one more.

Okay. - Okay.

All right, now I
really gotta go.

- May we all remember
to celebrate the journey

and honor the
special individuals

who have touched our
lives in so many ways.

Tonight we take time to reflect.

- You know, he's right.

It is all about the journey.

Remember when I got
diagnosed two years ago,

I had to remind myself
to focus on the journey

and that was what was gonna
help me get through it.

We all need to feel
loved and valued

'cause we're not
just our disease.

And the journey makes
the whole difference.

- Here to please take the time

to recognize what you are
personally grateful for.

- Your courage and your
fight that you have,

your kids, your survival.

That's my inspiration.

- It's my pleasure to
introduce the melodic stylings.

- Melodic stylings.

- Our very own Michael Lafata.

- Thank you, Dr. Olson.

I would like to thank everyone

for giving me the opportunity

to be a part of
today's celebration.

Now I'd like to perform a song

that I had the pleasure to write

with this very
special young lady.

Tiffany is the
daughter of the patient

that we just sang to,
my dear friend Cooper.

And Coop, if you're listening,

I'm proud to say
that Tiffany and I

have become really good friends.

Even though she refers
to me as Dr. Dumbshit.

I just wanna let
you guys all know

that our song is about
the compassionate work

and the involvement that a
supportive care team can provide

and the amazing people
that come into our lives.

It's called You'll
Never Be Alone.

- Yeah, Michael!