A Gifted Man (2011–2012): Season 1, Episode 3 - In Case of Discomfort - full transcript

This procedure's gonna be so cool.

Sure as hell isn't
for the faint of heart.

So, first I'll perform a laminectomy

to expose the spinal cord.

Then I'll excise the dura,
peel it back,

ever so delicately to get my
fingers around the neoplasm...

If you're trying to
get me in bed again...

it's not working.

Are you saying you don't find
surgery as exciting as I do?

Well, I do like the way your mouth
moves when you describe it.

Really?



Now, are we on or off the record?

I take my recorder everywhere.

I don't remember it last night.

Maybe I dropped it.

Do you know what's at stake
with this procedure?

(tape recorder beeps)
Tell me.

46-year-old male, two-time
New York City marathon winner.

(inhales deeply)

I succeed, he's winning races
for the rest of his life.

The knife slips... he's
in a wheelchair forever.

(tape recorder beeps)

I do trust those fingers of yours.

Mm, yeah, smart girl.

So that's my lead for my article:



"There's nothing Michael Holt
loves more than a challenge."

(chuckling):
It's what I live for.

I gotta go to work.

But I assume when that
"Top Ten Surgeons List"

comes out in your magazine...

You'll be right on top.

(Michael sighs)

Whew!

Nothing like a massive
hemangioblastoma

to kick off the day.

It was like that thing from Alien,

all octopused around his spine.
(chuckles)

Just had to show it who's boss.

You know I heard two surgeons
turned this case down

because it was such a cluster.

(laughing):
Really?

RITA:
Good morning, Michael.

Oh, you're looking happy.

You must have forgotten
about the dinner tonight.

The paralysis research?

Oh. The Fallwyck Club at 8:00,
business attire.

Pat Ross here?

He's not on the schedule.

Old buddy of mine from med school.

I told him to stop by this morning.

You don't have time for reunions.

He's an ER doc.

The city shut down his hospital.

He's looking for a job.

I told him about Clinica Sanando,

how Anna was running it when
she died and, you know...

Michael, you already
have an interview

for your ex-wife's job.

I do?

Mm-hmm. Dr. Sykora.

I don't know him.

He's a she.

Philip Romero called

and asked if I could squeeze her in.

He said he used
to be Anna's boyfriend

when she died.

Yeah, and president
of the Clinic Board.

I told him I'd find
the new medical director.

Apparently, he wants
to micromanage me.

Maybe he knows how busy you are.

Here at Holt Neuro.

Where you work.

Dr. Sykora, sorry
to keep you waiting.

I was in surgery.
Michael Holt.

Kate.
Hi.

Thanks for seeing me.
Yeah.

Sure. My pleasure.
Have a seat.

Please, please, sit, sit.

Can I get you a cup
of coffee or some water?

Uh, no. I'm good. Thank you.

All right.
You're a friend of Philip's?

(chuckling):
Not really.

We met last year at a fund-raiser

for the West Side Mission.

It's a homeless shelter
up near Columbia.

Anyway, we got to talking,
and I told Philip

that I'm looking to get back
in the trenches.

Well, Clinica Sanando
is right at the bottom of one.

So let's see what we got here...
Wash U. Med school,

family medicine residency
at UC San Diego,

family practice for five years,

VP, Community Affairs,

Glentrix Health...

It's a nonprofit of some kind?

New HMO.

I'm guessing you don't see

very many HMO patients here.

None.

So what does a VP
of Community Affairs

actually do?
Uh, well, I was

hired to implement a wellness
program for the uninsured.

It turned out to be a smoke screen.

The HMO just wanted the PR buzz,

and I spent too much time

in meetings
and not treating patients.

Well, you'll get that
in spades at the clinic.

Great.

I got to be brutally honest
with you though,

it's an uphill climb.

How steep?
Almost vertical.

Too many patients, not enough staff,

lousy equipment,

no money to replace it.

I'm surprised somebody with your
experience would want the job.

(laughs)

What?

What's so funny?

Well, that was the worst

sales pitch I've ever heard.

It's not a sales pitch.

Obviously, you have someone
else in mind for the job,

and you're trying to scare me away.

Well, I didn't mean to...
Offend me?

My time is as valuable
as yours, Dr. Holt.

And my feet hurt like hell
in these heels.

So the next time you decide
to waste someone's morning,

why don't you do everyone
a favor and just say no.

Now wait a minute.

Hope it works out
with your new medical director.

We'll call you when...
Save it, sister.

Went well, didn't it?

No good deed goes unpunished.

C-B!
Ah.

Thanks for coming.

Pat Ross, this is Rita;
she runs my life.

He can't possibly pay you enough.

Oh, I like you already.

What's the C-B stand for?

Cadaver buddy.

Nobody could cut up a corpse
like Michael here.

We were dissection
partners in Anatomy.

PAT:
He tutored me a bit.

I remember you were the only one

who could ID the ligament of Treitz.

I'll let you two to reminisce.

Thanks, Rita.
Yeah.

So, this is it.

Looks like a fixer-upper.

TAVO: Oh, Dr. Mike!
Glad you're here.

Only to give a tour.

This is Pat Ross; he's
going to replace Dr. Anna.

- Oh, today? Right on!
- Yeah.

Right. So we got a great staff,

they got three exam rooms,

you got a private office
in the back...

- Uh, who's in charge of securing funding?
- You.

Purchasing?
Yeah, you.

Accounting?
You, you, you.

All you.
You're in the driver's seat.

While I'm treating patients all day?

Yeah, well, you know,
I know it needs a lot of work,

but you can make it your own.

Michael. Thought I heard your voice.

Admit it, you can't get enough of us.

Yeah. Zeke Barnes.
Pat Ross.

Zeke's a family doctor.

- I helped him out last week.
- You could do it again.

I got a compression
fracture in Room Two

with your name on it.
You look like a doc, too.

- I do?
- Johns Hopkins tie tack gives it away.

Pat is going to be your new boss.

Oh, great.
Awesome. Hey,

you can take the lady in the
waiting room with the mask on.

Rule out yellow fever.

You can use your new office.

Yellow fever?
Oh, yeah.

Immigrants come in from all over.

You get to see everything here.

I've seen enough.

Come on, it's not that bad.

(laughs)
It's not that bad? It's a dump.

Look, Mike, Mike, I'm used
to having everything I need.

What, you don't need a job?

Not this one.
Thanks anyway.

If I change my mind, I'll call you.

You kidding me?
I'm sorry, Mike.

TAVO:
Dr. Mike, I need your help!

Tavo, actually I'm just leaving.

Rafe, this is Dr. Holt.

Oh. What happened to you?

- He shattered the backboard.
- I was showing off for the kids,

trying to slam-dunk,
and think I broke my arm.

Did you make the shot at least?

(suppressed groan)
Ah!

Yeah, you dislocated your shoulder.

TAVO: Come on, let Dr. Holt
take care of your dad.

- Tavo, honestly, I gotta...
- It's cool. I got donuts for him.

(hiccups)
I got these hiccups, too.

Oh, it's not uncommon

after a shock to your system.

Now, what's going on here?

Let's take a look.

Right here.

Hold still.
(hiccups)

Kind of old to being
doing slam dunks.

I run a youth league
for troubled kids.

I'm the only dad most of them got.

(hiccups)

Boys like that will eat you alive

if you don't walk the walk, right?

How are you doing over there?

It's done.

Clean up those cuts.
(Rafe hiccups)

- Sorry, I was lancing a mother of a boil.
- About time.

(Rafe hiccups)
MICHAEL: All right, finished.

You're in good hands
with Dr. Mike here.

He's a top-notch surgeon.

Sedate him with some midazolam.

We'll pop that shoulder
back into place.

Uh, we don't keep midazolam here.

You're kidding.
No,

we dispense benzos or narcotics,

we're sitting ducks for a robbery.

So, good ol' fashioned lidocaine
will have to do.

I gotta get to work.
How long is this gonna take?

ZEKE: What do you do?
RAFE: I used to teach phys-ed

in the Bronx, but I got laid off.

Now I'm flipping burgers
to keep it together.

- This is gonna sting and burn a little.
- Okay.

All right, switch with me.

Sit up for a second.

Well, what's that for?

Countertraction.

(hiccups, groans)

Tell me when you're ready.

(grunting):
Almost there.

Ow!

There we go.
Ow.

(hiccups)

Hold still.

Man, feels better already.

Hey, uh, what do I do
about these hiccups?

Try breathing into a paper bag.

Hey! Michael, hold up.

Professor Philip.
I just called your office.

Your assistant said you were here,

giving our new clinic
director a tour.

I'd like to meet him.
Well, unfortunately,

- he didn't take it.
- Uh-huh. Over money?

It wasn't a good fit.

What about Kate Sykora?
You met her, right?

Yeah. She wasn't really
right for the job.

This place is a hard sell.

I know.

Anna was here 24/7.

Hard to date someone
you barely get to see.

Don't worry.
I'll find someone to run it.

BOY:
Dad!

Somebody help!
Please, help him!

Everyone stay back.
Nathan, come with me.

He suddenly got dizzy
and then collapsed.

He's not breathing.
We need a defibrillator!

MICHAEL:
Hurry!

What the hell happened?

Syncopal episode.
His pulse is thready.

Where's the defibrillator?
Right here.

I'll check his rhythm.

(rhythmic beeping)

He's in V tach.

From a dislocated shoulder?

Yeah. We gotta zap him.

Everybody stand clear.

(rhythmic beeping)

(respirator hissing)

ZEKE:
He's back in sinus rhythm.

He's breathing on his own.

MICHAEL:
His pulse is getting strong.

Wh-What happened?

You passed out.

We had to shock your heart
back into normal rhythm.

All right, Tavo,
let's get him into a room.

- Yo, Philip, give me a hand.
- Gently, slowly.

Watch his shoulder.

(grunting)

Easy, easy, easy.

I don't get it.

A few lacerations shouldn't
have sent him into V tach.

Yeah, neither should
a shoulder reduction.

Lidocaine toxicity could have
caused the arrhythmia.

No, I didn't hit a vein
when I gave him the anesthetic.

Maybe it was cardio myopathy
from a recent virus.

Yeah, or he's on something...
speed, energy drinks.

Well, whatever it is, I'd
better keep him monitored.

Yeah. I gotta go.
Thank you.

Nice work.

Not now.
Believe me,

if I could, I would call
your oh-so-adorable assistant

and make an appointment,

but I can't control when I appear.

Yeah, I can't stop
and chat every time

the ghost of my ex-wife shows up.

Were you talking to me?

No, I was... not...

I was just...

going in here.

Wow.

This is more of a mess
than I remember.

(laughing)

Is that... that's, that's
what this is about,

just, uh, cleaning up
your, uh, your messes?

Because I'm not gonna do that.

Why not?

What?!

Why can't you clean up my messes?

What would be so wrong with that?

I have a job.

Curing people with brain tumors,
people with paralysis...

People with checkbooks.

Yeah, so?
They get sick, too.

Can you just haunt
somebody else for a while?

Oh, believe me, there is
nothing I would like more

than to be resting in peace
instead of fighting with you.

But something even bigger
than you, Michael Holt,

put me here, now, with you,

and if you can't
respect that and help to do

the things that
I can't do any longer,

because I got hit by a damn car,

then you might as well be dead, too.

ZEKE:
Wait a minute...

RAFE:
I gotta go.

ZEKE:
Hey, come on, man.

I don't have time!

Dad, you're okay!
Yeah, I'm all right.

Hey, Dr. Mike,

Rafe here is refusing

to stay and be monitored.

Mr. Douglas, listen to your doctor.

Let's roll.

Hey, dumb-ass!

You could've died in there.

You need to be monitored and
then go see a cardiologist.

Yeah?

How much is that gonna cost?

Echocardiogram, stress test, EBCT...

I don't know-- maybe three grand?

Are you out of your mind?

That's three months rent.

All right, come on, I can get you in

to see a guy at County
by the end of the week,

for a couple hundred bucks.

What world are you living in, man?

I make eight bucks an hour,
and I don't have insurance.

I don't show up for work,
I lose my job.

So what if you drop dead, face-first,

into a deep-fat fryer?

Look at you in your fancy suit
with a smirk on your face,

telling me what to do.

Tell your patient...

I'm sending him for a full workup.

Hey, I'm standing right here,
and I'm telling you

I can't afford any workup.

Tell him I'm referring him
to Howard Eastman,

best cardiologist in New York.

Arrogant son of a bitch.

Do what the doc says... call the guy.

Yeah, all right.

I'll call him.

(sighs heavily)

Wow, you really are good
with people, aren't you?

Got him to see a doctor, didn't I?

Do me a favor...
you need any more help,

don't call me.

(horn blaring)

MAN: First, it's hay fever,
then it's a sinus infection.

WOMAN: Ed's sniffling
and hacking all day long.

It scares the dogs.

(laughs politely):
Yeah, I bet.

Well, I wish I could help,
but you need an allergist,

and I'm a...

Neurosurgeon.

Excuse us.

Excuse me.

Michael Holt, right?

Have we met?

Not face-to-face, but...

I flew an emergency nerve donation

from Seattle to LaGuardia last year.

Ambulance brought it to Holt Neuro.

I think the patient's
name was Santiago.

Yeah... left arm was mangled
in a motorcycle accident.

Transplanted the radial nerve,
got it working again.

You're the pilot
who made that happen?

(laughs)

Carol Gordon.
Nice to meet you.

(gasps)
Ow.

You okay?

Please, I don't want to be

one of those people at parties

that pesters you with all of
their little aches and pains.

Oh, no, you just
rescued me from that.

May I?

Any, uh... swelling?

Does it ever feel hot?

Both.
Mm.

Couple of times.

You know, it could be carpal tunnel.

Guessing you do a lot
of repetitive motions

in the cockpit.

Uh, flicking switches, pressing
buttons up and down panels.

It's a pretty simple procedure,
actually, for the pain.

I'd be happy to do it.

Personally?

Quick snip of the carpal
ligament, you're good as new.

Send you home the same day.

Maybe after I'm healed,

I'll fly you down to the Caribbean.

Personally?

In my very own Challenger 604.

Wow! I'll drink to that.

(gasps)
Ooh!

I'm so sorry.
Let me help you.

Got myself good, didn't I?

Yeah, you could use
a couple stitches.

Uh, let's get out of here.

Oh, you don't have
to take me to the ER.

I'm not.

Come on.

Seems like overkill... a neurosurgeon

wasting time on a dumb cut.

I suture skin all the time.

Your place is impressive.

It's like a spa... that happens
to have an operating room.

We also have a top staff of
neurologists, psychiatrists,

sports medicine specialists,
sauna and steam,

24/7 concierge...

So only the best for your patients.

I assume you do the same
for your passengers.

All-leather seating, sleeping cabin,

shower, a fully stocked galley,

and all the latest
state-of-the-art avionics.

We have a building-wide,
positive-pressure

HEPA filtration system.

Not a single post-op infection
since we opened for business

six years ago.

Are you trying to
seduce me, Dr. Holt?

I'm trying to get you
to let me run tests

to confirm your carpal tunnel.

When I have time.

Carol, you let this go,
your hand gets weaker,

the pain and numbness gets worse.

You don't want to drop
any more martinis.

I'm flying a charter to Bermuda
late tomorrow afternoon.

Think you can test me
first thing in the morning?

Yes. Come by.

I'll make sure you get in.

Thanks, Rich.

(elevator bell dings)

Morning, Rita.

Oh, I'm sure it is.

After the night you had in the OR

with the young lady who was
waiting here this morning.

Her name is Carol and
I was suturing her hand.

Is that what the kids
are calling it these days?

She's here for a carpal tunnel test.

Just grab her a gown
while I track down Bax.

Oh. Okay.

You didn't prepare me
for electroshock therapy.

Bax has to do the tests
to indicate whether or not

I need to operate.

So he's like your ground crew.

(laughs)

Yes, the navigator in the OR.

How we looking?

Uh, latency and amplitude are normal.

It means your nerve
functions are fine.

Then what's causing my pain?

Could be tendonitis, arthritis...

I'll know more after I test
your fast-twitch muscle functions.

That's going into me?

Only into your abductor
pollicis brevis muscle.

Your hand.

BAX:
I'll be gentle, but...

it's gonna feel weird.

You ready?

I guess.
All right.

(groans quietly)

So... where exactly do you fly?

Where do you want to go?

I can get you to Europe
and South America non-stop;

Australia and Asia
with one layover to refuel.

BAX: Very good.
Now, flex your thumb slowly,

until I tell you to stop.

Your family must miss you,
you being gone so much.

No family.

Just me and the big blue sky.

My father was a pilot.

I wanted to fly since the moment
he let me take the yoke.

BAX: Okay, you can
stop flexing your thumb.

EMG is normal, too.

So I don't have carpal tunnel.

Not necessarily.
Some people have it

and their test results
are still negative.

How much did you have
to drink last night?

Just the one Cosmo.

I was dying for another,
but dropping that glass

kind of nipped that in the bud.

(laughs):
Yeah.

Everything okay?

Yeah, fine.

Bax and I need to
discuss a few things.

Maria will take you in the exam room.

Hang tight.
We'll be right in.

I'll be waiting.

You saw the tremor, right?

Yeah, yeah.

I got this new thing called "vision."

She mention any other history
of neuro symptoms,

besides carpal tunnel?

No. No.

That's why I asked how
many drinks she had

at that benefit last night.

Could be alcohol related.

Pilot with a drinking problem...
that's, that's fantastic.

It's a high-stress job.

That could cause tremors;
fatigue, too.

So could drug abuse,
strokes and a brain tumor.

She needs an MRI.

MRI.

All right, Carol,
let's get you to an MRI...

Colette, did you see
Miss Gordon leave?

Uh, yeah, couple minutes ago.

She said she was done
and you told her to go home.

I've never seen a patient
run out on you.

Yeah. Second one in two days.

- Finished with your lady pilot yet?
- No.

'Cause I've got all
your other patients

in a holding pattern.

(phone ringing)

Let me guess-- Zeke?

It is indeed.

Hey, I never heard from Rafe Douglas,

our dislocated shoulder
from yesterday.

I got enough problems
with my patients

without having to deal with yours.

I just want you to ask
your cardiologist pal

if Rafe ever showed up there.

Do I have to hand-hold everybody?

I gave you the number.

Call him yourself.
Don't call me.

I've had it with people
who don't listen.

Are we leaving surgery
to become a pathologist?

Dead people never talk back.

That's what she thinks.

Uh... Rita...

call the FAA.

Get me someone in Air Safety.

What on earth for?

Just do it.

Never easy, is it?

Thought you weren't speaking to me.

Eh, we could never stay mad with
each other long, could we?

Yeah? Try me.

So, besides me, what's bothering you?

(wry laugh)

My patient, Carol Gordon,

just walked out on me.

She's a pilot.
Her hand tremors.

Until I know what's causing it,

she's got no business being
in the cockpit of a plane.

Like the ice road trucker in Alaska.

With the crazy mustache.

Looked like he had
a ferret on his lip.

(both laugh)

His big ol' pupils.

Hands shaking.

You thought he had DTs

from alcohol withdrawal.

You were about to call the cops.

Until you asked him
how much coffee he drank.

"18 cups a day.
"18 cups a day.

Five sugars in each."
Five sugars in each."

That was different.

He was right there.

She... ran away.

I let her fly, something
bad happens, it's on me.

I got to call the FAA.

So you can fly off
into the wild blue yonder?

No, I am just doing my job, Anna.

Rita, you got them on the line yet?

But what if you report her to the FAA

and they yank her license?

What if you find out it's just
one too many cups of coffee?

So she quits drinking caffeine...
no harm, no foul.

I'm not the bad guy here, Anna.

Yeah, that's not the same
thing as being the good guy.

(sighs)

Do you think the FAA will ever

let her fly again after
you've turned her in?

They'll wonder why she didn't

go see a doctor and report herself.

RITA:
FAA Safety Officer Collum on line two.

Michael.

I got it.

Michael.

You don't want me to let her fly.

I think you should find
out the whole story.

125... they've encountered
some moderate to severe chop,

which we do not want to
have for this family.

So I think we'll climb to about
35 and just cruise from there.

Awfully far from those
HEPA-filtered hallways of yours.

Well, my patients don't usually
leave before I'm done.

I'm not your patient.

That's right, you're a pilot.

So let me guess, family vacation?

You're in the way of my preflight.

Oh, by all means.
Plane looks great,

it's the pilot who's not airworthy.

Screw you.
Me?

Wow. You stroke out at 30,000 feet,

they're the ones who are screwed.

Nothing is going to happen.

You'd bet their lives on that?

I have a copilot, and I'm fine.

Well, your left hand
thinks differently.

Come with me right now to
Holt Neuro, or I call the FAA.

You're not gonna do that.

Michael.

Two years ago, I flew
my best friend Rachel

and her family to Puerto Vallarta.

Surprise birthday present.

Hi.

Safety Officer Collum, please.

We were sitting on the beach,

I noticed her foot twitching.

She said she would go to the doctor.

It was brain cancer.

Glioblastoma.

I'd never even heard
of the word before.

The doctors kept trying
to take it out,

but it just kept coming back.

Until she died eight months later.

Her husband
and two adorable little girls

watched her slip away.

Carol, you don't know if you
have cancer and neither do I.

Your tremor could be something
or it could be nothing.

But we have to find out.

(sighs softly)

How long will this take?

MICHAEL:
About 45 minutes.

Lie still and don't talk.

We don't want to do this twice.

I don't want to do it at all.

Just close your eyes and relax.

Imagine yourself at 35,000 feet,

soaring through a cloudless sky.

(machine chugging, humming)

Your MRI shows
two lesions in your brain.

It's a glioblastoma, isn't it?

Actually, that's
the one thing that it isn't.

Multiple lesions usually mean that

cancer has metastasized from
somewhere else in your body.

But we scanned your entire body
and didn't find anything.

Then what is it?

I'm not exactly sure.

You're the best in the business,

this place has every
possible machine,

every expert, you even
bragged to me about it.

How could you not know?

Well, because there are
a number of conditions

that can cause brain lesions.

Some of them are infectious.

Other than my hands, I feel fine.

Well, then you'll fly
right through surgery.

You want to cut my head open?

It's the only way to determine
what those lesions are.

This one right here on
your primary motor cortex

is what's causing the tremor.

If I don't remove it, your arm
could be permanently paralyzed.

(sighs softly)

I've had engines die during takeoff,

I've landed in storms,
70-mile-an-hour crosswinds,

I've even skidded off
a runway in Beijing.

But you've never been as scared
as you are right now.

'Cause you think
you'll never fly again.

Carol, I'm gonna
make sure that you do.

(sighs)

When do you want to operate?

First thing tomorrow morning.

Hey, Rita, I'm going home.

So just forward me Carol
Gordon's images and blood work

so I can review them
tonight, okay? Thanks.

Thanks, Rich.

(keys clink)

Need to go right.

I need to go that way.

What's going on?

You got to go straight.

UN General Assembly's in session.

Oh, man, I got to get to the bridge.

The bridge is all jammed up.

You're gonna have to go downtown.

(hip-hop music playing,
dogs barking)

(cell phone ringing)

Dr. Holt.

(over phone):
Michael, Howard Eastman.

Howard, what's up?

Haven't seen you
at the club in a while.

Ah, I know.

Hope you're not trying
to get me out there.

I don't have much time now for golf.

It's about that guy
with the arrhythmia,

Rafe Douglas.

Yeah.

He never called.

Ah, damn it. You know...

(car horn honks)

Whoa.

(tires screech)

Howard, I'll call you back.

Hey, buddy.
Hey.

Is this your ball?

Nope.

No.

(chuckles):
No.

No, no, no, no, no, Anna.

Rafe is not my patient,
not my patient.

Tell you what.

I make this shot, I call.

I miss, I go home.

I'm never making this shot.

Tavo, Michael Holt.

Yeah, I just, I need a number
of one of your patients.

(cell phone buzzing,
TV playing sports)

Hello.

Ms. Douglas, hi.
It's Dr. Holt.

I treated your husband
at Clinica Sanando.

(whispers):
It's that doctor.

(whispers):
No. No.

I'm sorry, uh,
Rafe's not home right now.

Well, has he had
any chest pains, weakness,

dizziness, passing out?

No.

Rafe is feeling better.

He, uh, went to the store.

Okay. Thank you very much.

Happy now, Anna?

Carol, hi.
I'm Dr. Lantz.

I'll be the anesthesiologist
for your surgery.

Do me a favor, put me way, way under.

(chuckles)

There is nothing to be nervous about.

Say that when they're
operating on your brain.

(chuckles)

So, ever have any problems

during surgery with anesthesia?

I have never had surgery before.

Any allergies?

Only allergic to that
Real Housewives show.

(chuckles)

You're all set.

Give us a couple of minutes,
we'll get started.

Dr. Lantz.

Can I ask you a question?

Fine, I'll give you my phone number.

It's about Michael.

Is he as good as he says he is?

As everyone says he is?

Honestly?

No, he's not.

He's better.

Trust me, if you need
your head cut open,

you want to be in the hands
of Michael Holt.

I'll excise the cyst on
the primary motor cortex first.

That's a piece of cake.

Second one is no picnic though.

It's right next to Broca's.

On top of the frontal operculum.

Yeah.

Go even a millimeter too
deep, she loses speech.

Only one way to make sure I don't.

Brain mapping.

She'll have to be awake.

Tell Lantz to wake her up.

(monitor beeping rhythmically)

BAX: Carol,
I'm gonna show you some images.

I want you to identify them.

On top of cutting my head open,
you're giving me a pop quiz?

You'll do fine.

So, Michael, do I have a nice brain?

Most beautiful I've ever seen.

I bet you say that to all the girls.

But I mean it with you.

No speech arrests,
so let's start dissecting.

No speech what?

The fact that you're speaking

means I'm in a safe place.

That's a relief.

BAX:
All right, Carol,

tell me what you see.

A cat.
Good.

Okay, I'm down to the first mass.

Suction.

Carol, what do you see

now?

A helicopter.

Right again.

CAROL:
Michael, do I want to
know what you found?

Definitely.

Doesn't look like cancer.

Thank God.

Then what is it?

Carol, focus on the pictures.

Now you sound like Bax.

(Bax laughs)
What is it?

It looks like...

neurocysticercosis.

What is that?
A kind of larva.

What?!
Relax.

They're not alive.

And besides, you'd rather
have this than cancer.

Eat any bad pork lately?

Pork?

That's how our little
worm friend got in.

Uh, back in January.

I had a layover in Ecuador.

Got really sick.

Now.

BAX:
Hey, your hand stopped shaking.

(Carol gasps)

Does that mean I can fly again?

First things first...

Bax, I'm moving on
to the other lesion.

BAX:
All right.

Carol, take a look at the screen.

Tell me what you see.

The heels are my length,

but I wouldn't be caught
dead in those horr...

(slurring words)

(machine beeps)
Michael, you hit her speech center.

I'm nowhere near Broca's.

Her speech should be intact.

(slurring)
Then what the hell's going on?

She's lost consciousness.

Pulse is crashing.
BP's rising.

Cushing's reflex!

The cyst ruptured spontaneously.

Fluid's leaking onto her brain;
that's why she can't speak.

LANTZ:
Pressure's 170!

She's having an allergic
reaction to the cyst fluid.

Her brain's herniating
through the craniotomy.

We need to raise the head of
the bed and hyperventilate.

Heart rate's still dropping.

Put her on a mannitol drip
to lower the swelling,

and nitroprusside to get her BP down.
Bax, bag her while I do it.

Come on, let's go!

All right. Done.

Irrigation and suction.

LANTZ:
She's stabilizing.

BP's going down,
heart rate's coming up.

Great work.

Swelling's going down.

Did you stop it in time?
I hope so.

We'll know if she wakes up.

(monitor beeping rhythmically)

Her cyst didn't burst because of you.

You had no way of knowing it would.

I still should've
removed that one first.

BAX: It could have sprung a leak
when she was in the air.

You saved lives by getting her here.

Yeah, I hope hers is one of them.

(knocking)

Michael, I just got a call
from Clinica Sanando.

Dr. Zeke?
Not now, Rita.

He said it was important...
about Rafe Douglas.

What about him?

He's on his way to the
clinic with neuro symptoms.

Severely disoriented.
That arrhythmia

could have thrown a clot
and caused a stroke.

I gotta run.

I'll have your car brought up.

There no time.

Just have someone drop
it off at the clinic.

What's happening?

He came in like this.

Lungs are clear, heartbeat's faint.

Give me your stethoscope.

Looks like his neck veins
are dilated, too.

He didn't present with that
when he came in the other day.

Pressure's dropping-- 80/40.
What the hell is going on?

Distended neck veins,

distant heartbeat,

all the hiccupping...

He's got a sac full of
blood around his heart,

it stopped it from beating.

Cardiac tamponade.

Pressure's down to 60/30.

Call for an ambulance.

We gotta drain that blood.

Yeah. I can't crack his chest here.

You're the surgeon.

Not a cardiac surgeon.

I'll do a pericardiocentesis.
Grab me a spinal needle.

Spinal needle.

He must have bruised his heart
when he landed from that dunk.

Cardiologist would've seen it,
if Rafe decided to show up.

- We don't have a spinal needle in here.
- Just get me any needle

I can put through his sternum.
Pressure's down to 50.

Now get me an ultrasound

so I can see where
I gotta harpoon this guy.

- We don't have an ultrasound.
- Oh, come on. I gotta go in blind?

What kind of a place is this?
The one that we got.

- Here you go.
- Fine, fine, fine. I'll use landmarks.

Left clavicle...
sub-xiphoid...

go in at a 45 degree angle...

Get it right.
Don't want to drop a lung.

(gasping)

There we go.

Easy, easy.

Damn it, I'm not getting any blood.

Pressure's 40.

Yep. There we go.

There it is.

Yep. I got it.

There we go.

Pulse getting stronger.

Rhythm's regular,

pressure's up to 80.

Dr. Michael Holt, baby, in the house!

Way to go!

This isn't my house.

Is my dad okay?

He will be if he gets to an OR.

Of course you're here.

No, Michael, wait.

I should've never let you
drag me into this place.

I could never drag you anywhere.

What is this, Anna?

What is what?

You-you-you come back from the dead.

You get me all tangled up
with these patients.

You make me go after Carol,
now she's in a coma.

Well, would you rather
have turned her in?

I'd have rather gone
straight home last night,

but instead,
you made me take a detour

to Rafe's basketball court.
What was that?

Then the ball just mysteriously
comes out of nowhere,

hits my windshield?
And then all of a sudden,

yeah, I gotta take a shot.

Just to call him!
I didn't do any of that.

Well, none of that ever would
have happened, until you died.

You're scared.

- I am pissed off.
- No. You're scared.

You've built a beautiful
wall around your life,

and you filled it with people
who are at your beck and call,

with your hi-tech toys.

I didn't have what I needed in there.

Did you save him?

You don't like being out
of your comfort zone

any more than I like being dead.

Or whatever you are.

Michael!

Where do you want to send him?

Manhattan Memorial.
Listen...

I'm going to send you to the
best cardiac surgeon I know.

You need to go to surgery right now.

I can't afford it.

You can't afford not to.

For your wife

and your son and all those kids
who count on you.

All right? Even if it means
you pay 20 bucks a week.

MRS. DOUGLAS:
Rafe, we'll find a way.

Thanks for talking to me, man.

Michael!

I've been trying to reach you.

About what?

I talked to Kate Sykora...
she said you blew her off.

- Yeah, after you forced her on me.
- Forced her?

I only want what's best
for this place.

I thought you did, too.

Dr. Holt.
Thank you.

Yeah, thank you.

You're welcome.

Ah... what? What else?

What did he say?

Who, Rafe's son?
He thanked me.

No, I mean Philip.

He asked if I found your replacement.

Why would he ask you that?

Because I volunteered
to do it. Stupidly.

That's not stupid, that's sweet.

Maybe you liked Philip
breathing down your neck,

but I can live without it.

You're not angry about Philip,
you're angry about being here.

When it comes
to complex brain surgery,

no one can touch you,
but if a patient needs

just a little bit more
than medical care...

It's not my job.

I'm not like you, Anna.

I'm not the one to take
care of your patients.

Did you find someone?
No.

I offered it to someone,
he turned it down.

Philip had somebody,
but she was the wrong type.

Are you sure?

So now you're gonna second-guess me?

Philip may be a lot of things...

but he has good taste in women.

(sighs)

(knocking on door)

Dr. Holt.

Dr. Sykora. I'm sorry
to bother you at hom

but, um... you weren't
returning my calls.

And I don't blame you.

What can I do for you?

Accept my apology for acting
like a jerk the other day.

And come and run your clinic

because your first choice
turned you down?

Yeah.

So I'm offering you the job.

Okay.

Great.

No, I'll think about it.

Good night, Michael.

(door closes)

(elevator bell dings)

Rita?

It's late. What are you doing here?

Since when do I have a life?

Handball with Bax
at 8:00 tomorrow morning.

A spina bifida repair at 10:30.

Then lunch with your investors.

Usual time and place?

Yeah. How's Carol?

No change.

She's still unconscious.

Night, Michael.

Not yet.

(sighs)

Welcome back.