A Gifted Man (2011–2012): Season 1, Episode 8 - In Case of Missed Communication - full transcript

Come back next week, and
we'll take out the sutures.

Have a Happy
Thanksgiving, Dr. Holt.

Thank you.
Well, well.

Scrooge found a smile.

She's my last patient.

I'm done here for a week.

Oh, so we all have something
to be thankful for.

Watch your back,
Dr. Mike.

What's this?
It's equipment

for the new trauma room.

Got it from one of the ers
that was closing... cheap.



Really?
I'll find a way to pay for it.

Are you joining us for dinner?
You and the hubby?

No.

The first annual

Anna Paul Thanksgiving dinner
at clinica sanando.

Christina, after
all your messages,

we're not having dinner
at your place?

Mom canceled it.
What's up, Uncle Mike?

Milo. This clinic is
such an inspiration,

I had to get involved.

Anton and I
are planning the dinner,

and Milo's going
to help us cook.

Yeah. Can't wait.

Anna gave people here
a lot to be thankful for.



Have a good time.

You're not going to be here?

Anna was your wife.

Ex-wife.
And I don't need to be told

when and where to be grateful.

Anna:
Come on.

Christina's a good cook.

And you've always
been a yam fan.

(Sighs)

She's back, isn't she?

- Don't start with me, Anton.
- Anna's here?

- Now?
- I could drive a truck

through the tear
in your energetic body.

Anna! Anna,
it's me, Christina.

- So loud? Really?
- I miss you.

Happy Thanksgiving.

Are you really

going to spend
Thanksgiving by yourself?

What, you, uh...

Want to spend it together?

No! Well, I mean, it
would be nice, but...

Right, but, uh, I would cook,

I'd eat, do all the dishes.

And that's, uh,
if you'd show up

from, uh... where is it?

Have you ever noticed

that your mood changes
around the holidays?

Maybe I'm not
such a yam fan after all.

Or maybe Thanksgiving
brings up bad memories.

Your sister said something
about that once.

Oh. Christina blab

about any other
deep, dark family secrets?

This might be a great place
to spend Thanksgiving.

And we're all so grateful to
you for everything you've done.

Especially me.

(Sighs)

Easy.

Hey, Dr. Holt.

- Lenny?
- Hey. Good to see you

- again, sir.
- What is this "sir" crap?

- Thought you were in Afghanistan.
- Yeah, they sent me home

'cause you can't shoot
with a bad trigger finger.

- What did you do, break a nail?
- Shrapnel from an IED.

Oh. Wow.

Rita didn't tell me
you were coming home.

Yeah, I didn't tell mom.

(Laughing):
Oh, this is going to be good.

All right.

Morning.

Rita:
Morning.

Bottoms up.

No, I don't want that drink.

I hate that drink.

You drink this stuff
every morning.

No, no, no.

But today, I would like a...

Root beer float with
rocky road ice cream.

That's my boy's favorite drink.

Well, then,
you better make two of them.

What?

Oh, my God.

No.

Leonard Hall Junior.

- Hey, mom.
- You're not supposed

to be back till January.

What on earth
happened to your hand?

That's my ticket home.

I report to Fort Bragg
on Monday.

This is the best
Thanksgiving surprise

I could ever hope for.

If your father
knows about this,

I'm going to kill him.

Dad doesn't know;
Only Michael.

I just found out a minute ago.

Yeah, well,
you're still a dead man.

When your father sees you,

he's going to wet his breeches.

(Phone ringing)

Rita:
Let's go call him.

I'm going to go make my rounds.

If the clinic calls, tell them
I am done till next week.

Zeke: - What is the problem?
Man: - That guy's an idiot.

He doesn't like
cranberry sauce.

I said I like fresh,

just not that crap in a can!

That's the best part!

It's shaped like a can!

- You're a moron!
- All right, shut up, shut up!

You, sit! Sit over
here on this blanket!

Sit down! Sit your ass down!

And you, sit down
and face forward!

First one of you so much
as looks at the other one,

you're out on your ass!

Little too much,
uh, holiday spirit?

Yeah, about 100 proof.

Well, at least they're lively.

Haven't had a patient
under 70 all day,

and most of them are depressed.

Oh, that always happens
around the holidays.

Someone brings in granny
'cause they think she

don't look too hot, and the
only thing wrong with her

is she's a year older
than the last time they saw her.

- I'm taking a break.
- Thought you quit.

One day at a time.

And today's not the day.

(Horn honking)

Hey. I got a guy
in trouble back here.

Come on!

I was about to head back
to the depot,

and I heard him
wheezing back here.

I thought he got off
at the last stop.

(Wheezing)

Tell me what's wrong, pal.

His name's Dennis.

He rides back and forth
all day long.

Help me get him inside.

All right.

Hector! I need a room
and an ambu bag!

All the exam rooms are full.
Put him in the trauma room.

It's not finished yet.
It's got an exam table.

Find me Kate now!

And O2, and a monitor!
Hurry up!

Who's our guest?

Dennis... no I.D., can't breathe,
ambu bag's not helping.

We're going to lose him if we
don't get him on a ventilator.

Lucky him... an
intubation kit

and a vent turned
up an hour ago.

Somewhere in these boxes here.

Well, you take over bagging.
I'll look for it.

Yeah.

Here's our new
blood count machine.

What's this?
(Rapid beeping)

Ultrasound. Hurry up.
I'm losing him.

Found the intubation kit. Great.

Charisse, push meds.

Thanks. Find the vent.

Vent, vent, vent...
Okay, I see the cords.

Endotracheal tube.

Okay, I'm in.

Okay.

Zeke, where's my vent?

Kate, there is no
ventilator in here.

Maybe you didn't order one.

Delivery guys must have left it
on the truck.

I'm looking at the packing list
right now... it's not on here.

Okay. Well, we'll just
have to keep bagging him

until we get him to a hospital.

Bus driver found this on
the floor of the bus.

- Says it's your patient's.
- Thank you.

- Call 911 for us, please.
- I'm on it.

Sats are on the way back up.

Here we go.

What'd you find?

Medical bracelet.

Got a last name on it?

Dennis Jones.

That's not all.

He's a DNR.

We just saved a guy
who didn't want to be saved.

Now what the hell do we do?

A Gifted Man 01x08
In Case of Missed Communication
Original Air Date: November 18, 2011

What a mess.
(Monitor beeping)

Wish we knew Dennis had a DNR

before we intubated him.

We know now.

We can't take it out.

That's euthanasia.

That'd be what he wants.

He didn't want us
to save his life,

but ending it
is a different story.

Even though he had this?

Clasp is broken.

Might have fallen off.

Or maybe he changed his mind
about the DNR,

took it off, forgot it
was in his coat pocket.

I told Autumn to run down

every Dennis Jones
in the phone book.

Maybe he's got a next of kin
who's his proxy.

Good idea.

Hey, what happened
to that ambulance?

EMS is too jammed up
with emergency runs

to spare a bus
for a patient transport.

Then we'll pay for
a private ambulance

when we find a
hospital to take him.

In the meantime,
we got to keep bagging him

unless he dies or wakes up

and tells us
to take the tube out.

Want me to start
calling hospitals?

No. You know what?
My hand is tired,

and, uh, I have
better phone manners.

(Sighs)

Like I said, we didn't
know that he was DNR

until after we intubated.

Yes, ma'am, we're idiots.

And you're a bitch.

It's official.

No hospital in the five boroughs
will take Dennis.

No one has a spare ventilator
for a patient who's DNR?

Nope. They don't want
to get sued when he wakes up.

Any luck finding his family?

I called every Dennis Jones

in the book...
All 18 of them.

No one knows him.

Well, we saved him, we own him.

(Monitor beeping)

Okay, so there's no crackling
in your lungs,

which rules out pneumonia.

What is your story, Dennis?

How come you don't want
to be saved?

Are you sick,
or you just run out of gas?

You must have some
reason to live.

I know, it's none
of my business.

Sorry.

Just have to grab
some stuffing mix.

Stuffing mix.

Think I saw a few boxes

under the X-ray film
over there.

Don't worry about it.
I'll find it.

You just keep breathing
life into him.

Yeah.

Hey, you know,
you could help me

actually breathe life into him
for a minute

while I get this machine
hooked up

to try and see what's wrong
with him.

Are you sure that's okay?

Yeah. As long as
I'm here, it's legal.

Then I would be honored.

Yeah, it's just an
easy in and out here.

Just a little, gentle squeeze.

Keep it going.
That's perfect.

Your friend's carrying
some pretty dark energy.

Is that your
shamanistic diagnosis?

Hard to miss a soul in pain.

And where do you think
his pain might be coming from?

Well, all of his chakras
are pretty blocked,

but the fourth
is definitely the worst.

The fourth.

Which one was that?

It's right there.

It's his heart.

Well, nothing's showing up
on his echocardiogram.

Ticker's not dilated.

He's got a good
ejection fraction.

That rules out
congestive heart failure.

Maybe it's spiritual.

Maybe it's neurological.

(Sighs)

Zeke, I'm off the clock
till next week.

Oh, sorry.
Didn't get the memo.

But I did get
an African-American male

in respiratory failure

with no other
cardiothoracic findings.

If you think it's neurological,

then send him to a hospital
for an MRI.

Come on.
This is your kind of patient.

He's an unconscious head case

with a tube down his throat.

He can't even talk back.

You want me to drop everything
the day before Thanksgiving?

This guy's hanging on
by a thread here.

Are you gonna help me or not?

Yeah, I'll be there
in a few minutes.

(Laughter)

Sorry to break up the party.

Oh, Michael, I'm sorry,
we'll get out of here.

No, no, no, no, it's fine,
sit, sit, sit.

Good to see you, Len,
it's been a while.

It's not every day my wife calls

and tells me to get
my butt over here.

(Chuckles) Hey, how
crazy did she go

when she saw him?

Oh, Rita?
Oh, just her usual

demure self.

Well, I'd better get
my demure self

to the grocery store
and see if they have

any decent-sized
turkeys left.

- Yeah.
- You coming over for dinner?

Hey, we'd love to have you.

You know, I would,
but, uh, I've got other plans.

Get me a 20cc syringe
filled with water.

Any clues?

Well, it could be a stroke
or a brain stem hemorrhage.

Yeah, peripheral
reflexes are normal.

All right, let's
take a peek here.

Pupils are equal and reactive.

Testing his
vestibulocochlear reflex?

Yeah.

That's normal, too.

So you got nothing.

My advice...
Send him to an ER

for a chest X-Ray
and a head CT.

We tried; Nobody wants him.

Well, somebody has to take him.

Not under these circumstances.

Dennis is a DNR.

You're joking.

It was an accident.

He accidentally swallowed
an endotracheal tube?

I carried him off a city bus

in respiratory distress
and we intubated him.

His DNR bracelet
wasn't on his wrist.

It was in his coat pocket.

So not only did you resuscitate
someone who didn't even want it,

you brought me here
to diagnose somebody

that I can't even treat.

Are you suggesting that we
take out the tube?

No, but didyou stop and think
about what you were doing?

If he lasts a few more days,
you're gonna have to put

a feeding tube in his stomach.
(Phone vibrating)

- Did you think of that possibility?
- We're dancing as fast

- as we can here.
- Ugh, and kicking my ass

- in the process.
- You would have done exactly

the same thing
if you had been in our shoes.

You don't know that.
Rita, what's up?

It's Len. Rita's on the
phone with the police.

- She told me to call you.
- What happened?

Lenny's been
in a motorcycle accident.

All right,
have her tell the cops

to bring him over to Holt.

Well, first they've got

to get him out
from under a car.

Where's the accident?

Michael wants to
know where he is.

Avenue D and East Fourth.

All right, that's close.
Uh, tell her I'm on my way.

What's wrong?

Rita's son is hurt.

(Siren wailing)

Officer:
Hey, you can't...

The guy on the bike...
I'm his doctor. Okay.

How'd it happen?
Motorcycle swerved,

hit a cab, which
struck a parked car.

- Only your guy on the bike got hurt.
- Did he lose consciousness?

For a couple of minutes, and since he
came to, he's been talking kind of crazy.

All right, I'm his doctor, guys,
what are his vitals?

A little tachy

and he's vasoconstricting,
so I'm having trouble

getting this iv in.
All right, I got it.

Get outta the way.
Lenny: Radio J-Tac.

Lenny, it's
Michael Holt, buddy.

You're, you're in New York,
you're not in Afghanistan.

Fire on my six.

Nobody's under fire.

You need to stay still, okay?

Michael?

Yeah, it's me.

You're gonna be fine.

Cycle another BP as soon

as we get him from
under the car.

Can we get a little
help with the car?

Okay, ready when you are.

All right,
soon as this thing comes up,

we pull him out together,
keep his spine in line.

All right, we're
ready when you are.

Okay, bring it up.

Ready? One, two,
three, go.

Okay, Lenny, do you
remember what happened?

Yeah, I almost hit an IED.

Well, you took, uh,
took evasive action,

you saved a lot of people.

Can you lift it?

Okay.

You're okay now.

(Garbled radio transmission)

Wait, take us to Holt Neuro.

(Engine starts)

Do you have orders for me, sir?

Yep, we're gonna do a drill.

Wiggle your fingers

and toes.

I can't, sir.

Can you feel this?

Feel what?

How about this?

I don't feel anything.

Am I okay?

You hang in there.

Rita: Lenny.

We're right here, son.

Lenny: What are you guys doing
in Afghanistan?

Was he altered at the scene?

Yeah, his arms and legs
aren't responsive

to painful stimulation.

Just get him upstairs.

You're saying he's paralyzed.

Is he going to walk again?

You got to stay calm.

I'll know more
after I do the CT.

All right.

The brain's not bleeding.

Lantz:
That's a good sign.

(Typing)

That's not.

Jefferson fracture...

Circle these...

With burst lateral mass
and bone fragments.

His brain isn't bleeding.

Thank God.

Then why does he think
he's still in Afghanistan?

Severe post-concussive
syndrome from the head trauma.

His thinking will clear up
in the next few days.

We sedated him
so he won't move around

and make his injury worse.

What kind of injury, Michael?

Lenny has a Jefferson fracture...

A break of the front
and rear arches

of the first
cervical vertebrae.

Is his spinal cord intact?

Yes,

but bone fragments
are compressing it

and making it swell.

That's why he's paralyzed.

I put him on a steroid

to reduce the swelling,
but he has to have surgery

to relieve the pressure
and to stabilize his spine.

Four tours of duty... he almost
gets blown up a dozen times

and comes home with barely a
scratch, and now this happens.

We'll get through it...
All of us.

The critical window
to operate is

within 12 hours,
but he is obviously

in no shape to consent to
surgery, so as next of kin...

You've got our permission,
Michael, do whatever it takes.

I'll get an MRI to give us
a better look at the break,

run some labs, and then we'll
get him prepped for surgery.

You know,
when I was a resident...

This guy came into the er with
the words "do not resuscitate"

tattooed across his chest.

Now, that

was definitive.
(Gagging)

Dennis.

Kate, get in here!

Kate!

It's okay,

let me explain what's
happening here.

I'm Dr. Barnes,
this is Dr. Sykora.

You came in here not
breathing, we put a tube

down your throat into your lungs
to help you breathe.

It was the only way
to keep you alive.

(Dennis grunting)

Uh, a pen, he wants a pen.

Okay.

"Stop this now."

Mr. Jones, if we take the
tube out, there's no guarantee

you're going to be able to
breathe on your own! (Grunting)

Yeah, customer's always right.

Let's get him up.
Okay.

(Coughing)

All right, hold still,
hold still.

You ready?
Yeah.

(Grunting)

(Gagging)

(Coughing)

Can't you read?

Where's my bracelet?

We found it

in your pocket
after we put the tube in.

(Groans)

That's right,
the damn thing broke.

(Gasps)

You still shouldn't have done
this to me.

We didn't know you were DNR

when the bus driver
brought you in.

Any doctor would have tried
to save you.

I didn't want

to be saved.

Get me my clothes.

You're in no condition
to be leaving.

Lady, get your hands off me.

- Calm down.
- All right, then let me

- unhook your IV.
- Aah!

Okay.

Wow, you must
really want to die.

Uh-huh, that's right.

You want to at
least tell us why?

(Panting):
That's none of your business.

Come on, you got
to help me out.

I got to fill out a
bunch of paperwork

explaining why you refused
medical treatment.

There's got to be a reason
why you'd want to give up.

Write down
"Nothing to live for."

Zeke:
Really?

No family?

Wife died two years ago

of lung cancer.

Daughter stopped talking to me.

Tried calling her; She moved.

Sounds like you wanted
to talk to her.

Yeah, but Kelly didn't want
to talk to me.

Now I got lung cancer, too.

I'm getting out of
here and ain't nothing

you can do to stop me.

Well, maybe you should
wait till Kelly shows up.

You found her?

You were out cold, so
I tracked her down.

She'll be here in
a few hours, tops.

You should stick around.

We'll look after you.

Come on.

There's no way you're putting
that tube back in my throat.

Can I at least have
a nurse put you

on some oxygen so you'll be

more comfortable
while you wait?

Yeah, all right.

Dr. Barnes, can I talk
to you for a moment?

(Groans)

What are you thinking?

- You did not find his daughter.
- So you're fine with him

dropping dead two steps
outside our front door?

No, of course I'm not,
but it's his life.

He made a choice.

And if he's wrong?

Look, he said
his daughter's name is Kelly.

Maybe I can find her.

At the very least,
those two should talk

before he kicks the bucket.

All right, well,
just get cracking.

He doesn't have a whole
lot of time left.

You want an espresso?

Yeah, make mine a double.

- I just finished Lenny's pre-op images.
- And?

Something worse than
a Jefferson fracture?

Check out what's
right below it.

It's an AVM.

Just look at that thing

the wrong way
and it'll rupture.

We'll have to operate
on top of a land mine.

Michael: There's a new problem
on Lenny's spinal cord

that the MRI revealed.

Our son has an AVM?

I'm afraid so.

Excuse me, but I haven't spent
my whole damn life in medicine.

What the hell is an AVM?

It's an arteriovenous
malformation.

It's a tangle
of arteries and veins.

And he got this
during the wreck?

He was born with it, hon.

The accident revealed it.

He's lucky it didn't
rupture in the crash.

He could've died
from blood loss.

Well, he's still
in very serious danger,

because the AVM is right next
to the fracture I have to fix.

It's also very close

to the innervation
of respiratory muscles.

So I need to ask you:

Does Lenny have
an advance directive?

You mean, has he said
how far you should go

to keep him alive
if something goes wrong?

Yeah.

Nothing's gonna go wrong.

But no, he doesn't have one.

So any decision
about life support...

We'd make together,
just like always.

Like Rita said, he'd want you

to do everything possible.

Well, you know I will.

(Monitor beeping steadily)

Is that the guy you
saved accidentally?

He's still pissed off about it.

You're Michael's sister, right?

Mm-hmm.

And you're Zeke.

It's nice to meet you.

You, too.

You hungry?

A new stuffing recipe
I'm trying for tomorrow.

In other words,

if it turns out to be crappy,

at least I can get
immediate medical care?

Something like that.

So is he going to live?

Good question.

Not having family
here is tough.

Yeah.

I'm working on that.

Speaking of family,
your brother...

Has he always been such a...

Hard-ass?

(Laughs)

Pretty much.

Kate thinks he's allergic
to Thanksgiving.

Probably 'cause of the last one
we spent together as a family.

Oh, that bad, huh?

Pretty brutal, actually.

Michael was 11, I was nine.

Took me years to get over it.

Anton helped, actually.

Hmm.

Well, maybe he should
take a crack at Michael.

That'll happen right after

Michael takes up
transcendental meditation.

(Chuckles)

I hope you find his family.

So if you are
Dennis Jones's daughter,

please call Clinica Sanando
as soon as possible.

Thank you.

Wrong number. Sorry.

Doesn't sound like
you found her.

Google lists seven Kelly Jones
in the tri-state.

But three have never
heard of Dennis,

one never picks up.

One's disconnected,

and I just got
my second wrong number.

So which one of you are
going to stay with him tonight?

'Cause we close in ten minutes.

Guess that'll be me.

No, I'll stay with Dennis.

You sending me home?
No.

You are gonna go find
the Kelly Jones

who doesn't answer her phone.

Stop or get a face full of mace.

I'm not a mugger.

I'm just looking for someone

that lives here... Kelly Jones.

I know Kelly,
but who the hell are you?

I'm Zeke Barnes.
I'm a doctor.

I work at a clinic in Manhattan.

I've been treating
Kelly's father. He's very sick.

Then he's getting
what he deserves.

Oh.

So you're Kelly.

You know, he really needs you.

No, he doesn't.

And I don't need him.

Look, I know you two stopped
talking after your mother died.

Did he tell you why?

My mom was in so much pain,

and my dad made her fight,
even when there was no hope.

He made her suffer.

Well, he told me
he tried to call you.

Maybe he wanted to apologize.

Well, that door closed
a long time ago.

How long do you think
he'll be under?

Uh, excise bone fragments,
stabilize his spine.

I'd say at least six hours.

- I'll finish prepping.
- Yep.

Len: - I can't believe this.
Rita: - I'm not telling him.

Look, if you don't
tell him, I will.

Are you threatening me?

Tell who? Me?

Sorry, Michael.

Um, family discussion.

Family discussion, my ass.

She lied.

To me and to you, Michael.

Leonard Hall, please
don't do this.

Before Lenny shipped out
to Iraq the first time,

he and I had a long talk.

I told him about
being in Vietnam,

all the guys I saw maimed.

Lenny says, "Dad, if I have to be
kept alive by a machine,

I'd rather be dead."

He never would've said that.

So I was thinking about this
a little while ago

when I went home to get us
a change of clothes.

I started nosing around
the paperwork he sent Rita.

You had no right to do that!

I found this.

Lenny's living will.

Rita, did you know about this?

I saw it.

But I don't give a damn
what's on that piece of paper.

That piece of paper says

our son doesn't want to be
kept alive by a machine.

It's all we got!

He's all we've got!

You just want him to die
if something happens?

Of course I don't
want to let him die.

Then why'd you make him
go to West Point?

- I never wanted him to go!
- Rita, that was his decision.

You know that.
Just like this is.

You have no idea what he wants!

Enough!

Lenny's an adult,
and he made an adult decision,

and I have to abide by it.

If something happens in
that O.R., I can't put him on

a machine to keep him alive
just because you want me to.

Go to hell!

Anna: It's terrible when a family
can't talk to one another.

Especially on Thanksgiving.

Well, my most memorable
Thanksgiving was when I was 11,

and my dad went after
my mom with a knife.

I knew your mother died,
I had no idea your father...

Killed her?

No, he didn't.

Not that he wasn't trying.

We were screaming, and he...

Cut her arm up pretty good.

She ran out the front door.

I followed the blood down
the driveway, and...

She was gone.

And that whole
night, I just sat,

staring out my window...

Waiting for her to come back.

She never did.

Christina and I made a promise

that we would never tell anyone
what really happened.

And I got really good

at believing
that my mom was dead.

So, she's still alive?

I don't know.

Lantz:
Michael?

Lenny's in the O.R.

Then let's go.

(Rhythmic beeping,
ventilator whooshing)

That's the last bone fragment.

Lenny's spinal cord is intact.

Let's close the dura, stabilize
his spine, and we're done.

How we doing, Victor?

Lantz:
Ah, looks good.

Heart rate and BP are steady.

But his end title CO2
is climbing.

I'll increase
his ventilatory rate.

Any idea what's causing that?

Probably just underventilated.

Close the dura.

I need the hardware.

Michael,

his temperature's going up.

(Rapid beeping)

What the hell's wrong?

I don't know,

but temp just spiked to 105.

He's going into spasm.
Spasm plus fever...

It's malignant hyperthermia.

If he's having a reaction

to the anesthesia,
I got to wake him up.

Well, you can't.
Spine's still open.

Yeah, if I don't wake him up,

his muscles will break down,
or his brain will burn up.

And if I close him before
I stabilize his spine,

he's a quadriplegic
on a respirator.

At least he'll be alive.

Respirator is not an option.

I am finishing the surgery.

Cool him down however you need.

Get me ice packs
and chilled saline.

Putting him
on a dantrolene drip.

Placing ice packs now.

Lantz:
His temperature

is coming back down.

All right, done.
Let's close him up.

Temp's 102.
I'm waking him up.

All right,
repeat blood chemistry

and continue cooling measures.
Did you get his temp down

before his brain burned up?

I hope so.

Stay with me, Lenny.

Lenny?

He's in recovery.

Bone fragments are gone.

Spinal cord is decompressed.

What happened in there, Michael?

What took so long?

Did his AVM bleed?

Well, his AVM wasn't an issue.

Lenny had a reaction
to the anesthesia.

I didn't know he was allergic.

Well, no one did.

He's never had
surgery before, right?

But we got it under control,
and we fixed his spine.

You saved him, Michael.

You did what I asked.

Well, fortunately,
I didn't have to make

that choice.

But if I did, I would have done
what Lenny wanted.

I know.

Do you want to tell Len?

I'm not sure he'll even listen.

I think he'll be happy to know
that his son's gonna make it.

Come on, Dennis, you made it
through the night.

Don't leave now.

Why, so you can lie some more?
My daughter was never coming.

Dennis, if you walk
out that door now,

you won't make it
halfway down the block.

- Fine by me.
- Dennis,

I'm sorry, but I know
you don't want to die.

You don't know,
so save your apologies.

Kelly: Because it's you
who should apologize.

Kelly.

I spent all night thinking
that if today means anything,

it means family, so, yes,
I came to hear your apology.

What?

What do I have
to apologize for?

(Sighs)

You're the one
who left two years ago.

You lied to get me here?

- Like you lied to keep me here.
- I didn't lie.

You said you called her,
you wanted to talk to her.

For her to apologize.

Me?! You put mom
through hell

when all she wanted was to
spend her last days in peace!

Let me out of here.

Dennis, hold on.
Get your hand off me.

What's wrong with his eye

and why is his voice messed up?

Dennis, had you been
feeling weak

before you were brought in here?
I always feel weak.

Seeing double, having
trouble swallowing food?

Yeah, it's all cancer, right?

Did a doctor actually tell you
you have lung cancer?

Dennis: No, but I smoked two
packs a day for 40 years

like my wife did.

(Panting): I'm always tired
and short of breath.

It's cancer.

I'm not so sure.

You need to stay here while
we figure it out, okay?

So I'd like you to go
back to that room.

You can take
your daughter with you.

What?
I'm not going anywhere with him.

All right, enough of this crap.
You're going back to the room...

You're going, too...
Or I'm gonna reinsert

that breathing tube,

and this time it might
not be down your throat.

That's what we call
doctor's orders

here at Clinica Sanando.

Let's go.

Milo, I need your help.

Kate, if this is
about your DNR guy,

I am not coming
over there again.

I am not asking you to,
but he now has double vision,

trouble swallowing, a droopy
eyelid, and a fading voice.

Sounds like myasthenia gravis.

- Great minds think alike.
- All right, you need

to do an edrophonium test
to confirm the diagnosis.

You think we stock edrophonium?

Okay, fine, send someone over.
(Elevator bell dings)

Wow, that was fast.

Thank you, Michael.

- Uncle Mike.
- Yeah, I know, I know, I know,

Kate sent you.

Have you noticed how hot she is?

Have you noticed
you're half her age?

Are you really not coming to
the Clinica for Thanksgiving?

Is this you talking
or your mother?

She really wants you there.

Milo, your mother and I don't
have the best track record

when it comes to the holidays.

It's not like you
can change the past.

Okay, that's definitely
your mom talking.

Just seems like the two of you

would have fun if
you dropped by.

It's not like I
care or anything.

I'll think about it.

(Monitor beeping)

Here you go.
Thanks, Milo.

He's your patient.

You run the test.

What are you testing him for?

Myasthenia gravis.

It's an autoimmune disease
that attacks the muscles,

including the ones
that help you breathe.

So that's what's killing me?

Let's not get
ahead of ourselves.

Take my hands.

There you go.

What the hell was
in that needle?

It was an enzyme inhibitor

called edrophonium.

It proves you have
myasthenia gravis.

That's why your breathing
has gotten worse lately.

I breathe so much better.

Does that mean
I'm not going to die?

It's a treatable condition
if you get on meds

and you go to the doctor
when you're supposed to.

Kate: Dennis, you need
to decide right now

if you really want to live

'cause these meds only
last for a short while

and if you go down again,
we have to honor your DNR.

Kelly, you should say
good-bye now,

'cause he's not going
to last much longer.

Dad, please.

Mom fought till the bitter end
because you wanted her to.

Why won't you fight
like she did?

'Cause if you don't forgive me

for the way I acted,

I don't really have
anything to live for.

I just needed your mom

to stay with me so bad.

And now I need you
to stay with me.

(Breathing heavily)

(Rapid beeping) Zeke:
Meds are wearing off.

Pulse ox is down to 70.

Dad, tell them.

I won't fight you anymore.

(Beeping stops)

Welcome back... again.

Mom, dad?

Hey.

We're right here, Lenny.

Uh-oh, what happened?

I was on my bike.

You had an accident, son,
but you're okay now.

Michael operated on you.

Uh-huh, that IED
in the street.

Is that what it was?

No, it was a piece of garbage.

Looked like an IED.

Your son's mental status
is normal.

- What about...?
- Yeah.

(Clears throat)

All right, Lenny,
can you wiggle your toes?

Lenny:
I'll try.

Len: Hey, hey, hey, hey, hey.
(Rita laughs)

Excellent, now try the left.

Ah.

(Rita laughing)

All right, so we're going
to get you home,

and once that spine heals,
send you to rehab and, uh,

- back on your feet.
Rita: - And never

on a motorcycle again.

(All laugh)

Everyone up for Turkey?

I ordered from the deli
across the street.

Mm-hmm, sounds good, mom.

What about you, Michael?

Actually, I'm gonna head out,
thank you.

Happy Thanksgiving, guys.

Hmm.

Hey, Kate.

Hey, sorry for yelling
at you yesterday.

You've done nothing
but a great job

ever since the moment
you set foot in this joint.

Yeah, well, tell me that

when I can't pay my
credit card bills.

Zeke, here you go.

Happy Thanksgiving.

You, too.

Thank you, Christina.

Just, uh, you can't leave
without telling me why.

Why what?

Why you fought so hard
to keep Dennis alive

when even he wouldn't fight.

Guess I just hate to lose
someone whose time isn't up.

Happy Thanksgiving, Kate.

Sure you don't want me
to heat that up for you, mom?

Oh, no.

Sit, sit, Zeke, sit and eat.

So how was today?

Not so bad.

Looks good, huh?

Oh, very good, yes,

but next year I'm going to make

Thanksgiving dinner myself,

just the way you like it.

No one fights like you do, mom.

(Indistinct chatter)

Michael, I thought
you weren't coming.

Yeah, you either.

Not celebrating with the hubby?

I, uh, told him
that I had to work.

Oh.

Here.

So did your DNR guy have
myasthenia gravis?

He does, yeah,

but he's better and
he wants to live.

Good.

How's Rita's son?

It's a tough road ahead,
but he's alive.

You don't happen
to have any forms

for a living will
lying around, do you?

You don't have an
advance directive?

I'm not going to die.

(Both laugh)
All right.

I'll, I'll help you
with your forms

if you help me with mine.

Gentlemen.

- Uncle Mike, you made it.
- Yeah.

Mikey Mike, welcome.

Happy Thanksgiving.

Thanks... you, too.
Homemade tofu Turkey?

That sounds terrible.

Sure.

- Enjoy.
- Thanks.

Save me a seat.

You got it.

Happy to see you here.

Yeah, me, too.

You okay?

I've been thinking a lot about,
uh, that Thanksgiving,

uh, about the story
we've been telling

about mom leaving.

Why are you talking
about this now?

I think it's time
to face the truth.

Come on, I'll get you a fork.

Thank you.

Maybe a knife.

Definitely a bunch
of napkins for you.

(Laughter)

A Gifted Man 01x08
In Case of Missed Communication
Original Air Date: November 18, 2011