The Resident (2018–…): Season 1, Episode 3 - Comrades in Arms - full transcript

- Previously on The Resident...
- Everything you thought you knew

about medicine is wrong. All
the rules you followed, we'll break.

You don't have the
right to play God, Conrad.

I will do whatever it
takes to get you back.

Chief of surgery.

Resident. Try to remember that.

Dr. Okafor.

Don't be nervous.
I'll talk you through it.

Acute leukemic, on chemo.

Lily means a lot to all of us.

She's been in and out of the
ER so often we're all invested.



- Where's Lily Kendall?
- She went home.

Her count improved
substantially.

♪ ♪

♪ You're getting way
too big for your boots ♪

♪ You're never too
big for the boot ♪

♪ I've got the big
size 12s on my feet ♪

♪ Your face ain't
big for my boot ♪

♪ Kick up the yout,
man, know that I... ♪

- We're in third place.
- Now or never.

Sir, yes, sir.

Second place.

Oh, I know how
you feel about losing.

♪ How dare you twist
up the truth, look ♪

♪ I'm too hot ♪



♪ Lunch money in my shoebox ♪

♪ Still steal meat
from the stew pot ♪

♪ Mandem go sick when
my tune drops, little man ♪

♪ That's a Hublot,
not a Hublot, wait ♪

♪ Wait, I'm bound
to ride for Flipz ♪

♪ Real Gs gonna ride around... ♪

- We got this.
- We do?

I do.

♪ I never left my
9:00 to 5:00 for this... ♪

15th Marine Expeditionary.

Valor, honor... Whoa...

- Victory.
- Yo!

Dudes. Awesome race!

Of course... random drunk guy.

Cold ones on me.

Aah... aah!

My leg!: I need a doct...

It's broke.

Doctor!

Right fibula. Compound fracture.

We need a splint.

- Oh, it hurts. It hurts so bad.
- Deep breaths, buddy,

we don't want you going
into shock. What's your name?

- Ooh. Hank.
- That's the best we got.

- We'll just wrap him up.
- Like old times...

- medic and surgeon?
- He's about to tell us how much he misses

the good ol' days when we
were in Afghanistan together.

Give me some credit,
hey. All right, listen,

this is gonna sting. Might
want to bite down on that.

- But I do miss it sometimes. Don't you?
- I don't miss

being shot at. No
sane person would.

Not trying to take
that personally.

Setting the leg...

now! -

There we go. All right.

Doing great, buddy.

♪ I was born for this ♪

Let's go!

♪ Baby, I was born... ♪

♪ ♪

Lily, hey.

Oh, hey, Nic.

You left Chastain so abruptly
the other day. I was worried.

Yeah, I'm fine. Thank you.

Just grabbing a prescription.

You feeling okay?

You want to come upstairs?
I can take your temperature,

- make sure you don't have a fever.
- No, no, I'm-I'm good.

Yeah, I'll stop by Dr. Hunter's
clinic if I need anything.

- You sure?
- Mm-hmm.

'Kay.

Thanks.

Come on, Mr. Rosenthal.

I got to take you for some
fresh air, and then to PT.

No, thanks.

What I need is a
drink and smoke.

Good morning, Mr. Rosenthal.

Lucky you... A free
ride with Louisa,

our most popular transpo worker.

Ah, just a quick spin.

Don't want a spin
around nothing.

- You need sunshine.
- Vitamin D,

helps you absorb calcium.

Which promotes bone density.

You don't want to break
your hip again, do you?

You know, you should really
listen to Louisa. You know why?

No, why?

She's studying to be a doctor.

Med school, huh?

You got a ways to go.

How old are you, 12?

Ah, close. 22.

And she volunteered at
Chastain all through high school.

- Hmm.
- Hi, Louisa.

- Hey.
- Nic, seriously,

what is this mandatory
meeting about?

I have 30 patients to see.

- Billing.
- Billing?

Whoa, sign me up.
Love me some billing.

Enough already.

You okay?

Yeah. Diagnosed myself
with a muscle pull this morning.

Some kind of softball injury.

Might have to, uh,
skip out early today.

Plus, I have to cram.
Midterms next week.

Bio and calc.

Well, if you need
any help at all,

I got a 132 on the bio
section of my MCATs.

Kid brags a lot, doesn't he?

Thanks, Dr. Pravesh.

I might take you
up on that offer.

Compound fracture
of the right fibula.

Now, we reset it in the field,
but he might need surgery.

All right. I'll be right there.

- We'll see you inside.
- Okay.

- Thanks, Doc.
- Let's go.

You did great, Hank.

Yeah, except for the crying.

And screaming for a doctor.

And breaking all
those beer bottles.

The truth? That
was like old times.

Well, you miss it so much,
why don't you go back?

Yeah, I've been
meaning to tell you.

Jude, I was joking.

Thinking about re-enlisting.

- Back into the Marines?
- Yeah.

Do boys ever grow up?

- Yes. -No.
- Mandatory meeting, we're late.

I thought you were
gonna get us out of this?

Yeah, well, I told her we
had seven open cases...

All residents, all
nurses. Let's go.

You smell like a barn.

- I like barns.
- Never been in one.

What? I grew up in Queens.

I've smelled worse, trust me.

Excuse me.

Morning, everyone.

We're here today to talk
about reimbursement.

No one's favorite
part of the day, right?

Okay, put that away, sweetie.

Now, to simplify, doctors
and nurses at Chastain

need to charge
more per procedure.

For example: ear infection.

Typically billed to insurance
as service code one

at about... yeah?

$200.

But what if that ear infection

took a trip to the brain?

That's now a code four. Serious.

Costly.

We can bill in the thousands.

Illness is unpredictable,
so billing must be proactive.

Right? It's called upcoding.

Think... CUTE.

Code. Up. To. Excellence.

Enjoy. I'm out.

Third year. First year.

Welcome to American
healthcare 101.

Okay, what are we
all concerned about?

How much did you
have to drink today?

Not really sure.

You were at the
race all morning?

Which Conrad and
I won, by the way.

I had a beer before the race.

Jaundiced skin, scleral icterus.

I'm sending him for a liver
panel and an ultrasound.

How's our number one fan?

You see this?

This is a stateside doctor,
doing what he was born to do...

Running liver function
tests in a cushy, big-city ER.

♪ I am the very model ♪

♪ Of a modern major-general ♪

♪ I've information vegetable,
animal and mineral ♪

♪ I know the kings of England ♪

♪ and I quote the
fights historical... ♪

I was also born to sing.

Ooh.

You get out on the
boat this weekend?

Yeah, the fish
weren't biting. You?

Well, a little golf.

You know, actually, I
had a question for you.

Old guy I was playing with
has developed a bit of a tremor.

And it's giving him the yips.

And I prescribed the
standard... Beta blockers...

But it hasn't helped.

You know, I know
there's surgery,

but it seems a little drastic.

Well, cracking open his
head for a missed putt

is a bit much, huh?

Yeah, what about
benzodiazepines?

Last resort, he can try 'em.

But the side effects
are gonna be...

- Aggression and cognitive impairment.
- Yeah.

I guess it just depends how
desperate the guy is, though.

- Cheers.
- Cheers.

Rosenthal in 5931...
Catheter out and discharge.

Anderson 5942...

Monitor her rhythm. Where
were you and Dr. Silva deployed?

Afghanistan.

If she spikes a
fever, you add...

IV piperacillin.

My brother was in the
army, two tours in Iraq.

He came back a
very different guy.

Did you see any action?

I was a corpsman in the Marines.

Jude was a base surgeon.

We tried to save
lives, not take them.

But mostly, we had
each other's back.

Now let's move on to medicine.
We have a busy day ahead of us.

Let me know if there's anything
in the marketing department...

Look busy.

The upcoding system.

Don't forget testing.

A well-insured patient
should be tested

for all possible outcomes,
no matter how unlikely.

Dr. Hawkins, have
you met Barb Olsen?

She's our billing consultant.

Here for two weeks to help
Chastain become more efficient.

Of course. The bike shorts.

Yeah, I already saw you at
my presentation... well, briefly.

I got paged.

Didn't I get paged?

I didn't hear anything.

Well, nice meeting you.

Barb, there's, um...

Payback. For making
me sit in that presentation.

What's your problem?

A strong kid like you...
Can't you go any faster?

I got a life to lead.

Hey, Louisa, how's my
man Rosenthal treating you?

Like the daughter he never had.

A nightmare.

The Chastain softball team

crushed Emory yesterday.

Yeah, we did.

Is your back still
bothering you?

Uh, yeah, it's no big deal.

Now I'm thinking it's a
pinched nerve, lumbar spine.

Pain that, uh, radiates
along the affected nerve.

That's impressive, but
you're not quite a doctor yet.

- Let me have a look.
- Uh, maybe later.

I told Joey in Ped Onc I'd
take him to the play area.

Man, that munchkin is cute.

Check back in
with her in an hour.

I just want to examine
her and make sure...

Hey! We need some help in here!

- Oh, my God, I'm sorry.
- It's okay.

It's okay, stay still.

We got you.

I'm too young for kidney stones.

I'm thinking it's
just a gas bubble.

It's really no big deal.

How long have you
been short of breath?

Just a few days.

I was thinking it
was from the pain.

Your lungs sound congested.

We need a full workup.

This could be serious.

No, I'm okay. I swear.

I can't be sick, they'll
send me back home.

And I need every dime
to make ends meet.

And a CT scan as well.

MRI's probably
the better option.

Actually, maybe we should
check her insurance first.

- Uh, can this wait?
- No.

Can I a moment with
the patient, please?

We're conducting an exam here.

Dr. Hawkins, the administration
has given me license

to inspect all
hospital finances.

You're a subcontractor
to the hospital, right?

Yes. Is this really necessary?

I'm feeling better. I
just want to go home.

Rest up.

She wants to go home. Great.

She can't. She needs an MRI.

Do you know if your
company will cover an MRI?

Does anyone know that stuff?

Then if it doesn't, an X-ray

- is more than sufficient.
- Actually, it isn't.

Louisa is part of
the Chastain family.

- She deserves our best care.
- Well, I can see

that she's a wonderful
young woman...

I can't do this.

I'm sorry, thank
you, but I'll just leave.

It would be wise
for you to let her go.

Wow. Really?

Louisa...

Easy. Easy.

There you go.

Pulse is weak.

Distant heart sounds,
distended jugular veins.

Cardiac tamponade.

Too unstable to move.

I need 18-gauge spinal needle

with a 20cc syringe.

I'll prep the ultrasound
in exam room four.

Good. Go.

Louisa, you have
fluid around your heart.

We're going to
relieve the pressure.

You cut, I draw.

Quickly, we're losing her.

Ready.

Now, Louisa, you're
gonna feel pressure

and then stinging.

You're okay, Louisa.

DEVON: Another loud noise

and we're almost done.

Don't worry, just a
few more minutes.

Get her out of that machine.

- We're almost finished.
- She's not insured.

She can't pay for her treatment,
that's why she ran away.

Or maybe she didn't
want to burden the hospital.

Well, it's a little
late for that,

'cause Chastain is gonna have

to eat the cost of that MRI.

- That's $10,000.
- $10,000 is what

they charge the
insurance company.

It doesn't cost the
hospital anything like that.

Are you offering to pay?

Here, for your intake files.

I will call her employer,
see what I can negotiate.

God, I hate that woman.

You and I will run
point on Louisa's care.

We need to get as
much done as we can

before the administration
pulls the plug.

We can't let them kick her out.

Well, don't panic yet.

Worst case, we guide
her to another hospital.

Where she never even
makes it past ER triage.

Trust me.

LFT panel.

Hank, you have acute hepatitis.

Is that bad?

It means that you've
consumed so much alcohol

that your liver's
temporarily paralyzed.

It's quite a feat, actually.

Exactly how many
beers did you have?

- Two...
- Two beers?

Two dozen.

If you don't cut back, your
liver's gonna stop functioning.

Your stomach will swell,

you're gonna become
confused, then sleepy,

you slip into a
coma, then you die.

I'm not trying to scare
you, it's just the truth.

You're drinking
yourself to death.

I know.

Help me?

I can get you into
a rehab facility.

I can't do rehab.

I'd lose my job.

But the rest of it, yeah.

I'm ready to quit.

I am. I've struggled with
alcohol my whole life.

Look, the moment
I walk out of there,

I swear, I will go
straight to a meeting.

I'll get a sponsor, I'll stay
in AA the rest of my life.

That's easy to say,
pal. It's hard to do.

Atwood, Henry, two of
Lorazepam for withdrawal.

Thank you, Doctor.

You can do whatever you
want, it's not gonna help.

His problem is self-inflicted.

Hell, 90% of the
patients that come in here

have done stupid
stuff to themselves.

Remind me how you got
that scar on your thumb.

Wasn't it field-dressing
a possum?

I was nine years old.

And I treated the injury myself.

Of course you did.

It still doesn't explain
why you eat possum.

Yeah, we all didn't have moms

who would shop and cook for us.

Or dads who were sober
enough to drive us to the ER.

Exactly, and that's
why I'm here...

To help whoever
walks in that door

who can't help themselves.

It doesn't matter whether
they eat lobster or road kill.

I take care of them.

All right.

Let me ask you this.

What is the most fun you
have had in the last week?

My guess?

You and me fixing up Hank

in the back of
that pickup truck.

Seat-of-our-pants medicine.

Nobody telling us what to do

or making us fill out forms.

Then what happens?

We come back to work,

and a patient is
trying to run away

because she doesn't
have insurance.

We can't even treat someone
who's worked at Chastain

for the past two years.

How many wounded
Marines did you ever ask

for proof of insurance?

Well...

I guess I got my work cut
out for me, then, don't I?

You keep tilting
at windmills, huh?

- Currently on any medications?
- No, but I'm...

Have you eaten anything
in the last eight hours?

I'm not having surgery today.

It says here, "Reynolds,
hernia surgery, 2:15."

I'll be assisting.

I'm having some more tests.

- Excuse me?
- A very nice lady came in

and talked my doctor into
ordering some more blood work.

Another CT scan and an MRI.

You don't need an MRI,
you need hernia surgery.

She said I needed it
to be on the safe side.

She was very convincing.

Why is my hernia
patient having more tests?

He doesn't need more tests.

Another Barb victim.

Profit before patients...
The new healthcare mantra.

Barb is like a migraine.
You can feel it coming,

but you can't stop it.

Then it gets worse and
worse, and you throw up.

What do you guys think
of the name "Say Ah"

for a resident-nurse
a cappella group?

"Say Ah"?

Yeah, you know, to
serenade patients.

No one wants you
to sing them a song.

The meaner she is to me,
the more I'm in awe of her.

Yeah, that's kind
of how it works.

Wow.

You got Louisa's results?

This is a T2 hyperintense,

enhancing mass,
encasing the spleen, kidney,

and vertebral bodies.
Most consistent with...

A retroperitoneal sarcoma.

Which would explain
the fluid in her heart.

She lied to us. And
to her employer.

She didn't run away because
she doesn't have insurance,

she ran away because she's
an undocumented immigrant.

She has a highly
aggressive tumor.

If she doesn't get surgery
right away, she dies.

No more tests,

no more treatment on our dime.

This hospital isn't a charity.

I felt this was important enough
to bring to the CEO's office

right away. Ms.
Rodriguez is an uninsured,

undocumented immigrant.

She has no family
in this country.

She was brought here
from El Salvador as a child.

No one can take her once
she leaves the hospital.

State rules are clear on this.

Ms. Rodriguez cannot be
released into her own care.

That means Chastain
would be stuck with her

for a long time.

She'd be living
here at our expense.

She would be a Perma Patient.

Not every CEO knows that term.

Claire is not your average CEO.

Dr. Bell, what's her prognosis?

Well, the five-to ten-year
survival rate is excellent

if we operate right away, but...

the longer we wait,
the worse her odds.

And if her surgery is
successful, what's the rehab?

Six months to a year.

Okay, best-case scenario,

what is Louisa's
care gonna cost us?

Chastain does the
surgery, it goes well, post-op,

she can walk with a physical
therapist down the hall...

Half a million dollars.

And worst case?

Post-op, Ms. Rodriguez
can't even get out of the bed...

Two million dollars.

Hang in there, your count is
moving in the right direction.

Lane.

Hey, Conrad. How are you?

I'd like to call you in
for an oncology consult.

Okay. Who's the patient?

Louisa Rodriquez, transport
worker here at Chastain.

Good person. She's uninsured

and an undocumented immigrant.

Um, a full course of
radiation and chemotherapy

is, uh, very expensive.

I understand, but don't
you have a foundation

- for cases like this?
- Yes, I do,

but it's not for the
undocumented.

Look, I'll make some inquiries,

but I can't make any promises.

- That'd be fantastic.
- Conrad.

Administration just
put Louisa's surgery

- on indefinite hold.
- Lane...

- Louisa's all alone.
- I'll see what I can do.

I forgot to tell you
I saw Lily earlier.

She didn't look good.

Nic, she has cancer.

I know we've been through this,

and I'm sure Lane had
every reason to discharge Lily,

- but my instincts are...
- Lane will take care of her.

Lily's in good hands.

Okay, well, I'll be
going... Oh, excuse me.

Oh, Nurse Nevin.

If I could just have a moment?

I'm actually really
busy right now.

Okay, but I don't think the
nurses are getting the hang

of the upcoding system
and the multiple-test vectors.

Our nurses are
laser-focused on patient care.

That is their primary
responsibility.

♪ Too late to go back to sleep ♪

-♪ It's time to trust my
instincts ♪ -Excuse me.

♪ Close my eyes ♪

♪ And leap ♪

♪ It's time to try ♪

♪ Defying gravity ♪

♪ I think I'll try ♪

♪ Defying gravity ♪

♪ And you can't hold me down. ♪

A little flat.

You're a little flat.

Next!

Claire, this is Jim Phillips,
CEO of Atlanta General,

and Stuart Green
from our Lady of Mercy.

The three of us go way back.

Ms. Thorpe took over
as CEO of Chastain,

- what, six months ago?
- Yes.

They're all yours.

Gentlemen, it's lovely
to meet you both,

and thank you for coming
in on such short notice.

I'll get right to the point.

We have a patient,
uninsured, undocumented,

with a retroperitoneal sarcoma.

Possible six months
to a year rehab.

Given our fixed costs per bed,

this patient represents a
considerable burden on Chastain.

As they would for
Atlanta General.

Yes, but Atlanta General and
Our Lady of Mercy's fixed costs

are much lower than ours.

What are you
suggesting, Ms. Thorpe?

If either one of you will take
this patient off our hands,

pre-surgery,

we'll pay a fee,
one-time, of $250,000.

If you can funnel us
five Medicare patients

and up the fee to
$300,000, we'll consider it.

What if I offered you

five Medicaid
patients and $250,000?

Medicaid
reimbursements are junk.

Ten Medicaid and 300 grand.

I'm offering seven
Medicaid and 275.

Too low.

We're out.

Stuart, Our Lady of
Mercy has a charity fund.

What if we did the surgery
and you did the rehab?

We could give your fund
$100,000 that you could use

at your discretion.

We just built a
new cardiac wing.

Which is a-a beautiful wing.

Cost us $40 million.

And I am sure that you will
make that back in fees in no time.

My board would kill me if we
took another Perma Patient.

I'm gonna to have to pass.

I'm sorry.

Who can we call, Louisa?

You must have family here.

My parents brought me here
when I was three years old.

My mom died two years ago,

and my dad moved
back to El Salvador.

I'm alone.

And you support yourself?

Yeah.

I guess I was crazy to think
I'd make it to med school

without being found out.

If Immigration gets
their hands on me,

they'll send me back,
no questions asked.

But this is the only
country I've ever known.

And to be a doctor...

that's my dream.

I'm so sorry to cause all
this trouble, Dr. Pravesh.

Everyone at Chastain has
been nothing but good to me.

Louisa, we're going to help you,

and you deserve
better than this.

I looked up the
surgery on my phone.

Cancer wrapped
around a lot of organs.

Pretty dangerous stuff, huh?

Yes.

It is.

But we both know it is
the only road to a cure.

Do you know how some people
say they're not afraid of dying?

That's crazy, right?

It scares the hell out of me.

Louisa, you're going
to be a doctor someday.

Helping you get there...

that's our dream.

Hey.

I, uh, checked
with my foundation,

and got a fast, hard no.

Our donors expect their gifts

to pay for the treatment
of U.S. citizens.

There are plenty of
deserving Americans out there

waiting for a chance.

Ugh.

I hate to disappoint you,
Conrad, that's the hardest part.

Thanks for trying.

You know, we do the best we can,

as often as we can.

But we can't save everyone.

You're all post-surgery,
and you all want to go home.

So today, we're
going to have a race.

Whoever gets to the end of
the hallway first gets discharged.

No more poking,
needles, BP checks.

You can cook your own meals,
take a warm shower. Sound good?

If you can't walk to
the end of the hallway,

you're here for another week.

One, two, three. Go.

Too slow, Mrs.
Pill. You're done.

Mr. Farragut, the same.

No time to treat a heart attack,

Mr. Smith, off you go.

Discharge the winners.

The losers can go
back to their rooms.

Take it easy, all right?
You're gonna be fine.

- Culling the herd?
- Yep.

Administration won't allow

- Louisa's surgery.
- Unfortunate.

But I heard she is undocumented.

Rules are rules.

Am I crazy, but aren't
you and me supposed to be

in the trenches together
on situations like this?

Please, tell me this is
not actually how you feel.

What I feel doesn't matter.

What I feel doesn't help.

I deal in facts.

Okay. Fine.

Because the hospital is trying
to save money, Louisa might die.

Fact.

She might die from surgery, too.

Fact.

Love the optimism.

How dangerous is it, Mina?

Very intricate, very demanding.

Seven, eight hours.

But glorious.

Sounds like it's
right up your alley.

Conrad, we all feel
terrible for Louisa.

She's an enormous liability.

As much as two million dollars

over the course
of her treatment.

Look, I get that it's
a bottom-line world.

You made that clear.

But I want you to think
back for a moment,

to when you were in med school.

It wasn't all about
making money.

That was a long time ago.

Healthcare has
changed since then.

We need to deal
with the new reality.

I think we can both agree

that every doctor has
that singular moment

when they decide they're
going into medicine.

For you, to be a surgeon.

And even if it was decades
ago, I'd bet everything I got

you remember it
like it was yesterday.

And I don't buy for one second

that it had anything
to do with money.

It didn't.

I fell in love with cutting.

I fell in love with the OR.

I love it.

Still.

But the money has to
come from somewhere.

If we treat Louisa, our
other patients will suffer.

Services will be cut.

Hours, staff.

You know, I don't like the
idea of putting a price tag

on a life any more than you do.

But the system
doesn't run on air.

No matter how
much we love Louisa,

her price tag

is not two million dollars.

Don't say anything.

Nothing.

Catch you at a bad time?

I'd like to shove
CUTE right up her...

Throw it in the trash.

You'll feel better.

Look at that.

Stress management.

I'm guessing you
didn't come up here

to talk to me about upcoding.

No.

It's about your boy, Conrad.

Look, he's taking things hard.

If he doesn't start
to choose his battles,

he's gonna burn out.

Yeah, well, I can't
control Conrad.

Never could.

And he's not my boy.

Not anymore.

Sorry to hear that.

Alabama Shakes is playing
Terminal West next week.

- Oh, yeah?
- Mm-hmm.

I got an extra ticket.

I remember you saying
you liked their music.

I do.

It's not a date.

Just a concert.

Have a little fun.

Rapid response, 5922. Let's go.

She's crashing.

- Blood pressure?
- 70/40.

- Cycling right now.
- Her IV blew in the MRI.

We haven't been able
to get another line since.

She's bleeding internally.

Now it's 60/30.

She's a hard stick.

Her vessels are clamped
down, she's too volume-depleted.

Emergency IO.

Yeah, I've never
done that before.

Get the kit.

You're doing it now.

Push the needle in.

Once you hit the bone, drill.

Keep it steady.

Drill.

Okay, release.

Flush.

Running in fluids.

We're in the clear.

- For now.
- She'll keep bleeding

until we get her to surgery.

There are four oncology
surgeons on call.

Why can't we ask one of
them to do the operation?

Good idea. Let's practice that.

I'll be Dr. Hillis.

Go ahead, pitch me the surgery.

Hi, Dr. Hillis, I need
a surgical oncologist

to operate on a
patient right away.

Okay, sure, who's the patient?

Louisa Rodriguez.

Actually, I forgot.

I'm booked solid today.

Ask Dr. Miller.

Dr. Miller, I need an
oncology surgeon...

Would love to, but I'm
headed to Aruba today

with my fiancée.

Dr. Singh says the failure rate

for this surgery
is through the roof.

Dr. Weiss heard
the administration

is dead set against it...

- The administration is wrong.
- Maybe they are,

but Dr. Weiss makes 400K a
year, really wants to keep his job.

Okay.

They're gonna wiggle their
way out of it any way they can.

But we know someone
dying to do the operation.

But it's not in your specialty.

So? I'm arrogant enough
to believe I can do it.

And I'm your only option.

Just get an
attending to sign off.

I need you to sign
off on a surgery.

It's not in your specialty.
You'll just be supervising.

Yeah, and what's the catch?

No catch.

Look, I know you, pal.

What rules am I gonna break?

Not breaking. Bending.

Bending, okay.

- Who's the patient?
- Louisa Rodriguez.

Oh, I'm in.

Surgery's a go. Mina's on deck.

Conrad, someone
called Immigration.

They're coming for Louisa.

How can I help you, gentlemen?

- Sir, you need to move aside.
- I will,

if you tell me what's going on.

Hospitals are sensitive areas,

along with schools and churches.

And sensitive areas

cannot be accessed
by immigration officials

without arrest warrants
or under investigation

of an imminent
national security threat.

ICE policy letter,
October 24, 2011.

You're interfering
with the actions

of authorized federal agents.

- You're gonna regret this.
- I doubt that.

Well then, you better
drag us both out of here.

Conrad.

Stop.

Step aside or you
will both be fired.

It's okay. Let them pass.

♪ ♪

♪ Daylight dims into grim ♪

♪ The pressure higher
than the tallest steeple ♪

We need to hurry.

♪ For my sins your caved in ♪

♪ The house of glass I
filled with empty people ♪

♪ It was a black
and stormy night ♪

Dr. Okafor, you may proceed.

♪ The kind that's
always pulling you in ♪

♪ Pulling you in again ♪

Surgery's underway.
Sterile environment.

You cannot enter under any
circumstance. No one can.

♪ The kind that's
always pulling you in ♪

♪ Pulling you in again. ♪

Pushing us to charge more,
and order endless tests.

Yeah, Dr. Pravesh wants
the feeding tube out for 4710.

Barb called
Immigration. I'm sure of it.

MRI order from Dr. Williams.

Wait. Give that back to me.

- Is this scheduled for right now?
- Mm-hmm.

- Pull him out.
- What are you doing?

- Did you push his doctor to order this test?
- I did.

Without checking
the patient history?

Open the microphone.

Mr. Reynolds, do you
know how an MRI works?

It has incredibly
powerful magnets.

Magnets that will rip anything
metal out of your body.

Anything at all.

Do you have anything metal
in your body, Mr. Reynolds?

Mr. Reynolds has
a penile implant,

a metal-based penile implant.

How much is your penis
worth to you, Mr. Reynolds?

Say, in a lawsuit?

A million dollars?
Five million dollars?

Stop the machine!

You are not a doctor
and you are not a nurse.

Not every test is safe.

Not every procedure
should be billed

for ten times what it's worth.

You're gonna end up
getting someone killed.

- Now wait just a second...
- I'll be filing an incident report

with the Comptroller's
office and the CEO.

Good luck getting
hired at Chastain again.

Louisa.

Do you have any nausea?

No.

I feel okay.

You've been so
kind to me, all of you.

I'll never be able
to repay you for this.

But I'll still need some
help on my bio midterm.

Anytime.

So...

the operation came
off without a hitch.

You had a spectacular surgeon.

Cake.

What are her rehab markers?

Well, if she can walk to
the door, we're in the clear.

If not...

Hey. Well, you look good.

You know, it's really important

that we get you up
on your feet right away.

So... how about
you get out of bed

and show us how you
can walk to the door?

Okay.

Let's really concentrate.

Here we go.

I'm so sorry.

Two million.

It's okay.

You'll be fine.

Louisa,

rehab is gonna be
a long, hard road,

but we all know
how tough you are.

You'll get through this.

With some time and care,

you'll be right back where
you were in a year or so.

We've got your
back the whole way.

Hey, Art.

Randolph.

Hey, uh, how's your
golfing buddy doing?

The one with the tremor?
He sink any more putts?

Oh, uh...

He just started
taking the medication.

- Probably too soon to tell.
- Okay.

Well, keep me updated.

Yeah. Yeah. Will do.

Jude and I are
gonna go grab a beer.

You want to join?

She's a lot cuter than
either of you guys.

True enough.

Enjoying your
victory, Dr. Hawkins?

Did you call Immigration?

You had your billing
consultant do it for you.

Barb Olsen's contract

with this hospital
has been suspended.

But I have to pull two
million dollars out of thin air.

- I understand...
- No.

You will understand full
well when I take that money

out of the Internal
Medicine and ER budgets.

Be prepared to be
woefully understaffed

for the next 12 months.

By the way, thank you for today.

Yeah.

Thorpe could've had
you canned on the spot.

Well, I get fired, it makes
the decision for me, right?

I show up tomorrow at
Fort Benning, 6:00 a.m.

Hell, you could
be there with me.

Hmm?

All right, so you're
starting to come around.

What are you so
damn happy about?

Because I know exactly where
I'm supposed to be tomorrow,

and it's at Chastain.

Yeah.

Valor, honor...

Victory.

Mm.

I got these.

So, you know, I've been
meaning to ask, you and Nic...

That still a thing?

She doesn't think so, but...

I think she's worth
fighting for. Don't you?

Oh, hell yeah. Game on.

♪ ♪

♪ You gave me scars ♪

♪ Beautiful scars ♪

♪ On my back and all ♪

♪ You see how far I come ♪

♪ You gave me scars,
beautiful scars... ♪

28-year-old female.
Cancer patient.

Short of breath and
vomiting. BP's dropping.

Volts and a liter of
saline right now...

Captioned by Media
Access Group at WGBH