The Resident (2018–…): Season 3, Episode 14 - The Flea - full transcript
Cain feels disrespected by Logan Kim when he is left out of a major decision regarding Conrad. Meanwhile, the doctors work together to try to save the lives of two big Red Rock donors who ...
The Resident...
Today is the day we introduce
3B Life to the American public.
So you are Bell
and Cain’s new partner?
They’re the new partners.
I’m the founder.
-You should call me.
-Okay.
I’ve just been hired
as the new team doctor
for Georgia FC.
This will remain
at St. John’s unless
there’s another hospital
I decide to call home.
What would be the terms?
Chief resident.
-Good to have you back.
-Cheers.
I told you the table-side
Caesar was a bad idea.
You know that little asterisk
they put on the menu?
"This contains raw egg"?
Why did I ignore it?
’Cause you love to live life
on the edge. Like me.
I really wanted to be with you
your first day back at Chastain.
I know, but it’s only one day.
And we have so many more
to come.
Unless you continue
to ignore the asterisk.
All right.
Kitchen’s stocked.
Bananas...
-rice...
-Applesauce, toast.
Yes, I’m well aware
of the BRAT diet.
Have a good first day back.
Be with you in spirit.
-All right. I love you.
-
Oh, nice. My little BRAT.
Now go. I’m gonna be sick again.
-Stay out of trouble.
-Call me if you need anything.
-Hey, Pravesh?
-Hmm?
-Does that guy
look familiar to you?
-Oh, no. No, no, no.
-Why?
-I don’t know, I...
I think he used to work here.
You know, it’s just
really hard to remember,
you know, with all these faces
just coming and going
around here.
Oh, yeah, yeah.
You boys done?
-Hmm?
-Oh, wait. I do
remember that voice.
Dr. Conrad Hawkins.
The man who went up against Red
Rock and lived to tell the tale.
Oh. Oh! Oh.
You miss all this?
You have no idea.
How do you feel about getting
your footsies wet in the ER?
-We could use the help.
-Ah!
-Wet footsies. I’m in.
Psst.
Good to see you, darling.
Dr. Hawkins.
Welcome back.
Thank you.
Nice to be back.
Let’s go.
Brought Hawkins back?
Uh, hey, let me call you back.
He signed a lucrative deal with
a national sports franchise.
-He’s still a whistleblower.
-I’m aware.
Risk versus reward.
I made the call.
It’s insanity.
Turns out he’s a rainmaker.
And Red Rock likes the rain.
Yeah, I’m well aware.
Remember who you’re talking to?
Now, careful now... Barrett.
Proceed with caution.
I should have been informed.
Leaving me out of the loop
on Hawkins is
a sign of disrespect
to the surgeon who’s made
more rain for you and Red Rock
than anyone else.
Not as much as you used to.
Your billing is moving
in the wrong direction.
Pair that with the expensive
neuro center we’re building
on your behalf,
by my assessment I’d say...
you got to hustle up.
Hustle up?
What exactly are you implying?
Everyone has an expiration date.
Everyone.
I’m game.
I’m game, too.
Even though most people don’t
normally do it this way.
That’s true.
When most people start out,
they only show each other
qualities.
And hide their worst, pretend
to be someone they’re not.
It could be months before you
find out who you’re really with.
Years.
We will lay it all on the table
next to these inedible eggs
and DOA flapjacks.
-
-A breakfast interrogation.
Won’t be my first time
on the witness stand.
-Oh.
-Mm-hmm.
-Well, let’s start there,
why don’t we?
-Okay.
Oh, hey, uh...
Just checked on that
outside hospital
hernia transfer.
His incision was oozing.
I interrupt something?
Enjoy your meal.
Uh...
where were we?
I was about to ask you
about your worst breakup.
Yeah.
No.
No, we’re-we’re not going there.
-What?! We’re just...
-N-No.
Sorry. Not-not a chance. The...
-
-I-Is...? Whoa.
Is that my pager? I think...
Oh, look at that.
Saved by the pager.
-Did you just page yourself?
-Excuse me?
-What? Huh?
-What do you mean?
Who does that?
- Okay.
-Listen, got to go.
-Catch you later.
-
Incoming Bay Six.
-Hmm.
-All right, let’s do this.
Doug, I’m Dr. Hawkins.
So what’s going on?
Uh... it was Taco Tuesday.
I do it up real nice
for the kids.
Queso, green chilis.
I was cleaning the table off,
and I looked down,
and that’s when I saw it.
Saw what?
Drool.
I was in the middle
of a photo shoot
when it got real bad.
Well, it’s not uncommon
for flashing lights
to trigger a headache.
Your pupils are pinpoint.
That means smaller than normal.
I know what pinpoint means,
thank you.
How long will it take me
to get normal?
I’m tip-top
from top to tail, baby.
-Then why are you here, Raj?
-
Look, I get the runs,
like, every 20 minutes.
All right,
I was on a date last night.
Had to get off to the john
before the food even arrived.
We were supposed to go see a
movie after. Forget it.
We might as well watch it
on my phone in the bathroom.
All right.
-All right.
So you pull me into the ER
for what appears
to be a drooler,
a headache, and diarrhea.
So we threw you
some softball cases.
We just don’t want
to lose you again.
Don’t fly too close to the sun
on your first day back.
-Mm-hmm.
I could use a little sun.
Mind if I join?
Hawkins is back in action.
What a lovely sight.
They should be landing soon.
54-year-old woman, Jet Ski
collision with a motorboat.
Propeller lodged in pelvis.
Pulse 126.
Got it.
Voss, you’re with me.
Careful not
to disrupt the propeller blade.
Roger that.
-What’s her name?
-Becky Copple.
Becky, we’re gonna take care
of you, okay?
What have we got?
55-year-old male, same accident.
Hit his head on the deck.
No LOC.
GCS 14 on scene for confusion.
I’m fine.
Just please save my wife.
Becky,
do you know where you are?
Hospital.
BP’s 75/40, pulse in the 140s,
02 sat 99%.
She’s cold and clamped down,
going into shock.
shock.
Hang two units of O neg now
and activate
massive transfusion protocol.
Dr. Feldman,
can you put in a central line?
Oh, there’s blood in her pelvis.
The propeller could be
tamponading
a more catastrophic bleed.
Becky, can you wiggle
your left toes?
Great. How about your right?
I... I...
can’t move my leg.
What’s going on?
Ah, pupils are equal
and reactive.
This shouldn’t need stitches.
How you feeling?
Ah, just-just a headache.
Maybe my eyes are
a little bit blurry.
Okay, possible concussion.
We’ll run some tests.
-
-Hey, I got another patient.
-I got to go. You good?
-Good.
-Sure?
-Mm.
-John?
-Mm.
-Squeeze my fingers.
-Ah.
Squeeze my fingers. Good. Good.
So you live here in Atlanta?
Yeah, we do, but we spend most
of our time on the road.
-Oh, yeah, why’s that?
-Uh, well,
Becky and I started the Copple
Foundation about 15 years ago.
All right, push on the gas.
Push on the gas. That’s good.
Yeah, we, uh, serve the causes
that we’re
most passionate about.
Health care is one of them.
And that is why
we know this man so well.
-John.
I’m so sorry
to hear about the accident.
Thank you, Logan.
I’m, uh...
Becky’s hurt really bad.
I assure you
she-she’s in the hands
of our absolute best.
As are you.
Thank you.
-I’ll be right back.
John and Becky Copple are among
the biggest donors to Red Rock.
Most notably,
our new neuro center.
You gave me a reason
to bring you back.
Let’s make sure that I continue
to feel good about my decision.
Okay?
BP’s up to 100/60.
Pulse has come down to the 90s.
This is our window to move her.
Hang another unit of blood
and let’s bring the cooler
with us to CT.
And then to the OR
to remove the propeller.
Come on, people, let’s move.
Wait, wait. Wh-Wh-Where-where
are they taking her?
Imaging. Just part
of the process.
It was my idea to go Jet Skiing.
Becky loves the outdoors.
I hate the sun.
It’s one of the few things
we don’t have in common.
But this boat
came out of nowhere.
And we crashed at full speed.
I just wish I had gotten
the worst of it and not her.
I can’t lose her.
I just...
I-I don’t even know what my life
looks like without Becky.
I understand.
But if we don’t take care
of you, then you can’t
take care of Becky, so how about
we focus on you for a minute?
Deal?
-Deal.
-All right.
I’m seeing
on your medical record
you had a brain tumor
removed eight years ago?
I did. Yes.
It was a benign growth.
-Hmm.
-Why?
Just want to get a CT
to make sure everything’s okay.
-Sound good?
-Let’s do it.
So, thanks to ads,
point of sale displays,
strategic partnerships...
Oh, Randy, there you are.
Have a seat.
The lovely Andrea just came
to the interesting part.
You gentlemen remember
our first quarter projections.
Well, this is
our actual revenue.
50,000 units sold
in the first month.
100 last week alone.
-Those are real numbers?
-Mm-hmm.
I mean, I knew we were
doing well, but...
We can barely keep up
with demand.
Well, then,
I say we increase production,
with a larger facility.
We could expand
to other regions.
-Mm-hmm.
You know,
we should put some cash into R&D
and lay the foundation
for a whole new line.
You’ll all be parking
your yachts
next to mine
before the year’s out.
You know, maybe you can
quit teaching Pilates.
Or, hell, she could buy
the studio.
Hell, she could buy Pilates.
I don’t think that’s possible.
Uh, with the fortunes
we’re gonna make, it is.
-
-L-Listen, listen.
I-I-I have been here before.
All right? I mean, we are
playing with the big boys now.
And with profits this promising,
competitors will be
trying to buy us
for a nickel and a rubdown.
But I think we can all agree
that the real winning formula
is not just what’s in this
little bottle. No, no, no.
No, it’s-it’s the people
in this room.
All y’all, the-the men and
brilliant lady right here,
united, working together.
We have struck gold, my friends,
and I don’t know,
but anybody here want
to let ’em take away our gold?
-I’d like to see ’em try it.
That is one enormous fracture.
The propeller sliced through
her sacroiliac joint.
Explains why
she can’t move her leg.
Her pelvis has been completely
separated from her spine.
And it’s torn
through her internal
iliac artery.
The damage is so extensive
-because this propeller
is cupped.
- So,
the plan is,
we remove the propeller,
stop the bleeding
before she exsanguinates.
Then, if we succeed,
reattaching her pelvis
to her spine
will not be a walk in the park.
I’ll prep the OR.
What’s the story?
TBI.
History of a benign brain tumor
that was successfully removed,
but it’s regrown.
Well, hopefully
it’s still benign.
I’ll send it to pathology
when I take it out.
I’m gonna need to review his
prior scans and path reports.
-Mm-hmm.
-There’s also
an associated hemorrhage.
-Is he symptomatic?
-Headache, blurry vision.
And it’s only gonna get worse
the longer we wait.
We’re gonna have to operate
soon. Any there any issues
-that might complicate
his surgery?
-Eh, mild hyponatremia.
That’s likely related
to dehydration.
Otherwise,
labs were unremarkable.
All right.
I’ll take him to my OR.
Sir, you need to stay
in your bed.
And keep your pants on.
L-Look.
Fasciculations?
-When did it start?
-A few minutes ago.
-Let’s get another
full set of labs.
-Right.
We’ll check for
any electrolyte abnormalities.
Should I, uh,
cancel Waffle Wednesday?
Maybe just reschedule
till next week.
A little help over here!
Respiratory distress, Bay Eight.
Pravesh.
-Stay there.
Get me an intubation kit.
She started to wheeze and
couldn’t clear her secretions.
We tried BiPap
and she became altered
and we couldn’t
get her sats over 72%.
Mild crackles bilaterally.
Increase the PEEP.
PEEP is up to 15.
Okay, that bought us some room.
But she’s still skimming
the treetops.
All right, let’s get a blood gas
and a chest X-ray.
And write her for broad-spectrum
antibiotics with cultures first.
Once we get the gas, we’ll
put her on ARDSNet protocol.
If her oxygenation
is still tenuous,
we’ll start inhaled epo.
Good plan. But this is strange.
I mean, she came in
with a headache, for God’s sake.
And now she’s very close
to max vent settings.
We need to figure this out.
And fast.
Can I talk to my wife?
We need to get you both
in ORs ASAP.
No, no, please. I just...
-I need a sec.
-We have to be quick, though.
Hold up, hold up.
I know what you’re gonna say.
We’re in good hands.
We’re both gonna be fine.
You love me.
I was gonna lead
with "I love you."
But, yes, all of that.
Then I’ll see you tonight.
Make sure we’re
in a recovery room together.
In our 20 years of marriage,
we’ve never spent a night apart.
We wouldn’t want to break
a streak like that.
Well, you’ve got two softies
who’ll do our best
to make it happen,
but right now we got to go.
I love you.
-I love you.
-I love you.
Hey.
How you feeling?
Better. Thank you.
It’s so quiet. Where are you?
Our supply closet.
supply closet now?
Well, we-we share it
with Jess and Irving,
but it’s mostly ours.
You okay?
Nic,
I just...
I just want
to say thank you for...
...for being there
and for, for never doubting
that I would be okay
and for helping me.
Helping me find
my way back here.
You don’t need to thank me.
Yes.
I do.
Hey.
You’d do the same for me.
But you need to get back
to work.
People are gonna think
you lost your mind,
talking to yourself alone
in a supply closet
on your first day back.
That’s fair. That’s fair.
I’ll get home as soon as I can
I know you will.
I’ll see you tonight.
Again?
Unfortunately, Raj’s bathroom
situation has escalated.
But all of his stool studies
have come back negative.
Mr. Corson’s pants
are back on, but he’s
still having fasciculations,
and he’s started
to act confused.
What?
Pravesh. What’s up?
I haven’t heard that term
since I was in medical school.
Meiosis, urination...
Diarrhea, diaphoresis...
Lacrimation, excitation
of the central nervous system,
salivation.
Yeah, so, if you add
Doug, Cynthia
and Raj’s symptoms together,
it is textbook
organophosphate poisoning.
How do three patients
who have nothing in common
get exposed to a toxin
that’s only found
-in pesticides
and chemical weapons?
-I don’t know.
But they’re all showing
different signs of exposure.
If it is,
we need to treat them fast.
Organophosphate poisoning
can progress rapidly.
Hundley, push atropine
and one gram of 2-PAM
-for all three of them.
-On it.
Dr. Okafor,
why don’t you give
that propeller blade
a nice, big tug.
It’s not budging.
It’s stuck in the SI joint.
You have to pull
with more force.
Put your back into it, dear.
Okay, it’s not working.
Step aside.
I’ve got Excalibur.
Damn.
-It won’t come out.
Allow me.
Ortho isn’t just
about brute strength.
Sometimes you have to think
outside of the box.
Hammer, please?
use brute strength.
Get ready.
Suction.
Retractors.
Sutures.
What are the odds
a benign brain tumor regrows?
Well, it’s rare,
but it can happen.
Don’t worry.
I’m here to deal with that.
We’re gonna proceed
with the craniotomy
-to remove the tumor.
-Copy that.
I’ll get scrubbed up.
Thank you, Dr. Cain.
You’re welcome.
John, I’m gonna administer
the propofol now.
Start counting backwards
for me from ten.
-Just breathe.
What’d you give him?
Just relax.
Just breathe.
What did you give him?
I haven’t given him
anything yet.
You must have done something.
He’s tach’ing away in the 150s.
His BP shot up to 180s.
- It hurts!
- What?
-Where do you Where does
it hurt? Tell me what hurts.
-It hurts!
-What’s-what’s hurt? What hurts?
-My stomach!
-Your stomach?
-
Abort the surgery!
Dr. Austin,
you’re on the left pelvis.
Dr. Okafor, you’re on the right.
Fasten this obtrusive instrument
on each side.
Now for the most critical part
of the surgery.
We must bring her pelvis
and spine back into alignment.
We’re gonna
reduce her SI joint?
-Correct.
You will both push your side of
the pelvis towards one another.
How hard do we push?
It must be equal pressure.
And what if one pushes harder
than the other?
Then her pelvis will be
misaligned from her spine.
We could crush her sacral nerves
and leave her paralyzed.
You must be perfectly in sync.
I know I can count on you both.
We got this.
On three?
One, two, three.
Slowly.
A little more pressure
from you both.
Feeling some resistance.
I’ll adjust.
Stop.
How did we do?
That’s anatomic.
I’ve never seen
a more perfect alignment.
Game, set...
Match.
My patient is stagnating in
the ICU after an aborted surgery
because something you missed.
We don’t know that yet.
Then what do you know?
-You’re the internist
here, right?
-Mm-hmm.
In the great ecosystem
of this hospital, a flea.
You had one job
to make sure my patient
was tuned up for surgery.
So let me give you some advice
upon your fresh return
to this hospital.
Go do your one job
so my patient doesn’t die.
What the hell happened in there?
I’m replaying it in my head.
This, uh,
acute abdominal pain with nausea
and hemodynamic instability
in the OR
but with absolutely no prodrome.
Could he have thrown
a clot to his bowel?
I thought about that,
but nothing on imaging.
And his lactate is flat.
So what’s your plan?
Uh, reexamine head to toe.
Rerun labs.
Get to the bottom of this.
Listen,
let me know how I can help you.
They-they took your head.
You figured out
how to grow another one.
But don’t think for a second
they’re not looking
for any reason
to bring the ax down again.
Who’s "they"?
Kim did the firing,
but he and Cain are a team.
There’s no way
Cain didn’t have a hand in it.
And Cain doesn’t care
that you brought in Georgia FC.
For him, getting rid of you
is personal.
Be careful.
Buy you coffee?
No.
Please?
Thank you.
Fine.
Uh, one almond milk latte
and one...
-Large coffee.
-Thanks.
What do you want to know
about him?
AJ seems amazing,
but I have been conned before.
So, woman-to-woman,
off the record,
jump in or run like hell?
-
-All three patients
have stabilized.
Cynthia just got extubated.
-So you were right.
-Yeah.
But how do three people
with no connection
end up with the same rare poison
in their system?
First, we find out. Then we call
County Public Health
and stop whatever caused this.
So, you live nearby in...?
-Savannah.
-Chamblee.
Sandy Springs.
Any recent exposure
to chemicals?
-No.
-No.
I bought a can of body spray.
Has anyone sprayed insecticides
near your home or your garden?
I don’t have a garden.
Not that I’m aware of.
No.
Any vitamins or supplements?
Yeah.
Yeah, I just picked up
a new one.
Um...
3, uh... 3B something.
3B Life.
That’s it.
Hey, fingers crossed, I look
just as good as that doctor
on the label
when I’m his age, right?
Three different patients...
All with
organophosphate poisoning.
All on 3B Life.
Well, maybe they use
the same cleaning supplies
or pesticides.
We did
extensive patient histories.
You can’t possibly know
everything
that they came
in contact with...
Yes, but, right now,
the only link that we do have
is your supplement.
-How widely was it distributed?
-Wide.
You can’t call the CDC
on three patients.
Okay. We need to call Public
Health and warn them about it.That’s ridiculously premature.
Dr. Bell, I know that you have
a personal stake in this,
-but we have to...
-Okay.
Maybe, maybe they have
other things in common.
And if we act too quickly,
we’ll destroy the reputation
of a good product
that is helping people,
not to mention me.
Yeah, but if we wait,
people could die.
So, beyond
an acute cholinergic crisis,
people could have serious
long-term disabilities...
I don’t need to be educated on
the effects of organophosphates.
Okay, Dr. Bell, we just need
to do the right thing.
I can only see you
when I turn to look at you.
When you stand to the right
of me, I can’t see you at all.
Must be because of the tumor.
The bleeding is causing
some swelling,
and that is what’s affecting
your vision.
Well, will it get better?
I-I can’t go blind.
We’re giving you some steroids.
We’re gonna decrease
the swelling.
Now, if we can get
that tumor out soon,
-then you should regain
your vision.
-"If"?
-Let’s get it out now.
-Yes, I know.
I am of the same mind.
But your labile blood pressure
and heart rate
haven’t been responding
to the treatments.
-
-And I can’t risk
sending you back into surgery
unless Dr. Hawkins
can come up with a plan
to make sure
that you’re safe in the OR.
What’s the plan?
-Yes, Dr. Hawkins.
What is the plan?
John, I know you’ve been scanned
and examined up and down,
but do you mind
if I take one more look?
Did that start to hurt
after the accident?
No, actually.
That pain
has been on and off for a while.
Sometimes it hurts so bad,
I feel like
it’s gonna rip right through me.
Like today in the OR.
And then...
all of a sudden, it gets better.
Now...
I’m gonna untie your gown
so I can get a good listen...
to your lungs.
What?
What’s wrong?
There are blisters
on your shoulder.
I did not see that earlier.
Why the hell
didn’t you see that earlier?
That’s your job. Didn’t you do
a full physical examination?
They-they weren’t there
this morning.
I’m sure. I would know.
I’ve had them in the past.
That’s why I hate the sun.
And when we were outside,
I was covered from head to toe.
Hyponatremia.
Recurrent abdominal pain.
Blistering skin lesions.
Blistering.
Blistering, blistering,
blistering skin lesions.
I need a urine sample.
Right now.
There’s got to be a mistake.
I don’t know.
It doesn’t make sense.
We ship out hundreds
of thousands of units
and only three people get sick?
Well, it’s not just three.
No, I just found out
that two more patients
have been diagnosed
with organophosphate poisoning
-over at Atlanta General.
-Oh, my God.
They’re stable.
They’re getting treatment,
just like the ones here
at Chastain.
Are they on 3B?
They’re on supplements.
But if I ask for specifics,
the doctors there will make
the same connection that we did.
Then we test the facility,
-we prove it’s not us.
- Agreed, but...
Zip is gonna start talking
about an exit strategy.
-Wait, what? It’s too soon.
-No, Andrea,
there’s a chance,
no matter what the percentage,
that 3B is the culprit and
that we’re dead in the water.
-
-I can’t believe
this is happening.
I-I...
I have to call the partners.
Your post-op CBC is stable.
No more bleeding.
Distal pulses are strong.
Becky, can you wiggle your toes?
Looks good.
Recovering from major surgery
is challenging,
so we will be monitoring you
closely.
Thank you.
And what about John?
He didn’t have surgery yet.
Why?
We don’t know.
But we do know
his doctors are working on it.
What does that mean?
Will he be okay?
Can I be with him?
First, you must get well.
Then you can be strong for him.
When he had brain surgery
eight years ago,
I held his hand all night.
Like I could keep him with me,
just by physically holding on.
And it worked.
Well, as soon as we can,
we’ll get you two
back together again.
And now we have urine
in the sun.
Dr. Hawkins, I’m starting
to lose my patience.
Just wait.
I am not gonna stand here
and stare at another man’s urine
with you while John’s tumor
continues to swell.
We don’t have time for this.
It was time well spent.
What-What’s happening?
John, this urine changed color.
That explains what happened
in the OR
and gives us a diagnosis
porphyria.
Porphyria’s when you have an
excess of the chemical porphyrin
and it builds up in your organs,
and when that happens,
certain stressors, like...
the intense lighting in the OR,
triggers a crisis
that causes things
like blisters, stomach pain,
and even organ damage.
You got all that from my pee?
Combined with your exam
and history of previous
stomach pain and skin blisters.
But yes,
when the porphyrins turned
your urine dark in the sun,
my clinical suspicion
was confirmed.
So I’ve had this my whole life?
Incredibly rare, easily missed,
but the good news is...
...we can treat you.
We’ll be sending
confirmatory labs of course,
but I am confident you
will be back in the OR soon.
Which Dr. Cain and I
will be prepping for you.
-
I made a list
of all the meds that can be
fatal to a porphyria patient.
Avoid these at all costs.
I haven’t had a porphyria
patient since residency.
Yep, this is a unique case.
That’s exactly why
I made a list for everyone.
Propofol for anesthesia,
that’s safe.
Morphine’s okay.
Just let me know before you give
-any antibiotics.
Dr. Hawkins is right.
We all need to review
the drug list.
And the reason John crashed
in the OR before
was because of these intense
lights, so we got these filters.
We’ll still be able to see,
but they change the wavelength
of the light
that hits John’s body.
Avoiding a porphyric crisis.
What the hell happened?
She came out fine
after the surgery,
then she went into V tach
and lost her pressure.
Hold compressions.
Checking a rhythm.
Damn, she’s still in V fib.
We need to shock again.
Charging to 200.
Clear.
Restart compressions.
I’ll take over.
Code labs are back.
Hemoglobin is stable.
She’s not losing blood.
But her calcium is under five.
That’s not doing her heart
any favors.
Okay, we need more calcium.
One gram
of calcium chloride, now.
We ordered it hours ago. There’s
a calcium chloride shortage.
Take it from the crash cart.
She should have received
more calcium
with her blood transfusions.
This is what happens
when drug companies
discontinue products that
save lives but don’t make money.
Calcium chloride is in.
Continue compressions.
30 seconds
to the next pulse check.
Hope this works.
Bull’s-eye.
Time to remove the tumor.
How are the lights?
Sufficient. My patient’s
hemodynamic instability
is no longer distracting me.
You might want
to follow that lead.
Forceps.
His wife Becky just coded.
They’re still working on her.
Get this to path.
It’s been hours why is he
just getting to the tumor now?
It’s a delicate surgery.
Dr. Cain is in the middle
of a very complicated surgery,
and with the added precautions
for the porphyria...
John’s a lucky guy.
I can see you.
All of you.
Surgery went well.
Your tumor’s gone, and your
preliminary path looks benign.
And we have a plan to manage
your porphyria moving forward.
Today you received
Chastain’s finest,
as promised.
But Becky...
where is she?
She sustained serious injuries
in the crash,
but, like you said before,
John, your wife...
she is strong enough
for both of you.
She survived
a very grueling surgery.
But hey, don’t worry,
we will make sure you
do not spend tonight apart.
Your streak will be intact.
So now what?
I don’t want to give up.
What if I’m wrong?
What if my supplements
are hurting people?
Look... you and I
don’t know each other well,
but you have shown me so far
a woman who
doesn’t half-ass anything.
So I believe
that you know your stuff.
And I believe
that you will do
the right thing.
I know it’s not the 3B.
-I know it.
-Actually, you don’t.
I see a future
-buried in lawsuits.
-Oh, please, do not use
-the "L" word.
-Okay, once we test
the manufacturing facility...
We’ll already be
by then.
I know you’re both concerned
about your own liability.
-If...
-We poisoned people?
Yeah, I think we might be a
little bit concerned about that.
Okay, but let’s remember that
I’m the reason that we’re here.
My product,
my skill, my judgment,
that’s... that’s
what got us this far.
So I ask that you trust me
to see us through this.
Please.
How many units have we sold?
Enough that a recall costs us
millions more.
All to protect a brand
that we don’t even know
will be worth anything
when this whole thing is done.
It’s time to walk away
from the table.
I agree, I agree.
We got to protect ourselves,
cut our losses.
I-I think we
should declare bankruptcy.
Liquidate the assets,
make sure there’s nothing left
to sue for.
Okay, everything I have is
in this company don’t do this.
It’s over.
Okay?
I’m sorry.
Maybe next time, don’t make your
supplements out of fertilizer.
You have no idea
what you’re talking about.
You’re just a fat cat
who came along for the ride.
And I appreciate the cash,
but do not speak to me
like that again.
I am just fine to go it alone,
if that’s what I’m up against.
There’s another way.
I’ll buy you out.
-Both of you.
-
Take on all the liability
myself.
You sure you have the cash
for that suicide mission?
I’ll figure it out.
50 cents on the dollar
for all your shares.
Hell, I mean, if I can get
some of my money back
and, uh, dodge this bullet,
I don’t care how you do it.
I’m sold.
Okay.
But make it fast.
Why... did you...
-
-Why... why did...
Well, because, at this point,
they think it’s a coin toss
that 3B’s at fault.
They’re panicking.
And I think the odds
are slightly better than that.
You know, yeah, it’s...
kind of betting the farm, but...
...it’s a chance to get
full ownership back
for the two people
I care most about.
Wow.
Thank you.
No, don’t thank me.
Just...
Just pray we’re not wrong.
Otherwise,
I just made the biggest mistake
of my life.
And we’re both ruined.
Where’s your friend?
She’s going through
some things right now.
Hmm. Are you looking
for her red flags?
Well, it’s early.
You know?
She’s looking
red flags.
What’d you tell her?
I tell her.
You know, you are enjoying this
a little too much.
Mm-hmm.
I led with "compassionate."
Closed with "brilliant."
That she would be wise
to hold on and not let go.
And I told her about your cats.
All five of them.
The woman deserved a warning.
-Hey.
-
Ah...
Mm...
You do not look or smell
like a 12-hour shift.
My new office has a shower.
Ooh. I remember that shower.
How are you feeling?
So much better.
You survived.
Yeah, and my patients did, too.
-Really?
This amazing couple,
20 years together,
never spent
a single night apart.
amazing.
Something to aspire to.
No way.
-No way, right?
-No.
I mean, I love you, but...
time apart is healthy.
We’ve got, like,
a thing that works for us.
-It works beautifully.
-Mm-hmm.
Which requires
the occasional night apart.
Handful of nights;
rare exceptions.
handfuls.
-Easy, now.
Tonight is not
one of those nights.
How many handfuls?
-I know you’re not asleep.
-
Today is the day we introduce
3B Life to the American public.
So you are Bell
and Cain’s new partner?
They’re the new partners.
I’m the founder.
-You should call me.
-Okay.
I’ve just been hired
as the new team doctor
for Georgia FC.
This will remain
at St. John’s unless
there’s another hospital
I decide to call home.
What would be the terms?
Chief resident.
-Good to have you back.
-Cheers.
I told you the table-side
Caesar was a bad idea.
You know that little asterisk
they put on the menu?
"This contains raw egg"?
Why did I ignore it?
’Cause you love to live life
on the edge. Like me.
I really wanted to be with you
your first day back at Chastain.
I know, but it’s only one day.
And we have so many more
to come.
Unless you continue
to ignore the asterisk.
All right.
Kitchen’s stocked.
Bananas...
-rice...
-Applesauce, toast.
Yes, I’m well aware
of the BRAT diet.
Have a good first day back.
Be with you in spirit.
-All right. I love you.
-
Oh, nice. My little BRAT.
Now go. I’m gonna be sick again.
-Stay out of trouble.
-Call me if you need anything.
-Hey, Pravesh?
-Hmm?
-Does that guy
look familiar to you?
-Oh, no. No, no, no.
-Why?
-I don’t know, I...
I think he used to work here.
You know, it’s just
really hard to remember,
you know, with all these faces
just coming and going
around here.
Oh, yeah, yeah.
You boys done?
-Hmm?
-Oh, wait. I do
remember that voice.
Dr. Conrad Hawkins.
The man who went up against Red
Rock and lived to tell the tale.
Oh. Oh! Oh.
You miss all this?
You have no idea.
How do you feel about getting
your footsies wet in the ER?
-We could use the help.
-Ah!
-Wet footsies. I’m in.
Psst.
Good to see you, darling.
Dr. Hawkins.
Welcome back.
Thank you.
Nice to be back.
Let’s go.
Brought Hawkins back?
Uh, hey, let me call you back.
He signed a lucrative deal with
a national sports franchise.
-He’s still a whistleblower.
-I’m aware.
Risk versus reward.
I made the call.
It’s insanity.
Turns out he’s a rainmaker.
And Red Rock likes the rain.
Yeah, I’m well aware.
Remember who you’re talking to?
Now, careful now... Barrett.
Proceed with caution.
I should have been informed.
Leaving me out of the loop
on Hawkins is
a sign of disrespect
to the surgeon who’s made
more rain for you and Red Rock
than anyone else.
Not as much as you used to.
Your billing is moving
in the wrong direction.
Pair that with the expensive
neuro center we’re building
on your behalf,
by my assessment I’d say...
you got to hustle up.
Hustle up?
What exactly are you implying?
Everyone has an expiration date.
Everyone.
I’m game.
I’m game, too.
Even though most people don’t
normally do it this way.
That’s true.
When most people start out,
they only show each other
qualities.
And hide their worst, pretend
to be someone they’re not.
It could be months before you
find out who you’re really with.
Years.
We will lay it all on the table
next to these inedible eggs
and DOA flapjacks.
-
-A breakfast interrogation.
Won’t be my first time
on the witness stand.
-Oh.
-Mm-hmm.
-Well, let’s start there,
why don’t we?
-Okay.
Oh, hey, uh...
Just checked on that
outside hospital
hernia transfer.
His incision was oozing.
I interrupt something?
Enjoy your meal.
Uh...
where were we?
I was about to ask you
about your worst breakup.
Yeah.
No.
No, we’re-we’re not going there.
-What?! We’re just...
-N-No.
Sorry. Not-not a chance. The...
-
-I-Is...? Whoa.
Is that my pager? I think...
Oh, look at that.
Saved by the pager.
-Did you just page yourself?
-Excuse me?
-What? Huh?
-What do you mean?
Who does that?
- Okay.
-Listen, got to go.
-Catch you later.
-
Incoming Bay Six.
-Hmm.
-All right, let’s do this.
Doug, I’m Dr. Hawkins.
So what’s going on?
Uh... it was Taco Tuesday.
I do it up real nice
for the kids.
Queso, green chilis.
I was cleaning the table off,
and I looked down,
and that’s when I saw it.
Saw what?
Drool.
I was in the middle
of a photo shoot
when it got real bad.
Well, it’s not uncommon
for flashing lights
to trigger a headache.
Your pupils are pinpoint.
That means smaller than normal.
I know what pinpoint means,
thank you.
How long will it take me
to get normal?
I’m tip-top
from top to tail, baby.
-Then why are you here, Raj?
-
Look, I get the runs,
like, every 20 minutes.
All right,
I was on a date last night.
Had to get off to the john
before the food even arrived.
We were supposed to go see a
movie after. Forget it.
We might as well watch it
on my phone in the bathroom.
All right.
-All right.
So you pull me into the ER
for what appears
to be a drooler,
a headache, and diarrhea.
So we threw you
some softball cases.
We just don’t want
to lose you again.
Don’t fly too close to the sun
on your first day back.
-Mm-hmm.
I could use a little sun.
Mind if I join?
Hawkins is back in action.
What a lovely sight.
They should be landing soon.
54-year-old woman, Jet Ski
collision with a motorboat.
Propeller lodged in pelvis.
Pulse 126.
Got it.
Voss, you’re with me.
Careful not
to disrupt the propeller blade.
Roger that.
-What’s her name?
-Becky Copple.
Becky, we’re gonna take care
of you, okay?
What have we got?
55-year-old male, same accident.
Hit his head on the deck.
No LOC.
GCS 14 on scene for confusion.
I’m fine.
Just please save my wife.
Becky,
do you know where you are?
Hospital.
BP’s 75/40, pulse in the 140s,
02 sat 99%.
She’s cold and clamped down,
going into shock.
shock.
Hang two units of O neg now
and activate
massive transfusion protocol.
Dr. Feldman,
can you put in a central line?
Oh, there’s blood in her pelvis.
The propeller could be
tamponading
a more catastrophic bleed.
Becky, can you wiggle
your left toes?
Great. How about your right?
I... I...
can’t move my leg.
What’s going on?
Ah, pupils are equal
and reactive.
This shouldn’t need stitches.
How you feeling?
Ah, just-just a headache.
Maybe my eyes are
a little bit blurry.
Okay, possible concussion.
We’ll run some tests.
-
-Hey, I got another patient.
-I got to go. You good?
-Good.
-Sure?
-Mm.
-John?
-Mm.
-Squeeze my fingers.
-Ah.
Squeeze my fingers. Good. Good.
So you live here in Atlanta?
Yeah, we do, but we spend most
of our time on the road.
-Oh, yeah, why’s that?
-Uh, well,
Becky and I started the Copple
Foundation about 15 years ago.
All right, push on the gas.
Push on the gas. That’s good.
Yeah, we, uh, serve the causes
that we’re
most passionate about.
Health care is one of them.
And that is why
we know this man so well.
-John.
I’m so sorry
to hear about the accident.
Thank you, Logan.
I’m, uh...
Becky’s hurt really bad.
I assure you
she-she’s in the hands
of our absolute best.
As are you.
Thank you.
-I’ll be right back.
John and Becky Copple are among
the biggest donors to Red Rock.
Most notably,
our new neuro center.
You gave me a reason
to bring you back.
Let’s make sure that I continue
to feel good about my decision.
Okay?
BP’s up to 100/60.
Pulse has come down to the 90s.
This is our window to move her.
Hang another unit of blood
and let’s bring the cooler
with us to CT.
And then to the OR
to remove the propeller.
Come on, people, let’s move.
Wait, wait. Wh-Wh-Where-where
are they taking her?
Imaging. Just part
of the process.
It was my idea to go Jet Skiing.
Becky loves the outdoors.
I hate the sun.
It’s one of the few things
we don’t have in common.
But this boat
came out of nowhere.
And we crashed at full speed.
I just wish I had gotten
the worst of it and not her.
I can’t lose her.
I just...
I-I don’t even know what my life
looks like without Becky.
I understand.
But if we don’t take care
of you, then you can’t
take care of Becky, so how about
we focus on you for a minute?
Deal?
-Deal.
-All right.
I’m seeing
on your medical record
you had a brain tumor
removed eight years ago?
I did. Yes.
It was a benign growth.
-Hmm.
-Why?
Just want to get a CT
to make sure everything’s okay.
-Sound good?
-Let’s do it.
So, thanks to ads,
point of sale displays,
strategic partnerships...
Oh, Randy, there you are.
Have a seat.
The lovely Andrea just came
to the interesting part.
You gentlemen remember
our first quarter projections.
Well, this is
our actual revenue.
50,000 units sold
in the first month.
100 last week alone.
-Those are real numbers?
-Mm-hmm.
I mean, I knew we were
doing well, but...
We can barely keep up
with demand.
Well, then,
I say we increase production,
with a larger facility.
We could expand
to other regions.
-Mm-hmm.
You know,
we should put some cash into R&D
and lay the foundation
for a whole new line.
You’ll all be parking
your yachts
next to mine
before the year’s out.
You know, maybe you can
quit teaching Pilates.
Or, hell, she could buy
the studio.
Hell, she could buy Pilates.
I don’t think that’s possible.
Uh, with the fortunes
we’re gonna make, it is.
-
-L-Listen, listen.
I-I-I have been here before.
All right? I mean, we are
playing with the big boys now.
And with profits this promising,
competitors will be
trying to buy us
for a nickel and a rubdown.
But I think we can all agree
that the real winning formula
is not just what’s in this
little bottle. No, no, no.
No, it’s-it’s the people
in this room.
All y’all, the-the men and
brilliant lady right here,
united, working together.
We have struck gold, my friends,
and I don’t know,
but anybody here want
to let ’em take away our gold?
-I’d like to see ’em try it.
That is one enormous fracture.
The propeller sliced through
her sacroiliac joint.
Explains why
she can’t move her leg.
Her pelvis has been completely
separated from her spine.
And it’s torn
through her internal
iliac artery.
The damage is so extensive
-because this propeller
is cupped.
- So,
the plan is,
we remove the propeller,
stop the bleeding
before she exsanguinates.
Then, if we succeed,
reattaching her pelvis
to her spine
will not be a walk in the park.
I’ll prep the OR.
What’s the story?
TBI.
History of a benign brain tumor
that was successfully removed,
but it’s regrown.
Well, hopefully
it’s still benign.
I’ll send it to pathology
when I take it out.
I’m gonna need to review his
prior scans and path reports.
-Mm-hmm.
-There’s also
an associated hemorrhage.
-Is he symptomatic?
-Headache, blurry vision.
And it’s only gonna get worse
the longer we wait.
We’re gonna have to operate
soon. Any there any issues
-that might complicate
his surgery?
-Eh, mild hyponatremia.
That’s likely related
to dehydration.
Otherwise,
labs were unremarkable.
All right.
I’ll take him to my OR.
Sir, you need to stay
in your bed.
And keep your pants on.
L-Look.
Fasciculations?
-When did it start?
-A few minutes ago.
-Let’s get another
full set of labs.
-Right.
We’ll check for
any electrolyte abnormalities.
Should I, uh,
cancel Waffle Wednesday?
Maybe just reschedule
till next week.
A little help over here!
Respiratory distress, Bay Eight.
Pravesh.
-Stay there.
Get me an intubation kit.
She started to wheeze and
couldn’t clear her secretions.
We tried BiPap
and she became altered
and we couldn’t
get her sats over 72%.
Mild crackles bilaterally.
Increase the PEEP.
PEEP is up to 15.
Okay, that bought us some room.
But she’s still skimming
the treetops.
All right, let’s get a blood gas
and a chest X-ray.
And write her for broad-spectrum
antibiotics with cultures first.
Once we get the gas, we’ll
put her on ARDSNet protocol.
If her oxygenation
is still tenuous,
we’ll start inhaled epo.
Good plan. But this is strange.
I mean, she came in
with a headache, for God’s sake.
And now she’s very close
to max vent settings.
We need to figure this out.
And fast.
Can I talk to my wife?
We need to get you both
in ORs ASAP.
No, no, please. I just...
-I need a sec.
-We have to be quick, though.
Hold up, hold up.
I know what you’re gonna say.
We’re in good hands.
We’re both gonna be fine.
You love me.
I was gonna lead
with "I love you."
But, yes, all of that.
Then I’ll see you tonight.
Make sure we’re
in a recovery room together.
In our 20 years of marriage,
we’ve never spent a night apart.
We wouldn’t want to break
a streak like that.
Well, you’ve got two softies
who’ll do our best
to make it happen,
but right now we got to go.
I love you.
-I love you.
-I love you.
Hey.
How you feeling?
Better. Thank you.
It’s so quiet. Where are you?
Our supply closet.
supply closet now?
Well, we-we share it
with Jess and Irving,
but it’s mostly ours.
You okay?
Nic,
I just...
I just want
to say thank you for...
...for being there
and for, for never doubting
that I would be okay
and for helping me.
Helping me find
my way back here.
You don’t need to thank me.
Yes.
I do.
Hey.
You’d do the same for me.
But you need to get back
to work.
People are gonna think
you lost your mind,
talking to yourself alone
in a supply closet
on your first day back.
That’s fair. That’s fair.
I’ll get home as soon as I can
I know you will.
I’ll see you tonight.
Again?
Unfortunately, Raj’s bathroom
situation has escalated.
But all of his stool studies
have come back negative.
Mr. Corson’s pants
are back on, but he’s
still having fasciculations,
and he’s started
to act confused.
What?
Pravesh. What’s up?
I haven’t heard that term
since I was in medical school.
Meiosis, urination...
Diarrhea, diaphoresis...
Lacrimation, excitation
of the central nervous system,
salivation.
Yeah, so, if you add
Doug, Cynthia
and Raj’s symptoms together,
it is textbook
organophosphate poisoning.
How do three patients
who have nothing in common
get exposed to a toxin
that’s only found
-in pesticides
and chemical weapons?
-I don’t know.
But they’re all showing
different signs of exposure.
If it is,
we need to treat them fast.
Organophosphate poisoning
can progress rapidly.
Hundley, push atropine
and one gram of 2-PAM
-for all three of them.
-On it.
Dr. Okafor,
why don’t you give
that propeller blade
a nice, big tug.
It’s not budging.
It’s stuck in the SI joint.
You have to pull
with more force.
Put your back into it, dear.
Okay, it’s not working.
Step aside.
I’ve got Excalibur.
Damn.
-It won’t come out.
Allow me.
Ortho isn’t just
about brute strength.
Sometimes you have to think
outside of the box.
Hammer, please?
use brute strength.
Get ready.
Suction.
Retractors.
Sutures.
What are the odds
a benign brain tumor regrows?
Well, it’s rare,
but it can happen.
Don’t worry.
I’m here to deal with that.
We’re gonna proceed
with the craniotomy
-to remove the tumor.
-Copy that.
I’ll get scrubbed up.
Thank you, Dr. Cain.
You’re welcome.
John, I’m gonna administer
the propofol now.
Start counting backwards
for me from ten.
-Just breathe.
What’d you give him?
Just relax.
Just breathe.
What did you give him?
I haven’t given him
anything yet.
You must have done something.
He’s tach’ing away in the 150s.
His BP shot up to 180s.
- It hurts!
- What?
-Where do you Where does
it hurt? Tell me what hurts.
-It hurts!
-What’s-what’s hurt? What hurts?
-My stomach!
-Your stomach?
-
Abort the surgery!
Dr. Austin,
you’re on the left pelvis.
Dr. Okafor, you’re on the right.
Fasten this obtrusive instrument
on each side.
Now for the most critical part
of the surgery.
We must bring her pelvis
and spine back into alignment.
We’re gonna
reduce her SI joint?
-Correct.
You will both push your side of
the pelvis towards one another.
How hard do we push?
It must be equal pressure.
And what if one pushes harder
than the other?
Then her pelvis will be
misaligned from her spine.
We could crush her sacral nerves
and leave her paralyzed.
You must be perfectly in sync.
I know I can count on you both.
We got this.
On three?
One, two, three.
Slowly.
A little more pressure
from you both.
Feeling some resistance.
I’ll adjust.
Stop.
How did we do?
That’s anatomic.
I’ve never seen
a more perfect alignment.
Game, set...
Match.
My patient is stagnating in
the ICU after an aborted surgery
because something you missed.
We don’t know that yet.
Then what do you know?
-You’re the internist
here, right?
-Mm-hmm.
In the great ecosystem
of this hospital, a flea.
You had one job
to make sure my patient
was tuned up for surgery.
So let me give you some advice
upon your fresh return
to this hospital.
Go do your one job
so my patient doesn’t die.
What the hell happened in there?
I’m replaying it in my head.
This, uh,
acute abdominal pain with nausea
and hemodynamic instability
in the OR
but with absolutely no prodrome.
Could he have thrown
a clot to his bowel?
I thought about that,
but nothing on imaging.
And his lactate is flat.
So what’s your plan?
Uh, reexamine head to toe.
Rerun labs.
Get to the bottom of this.
Listen,
let me know how I can help you.
They-they took your head.
You figured out
how to grow another one.
But don’t think for a second
they’re not looking
for any reason
to bring the ax down again.
Who’s "they"?
Kim did the firing,
but he and Cain are a team.
There’s no way
Cain didn’t have a hand in it.
And Cain doesn’t care
that you brought in Georgia FC.
For him, getting rid of you
is personal.
Be careful.
Buy you coffee?
No.
Please?
Thank you.
Fine.
Uh, one almond milk latte
and one...
-Large coffee.
-Thanks.
What do you want to know
about him?
AJ seems amazing,
but I have been conned before.
So, woman-to-woman,
off the record,
jump in or run like hell?
-
-All three patients
have stabilized.
Cynthia just got extubated.
-So you were right.
-Yeah.
But how do three people
with no connection
end up with the same rare poison
in their system?
First, we find out. Then we call
County Public Health
and stop whatever caused this.
So, you live nearby in...?
-Savannah.
-Chamblee.
Sandy Springs.
Any recent exposure
to chemicals?
-No.
-No.
I bought a can of body spray.
Has anyone sprayed insecticides
near your home or your garden?
I don’t have a garden.
Not that I’m aware of.
No.
Any vitamins or supplements?
Yeah.
Yeah, I just picked up
a new one.
Um...
3, uh... 3B something.
3B Life.
That’s it.
Hey, fingers crossed, I look
just as good as that doctor
on the label
when I’m his age, right?
Three different patients...
All with
organophosphate poisoning.
All on 3B Life.
Well, maybe they use
the same cleaning supplies
or pesticides.
We did
extensive patient histories.
You can’t possibly know
everything
that they came
in contact with...
Yes, but, right now,
the only link that we do have
is your supplement.
-How widely was it distributed?
-Wide.
You can’t call the CDC
on three patients.
Okay. We need to call Public
Health and warn them about it.That’s ridiculously premature.
Dr. Bell, I know that you have
a personal stake in this,
-but we have to...
-Okay.
Maybe, maybe they have
other things in common.
And if we act too quickly,
we’ll destroy the reputation
of a good product
that is helping people,
not to mention me.
Yeah, but if we wait,
people could die.
So, beyond
an acute cholinergic crisis,
people could have serious
long-term disabilities...
I don’t need to be educated on
the effects of organophosphates.
Okay, Dr. Bell, we just need
to do the right thing.
I can only see you
when I turn to look at you.
When you stand to the right
of me, I can’t see you at all.
Must be because of the tumor.
The bleeding is causing
some swelling,
and that is what’s affecting
your vision.
Well, will it get better?
I-I can’t go blind.
We’re giving you some steroids.
We’re gonna decrease
the swelling.
Now, if we can get
that tumor out soon,
-then you should regain
your vision.
-"If"?
-Let’s get it out now.
-Yes, I know.
I am of the same mind.
But your labile blood pressure
and heart rate
haven’t been responding
to the treatments.
-
-And I can’t risk
sending you back into surgery
unless Dr. Hawkins
can come up with a plan
to make sure
that you’re safe in the OR.
What’s the plan?
-Yes, Dr. Hawkins.
What is the plan?
John, I know you’ve been scanned
and examined up and down,
but do you mind
if I take one more look?
Did that start to hurt
after the accident?
No, actually.
That pain
has been on and off for a while.
Sometimes it hurts so bad,
I feel like
it’s gonna rip right through me.
Like today in the OR.
And then...
all of a sudden, it gets better.
Now...
I’m gonna untie your gown
so I can get a good listen...
to your lungs.
What?
What’s wrong?
There are blisters
on your shoulder.
I did not see that earlier.
Why the hell
didn’t you see that earlier?
That’s your job. Didn’t you do
a full physical examination?
They-they weren’t there
this morning.
I’m sure. I would know.
I’ve had them in the past.
That’s why I hate the sun.
And when we were outside,
I was covered from head to toe.
Hyponatremia.
Recurrent abdominal pain.
Blistering skin lesions.
Blistering.
Blistering, blistering,
blistering skin lesions.
I need a urine sample.
Right now.
There’s got to be a mistake.
I don’t know.
It doesn’t make sense.
We ship out hundreds
of thousands of units
and only three people get sick?
Well, it’s not just three.
No, I just found out
that two more patients
have been diagnosed
with organophosphate poisoning
-over at Atlanta General.
-Oh, my God.
They’re stable.
They’re getting treatment,
just like the ones here
at Chastain.
Are they on 3B?
They’re on supplements.
But if I ask for specifics,
the doctors there will make
the same connection that we did.
Then we test the facility,
-we prove it’s not us.
- Agreed, but...
Zip is gonna start talking
about an exit strategy.
-Wait, what? It’s too soon.
-No, Andrea,
there’s a chance,
no matter what the percentage,
that 3B is the culprit and
that we’re dead in the water.
-
-I can’t believe
this is happening.
I-I...
I have to call the partners.
Your post-op CBC is stable.
No more bleeding.
Distal pulses are strong.
Becky, can you wiggle your toes?
Looks good.
Recovering from major surgery
is challenging,
so we will be monitoring you
closely.
Thank you.
And what about John?
He didn’t have surgery yet.
Why?
We don’t know.
But we do know
his doctors are working on it.
What does that mean?
Will he be okay?
Can I be with him?
First, you must get well.
Then you can be strong for him.
When he had brain surgery
eight years ago,
I held his hand all night.
Like I could keep him with me,
just by physically holding on.
And it worked.
Well, as soon as we can,
we’ll get you two
back together again.
And now we have urine
in the sun.
Dr. Hawkins, I’m starting
to lose my patience.
Just wait.
I am not gonna stand here
and stare at another man’s urine
with you while John’s tumor
continues to swell.
We don’t have time for this.
It was time well spent.
What-What’s happening?
John, this urine changed color.
That explains what happened
in the OR
and gives us a diagnosis
porphyria.
Porphyria’s when you have an
excess of the chemical porphyrin
and it builds up in your organs,
and when that happens,
certain stressors, like...
the intense lighting in the OR,
triggers a crisis
that causes things
like blisters, stomach pain,
and even organ damage.
You got all that from my pee?
Combined with your exam
and history of previous
stomach pain and skin blisters.
But yes,
when the porphyrins turned
your urine dark in the sun,
my clinical suspicion
was confirmed.
So I’ve had this my whole life?
Incredibly rare, easily missed,
but the good news is...
...we can treat you.
We’ll be sending
confirmatory labs of course,
but I am confident you
will be back in the OR soon.
Which Dr. Cain and I
will be prepping for you.
-
I made a list
of all the meds that can be
fatal to a porphyria patient.
Avoid these at all costs.
I haven’t had a porphyria
patient since residency.
Yep, this is a unique case.
That’s exactly why
I made a list for everyone.
Propofol for anesthesia,
that’s safe.
Morphine’s okay.
Just let me know before you give
-any antibiotics.
Dr. Hawkins is right.
We all need to review
the drug list.
And the reason John crashed
in the OR before
was because of these intense
lights, so we got these filters.
We’ll still be able to see,
but they change the wavelength
of the light
that hits John’s body.
Avoiding a porphyric crisis.
What the hell happened?
She came out fine
after the surgery,
then she went into V tach
and lost her pressure.
Hold compressions.
Checking a rhythm.
Damn, she’s still in V fib.
We need to shock again.
Charging to 200.
Clear.
Restart compressions.
I’ll take over.
Code labs are back.
Hemoglobin is stable.
She’s not losing blood.
But her calcium is under five.
That’s not doing her heart
any favors.
Okay, we need more calcium.
One gram
of calcium chloride, now.
We ordered it hours ago. There’s
a calcium chloride shortage.
Take it from the crash cart.
She should have received
more calcium
with her blood transfusions.
This is what happens
when drug companies
discontinue products that
save lives but don’t make money.
Calcium chloride is in.
Continue compressions.
30 seconds
to the next pulse check.
Hope this works.
Bull’s-eye.
Time to remove the tumor.
How are the lights?
Sufficient. My patient’s
hemodynamic instability
is no longer distracting me.
You might want
to follow that lead.
Forceps.
His wife Becky just coded.
They’re still working on her.
Get this to path.
It’s been hours why is he
just getting to the tumor now?
It’s a delicate surgery.
Dr. Cain is in the middle
of a very complicated surgery,
and with the added precautions
for the porphyria...
John’s a lucky guy.
I can see you.
All of you.
Surgery went well.
Your tumor’s gone, and your
preliminary path looks benign.
And we have a plan to manage
your porphyria moving forward.
Today you received
Chastain’s finest,
as promised.
But Becky...
where is she?
She sustained serious injuries
in the crash,
but, like you said before,
John, your wife...
she is strong enough
for both of you.
She survived
a very grueling surgery.
But hey, don’t worry,
we will make sure you
do not spend tonight apart.
Your streak will be intact.
So now what?
I don’t want to give up.
What if I’m wrong?
What if my supplements
are hurting people?
Look... you and I
don’t know each other well,
but you have shown me so far
a woman who
doesn’t half-ass anything.
So I believe
that you know your stuff.
And I believe
that you will do
the right thing.
I know it’s not the 3B.
-I know it.
-Actually, you don’t.
I see a future
-buried in lawsuits.
-Oh, please, do not use
-the "L" word.
-Okay, once we test
the manufacturing facility...
We’ll already be
by then.
I know you’re both concerned
about your own liability.
-If...
-We poisoned people?
Yeah, I think we might be a
little bit concerned about that.
Okay, but let’s remember that
I’m the reason that we’re here.
My product,
my skill, my judgment,
that’s... that’s
what got us this far.
So I ask that you trust me
to see us through this.
Please.
How many units have we sold?
Enough that a recall costs us
millions more.
All to protect a brand
that we don’t even know
will be worth anything
when this whole thing is done.
It’s time to walk away
from the table.
I agree, I agree.
We got to protect ourselves,
cut our losses.
I-I think we
should declare bankruptcy.
Liquidate the assets,
make sure there’s nothing left
to sue for.
Okay, everything I have is
in this company don’t do this.
It’s over.
Okay?
I’m sorry.
Maybe next time, don’t make your
supplements out of fertilizer.
You have no idea
what you’re talking about.
You’re just a fat cat
who came along for the ride.
And I appreciate the cash,
but do not speak to me
like that again.
I am just fine to go it alone,
if that’s what I’m up against.
There’s another way.
I’ll buy you out.
-Both of you.
-
Take on all the liability
myself.
You sure you have the cash
for that suicide mission?
I’ll figure it out.
50 cents on the dollar
for all your shares.
Hell, I mean, if I can get
some of my money back
and, uh, dodge this bullet,
I don’t care how you do it.
I’m sold.
Okay.
But make it fast.
Why... did you...
-
-Why... why did...
Well, because, at this point,
they think it’s a coin toss
that 3B’s at fault.
They’re panicking.
And I think the odds
are slightly better than that.
You know, yeah, it’s...
kind of betting the farm, but...
...it’s a chance to get
full ownership back
for the two people
I care most about.
Wow.
Thank you.
No, don’t thank me.
Just...
Just pray we’re not wrong.
Otherwise,
I just made the biggest mistake
of my life.
And we’re both ruined.
Where’s your friend?
She’s going through
some things right now.
Hmm. Are you looking
for her red flags?
Well, it’s early.
You know?
She’s looking
red flags.
What’d you tell her?
I tell her.
You know, you are enjoying this
a little too much.
Mm-hmm.
I led with "compassionate."
Closed with "brilliant."
That she would be wise
to hold on and not let go.
And I told her about your cats.
All five of them.
The woman deserved a warning.
-Hey.
-
Ah...
Mm...
You do not look or smell
like a 12-hour shift.
My new office has a shower.
Ooh. I remember that shower.
How are you feeling?
So much better.
You survived.
Yeah, and my patients did, too.
-Really?
This amazing couple,
20 years together,
never spent
a single night apart.
amazing.
Something to aspire to.
No way.
-No way, right?
-No.
I mean, I love you, but...
time apart is healthy.
We’ve got, like,
a thing that works for us.
-It works beautifully.
-Mm-hmm.
Which requires
the occasional night apart.
Handful of nights;
rare exceptions.
handfuls.
-Easy, now.
Tonight is not
one of those nights.
How many handfuls?
-I know you’re not asleep.
-