09x02 - This Town Ain't Big Enough for Both of Us
Posted: 01/25/24 08:53
[DRAMATIC MUSIC]
Dr. Ripley, we've met before,
haven't we?
County Juvenile.
My psych care, remember?
I remember that you were violent.
Do not treat me like the boy
you knew 20 years ago.
You've been working nonstop all day.
If I had a guy like Ben
waiting for me...
Just stop.
My wonderful husband wants a divorce.
Sean is donating his kidney to you.
I don't deserve it.
I was a terrible father.
I want to do this.
No, look, I'm sorry, but I think
it's only fair he stays with me.
If the cat was this important to you,
why did we save the question
of his custody for last?
Maggie refers to him as "the cat."
- He's a cat.
- She's making my point for me.
- His name is Jasper.
- I know his name is Jasper.
I gave him the name.
Yeah, and I'm the one that found him.
I'm also the one
that spends more time with him.
Because I work longer hours.
Exactly, because you're never home
long enough to look after him.
He's a cat.
He doesn't need 24-hour surveillance.
Maggie, Ben, please.
Remember what you agreed to
at the outset of this mediation...
no blaming and no shaming.
Come on.
Let's not throw away all
the progress that we've made.
Come on, Maggie.
You know he prefers being with me.
Let the record show
that I'm disputing that.
There is no official record, Maggie.
It's just three people in a room
for a win-win compromise.
[SOMBER MUSIC]
This is not working for me.
Come on. Maggie.
Look, we're almost
at the finish line here.
No. Only you are.
♪ ♪
Your chariot awaits.
Well, I appreciate the thought,
but I can manage fine.
Mm, hospital protocol
for all surgical patients,
which I believe you signed off on.
Don't make me call security.
Come on.
All right, all right, all right.
Let's make this quick, okay?
I don't wanna attract
any undue attention.
Hold on tight.
- [LAUGHS]
- Mm.
[ELEVATOR DINGS] Whoa!
Oh, Dr. Archer,
I was hoping I'd catch you.
Good luck on your transplant.
And please, give my best to your son.
I will. Thank you.
Thank you, Ms. Goodwin.
Excuse me, Ms. Goodwin.
There's a Zola Ahmad here to see you?
I'll be right there.
Oh.
Is that the one
Melvoin wants to fob off on us
to fill the vacant residency?
She comes highly recommended
by our chief of medicine, yes.
Her CV is a little spotty,
don't you think?
I could vet this one with you,
push my surgery back a few hours...
Hey, are you kidding me with this?
Listen to Dr. Asher.
And don't worry, I will make sure
she's up to snuff, Commander.
Oh, Ms. Goodwin.
Dr. Melvoin spoke
very highly of the time
you worked together at the Mayo Clinic.
That's very generous of him.
Except Mayo itself
was less enthusiastic.
Evidently, your residency was terminated
for your practicing what they deemed
"vigilante medicine."
Okay, I need to explain.
Please do.
Insurance wouldn't cover
a patient's overnight care
I felt was necessary,
so I put them up in a hotel
and monitored their care from there.
Uh-huh.
And that was it, the one incident?
Yes.
Hmm.
Except no.
You're referring to Trinity Ann Arbor.
That was more of a work culture thing.
I mean, great hospital,
but everything was so regimented.
And I... honestly, I just think
that I haven't found my perfect fit yet.
Well, Dr. Melvoin feels
you got a raw deal
and deserve a second chance.
That's very nice of him.
Except, technically,
this would be your third chance.
Look, Ms. Goodwin, I know
I've had a few false starts.
And as desperate as I am
to get back to work...
because I love being a doctor,
I really do...
I don't wanna feel like
I'm being foisted on anyone.
You're not.
I make the personnel decisions here,
not Dr. Melvoin.
That's why the first year
of your residency here
will be on a probationary basis,
which means you could be
dismissed at will,
if that's acceptable to you.
Yeah. Yes. Thank you.
Well, it might get
extra chaotic here today
since the head of our ED
is out of pocket.
So you will be reporting
to Dr. Marcel here.
- Hi.
- Hi.
No better place to start
than covering trauma.
I hope this works out.
Thank you, Ms. Goodwin.
After you.
- So you're my attending.
- I am.
Lucky me.
There's a change room
through the doctor's lounge
over there, okay? [ALARM BLARES]
Incoming. High-speed crash.
You're going to Baghdad, Court.
Sheryl Martin, 45, struck a parked car
at 40 miles per hour.
GCS 8.
Expanding hematoma
on right side of the neck,
unable to intubate in the field.
Guy crossed the street out of nowhere.
I would've k*lled him if I
hadn't swerved out of the way.
This is the husband, Wade.
Wade, why don't you hang out
here for me, okay?
We're gonna take good care
of your wife, I promise.
All right, guys, here we go.
Ready, one, two, three.
Matt, what's the status
of the pedestrian?
Second ambulance right behind us.
Okay. Laryngoscope.
Sheryl, can you hear me?
Jaw thrust and keep bagging.
Let's get this airway under control.
Sats 79 and falling.
No breath sounds.
Lots of resistance on the bag.
Okay, let me get in.
[TENSE MUSIC]
I can't see too clearly.
She's too far displaced on the left.
We need to release this hematoma
if we want a shot at the airway.
Not outside the OR.
If we open it, she could bleed to death
before we even get to her.
- [MONITOR BEEPING]
- 75.74.
I'm not sure we have any better choices.
We retrograde a wire into the airway.
Won't require too big an incision.
Get me a triple lumen kit
and a Magill, please.
- You ever done one of these?
- I'm a quick study.
Okay, you're gonna grab that needle,
push it through
her cricothyroid membrane
and insert the wire
up and out of her mouth.
[MONITORS BEEPING]
♪ ♪
Okay, got it.
Now what?
Feed the tube back over the wire,
and we have a secure airway.
Sats at 72 now.
Come on, get through.
Oh, what do you think you're doing?
Opening up the hematoma to decompress.
No, no, no. Don't...
♪ ♪
Tube passing through yet?
Yeah, I think I'm in.
All right, start bagging.
Breath sounds?
Check her pulse.
- Bilateral breath sounds.
- All right, we got her airway.
Let's get her on a vent.
Let me get a chest X-ray stat.
I thought we decided not
to tackle the hematoma in here.
Sorry. I didn't feel like
we had another choice.
All right.
Go change into your scrubs now.
Go on.
Stethoscope.
Thanks.
♪ ♪
- Oh.
- Oh, excuse me.
- Didn't see you there.
- Oh, I'm sorry.
You hit the gym already?
Nope, ran to work.
In this weather?
Four miles each way
every day, rain or shine.
And snow and sleet, apparently.
Hey, Mitch, listen,
I know that I was your doctor
a long time ago.
But as far as I'm concerned,
you know, that was then.
And now we're colleagues,
you know, period, okay?
I didn't want you to think
I'd be looking
over your shoulder all the time.
Okay, good to know.
In terms of the conversation
we were having on the balcony...
Yeah, I'm running late.
Still gotta shower and change.
Oh.
You stocked your fridge
like we discussed, right?
You don't wanna be schlepping
back and forth to the market.
I made a Costco run two days ago.
He's way ahead of you, Dean.
And what about calling your
mother, like we talked about?
- I did.
- And she's okay with this?
Yeah.
Good. That's good.
When's the last time you and she spoke?
Uh, it's been a little while.
Okay, guys, today's the day.
Latest labs are looking good.
Anyone wanna pull the rip cord,
now would be the time.
[SOFT MUSIC]
Then we are a go.
Sean, we'll see you in the OR in five.
Sounds good.
I love you, son.
I know.
♪ ♪
Mr. Martin, I know
that might have looked scary,
but your wife's X-rays look good.
There's nothing life-threatening.
I'm gonna quickly take her
into that OR over there
and patch up whatever it is
that caused the bleed.
I don't anticipate
any complications, all right?
Okay. And the guy I winged earlier,
do we know how he's doing?
- We're gonna check on him now.
- Okay.
Again, about that hematoma...
You made a tough call in a tight spot.
Just don't make a habit of it.
- Who's this?
- Hey, Zach.
Dr. Zola Ahmad.
Dr. Ahmad, Dr. Hudgins.
So what are we looking at?
Patient's name is Luis Obrador.
Says he's from Caracas.
I thought I heard him say
something about a coyote
that got them over the border.
Crazy story.
Good thing Doris speaks Spanish.
Got any injuries?
Minor lacerations
on the right arm and leg,
could use a couple sutures.
Oh, and he said he was
on his way to the drugstore
when he got hit,
seems to be fighting off
some kind of infection.
I was just about to put in
orders for labs.
I'll take care of it.
Was there anyone
he wanted us to contact?
Yeah, the police.
Why? To file a report?
I don't know.
I was kind of confused myself.
[PENSIVE MUSIC]
We euphemistically call this
a twitch monitor.
We place two electrodes right here
on either side of the ulnar nerve,
then send a pulse.
And that's how you check
for any neuromuscular blockade.
Dr. Ripley.
Carry on.
Allison Levine, 39, ambo'd in
with respiratory distress.
Sats below 90.
Blood gas show she's hypercapnic
but compensating.
Says here she's a survivor.
She beat lung cancer some 20 years ago,
been in remission since.
But five weeks ago,
she was diagnosed again.
And it's progressed this fast?
Metastatic.
Okay. Thank you, Kai.
Yeah.
Hi, Allison. I'm Dr. Ripley.
I understand you collapsed
in your greenhouse?
Just had it built.
One second, I'm saying
good morning to the orchids,
and the next, I'm face-to-face
with the turnips.
How about we take a listen?
Apologies if I'm a little funky.
I've been trying a new compost.
I don't smell a thing, Allison.
[LAUGHS] You're being nice.
Everyone's nice to you
when they know you're dying.
What are you talking about?
You can fight this off.
I heard you've already
done it once before.
I'm not so sure.
You're just rusty from having been
out of the saddle so long.
Really, I'm just hoping...
[MONITOR BEEPING]
- Sats at 85.
- Let's get her on a mask.
To live long enough to...
Okay, Allison, just save your strength.
See my first tomatoes.
Let's get a crash cart in here.
[TENSE MUSIC]
Hang with me, Allison.
We gotta intubate,
but it's gonna be all right.
♪ ♪
Tied off a couple small vessels.
- She should be fine.
- Great.
I was wondering if you would
take a look at the C-spine CT.
If you look over here
on Sheryl's non-injured side,
in the SCM muscle...
Yeah, that looks like it could be
related to the trauma in some fashion,
- or incidentaloma.
- Probably.
I still think it warrants an MRI.
- Dr. Marcel?
- Yeah?
How's my wife?
She's stable and doing very well, Wade.
In fact, the damage was
much less significant
than it might have appeared.
[SIGHS] That's such a relief.
So how long till she wakes up?
Actually, while she's
still sedated and intubated,
we wanna send Sheryl in for an MRI.
Is that necessary?
I thought you said it looked good.
Well, a CAT scan showed
a soft tissue mass
within the sternocleidomastoid
muscle on Sheryl's neck.
It could be something
related to the injury.
Could be pre-existing.
The MRI will help us figure that out.
Well, is this something
I need to worry about?
Let's not get ahead of ourselves.
How long is it gonna take?
We'll see to it that
your wife gets top priority.
Officer, are you here
to take my statement?
- Excuse me?
- Yeah, I wanna press charges
on that guy right over there.
I overheard someone say that
he might be here illegally.
I need to make sure that
doesn't affect my insurance.
I'll have someone
come speak to you, mister...?
- Martin, Wade Martin.
- Okay.
- Give me a minute.
- Thank you.
- Do you have a moment?
- Yeah.
It seems I'm in a bit of a pickle.
How so?
I'm officially here
as Mr. Obrador's emergency contact.
What?
He's being sheltered
in the lobby of our district,
and he's not the only one.
They set up camp about a week ago.
That's why he asked to call the police.
And it's not just us.
There are migrants in almost
every district of the city,
and the buses keep
coming up from the border
almost every day.
They're fleeing
a pretty horrific situation
down in Venezuela.
I'm gonna go put
those orders in for radiology.
♪ ♪
[GASPS] Sorry.
- It's okay. I'm on hold.
- Okay.
How did the first day of mediation go?
I got ambushed and gaslit.
Oh, I'm sorry.
Oh, it's just my fault
for being so agreeable.
You were happy with your
divorce lawyer, right?
Could you text me his number?
You really think that's necessary?
It worked for you.
All right, I'll send you his contact.
But promise me that you'll sleep on it
before calling him.
Ben is the one who pulled the plug
on this marriage, Sharon.
♪ ♪
I'm sorry, ma'am.
Is there something you're looking for?
My son, he's supposed
to go into surgery today.
- I need to find him.
- Okay. Maybe I can help you.
- What's your son's name?
- Sean. Sean Archer.
Your Dr. Archer's ex?
I would have been here sooner.
Just... there were no flights.
Am I too late?
From what I understand,
surgery went well,
and there were no complications.
Sean's kidney is gone already?
Wow, they crippled my son. [SCOFFS]
I can tell you from
personal experience, ma'am,
that that's not the case.
I'm a donor myself, four years running,
and I'm doing fine.
I've even survived cancer.
Is that supposed to be comforting?
You know what? I'm sorry.
I appreciate the gesture.
It's... [SIGHS]
I only found out about this yesterday.
I understand.
Dean's right down this way.
I told him you were coming.
- I'm not hungry.
- You're gonna need food.
Well, don't you look like crap.
Leanne.
I heard your kidneys are shot.
So now what?
What, you're gonna take one of Sean's?
I spoke with him last night, you know.
Yeah, I do know.
I encouraged him to call you.
Oh, gee, thanks a lot.
The night before the operation.
I told him I was not okay with this.
Well, that's not what Sean said.
He said you were.
Well, he lied to you, Dean.
Or I don't know, maybe...
maybe you're lying to me,
which I wouldn't put past you.
You know what? I should have known,
when Sean told me
you were back in his life,
that you had some kind of agenda.
- This is all you.
- You need to calm down.
You know what? You ghosted your son
for over a decade, you son of a b*tch.
Is this why you suddenly
decided to reconnect with him?
Because, ooh,
now you need a kidney, huh?
No, that's... that's not
what happened at all.
Dean reached out to Sean
well before he was injured.
Who is this, your new buddy?
This is Hannah, Dr. Asher.
I work with Dean.
Yeah, sure you do.
I can put a stop to this, you know?
I've already contacted a lawyer.
You should be ashamed of yourself.
So, Dean, ready to meet your new kidney?
[TENSE MUSIC]
Dr. Ripley? I'm Neva, Allison's sister.
I came as soon as I could.
Your sister is stable
and resting comfortably.
Here, I'll show you.
This disease blindsided the both of us.
When you hear the word metastatic,
the floor just drops out
from beneath you.
I know. I'm sorry.
Listen, Neva, I wanted
to ask you some questions
about how they came
to make that diagnosis.
It was five weeks ago, right?
No! I'm too late!
Allison's still with us, Neva.
She's just been intubated.
But she didn't want to be intubated.
It's in her advance directive.
I'm sorry. We were unaware of one.
We literally just made it two days ago.
I have a copy on my phone.
See? DNI, DNR.
Naming me as her surrogate.
We had it notarized.
Okay, we'll get to that
in a moment, Neva.
But first, your sister mentioned
she just built a greenhouse.
Do you know when
she started working in it?
I don't know, maybe eight weeks ago.
What does it have to do with anything?
Well, there's a fungus that's
prevalent in soil and compost,
especially in moist environments
like a greenhouse.
People like Allison,
whose lungs and immune system
have been compromised, they can be
more susceptible to infection.
- A fungal infection?
- Yes. Aspergillosis.
It will look,
for all intents and purposes,
exactly like a rapidly
spreading metastatic cancer,
infecting the lungs,
the kidneys, the brain.
The only way to rule it out
for sure is to get a biopsy.
Didn't her oncologist do that already?
If they did, I'm not
seeing it in her records.
But we can do it right here.
You don't understand.
This is her worst nightmare.
You want me to keep her like
this because you have a hunch?
Do you know how many specialists
we've seen this past month?
Countless, every day,
all with the same diagnosis.
Did any of them ask
about the greenhouse?
No offense, but you're an ED doctor.
Without a biopsy to confirm,
there's a chance
one of your so-called specialists
just handed your sister a death sentence
based on incomplete information.
Maybe I need to speak
to your supervisor.
Neva, please just stop
and listen to me for a second.
Who can I speak to who's in charge here?
♪ ♪
Hi. I'm Dr. Charles. How can I help you?
♪ ♪
She can't really get an injunction
to stop the transplant, can she, Peter?
- Well, she can try.
- On what grounds?
Sean's an adult.
He signed his informed consent.
My guess is, she's gonna try
and convince a judge
that as a recovering addict
and a parolee,
Sean lacked the decisional capacity
to lend his full consent.
Okay, that's ridiculous.
I don't think
she's gonna have any success.
And the onus is on her.
So as it stands now,
I'm completely comfortable
moving forward with the transplant.
Yeah, well, I'm not.
If Leanne is not okay with Sean
giving me this kidney,
then I'm not taking it.
Dean, don't do this.
Just give me some time.
I just need to talk to him.
Dr. Cameron, if the intended recipient
did change his mind at this juncture,
what would our next steps be?
Well, it's unlikely we would
find a match at this hour,
so the only ethical thing to do
would be to place the kidney
back inside the donor.
But I'm only comfortable with
keeping it on ice for so long.
- How long?
- Two, three hours tops.
You got 90 minutes.
If this isn't resolved by then,
the kidney goes back to Sean.
Understood.
[APPREHENSIVE MUSIC]
Palliative said they'll transfer her up
in about an hour or so.
Thanks, Doris.
You're really gonna let this happen?
I'm sorry.
Patient has a valid and enforceable DNI.
Even if it is,
the woman is being irrational.
I'm trying to save her sister's life.
You realize how we got here, right?
Someone... in this case,
probably a completely
out-of-their-depth GP...
starts with a faulty assumption
of, "Hey, this must be
Allison's cancer returning."
And then boom, you get this daisy chain
of error after error with a DNI
that was only consented to
under a false premise.
Honestly, I'm having no problem
at all seeing your logic.
But I'm not the one
that you have to convince.
Yeah, well, I'm afraid
she's tuned me out.
Look, she's carrying
this enormous burden,
honoring the dying wishes of someone
she loves very, very much.
Maybe focus more on that
and less on how right you are.
Zach, have you taken a look
at your patient's labs yet?
White count's in the 30s
with a pretty aggressive shift.
Mostly neutrophils.
I don't know, escalating
pretty quickly for just a flu.
He's been vomiting
kind of relentlessly as well.
[TENSE MUSIC]
♪ ♪
Hold on, Luis. It's gonna be okay.
[MONITORS BEEPING]
When did he break out in this rash?
I don't know.
It must have just happened.
Did you check for insect bites?
Why? He came in with an injured arm.
♪ ♪
Ask him how many days
he's been in the U.S.
Luis... [SPEAKING SPANISH]
[SPEAKING SPANISH]
About a week and a half.
How many people was he traveling with?
[BOTH SPEAKING SPANISH]
Ten others, all being housed
in the police station.
♪ ♪
Have you seen Dr. Marcel?
He just got called into the OR.
What about Ms. Goodwin?
Is she reachable?
You can leave a message
with her assistant if you like.
- What district again?
- The 23rd.
It's about a mile from here.
Tell Dr. Marcel that
I'll be back as soon as I can.
This is just not about
the kidney, Leanne, okay?
This is about Sean and all
the changes that I've seen.
And if he wakes up
and he finds out that his...
- You've already said this.
- You're not listening to me.
- You know what?
- You're not listening to me!
You know what? We're done here, Dean.
- [GROANS]
- So?
Well...
You look resigned.
What am I supposed to do, hmm?
Please don't tell me this is you
just finding another way to not
accept a gift from your son.
Oh, it's not that.
I... I want this kidney.
Good.
You're finally saying it
like you mean it.
Now go tell Dr. Cameron.
But Leanne...
Leanne is being petty and vindictive.
I am sorry to be so blunt,
but this is not about protecting Sean.
This is about hurting you.
Don't feed into it.
She's the mother of my child.
I go through with this
against her wishes,
Sean might never be able
to have a relationship
with his mom ever again.
[SOMBER MUSIC]
Do you remember
that Archer that I first met,
the self-serving, egocentric jerk
that only cared about himself?
Why can't you be more like him today?
♪ ♪
- Dr. Marcel?
- Yeah?
It's been over an hour, and my wife
hasn't gotten an MRI yet.
I assure you, we have not forgotten.
Dr. Ahmad said she'd make it a priority,
but I haven't seen a trace of her.
As soon as an MRI frees up, Mr. Martin,
I promise, she's next in queue.
Excuse me.
Doris, where's Zola?
I'm gonna need rooms
for all of these patients,
preferably isolated from the rest of ED.
What the hell's going on?
I brought in the rest of the migrants
that came in from Venezuela with Luis.
Two of them have similar symptoms.
I'm talking about you. Where were you?
Walking off the floor
without notifying a supervisor.
I know. I'm sorry.
But you were in surgery,
and I found a bug bite on his ankle.
You think it might be
something infectious?
Typhus maybe, or malaria if we're lucky.
Or something contagious, if we're not.
Maggie?
What's going on?
Let's get these good folks
into contact and droplet isolation.
And make sure they're comfortable.
Also, no one goes in and out
without gowns, gloves,
and masks, and have phlebotomy run
IFA assays on everyone stat, okay?
- Yeah, I got it.
- Hey.
There's not gonna be another warning.
Doris, you're with me.
Chewy, Tracy, Ben, let's go.
I really don't wanna have
to adjudicate this all over, Dr. Ripley.
I understand.
I just wanted to apologize
for my belligerence earlier.
I can't even fathom
what you must be going through,
the pain, the burden of such
an immense responsibility.
I'm sorry for not honoring that.
Thank you.
I have been accused of being bullheaded.
For good reason, it turns out.
You have that in common with Allison.
Listen, I realize I'm asking a lot
for you to follow me
on what might seem like
nothing more than a whim.
But if I were able to lighten
Allison's sedation
enough for you to ask
what she wanted directly,
would you be open to that?
No.
No, I know we agreed to use a mediator.
We also agreed to stay together
for the rest of our lives.
Look how long that lasted.
You know, I can't talk
about this right now.
You're gonna have to call me later.
Yeah.
There you go.
- Maggie?
- Yeah?
What's all this about?
The new resident.
She thinks that we have
an outbreak on our hands.
My guess is that she's getting
a little ahead of herself,
but we'll see.
Okay.
What's happening with Dean?
Has he made any headway with his ex?
No, neither of us have.
- You mean you talked to her?
- I tried.
Figured we might be able to connect,
one addict to another.
But I guess that that was
not the right strategy.
I think Leanne is just trying
to do what's best for her son
- and just...
- Maggie. Maggie, Maggie.
You don't know all the facts.
Leanne was no great mother.
I think that her motivations
here are pretty obvious.
If Dean gets the kidney,
it means that Sean loves him
more than her.
I mean, she's still
so resentful and angry
about the divorce,
but getting her to see that,
I don't think it's gonna be possible.
[SIGHS]
[PENSIVE MUSIC]
♪ ♪
Her eyes are still closed.
Her medication has an active metabolite,
so she's not fully awake.
She doesn't have full muscle control.
But she can hear us.
Allison, it's me, Neva.
I know I promised
not to let you be intubated,
but, well, now that we're here,
Dr. Ripley wanted to run one more test.
A bronchoscopy, Allison,
so that we can biopsy
a sample from your lung.
There's a chance what's ailing you
is actually a fungal infection.
I only wanna do it if you do, Allison.
Do you understand?
If you agree to the procedure, Allison,
give me a thumbs up.
[SOFT DRAMATIC MUSIC]
♪ ♪
There.
I see it. She's saying yes.
We'll get started right away.
- She's asymptomatic.
- For now.
A lot of these diseases have
long incubation periods.
Wait, why are you moving my wife?
Sir, please, it's just temporary.
Hey, Mr. Martin.
You okay? What's going on?
Did you two authorize this?
Mr. Martin, my apologies.
It appears we're momentarily...
You think I don't see what's going on,
but you're giving all the rooms to them.
Hold on now.
Same thing happened at my kid's school.
They commandeered her gym for a shelter.
Look, Wade, I assure you
we have enough resources
- to take care of everyone.
- No, we don't.
People keep saying that,
but we just don't, okay?
The whole volleyball season
got canceled,
and my daughter needed that
for her scholarship.
And now my wife,
she's obviously not receiving
your full attention.
How come nobody's looking out for us?
I understand
that this is an inconvenience,
but we do need to free up this room.
- Okay, go ahead.
- No, get away from her!
- Wade, Wade, Wade.
- Mr. Martin, please.
- Stop handling me!
- Wait! Hey!
- No!
- Hey, hey.
- Calm down!
- No!
No! Get away from me!
- Get off of me!
- Calm down, Mr. Martin!
- Let's go.
- Get off of me!
Get off of me!
No! No!
- You all right?
- Yeah, I'm fine.
I'll go get that blood draw started.
The biopsy came back positive?
In this case, that's a good thing.
Aspergillosis is at least
something we can treat.
So she's not going to die?
Well, we're not out of the woods yet.
I've started Allison on some
heavy antifungal medications.
We should know fairly quickly
if she responds.
But I'm very hopeful.
[CRYING]
We all just assumed.
[SOFT MUSIC]
♪ ♪
I can't believe I almost stopped you
from saving her life.
I don't know how to ever thank you.
Hey, man. Well done.
Excellent work, Dr. Ripley.
Nah, just a lucky hunch.
Oh, come on.
Take a little credit.
I was stuck in my head earlier today,
and you helped me get out of it.
Thank you.
Any updates?
I wish I could say
this was an isolated incident.
But from what I'm hearing around town,
it seems like the welcome
wagon's broken down.
Rosado's offering
to take Mr. Martin into custody
if we feel the staff's safety
is threatened.
Dr. Ahmad?
You're asking my opinion?
I am.
Can I just say that
I feel responsible for Wade?
I should have spoken to him directly
before we tried to move his wife.
I'm not asking you to defend
any of your interactions
with Mr. Martin.
Thank you, Ms. Goodwin.
I am interested, however,
in you defending
the thought process that convinced you
that leaving the ED
in the middle of your shift
without notifying your supervisor
was a wise idea.
I know this is a bad look,
this being probationary and all.
But my brain sometimes seizes
on an idea,
and I feel this adrenaline sh**t up.
And I keep telling myself,
"Slow down, Zola.
Slow down," but...
I'm working on it.
I see.
I should go check on another patient.
Wanna hear my opinion of her now?
Won't be complimentary.
Let's double back on that
at the end of the day.
♪ ♪
I hear they're getting ready
to put Sean's kidney back in him.
Shouldn't be too much longer now.
Things were rough between
you and Dr. Archer, huh?
To put it mildly, yeah.
I get it.
My husband Ben and I
are getting a divorce.
His decision, by the way.
- Oh. I'm sorry.
- Yeah.
And as stupid as it may sound,
we're fighting over a cat.
Ben wants it.
And even though I never
really bonded with the thing,
there's no way I'm letting him have it.
No way.
I just feel so angry all the time.
I don't recognize myself.
I guess I wanna hurt him for leaving me.
For rejecting me.
How did you and Dr. Archer meet?
It was a 4th of July beach party.
- Mm.
- Yeah.
How about you and Ben?
Chemo. We both had cancer.
- Oh. Oh, wow.
- We're fine.
It's the marriage that's terminal.
I loved him.
God, I love him.
He could be so sweet
and do these little things,
like making sure I took
my vitamins every morning.
I remember, when I was
pregnant with Sean,
Dean and I took a road trip
out to the desert.
He was stationed at Coronado.
And I don't know how,
but I stepped on a cactus.
- Oh.
- Don't... don't ask.
Anyway, he... he spent
the next five hours
getting the needles
out of the sole of my foot
with tweezers and Elmer's Glue,
all while keeping me
supplied with ice chips.
- [LAUGHS]
- Uh-huh.
You know, Leanne, as angry as I am,
I wasn't exactly blameless.
I did some things.
[SIGHS]
Yeah, I did some things too.
♪ ♪
How long before the surgery?
Excuse me, Dr. Charles?
I was wondering if you might
like to meet my sister.
Oh. That'd be my pleasure.
We're gonna move you upstairs
to an ICU bed,
so settle in.
I can't promise
any fresh vegetables, but...
Orange Jell-O, though, seriously good.
Allison, this is Dr. Charles,
who I was telling you about.
I just wanted to thank you.
I don't know how to repay you both.
Dr. Ripley was telling me
that you had a green thumb.
I'm just... I myself have always
been partial to stone fruits,
is all I'm gonna say.
[LAUGHS] Deal.
You're gonna have to wait
till summer, though.
And you, Neva, if you hadn't
ignored my DNI...
If you hadn't given the thumbs up,
I wouldn't have had the courage.
Thumbs up?
Well, it was more of a twitch,
but it was definitely a yes.
Not that it matters much,
but I don't really remember
much of that.
Well, the midazolam we had you on
is probably why
your memory's a bit fuzzy.
It may very well come back
to you in a day or two.
In any event, we're just glad
you're on the road to recovery.
Speaking of which, let me go
check on that transfer.
[TENSE MUSIC]
I'm gonna let you rest.
But really nice to meet you.
So glad it worked out,
and we are always here, okay?
- Thanks again, Dr. Charles.
- You bet.
♪ ♪
Hey, Ms. Goodwin.
Have you seen the IFA assay
that just came back on Luis Obrador
and the other migrants?
- Murine typhus?
- Mm-hmm.
- From flea bites.
- Yeah, probably contracted
while they were crossing the border.
Infested blankets, maybe.
Yeah, timing makes sense.
It could take up to 12 days
to show symptoms.
Well, it's a good thing
Dr. Ahmad caught it when she did.
She might have saved some lives.
- Dr. Marcel?
- Yeah?
Have you seen this? Sheryl's MRI.
Inflamed lymph nodes in Sheryl's neck.
Frozen biopsy came back as a sarcoma.
Oh, dear.
It looks like it might
already be spreading.
Someone's gonna need to break
the news to her husband.
Yeah.
I'll go tell him.
It should be me.
Unless you prefer it to be anyone else.
Go ahead.
[PENSIVE MUSIC]
♪ ♪
You know, I hesitate to say
who she reminds me of.
You were forced to suspend him
on more than one occasion.
I'll give you a hint.
He had red hair.
You, uh... you really want
a sequel on your hands?
Above and beyond.
I can't say I wasn't warned.
Excuse me?
We're gonna have to teach
this one how to pace herself.
We wouldn't want that fire
to burn out too quickly.
♪ ♪
Hey, Dad.
Hey, son.
How are you two?
- Good.
- Yeah.
Well, well, well.
Should I go get Leanne
and let her know that you're awake
and that the transplant was a success?
Mom's here?
Yeah, she gave us her blessing.
- She did?
- Yeah.
Would you go find her
so we can thank her?
Absolutely.
♪ ♪
[ELEVATOR DINGS] Leanne? Hold up!
They're asking for you.
♪ ♪
Oh. Hey, man.
Really great grab on that diagnosis,
you know, once again.
- Yeah. Thanks.
- I'm still stumped, though,
is how you got Allison's sign-off.
I mean, aren't you supposed
to turn the midazolam down
when you get a patient's consent?
Excuse me?
What'd you do, like, hook her up
to a twitch monitor or something?
What are you accusing me of?
Nothing.
I'm not accusing you of anything.
I'm just saying that as somebody
who, after 40 years,
is still regularly tempted
to mess with the rules
for all the right reasons,
it's just... you know,
it ain't worth it.
Almost lost my license that way.
♪ ♪
This couldn't wait till tomorrow?
Not really.
You were right
about what you said earlier.
[CAT MEOWING]
He belongs with you.
I don't know what to say.
Thank you.
You wanna come in?
No, I really just wanna move on.
Let's try and wrap this up
tomorrow, okay?
♪ ♪
Dr. Ripley, we've met before,
haven't we?
County Juvenile.
My psych care, remember?
I remember that you were violent.
Do not treat me like the boy
you knew 20 years ago.
You've been working nonstop all day.
If I had a guy like Ben
waiting for me...
Just stop.
My wonderful husband wants a divorce.
Sean is donating his kidney to you.
I don't deserve it.
I was a terrible father.
I want to do this.
No, look, I'm sorry, but I think
it's only fair he stays with me.
If the cat was this important to you,
why did we save the question
of his custody for last?
Maggie refers to him as "the cat."
- He's a cat.
- She's making my point for me.
- His name is Jasper.
- I know his name is Jasper.
I gave him the name.
Yeah, and I'm the one that found him.
I'm also the one
that spends more time with him.
Because I work longer hours.
Exactly, because you're never home
long enough to look after him.
He's a cat.
He doesn't need 24-hour surveillance.
Maggie, Ben, please.
Remember what you agreed to
at the outset of this mediation...
no blaming and no shaming.
Come on.
Let's not throw away all
the progress that we've made.
Come on, Maggie.
You know he prefers being with me.
Let the record show
that I'm disputing that.
There is no official record, Maggie.
It's just three people in a room
for a win-win compromise.
[SOMBER MUSIC]
This is not working for me.
Come on. Maggie.
Look, we're almost
at the finish line here.
No. Only you are.
♪ ♪
Your chariot awaits.
Well, I appreciate the thought,
but I can manage fine.
Mm, hospital protocol
for all surgical patients,
which I believe you signed off on.
Don't make me call security.
Come on.
All right, all right, all right.
Let's make this quick, okay?
I don't wanna attract
any undue attention.
Hold on tight.
- [LAUGHS]
- Mm.
[ELEVATOR DINGS] Whoa!
Oh, Dr. Archer,
I was hoping I'd catch you.
Good luck on your transplant.
And please, give my best to your son.
I will. Thank you.
Thank you, Ms. Goodwin.
Excuse me, Ms. Goodwin.
There's a Zola Ahmad here to see you?
I'll be right there.
Oh.
Is that the one
Melvoin wants to fob off on us
to fill the vacant residency?
She comes highly recommended
by our chief of medicine, yes.
Her CV is a little spotty,
don't you think?
I could vet this one with you,
push my surgery back a few hours...
Hey, are you kidding me with this?
Listen to Dr. Asher.
And don't worry, I will make sure
she's up to snuff, Commander.
Oh, Ms. Goodwin.
Dr. Melvoin spoke
very highly of the time
you worked together at the Mayo Clinic.
That's very generous of him.
Except Mayo itself
was less enthusiastic.
Evidently, your residency was terminated
for your practicing what they deemed
"vigilante medicine."
Okay, I need to explain.
Please do.
Insurance wouldn't cover
a patient's overnight care
I felt was necessary,
so I put them up in a hotel
and monitored their care from there.
Uh-huh.
And that was it, the one incident?
Yes.
Hmm.
Except no.
You're referring to Trinity Ann Arbor.
That was more of a work culture thing.
I mean, great hospital,
but everything was so regimented.
And I... honestly, I just think
that I haven't found my perfect fit yet.
Well, Dr. Melvoin feels
you got a raw deal
and deserve a second chance.
That's very nice of him.
Except, technically,
this would be your third chance.
Look, Ms. Goodwin, I know
I've had a few false starts.
And as desperate as I am
to get back to work...
because I love being a doctor,
I really do...
I don't wanna feel like
I'm being foisted on anyone.
You're not.
I make the personnel decisions here,
not Dr. Melvoin.
That's why the first year
of your residency here
will be on a probationary basis,
which means you could be
dismissed at will,
if that's acceptable to you.
Yeah. Yes. Thank you.
Well, it might get
extra chaotic here today
since the head of our ED
is out of pocket.
So you will be reporting
to Dr. Marcel here.
- Hi.
- Hi.
No better place to start
than covering trauma.
I hope this works out.
Thank you, Ms. Goodwin.
After you.
- So you're my attending.
- I am.
Lucky me.
There's a change room
through the doctor's lounge
over there, okay? [ALARM BLARES]
Incoming. High-speed crash.
You're going to Baghdad, Court.
Sheryl Martin, 45, struck a parked car
at 40 miles per hour.
GCS 8.
Expanding hematoma
on right side of the neck,
unable to intubate in the field.
Guy crossed the street out of nowhere.
I would've k*lled him if I
hadn't swerved out of the way.
This is the husband, Wade.
Wade, why don't you hang out
here for me, okay?
We're gonna take good care
of your wife, I promise.
All right, guys, here we go.
Ready, one, two, three.
Matt, what's the status
of the pedestrian?
Second ambulance right behind us.
Okay. Laryngoscope.
Sheryl, can you hear me?
Jaw thrust and keep bagging.
Let's get this airway under control.
Sats 79 and falling.
No breath sounds.
Lots of resistance on the bag.
Okay, let me get in.
[TENSE MUSIC]
I can't see too clearly.
She's too far displaced on the left.
We need to release this hematoma
if we want a shot at the airway.
Not outside the OR.
If we open it, she could bleed to death
before we even get to her.
- [MONITOR BEEPING]
- 75.74.
I'm not sure we have any better choices.
We retrograde a wire into the airway.
Won't require too big an incision.
Get me a triple lumen kit
and a Magill, please.
- You ever done one of these?
- I'm a quick study.
Okay, you're gonna grab that needle,
push it through
her cricothyroid membrane
and insert the wire
up and out of her mouth.
[MONITORS BEEPING]
♪ ♪
Okay, got it.
Now what?
Feed the tube back over the wire,
and we have a secure airway.
Sats at 72 now.
Come on, get through.
Oh, what do you think you're doing?
Opening up the hematoma to decompress.
No, no, no. Don't...
♪ ♪
Tube passing through yet?
Yeah, I think I'm in.
All right, start bagging.
Breath sounds?
Check her pulse.
- Bilateral breath sounds.
- All right, we got her airway.
Let's get her on a vent.
Let me get a chest X-ray stat.
I thought we decided not
to tackle the hematoma in here.
Sorry. I didn't feel like
we had another choice.
All right.
Go change into your scrubs now.
Go on.
Stethoscope.
Thanks.
♪ ♪
- Oh.
- Oh, excuse me.
- Didn't see you there.
- Oh, I'm sorry.
You hit the gym already?
Nope, ran to work.
In this weather?
Four miles each way
every day, rain or shine.
And snow and sleet, apparently.
Hey, Mitch, listen,
I know that I was your doctor
a long time ago.
But as far as I'm concerned,
you know, that was then.
And now we're colleagues,
you know, period, okay?
I didn't want you to think
I'd be looking
over your shoulder all the time.
Okay, good to know.
In terms of the conversation
we were having on the balcony...
Yeah, I'm running late.
Still gotta shower and change.
Oh.
You stocked your fridge
like we discussed, right?
You don't wanna be schlepping
back and forth to the market.
I made a Costco run two days ago.
He's way ahead of you, Dean.
And what about calling your
mother, like we talked about?
- I did.
- And she's okay with this?
Yeah.
Good. That's good.
When's the last time you and she spoke?
Uh, it's been a little while.
Okay, guys, today's the day.
Latest labs are looking good.
Anyone wanna pull the rip cord,
now would be the time.
[SOFT MUSIC]
Then we are a go.
Sean, we'll see you in the OR in five.
Sounds good.
I love you, son.
I know.
♪ ♪
Mr. Martin, I know
that might have looked scary,
but your wife's X-rays look good.
There's nothing life-threatening.
I'm gonna quickly take her
into that OR over there
and patch up whatever it is
that caused the bleed.
I don't anticipate
any complications, all right?
Okay. And the guy I winged earlier,
do we know how he's doing?
- We're gonna check on him now.
- Okay.
Again, about that hematoma...
You made a tough call in a tight spot.
Just don't make a habit of it.
- Who's this?
- Hey, Zach.
Dr. Zola Ahmad.
Dr. Ahmad, Dr. Hudgins.
So what are we looking at?
Patient's name is Luis Obrador.
Says he's from Caracas.
I thought I heard him say
something about a coyote
that got them over the border.
Crazy story.
Good thing Doris speaks Spanish.
Got any injuries?
Minor lacerations
on the right arm and leg,
could use a couple sutures.
Oh, and he said he was
on his way to the drugstore
when he got hit,
seems to be fighting off
some kind of infection.
I was just about to put in
orders for labs.
I'll take care of it.
Was there anyone
he wanted us to contact?
Yeah, the police.
Why? To file a report?
I don't know.
I was kind of confused myself.
[PENSIVE MUSIC]
We euphemistically call this
a twitch monitor.
We place two electrodes right here
on either side of the ulnar nerve,
then send a pulse.
And that's how you check
for any neuromuscular blockade.
Dr. Ripley.
Carry on.
Allison Levine, 39, ambo'd in
with respiratory distress.
Sats below 90.
Blood gas show she's hypercapnic
but compensating.
Says here she's a survivor.
She beat lung cancer some 20 years ago,
been in remission since.
But five weeks ago,
she was diagnosed again.
And it's progressed this fast?
Metastatic.
Okay. Thank you, Kai.
Yeah.
Hi, Allison. I'm Dr. Ripley.
I understand you collapsed
in your greenhouse?
Just had it built.
One second, I'm saying
good morning to the orchids,
and the next, I'm face-to-face
with the turnips.
How about we take a listen?
Apologies if I'm a little funky.
I've been trying a new compost.
I don't smell a thing, Allison.
[LAUGHS] You're being nice.
Everyone's nice to you
when they know you're dying.
What are you talking about?
You can fight this off.
I heard you've already
done it once before.
I'm not so sure.
You're just rusty from having been
out of the saddle so long.
Really, I'm just hoping...
[MONITOR BEEPING]
- Sats at 85.
- Let's get her on a mask.
To live long enough to...
Okay, Allison, just save your strength.
See my first tomatoes.
Let's get a crash cart in here.
[TENSE MUSIC]
Hang with me, Allison.
We gotta intubate,
but it's gonna be all right.
♪ ♪
Tied off a couple small vessels.
- She should be fine.
- Great.
I was wondering if you would
take a look at the C-spine CT.
If you look over here
on Sheryl's non-injured side,
in the SCM muscle...
Yeah, that looks like it could be
related to the trauma in some fashion,
- or incidentaloma.
- Probably.
I still think it warrants an MRI.
- Dr. Marcel?
- Yeah?
How's my wife?
She's stable and doing very well, Wade.
In fact, the damage was
much less significant
than it might have appeared.
[SIGHS] That's such a relief.
So how long till she wakes up?
Actually, while she's
still sedated and intubated,
we wanna send Sheryl in for an MRI.
Is that necessary?
I thought you said it looked good.
Well, a CAT scan showed
a soft tissue mass
within the sternocleidomastoid
muscle on Sheryl's neck.
It could be something
related to the injury.
Could be pre-existing.
The MRI will help us figure that out.
Well, is this something
I need to worry about?
Let's not get ahead of ourselves.
How long is it gonna take?
We'll see to it that
your wife gets top priority.
Officer, are you here
to take my statement?
- Excuse me?
- Yeah, I wanna press charges
on that guy right over there.
I overheard someone say that
he might be here illegally.
I need to make sure that
doesn't affect my insurance.
I'll have someone
come speak to you, mister...?
- Martin, Wade Martin.
- Okay.
- Give me a minute.
- Thank you.
- Do you have a moment?
- Yeah.
It seems I'm in a bit of a pickle.
How so?
I'm officially here
as Mr. Obrador's emergency contact.
What?
He's being sheltered
in the lobby of our district,
and he's not the only one.
They set up camp about a week ago.
That's why he asked to call the police.
And it's not just us.
There are migrants in almost
every district of the city,
and the buses keep
coming up from the border
almost every day.
They're fleeing
a pretty horrific situation
down in Venezuela.
I'm gonna go put
those orders in for radiology.
♪ ♪
[GASPS] Sorry.
- It's okay. I'm on hold.
- Okay.
How did the first day of mediation go?
I got ambushed and gaslit.
Oh, I'm sorry.
Oh, it's just my fault
for being so agreeable.
You were happy with your
divorce lawyer, right?
Could you text me his number?
You really think that's necessary?
It worked for you.
All right, I'll send you his contact.
But promise me that you'll sleep on it
before calling him.
Ben is the one who pulled the plug
on this marriage, Sharon.
♪ ♪
I'm sorry, ma'am.
Is there something you're looking for?
My son, he's supposed
to go into surgery today.
- I need to find him.
- Okay. Maybe I can help you.
- What's your son's name?
- Sean. Sean Archer.
Your Dr. Archer's ex?
I would have been here sooner.
Just... there were no flights.
Am I too late?
From what I understand,
surgery went well,
and there were no complications.
Sean's kidney is gone already?
Wow, they crippled my son. [SCOFFS]
I can tell you from
personal experience, ma'am,
that that's not the case.
I'm a donor myself, four years running,
and I'm doing fine.
I've even survived cancer.
Is that supposed to be comforting?
You know what? I'm sorry.
I appreciate the gesture.
It's... [SIGHS]
I only found out about this yesterday.
I understand.
Dean's right down this way.
I told him you were coming.
- I'm not hungry.
- You're gonna need food.
Well, don't you look like crap.
Leanne.
I heard your kidneys are shot.
So now what?
What, you're gonna take one of Sean's?
I spoke with him last night, you know.
Yeah, I do know.
I encouraged him to call you.
Oh, gee, thanks a lot.
The night before the operation.
I told him I was not okay with this.
Well, that's not what Sean said.
He said you were.
Well, he lied to you, Dean.
Or I don't know, maybe...
maybe you're lying to me,
which I wouldn't put past you.
You know what? I should have known,
when Sean told me
you were back in his life,
that you had some kind of agenda.
- This is all you.
- You need to calm down.
You know what? You ghosted your son
for over a decade, you son of a b*tch.
Is this why you suddenly
decided to reconnect with him?
Because, ooh,
now you need a kidney, huh?
No, that's... that's not
what happened at all.
Dean reached out to Sean
well before he was injured.
Who is this, your new buddy?
This is Hannah, Dr. Asher.
I work with Dean.
Yeah, sure you do.
I can put a stop to this, you know?
I've already contacted a lawyer.
You should be ashamed of yourself.
So, Dean, ready to meet your new kidney?
[TENSE MUSIC]
Dr. Ripley? I'm Neva, Allison's sister.
I came as soon as I could.
Your sister is stable
and resting comfortably.
Here, I'll show you.
This disease blindsided the both of us.
When you hear the word metastatic,
the floor just drops out
from beneath you.
I know. I'm sorry.
Listen, Neva, I wanted
to ask you some questions
about how they came
to make that diagnosis.
It was five weeks ago, right?
No! I'm too late!
Allison's still with us, Neva.
She's just been intubated.
But she didn't want to be intubated.
It's in her advance directive.
I'm sorry. We were unaware of one.
We literally just made it two days ago.
I have a copy on my phone.
See? DNI, DNR.
Naming me as her surrogate.
We had it notarized.
Okay, we'll get to that
in a moment, Neva.
But first, your sister mentioned
she just built a greenhouse.
Do you know when
she started working in it?
I don't know, maybe eight weeks ago.
What does it have to do with anything?
Well, there's a fungus that's
prevalent in soil and compost,
especially in moist environments
like a greenhouse.
People like Allison,
whose lungs and immune system
have been compromised, they can be
more susceptible to infection.
- A fungal infection?
- Yes. Aspergillosis.
It will look,
for all intents and purposes,
exactly like a rapidly
spreading metastatic cancer,
infecting the lungs,
the kidneys, the brain.
The only way to rule it out
for sure is to get a biopsy.
Didn't her oncologist do that already?
If they did, I'm not
seeing it in her records.
But we can do it right here.
You don't understand.
This is her worst nightmare.
You want me to keep her like
this because you have a hunch?
Do you know how many specialists
we've seen this past month?
Countless, every day,
all with the same diagnosis.
Did any of them ask
about the greenhouse?
No offense, but you're an ED doctor.
Without a biopsy to confirm,
there's a chance
one of your so-called specialists
just handed your sister a death sentence
based on incomplete information.
Maybe I need to speak
to your supervisor.
Neva, please just stop
and listen to me for a second.
Who can I speak to who's in charge here?
♪ ♪
Hi. I'm Dr. Charles. How can I help you?
♪ ♪
She can't really get an injunction
to stop the transplant, can she, Peter?
- Well, she can try.
- On what grounds?
Sean's an adult.
He signed his informed consent.
My guess is, she's gonna try
and convince a judge
that as a recovering addict
and a parolee,
Sean lacked the decisional capacity
to lend his full consent.
Okay, that's ridiculous.
I don't think
she's gonna have any success.
And the onus is on her.
So as it stands now,
I'm completely comfortable
moving forward with the transplant.
Yeah, well, I'm not.
If Leanne is not okay with Sean
giving me this kidney,
then I'm not taking it.
Dean, don't do this.
Just give me some time.
I just need to talk to him.
Dr. Cameron, if the intended recipient
did change his mind at this juncture,
what would our next steps be?
Well, it's unlikely we would
find a match at this hour,
so the only ethical thing to do
would be to place the kidney
back inside the donor.
But I'm only comfortable with
keeping it on ice for so long.
- How long?
- Two, three hours tops.
You got 90 minutes.
If this isn't resolved by then,
the kidney goes back to Sean.
Understood.
[APPREHENSIVE MUSIC]
Palliative said they'll transfer her up
in about an hour or so.
Thanks, Doris.
You're really gonna let this happen?
I'm sorry.
Patient has a valid and enforceable DNI.
Even if it is,
the woman is being irrational.
I'm trying to save her sister's life.
You realize how we got here, right?
Someone... in this case,
probably a completely
out-of-their-depth GP...
starts with a faulty assumption
of, "Hey, this must be
Allison's cancer returning."
And then boom, you get this daisy chain
of error after error with a DNI
that was only consented to
under a false premise.
Honestly, I'm having no problem
at all seeing your logic.
But I'm not the one
that you have to convince.
Yeah, well, I'm afraid
she's tuned me out.
Look, she's carrying
this enormous burden,
honoring the dying wishes of someone
she loves very, very much.
Maybe focus more on that
and less on how right you are.
Zach, have you taken a look
at your patient's labs yet?
White count's in the 30s
with a pretty aggressive shift.
Mostly neutrophils.
I don't know, escalating
pretty quickly for just a flu.
He's been vomiting
kind of relentlessly as well.
[TENSE MUSIC]
♪ ♪
Hold on, Luis. It's gonna be okay.
[MONITORS BEEPING]
When did he break out in this rash?
I don't know.
It must have just happened.
Did you check for insect bites?
Why? He came in with an injured arm.
♪ ♪
Ask him how many days
he's been in the U.S.
Luis... [SPEAKING SPANISH]
[SPEAKING SPANISH]
About a week and a half.
How many people was he traveling with?
[BOTH SPEAKING SPANISH]
Ten others, all being housed
in the police station.
♪ ♪
Have you seen Dr. Marcel?
He just got called into the OR.
What about Ms. Goodwin?
Is she reachable?
You can leave a message
with her assistant if you like.
- What district again?
- The 23rd.
It's about a mile from here.
Tell Dr. Marcel that
I'll be back as soon as I can.
This is just not about
the kidney, Leanne, okay?
This is about Sean and all
the changes that I've seen.
And if he wakes up
and he finds out that his...
- You've already said this.
- You're not listening to me.
- You know what?
- You're not listening to me!
You know what? We're done here, Dean.
- [GROANS]
- So?
Well...
You look resigned.
What am I supposed to do, hmm?
Please don't tell me this is you
just finding another way to not
accept a gift from your son.
Oh, it's not that.
I... I want this kidney.
Good.
You're finally saying it
like you mean it.
Now go tell Dr. Cameron.
But Leanne...
Leanne is being petty and vindictive.
I am sorry to be so blunt,
but this is not about protecting Sean.
This is about hurting you.
Don't feed into it.
She's the mother of my child.
I go through with this
against her wishes,
Sean might never be able
to have a relationship
with his mom ever again.
[SOMBER MUSIC]
Do you remember
that Archer that I first met,
the self-serving, egocentric jerk
that only cared about himself?
Why can't you be more like him today?
♪ ♪
- Dr. Marcel?
- Yeah?
It's been over an hour, and my wife
hasn't gotten an MRI yet.
I assure you, we have not forgotten.
Dr. Ahmad said she'd make it a priority,
but I haven't seen a trace of her.
As soon as an MRI frees up, Mr. Martin,
I promise, she's next in queue.
Excuse me.
Doris, where's Zola?
I'm gonna need rooms
for all of these patients,
preferably isolated from the rest of ED.
What the hell's going on?
I brought in the rest of the migrants
that came in from Venezuela with Luis.
Two of them have similar symptoms.
I'm talking about you. Where were you?
Walking off the floor
without notifying a supervisor.
I know. I'm sorry.
But you were in surgery,
and I found a bug bite on his ankle.
You think it might be
something infectious?
Typhus maybe, or malaria if we're lucky.
Or something contagious, if we're not.
Maggie?
What's going on?
Let's get these good folks
into contact and droplet isolation.
And make sure they're comfortable.
Also, no one goes in and out
without gowns, gloves,
and masks, and have phlebotomy run
IFA assays on everyone stat, okay?
- Yeah, I got it.
- Hey.
There's not gonna be another warning.
Doris, you're with me.
Chewy, Tracy, Ben, let's go.
I really don't wanna have
to adjudicate this all over, Dr. Ripley.
I understand.
I just wanted to apologize
for my belligerence earlier.
I can't even fathom
what you must be going through,
the pain, the burden of such
an immense responsibility.
I'm sorry for not honoring that.
Thank you.
I have been accused of being bullheaded.
For good reason, it turns out.
You have that in common with Allison.
Listen, I realize I'm asking a lot
for you to follow me
on what might seem like
nothing more than a whim.
But if I were able to lighten
Allison's sedation
enough for you to ask
what she wanted directly,
would you be open to that?
No.
No, I know we agreed to use a mediator.
We also agreed to stay together
for the rest of our lives.
Look how long that lasted.
You know, I can't talk
about this right now.
You're gonna have to call me later.
Yeah.
There you go.
- Maggie?
- Yeah?
What's all this about?
The new resident.
She thinks that we have
an outbreak on our hands.
My guess is that she's getting
a little ahead of herself,
but we'll see.
Okay.
What's happening with Dean?
Has he made any headway with his ex?
No, neither of us have.
- You mean you talked to her?
- I tried.
Figured we might be able to connect,
one addict to another.
But I guess that that was
not the right strategy.
I think Leanne is just trying
to do what's best for her son
- and just...
- Maggie. Maggie, Maggie.
You don't know all the facts.
Leanne was no great mother.
I think that her motivations
here are pretty obvious.
If Dean gets the kidney,
it means that Sean loves him
more than her.
I mean, she's still
so resentful and angry
about the divorce,
but getting her to see that,
I don't think it's gonna be possible.
[SIGHS]
[PENSIVE MUSIC]
♪ ♪
Her eyes are still closed.
Her medication has an active metabolite,
so she's not fully awake.
She doesn't have full muscle control.
But she can hear us.
Allison, it's me, Neva.
I know I promised
not to let you be intubated,
but, well, now that we're here,
Dr. Ripley wanted to run one more test.
A bronchoscopy, Allison,
so that we can biopsy
a sample from your lung.
There's a chance what's ailing you
is actually a fungal infection.
I only wanna do it if you do, Allison.
Do you understand?
If you agree to the procedure, Allison,
give me a thumbs up.
[SOFT DRAMATIC MUSIC]
♪ ♪
There.
I see it. She's saying yes.
We'll get started right away.
- She's asymptomatic.
- For now.
A lot of these diseases have
long incubation periods.
Wait, why are you moving my wife?
Sir, please, it's just temporary.
Hey, Mr. Martin.
You okay? What's going on?
Did you two authorize this?
Mr. Martin, my apologies.
It appears we're momentarily...
You think I don't see what's going on,
but you're giving all the rooms to them.
Hold on now.
Same thing happened at my kid's school.
They commandeered her gym for a shelter.
Look, Wade, I assure you
we have enough resources
- to take care of everyone.
- No, we don't.
People keep saying that,
but we just don't, okay?
The whole volleyball season
got canceled,
and my daughter needed that
for her scholarship.
And now my wife,
she's obviously not receiving
your full attention.
How come nobody's looking out for us?
I understand
that this is an inconvenience,
but we do need to free up this room.
- Okay, go ahead.
- No, get away from her!
- Wade, Wade, Wade.
- Mr. Martin, please.
- Stop handling me!
- Wait! Hey!
- No!
- Hey, hey.
- Calm down!
- No!
No! Get away from me!
- Get off of me!
- Calm down, Mr. Martin!
- Let's go.
- Get off of me!
Get off of me!
No! No!
- You all right?
- Yeah, I'm fine.
I'll go get that blood draw started.
The biopsy came back positive?
In this case, that's a good thing.
Aspergillosis is at least
something we can treat.
So she's not going to die?
Well, we're not out of the woods yet.
I've started Allison on some
heavy antifungal medications.
We should know fairly quickly
if she responds.
But I'm very hopeful.
[CRYING]
We all just assumed.
[SOFT MUSIC]
♪ ♪
I can't believe I almost stopped you
from saving her life.
I don't know how to ever thank you.
Hey, man. Well done.
Excellent work, Dr. Ripley.
Nah, just a lucky hunch.
Oh, come on.
Take a little credit.
I was stuck in my head earlier today,
and you helped me get out of it.
Thank you.
Any updates?
I wish I could say
this was an isolated incident.
But from what I'm hearing around town,
it seems like the welcome
wagon's broken down.
Rosado's offering
to take Mr. Martin into custody
if we feel the staff's safety
is threatened.
Dr. Ahmad?
You're asking my opinion?
I am.
Can I just say that
I feel responsible for Wade?
I should have spoken to him directly
before we tried to move his wife.
I'm not asking you to defend
any of your interactions
with Mr. Martin.
Thank you, Ms. Goodwin.
I am interested, however,
in you defending
the thought process that convinced you
that leaving the ED
in the middle of your shift
without notifying your supervisor
was a wise idea.
I know this is a bad look,
this being probationary and all.
But my brain sometimes seizes
on an idea,
and I feel this adrenaline sh**t up.
And I keep telling myself,
"Slow down, Zola.
Slow down," but...
I'm working on it.
I see.
I should go check on another patient.
Wanna hear my opinion of her now?
Won't be complimentary.
Let's double back on that
at the end of the day.
♪ ♪
I hear they're getting ready
to put Sean's kidney back in him.
Shouldn't be too much longer now.
Things were rough between
you and Dr. Archer, huh?
To put it mildly, yeah.
I get it.
My husband Ben and I
are getting a divorce.
His decision, by the way.
- Oh. I'm sorry.
- Yeah.
And as stupid as it may sound,
we're fighting over a cat.
Ben wants it.
And even though I never
really bonded with the thing,
there's no way I'm letting him have it.
No way.
I just feel so angry all the time.
I don't recognize myself.
I guess I wanna hurt him for leaving me.
For rejecting me.
How did you and Dr. Archer meet?
It was a 4th of July beach party.
- Mm.
- Yeah.
How about you and Ben?
Chemo. We both had cancer.
- Oh. Oh, wow.
- We're fine.
It's the marriage that's terminal.
I loved him.
God, I love him.
He could be so sweet
and do these little things,
like making sure I took
my vitamins every morning.
I remember, when I was
pregnant with Sean,
Dean and I took a road trip
out to the desert.
He was stationed at Coronado.
And I don't know how,
but I stepped on a cactus.
- Oh.
- Don't... don't ask.
Anyway, he... he spent
the next five hours
getting the needles
out of the sole of my foot
with tweezers and Elmer's Glue,
all while keeping me
supplied with ice chips.
- [LAUGHS]
- Uh-huh.
You know, Leanne, as angry as I am,
I wasn't exactly blameless.
I did some things.
[SIGHS]
Yeah, I did some things too.
♪ ♪
How long before the surgery?
Excuse me, Dr. Charles?
I was wondering if you might
like to meet my sister.
Oh. That'd be my pleasure.
We're gonna move you upstairs
to an ICU bed,
so settle in.
I can't promise
any fresh vegetables, but...
Orange Jell-O, though, seriously good.
Allison, this is Dr. Charles,
who I was telling you about.
I just wanted to thank you.
I don't know how to repay you both.
Dr. Ripley was telling me
that you had a green thumb.
I'm just... I myself have always
been partial to stone fruits,
is all I'm gonna say.
[LAUGHS] Deal.
You're gonna have to wait
till summer, though.
And you, Neva, if you hadn't
ignored my DNI...
If you hadn't given the thumbs up,
I wouldn't have had the courage.
Thumbs up?
Well, it was more of a twitch,
but it was definitely a yes.
Not that it matters much,
but I don't really remember
much of that.
Well, the midazolam we had you on
is probably why
your memory's a bit fuzzy.
It may very well come back
to you in a day or two.
In any event, we're just glad
you're on the road to recovery.
Speaking of which, let me go
check on that transfer.
[TENSE MUSIC]
I'm gonna let you rest.
But really nice to meet you.
So glad it worked out,
and we are always here, okay?
- Thanks again, Dr. Charles.
- You bet.
♪ ♪
Hey, Ms. Goodwin.
Have you seen the IFA assay
that just came back on Luis Obrador
and the other migrants?
- Murine typhus?
- Mm-hmm.
- From flea bites.
- Yeah, probably contracted
while they were crossing the border.
Infested blankets, maybe.
Yeah, timing makes sense.
It could take up to 12 days
to show symptoms.
Well, it's a good thing
Dr. Ahmad caught it when she did.
She might have saved some lives.
- Dr. Marcel?
- Yeah?
Have you seen this? Sheryl's MRI.
Inflamed lymph nodes in Sheryl's neck.
Frozen biopsy came back as a sarcoma.
Oh, dear.
It looks like it might
already be spreading.
Someone's gonna need to break
the news to her husband.
Yeah.
I'll go tell him.
It should be me.
Unless you prefer it to be anyone else.
Go ahead.
[PENSIVE MUSIC]
♪ ♪
You know, I hesitate to say
who she reminds me of.
You were forced to suspend him
on more than one occasion.
I'll give you a hint.
He had red hair.
You, uh... you really want
a sequel on your hands?
Above and beyond.
I can't say I wasn't warned.
Excuse me?
We're gonna have to teach
this one how to pace herself.
We wouldn't want that fire
to burn out too quickly.
♪ ♪
Hey, Dad.
Hey, son.
How are you two?
- Good.
- Yeah.
Well, well, well.
Should I go get Leanne
and let her know that you're awake
and that the transplant was a success?
Mom's here?
Yeah, she gave us her blessing.
- She did?
- Yeah.
Would you go find her
so we can thank her?
Absolutely.
♪ ♪
[ELEVATOR DINGS] Leanne? Hold up!
They're asking for you.
♪ ♪
Oh. Hey, man.
Really great grab on that diagnosis,
you know, once again.
- Yeah. Thanks.
- I'm still stumped, though,
is how you got Allison's sign-off.
I mean, aren't you supposed
to turn the midazolam down
when you get a patient's consent?
Excuse me?
What'd you do, like, hook her up
to a twitch monitor or something?
What are you accusing me of?
Nothing.
I'm not accusing you of anything.
I'm just saying that as somebody
who, after 40 years,
is still regularly tempted
to mess with the rules
for all the right reasons,
it's just... you know,
it ain't worth it.
Almost lost my license that way.
♪ ♪
This couldn't wait till tomorrow?
Not really.
You were right
about what you said earlier.
[CAT MEOWING]
He belongs with you.
I don't know what to say.
Thank you.
You wanna come in?
No, I really just wanna move on.
Let's try and wrap this up
tomorrow, okay?
♪ ♪