Brilliant Minds (2024) s02e09 Episode Script
The Fire Fighter
1
Previously on "Brilliant Minds"
How is your father doing?
Is he still leaving half-empty
coffee cups in every room?
I haven't noticed.
He left again.
I'm good, Mom.
You don't have to worry
about me anymore.
Are you guys back together?
We haven't had, like,
the official conversation yet,
but, uh, yeah, we are.
30-year-old schizoaffective male,
complaining of daily chest pains.
Sam, what did you hear just now?
Feels like 10 different radio
stations on at the same time.
Got you a stay
in a temporary housing facility.
Here. You'll need money.
Did Sam show back up
for his appointment?
Mnh-mnh.
[FIRE ROARING, ALARM BEEPING]
- Matthew!
- Dad, please!
- Matthew, we need you.
- [COUGHING]
Help us!
[SOFTLY] Matthew? Hey, where are you?
[ECHOING] Where are you?
Where are you?
Dr. Wolf. Always good to see you.
Matthew, how is Bronx Gen's
favorite silver fox doing?
Living the dream, my man.
But I've got a bone to pick.
Well, a few, actually.
Two obstructed evacuation routes,
a broken sprinkler deflector,
and I'm pretty sure I saw
Nurse Carter light up
a pumpkin spice candle.
Who's the fire marshal on this floor?
I assigned Dr. Wolf
because he never leaves.
Gave him the cute
little vest and everything.
Thank you, Nurse Silva.
It's great to see you, Mr. Ramati.
Hey, Chris at the station wants
to know why you ghosted him.
Well, you can tell Chris
at the station
that I'm working double shifts,
and I don't answer to "You up?"
Noted.
Well, you never set me up
with a fireman.
Well, take my safety course,
Fire Marshal,
and you can have
your pick of the litter.
[CHUCKLES]
Well, why don't we get you in
for your monthly checkup first?
- How's that sound?
- Great.
I know what y'all thinking.
It's Thanksgiving week.
Thorne's buying big.
Let me remind you,
lunch specials only.
I don't make enough to be buying y'all
full size Shaking Beef entrees.
Oh.
Luckily for you, Sam,
I can edit my order.
What's it gonna be? Bahn Mi sando?
Or something something new?
Sam, you okay, bro?
- Oh, I got a live one here.
- [COUGHING]
I need access, blood pressure,
an airway ready
- Yes, Doctor.
- and blood.
[PEOPLE SPEAKING INDISTINCTLY]
MTP in trauma now.
Hey, Sam, talk to me.
[PEOPLE SPEAKING INDISTINCTLY]
What in the hell happened to you?
♪
- Mama?
- [KNOCK ON DOOR]
No. Quick, you have to hide.
Why Why am I hiding
from my own son?
I don't want to confuse him.
We don't know what this is.
Oh, I think I know what this is.
Mama, are you awake?
I couldn't reach the tail.
- [LAUGHS] Shh!
- What?
- Alright.
- One sec!
Go.
Can we just talk about this?
No.
Hi, honey. Morning.
Oh, my!
I'm so impressed.
You got that on all by yourself?
Not the tail. I couldn't reach.
Oh, here, I'll help you. Here.
Stick your arm through here.
This looks great.
Okay, Turkey.
Let's get you some breakfast.
- [EXHALING STEADILY]
- Come on, Matthew. Push.
Push. All the way out.
Three, two, one.
Very good. Okay. Take a minute.
Catch your breath.
I like your new look.
They call it athleisure.
How we looking, Dr. D?
There appears
to be a significant decline
since your last visit.
Your lung capacity is at 55%.
This tells us
that your respiratory muscles
are getting weaker,
and we need to talk about
the next steps.
- Fine. I'll quit smoking cigars.
- [CHUCKLES]
Test me again. I'll do better.
Hey. Sorry to interrupt.
Wolf, you have a visitor.
Matthew. So this is
where you hide out.
You stood me up
for our last appointment.
- It must've slipped my mind.
- Hmm, must have.
Well, consider this your reminder.
I will see you later.
It's a date.
Okay. Uh, you two
can carry on without me.
I'll be back.
Alright. Let her rip.
[CHUCKLES] You got it.
Trigger warning
Your mom is on the premises
planning the holiday gala.
Apparently, she's still chairing it.
I thought she was in Turks and Caicos.
She was. And now she's here
telling Silva and all the nurses
about a masseuse named Baptiste
who made her feel like she was 25.
Okay. Tell her Josh fired me
and I moved to a yurt
- in the desert.
- Mnh-mnh, not getting involved.
I got my own mama to deal with.
The entire Pierce posse
is coming to stay with me,
because they don't want me and Maya
to be alone on Thanksgiving.
At this point, I'd take
Morris back if it meant
- they'd stay at a hotel.
- Carol. For shame.
Wolf, my mom keeps sending me
links to better mattresses
Sounds like she needs
a Baptiste in her life.
Hi, Mom.
Hello, Mugwump.
Mm!
You look tired. Is he sleeping?
Unh-unh, not getting involved.
It's nice seeing you, Muriel.
Okay, these are filthy.
You're always so good about
keeping your glasses clean.
- Mom, just, please.
- Okay, okay.
Why don't you take a break
and spend Thanksgiving with your mom?
Oh, I can't. Uh, work,
patients, saving lives.
- Busy, busy.
- I'll make my sweet potato
casserole with the mini marshmallows.
Come on. It's no fun
cooking for one, and I miss you.
Okay, well, I'll see what I can do.
Okay.
Hey. You paged me?
Yeah, so, Sam came in with
sky-high LFTs and hematemesis.
- Liver failure?
- Yeah.
How? He doesn't have any
history of liver disease.
Exactly.
Not a drinker, doesn't shoot up,
never overdosed.
Is he still bleeding?
Not since the endoscopy,
but he is in renal failure.
If this doesn't reverse itself,
he's gonna need a liver transplant.
Can I see him?
Yeah.
I know you care about him.
If he needs a transplant,
he's going to need
all the help he can get.
♪
Well, we got the same number
three times.
The test results aren't changing.
This is where we are.
Matthew, we need to talk about
what that means.
I'm not sleeping with
some machine to help me breathe.
That is not me. I am not that guy.
Well, we don't have to
make a decision right now,
but the breathing test is telling us
that things are moving faster
than we'd hoped,
and we need to make a plan
before we get into trouble.
Dr. Wolf, when I told you
I couldn't use my hands,
you said I couldn't live alone.
Fine. The guys at the station,
they got me.
Dennis is downstairs
in the cafeteria right now.
He loves the egg salad here.
But that's it.
I'm not having them deal with
strapping me in and out
of a machine at night.
I gotta draw the line.
Matthew, what about your family?
- Have you told them yet?
- What's it matter?
It matters because ALS isn't
something you survive alone.
And sometimes lying to your loved ones
can hurt them more than the truth.
You talking about my family or yours?
Nobody survives this.
We both know that.
And I know
how to take care of my family.
So I guess you heard about
the breathing test?
That was a total bust.
You're up against some hard decisions.
I also heard
that your family still doesn't
know about your diagnosis.
My daughter has
one semester left at Amherst.
I am not about to do anything
that's going to distract her.
So you're not going to see
them over the holidays?
They take one look at this,
my ex will take me back out of pity.
My daughter will fail her finals,
lose her focus.
So, yes, that means I don't see them.
Didn't you say
Thanksgiving was your holiday,
the one you all do together,
even after the divorce?
Not this year.
I know. Who's to say
there's a next year?
But if there isn't, then
this is the gift I give them.
One more happy moment.
Not that voice banking app
you keep recommending to me.
I understand how considering a future
where you can't talk
might feel intolerable. I do.
But, Matthew, this is
the umbrella, not the rain.
We're giving you more power
over this disease, not less.
And I think telling your family
might serve a similar purpose.
You know what?
There is something
I need to tell them.
Okay, Siri. [CELLPHONE BEEPS]
Text Alicia.
Okay. What do you want to say
to Alicia?
I won't be home
for Thanksgiving this year.
I got to work.
Sam is in fulminant hepatic failure,
and we don't know what happened.
- Ericka, this is
- Bad. Yeah, I know.
I'm going to call the liver
transplant team to evaluate.
No, hold on. Not yet.
What is his neuro exam?
He's slow, but he's awake and alert.
Have you ever treated
acute liver failure before?
These are some of the sickest
patients you'll ever see.
Your job is to ensure
this doesn't become
a neurological emergency.
I want you to think
of Sam's mental status
as a key prognostic sign.
Once that declines,
his time is even shorter.
But if he's awake,
we can afford to wait a beat
before calling transplant.
With this team, we have one shot.
If they say no,
they will never reassess.
So what do we do?
I have an idea.
He's just not a good candidate.
Look, I know Sam's young,
and you all care about him
and have developed
a relationship with him
during his many visits to our E.R.
But that committee
will see an unhoused man
with unstable psych disease
and zero family support,
someone who won't take the meds
that will keep him
from rejecting his new liver.
I know what the chart says,
but that's not the whole story.
I had just started seeing Sam.
He had good premorbid function,
was a college student
when he had his first break,
and he wanted to get better.
I was hopeful.
You'll get the chance
to talk to the transplant team.
But I don't think that'll be enough.
Sam still has no family here,
which means there would be no one here
to help him take his meds
or get him to appointments.
Whether right or wrong, you
simply cannot get a transplant
if you're entirely alone.
So for Sam, being alone means death.
I'm supposed to accept that?
Transplant decisions can be
capricious and outright biased.
We've all seen candidates rejected
because of something
that feels unjust.
But these concerns are valid.
Patients like Sam
get overlooked all the time.
But he wanted to get help.
Dr. Pierce said it.
He told us that in his own way
each time he came into our E.R.
- I'm not giving up.
- Neither am I.
Okay. We need to talk to Sam.
Figure out if a transplant is
even something he would want.
And we need to do it now before
he loses his mental status.
Wolf, Carol, you know this.
Even if this is what he wants,
he's just not a good candidate
on paper.
Then we make him one.
I can't believe
Sam is in liver failure.
It'll be a hard sell
to the transplant committee,
- but I'll do what I can.
- Thank you.
Hey, how is Matthew?
I'm worried about him.
His disease is progressing
faster than I had hoped,
but he's still in denial.
Some aspect of denial is necessary.
Adaptive, even.
Not when it's unsustainable.
Matthew's stubborn,
and I don't want him
wasting what time he has left
avoiding the people
who are closest to him.
I'm going to go down to the
station and check on him there,
see if I can make any progress.
That's a good idea.
But I also know you want to see
some firemen in action.
Carol, do not objectify
New York's bravest.
But the 2026 calendar did come out.
Remind me to show you Mr. October.
[CHUCKLES]
[MONITOR BEEPING]
Sam?
Hi.
Can you hold your hands out like this?
What's going on?
That's called asterixis.
It's a sign of liver failure.
Sam, I'm not going to sugarcoat this.
We need to get you a new liver.
But in order to do that, I
need to know some things first.
What happened since
the last time we saw you here?
[SIGHS] You're mad
about your credit card.
- I'm sorry.
- Hey, I'm not mad.
You got yourself some stuff
you needed.
That's why I gave it to you.
No. I didn't use
your card for anything.
The meds helped.
But the voices, uh
I yelled at them.
Then these kids started beating me,
- hitting me, kicking me.
- Why didn't you come here?
We could have helped you.
They took your card.
I told you I'd bring it back.
I didn't wanna
Uh, had my meds, though.
Took 'em every day.
Meds for pain, too.
What were you taking for pain?
Red? I took 'em all.
Acetaminophen.
That's what caused the liver failure.
Is there any way you could
get in touch with your family?
It would really help
if they could be here.
Already dead to them.
I don't want to die.
Okay, junior firefighters.
There are four very important things
you need to know
when caught in a fire.
Number one,
stay low to avoid the smoke.
Number two, to raise the alarm,
pull the fire alarm or yell for help.
Number three, exit the building
as quickly as possible.
And number four,
never, ever hide
in a burning building.
So just remember FRED
Floor, Raise the alarm,
Exit, Don't hide.
Which reminds me,
there is a very special member
of our team
I think you'd really like to meet,
so I'm going to bring him out now.
- Are you ready?
- Yeah!
Okay, Fred, where you at,
boy? Come on out.
[KIDS CHATTERING EXCITEDLY]
Come on and meet Fred, y'all. Come on.
[KIDS LAUGHING, CHATTERING]
Where is he?
Where is he?
Matthew, we need to talk right now.
[KIDS OOH'ING]
Where do you get off
not coming for Thanksgiving?
Our little girl's coming home,
and you're blowing us off?
Alicia, can you not do this here?
Hi, uh, I'm so sorry to interrupt.
- And who are you?
- I am Dr. Oliver Wolf.
Perhaps we should all talk.
How could this happen?
I cooked healthy meals
for the family every night.
I always had a cruciferous
vegetable at the table.
And this is what we get?
I can assure you
that this is not about
what you did or did not do.
Alicia, I'm the one
who's dying, not you.
No, Matthew, don't say that.
No one is dying.
How could you have kept this from us?
Let's all just try to understand
the position Matthew is in.
There's no right or wrong way
to process this diagnosis.
So what do we do? How do we fix this?
Um, unfortunately, we can't fix this.
ALS is a progressive disease.
I did some googling on the train.
I want a list of all
the medicines that he's taking,
upcoming appointments.
I read that there are only
a few FDA approved treatments,
so I want him to get pushed into
a trial as soon as possible.
We are exploring every trial.
And yes,
this is a devastating diagnosis.
But I want you all to know
that research is accelerating.
There are thousands of people
all over the world
studying this disease,
and there is real hope for
effective treatment on the horizon.
In the meantime, our goal
is to help Matthew live
the best life possible.
Right. So Matthew is gonna
live with me.
I'm taking care of him. No questions.
Are you guys done speaking about me
like I'm not even in the room?
And there's plenty
of resentment there.
I'm not moving in with you.
- I don't resent you.
- Dad, nobody resents you.
And I'm gonna come back home, too.
I only have one
semester left of school,
so I can go back and finish whatever.
- What does that mean, whenever?
- Dad, don't be ridiculous.
I can't just stay in school.
The hell you can't.
You can't do this on your own.
Be for real, Daddy.
You live in a walk-up.
I live in a fire station,
Gabby. I can manage.
Remember, we fight the disease,
not the tools we have to help us.
No. I'm not letting
anybody uproot their lives
for me. I can fight this on my own.
End of story.
Thank you.
Eastgate Medical didn't have
any family contact for Sam,
and he is too confused now
to be able to tell us anything,
even if he wanted to.
Neither did St. Elizabeth's,
Queensbridge,
or anywhere else
Sam's been hospitalized.
I'm striking out here, too.
It's wild how hard it is
to get a transplant.
I don't think I'd even qualify.
- Two people? Really?
- I'd vouch for you.
I wouldn't let you. You'd have Liam.
How about you, Ericka?
You think you'd make the list?
Um, I don't know.
My parents wouldn't move.
Would you even want one?
Immune suppression and infections
the rest of your life?
Fearing rejection?
If the alternative is death,
yeah, I would take it.
The thing is, we would be listed.
Even if we drink
or don't have social support,
we'd be listed because we're the
people they make exceptions for.
And that sucks.
Privilege.
Hey. I think I found the number.
Green beans, uh, sweet potatoes.
- Oh, two pie crusts.
- Look at this big boy.
[LAUGHS] As if we needed
that much turkey.
- Uh-huh.
- [LAUGHS]
Oh, you kids, you're
getting coal for Christmas.
Hey!
- [CHUCKLES]
- [CELLPHONE VIBRATING]
- Hello.
- Hi. I'm calling
to reach Claire Mapesbury.
Yes, this is Claire.
- This is Dr. Ericka Kinney
- Who is it?
from Bronx General Hospital.
I'm one of the doctors
who's been taking care
of your son, Sam Mapesbury.
- What's going on?
- He's in our ICU
and very sick with liver failure.
I wanted to call you to update
you and answer any questions
It's Sam.
You know, I don't know
what's more shocking,
that Matthew has ALS
or that he's seeing a psychiatrist.
Reluctantly seeing a psychiatrist.
Well, that tracks.
If your sessions are anything
like our marriage,
you ask him how he's doing,
he mumbles fine, cracks open a beer
and plops down on the couch
to watch a Jets game.
Oh, honey, if he's a Jets fan,
he's never fine.
[LAUGHS]
He does talk.
Sometimes I can't get a word in.
Oh.
I see that strikes a chord.
Can you tell me why?
My sister set us up on a blind date.
I was so pissed at her at first.
She knew I liked
the strong, silent type.
And Matthew would not shut up.
We closed the restaurant down,
and when he kissed me
good night, he whispered
"We will never run out
of things to say to each other."
Sometimes marriage is all about
how you navigate the silences.
How do you navigate an abyss?
It wasn't all his fault. We went
through a lot early on.
9/11. We had friends
whose husbands
didn't come home that day.
So how could I complain?
My husband did.
But he didn't really.
I would look at him and say,
"Matthew, where are you?"
He never let me back in.
It's why we split.
So to hear that he talks to you
What he practices in this office
is what he'll bring
to his relationships
outside of this room, including
his relationship with you.
That's all I ever wanted,
was for him to tell me
that he wasn't fine.
[RADIO CHATTER, SIREN WAILING]
[COFFEE WARMER CLICKING, HISSING]
Yo, guys, what are you trying
to do, burn this place down?
[INDISTINCT RADIO CHATTER CONTINUES]
Guys.
Thanks for the patch up.
So, how did you fall?
I was being careless.
Matthew, I'm glad
that you have support
at the fire station, but I am worried
it's not a safe,
long term solution for you.
What's long term here?
I'm not sure I can keep fighting it.
[CHUCKLES]
I'm tempted to
tell you how resilient you are,
to talk about adaptation,
to tell you it's
incredible what people can learn
to accept as their new normal.
But none of that's
gonna help right now, is it?
I feel like
every time
I learn to adapt to a new loss,
I lose something else.
From where I'm sitting,
all of the core elements
that make you Matthew
are still intact.
Then let me keep this one.
I don't care about me,
but my girl Gabby and even Alicia,
I need to protect them.
Sam, there's some people here
to see you.
Sam.
Did I ruin your Easter?
It's Thanksgiving.
No way, kid. This is the only
place we want to be right now,
with you.
Hey, Doc.
Sorry to just surprise you like this.
Oh, uh, you're the chief?
- Mr. October, right?
- [CHUCKLES]
You can call me Dennis.
What can I do for you, Dennis?
Uh, look, we all knew
Matty living at the station
was temporary,
but we thought it was safe.
I, uh
I shouldn't have left him alone.
Don't blame yourself. You got
him out of his apartment.
You helped him maintain something
that felt normal
for a little while longer.
That's not nothing.
Yeah.
Matty's the best we got.
You know, he trained me.
My first week in,
I thought there's no way
I could do this,
but Matty made me realize I could.
He'd always say, "Alone,
we can do so little.
But together, we can do so much."
It's a quote from, uh,
Helen Mirren, I think.
Yeah, it's Helen Keller,
but easily confused.
I just wish we could
do more for Matty.
Actually, I might know a way you can.
Cow's milk is back, right?
Thanks. I've been reading about
stem cell clinical trials.
Is that something
that my dad could do?
Uh, it's a possibility.
But ultimately,
that's for him to decide.
You and your dad seem close.
I mean, he talks about you
all the time.
I've always been into modern art.
It's really not his thing.
But he used to keep a calendar
on the fridge of openings
happening in the city.
And every weekend he'd take me
to a new one.
And when I got a phone,
he started texting me
these random photos
and captioned them, "Art or not?"
He's one of a kind.
I can't imagine, uh
What your dad needs is
for you to keep going.
One good thing about modern art,
you don't need
fine motor skills to enjoy it.
Keep going. Together.
Talk to me, Sam! Open your eyes, Sam.
Sam. Excuse me.
- Sam? Sam?
- What happened?
He's unresponsive.
He was talking 30 minutes ago.
He wouldn't wake up.
We called you right away.
I need a rapid response
to room 12 in the ICU!
I'm sorry. We're gonna need the room.
- W-What's happening to him?
- We're taking care of him.
- Okay?
- Sam?
- Okay. Okay.
- Sam?
Pupils equal and reactive,
but he's obtunded,
and he's desatting. He
can't protect his airway.
Severe hepatic encephalopathy,
likely cerebral edema.
Ericka, prep an airway, now.
I'm ready for etomidate and sux.
You told me
that my job was to keep this
from becoming
a neurological emergency.
Is there anything
I could have done differently?
You were monitoring him,
and you gave him
the only antidote
for acetaminophen overdose.
But as his liver failed
and ammonia accumulated,
brain swelling became inevitable.
Which can lead
to brain herniation and death.
What's the immediate treatment?
Hyperventilating him
and dosing him with mannitol
and hypertonic saline
will lower the ICP
as a temporary measure.
But only a new liver will stop
the swelling permanently.
And we don't have long
to get it for him.
Correct.
So he's on the list
for this new liver?
Not yet. Unfortunately,
it's been difficult
because of Sam's housing situation.
The committee is reticent to list Sam
if he doesn't have a support system,
people committed to caring
for him after the transplant.
Well, he has that. He has us.
[SIGHS] We used to be so close,
but when he got sick, we became
the last people that he wanted.
Those thoughts in his head,
all that paranoia, the voices,
it turned him against us.
He didn't want to stay with us.
He said it felt like prison.
I-I went to the city once
to bring him home,
but he wouldn't come. He thought
we were trying to hurt him.
He told me never to call him again.
I had his siblings back home.
I had to be there for them, too.
Doctor, I feel guilty and scared
for Sam every single day.
Can I just bring him home?
I'm afraid a transfer
to another hospital now,
particularly one farther away is
It's too risky.
I know that you have
a life back in Ohio,
but if there is any way that you
could be here for Sam
We can rent a place here,
whatever Sam needs.
He's our son.
We let him go once.
We're not doing it again.
You watch all your patients
while they sleep
or just your favorites?
Oh, just my favorites.
How are you sleeping?
Terribly.
Keep having this dream.
Wakes me up most nights.
I'm, uh,
in my old house with my family.
There's a fire, and I can
I can hear them calling for me.
I
I try to save them, but I can't.
That sounds terrifying.
I wonder whether your weakness
and trouble breathing at night
may be causing this vivid dream.
Your oxygen level drops,
carbon dioxide climbs.
Your REM sleep is in disarray.
The good news is, there's a solution.
That BiPAP machine I mentioned
will help you breathe deeper
while you sleep.
[SIGHS]
I'll take your machine.
Fight the disease, not the tools.
Yeah.
You gonna discharge me now?
No. Tell me more
about this dream first.
Walk me through it.
Careful what you wish for.
- Matthew!
- Dad! Please!
Matthew, we need you.
Matthew, where are they?
- Matthew!
- Daddy.
- I don't know.
- Please!
- I don't know. I can't move.
- Help us!
- I can't save them.
- Daddy, please!
Come on out! Please, come out.
Daddy!
What if you're not supposed to?
What if they're supposed to save you?
Oh, Oliver.
I stand with moss and
branches under my bare feet ♪
Look back at all the chances
I missed narrowly ♪
But I'll move along, can't
keep on looking backwards ♪
There's a light, there's a light ♪
- [CRYING]
- Up ahead ♪
The transplant committee said no.
What happened?
I told them that Sam had just
started a medication regimen
that I hoped would work for him,
the meds he's been taking
since discharge,
and that he had a supportive family.
I also told them
that the acetaminophen
was an unintentional overdose
and that Sam truly
wanted to get better to live.
But he was on the margin, Ericka,
and they had to take a leap.
Sometimes they take it,
sometimes they don't.
I thought when we got his family,
they would see that he is
someone, someone worth saving.
Just because they declined him
doesn't mean all programs will.
I've already called
my friend at Columbia.
We'll call Cornell, as well.
We just need to find a program
that isn't so risk averse.
But even if they say yes,
what are the chances
they decide in time?
- Okay, how long does Sam have?
- He needs a new liver fast,
or he won't make it.
For now, we manage Sam's ICP
as best we can, and we hold out hope.
Mm-hmm.
Uh, hey, Silva.
Um, where are you going with that pie?
Uh, bringing it to our staff potluck.
I know this is weird,
but I could actually use it
for a patient, if that's okay.
Okay. Yeah.
Anything for your patients.
Thank you.
Um, I finally convinced Matthew
to attend his family's Thanksgiving.
He asked me to go with him.
So I can't show up empty handed.
- Is it too late to bail?
- [INDISTINCT CONVERSATIONS]
Uh, yeah, it sure is.
Besides, I went to a lot
of trouble to get that pie.
- I want to eat it.
- Or we could just
run down the street to the pub
and grab a whiskey.
- [CHUCKLES]
- Okay.
Dr. Wolf, please have a seat.
[INDISTINCT CONVERSATIONS]
[GLASS CLINKING]
I just want to say
how much it means to me
to have all of you
around the table. This year,
what I'm most grateful for
is second chances.
Dr. Wolf, would you like to go next?
Uh, I guess I'm coming to appreciate
unexpected reunions.
Mm.
Matthew.
Yeah. Um
I'm grateful for my family
and that, uh,
I haven't been a burden on them.
Matthew, please.
I can't live in my apartment anymore,
and I can't live at the station.
It's too much.
So
I made arrangements with a facility.
A home. A place I can move to.
I'll be safe, you know, for as
long as I can tolerate it.
But my ship is sinking,
and I'm not taking any of you with me.
- Dad, we want to help.
- That's not your job, honey.
- It's too much.
- It's not, though.
It's not, because we
wouldn't be doing it alone.
What do you mean?
We all agree that living
at the station isn't a solution.
But the guys, they want
to help out as much as they can.
Matthew, I want you
to move back into the house.
I won't be doing it alone,
and neither will you.
And don't even try to argue.
Dennis has planned
a month's worth of frozen meals.
He's gone full Martha Stewart. Okay?
I'll bet he has.
You have a lot of good people
around you
who want to help out
as much as they can.
[TRUCK HORN BEEPS]
Take a look.
Yeah, Matthew!
[INDISTINCT CONVERSATIONS]
[CHEERS AND APPLAUSE]
Yeah, appreciate you, Matt!
Wait. Who are all these people, Dad?
- People from work.
- And lives he's saved.
- Here for you.
- Hey, we appreciate you!
Sometimes letting people help
is the greatest gift
you can give them.
Thank you, Matthew!
We got your back, bud!
Thank you for bringing all this stuff.
Yeah, thanks, Auntie.
Everything looks great.
I'm sorry I had to work
on Thanksgiving.
It's no worries. We got you. Always.
- Thank you.
- Okay.
Hey, hey, hey.
Okay, word on the floor,
your sweet potato pie is to die for.
It sure is. This an old family recipe.
- Uh
- Uh, Anthony, this is my sister,
Helen.
Anthony runs our emergency room.
Lovely to meet you.
Any plans for the holidays,
or is it all gunshot wounds
and severed limbs?
[CHUCKLES] No,
mostly cuts and burns, actually.
But I'm headed out.
Kids are with my ex,
so it's going to be a quiet one.
But you know what I am
thankful for this year?
An entire Thanksgiving in the E.D.,
and not one patient spoiled
the Cowboys game.
The Cowboys? Oh, no. And I was
just starting to like you.
What? Ladies, look, I'm not that bad.
Tell her. I'm not that bad!
Oh, my God. Who made this?
Mm. I told my staff,
best dish gets Christmas off.
You realize this is our
first Thanksgiving as a family?
I wish I could have made it special.
This is special. We're together.
♪
Matthew?
Hey.
Got you a little something,
if you want to take a break
from athleisure.
Hey. Where are you?
I'm right here.
You were waiting outside
for me in the sun ♪
The act of rescue
is often linked to things
like heroism and bravery.
But for guys like me,
I've always looked at it
as an act of caring.
I don't get it.
Dad, it's art.
If you say so.
Oh, the glory of it all ♪
I guess I never saw myself as the one
who needed to be cared for.
Until I saw how hard it'd be
to reach you ♪
And I would always be light years ♪
Light years away from you ♪
Light years, light years ♪
But I know now
that even on my hardest of days,
you and your mom will be there
to save me from any fires
that may come our way.
- Mom?
- [GASPS] Oh, Oliver.
It's too soon.
I wanted to surprise you.
I brought Thanksgiving to you.
Ta-da!
Everyone was lighting up
the shadows alone ♪
You could have been
right there next to me ♪
I saw your ferns, Oliver.
I-I've been so busy at work.
I know, so, you know, I just
I took some of them
upstairs to the bathroom.
I ran the shower for a while.
The steam should perk them right up.
- They're dead.
- They'll be better tomorrow.
You'll see.
And now we are going to get
this big boy out.
Whew!
You know, it was always
his job to carve the turkey.
And our friends would applaud
because he made it look so easy.
Ugh, used to drive me crazy.
I do everything else,
- and all the
- Mom.
Light years, light years
away from you ♪
Sometimes the most
heroic thing you can do
isn't running into
the burning building.
It's quieter, smaller,
but in a way, even harder,
at least for me.
Letting you and your mother in,
accepting help.
Agreeing to this voice
banking business
Dr. Pierce has been talking about.
Allowing myself to be rescued
even when I don't want to.
For me, this is the
bravest thing I've ever done.
And it's scary as hell.
But it is worth it
if it means more time with you.
♪
Greg, move your head.
sync & corrections awaqeded
♪
♪
♪
Previously on "Brilliant Minds"
How is your father doing?
Is he still leaving half-empty
coffee cups in every room?
I haven't noticed.
He left again.
I'm good, Mom.
You don't have to worry
about me anymore.
Are you guys back together?
We haven't had, like,
the official conversation yet,
but, uh, yeah, we are.
30-year-old schizoaffective male,
complaining of daily chest pains.
Sam, what did you hear just now?
Feels like 10 different radio
stations on at the same time.
Got you a stay
in a temporary housing facility.
Here. You'll need money.
Did Sam show back up
for his appointment?
Mnh-mnh.
[FIRE ROARING, ALARM BEEPING]
- Matthew!
- Dad, please!
- Matthew, we need you.
- [COUGHING]
Help us!
[SOFTLY] Matthew? Hey, where are you?
[ECHOING] Where are you?
Where are you?
Dr. Wolf. Always good to see you.
Matthew, how is Bronx Gen's
favorite silver fox doing?
Living the dream, my man.
But I've got a bone to pick.
Well, a few, actually.
Two obstructed evacuation routes,
a broken sprinkler deflector,
and I'm pretty sure I saw
Nurse Carter light up
a pumpkin spice candle.
Who's the fire marshal on this floor?
I assigned Dr. Wolf
because he never leaves.
Gave him the cute
little vest and everything.
Thank you, Nurse Silva.
It's great to see you, Mr. Ramati.
Hey, Chris at the station wants
to know why you ghosted him.
Well, you can tell Chris
at the station
that I'm working double shifts,
and I don't answer to "You up?"
Noted.
Well, you never set me up
with a fireman.
Well, take my safety course,
Fire Marshal,
and you can have
your pick of the litter.
[CHUCKLES]
Well, why don't we get you in
for your monthly checkup first?
- How's that sound?
- Great.
I know what y'all thinking.
It's Thanksgiving week.
Thorne's buying big.
Let me remind you,
lunch specials only.
I don't make enough to be buying y'all
full size Shaking Beef entrees.
Oh.
Luckily for you, Sam,
I can edit my order.
What's it gonna be? Bahn Mi sando?
Or something something new?
Sam, you okay, bro?
- Oh, I got a live one here.
- [COUGHING]
I need access, blood pressure,
an airway ready
- Yes, Doctor.
- and blood.
[PEOPLE SPEAKING INDISTINCTLY]
MTP in trauma now.
Hey, Sam, talk to me.
[PEOPLE SPEAKING INDISTINCTLY]
What in the hell happened to you?
♪
- Mama?
- [KNOCK ON DOOR]
No. Quick, you have to hide.
Why Why am I hiding
from my own son?
I don't want to confuse him.
We don't know what this is.
Oh, I think I know what this is.
Mama, are you awake?
I couldn't reach the tail.
- [LAUGHS] Shh!
- What?
- Alright.
- One sec!
Go.
Can we just talk about this?
No.
Hi, honey. Morning.
Oh, my!
I'm so impressed.
You got that on all by yourself?
Not the tail. I couldn't reach.
Oh, here, I'll help you. Here.
Stick your arm through here.
This looks great.
Okay, Turkey.
Let's get you some breakfast.
- [EXHALING STEADILY]
- Come on, Matthew. Push.
Push. All the way out.
Three, two, one.
Very good. Okay. Take a minute.
Catch your breath.
I like your new look.
They call it athleisure.
How we looking, Dr. D?
There appears
to be a significant decline
since your last visit.
Your lung capacity is at 55%.
This tells us
that your respiratory muscles
are getting weaker,
and we need to talk about
the next steps.
- Fine. I'll quit smoking cigars.
- [CHUCKLES]
Test me again. I'll do better.
Hey. Sorry to interrupt.
Wolf, you have a visitor.
Matthew. So this is
where you hide out.
You stood me up
for our last appointment.
- It must've slipped my mind.
- Hmm, must have.
Well, consider this your reminder.
I will see you later.
It's a date.
Okay. Uh, you two
can carry on without me.
I'll be back.
Alright. Let her rip.
[CHUCKLES] You got it.
Trigger warning
Your mom is on the premises
planning the holiday gala.
Apparently, she's still chairing it.
I thought she was in Turks and Caicos.
She was. And now she's here
telling Silva and all the nurses
about a masseuse named Baptiste
who made her feel like she was 25.
Okay. Tell her Josh fired me
and I moved to a yurt
- in the desert.
- Mnh-mnh, not getting involved.
I got my own mama to deal with.
The entire Pierce posse
is coming to stay with me,
because they don't want me and Maya
to be alone on Thanksgiving.
At this point, I'd take
Morris back if it meant
- they'd stay at a hotel.
- Carol. For shame.
Wolf, my mom keeps sending me
links to better mattresses
Sounds like she needs
a Baptiste in her life.
Hi, Mom.
Hello, Mugwump.
Mm!
You look tired. Is he sleeping?
Unh-unh, not getting involved.
It's nice seeing you, Muriel.
Okay, these are filthy.
You're always so good about
keeping your glasses clean.
- Mom, just, please.
- Okay, okay.
Why don't you take a break
and spend Thanksgiving with your mom?
Oh, I can't. Uh, work,
patients, saving lives.
- Busy, busy.
- I'll make my sweet potato
casserole with the mini marshmallows.
Come on. It's no fun
cooking for one, and I miss you.
Okay, well, I'll see what I can do.
Okay.
Hey. You paged me?
Yeah, so, Sam came in with
sky-high LFTs and hematemesis.
- Liver failure?
- Yeah.
How? He doesn't have any
history of liver disease.
Exactly.
Not a drinker, doesn't shoot up,
never overdosed.
Is he still bleeding?
Not since the endoscopy,
but he is in renal failure.
If this doesn't reverse itself,
he's gonna need a liver transplant.
Can I see him?
Yeah.
I know you care about him.
If he needs a transplant,
he's going to need
all the help he can get.
♪
Well, we got the same number
three times.
The test results aren't changing.
This is where we are.
Matthew, we need to talk about
what that means.
I'm not sleeping with
some machine to help me breathe.
That is not me. I am not that guy.
Well, we don't have to
make a decision right now,
but the breathing test is telling us
that things are moving faster
than we'd hoped,
and we need to make a plan
before we get into trouble.
Dr. Wolf, when I told you
I couldn't use my hands,
you said I couldn't live alone.
Fine. The guys at the station,
they got me.
Dennis is downstairs
in the cafeteria right now.
He loves the egg salad here.
But that's it.
I'm not having them deal with
strapping me in and out
of a machine at night.
I gotta draw the line.
Matthew, what about your family?
- Have you told them yet?
- What's it matter?
It matters because ALS isn't
something you survive alone.
And sometimes lying to your loved ones
can hurt them more than the truth.
You talking about my family or yours?
Nobody survives this.
We both know that.
And I know
how to take care of my family.
So I guess you heard about
the breathing test?
That was a total bust.
You're up against some hard decisions.
I also heard
that your family still doesn't
know about your diagnosis.
My daughter has
one semester left at Amherst.
I am not about to do anything
that's going to distract her.
So you're not going to see
them over the holidays?
They take one look at this,
my ex will take me back out of pity.
My daughter will fail her finals,
lose her focus.
So, yes, that means I don't see them.
Didn't you say
Thanksgiving was your holiday,
the one you all do together,
even after the divorce?
Not this year.
I know. Who's to say
there's a next year?
But if there isn't, then
this is the gift I give them.
One more happy moment.
Not that voice banking app
you keep recommending to me.
I understand how considering a future
where you can't talk
might feel intolerable. I do.
But, Matthew, this is
the umbrella, not the rain.
We're giving you more power
over this disease, not less.
And I think telling your family
might serve a similar purpose.
You know what?
There is something
I need to tell them.
Okay, Siri. [CELLPHONE BEEPS]
Text Alicia.
Okay. What do you want to say
to Alicia?
I won't be home
for Thanksgiving this year.
I got to work.
Sam is in fulminant hepatic failure,
and we don't know what happened.
- Ericka, this is
- Bad. Yeah, I know.
I'm going to call the liver
transplant team to evaluate.
No, hold on. Not yet.
What is his neuro exam?
He's slow, but he's awake and alert.
Have you ever treated
acute liver failure before?
These are some of the sickest
patients you'll ever see.
Your job is to ensure
this doesn't become
a neurological emergency.
I want you to think
of Sam's mental status
as a key prognostic sign.
Once that declines,
his time is even shorter.
But if he's awake,
we can afford to wait a beat
before calling transplant.
With this team, we have one shot.
If they say no,
they will never reassess.
So what do we do?
I have an idea.
He's just not a good candidate.
Look, I know Sam's young,
and you all care about him
and have developed
a relationship with him
during his many visits to our E.R.
But that committee
will see an unhoused man
with unstable psych disease
and zero family support,
someone who won't take the meds
that will keep him
from rejecting his new liver.
I know what the chart says,
but that's not the whole story.
I had just started seeing Sam.
He had good premorbid function,
was a college student
when he had his first break,
and he wanted to get better.
I was hopeful.
You'll get the chance
to talk to the transplant team.
But I don't think that'll be enough.
Sam still has no family here,
which means there would be no one here
to help him take his meds
or get him to appointments.
Whether right or wrong, you
simply cannot get a transplant
if you're entirely alone.
So for Sam, being alone means death.
I'm supposed to accept that?
Transplant decisions can be
capricious and outright biased.
We've all seen candidates rejected
because of something
that feels unjust.
But these concerns are valid.
Patients like Sam
get overlooked all the time.
But he wanted to get help.
Dr. Pierce said it.
He told us that in his own way
each time he came into our E.R.
- I'm not giving up.
- Neither am I.
Okay. We need to talk to Sam.
Figure out if a transplant is
even something he would want.
And we need to do it now before
he loses his mental status.
Wolf, Carol, you know this.
Even if this is what he wants,
he's just not a good candidate
on paper.
Then we make him one.
I can't believe
Sam is in liver failure.
It'll be a hard sell
to the transplant committee,
- but I'll do what I can.
- Thank you.
Hey, how is Matthew?
I'm worried about him.
His disease is progressing
faster than I had hoped,
but he's still in denial.
Some aspect of denial is necessary.
Adaptive, even.
Not when it's unsustainable.
Matthew's stubborn,
and I don't want him
wasting what time he has left
avoiding the people
who are closest to him.
I'm going to go down to the
station and check on him there,
see if I can make any progress.
That's a good idea.
But I also know you want to see
some firemen in action.
Carol, do not objectify
New York's bravest.
But the 2026 calendar did come out.
Remind me to show you Mr. October.
[CHUCKLES]
[MONITOR BEEPING]
Sam?
Hi.
Can you hold your hands out like this?
What's going on?
That's called asterixis.
It's a sign of liver failure.
Sam, I'm not going to sugarcoat this.
We need to get you a new liver.
But in order to do that, I
need to know some things first.
What happened since
the last time we saw you here?
[SIGHS] You're mad
about your credit card.
- I'm sorry.
- Hey, I'm not mad.
You got yourself some stuff
you needed.
That's why I gave it to you.
No. I didn't use
your card for anything.
The meds helped.
But the voices, uh
I yelled at them.
Then these kids started beating me,
- hitting me, kicking me.
- Why didn't you come here?
We could have helped you.
They took your card.
I told you I'd bring it back.
I didn't wanna
Uh, had my meds, though.
Took 'em every day.
Meds for pain, too.
What were you taking for pain?
Red? I took 'em all.
Acetaminophen.
That's what caused the liver failure.
Is there any way you could
get in touch with your family?
It would really help
if they could be here.
Already dead to them.
I don't want to die.
Okay, junior firefighters.
There are four very important things
you need to know
when caught in a fire.
Number one,
stay low to avoid the smoke.
Number two, to raise the alarm,
pull the fire alarm or yell for help.
Number three, exit the building
as quickly as possible.
And number four,
never, ever hide
in a burning building.
So just remember FRED
Floor, Raise the alarm,
Exit, Don't hide.
Which reminds me,
there is a very special member
of our team
I think you'd really like to meet,
so I'm going to bring him out now.
- Are you ready?
- Yeah!
Okay, Fred, where you at,
boy? Come on out.
[KIDS CHATTERING EXCITEDLY]
Come on and meet Fred, y'all. Come on.
[KIDS LAUGHING, CHATTERING]
Where is he?
Where is he?
Matthew, we need to talk right now.
[KIDS OOH'ING]
Where do you get off
not coming for Thanksgiving?
Our little girl's coming home,
and you're blowing us off?
Alicia, can you not do this here?
Hi, uh, I'm so sorry to interrupt.
- And who are you?
- I am Dr. Oliver Wolf.
Perhaps we should all talk.
How could this happen?
I cooked healthy meals
for the family every night.
I always had a cruciferous
vegetable at the table.
And this is what we get?
I can assure you
that this is not about
what you did or did not do.
Alicia, I'm the one
who's dying, not you.
No, Matthew, don't say that.
No one is dying.
How could you have kept this from us?
Let's all just try to understand
the position Matthew is in.
There's no right or wrong way
to process this diagnosis.
So what do we do? How do we fix this?
Um, unfortunately, we can't fix this.
ALS is a progressive disease.
I did some googling on the train.
I want a list of all
the medicines that he's taking,
upcoming appointments.
I read that there are only
a few FDA approved treatments,
so I want him to get pushed into
a trial as soon as possible.
We are exploring every trial.
And yes,
this is a devastating diagnosis.
But I want you all to know
that research is accelerating.
There are thousands of people
all over the world
studying this disease,
and there is real hope for
effective treatment on the horizon.
In the meantime, our goal
is to help Matthew live
the best life possible.
Right. So Matthew is gonna
live with me.
I'm taking care of him. No questions.
Are you guys done speaking about me
like I'm not even in the room?
And there's plenty
of resentment there.
I'm not moving in with you.
- I don't resent you.
- Dad, nobody resents you.
And I'm gonna come back home, too.
I only have one
semester left of school,
so I can go back and finish whatever.
- What does that mean, whenever?
- Dad, don't be ridiculous.
I can't just stay in school.
The hell you can't.
You can't do this on your own.
Be for real, Daddy.
You live in a walk-up.
I live in a fire station,
Gabby. I can manage.
Remember, we fight the disease,
not the tools we have to help us.
No. I'm not letting
anybody uproot their lives
for me. I can fight this on my own.
End of story.
Thank you.
Eastgate Medical didn't have
any family contact for Sam,
and he is too confused now
to be able to tell us anything,
even if he wanted to.
Neither did St. Elizabeth's,
Queensbridge,
or anywhere else
Sam's been hospitalized.
I'm striking out here, too.
It's wild how hard it is
to get a transplant.
I don't think I'd even qualify.
- Two people? Really?
- I'd vouch for you.
I wouldn't let you. You'd have Liam.
How about you, Ericka?
You think you'd make the list?
Um, I don't know.
My parents wouldn't move.
Would you even want one?
Immune suppression and infections
the rest of your life?
Fearing rejection?
If the alternative is death,
yeah, I would take it.
The thing is, we would be listed.
Even if we drink
or don't have social support,
we'd be listed because we're the
people they make exceptions for.
And that sucks.
Privilege.
Hey. I think I found the number.
Green beans, uh, sweet potatoes.
- Oh, two pie crusts.
- Look at this big boy.
[LAUGHS] As if we needed
that much turkey.
- Uh-huh.
- [LAUGHS]
Oh, you kids, you're
getting coal for Christmas.
Hey!
- [CHUCKLES]
- [CELLPHONE VIBRATING]
- Hello.
- Hi. I'm calling
to reach Claire Mapesbury.
Yes, this is Claire.
- This is Dr. Ericka Kinney
- Who is it?
from Bronx General Hospital.
I'm one of the doctors
who's been taking care
of your son, Sam Mapesbury.
- What's going on?
- He's in our ICU
and very sick with liver failure.
I wanted to call you to update
you and answer any questions
It's Sam.
You know, I don't know
what's more shocking,
that Matthew has ALS
or that he's seeing a psychiatrist.
Reluctantly seeing a psychiatrist.
Well, that tracks.
If your sessions are anything
like our marriage,
you ask him how he's doing,
he mumbles fine, cracks open a beer
and plops down on the couch
to watch a Jets game.
Oh, honey, if he's a Jets fan,
he's never fine.
[LAUGHS]
He does talk.
Sometimes I can't get a word in.
Oh.
I see that strikes a chord.
Can you tell me why?
My sister set us up on a blind date.
I was so pissed at her at first.
She knew I liked
the strong, silent type.
And Matthew would not shut up.
We closed the restaurant down,
and when he kissed me
good night, he whispered
"We will never run out
of things to say to each other."
Sometimes marriage is all about
how you navigate the silences.
How do you navigate an abyss?
It wasn't all his fault. We went
through a lot early on.
9/11. We had friends
whose husbands
didn't come home that day.
So how could I complain?
My husband did.
But he didn't really.
I would look at him and say,
"Matthew, where are you?"
He never let me back in.
It's why we split.
So to hear that he talks to you
What he practices in this office
is what he'll bring
to his relationships
outside of this room, including
his relationship with you.
That's all I ever wanted,
was for him to tell me
that he wasn't fine.
[RADIO CHATTER, SIREN WAILING]
[COFFEE WARMER CLICKING, HISSING]
Yo, guys, what are you trying
to do, burn this place down?
[INDISTINCT RADIO CHATTER CONTINUES]
Guys.
Thanks for the patch up.
So, how did you fall?
I was being careless.
Matthew, I'm glad
that you have support
at the fire station, but I am worried
it's not a safe,
long term solution for you.
What's long term here?
I'm not sure I can keep fighting it.
[CHUCKLES]
I'm tempted to
tell you how resilient you are,
to talk about adaptation,
to tell you it's
incredible what people can learn
to accept as their new normal.
But none of that's
gonna help right now, is it?
I feel like
every time
I learn to adapt to a new loss,
I lose something else.
From where I'm sitting,
all of the core elements
that make you Matthew
are still intact.
Then let me keep this one.
I don't care about me,
but my girl Gabby and even Alicia,
I need to protect them.
Sam, there's some people here
to see you.
Sam.
Did I ruin your Easter?
It's Thanksgiving.
No way, kid. This is the only
place we want to be right now,
with you.
Hey, Doc.
Sorry to just surprise you like this.
Oh, uh, you're the chief?
- Mr. October, right?
- [CHUCKLES]
You can call me Dennis.
What can I do for you, Dennis?
Uh, look, we all knew
Matty living at the station
was temporary,
but we thought it was safe.
I, uh
I shouldn't have left him alone.
Don't blame yourself. You got
him out of his apartment.
You helped him maintain something
that felt normal
for a little while longer.
That's not nothing.
Yeah.
Matty's the best we got.
You know, he trained me.
My first week in,
I thought there's no way
I could do this,
but Matty made me realize I could.
He'd always say, "Alone,
we can do so little.
But together, we can do so much."
It's a quote from, uh,
Helen Mirren, I think.
Yeah, it's Helen Keller,
but easily confused.
I just wish we could
do more for Matty.
Actually, I might know a way you can.
Cow's milk is back, right?
Thanks. I've been reading about
stem cell clinical trials.
Is that something
that my dad could do?
Uh, it's a possibility.
But ultimately,
that's for him to decide.
You and your dad seem close.
I mean, he talks about you
all the time.
I've always been into modern art.
It's really not his thing.
But he used to keep a calendar
on the fridge of openings
happening in the city.
And every weekend he'd take me
to a new one.
And when I got a phone,
he started texting me
these random photos
and captioned them, "Art or not?"
He's one of a kind.
I can't imagine, uh
What your dad needs is
for you to keep going.
One good thing about modern art,
you don't need
fine motor skills to enjoy it.
Keep going. Together.
Talk to me, Sam! Open your eyes, Sam.
Sam. Excuse me.
- Sam? Sam?
- What happened?
He's unresponsive.
He was talking 30 minutes ago.
He wouldn't wake up.
We called you right away.
I need a rapid response
to room 12 in the ICU!
I'm sorry. We're gonna need the room.
- W-What's happening to him?
- We're taking care of him.
- Okay?
- Sam?
- Okay. Okay.
- Sam?
Pupils equal and reactive,
but he's obtunded,
and he's desatting. He
can't protect his airway.
Severe hepatic encephalopathy,
likely cerebral edema.
Ericka, prep an airway, now.
I'm ready for etomidate and sux.
You told me
that my job was to keep this
from becoming
a neurological emergency.
Is there anything
I could have done differently?
You were monitoring him,
and you gave him
the only antidote
for acetaminophen overdose.
But as his liver failed
and ammonia accumulated,
brain swelling became inevitable.
Which can lead
to brain herniation and death.
What's the immediate treatment?
Hyperventilating him
and dosing him with mannitol
and hypertonic saline
will lower the ICP
as a temporary measure.
But only a new liver will stop
the swelling permanently.
And we don't have long
to get it for him.
Correct.
So he's on the list
for this new liver?
Not yet. Unfortunately,
it's been difficult
because of Sam's housing situation.
The committee is reticent to list Sam
if he doesn't have a support system,
people committed to caring
for him after the transplant.
Well, he has that. He has us.
[SIGHS] We used to be so close,
but when he got sick, we became
the last people that he wanted.
Those thoughts in his head,
all that paranoia, the voices,
it turned him against us.
He didn't want to stay with us.
He said it felt like prison.
I-I went to the city once
to bring him home,
but he wouldn't come. He thought
we were trying to hurt him.
He told me never to call him again.
I had his siblings back home.
I had to be there for them, too.
Doctor, I feel guilty and scared
for Sam every single day.
Can I just bring him home?
I'm afraid a transfer
to another hospital now,
particularly one farther away is
It's too risky.
I know that you have
a life back in Ohio,
but if there is any way that you
could be here for Sam
We can rent a place here,
whatever Sam needs.
He's our son.
We let him go once.
We're not doing it again.
You watch all your patients
while they sleep
or just your favorites?
Oh, just my favorites.
How are you sleeping?
Terribly.
Keep having this dream.
Wakes me up most nights.
I'm, uh,
in my old house with my family.
There's a fire, and I can
I can hear them calling for me.
I
I try to save them, but I can't.
That sounds terrifying.
I wonder whether your weakness
and trouble breathing at night
may be causing this vivid dream.
Your oxygen level drops,
carbon dioxide climbs.
Your REM sleep is in disarray.
The good news is, there's a solution.
That BiPAP machine I mentioned
will help you breathe deeper
while you sleep.
[SIGHS]
I'll take your machine.
Fight the disease, not the tools.
Yeah.
You gonna discharge me now?
No. Tell me more
about this dream first.
Walk me through it.
Careful what you wish for.
- Matthew!
- Dad! Please!
Matthew, we need you.
Matthew, where are they?
- Matthew!
- Daddy.
- I don't know.
- Please!
- I don't know. I can't move.
- Help us!
- I can't save them.
- Daddy, please!
Come on out! Please, come out.
Daddy!
What if you're not supposed to?
What if they're supposed to save you?
Oh, Oliver.
I stand with moss and
branches under my bare feet ♪
Look back at all the chances
I missed narrowly ♪
But I'll move along, can't
keep on looking backwards ♪
There's a light, there's a light ♪
- [CRYING]
- Up ahead ♪
The transplant committee said no.
What happened?
I told them that Sam had just
started a medication regimen
that I hoped would work for him,
the meds he's been taking
since discharge,
and that he had a supportive family.
I also told them
that the acetaminophen
was an unintentional overdose
and that Sam truly
wanted to get better to live.
But he was on the margin, Ericka,
and they had to take a leap.
Sometimes they take it,
sometimes they don't.
I thought when we got his family,
they would see that he is
someone, someone worth saving.
Just because they declined him
doesn't mean all programs will.
I've already called
my friend at Columbia.
We'll call Cornell, as well.
We just need to find a program
that isn't so risk averse.
But even if they say yes,
what are the chances
they decide in time?
- Okay, how long does Sam have?
- He needs a new liver fast,
or he won't make it.
For now, we manage Sam's ICP
as best we can, and we hold out hope.
Mm-hmm.
Uh, hey, Silva.
Um, where are you going with that pie?
Uh, bringing it to our staff potluck.
I know this is weird,
but I could actually use it
for a patient, if that's okay.
Okay. Yeah.
Anything for your patients.
Thank you.
Um, I finally convinced Matthew
to attend his family's Thanksgiving.
He asked me to go with him.
So I can't show up empty handed.
- Is it too late to bail?
- [INDISTINCT CONVERSATIONS]
Uh, yeah, it sure is.
Besides, I went to a lot
of trouble to get that pie.
- I want to eat it.
- Or we could just
run down the street to the pub
and grab a whiskey.
- [CHUCKLES]
- Okay.
Dr. Wolf, please have a seat.
[INDISTINCT CONVERSATIONS]
[GLASS CLINKING]
I just want to say
how much it means to me
to have all of you
around the table. This year,
what I'm most grateful for
is second chances.
Dr. Wolf, would you like to go next?
Uh, I guess I'm coming to appreciate
unexpected reunions.
Mm.
Matthew.
Yeah. Um
I'm grateful for my family
and that, uh,
I haven't been a burden on them.
Matthew, please.
I can't live in my apartment anymore,
and I can't live at the station.
It's too much.
So
I made arrangements with a facility.
A home. A place I can move to.
I'll be safe, you know, for as
long as I can tolerate it.
But my ship is sinking,
and I'm not taking any of you with me.
- Dad, we want to help.
- That's not your job, honey.
- It's too much.
- It's not, though.
It's not, because we
wouldn't be doing it alone.
What do you mean?
We all agree that living
at the station isn't a solution.
But the guys, they want
to help out as much as they can.
Matthew, I want you
to move back into the house.
I won't be doing it alone,
and neither will you.
And don't even try to argue.
Dennis has planned
a month's worth of frozen meals.
He's gone full Martha Stewart. Okay?
I'll bet he has.
You have a lot of good people
around you
who want to help out
as much as they can.
[TRUCK HORN BEEPS]
Take a look.
Yeah, Matthew!
[INDISTINCT CONVERSATIONS]
[CHEERS AND APPLAUSE]
Yeah, appreciate you, Matt!
Wait. Who are all these people, Dad?
- People from work.
- And lives he's saved.
- Here for you.
- Hey, we appreciate you!
Sometimes letting people help
is the greatest gift
you can give them.
Thank you, Matthew!
We got your back, bud!
Thank you for bringing all this stuff.
Yeah, thanks, Auntie.
Everything looks great.
I'm sorry I had to work
on Thanksgiving.
It's no worries. We got you. Always.
- Thank you.
- Okay.
Hey, hey, hey.
Okay, word on the floor,
your sweet potato pie is to die for.
It sure is. This an old family recipe.
- Uh
- Uh, Anthony, this is my sister,
Helen.
Anthony runs our emergency room.
Lovely to meet you.
Any plans for the holidays,
or is it all gunshot wounds
and severed limbs?
[CHUCKLES] No,
mostly cuts and burns, actually.
But I'm headed out.
Kids are with my ex,
so it's going to be a quiet one.
But you know what I am
thankful for this year?
An entire Thanksgiving in the E.D.,
and not one patient spoiled
the Cowboys game.
The Cowboys? Oh, no. And I was
just starting to like you.
What? Ladies, look, I'm not that bad.
Tell her. I'm not that bad!
Oh, my God. Who made this?
Mm. I told my staff,
best dish gets Christmas off.
You realize this is our
first Thanksgiving as a family?
I wish I could have made it special.
This is special. We're together.
♪
Matthew?
Hey.
Got you a little something,
if you want to take a break
from athleisure.
Hey. Where are you?
I'm right here.
You were waiting outside
for me in the sun ♪
The act of rescue
is often linked to things
like heroism and bravery.
But for guys like me,
I've always looked at it
as an act of caring.
I don't get it.
Dad, it's art.
If you say so.
Oh, the glory of it all ♪
I guess I never saw myself as the one
who needed to be cared for.
Until I saw how hard it'd be
to reach you ♪
And I would always be light years ♪
Light years away from you ♪
Light years, light years ♪
But I know now
that even on my hardest of days,
you and your mom will be there
to save me from any fires
that may come our way.
- Mom?
- [GASPS] Oh, Oliver.
It's too soon.
I wanted to surprise you.
I brought Thanksgiving to you.
Ta-da!
Everyone was lighting up
the shadows alone ♪
You could have been
right there next to me ♪
I saw your ferns, Oliver.
I-I've been so busy at work.
I know, so, you know, I just
I took some of them
upstairs to the bathroom.
I ran the shower for a while.
The steam should perk them right up.
- They're dead.
- They'll be better tomorrow.
You'll see.
And now we are going to get
this big boy out.
Whew!
You know, it was always
his job to carve the turkey.
And our friends would applaud
because he made it look so easy.
Ugh, used to drive me crazy.
I do everything else,
- and all the
- Mom.
Light years, light years
away from you ♪
Sometimes the most
heroic thing you can do
isn't running into
the burning building.
It's quieter, smaller,
but in a way, even harder,
at least for me.
Letting you and your mother in,
accepting help.
Agreeing to this voice
banking business
Dr. Pierce has been talking about.
Allowing myself to be rescued
even when I don't want to.
For me, this is the
bravest thing I've ever done.
And it's scary as hell.
But it is worth it
if it means more time with you.
♪
Greg, move your head.
sync & corrections awaqeded
♪
♪
♪