Watson (2024) s02e14 Episode Script
Wrongful Life
1
It's been a long road,
but I think we're there.
You have a viable embryo.
- Are you sure?
- I'm about as sure as I can be.
We've ruled out any major
chromosome abnormalities,
and the single-gene conditions
we can screen.
As long as the implantation
is successful,
you can have a viable pregnancy.
(EXHALES)
Wow.
That is, uh (SIGHS)
(CHUCKLES) Thank you.
(SIGHS) Thank you.
I need to call my husband
and tell him the good news.
- Of course.
- Thank you.
You're very welcome.
♪
INGRID: Huh. Identical twins.
Do you just do everything together?
- I applied here first.
- We have different specialties.
Something tells me
Dr. Watson's gonna have
a field day with you two.
Well, I'm not sure what that means,
but I'm hoping to utilize
Dr. Watson's work
on immune pathways
to fight infections.
SASHA: I was thinking
of something similar.
Are you an immunologist?
Me, too. And rheumatology.
I'm double boarded.
- I'm infectious disease, actually.
- SASHA: Oh.
Interesting.
Maybe we can work
on a project together.
Everybody says that Watson
is good and fair
Clearly into competition.
Should we make a bet
about who gets cut first?
Why would he hire all of us
just to turn around and cut one?
Oh, let me guess, family medicine?
Not far off.
Functional medicine.
Oh. (LAUGHS) Okay.
Let me help you understand.
Watson either has
one too few desks or
one too many fellows,
and he's had ample time
to get another desk.
SASHA: Or maybe
it's a hot desk situation.
So, you're a
"glass-half-full" type. Got it.
(CHUCKLES)
SHINWELL: Ready for
our first official day, guv?
WATSON: I am.
Just got to do
a little decorating first.
Holmes's violin.
Feels like he could just walk in,
play us a tune,
solve a mystery or two.
Yeah, I wish he could.
We'll just have to honor
his memory with our work.
Fellows here yet?
Down in the bullpen.
One concern. You asked me
to order four desks.
There are five fellows.
Hmm.
(LAUGHS)
Seems like this desk
has already been claimed.
PAOLA: It's mine.
Been here for a week,
working on our first case.
Thought I'd make myself at home.
I'm sure you four can make
the three other desks work.
You're the one who cuts, aren't you?
Paola Barajas. Surgical specialist.
Ingrid Derian, neurologist.
My bet is Miss Glass-Half-Full
is the first to go.
Nobody's going anywhere.
And don't underestimate me.
WATSON: Fellows.
Good morning.
Happy first day. Welcome.
Et cetera, et cetera.
Why don't we meet
in the conference room?
Kyren Garner. 16.
He has been my patient
since before his birth.
I worked with his parents
during my genetics fellowship
to help them conceive.
So what's his deal?
I just assume there must be
a rare genetic condition at play
if we're here discussing him
16 years later.
WATSON: That's correct,
Dr. Derian. You're half-right.
Kyren has VACTERL association.
VACTERL patients
have multiple anomalies.
The name is an acronym.
It's a disorder that really means
"a bunch of disorders."
Each letter stands for
a different body part
- that can be affected.
- SASHA: But it's not genetic.
There's no clear cause,
and since you can't test for it,
it's hard to diagnose prenatally.
Correct.
We knew Kyren had a VSD
from a sonogram.
So, you knew he had a heart condition,
but you need three of these anomalies
to be diagnosed with VACTERL.
It was at his birth that we learned
Kyren had two more:
a tracheoesophageal fistula and
a malformation of his lower GI tract.
That gives him VACTERL.
Poor kid.
That means he had several surgeries
soon after he was born.
Yes, he did.
Kyren learned to walk
in the PEDS ward,
after a G tube revision.
And then, he celebrated
his seventh birthday
here at UHOP once we
readmitted him for one
of his chronic UTIs.
He and his family
must've spent more nights
in the hospital than at home.
Well, it's just mostly he
and his mother now.
His medical needs were a lot
for his father.
Kyren has had over 12 surgeries
just to simply rebuild his body.
And even so, at 16,
he was accepted to Penn State
for robotics.
Though he had to defer.
But tomorrow,
I'll perform his final surgery
to fuse his spine and
correct his severe scoliosis.
WATSON: We'll get Kyren to college
sooner rather than later,
but I'd like you all to acquaint
yourselves with this case.
Dr. Barajas and I are gonna meet
with Kyren and his mother.
But they were my first patients
when I was a fellow.
Now, they're yours.
Sorry, Dr. Watson,
I couldn't help but notice
there are only four desks.
Hmm.
I'll have to look into that.
- MARLISE: Oh, thank you.
- WATSON: Mm-hmm.
Wow, this is definitely an improvement
over that tiny office I met you in.
(LAUGHS) Isn't it?
Yeah, you're really coming up
in the world.
They built this entire clinic for you?
Well, for the advancement of genetics
and the education
of a select group of fellows.
- Dr. Paola Barajas.
- Hi.
- I'll be doing Kyren's spinal fusion.
- Nice to meet you.
Yeah. You know, I'm gonna have
my own robotics clinic one day,
just like this.
Better than this, maybe.
Well, if anyone has the brains
and perseverance
to accomplish their dreams,
it's you, Kyren.
Yeah. Now I just need the body.
- Kyren.
- What?
Dr. Watson understands my need
for bodily improvement.
Our plan will do just that.
We'll use metal rods
to hold your spine straight
and bone grafts to fuse the vertebrae.
Once it's fused, your spine
will never curve again.
It's a very successful technique.
We do it all the time.
Really? And, uh, when do I get
to Penn State?
After about a year of P.T.
WATSON: Now, the recovery is intense,
but once you're through, I mean,
you'll be done with
all of the major issues
associated with VACTERL.
Right.
I don't know. Will I, though?
Kind of feels like I'll never
be done with this, Dr. Watson.
I know it feels that way, Kyren,
but you're almost there.
And I promise you, you will be done.
- Now, remember, I don't
- KYREN: Yeah, yeah, yeah.
You don't make promises
you can't keep. I know.
All done.
It's been a long road,
but it's official.
You're cleared for college.
(CHUCKLES) Oh, my gosh.
- Yes?
- Yes. Yes.
Finally. Wow.
Mom, orientation's next week.
We got to choose our teams
and get into our rover designs
for the challenge.
Now, make sure
that you stick to the diet
- that Dr. Croft designed for you.
- Yeah, yeah.
And don't be a stranger, okay?
- Yeah.
- (WATSON CHUCKLES)
Oh, man, it is so crazy to think
I'm not gonna be seeing you
in a couple weeks for a check-up.
Well, you're at the finish line
now, Kyren.
The most serious challenges
of the VACTERL are behind you.
Mm.
Thank you for everything you've done,
- Dr. Watson. Thank you.
- WATSON: Of course.
Come on, Mom, don't get mushy.
- You're gonna give him the ick.
- (LAUGHS) Sorry.
(CHUCKLES)
- (SNEEZES)
- Bless you.
Thank (SNEEZES)
- (SNEEZES)
- (BACK CRACKS)
- Ah. (PANTING)
- Kyren?
- Ah, my back.
- MARLISE: Kyren.
- Kyren, what's happening? What's happening?
- My back. My back, it hurts.
Shinwell!
(GROANING, PANTING)
What's wrong with his back?
KYREN: What's happening?
What's happening?
It looks like one of your rods broke
- and is tenting your skin.
- (KYREN CRIES OUT IN PAIN)
We need to get a gurney for Kyren.
Ask Dr. Morstan to meet us in the OR.
- On it.
- KYREN: Wait. Wait, wait,
wait, wait, wait, ortho
Kyren, we have to get you
to the OR before this rod
- breaks through your skin.
- KYREN: No, no, no.
I can't go through
another procedure. Okay?
Dang, you promised
this was the last surgery.
You promised.
(STAMMERS) You Dr. Watson,
you never break your promises.
You lied to me. (CRYING)
♪
(SIGHS)
(GRUNTS)
WATSON: Mary, what are you seeing?
MARY: No corrosion here, either.
Well, there's no
visible signs of infection,
but we've taken cultures.
Wait.
Kyren's spinal fusion
was two years ago,
when your clinic opened, right?
Yeah, that's right. Why?
MARY: Well, I mean,
it didn't show up on imaging,
but now that I'm in here,
I can see why his rod broke.
His bones didn't fuse.
Two years ago, we did a surgery
to fuse Kyren's spine, but
his bones didn't fuse,
which caused the rod to fracture
from too much tension.
Our job today is to figure out
why his surgery failed.
Infection is the obvious answer.
Cultures from the OR are pending,
but we do know that Kyren
didn't have any fever
or other symptoms
before his rod broke.
Could be hardware.
Maybe the screws or rods
were faulty in some way?
I can check for recalls.
Or Kyren could have
a metal hypersensitivity.
He could be rejecting the hardware.
Ingrid, Adam,
look into all the hardware.
He still has one rod
and all the screws in his back.
If there is a problem
If there's a problem, we need to know.
Sasha and Stephens,
look through all of his
medical records. See if there's
anything in his history
that we could've missed.
We're on it, but
Watson, are you okay?
I will be once we get answers.
I want updates in the morning.
Didn't Paola do his spinal fusion?
Wow. Paola.
I forgot we once were five.
Should we reach out to her?
Ask her about the case?
Maybe she has some insights.
INGRID: Why would we do that?
Her surgery failed.
If you need a refresher,
Watson fired her.
We don't know
if she was actually fired.
Watson never told us.
ADAM: Would he tell us?
I mean, he told us
about Ingrid, but
He never tried to replace Paola, so
Well, we've established
that's not Watson's strong suit.
SASHA: It's kind of wild,
all that's happened
since she was with us.
- KYREN: When did you know?
- MARLISE: Kyren, we didn't know.
KYREN: You had him do genetic testing.
I Dr. Watson. Thank God.
Kyren Kyren wants to know
when-when we knew.
Did you know how sick
I was gonna be
before I was born?
Did you tell my mom?
And she decided to have me anyway?
No. We couldn't know, Kyren.
She said you knew
about my heart condition.
- But, honey, it's not important.
- KYREN: Yes, it is.
It's my life.
You knew about how much pain
I was gonna go through,
and you decided to have me anyway.
Kyren, please don't talk like that.
I wouldn't trade you for anything.
- You know that.
- You need to tell me
exactly what you knew.
I deserve to know.
Kyren, when your mother
was five months pregnant,
she did an ultrasound.
Dr. Watson, I need your help.
My OB says there's a hole
in my baby's heart.
Yes, it's called a VSD.
It's the hole in the wall that divides
the lower chambers of his heart.
I don't understand.
Why didn't you say
Wh-Why didn't you tell me that
he would have a-a VSD before
But there's no way
we could've known that
from the genetic screening.
And sometimes, VSDs, they just,
- they just go away on their own.
- Okay, well, what if it doesn't?
There are a lot of good
treatment options if it doesn't.
Okay, well,
that's encouraging. (SIGHS)
My husband and I, we just
made partner at our law firms.
We want a child, but he's afraid
of having a sick child.
Do you see anything else
on the sonogram?
No. I don't see
anything else concerning.
What if I
if I terminated?
Would I still be able
to have another baby?
With an egg donor or maybe adoption.
I'm sorry, but your body's
no longer producing eggs, so
we can't make more embryos.
(SIGHS)
I had eight miscarriages
before I even met you, and
I was afraid the universe
was telling me
I wasn't meant to be a mother,
and then I-I got pregnant.
With my son, and-and now
Marlise, I can see that
you already love your son.
- I can see it.
- Yeah.
Whatever challenges
life throws at you,
you will face them,
and I'm gonna help you. I promise.
Okay?
(SIGHS)
Okay.
KYREN: So you didn't tell her
it could be VACTERL?
No, we didn't know for sure.
Not until you were born.
And then, once we did,
I put together the best possible care.
But you wouldn't have
had to do all that
if I wasn't here in the first place.
She could've saved me
from a lifetime of pain.
My dad wouldn't've left.
(CRYING): Kyren, I'm sorry.
No, I'm sorry.
I'm sorry you didn't get a choice.
'Cause if you knew everything
that would happen
all this pain
maybe
you would've made
a different decision.
I know I would've.
(EXHALES)
(SNIFFLES)
I've never seen him so disheartened.
Even even on his worst days,
he hasn't talked about wishing
he hadn't been born.
He's processing. It's
It's the first time
he's learned something new,
and he's just taking it in.
We've always known
what the next treatment was.
This is the first time
we didn't have a plan.
I-I'm scared it's more than that.
He didn't think we knew anything.
The fact that we did
And now, this is his life, he
he's mad.
And he
and he's hurt.
I mean, I don't blame him.
Honestly, I blame you.
Thank you.
Where are we with Kyren?
Uh, Adam's not here yet.
Then we're gonna proceed without him.
Kyren is okay physically,
but emotionally,
he's struggling.
We need to present him
with a plan as soon as possible.
The cultures Dr. Morstan took
came back negative,
as did his metal allergy test.
He doesn't have an infection
or metal hypersensitivity.
I looked over the OR notes.
There were no obvious concerns
reported during surgery.
INGRID: I checked with
the hardware manufacturers.
No reported issues
with the screws or rods.
(SIGHS) Okay, okay.
So who has any suggestions
about what we should do next?
- Nothing? Nobody?
- Uh
Okay, this is unacceptable.
Okay? You guys aren't
new fellows anymore.
You need to be searching
for possibilities always,
not waiting for me to ask.
Now, one of you two, you guys
- call Paola Barajas in
- WOMAN: Excuse me?
- Are you Dr. John Watson?
- WATSON: Yes.
Yes, I am.
You've been served.
For what?
The wrongful life of Kyren Garner.
The wrongful life?
What the hell does that even mean?
Kyren said he shouldn't be here.
He's suing me because he thinks
he never should've been born.
"Wrongful life." Sounds wrong.
It is wrong.
I can be iffy on existence as a whole,
but even I don't think
that life is wrongful.
- (SCOFFS)
- INGRID: There are a few people
whose lives I think might be wrongful.
But that's not
what this case is about.
(PHONE CHIMES)
It's Lauren.
She says these cases are rare.
Many states don't allow them.
The child has to prove their parents
would've terminated the pregnancy
if the doctor had given them
all of the information.
So, what the suit
is basically saying is that,
if Marlise knew that VACTERL
was a possibility,
she would've terminated the pregnancy.
And by extension, that Kyren
wishes that were the case.
Kyren is angry and in pain.
Seems like he's just lashing out.
Or he truly wishes he didn't exist.
But Kyren does exist.
I don't understand
how a court can debate
whether that
should've happened or not.
- Or pay out money for what?
- (PHONE WHOOSHES)
The curse of being alive?
Lauren says if Kyren wins,
"The damages amount
is based on an aggregate
of their medical expenses
over his lifetime."
My God.
Kyren's had so much medical care,
that must be tens
of millions of dollars.
His story is heartbreaking.
I don't know if any jury
would side against him.
What will this mean for Watson?
- For the clinic?
- (DOOR OPENS)
(INDISTINCT CONVERSATION)
- How is he?
- SHINWELL: Well, you know,
just as you'd expect if one
of your closest patients
decides to sue ya.
Dr. Morstan's up there
trying to talk him down.
How can we help?
(SIGHS)
Focus on your work.
Watson's worried that
we might've disappointed a patient.
Last thing he wants is
for us to disappoint any more.
WATSON: How can Kyren
believe he shouldn't exist?
We shouldn't even be
entertaining this lawsuit
because he does exist.
"Entertain"? That's not up to us.
A lawsuit like this is serious.
We definitely need to end this
before it turns into clickbait
and damages your reputation.
I'm not worried about clickbait
or my reputation.
But the board is.
They're not exactly happy about this,
especially given everything
with Mycroft Holmes.
This must be putting
a lot of pressure on you,
and I'm sorry for that.
Okay? But we shouldn't be
talking about a lawsuit.
With a failed fusion,
it's just a matter of time
- before the second rod breaks.
- John
What we need to do
is figure out what went wrong
- and fix it.
- Actually, we don't.
After he served you,
Kyren transferred hospitals.
- What?
- He's not your patient anymore.
(SIGHS)
(INDISTINCT CHATTER)
SHINWELL: They took
him ten minutes ago, guv.
I did think about
blocking the door, but
Mary told you that Kyren was
transferring before she told me?
Not one to rat on the boss, guv.
Oh, so you work for Mary now?
Ooh.
Technically speaking, we all
work for Dr. Morstan, guv.
Yeah, that's very true.
I guess blocking the door
certainly wouldn't have helped
the lawsuit.
No.
So how was he? How was Kyren?
He was okay.
Hurting, but okay.
We're talking about
settling the lawsuit.
That might be a way to convince
him to come back to UHOP.
And how do you feel about that, guv?
All I want is what's best for Kyren.
And if
if he needs this, then
Look, guv, if there's
one thing I know about you,
it's that you're always gonna
put your patient first.
That's all you're doing.
Appreciate you.
SASHA: Seems like Paola's
doing some cutting-edge work.
Using 3D printing
to customize components
for joint replacements.
I think it's worth
having a conversation
to see if any of it
can help Kyren, but
- she hasn't returned my call.
- INGRID: You were calling her
when we thought she was
the reason the bone didn't fuse.
Let me reach out to her.
Really? From what I recall,
the two of you
weren't exactly friendly.
Which is why I'm sure
she won't be able to refuse
surgeon-splaining all her
fancy tech and gadgets to me.
Why would you volunteer for that?
For Kyren.
Okay, look, I know
you're in therapy now
and have changed
some of your ways, but
there's something
you're not telling me.
I just know I probably owe her
an apology, okay?
What'd you do?
(PHONE CHIMES)
- Saved by the ding.
- Mm.
- Convenient.
- Made contact.
She can meet in the morning.
I'll let you know how it goes.
MORGAN: The, uh, board
wanted me to remind you,
no surprises in there.
WATSON: Understood.
I'll stick to the script.
This is serious, Dr. Watson.
If we don't play our cards right
We've got it, Charles. Thanks.
This'll all be over soon.
TANNERMAN: We appreciate you
all moving to a settlement so quickly.
MORGAN: Well, Dr. Watson
and UHOP care about Kyren,
and want the outcome that best
sets him up for success.
- (GRUNTS)
- WATSON: Kyren.
Are you all right?
- You look flushed.
- John
No, it's okay.
Old habits, right?
H-He's fine, Dr. Watson.
Kyren just had a minor UTI,
but he's taking antibiotics.
We caught it early.
Apologies. Before we move further,
we have one addition
to the settlement.
And what is it, Ms. Tannerman?
My client would like an apology
from Dr. Watson.
The excruciating pain my client
has felt his entire life
could have been avoided
if Dr. Watson had given
Marlise all of the information
when she brought him
the sonogram 18 years ago.
Okay, I'm sorry. So
you want me to apologize
for Kyren's existence?
I (STAMMERS)
Kyren, is that what you really want?
Yes.
(COUGHS)
That's what I want.
How long have you been on antibiotics?
See, I told you
he would never apologize.
No, it's not about that, Kyren.
You are sick.
- John.
- Is this some kind of stunt?
I've been working hard
to try to figure out
why your bones didn't fuse.
Now-now, just right now,
I got the clue that I needed
to understand what's going on.
Dr. Watson, I advise
against you getting involved.
Wait, what is it?
What's wrong with Kyren?
- I believe he has an infection
- KYREN: Stop!
Just stop.
Anything that's wrong with me
is your fault.
You made me.
And you let me live just to
be in hospitals like some freak.
Kyren, please, let me treat you.
- Okay?
- KYREN: Treat me?
Why?
I'm not even supposed to be alive.
- Oh, God.
- WATSON: Whoa, whoa.
Kyren. Kyren.
Call-call an ambulance, Georgia.
Please, help him.
Dr. Watson, please help my son.
Mary, let us take him to UHOP.
He should be with us.
This lawsuit isn't settled.
You shouldn't get involved.
Please, Dr. Morstan.
The board won't be happy.
Then let them take that up with me.
Marlise gives permission,
so UHOP will treat Kyren.
Put this under.
- Stay with us. Stay with us.
- MARLISE: It's okay.
WATSON: Just stay with us.
You're gonna be okay. Stay with us.
MARY: There.
(CHUCKLES) You were right.
I don't know how you knew
the infection was deep
in his spine. The initial
wound cultures were negative.
Well, Kyren had a fever,
and the new doctors assumed
that it was a UTI, and that tracks,
but the antibiotics weren't working,
so it had to be something else.
An occult spinal infection.
Explains everything.
Why his bones didn't fuse.
WATSON: And there it is.
So now, we have a plan.
We remove the infection
We do, but (SIGHS)
- it's tough, John.
- Kyren can do tough.
To treat the infection,
I'll need to remove
the remaining rod
and all of his hardware.
He'll be hospitalized for IV
until we can perform
the revision surgery.
Is Kyren prepared for that?
No, he's too sick
to make that decision.
Then we'll need Marlise to sign
a consent on his behalf.
We don't need this
to complicate the lawsuit.
Mary, thank you for letting
Kyren come back to UHOP.
I'm sure the board wasn't too happy.
Oh, they weren't.
And you're welcome.
(SIGHS)
INGRID: Nice write-up
in the Beechview journal.
PAOLA: Well, you know how it is.
Those publicity things are silly, but
they're fun to send home
to the parents.
So what are you working on right now?
Do you remember Kyren Garner?
The first patient we had
at the Holmes Clinic?
Of course. How's he doing
with his new spine?
Actually, his spine didn't fuse.
I know Sasha tried
to reach out to you.
I've been busy.
Why are we here?
I've been looking into the best
redo surgeries for Kyren.
I thought his anatomy might benefit
from the precision cages.
Can I see his chart and labs?
I think he's an ideal candidate.
Have him transfer to Beechview,
and my team will take the case.
I know it's important for Watson
that he stay at UHOP.
Dr. Morstan taking the lead
in the surgery.
Would you consider a collaboration?
You're different now.
I can't imagine the Ingrid I knew
asking me if I would consider
collaborating.
You're right. I wouldn't have.
(CHUCKLES) Paola
I'm the one who reached out
to Beechview about you.
What do you mean?
It was the desk.
I was pissed about you
claiming the desk I wanted,
so I sent Beechview your résumé.
I wanted you gone.
Sorry.
Let me get this straight.
You were pissed,
so you told a rival hospital
I'd be a great fit for their
new, state-of-the-art lab?
I just wanted you gone.
I didn't want patients
not to have you as a surgeon,
just somewhere else.
Somewhere not at that desk.
I can't tell if that makes me
like you more or less.
Have Dr. Morstan reach out to me
if she wants to move forward.
(SIGHS HEAVILY)
(DOOR OPENS)
Morning.
How's Kyren?
Okay.
CT scan went well.
Watson was able
to figure out what's wrong.
That's good.
- I'm just glad that he's back here at UHOP.
- Mm-hmm.
I'm not sure Watson
could handle knowing
he was in trouble somewhere else.
Hey. What's going on?
That kid's gonna wake up to learn
that he's stuck at UHOP for months.
He was already struggling.
I don't know how this
won't devastate him.
But then he'll get better.
Watson is dedicated to coming up
with the best plan for him.
I know, but
A plan doesn't really make up
for what Kyren's losing.
It doesn't really acknowledge it.
I don't know. It just feels like
he needs something more.
Like what?
(SHINWELL CLEARS THROAT)
Sorry, uh
Dr. Morstan has something
she wants to show yinz guys.
WATSON: During the washout,
Dr. Morstan took measurements
and combined them with Kyren's scans
to create this virtual replica
of his spine.
MARY: You can see
here, a hemivertebra at T8
and cleft through T9.
A malformation like that
could also contribute
to why the fusion didn't take.
- That, plus an occult infection.
- WATSON: Exactly.
It's a perfect storm. So,
how do we make sure his bones
fuse this time?
This might potentially be
a good time to mention
that I met with Paola Barajas.
She finally got back to someone?
She did. Looks like
some of the innovations
she's been working on at
the Beechview Medical Institute
can help Kyren.
It was a shame to lose Paola,
but I knew she would be
a better fit at Beechview.
So you didn't fire her?
On the contrary, I asked her to stay.
Whoa. Interesting.
Well, looks like Paola's
doing quite well where she is.
She suggests we use a custom cage
printed to Kyren's specifications.
That would make sense.
Something tailor-made
would prevent infection
and increase his chances
of a successful fusion.
She also said she may be
willing to collaborate.
That would be great.
I'll reach out to her and see
if we can put together
a specific surgical plan.
We could share the broad strokes
with Kyren and Marlise.
Yeah. I mean, let's do it.
I'm sure they could use
some good news.
KYREN: Good news?
How is removing every rod
and every screw good news?
I know it sounds daunting, Kyren,
but this is the best way
to treat the infection
that prevented your bones from fusing.
So
I have the pleasure
of lying down on my back for
who knows how long?
We'll give you IV antibiotics
for a month.
Once we're certain it's gone,
we can prepare
for your revision surgery.
A month?
So, I'm just as bad off
as when my back was deformed.
Worse off, actually.
Because back then,
I was gonna go to school.
I was gonna start my life.
Well, I guess,
I'm realizing
that's never gonna happen now.
I'm sure you can defer, Kyren.
Again?
What's the point in deferring
if a new problem's just gonna
pop up every time I get close?
Because there's no reason to believe
that something like this
is gonna happen again.
KYREN: Oh, you haven't heard?
I have a one in a million association.
Had to be rebuilt
starting an hour after birth.
And then my back broke because of some
occult infection that hid from even
"the world's greatest diagnostician"
for years.
You're a fighter, Kyren.
What don't you understand, Doctor?
Fighting is useless.
Something is always gonna come up.
Kyren, we are on the verge
of having a plan
to rebuild your spine
so something like that
will never happen again.
You can't quit on us now.
I'm not quitting on you.
I'm firing you.
Kyren, that is no way
to talk to the man
who is trying to save your life.
I didn't ask him to. You did.
I sued him
because I realized something
you could never accept.
My life is not worth saving.
Just leave.
Okay?
Get out of here, all of you.
I said everybody.
(SNIFFLES)
(GROANS)
WATSON: Yes?
Do you have a moment?
I just need to finish reviewing
these titanium cages.
- For Kyren?
- Mm-hmm.
I was under the impression
that he's no longer our patient.
Which is exactly why
I have to present him
with a flawless plan.
I see.
Actually, I don't see.
With all due respect, Watson,
I think your judgement is compromised.
I'm listening.
Well, that's the thing.
I don't think you are listening.
To Kyren, which is unlike you.
And it makes me wonder if
the personal nature of this case and
your connection to the patient
is clouding your judgement.
And how is my judgement being clouded?
You keep focusing on
alternative treatment plans,
pitching solutions.
Kyren doesn't believe
his life is worth fighting for.
Okay? Now, it's my job
to convince him otherwise.
No, it's not.
I'm sorry,
but I can speak with confidence
that reassurances and promises
don't always help.
In fact, those words,
as well-intentioned as they may be,
often represent
their own kind of pressure.
And added up, it can be another burden
on someone who's already struggling.
I hear your diagnosis, Dr. Croft.
What's your recommendation?
Empathy.
Compassion. Truly listening.
Making sure the patient knows
he's not alone.
That's my recommendation.
(DOOR OPENS)
(DOOR CLOSES)
PAOLA: Wait, I have
to ask. Where's Clyde?
I expected to see him
zipping around back there.
It's a long story.
You were saying, Dr. Morstan?
(SIGHS) The lower model,
it's too loose.
There's a millimeter gap
at the posterior wall.
Yeah, I see that.
It's collapsing from the deformity.
Is there any way we could model it
from the healthy vertebrae above it?
That's a great idea.
We could match the curvature.
But what if it's still
not quite right?
It's titanium. There's
no adjustments in the OR.
Well, actually, with 3D printing,
I could model a flexible lattice.
Build it with just enough give
for alignment.
That is ideal.
Amazing what you all can do
with this new tech.
Well, not to be a jerk,
Dr. Morstan, but (SIGHS)
you're an orthopedic surgeon
and the director of the hospital.
I'm a little surprised UHOP
doesn't have a more robust
ortho program.
You know, you might be
on to something.
I'm late for a meeting.
You two wrap up here,
and, Sasha, you can fill me in.
- Are you enjoying your fellowship?
- SASHA: Honestly?
More than I hoped I would.
It's been life-changing.
Life-changing?
(SCOFFS) I'd expect you
to use a word like that
to describe your wedding to?
Oh, you mean Zach.
I actually ended it
with him a while ago.
- Oh
- And, uh,
I'm dating Stephens now.
Stephens?
(LAUGHS)
Now, that's the bet
I should've made with Ingrid.
(CHUCKLES) Speaking of Ingrid,
she apologizes now?
Apparently, she does, and sometimes,
she even means it.
I told you to go away.
You're still fired.
I'm not here as your doctor.
I'm here as someone
who's known you for 18 years.
As a
I don't know. A friend?
I'd never call you a friend.
That's fair.
I haven't always acted like one.
A friend would've
listened to you, Kyren.
All these years,
you've been trying to tell me
how much pain you were in,
how hard life was for you.
Yeah.
And you wanted me to fight,
be positive.
Kyren, I
I thought that I was helping you
when I came at you with
all those plans and promises.
I realize now that that was
that was wrong.
And I'm truly sorry for that.
Life is hard for everybody.
But your life?
It's a whole nother level.
I see that.
I see you.
I wanted to make it different, Kyren.
I wanted to make it better.
Sometimes, medicine fails.
I'm sorry for that.
But I'm not sorry that you exist.
No matter what you do.
No matter what you think of me.
I'm sorry for what I did.
But I'm glad you're here.
MARY: The settlement is in.
The lawyers negotiated and all
of this explains where we got.
Kyren said you satisfied
the apology requirement.
Everybody's good with this number?
It's toward the further reaches
of what they think
a jury might've awarded,
but spares us court expenses
and potential negative press.
Well, at least Kyren and Marlise
have a financial safety net,
no matter what happens next, so
But you're good with this, too?
It's not ruining UHOP
or anything, is it?
I'm good with it.
All right. Where do I sign?
What are you doing in scrubs?
Uh, Kyren asked me
to be in the OR with him.
Mm. I'm glad the two of you made up.
It's better for the both of you.
It was your surgical plan
that sealed the deal.
Thank you for taking so much
interest in him and this case.
(SIGHS) I got to say,
I find what we're about to do
with the 3D cages fascinating.
It's a shame we had to go to
Beechview Medical Institute
to get them.
We should be working with
that kind of tech here at UHOP.
I agree, but why aren't we?
I asked myself the same question
and got started on an answer.
An ortho 3D printing program
is starting right here,
- under this roof.
- Mm-hmm.
What?
Well, during residency,
you chose ortho
because it exists in the space
between tradition and innovation.
The traditional piece
keeps patients safe.
BOTH: But the innovation
comes with such potential.
Mm-hmm. Yeah, I remember.
Yeah, you invested so much time in me
and in the Holmes Clinic.
Maybe it's time we return the favor.
How about a collaboration
on the cutting edge of orthopedics?
- Mm. An intriguing idea.
- Mm-hmm.
But I know you just want access
to my new tech lab.
Maybe.
(BOTH LAUGH)
(SIGHS) See you out there.
I'll see you out there.
("AUTOMATICALLY SUNSHINE"
BY THE SUPREMES PLAYING)
All right. How you doing? You nervous?
Always a little nervous
before surgery.
I get it.
Thanks for being here.
I told you I'd be here for you.
Really hope it goes better
than last time.
Yeah, me, too.
I will be there with you,
and so will
all those people
rooting for you there.
When it rains it pours, I'm yours ♪
And you're mine ♪
It's automatically sunshine ♪
It's better than being alone,
that's for sure.
All right. So you're ready?
All right. Count backwards from 100.
You're mine and I'm yours ♪
So who cares if when it rains,
it pours ♪
I'm yours, and you're mine ♪
It's automatically sunshine ♪
- 'Cause you're mine ♪
- Yeah, yeah ♪
And I'm yours ♪
So who cares if when it rains,
it pours ♪
- I'm yours and you're mine ♪
- Yeah, and you're mine ♪
It's automatically sunshine ♪
- Yeah, yeah ♪
- Sunshine ♪
- Ooh, baby, yeah, yeah, oh ♪
- Sunshine, sunshine. ♪
sync & corrections awaqeded
It's been a long road,
but I think we're there.
You have a viable embryo.
- Are you sure?
- I'm about as sure as I can be.
We've ruled out any major
chromosome abnormalities,
and the single-gene conditions
we can screen.
As long as the implantation
is successful,
you can have a viable pregnancy.
(EXHALES)
Wow.
That is, uh (SIGHS)
(CHUCKLES) Thank you.
(SIGHS) Thank you.
I need to call my husband
and tell him the good news.
- Of course.
- Thank you.
You're very welcome.
♪
INGRID: Huh. Identical twins.
Do you just do everything together?
- I applied here first.
- We have different specialties.
Something tells me
Dr. Watson's gonna have
a field day with you two.
Well, I'm not sure what that means,
but I'm hoping to utilize
Dr. Watson's work
on immune pathways
to fight infections.
SASHA: I was thinking
of something similar.
Are you an immunologist?
Me, too. And rheumatology.
I'm double boarded.
- I'm infectious disease, actually.
- SASHA: Oh.
Interesting.
Maybe we can work
on a project together.
Everybody says that Watson
is good and fair
Clearly into competition.
Should we make a bet
about who gets cut first?
Why would he hire all of us
just to turn around and cut one?
Oh, let me guess, family medicine?
Not far off.
Functional medicine.
Oh. (LAUGHS) Okay.
Let me help you understand.
Watson either has
one too few desks or
one too many fellows,
and he's had ample time
to get another desk.
SASHA: Or maybe
it's a hot desk situation.
So, you're a
"glass-half-full" type. Got it.
(CHUCKLES)
SHINWELL: Ready for
our first official day, guv?
WATSON: I am.
Just got to do
a little decorating first.
Holmes's violin.
Feels like he could just walk in,
play us a tune,
solve a mystery or two.
Yeah, I wish he could.
We'll just have to honor
his memory with our work.
Fellows here yet?
Down in the bullpen.
One concern. You asked me
to order four desks.
There are five fellows.
Hmm.
(LAUGHS)
Seems like this desk
has already been claimed.
PAOLA: It's mine.
Been here for a week,
working on our first case.
Thought I'd make myself at home.
I'm sure you four can make
the three other desks work.
You're the one who cuts, aren't you?
Paola Barajas. Surgical specialist.
Ingrid Derian, neurologist.
My bet is Miss Glass-Half-Full
is the first to go.
Nobody's going anywhere.
And don't underestimate me.
WATSON: Fellows.
Good morning.
Happy first day. Welcome.
Et cetera, et cetera.
Why don't we meet
in the conference room?
Kyren Garner. 16.
He has been my patient
since before his birth.
I worked with his parents
during my genetics fellowship
to help them conceive.
So what's his deal?
I just assume there must be
a rare genetic condition at play
if we're here discussing him
16 years later.
WATSON: That's correct,
Dr. Derian. You're half-right.
Kyren has VACTERL association.
VACTERL patients
have multiple anomalies.
The name is an acronym.
It's a disorder that really means
"a bunch of disorders."
Each letter stands for
a different body part
- that can be affected.
- SASHA: But it's not genetic.
There's no clear cause,
and since you can't test for it,
it's hard to diagnose prenatally.
Correct.
We knew Kyren had a VSD
from a sonogram.
So, you knew he had a heart condition,
but you need three of these anomalies
to be diagnosed with VACTERL.
It was at his birth that we learned
Kyren had two more:
a tracheoesophageal fistula and
a malformation of his lower GI tract.
That gives him VACTERL.
Poor kid.
That means he had several surgeries
soon after he was born.
Yes, he did.
Kyren learned to walk
in the PEDS ward,
after a G tube revision.
And then, he celebrated
his seventh birthday
here at UHOP once we
readmitted him for one
of his chronic UTIs.
He and his family
must've spent more nights
in the hospital than at home.
Well, it's just mostly he
and his mother now.
His medical needs were a lot
for his father.
Kyren has had over 12 surgeries
just to simply rebuild his body.
And even so, at 16,
he was accepted to Penn State
for robotics.
Though he had to defer.
But tomorrow,
I'll perform his final surgery
to fuse his spine and
correct his severe scoliosis.
WATSON: We'll get Kyren to college
sooner rather than later,
but I'd like you all to acquaint
yourselves with this case.
Dr. Barajas and I are gonna meet
with Kyren and his mother.
But they were my first patients
when I was a fellow.
Now, they're yours.
Sorry, Dr. Watson,
I couldn't help but notice
there are only four desks.
Hmm.
I'll have to look into that.
- MARLISE: Oh, thank you.
- WATSON: Mm-hmm.
Wow, this is definitely an improvement
over that tiny office I met you in.
(LAUGHS) Isn't it?
Yeah, you're really coming up
in the world.
They built this entire clinic for you?
Well, for the advancement of genetics
and the education
of a select group of fellows.
- Dr. Paola Barajas.
- Hi.
- I'll be doing Kyren's spinal fusion.
- Nice to meet you.
Yeah. You know, I'm gonna have
my own robotics clinic one day,
just like this.
Better than this, maybe.
Well, if anyone has the brains
and perseverance
to accomplish their dreams,
it's you, Kyren.
Yeah. Now I just need the body.
- Kyren.
- What?
Dr. Watson understands my need
for bodily improvement.
Our plan will do just that.
We'll use metal rods
to hold your spine straight
and bone grafts to fuse the vertebrae.
Once it's fused, your spine
will never curve again.
It's a very successful technique.
We do it all the time.
Really? And, uh, when do I get
to Penn State?
After about a year of P.T.
WATSON: Now, the recovery is intense,
but once you're through, I mean,
you'll be done with
all of the major issues
associated with VACTERL.
Right.
I don't know. Will I, though?
Kind of feels like I'll never
be done with this, Dr. Watson.
I know it feels that way, Kyren,
but you're almost there.
And I promise you, you will be done.
- Now, remember, I don't
- KYREN: Yeah, yeah, yeah.
You don't make promises
you can't keep. I know.
All done.
It's been a long road,
but it's official.
You're cleared for college.
(CHUCKLES) Oh, my gosh.
- Yes?
- Yes. Yes.
Finally. Wow.
Mom, orientation's next week.
We got to choose our teams
and get into our rover designs
for the challenge.
Now, make sure
that you stick to the diet
- that Dr. Croft designed for you.
- Yeah, yeah.
And don't be a stranger, okay?
- Yeah.
- (WATSON CHUCKLES)
Oh, man, it is so crazy to think
I'm not gonna be seeing you
in a couple weeks for a check-up.
Well, you're at the finish line
now, Kyren.
The most serious challenges
of the VACTERL are behind you.
Mm.
Thank you for everything you've done,
- Dr. Watson. Thank you.
- WATSON: Of course.
Come on, Mom, don't get mushy.
- You're gonna give him the ick.
- (LAUGHS) Sorry.
(CHUCKLES)
- (SNEEZES)
- Bless you.
Thank (SNEEZES)
- (SNEEZES)
- (BACK CRACKS)
- Ah. (PANTING)
- Kyren?
- Ah, my back.
- MARLISE: Kyren.
- Kyren, what's happening? What's happening?
- My back. My back, it hurts.
Shinwell!
(GROANING, PANTING)
What's wrong with his back?
KYREN: What's happening?
What's happening?
It looks like one of your rods broke
- and is tenting your skin.
- (KYREN CRIES OUT IN PAIN)
We need to get a gurney for Kyren.
Ask Dr. Morstan to meet us in the OR.
- On it.
- KYREN: Wait. Wait, wait,
wait, wait, wait, ortho
Kyren, we have to get you
to the OR before this rod
- breaks through your skin.
- KYREN: No, no, no.
I can't go through
another procedure. Okay?
Dang, you promised
this was the last surgery.
You promised.
(STAMMERS) You Dr. Watson,
you never break your promises.
You lied to me. (CRYING)
♪
(SIGHS)
(GRUNTS)
WATSON: Mary, what are you seeing?
MARY: No corrosion here, either.
Well, there's no
visible signs of infection,
but we've taken cultures.
Wait.
Kyren's spinal fusion
was two years ago,
when your clinic opened, right?
Yeah, that's right. Why?
MARY: Well, I mean,
it didn't show up on imaging,
but now that I'm in here,
I can see why his rod broke.
His bones didn't fuse.
Two years ago, we did a surgery
to fuse Kyren's spine, but
his bones didn't fuse,
which caused the rod to fracture
from too much tension.
Our job today is to figure out
why his surgery failed.
Infection is the obvious answer.
Cultures from the OR are pending,
but we do know that Kyren
didn't have any fever
or other symptoms
before his rod broke.
Could be hardware.
Maybe the screws or rods
were faulty in some way?
I can check for recalls.
Or Kyren could have
a metal hypersensitivity.
He could be rejecting the hardware.
Ingrid, Adam,
look into all the hardware.
He still has one rod
and all the screws in his back.
If there is a problem
If there's a problem, we need to know.
Sasha and Stephens,
look through all of his
medical records. See if there's
anything in his history
that we could've missed.
We're on it, but
Watson, are you okay?
I will be once we get answers.
I want updates in the morning.
Didn't Paola do his spinal fusion?
Wow. Paola.
I forgot we once were five.
Should we reach out to her?
Ask her about the case?
Maybe she has some insights.
INGRID: Why would we do that?
Her surgery failed.
If you need a refresher,
Watson fired her.
We don't know
if she was actually fired.
Watson never told us.
ADAM: Would he tell us?
I mean, he told us
about Ingrid, but
He never tried to replace Paola, so
Well, we've established
that's not Watson's strong suit.
SASHA: It's kind of wild,
all that's happened
since she was with us.
- KYREN: When did you know?
- MARLISE: Kyren, we didn't know.
KYREN: You had him do genetic testing.
I Dr. Watson. Thank God.
Kyren Kyren wants to know
when-when we knew.
Did you know how sick
I was gonna be
before I was born?
Did you tell my mom?
And she decided to have me anyway?
No. We couldn't know, Kyren.
She said you knew
about my heart condition.
- But, honey, it's not important.
- KYREN: Yes, it is.
It's my life.
You knew about how much pain
I was gonna go through,
and you decided to have me anyway.
Kyren, please don't talk like that.
I wouldn't trade you for anything.
- You know that.
- You need to tell me
exactly what you knew.
I deserve to know.
Kyren, when your mother
was five months pregnant,
she did an ultrasound.
Dr. Watson, I need your help.
My OB says there's a hole
in my baby's heart.
Yes, it's called a VSD.
It's the hole in the wall that divides
the lower chambers of his heart.
I don't understand.
Why didn't you say
Wh-Why didn't you tell me that
he would have a-a VSD before
But there's no way
we could've known that
from the genetic screening.
And sometimes, VSDs, they just,
- they just go away on their own.
- Okay, well, what if it doesn't?
There are a lot of good
treatment options if it doesn't.
Okay, well,
that's encouraging. (SIGHS)
My husband and I, we just
made partner at our law firms.
We want a child, but he's afraid
of having a sick child.
Do you see anything else
on the sonogram?
No. I don't see
anything else concerning.
What if I
if I terminated?
Would I still be able
to have another baby?
With an egg donor or maybe adoption.
I'm sorry, but your body's
no longer producing eggs, so
we can't make more embryos.
(SIGHS)
I had eight miscarriages
before I even met you, and
I was afraid the universe
was telling me
I wasn't meant to be a mother,
and then I-I got pregnant.
With my son, and-and now
Marlise, I can see that
you already love your son.
- I can see it.
- Yeah.
Whatever challenges
life throws at you,
you will face them,
and I'm gonna help you. I promise.
Okay?
(SIGHS)
Okay.
KYREN: So you didn't tell her
it could be VACTERL?
No, we didn't know for sure.
Not until you were born.
And then, once we did,
I put together the best possible care.
But you wouldn't have
had to do all that
if I wasn't here in the first place.
She could've saved me
from a lifetime of pain.
My dad wouldn't've left.
(CRYING): Kyren, I'm sorry.
No, I'm sorry.
I'm sorry you didn't get a choice.
'Cause if you knew everything
that would happen
all this pain
maybe
you would've made
a different decision.
I know I would've.
(EXHALES)
(SNIFFLES)
I've never seen him so disheartened.
Even even on his worst days,
he hasn't talked about wishing
he hadn't been born.
He's processing. It's
It's the first time
he's learned something new,
and he's just taking it in.
We've always known
what the next treatment was.
This is the first time
we didn't have a plan.
I-I'm scared it's more than that.
He didn't think we knew anything.
The fact that we did
And now, this is his life, he
he's mad.
And he
and he's hurt.
I mean, I don't blame him.
Honestly, I blame you.
Thank you.
Where are we with Kyren?
Uh, Adam's not here yet.
Then we're gonna proceed without him.
Kyren is okay physically,
but emotionally,
he's struggling.
We need to present him
with a plan as soon as possible.
The cultures Dr. Morstan took
came back negative,
as did his metal allergy test.
He doesn't have an infection
or metal hypersensitivity.
I looked over the OR notes.
There were no obvious concerns
reported during surgery.
INGRID: I checked with
the hardware manufacturers.
No reported issues
with the screws or rods.
(SIGHS) Okay, okay.
So who has any suggestions
about what we should do next?
- Nothing? Nobody?
- Uh
Okay, this is unacceptable.
Okay? You guys aren't
new fellows anymore.
You need to be searching
for possibilities always,
not waiting for me to ask.
Now, one of you two, you guys
- call Paola Barajas in
- WOMAN: Excuse me?
- Are you Dr. John Watson?
- WATSON: Yes.
Yes, I am.
You've been served.
For what?
The wrongful life of Kyren Garner.
The wrongful life?
What the hell does that even mean?
Kyren said he shouldn't be here.
He's suing me because he thinks
he never should've been born.
"Wrongful life." Sounds wrong.
It is wrong.
I can be iffy on existence as a whole,
but even I don't think
that life is wrongful.
- (SCOFFS)
- INGRID: There are a few people
whose lives I think might be wrongful.
But that's not
what this case is about.
(PHONE CHIMES)
It's Lauren.
She says these cases are rare.
Many states don't allow them.
The child has to prove their parents
would've terminated the pregnancy
if the doctor had given them
all of the information.
So, what the suit
is basically saying is that,
if Marlise knew that VACTERL
was a possibility,
she would've terminated the pregnancy.
And by extension, that Kyren
wishes that were the case.
Kyren is angry and in pain.
Seems like he's just lashing out.
Or he truly wishes he didn't exist.
But Kyren does exist.
I don't understand
how a court can debate
whether that
should've happened or not.
- Or pay out money for what?
- (PHONE WHOOSHES)
The curse of being alive?
Lauren says if Kyren wins,
"The damages amount
is based on an aggregate
of their medical expenses
over his lifetime."
My God.
Kyren's had so much medical care,
that must be tens
of millions of dollars.
His story is heartbreaking.
I don't know if any jury
would side against him.
What will this mean for Watson?
- For the clinic?
- (DOOR OPENS)
(INDISTINCT CONVERSATION)
- How is he?
- SHINWELL: Well, you know,
just as you'd expect if one
of your closest patients
decides to sue ya.
Dr. Morstan's up there
trying to talk him down.
How can we help?
(SIGHS)
Focus on your work.
Watson's worried that
we might've disappointed a patient.
Last thing he wants is
for us to disappoint any more.
WATSON: How can Kyren
believe he shouldn't exist?
We shouldn't even be
entertaining this lawsuit
because he does exist.
"Entertain"? That's not up to us.
A lawsuit like this is serious.
We definitely need to end this
before it turns into clickbait
and damages your reputation.
I'm not worried about clickbait
or my reputation.
But the board is.
They're not exactly happy about this,
especially given everything
with Mycroft Holmes.
This must be putting
a lot of pressure on you,
and I'm sorry for that.
Okay? But we shouldn't be
talking about a lawsuit.
With a failed fusion,
it's just a matter of time
- before the second rod breaks.
- John
What we need to do
is figure out what went wrong
- and fix it.
- Actually, we don't.
After he served you,
Kyren transferred hospitals.
- What?
- He's not your patient anymore.
(SIGHS)
(INDISTINCT CHATTER)
SHINWELL: They took
him ten minutes ago, guv.
I did think about
blocking the door, but
Mary told you that Kyren was
transferring before she told me?
Not one to rat on the boss, guv.
Oh, so you work for Mary now?
Ooh.
Technically speaking, we all
work for Dr. Morstan, guv.
Yeah, that's very true.
I guess blocking the door
certainly wouldn't have helped
the lawsuit.
No.
So how was he? How was Kyren?
He was okay.
Hurting, but okay.
We're talking about
settling the lawsuit.
That might be a way to convince
him to come back to UHOP.
And how do you feel about that, guv?
All I want is what's best for Kyren.
And if
if he needs this, then
Look, guv, if there's
one thing I know about you,
it's that you're always gonna
put your patient first.
That's all you're doing.
Appreciate you.
SASHA: Seems like Paola's
doing some cutting-edge work.
Using 3D printing
to customize components
for joint replacements.
I think it's worth
having a conversation
to see if any of it
can help Kyren, but
- she hasn't returned my call.
- INGRID: You were calling her
when we thought she was
the reason the bone didn't fuse.
Let me reach out to her.
Really? From what I recall,
the two of you
weren't exactly friendly.
Which is why I'm sure
she won't be able to refuse
surgeon-splaining all her
fancy tech and gadgets to me.
Why would you volunteer for that?
For Kyren.
Okay, look, I know
you're in therapy now
and have changed
some of your ways, but
there's something
you're not telling me.
I just know I probably owe her
an apology, okay?
What'd you do?
(PHONE CHIMES)
- Saved by the ding.
- Mm.
- Convenient.
- Made contact.
She can meet in the morning.
I'll let you know how it goes.
MORGAN: The, uh, board
wanted me to remind you,
no surprises in there.
WATSON: Understood.
I'll stick to the script.
This is serious, Dr. Watson.
If we don't play our cards right
We've got it, Charles. Thanks.
This'll all be over soon.
TANNERMAN: We appreciate you
all moving to a settlement so quickly.
MORGAN: Well, Dr. Watson
and UHOP care about Kyren,
and want the outcome that best
sets him up for success.
- (GRUNTS)
- WATSON: Kyren.
Are you all right?
- You look flushed.
- John
No, it's okay.
Old habits, right?
H-He's fine, Dr. Watson.
Kyren just had a minor UTI,
but he's taking antibiotics.
We caught it early.
Apologies. Before we move further,
we have one addition
to the settlement.
And what is it, Ms. Tannerman?
My client would like an apology
from Dr. Watson.
The excruciating pain my client
has felt his entire life
could have been avoided
if Dr. Watson had given
Marlise all of the information
when she brought him
the sonogram 18 years ago.
Okay, I'm sorry. So
you want me to apologize
for Kyren's existence?
I (STAMMERS)
Kyren, is that what you really want?
Yes.
(COUGHS)
That's what I want.
How long have you been on antibiotics?
See, I told you
he would never apologize.
No, it's not about that, Kyren.
You are sick.
- John.
- Is this some kind of stunt?
I've been working hard
to try to figure out
why your bones didn't fuse.
Now-now, just right now,
I got the clue that I needed
to understand what's going on.
Dr. Watson, I advise
against you getting involved.
Wait, what is it?
What's wrong with Kyren?
- I believe he has an infection
- KYREN: Stop!
Just stop.
Anything that's wrong with me
is your fault.
You made me.
And you let me live just to
be in hospitals like some freak.
Kyren, please, let me treat you.
- Okay?
- KYREN: Treat me?
Why?
I'm not even supposed to be alive.
- Oh, God.
- WATSON: Whoa, whoa.
Kyren. Kyren.
Call-call an ambulance, Georgia.
Please, help him.
Dr. Watson, please help my son.
Mary, let us take him to UHOP.
He should be with us.
This lawsuit isn't settled.
You shouldn't get involved.
Please, Dr. Morstan.
The board won't be happy.
Then let them take that up with me.
Marlise gives permission,
so UHOP will treat Kyren.
Put this under.
- Stay with us. Stay with us.
- MARLISE: It's okay.
WATSON: Just stay with us.
You're gonna be okay. Stay with us.
MARY: There.
(CHUCKLES) You were right.
I don't know how you knew
the infection was deep
in his spine. The initial
wound cultures were negative.
Well, Kyren had a fever,
and the new doctors assumed
that it was a UTI, and that tracks,
but the antibiotics weren't working,
so it had to be something else.
An occult spinal infection.
Explains everything.
Why his bones didn't fuse.
WATSON: And there it is.
So now, we have a plan.
We remove the infection
We do, but (SIGHS)
- it's tough, John.
- Kyren can do tough.
To treat the infection,
I'll need to remove
the remaining rod
and all of his hardware.
He'll be hospitalized for IV
until we can perform
the revision surgery.
Is Kyren prepared for that?
No, he's too sick
to make that decision.
Then we'll need Marlise to sign
a consent on his behalf.
We don't need this
to complicate the lawsuit.
Mary, thank you for letting
Kyren come back to UHOP.
I'm sure the board wasn't too happy.
Oh, they weren't.
And you're welcome.
(SIGHS)
INGRID: Nice write-up
in the Beechview journal.
PAOLA: Well, you know how it is.
Those publicity things are silly, but
they're fun to send home
to the parents.
So what are you working on right now?
Do you remember Kyren Garner?
The first patient we had
at the Holmes Clinic?
Of course. How's he doing
with his new spine?
Actually, his spine didn't fuse.
I know Sasha tried
to reach out to you.
I've been busy.
Why are we here?
I've been looking into the best
redo surgeries for Kyren.
I thought his anatomy might benefit
from the precision cages.
Can I see his chart and labs?
I think he's an ideal candidate.
Have him transfer to Beechview,
and my team will take the case.
I know it's important for Watson
that he stay at UHOP.
Dr. Morstan taking the lead
in the surgery.
Would you consider a collaboration?
You're different now.
I can't imagine the Ingrid I knew
asking me if I would consider
collaborating.
You're right. I wouldn't have.
(CHUCKLES) Paola
I'm the one who reached out
to Beechview about you.
What do you mean?
It was the desk.
I was pissed about you
claiming the desk I wanted,
so I sent Beechview your résumé.
I wanted you gone.
Sorry.
Let me get this straight.
You were pissed,
so you told a rival hospital
I'd be a great fit for their
new, state-of-the-art lab?
I just wanted you gone.
I didn't want patients
not to have you as a surgeon,
just somewhere else.
Somewhere not at that desk.
I can't tell if that makes me
like you more or less.
Have Dr. Morstan reach out to me
if she wants to move forward.
(SIGHS HEAVILY)
(DOOR OPENS)
Morning.
How's Kyren?
Okay.
CT scan went well.
Watson was able
to figure out what's wrong.
That's good.
- I'm just glad that he's back here at UHOP.
- Mm-hmm.
I'm not sure Watson
could handle knowing
he was in trouble somewhere else.
Hey. What's going on?
That kid's gonna wake up to learn
that he's stuck at UHOP for months.
He was already struggling.
I don't know how this
won't devastate him.
But then he'll get better.
Watson is dedicated to coming up
with the best plan for him.
I know, but
A plan doesn't really make up
for what Kyren's losing.
It doesn't really acknowledge it.
I don't know. It just feels like
he needs something more.
Like what?
(SHINWELL CLEARS THROAT)
Sorry, uh
Dr. Morstan has something
she wants to show yinz guys.
WATSON: During the washout,
Dr. Morstan took measurements
and combined them with Kyren's scans
to create this virtual replica
of his spine.
MARY: You can see
here, a hemivertebra at T8
and cleft through T9.
A malformation like that
could also contribute
to why the fusion didn't take.
- That, plus an occult infection.
- WATSON: Exactly.
It's a perfect storm. So,
how do we make sure his bones
fuse this time?
This might potentially be
a good time to mention
that I met with Paola Barajas.
She finally got back to someone?
She did. Looks like
some of the innovations
she's been working on at
the Beechview Medical Institute
can help Kyren.
It was a shame to lose Paola,
but I knew she would be
a better fit at Beechview.
So you didn't fire her?
On the contrary, I asked her to stay.
Whoa. Interesting.
Well, looks like Paola's
doing quite well where she is.
She suggests we use a custom cage
printed to Kyren's specifications.
That would make sense.
Something tailor-made
would prevent infection
and increase his chances
of a successful fusion.
She also said she may be
willing to collaborate.
That would be great.
I'll reach out to her and see
if we can put together
a specific surgical plan.
We could share the broad strokes
with Kyren and Marlise.
Yeah. I mean, let's do it.
I'm sure they could use
some good news.
KYREN: Good news?
How is removing every rod
and every screw good news?
I know it sounds daunting, Kyren,
but this is the best way
to treat the infection
that prevented your bones from fusing.
So
I have the pleasure
of lying down on my back for
who knows how long?
We'll give you IV antibiotics
for a month.
Once we're certain it's gone,
we can prepare
for your revision surgery.
A month?
So, I'm just as bad off
as when my back was deformed.
Worse off, actually.
Because back then,
I was gonna go to school.
I was gonna start my life.
Well, I guess,
I'm realizing
that's never gonna happen now.
I'm sure you can defer, Kyren.
Again?
What's the point in deferring
if a new problem's just gonna
pop up every time I get close?
Because there's no reason to believe
that something like this
is gonna happen again.
KYREN: Oh, you haven't heard?
I have a one in a million association.
Had to be rebuilt
starting an hour after birth.
And then my back broke because of some
occult infection that hid from even
"the world's greatest diagnostician"
for years.
You're a fighter, Kyren.
What don't you understand, Doctor?
Fighting is useless.
Something is always gonna come up.
Kyren, we are on the verge
of having a plan
to rebuild your spine
so something like that
will never happen again.
You can't quit on us now.
I'm not quitting on you.
I'm firing you.
Kyren, that is no way
to talk to the man
who is trying to save your life.
I didn't ask him to. You did.
I sued him
because I realized something
you could never accept.
My life is not worth saving.
Just leave.
Okay?
Get out of here, all of you.
I said everybody.
(SNIFFLES)
(GROANS)
WATSON: Yes?
Do you have a moment?
I just need to finish reviewing
these titanium cages.
- For Kyren?
- Mm-hmm.
I was under the impression
that he's no longer our patient.
Which is exactly why
I have to present him
with a flawless plan.
I see.
Actually, I don't see.
With all due respect, Watson,
I think your judgement is compromised.
I'm listening.
Well, that's the thing.
I don't think you are listening.
To Kyren, which is unlike you.
And it makes me wonder if
the personal nature of this case and
your connection to the patient
is clouding your judgement.
And how is my judgement being clouded?
You keep focusing on
alternative treatment plans,
pitching solutions.
Kyren doesn't believe
his life is worth fighting for.
Okay? Now, it's my job
to convince him otherwise.
No, it's not.
I'm sorry,
but I can speak with confidence
that reassurances and promises
don't always help.
In fact, those words,
as well-intentioned as they may be,
often represent
their own kind of pressure.
And added up, it can be another burden
on someone who's already struggling.
I hear your diagnosis, Dr. Croft.
What's your recommendation?
Empathy.
Compassion. Truly listening.
Making sure the patient knows
he's not alone.
That's my recommendation.
(DOOR OPENS)
(DOOR CLOSES)
PAOLA: Wait, I have
to ask. Where's Clyde?
I expected to see him
zipping around back there.
It's a long story.
You were saying, Dr. Morstan?
(SIGHS) The lower model,
it's too loose.
There's a millimeter gap
at the posterior wall.
Yeah, I see that.
It's collapsing from the deformity.
Is there any way we could model it
from the healthy vertebrae above it?
That's a great idea.
We could match the curvature.
But what if it's still
not quite right?
It's titanium. There's
no adjustments in the OR.
Well, actually, with 3D printing,
I could model a flexible lattice.
Build it with just enough give
for alignment.
That is ideal.
Amazing what you all can do
with this new tech.
Well, not to be a jerk,
Dr. Morstan, but (SIGHS)
you're an orthopedic surgeon
and the director of the hospital.
I'm a little surprised UHOP
doesn't have a more robust
ortho program.
You know, you might be
on to something.
I'm late for a meeting.
You two wrap up here,
and, Sasha, you can fill me in.
- Are you enjoying your fellowship?
- SASHA: Honestly?
More than I hoped I would.
It's been life-changing.
Life-changing?
(SCOFFS) I'd expect you
to use a word like that
to describe your wedding to?
Oh, you mean Zach.
I actually ended it
with him a while ago.
- Oh
- And, uh,
I'm dating Stephens now.
Stephens?
(LAUGHS)
Now, that's the bet
I should've made with Ingrid.
(CHUCKLES) Speaking of Ingrid,
she apologizes now?
Apparently, she does, and sometimes,
she even means it.
I told you to go away.
You're still fired.
I'm not here as your doctor.
I'm here as someone
who's known you for 18 years.
As a
I don't know. A friend?
I'd never call you a friend.
That's fair.
I haven't always acted like one.
A friend would've
listened to you, Kyren.
All these years,
you've been trying to tell me
how much pain you were in,
how hard life was for you.
Yeah.
And you wanted me to fight,
be positive.
Kyren, I
I thought that I was helping you
when I came at you with
all those plans and promises.
I realize now that that was
that was wrong.
And I'm truly sorry for that.
Life is hard for everybody.
But your life?
It's a whole nother level.
I see that.
I see you.
I wanted to make it different, Kyren.
I wanted to make it better.
Sometimes, medicine fails.
I'm sorry for that.
But I'm not sorry that you exist.
No matter what you do.
No matter what you think of me.
I'm sorry for what I did.
But I'm glad you're here.
MARY: The settlement is in.
The lawyers negotiated and all
of this explains where we got.
Kyren said you satisfied
the apology requirement.
Everybody's good with this number?
It's toward the further reaches
of what they think
a jury might've awarded,
but spares us court expenses
and potential negative press.
Well, at least Kyren and Marlise
have a financial safety net,
no matter what happens next, so
But you're good with this, too?
It's not ruining UHOP
or anything, is it?
I'm good with it.
All right. Where do I sign?
What are you doing in scrubs?
Uh, Kyren asked me
to be in the OR with him.
Mm. I'm glad the two of you made up.
It's better for the both of you.
It was your surgical plan
that sealed the deal.
Thank you for taking so much
interest in him and this case.
(SIGHS) I got to say,
I find what we're about to do
with the 3D cages fascinating.
It's a shame we had to go to
Beechview Medical Institute
to get them.
We should be working with
that kind of tech here at UHOP.
I agree, but why aren't we?
I asked myself the same question
and got started on an answer.
An ortho 3D printing program
is starting right here,
- under this roof.
- Mm-hmm.
What?
Well, during residency,
you chose ortho
because it exists in the space
between tradition and innovation.
The traditional piece
keeps patients safe.
BOTH: But the innovation
comes with such potential.
Mm-hmm. Yeah, I remember.
Yeah, you invested so much time in me
and in the Holmes Clinic.
Maybe it's time we return the favor.
How about a collaboration
on the cutting edge of orthopedics?
- Mm. An intriguing idea.
- Mm-hmm.
But I know you just want access
to my new tech lab.
Maybe.
(BOTH LAUGH)
(SIGHS) See you out there.
I'll see you out there.
("AUTOMATICALLY SUNSHINE"
BY THE SUPREMES PLAYING)
All right. How you doing? You nervous?
Always a little nervous
before surgery.
I get it.
Thanks for being here.
I told you I'd be here for you.
Really hope it goes better
than last time.
Yeah, me, too.
I will be there with you,
and so will
all those people
rooting for you there.
When it rains it pours, I'm yours ♪
And you're mine ♪
It's automatically sunshine ♪
It's better than being alone,
that's for sure.
All right. So you're ready?
All right. Count backwards from 100.
You're mine and I'm yours ♪
So who cares if when it rains,
it pours ♪
I'm yours, and you're mine ♪
It's automatically sunshine ♪
- 'Cause you're mine ♪
- Yeah, yeah ♪
And I'm yours ♪
So who cares if when it rains,
it pours ♪
- I'm yours and you're mine ♪
- Yeah, and you're mine ♪
It's automatically sunshine ♪
- Yeah, yeah ♪
- Sunshine ♪
- Ooh, baby, yeah, yeah, oh ♪
- Sunshine, sunshine. ♪
sync & corrections awaqeded