A Gifted Man s01e06 Episode Script

In Case of Memory Loss

Yeah, just pick up! You're slacking on me! Pick it up! You're slacking off on me.
Yeah! There you go! Nice! What happened? You all right? I can't I can't catch my breath.
I can't catch my breath.
Put your hands behind your head.
That'll open up your chest to let more air in.
It's like when I was a kid, you know? Asthma.
It felt like that It's weird, you know? Anybody got an inhaler? No, no, no, no.
No, it's okay.
I'm okay.
I'm okay.
- No, it's fine.
Let's finish.
- No, George, you aren't listening.
You were off your game last week, too.
All right? That's not like you.
Yeah, see? That's what I was saying before Why don't you come with me to the clinic and get checked out? I thought you were a brain surgeon.
What are you talking about? I work part-time at a clinic.
- It's a long story.
It's not far from here.
- No, no.
I hate doctors.
No offense.
George, I'm not gonna perform a craniotomy on you We don't have insurance, soan't do it.
It's a free clinic.
George Any other excuses? Here, where it says "sex" the correct answer is either "male" or "female.
" Not "yes" with an exclamation point.
Holt! First official day at work, and you're already doing patient outreach.
This is George.
Sudden shortness of breath playing soccer.
With retractions.
He's stable now.
Possible recurrence of childhood asthma.
Is room three open? Yeah, here Just sign this for me? - I'm fine, really.
- I'll take you back.
I'm sure you are.
Just humor me.
You can actually see the patient in exam one.
Seems like your kind of head case.
Thank you.
Homeless male, 40s, staggering.
Seemed pretty drunk.
And, uh, I don't know how they let you dress at the other joint, but we have standards.
You can get scrubs out of my office.
Did you start him on a banana bag? Yeah, he sobered up a little, but he still seems pretty out of it.
George, why don't you have a seat right there? You know, it could be a bad urinary tract infection making him altered.
Pretty unusual for a man in his 40s.
No, we see it in street people all the time dehydration, poor hygiene, prone to infection.
Anyway, have him pee in a cup and tell you who's President.
Just so you know George hates doctors.
Maybe it's you.
Holt a good soccer player? He's kind of show-off-y, but yeah.
I'm hearing congestion but no wheezing.
I don't think it's asthma.
You could have an upper respiratory infection.
Well, I've had this sinus thing.
Probably got it on a plane.
When you fly a lot, you're breathing in people's germs all the time.
Where you been flying to so much? Mumbai, once every couple months.
Jet lag bug you? Makes me nutty.
I never sleep great, anyway.
India, huh? For fun or for profit? My uncle, he has a store on 28th and Lex.
I actually started out as a stock boy.
Now I'm one of his buyers.
Here you go.
It's okay.
All right.
Has that been happening a lot? No.
George, I'm going to, uh, I'm gonna run some tests on you, all right? Let's just see what's kicking around in that chest of yours.
You know, I'm actually feeling better.
Don't sweat it.
It'll be quick and, I promise, relatively painless.
You gotta sit still for me.
You gotta sit still.
Get this out of me.
No Where's the bus? What? No.
You need to keep this in, okay? This is saline and vitamins.
I'm going to examine you to see if you got a head injury.
Get off! If I'm late! Nope There's no bus, okay? This is a clinic.
Leave me! Sounds like you could use some help? Just get me ten milligrams of Haloperidol and a mop.
Sir I can't help you if you don't let me examine you.
Now get back on the table.
Help me with my shirt.
I don't know how.
All right, but then you gotta let me put that I.
back in.
Got the Haloperidol.
Thank you.
All right, hang on.
That's my work.
How can you tell? Exactly, uh, one and a quarter inches, no stitch marks and a perfect line.
Hey Donnie? Are you Donnie Bremmer? Help me with my buttons.
Why do I know that name? Uh, he's a football player.
Right, right he cracked his back.
They said he'd never play again.
Yeah, until I operated on him.
Donnie Donnie, it's Dr.
You fractured your spine.
I fixed it.
You remember me? Dr.
Holt? Yeah.
You recognize me? I know you.
Who am I? You know, craziest thing about that guy you asked me to see, turns out Your friend George split.
Been running this place for a week, patients already jumping ship.
Maybe you should have let me treat him.
He was coughing up blood, in pulmonary distress.
He's been traveling back and forth to Mumbai.
They're lousy with TB there.
You think he's got tuberculosis? Why'd you let him leave? Oh, well, because I left my handcuffs at home this morning.
What do you mean, why did I let him leave? I went to the supply closet to get a PPD, came back to the room, he was gone.
If he's got tuberculosis, then everybody close to him is at risk his wife, his coworkers, all the passengers on those flights Yeah, the Health Department's gonna want to know about this.
Well, you can't do a skin test if he's gone.
Lesson number one for the day: You work in family medicine, you look for other options.
Chest X-ray that one's out, too.
There's a new test: Quantiferon TB Gold.
Uses blood and you get the results within 24 hours.
Never heard of it.
Well, you better brush up.
You gonna use that? Yeah.
I have a friend who works at a lab on 14th Street.
Said they'd do tests for the clinic.
Pro bono, in case of an emergency, and I think staving off an outbreak of tuberculosis counts.
You sure? I have consent.
The release George signed said we can run tests at our discretion.
In my little game of rock, scissors, paper paper wins.
Fair enough.
Call me when you hear.
What is this, a drive-by? You're leaving already? I'll make it up to you.
I gotta take the guy in room one over to Holt.
Why? He's an old patient of mine.
Rita Before you say anything Donnie Bremmer! My goodness, it's it's so nice to see you again.
Donnie came into the clinic today, but I thought he could use a little Holt TLC.
I'll get a wheelchair.
Donnie I still have that picture you signed for me.
Making that interception at the playoffs 2003.
It's hanging in our den, right next to the TV.
Let's book Donnie for an MRI, right away.
Here, sit down, pal.
And, uh, call Flores for a psych consult.
Donnie, I'm going to take excellent care of you.
Just like before.
By the way, those scrubs don't do your butt any favors.
You gotta be kidding me the Donnie Bremmer? Mm-hmm.
I shouldn't be shocked.
His post-football life was a disaster.
Bankruptcy, divorce, booze It doesn't make sense that he'd end up on the street.
I've seen it over and over again.
Fans stop screaming, the money dries up guys lose their identities; they can't cope.
Maybe he'd be better off if I hadn't gotten him back on the field for that last season.
I mean, that's when he went off the rails.
Probably thought he was invincible.
You think he's got alcoholic dementia? He's severely ataxic.
Lost in a fog.
Could also be a stroke or a cerebellar tumor.
Okay Sure this is Donnie's film? Yes, Dr.
I just did the study.
It looks completely clear.
No brain atrophy; no demyelination.
I was hoping for a tumor.
Something nice and benign.
Slice it out, couple weeks of rest, he's good as new.
I'm sorry since when a normal MRI bad news? When it's someone who's spent his entire career taking hits to the head.
Donnie's got CTE.
Every time a running back broke through the line Bam! And every receiver that came across the middle bam! Every time he got a concussion and went back into the game, that cost him.
His memory, his personality Damn it.
What did the tests show? Nothing.
Donnie's got Chronic Traumatic Encephalopathy, which is a kind of I know what it is.
I read Sports Illustrated.
Are you sure it's not something else? He ruled out every other possibility.
The only way to confirm CTE is through an autopsy.
The damage done to his brain cells can only be seen under a microscope, but There's no cure for this, is there? Scour the literature, contact every institution doing research.
Find me a way to help him.
Hey, Kate, what is it? Yes or no? George does not have TB.
So, no, we don't have to worry about him infecting an entire city.
Just why he's coughing up blood.
What else do we know about him? Besides the fact that people in white coats send him into a frenzy.
Not a lot.
Decent guy.
Nice wife.
Good job.
Could he be using drugs? I mean, he didn't want me to run any tests.
Are you there? Did we get cut off? Uh you know what? I'm gonna go talk to him.
See if I can get him to come in for more tests.
Hey, George.
Hey, what's up, Doc? You ever get sick of hearing that? Lift with the legs.
Yeah, the legs are still a little wonky from the game - this morning.
- Yeah.
Looks like you're having a little trouble with the arms, too.
So talk to me.
Why'd you leave the clinic? Oh.
Uh, tell that lady doctor I'm sorry.
You know, I just don't like people poking around at me, that's all.
Well, people who avoid doctors are usually the ones afraid of being sick.
Oh, yeah? Well, that's not me.
Even with a history of drug use? Where'd you hear that? More than once I've heard you say, "Soccer is my high now.
" That was just talk, man.
I bet if I took a good look at that tattoo I'd see it covering up track marks.
Listen to me.
I know you don't think you have any use for doctors, but we're pretty observant.
- You tell anybody and I will hurt you.
- Oh, okay.
- Okay? If Maria ever finds out, I swear - Calm down.
I got better things to do with my time then to go around gossiping about you.
But with your symptoms, and history of drug use, I gotta ask, have you ever been tested for HIV? Right when I got clean.
What about since then? It could have been too soon for the virus to show up.
- What, you think I'd expose my wife? - Not intentionally.
But your cough could be pneumocystis pneumonia, and if you have that, you need antibiotics.
And if yo're HIV-positive, you'd better get started on the antiretrovirals right away.
Man, you're way off, all right? Just get lost! Just listen to me.
Come back to the clinic with me, especially if you're worried about Maria.
you'll have your answer, one way or the other.
- You don't tell me what to do, okay? - Don't be stupid! I said leave.
****, you here, off the clock? Does your friend's lab still have George's blood? How come? I want to run an HIV test.
TB test made me think compromised immune system, plus his coughing up blood, and I saw muscle weakness in his arms and legs.
Well, he did mention he was having trouble sleeping.
Night sweats, maybe? Why didn't he, uh, come back in with you? Because he's an ass.
Does George want this test? Michael, did he give you permission to run the test? What happened to Miss We-Do-What-We-Have-To? It's Dr.
We-Do-What-We-Have-To, and this is a little more sensitive, don't you think? We need to run his blood for HIV.
You went in there and scared the crap out of him, didn't you? That's not how we do things in family medicine.
Call the lab.
You call the lab.
Give me the number.
I don't like this.
Then fire me.
My son always says that playing high school football is what got him prepared for the Army.
He was already shipped out to Iraq for his first tour the last time you were here.
As a matter of fact, that season, 2006, when you went back after Dr.
Holt operated on you? My husband and I would watch the games every Sunday.
And Lenny Jr.
, he watched from over there at the same time.
Felt like we were together as a family.
Just for a little bit.
So I thank you for that, Donnie.
I'm glad he can't see me now.
I destroyed everything.
You were sick.
Your brain was sick.
You didn't know.
What are you doing out here? Waiting for you.
I thought maybe you ran away and joined the circus.
Donnie's finally sleeping.
Trying to locate any relatives that might take him in.
His wife divorced him years ago, no kids.
Well, if you can't find anybody, just start calling nursing homes.
Oh, I'm sure all the nursing homes in the Tri-State area are just waiting for the next 200-pound, strapping 40-year-old to stop by.
They're not going to be able to deal with someone with his size and strength.
I'll find somebody.
What's on the schedule? Uh, Dr.
Salinger called.
Liz have an ortho consult for me? No, it's her daughter, Chloe.
She found her passed out in the bathroom this morning.
Is Liz here with her? She wanted to be, but she had an emergency surgery.
Uh Chloe is waiting in room one.
All right.
So your mom said she found you unconscious this morning.
For, like, two seconds.
Yeah? So tell me what happened.
I hit my head on the stupid medicine cabinet mirror.
How'd you do that? Opened the door, forgot to close it, bent down, stood up.
Well, you're lucky you didn't crack your head open.
Yep, that's me.
Any dizziness or nausea? No.
What is that? - Paint? - I don't I don't know.
I don't know, nothing.
Have you had any other symptoms before today? Headaches, neck pain? I haven't been feeling anything.
Well, tell you what, since you did lose consciousness, even if just for two seconds, I'd like to run a CT scan.
One of my nurses will set you up.
Hey, Donnie, how you feeling? The the, the shower was good.
You want us to get that hat clean for you? I don't know.
It's good.
I'd like to talk to you about what you have.
It's called Chronic Traumatic Encephalopathy.
Billy Nap, Napolitano.
They played together three seasons.
He, he had it.
I visited him.
He couldn't do nothing.
He died two years ago.
Well, CTE is a result of injuries to your head.
I want to electrically stimulate your brain, see if I can wake it up again.
I've never done this surgery on somebody with CTE before, but I am game if you are.
Think of this operation as a Hail Mary Pass.
You guys won your second championship off of one of those.
Oh This was taken right afterwards.
All right.
Hey, book the OR for this afternoon.
Call Victor Lantz.
Will do.
Don't screw it up.
Any word from Kate at the clinic? We're waiting on an HIV test.
I'll check on it.
Michael! I was finishing up a bone graft, sorry it took me so long to get here.
Do you have her results yet? Chloe's in the CT right now.
I hope we can chalk this up to my daughter just being a klutz.
Liz, is there any reason Chloe would want to hurt herself? Why? What color is the paint in her bathroom? Pale yellow.
I don't think Chloe accidentally bumped her head against the medicine cabinet.
Let me pull her up.
I think she banged her head against the wall on purpose.
Hard enough to knock herself out.
She's self-injuring, Liz.
I thought we were getting past it.
"It"? Five months ago, Chloe and her best friend Lauren, they were coming into the city, to see Wicked.
Lauren drove.
And I guess they didn't want to spend money parking in a lot, they parked far away, past Tenth Avenue.
They were coming back from the show, to the car, and, uh a son-of-a-bitch with a gun Lauren was looking in her bag for her keys, and of course she would have given him her keys, but she couldn't find them fast enough.
He shot her.
In front of Chloe.
My daughter watched her best friend die.
I'm sorry.
We tried a therapist, but after two sessions she refused to go back.
But I I hear her thrashing around at night.
She has she has terrible dreams.
And now this.
Can you help her? I'm not sure what I can do for her.
I I'm a neurosurgeon.
Michael, please, think of something.
Now Chloe's behavior makes sense.
She was trying to replace her emotional pain with a physical one by banging her head.
Well, CT's fine, so that's good.
So, short of a time machine, what do we have in our arsenal for her? Therapy.
They tried, and she bailed.
Not going to do a lot of good staring at your for What about Propranolol? - It's a blood pressure medication.
- They're using it for PTSD.
How's it administered? and after it's in the patient's system, they're asked to recall the traumatic event in specific detail.
It prevents the adrenaline from surging when the patient remembers what happened.
So in essence, we're training the brain not to react so viscerally.
The memory becomes less painful.
All right.
This could work.
You had no right to tell him.
Go get your own story to tell people.
You keep saying you're fine.
Why did you slam your head against a wall? For fun.
I'm sorry about what happened to your friend.
And to you.
Yeah, it sucked.
And if you're planning on keeping me locked in here until I talk to another shrink and-and get all boo-hoo-hoo about Lauren, you can forget it.
There is a medication that might make the memory less painful.
It's a beta blocker.
You'd only have to take it a few times.
Is it safe? Yeah, very few side effects.
Patients have been taking it in much larger doses for years for high blood pressure.
When can she start? No.
Why not? It's my brain! It's my memory! I found you, unconscious, on the bathroom floor.
How am I going to find you the next time? I'm not doing it.
This can help you feel better.
Chloe, please.
Get out! Both of you.
I'll keep her over night for observation.
I want to show you something.
This is who Chloe really is.
Is that her friend Lauren? Yeah, the morning it happened.
You know how kids post pictures on Facebook, one a day for the whole year? Chloe was doing that.
She was really excited, talking about maybe becoming a photojournalist.
She hasn't touched her camera.
Not since Lauren died.
I want her back.
She is a minor, Liz.
Force her to do the treatment.
I do admire you, Michael.
I never could muck around in people's heads the way you do.
You're doing a pretty good job in mine.
It's not a good time for a visit.
I got a teenage girl refusing treatment, guy on my soccer team who may have AIDS.
Well, maybe that's exactly why I'm here now.
Your guess is as good as mine.
Who's this patient? It's Donnie Bremmer.
He's a former football player.
Broke his back a few years ago, I got him on the field again.
Problem is, there's no evidence this will work.
No record of anyone even trying it with his particular pathology.
Well, someone has to go first.
I like his odds if it's you.
I like them, too.
What did I used to say about you? "The ego has landed?" On you, it kind of works.
Can I ask you something? Consult, doctor to doctor.
Oh, please.
I miss being a doctor more than I miss bubble baths.
And you know how much I loved bubble baths.
Did you ever put a patient on medication against their will? Never.
Well, that was definitive.
Well, I yelled at people because they didn't take their insulin, or called the pharmacy to check they'd picked up their meds.
That's not what you're talking about, is it? No, it's to help someone forget the worst moment of her life.
Not forget, exactly, but just soften the blow.
I can fix her.
I don't understand why someone would choose to suffer.
It's called being human.
Says the dead woman.
Well, we experience pain so we can learn from it, don't we? The tough times always made me ultimately much stronger.
Especially if I had someone to talk to.
Not everyone is you.
You, then.
If you could take a pill and forget what happened to us.
You know what? I, uh, I've got surgery in five minutes.
Or say you could erase Alaska, our marriage, me, forever, good-bye would you? I've tried to forget you for the last ten years.
Clearly I wasn't meant to.
How'd it go? Rita, you even have to ask? Went off without a hitch.
Thanks, Vic.
When will we know how well it worked? Soon as he wakes up.
What's next? Two things.
You got a call from a lab saying that the HIV test on your patient is negative.
And Kate Sykora called.
She said to tell you that George's wife is on her way over there.
I'm on my way.
You need to get your shoes resoled, running around so much.
Welcome to my world.
George must be relieved about the negative results.
He's not answering his phone.
I haven't even been able to tell him.
Okay, so if it's not TB, and it's not HIV, what are we looking at? Michael.
Oh, this is George's wife, Maria.
This is Dr.
Hi, Maria.
What's going on? George is gone.
He ran away.
Did he say why? Only said we couldn't be together anymore and to go to Clinica Sanando and have you do an AIDS test.
Okay, come on in.
Does he think that I cheated on him? That I gave him AIDS? He's the love of my life, I would never Maria, George is HIV negative.
Sit down.
Then why would he leave me that message? Has everything been okay between the two of you? Usually, but I don't want to say anything bad about him.
He's such a good man.
If you tell us what's going on, we can help you.
He's been kind of crazy.
Crazy how? He gets mad real quick.
Like he's someone else.
I mean, he was never like that.
Have you noticed anything out of the ordinary physically? He's been losing weight.
He says it's on purpose, but I don't think it's good for him.
And he hardly eats what I make for him anymore.
Now all he does is eat chips and pretzels instead of real food.
Or else he pours salt on everything.
Salt? Tons.
I said he's gonna give himself a heart attack, he keeps doing that.
He's got Addison's Disease.
What is that? It means that his adrenal glands aren't working properly.
It explains the weight loss, salt craving Personality changes, uh, muscle weakness.
He's probably had it for months, and now it's acute.
Is it serious? Yes.
He needs to be treated right away.
Is there someplace George goes when he gets upset? The only time we ever had a big fight, uh, when we were dating, he said he spent the night at the soccer field.
Okay, I want you to go home, in case George comes back.
We'll check out the field.
Where do you keep the hydrocortisone? I'll get it.
All right.
It all fits with Addison's except George is coughing up blood.
Well, takes a brain surgeon to figure that one out.
Draw up 100 milligrams for me; I'll show you.
See, it all seems unrelated until you think about the brain.
Coughing up blood must be from a lung cancer that has metastasized to the pituitary gland in George's head.
The tumor is blocking the pituitary from producing a hormone that stimulates the adrenal glands.
Causing Addison's.
This guy's in big trouble.
And if we don't find George very soon and treat him with steroids, Maria's going to be without the love of her life.
George, you here?! George! Kate, there he is.
Over here.
George? Oh, God.
Okay, yep.
It's gonna be okay, buddy.
I got you, okay? I got you.
This is Dr.
Kate Sykora.
I need an ambulance right away.
I'm at the park on the corner of Grand Street and Forsyth.
Think we made it on time? I hope so.
Long night.
Think it's morning already.
It's cool watching you pick his nose to grab that pituitary tumor.
Figured you'd like that.
Got to mix it up from time to time.
You mean like making house calls on soccer fields? He's a friend.
Seriously, how bad's it gonna be for him, the lung cancer? Bad that it's cancer, good that it's small cell, responds to chemo and hasn't spread everywhere else.
My money's on George.
You gonna go home, get some beauty rest? I wish.
Do you know who I am? A white coat.
You're the doctor.
Do you, you know where you are? Hospital.
There you go.
That's right.
Can I walk now? You fix my back? Yes, I did.
A long time ago.
Tell me your name.
Hey, can you look at me? Can you Can you tell me your name? Please? Help me with my helmet.
It's tight.
Why don't you try to rest.
I thought it would work.
I know.
I found his uncle Robert in Newark.
He sounded like a very nice man.
He said he'd been He said he'd been trying to find Donnie.
And I'll make damn sure that league has that address to send Donnie's pension to.
You got him off the street, Michael.
Michael, you gave him back his dignity.
I've got the best oncologist in Manhattan Memorial coming to see you.
Great guy.
Even you won't hate him.
George Hey, babe.
Thank God.
Don't get him too excited.
It's okay.
Thank you.
For caring about us so much.
I'll come back in and check in on you later.
Babe, I have something to tell you.
Never wanted you to know He's telling her about the drugs.
She won't care.
They're cute.
We don't say the word "cute" here at Holt Neuro, ever.
Duly noted.
What is that, fire alarm? That's the emergency door to the roof.
Chloe's not in her room.
All right.
I'm not going to jump.
I needed air.
Quite an amazing view, huh? You should bring your camera up here some time.
Can I sit? I lost someone.
She died suddenly too not long ago.
Not the way your friend did and I wasn't with her so I'm not saying it's the same.
You know, the hardest part for me has been separating the good stuff from the bad stuff.
And keeping what was so great about her, about us, without there being this dark, sad feeling.
Then you're not like me.
Because I want it to hurt.
Lauren died and I didn't.
She can't take a pill to feel better.
Why should I be able to? And don't tell me she'd want me to be all positive and sunshine and live life for the both of us.
I've heard that a million times already.
Well, I'm sure she'd want that.
You didn't know her.
She could be kind of a bitch sometimes.
I miss her.
I don't know how I'm ever going to be the same again.
Well, you won't be.
What happened to you, what you saw that day, and what happened to Lauren, that will be one of the things that defines you forever.
That's the truth, it just is.
The question is the way that it defines you.
Does it destroy you, or does it make you stronger? Make you want to live life a little extra hard.
You want me to take that medication.
No, I don't.
I don't.
I think you should find your own way through this.
With help.
Talk to somebody? Yeah.
My colleague Dr.
Flores is a great listener.
And just so you know, this may be the longest conversation I've ever had with a patient that didn't involve cutting their head open.
You did good.
So will you.
Thank you.
Stitched up a little Italian kid's chin at the clinic.
His grandmother paid me in pignolis.
Try one.
What's wrong? Donnie's dead.
His uncle found him.
He took an overdose of sleeping pills.
Must be an accident.
He must have gotten confused and lost count.
He left a note.
He said he knew it was only going to get worse for him, and he didn't want to live that way.
He left you his brain.
Don't hold back When the time is right Don't hold back Doesn't matter who you are Doesn't matter where you've been Doesn't matter where you start Only matter where you end It can be a real long road When I'm looking in your eyes Give me just one more chance - Give it just one more try - He believes in you.
He knows if anyone can find a cure it's you.
It's too late for Donnie.
Donnie's fine, Michael.
The time is right Don't hold back