A Gifted Man s01e16 Episode Script

In Case of Heart Failure

Look at you! Autumn.
I knew you'd come around.
Not you.
Come on, this guy makes more in an hour than I do all week.
Now he's gonna out-dress me? Not my choice.
Awards ceremony tonight at the Roosevelt Hotel.
- Ah, giving or getting? - What do you think? - "Achievements In Neurosurgical Research.
" - So, who's your plus one? - I mean, I'd be happy to go, but I got to wash my hair.
- No.
I'm going solo.
You should bring Kate.
She cleans up nice.
- Come on.
- Hey, Kate, come here! Michael's got this soirée tonight, and he needs some arm candy.
Why don't you go along with him, I'll hold down the fort? - It's really just a dumb thing.
- I have a lot of work to do - after we close, so I don't think - I mean, you'd be bored.
- She's got a little work.
- So Okay.
Forget I mentioned it.
Anyhoo I don't want my rubber chicken to get cold.
Good night, guys.
Michael? Can we talk? Uh, you know, now's not really a good time.
Every time I've gotten near you for the last week, you found some reason to be busy.
You kissed me, Michael, and I kissed you back.
I know.
What do you think that I'm supposed to? I'm married.
I'm sorry.
But I got this thing tonight.
- So you're running again.
- No.
Only thing I'm running is late.
We'll talk.
Hey, waiter, how about a refill? Gene! They will give this award to anyone.
Michael, you son of a bitch.
- How the hell are you, Mr.
Tipton? - Good, man.
- Hey, congrats on the award.
- Thank you.
Yes, well, you know, I'm not the one - braving natural disasters for art.
- Believe me, I was thinking, "Why am I not back in New York, "in some nightclub, losing some woman to the effortless charm of Michael Holt?" Oh, I've lost plenty to you.
Name one.
That's a good point.
Just keep your mitts off my date.
She's the love of my life.
Really? I met her two weeks ago, in India.
We just flew in.
She's Indian? Even more exotic.
Michael Holt, meet Trish Sulloway.
Oh, hi.
I took photos of Michael for a Time magazine article about neurosurgeons.
- I remember it.
- So, what were you doing in India? Depositions for a corporate law case.
Trish is a junior partner at Hunter & McFadden.
Beautiful and smart.
Your mom's gonna have a tough time finding something wrong - with her.
- Ladies and gentlemen, could you take your seats for dinner? And if our honorees will join me on the dais.
Shall we? Wish me luck, hon.
Good luck to you both.
Awarding Gene Tipton with a Pathfinder honor was a remarkably easy decision.
Gene's fearlessness has put him - You okay? - Yeah.
You'd think a guy who jumps on ice floes with polar bears wouldn't be scared to give a dumb speech.
Just remember to breathe and don't lock your knees, and if all else fails, picture the audience naked.
Ladies and gentlemen, please welcome to the podium, our first honoree, Gene Tipton! Good evening, everyone, and, uh, thank you.
It's a great pathfinder when you're honored Sorry.
That came out wrong.
Uh it's a great honor to be counted among Gene! Gene, can you hear me? Oh, no.
Gene? Somebody call an ambulance! Here.
I don't need to stay here.
You passed out and hit your head.
And scared me to death.
Just nerves and jet lag.
Believe me, part my hair on the other side, you won't even see the bump.
I have seen plenty of bumps that turn into something serious.
You did a CT, right? What did it show? Well, nothing.
No skull fracture, no bleeding in the brain.
- See? I'm fine.
- Well, I said you didn't have an injury to your brain, but you still got a fever of 101.
Yeah, you do feel warm, Gene.
I always catch something when I fly.
You want me to call your mommy? No.
I have a shoot with the Secretary General of the UN, first thing tomorrow morning.
You are gonna stay here until Michael says you're Please? Do it for me? What did I say? She's beautiful and smart.
He's lucky to have you, Michael.
Oh, there were probably a dozen docs in that audience tonight.
I was just the closest.
- I meant as a friend.
- Ah.
Well, you were the one who convinced him to stay.
Should I call Gene's mom? That's a terrible idea.
She's a handful.
Put it this way.
That time I went to Gene's studio for the Time magazine shoot, we weren't there half an hour before she showed up with milk and cookies.
That's nice.
Then she started vacuuming.
She has OMD Overbearing Mother Disease.
I have dealt with it before.
Then you'll have no problem with Blanche.
- Good night, Michael.
- Good night.
You have been sleeping here for a week.
You ever gonna come home? Home? You're still calling it that? You live there.
We live there.
Harrison, I caught you secretly meeting with a divorce attorney.
The only reason that I was talking to her was because I don't know what's in your head.
Well, actions speak louder than words.
And yours have told me everything I need to know.
So, I, uh, I guess there's nothing left to say.
I guess not.
I'm sorry you had to hear that.
I didn't realize there was trouble in paradise.
Still, I'm sorry.
What's the prognosis? On life support.
May be time to pull the plug.
Patient, patient, who wants a patient? Uh, keep filing.
I need the distraction.
I'll take them, Autumn.
I'm Dr.
How can I help you? Louise and I went ice skating at Rockefeller Center yesterday.
Dumb school kid was showing off, knocked her down, her foot slammed into a wall.
It didn't hurt at the time.
But I woke up this morning, and my big toe is all swollen and blue.
Somebody needs an X-ray.
Come on.
Yup, you fractured your big toe.
Does it need surgery? Nah.
The bone will heal itself.
But you do get to wear one of these for about a month, just until the break mends itself.
I don't suppose those come in a low-heeled pump? Not exactly fashionable footwear, huh? She can't go hiking with that, can she? We were planning a trip upstate next month to celebrate Louise's heart transplant.
You had a transplant? Six months ago yesterday.
I had cardiomyopathy.
We were worried that they wouldn't be able to find a heart for me in time, but out of the blue, the hospital called and said they found one.
- So - Now we celebrate by doing something fun like ice skating.
To remind us that every day is a gift.
All right, well, no hiking until this has healed completely.
- Mind if I give your heart a listen? - Okay.
- Just to make sure you're doing all right? - All right.
Ah No murmur.
No rubs.
You feeling all right otherwise, other than your throbbing toe? I've been really tired the past couple days, but.
- I didn't think it was anything.
- Okay.
Well, I don't want to alarm you, but some transplanted organs can carry infection.
So, I'd like to do a blood panel, and I'm gonna call the donor organization and make sure they screened your heart for everything.
Drink this.
Read that.
Gene Tipton's lab work? CBC and blood cultures normal.
No bacterial infections.
So, why are you frowning? His fever's up to 102.
You want me to book him a bed at Manhattan Memorial? Nah.
Keep him here.
He's a friend.
Uh, let's see if you still feel friendly when you see what he's been doing all morning.
- Put it away.
- Come on.
This stuff is amazing.
It's like the bridge of the starship Enterprise.
Yeah, a lot of this stuff is experimental and proprietary.
How are you feeling? Weak, sick to my stomach, and now I got a headache.
I told you to have a nurse page me if you started feeling worse.
Trish was at my bedside the entire night.
I barely even noticed how crappy I felt.
The moment I met her, everything in my life, every piece of the puzzle just clicked into place.
And you've known her how long? Maybe you'll feel this way about someone, someday.
Let's get you better before you walk down the aisle.
Come on.
The spinal tap showed nothing? Negative for meningitis.
As was your smear for malaria and your typhoid and dengue titers.
Are there other tests you can do? Yeah, dozens, but, uh, I need to ask Gene a few personal questions, - so - Honey, I can leave if you want No, there's no secrets.
Ask away.
Recent sexual history.
Yeah, what about it? - Gene, come on.
- I travel 50 weeks out of the year.
It's not exactly easy to have meaningful relationships.
But I've always used protection.
I'd like to do an HIV test just to make sure.
Is it okay if I test you, too? Sure, but for the record, Gene and I actually haven't slept together yet.
- No one's making a judgment.
- No, she's serious, Michael.
When you know you're gonna spend the rest of your life with someone, you can take your time.
- You all right? - Baby, you okay? I can't catch my breath.
Let's get you back into bed.
Okay, easy.
What do you hear? Decreased breath sounds at the bases.
I'm gonna put you on oxygen.
Just need you to take slow, deep breaths.
- Okay? - Michael, what's wrong with him? I'll tell you as soon as I find out.
What'd I do now? That was the organ donation administrator.
About your patient with the secondhand ticker.
Did they screen it for everything? Yeah, no, heart's clean as a whistle.
You seem spooked.
What's up? So the administrator wouldn't identify the donor by name, but he did say that Louise's heart came from a hit-and-run in Alphabet City this past September and that the donor was a physician in her late 30s.
Even in death, she was saving lives.
So do I tell him? Wouldn't you want to know? Kate, I know you want to talk to me.
N-N-No, it's not that.
Um, I have a patient that I'd like you to see, but you might want to sit down first.
Nothing a patient has can shock me.
This woman has Anna's heart.
Louise, Joel, this is Dr.
I've asked him to join us.
- Hi.
- Hey, did you come to listen to my new heart? It's funny, doctors find out and they all want to hear it, just like strangers coming up to pregnant women, wanting to touch their bellies.
Actually, I'd like to see it.
Did you talk to the organ donation people? Louise's heart is totally healthy.
And this is kind of strange, but based on my discussion with them, I think that your heart came from the woman who used to run this clinic.
Anna Paul.
You knew her? Only from the plaque under her picture out in the waiting room.
Oh, my God, what are the chances of that? Pretty small world, huh? So you knew her, right? Uh, no, Anna and I never met.
I was actually hired as her replacement, but from everything that I've heard, you could not have gotten a more loving heart.
She's got my heart? What about you, Dr.
Holt? Did you know her? Uh, I I started after Anna had left.
Why don't you tell them? Whether or not I knew her, you're still gonna get great care here.
Michael, you all right? So how does it look, Dr.
Holt? Looks beautiful.
I'm guessing the fatigue is not from an infection but rather a, uh, anemic reaction to your antirejection meds you're taking.
Kate will check your blood count.
It's nice to meet you both.
I'm curious, why did you lie? That woman didn't need to know that her heart belonged to my ex-wife.
- That's a good point.
- It's, it's not every day that your heart comes waltzing through the front door.
It's amazing, isn't it? I mean, for a minute, looking at the monitor, it almost felt as if I was still alive.
And in a way, you are.
You okay? I'm fine, yeah.
Well, I'm sure it must have been weird in there, seeing Anna's old heart.
Old heart? I thought it looked pretty good considering all it's been through.
Uh, yeah.
Um listen, if your patient's blood count goes down, you'll need to start her - On iron supplements.
- That's right.
Yeah, I know how to treat anemia.
Just being thorough.
About what happened last week Oh, Michael, we can really talk about this later.
- Talk about what? - No, I, I I wasn't thinking straight that day.
I, uh, I had just lost a patient who was a very, uh, dear friend, and, uh, well, you were right.
I, uh, I shouldn't have done it.
We shouldn't have done it.
So you think it was a mistake? - Did you sleep together? - No.
So not a mistake? We kissed.
I know.
You kissed? About time.
And like you said, you're married and we crossed a line.
- Okay, so we're agreed.
- Yes.
We'll just keep it professional.
Yeah, that's exactly what I wanted to say, sorry.
Big day for you, Brother Mike.
Heard Anna made another appearance in your life.
Saw a patient who had a transplant, Anton, you can snuff out the incense.
Universe taps you on the shoulder, you ought to pay attention.
To what? Woman who got Anna's heart lives two blocks away and happened to be at the top of the recipient list.
That is how organ donation works.
So you still believe in coincidences.
And you still got your head up your ass.
You know, it's no accident it was her heart that showed up.
You ought to try using yours.
Initial at the bottom.
Verify dosage, then sign.
You're using your angry signature.
I don't even know what that means.
Something at the Clinica that's troubling you? Nothing I want to talk about.
Oh, damn it, I just wrote "talk about.
" Oh, thank God nothing's troubling you.
Gene's new labs come back yet? All negative, but his fever is up to 103.
What's going on with this guy? He's been here 24 hours and I'm no closer to a diagnosis.
I'm here to see Gene Tipton.
I'm his mother, I'm not waiting.
Uh, hey, Mrs.
Tipton, I didn't know you were coming.
I got a message from a woman.
I didn't even know Gene was in town.
And yet you came prepared.
Well, I had a few things in the fridge you know me.
Can I see my son? Where is he? Uh, follow me.
Right in here.
Gene, honey.
Mom, what are you doing here? I called her.
I got her number out of your phone.
You've gotten sicker.
Tipton, I'm Trish.
I'm the one who left you that message.
Well, that's very sweet of you.
Honey, what's the matter with you? Why do you have a tube in your nose? - Mom, I'm fine.
- You should have called me as soon as you landed.
Why did I have to hear it from a stranger? I'm his girlfriend.
Oh, well, I'm here now, so you can just relax, and I brought you some food.
- And Doctor - Yes.
since my son isn't telling me what's going on, will you please tell me? Uh, Gene lost consciousness last night.
He's still here 'cause his temperature is elevated and he's been having trouble breathing.
- Well, you'll fix him.
- Believe me, I'm trying.
Gene, what's happening? Back up.
What's wrong with my son? He stopped breathing.
I need a nurse in here and an ambu bag! Bag him.
Need to get him to the O.
- What's wrong with him? - Rita! - Yeah, come on, ladies, let's go.
- My son.
I'm sorry.
Call Victor Lantz, tell him we need an emergency intubation.
Okay, on my count, one, two, three, go.
All right, I need his repeat labs stat.
Pulse ox is down to 78.
I got him paralyzed.
Blade and ET tube.
I'm in.
Whoa, what's happening? Why is he bleeding? Did you nick his trachea? No, no, it was an easy intubation.
Ah, damn it, he's got diffuse rhonchi now.
Need to scope him and see why he's bleeding.
What's going on with those labs? Just got them.
Couple of abnormals.
ALT is 2,800, creatinine is seven, and INR is up to 11.
He's in liver failure, and that's why he's not clotting.
His kidneys are shutting down, too.
Yeah, I see a bleeding vessel.
Give me the coagulation electrode so we can cauterize it.
If we don't reverse liver failure, he's going to keep bleeding.
Any idea what's going on? Not yet.
There's only so many holes you can patch before the dam bursts.
You must be awfully tired, Trish, after all that flying and now this.
If you want to go home I'm fine.
Actually, we got in last night.
And no one called me? It was late, and Gene thought it was just jet lag.
Obviously it's more than that.
- How is my son? - How is Gene? Uh he had blood in his lungs, but Dr.
Holt stabilized him.
Oh, my God.
I'm staying here with him.
Of course, we have a room ready for you.
Do you have one for me? Because I'm staying, too.
Excuse me, but he barely knows you.
My boy tells me all about his girlfriends, and he never mentioned you.
When my husband and I were dating, he took me to meet his mother.
I spilled a glass of Burgundy on her clean white carpet.
She put a rag in my hand and didn't speak to me for over a month.
That was 35 years ago and now we're as close as heat to a fire.
Oh, that's a lovely story.
Whew! Trish, I'll set up a room for you.
Let's go see Gene.
He has a breathing tube, so he can't speak.
Holt gave him something to sleep through the night.
Please don't try to wake him up.
Well - looks like you've met your match.
- Yeah.
Some icicles take longer to melt.
You headed home now? No, I got a patient at the clinic I need to check on first.
Oh, you mean the thing that wasn't troubling you earlier? I mean that patient that showed up with Anna's transplanted heart.
Oh, my God.
- Are they okay? - Oh, they're fine.
It's a minor injury; nothing to do with the transplant.
Well, that must've stirred up a lot of memories.
Some days it's like Anna never died.
Holt was right.
Your labs came back, and you are anemic.
That's why you've been so tired.
I want you to take an iron pill twice a day with prunes.
Prunes? I hate prunes.
Learn to like them, 'cause they're gonna help with - the constipation from the iron pills.
- Oh, God.
Before I got sick, I didn't even take vitamins.
Now I'm taking pills to keep from rejecting my heart, pills to fight the anemia from those pills, - and now prunes.
- She'll eat her prunes, Doc.
Good man.
This is a referral for an orthopedist.
- He'll make sure your toe is healing properly.
- Thank you.
- Dr.
- Hi.
What are you doing back here? Just wanted to make sure Louise was okay.
You mind if I, uh, - have one last listen? - Go ahead.
Sounds great.
Just wanted to make sure it was okay.
I've been in a lot of hospitals in my life, but you guys care more than all of them.
We try.
Any problems, don't hesitate to give us a call.
Thank you, Doctor.
Hey, Harrison.
You here to pick up Kate? Uh, sort of, yeah.
You two aren't in the middle of something, are you? What, you mean Kate? No.
I just had a patient leaving and - Harrison.
- Hi.
I am leaving, too.
Good night.
Why'd you come back? I thought we agreed there was nothing more to say.
Uh, there is.
I want to start a family.
What? I-I've been doing a lot of thinking, and I am married to this amazing woman who makes me happier than I've ever been.
So why am I screwing it up? Now I don't know what to say.
Just listen.
We have a chance to start over.
I just got an offer to be the CEO of a new med start-up in Houston.
It is the job - of a lifetime.
- I'm not leaving the clinic, Harrison this is all I've ever wanted to do.
And that is why I told them that I wouldn't take the job unless there was something there for you, too.
And there is.
A free clinic is opening and they want you to run it.
Double the staff, triple the resources.
You told them about me? Yeah.
Yeah, I sent them your-your resume.
And I-I know that was presumptuous.
But these jobs they would just give us more time for each other.
Harrison, I don't know.
You can you could meet them.
Can see if you like it.
But just come home.
Be my wife again.
And you really want to start a family? Yeah.
So, what do you say? Can we start over? Morning.
Feeling any better? Yeah, if better means going through a meat grinder.
Hey, where's Trish? Did she leave? She went to the ladies' room.
And your mom went to get a cup of coffee.
- Did you see the way she treated her last night? - Yeah.
Maybe it's time you remind her that you're a grown man.
How's my boy? Oh, your little boy is not in the greatest shape, but we're doing everything we can for him.
Are you sure this isn't something he picked up - in India? - Yeah, I tested for all the viruses endemic to that region all came back negative.
And Trish was in Mumbai, too, and she seems to be okay.
I hope so.
I was just brushing my teeth.
Maybe I haven't been flossing enough? Why? Have your gums bled before? Not like this.
You know, I'd like to examine your mouth.
Yeah, you have a small herpetic lesion on your gum - below your lower lip.
- You have herpes? - Mom.
- Did I get Gene sick when I kissed him? Unfortunately, it looks like you gave him a virus that combined with a strain he already had in his body.
It's extremely rare, but it can lead to a kind of superinfection that can spread in your blood and cause liver failure.
But you can treat it.
Absolutely with I.
acyclovir, and the same drug in pill form for you, Trish.
Oh, my God, this is all because of me.
- Well, it's entirely treatable.
- Sweetheart, you didn't know.
I thought I had a canker sore.
Oh, my God, if I hadn't just gone to brush my teeth You might have died.
But I didn't, Mom.
For once in your life, butt out! I'm sorry, Gene, for causing you so much pain.
- Trish - Where are you going? Trish? She made her decision.
Trish! - Busy already? - We see more patients before 9:00 a.
than your place sees all day.
Yeah, but you ever had a guy almost die from kissing someone? No, I I mean, it's just a shame when something nice can s-screw up the I'm just gonna stop talking right now.
Good, because Louise is back.
What's wrong? Okay.
Let's get her back there.
It's all right.
It started an hour ago.
I tried to call Joel, but he went to San Francisco for a meeting.
These look like petechiae.
It's a rash caused by the hemorrhaging of small blood vessels.
Did you have a headache, fever or stiff neck? No, it's just hard to breathe.
She broke her toe.
I'm thinking FES.
I'll call an ambulance.
- What's FES? - Fat Embolism Syndrome.
It's a condition caused by the release of fatty acids into your blood after you break a bone.
But why didn't you know? It can take several days to manifest.
- Will I be okay? - Once you get to the hospital.
You'll need to be on steroids, and then we'll put a filter in to make sure no clots block oxygen to your brain and your heart.
Could someone call my husband when he lands? Absolutely.
I'll have the social worker make sure he knows what's happening.
Be right back.
I hear Gene's on the road to recovery.
That Dr.
Holt is a miracle worker.
Oh, yes.
I see it every day.
- One of the joys of working here.
- Mm-hmm.
But not everyone's happy I saw Trish leave in tears.
Oh, guilt, I guess.
You know, she gave that infection to my son.
Good riddance.
Right? - Mm.
- I mean, I'd be furious if someone did that to me.
Can you imagine? Getting someone you love sick? How could you live with yourself? Actually Actually what? Actually, when Gene was 15, I got chicken pox.
I don't know how I avoided it for so long, but I did everything I could so he wouldn't catch it, but he got it anyway.
And then he ended up in the hospital with pneumonia.
I felt so terrible.
- He didn't hate you for that? - Well, no, of course not.
Why not? Well, it was a germ.
It wasn't my fault.
Enjoy your coffee.
I left word with your husband, but a water main broke on 3rd and traffic is stacked.
- Ambulance is gonna take a while.
- Well, we don't have a while.
You know what? I'll drive you to the hospital myself.
- Where are you going? - Ambulance is delayed.
I'm taking my car.
I was just out there there's three cars blocking the way.
Then we'll catch a cab.
Hey, Rita.
Tell Manhattan Memorial we're on our way.
And have them prep the O.
for an IVC filter.
You know, Dr.
Holt, you're a bad liar.
What are you talking about? I always heard surgeons were all business.
My transplant surgeon certainly was.
"Don't do this.
Don't do that.
" Until one night in the ICU when he thought I was asleep.
I saw him watching the heart monitor, and I knew that it was all just an act.
He was just acting tough because he was afraid.
It was his way of dealing with the fact that I might die.
I saw the same look of fear on your face when you were watching my heart, but there was something more.
Anna Paul was my ex-wife.
Why would you lie about that? Look out! Sorry.
Everyone okay? I'm fine.
Just take us to Holt Neuro Send an ambulance.
Eighth street and Avenue D.
You all right? Yeah, I think so.
Louise, you okay? I can't I can't move my leg.
- Okay, stay calm.
- My leg I can't feel my arm.
Stay here; I'll be right back.
I'm sorry, my boss called.
I only took my eyes off the road for a second.
We've got to get her out of here.
- You got a tire iron? - Yeah.
Anyone smell that? Come on! Gas tank's leaking bad.
Everybody stand back.
This cab could blow any second.
Buddy, you gotta get out of here.
I'm not going without her; You gotta get her out of here; you gotta help me.
Here, her feet are pinned.
We gotta get her out of here.
I can't get it open.
The door's stuck, too; we got to get her out through the back.
Go around to the front.
All right, you work on the door.
Got it.
Try to stay calm, Louise.
We're gonna pull you out, okay? All right, on my go, ready? One two, three.
Come on.
Come on.
Come on, you grab her legs.
Easy, easy.
Okay Let's go, come on.
Everybody okay? You okay? Thank you.
Louise? Louise? Is she okay? Okay - Oh, no, no, no.
- What's wrong? Her collar bone's pushed in, cutting off the blood flow to her heart.
Uh, you got any pliers in there? What do you got here? Come around, hold her arms down.
Keep them straight, hold her by the shoulders.
All right, keep them down.
Come on.
Come on.
Clavicle is back in place.
Ah, damn it, still no pulse.
Michael, can you save her? I'm trying.
What? The injury blocked the blood flow to her heart for too long.
Please don't let her die.
She's gone.
One of these days, the sky's gonna break And everything will escape And I'll know One of these days the mountains are gonna fall Into the sea And they'll know Trish, please come back.
I'm fine now, but, um, I'm not gonna be happy without you.
How are you feeling? Physically better.
Everything else Anything I can get you? My problems now can't be cured by you or Michael.
Are visiting hours over? I'm so sorry I left.
I will never leave you again.
I'm gonna give you two some privacy.
Me, too.
We're gonna head over to Miguel's.
You want to join us? That place is a dump.
That's why they can afford dollar beer night.
And that's why we can afford Miguel's.
I got to close up.
You sure? Yeah.
Get plastered for me.
See you tomorrow.
- Mike.
- Hey.
- You want to get a beer? - Uh, it's all right.
- Hi.
- You okay? I don't know.
You seem different, Michael.
Michael? What happened to your head? Uh Our cab got hit by a truck.
What?! Louise died at the scene.
So, how was the rest of your day? Harrison got his dream job.
Oh, great.
In Houston.
You're moving to Houston? No.
I love this place too much to leave.
I'm glad.
So, is Harrison going without you? He's gonna stay.
He wants to work on our marriage.
Is that what you want? You still open? I've got a bad pain in my belly.
Come with me.
We'll take care of you.
Holt? Give me a hand?