Chicago Med (2015) s04e20 Episode Script

More Harm Than Good

1 Will! Owen! Hi! - Hi.
- Wow, you're getting so big.
Might be time for you to start playing football.
No, Mom wants me to protect my brain.
Smart lady, your mom.
Where is she? Um, Natalie's in the café.
She's just getting us some coffee really quick, so I'm I'm watching Owen.
I'm Phillip Davis.
Yeah, Will Halstead.
We haven't officially met.
Natalie and I, we work together.
She she's told me about you.
Good things, I hope.
Of course.
- How's your daughter? - She's doing her best.
We're here for a surgery counsel, and I suggested Dr.
Rhodes.
Yeah, he's one of the best.
You're in good hands.
Phillip is gonna teach me how to ride a horse.
He is? Yeah, I I own a ranch in, uh, in Texas.
Ain't that right, partner? - Yee-haw.
- Yee-haw! Oh! Hey, Will.
Did you guys meet? - Yeah, just now.
- Thank you.
All right, come on, Owen, let's get you to daycare, buddy.
Come on.
See you later, little man.
No, I want to play with you.
Some other time, bud.
There you go.
Yeah.
Let's go.
Will, it was great meeting you.
Yeah, you too.
- I'll see you at work.
- See you.
Are you ready to go? All right, bud.
This is Gaia.
She won't let us treat her.
No visible injuries, but she's been screaming in pain the whole ride over and wouldn't tell us why.
Gaia, I'm Dr.
Choi.
Oh, yeah.
She's combative too.
- Is she under arrest? - We'll see.
We raided a flophouse after neighbors complained of a smell.
- Drug den? - Looks like it.
All right, let's transfer her on my count.
One, two, three.
- Any idea what she's on? - Not a clue, but it's lethal.
We've got ten dead bodies, only two survivors.
Gaia and another woman, Meadow.
- She's in the ambo behind us.
- I'll go get her.
Gaia, I can see you're in pain, but I can't help you if you don't help me.
Dr.
Choi? What kind of drug does that? Gaia, what did you take? This is Burgess.
Meadow, keep looking at me, all right? Keep breathing.
It burns! Ooh, I'm on fire! All right, let's transfer her on my count.
Ready? One, two, three.
All right, let's get a urine and blood toxin, a CBC, CMP, a chest X-ray, and an EKG.
No! I don't want your help! Oh! Get her.
Meadow? Meadow? She's not putting any weight on her legs.
Leave me alone.
Meadow, you do that again, I'm gonna need to put you in restraints.
Don't touch me! - Meadow.
- No! I said don't touch me! Gaia, this would go so much easier for you if if you just talked to me.
Just tell me what drug you took, and we can forget about all my other questions for now.
Would you let us take a little urine sample so we can figure it out for ourselves? Okay.
No IV, no monitor, no blood, no urine.
Look, you're clearly very uncomfortable.
At least let me give you something for the pain.
Gaia has pronounced hyperesthesia.
Excruciating pain from the lightest touch.
Even a slight breeze against her skin.
So does Meadow.
But she also has lower extremity paresis.
And still no idea what drug we're dealing with? Whatever it is, it's going after the nervous system, and it'll be days before the county sends us the autopsies on the other victims.
You get anywhere? They won't say anything.
And no guarantee of doctor-patient confidentiality would put them at ease? They turned down morphine.
I'm guessing they could care less about HIPAA.
So what do we do now? They're cognizant, responsive.
They have the right to refuse care.
Hopefully these young women will change their minds and accept treatment.
Seriously? Wait and see is the best we can do? Our hands are tied.
Well, keep me posted.
Now, I know that I have given you a ton of information, so if you get home, you feel overwhelmed, and you realize you have some questions, just give me a call.
Okay.
I'm nervous.
Sophie's gonna do just fine.
Damn, I am saying Get on that get me some Hey, hey.
Uh, what's going on? - I-I-I can't breathe.
- Okay.
What are you doing all the way up here? Why didn't you go to the ED? Your lungs sound junky.
How are your legs? Uh, swollen.
- All right.
- Yeah.
We're gonna admit you to the CICU.
Let's get stat labs, chest X-ray, EKG, and echo.
Come on.
Here we go.
Yeah, I-I-I feel like I did before my surgery.
I thought Dr.
Bekker fixed my ASD.
Yeah, so did I.
I met Natalie's boyfriend, Phillip, this morning.
He told Owen he owns a cattle ranch.
Okay.
You ever seen his hands? They're smooth.
Like, manicured.
No calluses.
So people with pretty hands can't own livestock? Come on.
No way a guy with hands like that owns a ranch.
Or he just wears gloves when he works, like we do, all day long.
I don't buy it.
I think he's lying and using Owen to get close to Natalie.
I think you overthink things.
Hey.
It was nice to see Owen.
Been awhile.
Yeah, he was excited to see you.
Phillip seems like a nice guy.
He is.
Thanks.
I mean, he must be nice if you're bringing him around Owen.
Excuse me? You've been dating, what, six weeks now? It took you a heck of a lot longer to let me get close to Owen and we've been working together for years by then.
You know, I don't need to defend my parenting choices to you.
Honestly, though, how well do you really know him? Okay, Dr.
Halstead, you have a patient in six.
Hi.
I'm Dr.
Halstead.
Vasiley Qipaqli? Butchered it, didn't I? You got close.
Just call him Vee.
It's easier.
Uh, I'm his cousin, Brandon Wycoff.
Nice to meet you.
So, Vee, what happened? He's visiting me from Moldova.
He knows, like, ten words of English.
Yeah, that's okay.
We can get a translator.
Well, good luck.
Most people there speak Russian or Romanian.
He's from the South.
He speaks Gagauz.
It's just better if I do the talking.
Long story short, he fell in the shower.
All right.
Look at the back of your head.
Eh, minor head laceration.
Doesn't even need a stitch.
Yeah, hey Anything hurt? Pain? Oh, I-I okay.
Okay, good.
Yeah.
I want to get an X-ray.
But I think the arm is just bruised.
There's nothing internal? I'm not seeing anything concerning.
Oh, thank God.
If he's a no-go, I'm screwed.
Sorry? Oh.
That came out wrong.
Um Fistula for dialysis and stage renal disease? Yeah.
My only hope is a new kidney.
Luckily, he's donating me one of his.
I love you, cuz.
Meadow, these are the same lesions we found on Gaia.
You're getting worse.
Please just let us help you.
No.
Dr.
Choi, come quick! Gaia.
She's not breathing.
No pulse.
Ventilator.
I'll take a quick look.
Asystole.
She's gone.
Time of death, 11:10.
I only left her for a few minutes.
I didn't hear her, I swear.
It's not your fault.
She wouldn't let us put on the monitors.
She killed herself? Suicide? Why? All I can come up with is, the pain must've been too much to bare.
I'm gonna have to imagine Meadow's going through the same thing.
I'm sorry, Ethan.
Yeah.
- Dr.
Manning? - Yeah.
We ordered a postmortem tox screen for Gaia.
Hopefully it'll show us what drug we're dealing with.
Yeah, but I'm not so sure we're dealing with a drug anymore.
Look at all this hair.
Is that from when Ethan pulled off the bag? Yeah, but there's too much of it.
I-I can't think of a recreational drug that would account for this amount of hair loss.
Heavy metal toxin or poison? That run-down house where they found them? Any number of contaminants could be in there.
All right, I'll have the labs expand Gaia's blood tests, search for heavy metals and toxins as well as other drugs.
But, you know, it still doesn't add up.
If neither Gaia or Meadow were taking an illegal drug, why were they so adamant about refusing treatment? Patient's middle name? Is that really necessary? I never put mine on anything.
Okay.
Date of birth.
I don't know, I-I I'm 30.
He's a year younger than me, maybe two.
- Is everything okay? - Yes.
The intake form has a few black boxes.
More than a few.
Look, the paperwork is irrelevant.
I'm covering the costs.
Billing is still going to want information.
Cash is king.
I'm sure they'll make an exception.
Are we done? Thanks, Leah.
Kind of shooting the messenger, don't you think? I'll buy her something from the gift shop.
Vee's X-ray? No fracture.
Great.
We can go.
Oh! You all right? I'm exhausted.
Kidney failure will do that to you.
I bet.
Transplant is next week at East Mercy.
I'm supposed to be resting, keeping my stress level low.
I brought you to Chicago to cure me, not make it worse.
I'm sorry.
Let's go.
Uh, hold on.
Let me take a look at you first.
I really am okay.
I have my own nephrologist.
He'll make a house call.
End-stage renal disease, I suspect they'll just send you to an ED for labs.
Yeah, you're probably right.
That's been the drill.
All right, but I want my doctor in the loop.
I'll have my assistant reach out to the hospital and set everything up.
Works for me.
I'll send someone in to get you registered.
We're gonna stay.
Hey.
I heard about your patient.
You all right? Yeah.
Emily and Bernie are here.
Bernie's not feeling well.
You are up, but I'll get another doctor if you need a few more minutes.
I got it.
Okay.
Treatment three.
Be nice.
It's okay, Bernie, we'll find something else.
I know, baby.
You're so good to me.
I love you.
- Hey, guys.
- Hey.
What's going on? Emily just found a really good apartment, but it was a little pricy.
Bernie, honey, I think he's talking about your stomach.
Oh, right, yeah, I'm, uh, I'm a little bloated.
Yeah, he's got a fever too.
Belly's really distended.
How long has it been this way? Couple of days.
All right, well, we'll get some labs and a CT abdomen, then go from there.
So you guys are getting an apartment.
- Trying to.
- That's good.
So everything's settled with your wife? - Ethan.
- Okay, then.
I'll go put in the order for your tests.
Hey there, Vincent.
I'm looking right at it.
Even my father still has a left-to-right shunt through a patent atrial septal defect.
And I'm telling you it wasn't there after I placed the intracardiac patch.
Negative bubble test.
His post-op echo was good.
I fixed the problem.
- Clearly, you didn't.
- You're incredible.
You've made it clear you think I'm a horrible person.
Now I'm a lousy surgeon as well? No, you're an excellent surgeon, which is why this is so glaring.
I take it that's your passive-aggressive way of saying I was careless? Or worse? However it happened, my father still needs a repeat repair of his ASD and I am going to advise him to have Dr.
Latham perform it.
At first, I thought your attacks on me were just you blowing off steam after we broke up.
But now I really think you're losing your mind.
Gaia's body tested positive for a highly toxic substance called thallium.
There may have been traces of it in the house where you all were staying.
The good news is, there is an antidote.
Prussian blue.
It stops the thallium from being absorbed into your body.
Meadow, do you understand what What Dr.
Manning is saying to you? Yes.
Are you willing to take the medicine? If you don't take the Prussian blue soon, you will die from this.
Will you leave me alone if I take the pills? Promise.
Okay.
I-I'll take 'em.
Okay.
Here you go.
We finally got through to her.
Yeah, but why? I mean why now all of a sudden? I'll take the win.
Would you do me a favor? Keep a very close eye on her? - Sure.
- Thank you.
Hey, let me ask you.
What's going on with Emily and Bernie and this hunt for an apartment? They're looking.
Yeah, I heard her place fell through, too expensive.
I just hope Bernie isn't dragging his feet.
Well, Emily hasn't complained.
Maybe, but she's still sleeping at your place with the baby.
- I don't mind.
- And Bernie's what? Sleeping across town on his wife's couch? Doesn't seem to faze him a bit.
Ethan, if you're thinking of getting involved, don't.
It's not gonna help.
You're Bernie's doctor.
Focus on that, okay? Dr.
Halstead, this is Dr.
Richard Haley.
Mr.
Wycoff's nephrologist.
Nice to meet you.
So you'll handle the red tape? Absolutely.
A VIP room is being prepared for Mr.
Wycoff as well as our conference room for you to consult with our transplant team.
I'm sorry.
What's happening? Well, I didn't like Brandon's labs.
His phos is up and he's anemic.
I'm moving up his kidney transplant to today.
I want him to get two units of O-neg, stat.
Whoa, whoa.
Not so fast.
Mr.
Wycoff's my patient.
I'll handle those orders.
Dr.
Halstead.
I appreciate you getting the ball rolling, but Dr.
Haley is gonna take over.
Miss Garrett, I am not comfortable with this.
Brandon doesn't seem to know anything about his cousin.
He's avoiding a paper trail by paying cash, and now some doctor we met two minutes ago is rushing him off to surgery? What about repeat labs? Pre-op scans? HLA confirmation? It will all happen.
Only now, it's going to take place here instead of East Mercy.
An easy and profitable win just fell into our laps, Dr.
Halstead.
Be grateful.
We're moving Mr.
Wycoff to the Ambassador Suite.
It time? Not yet.
Soon.
Vee? Vee.
Do you understand what's happening? Oh.
Um, Brandon, uh, need.
I have give.
You have to or want to? Dr.
Manning, Dr.
Charles.
Monique, get me suction.
Mm-hmm.
I don't understand.
The Prussian blue should be making her better.
It's only making her worse.
It's 'cause she didn't take the pills.
Where are they? - Dr.
Charles.
- Meadow, where Monique.
Meadow, without these pills, you will die.
We're supposed to die.
The oceans are warming.
Ice caps are melting.
We're killing the planet and no one cares.
Except for us.
The Angels of the Earth.
"We, the Angels of the Earth, "will not be so blind to ignore that human greed, negligence, "and abuse are destroying the planet.
We will serve the Earth by removing ourselves from it.
" Oh, my God.
They're a cult that believes that Earth is destined for destruction and the only solution is to kill themselves.
At least they're not making it all up out of thin air.
Each one of their claims is linked to a legitimate scientific study.
Yeah, I know, but their whole manifesto is still one big suicide note.
Well, at least you can put her on a psych hold and we can force treatment.
No, no, no, we can't.
Look, a psych hold just means we can keep her here so she doesn't harm herself more.
It still doesn't mean we can make her take Prussian blue or undo the things she's done to herself unless she wants us to.
So what can we do? Well, it's a long shot, but I could petition a court to deem her mentally incompetent because of the brainwashing she's received at the hands of this cult.
If not, Meadow controls her own fate.
I just got word your patient's gonna be admitted and moved upstairs to meet with transplant.
Mags.
I need you to stall the transfer.
I'm waiting on calls from translators.
Gwen Garrett called me personally on this one.
I can buy you maybe half an hour.
That's not gonna do it.
Damn it! Okay, let's get a head CT.
- Will! - Due diligence.
I'm just making sure there's not a delayed subdural hematoma that might endanger Vee in surgery.
This case smells that funky? It smells illegal.
Okay, I'll order you the CT.
You got an hour now.
But if I were you, I'd find a plan B.
Yeah, I need Miss Goodwin.
Dr.
Latham, how'd it go with my father? - No problems.
- Good.
So, uh, what was it? Was the intracardiac patch not sewn in properly or did the sutures come loose? Neither, the patch itself was faulty.
The patch? So there was no error on Dr.
Bekker's part.
Absolutely not.
Her sutures were placed perfectly, as always.
So, Bernie, I've got your CT results.
You have a complete small bowel obstruction.
Likely caused by adhesions related to your pancreatic pseudocyst surgery.
Wow, uh I've got an OR prepped for you now.
What about recovery time? A few days in the hospital, then another week or two of bed rest.
Honey, we'll have to put a hold on our job and apartment search.
Of course, your health comes first.
And I'll call Ashley and let her know I'm gonna be there a bit longer.
It's all gonna work out.
How, Bernie? How is everything gonna work out? Without a job? Without a place to live? Can't you see how hard this is on Emily? Not to mention her baby? For reasons I may never understand, Emily loves you with all of her heart.
So start showing her you feel the same way.
Get it together.
Mr.
Kim? I'm Dr.
Wilde.
We're here to take you to pre-op holding.
Let's go.
The black market? You think Mr.
Wycoff is buying your patient's kidney? Wouldn't be the first.
World Health Organization estimates that 7,000 kidneys are illegally harvested annually.
I have other reports from human rights groups, economic equality firms.
All right.
"Buyers of trafficked organs are high-income individuals "from developed countries.
"The typical seller is male, around 29, and from some of the world's poorest areas.
" I mean, this is Brandon and Vee.
Yes, they fit the profile, and I'm well aware of the magnitude of illegal organ transplants.
But this is Brandon's file from East Mercy.
Uh, transplant list status as well as Vee's donor papers.
Our lawyers have been all over these documents.
Nothing appears out of place.
And what about the nephrologist, Dr.
Haley? Privileges at hospitals across the city, including ours.
So Brandon's covered his bases.
That doesn't mean money hasn't changed hands.
Miss Goodwin, I'm telling you, there's something going on here.
This is the mission statement of the Angels of the Earth.
I've read it three times now.
Are you beginning to understand, then? I'm trying to.
As a scientist, I agree.
But I'm having a hard time believing that the planet is doomed to become uninhabitable.
Or how poisoning yourself with thallium will change that.
Would you have heard of the Angels of the Earth otherwise if I wasn't here? So you're a martyr? In 1963, a monk set himself on fire in protest of the Vietnamese government's discriminatory laws against Buddhism.
The government was overthrown.
Is that your hope? That the government is overthrown? No.
My my hope is that people wake up and take action instead of continuing to cook our planet by burning fossil fuels.
So then you believe the planet can be saved.
You're twisting my words.
- I'm not.
- Mm-hmm.
Your logic is flawed.
You want people to change, but you also think that change will be meaningless.
So what is the point of martyring yourself if it's unclear what you stand for? I-I'm not taking your pills.
Meadow, your hair is falling out.
You're running out of time.
Good.
I am not gonna let you die.
Monique, John? Put her in the soft restraints, then prepare for an NG tube.
I'm giving her the Prussian blue.
No! Maybe I should call Dr.
Charles.
I'm a licensed physician, and I am deeming the patient nondecisional.
Put her in the restraints.
Now.
No! No, you can't do that! I'm sorry.
You can't! No, please! You can't do this! No! Stop.
I have to ask you.
Is Brandon paying for your kidney? Money.
All right? Is Brandon paying you money for your kidney? No, uh no money.
It's okay.
Just tell me the truth so I can help.
Help? Uh, yes.
Ah.
Me.
Brandon.
Uh-huh.
Brandon sick.
I help family.
Dr.
Halstead? Is there a problem? No, just checking on Vee.
Making sure he's okay.
Me too.
Oh, you gotta be kidding me.
Look at us.
My mom took me to Moldova when I was eight.
She wanted me to experience the homeland.
And village after village, I was so bored.
But then on the last day, I met Vee.
And we couldn't speak to each other, but we both knew how to play soccer.
Football.
Football, football.
I football.
Hmm? Thank you for what you're doing for me.
You're saving my life.
I wish he knew what I was saying.
I think he does.
I'll leave you guys alone.
I have gifted millions to this hospital.
I expect first-class care.
Connor, get in here.
You should hear this.
A budget bloated with waste, and what is Miss Garrett's solution, is to save money on intracardiac patches.
Again, Mr.
Rhodes, I sincerely apologize.
I will personally look into how these patches ended up in the OR and I will make sure that it never happens again.
Full report next board meeting.
Of course.
And Gwen if memory serves, your contract extension is also an agenda item at that meeting.
I believe it is.
Perfect.
See you there.
Hey, uh, just got an update.
Bernie's surgery went well.
- He'll be out soon.
- That seat's taken.
And that seat's taken too.
Okay, I get it.
You're mad at me.
Why'd you yell at Bernie like that? I was sticking up for you.
You were kicking him when he's down.
Everything I said, Bernie needed to hear, and you were never gonna say it.
Yes, I want an apartment.
I want him to get a job.
But tough love won't get us there.
And coddling does? Miss Choi? Mr.
Kim's being moved to the ICU for recovery.
Whenever you're ready, you can go down and see him.
Thanks, Lizzie.
You don't get it.
Bernie's delicate.
He's warm, affectionate, and he needs encouragement and support.
And if you can't get behind that, then get out of our lives.
Dr.
Charles? I need you.
What the hell were you thinking? You could lose your license for this.
- For doing what's right? - For breaking the law! I don't want her to die either, Natalie, but the woman has rights! What are you going to do? Well, now that you've boxed me in, there's only one thing that I can do.
If you take out that tube, the only thing you will be doing is pushing Meadow one step closer to death.
Get out of my way.
Okay, this is gonna be uncomfortable.
Sorry about that.
I apologize for Dr.
Manning.
It it's hard for her to understand why you're doing this.
I thought you'd want to know that, um, because of your friend's deaths, everybody is talking about Angels of the Earth right now.
I mean, the Internet's going crazy.
We knew it would.
So thallium, huh? Clever.
A chemical compound not found in nature.
A poison that deteriorates the body in much the same way that climate change affects the Earth.
It's poetic.
You're smart.
You know, you've gotten pretty much everything you wanted.
And all that's left now is to wait? I think you've suffered enough, Meadow.
And I'd like to help ease that transition and give you a couple of sleeping pills if you let me.
Suffering is the point.
Look, Gaia put a bag over her head.
There is no one on the Internet calling her out for taking a shortcut.
Trust me.
It's just a thought.
Okay.
I'll take the sleeping pills.
Good.
Give Meadow 5 of eszopiclone.
It's okay.
Meadow has agreed to take eszopiclone.
Once she's out, she will no longer have the ability to advocate for herself.
And a strong legal case could be made that we then have the right to act under implied consent as surrogate decision-makers on her behalf.
So you can replace the NG tube and administer Prussian blue.
- Ava, hold up.
- Leave me alone, Connor.
Look, I am sorry for jumping to conclusions earlier.
I should have considered the possibility that the patch failed before placing all the blame on you.
And? And what? Seriously, Connor? Accusing me of botching your father's surgery is the only conclusion you're sorry for? What about your claim that I slept with him? That I manipulated the oversight committee? That I let you cut my hand in surgery? And God knows what else.
No apology for any of that madness.
I'll be honest.
When we broke up, I was devastated.
And I'm still getting over it.
But at no point have I cast you as a monster.
So why do you insist on making me one? Why do you want to hurt me so badly? You're such a good baby.
Yes, you are.
Hey, Bernie.
Um, Bernie, look I was out of line earlier.
I appreciate you saying that, Ethan.
Now on, if you need anything I want you to know you can come to me, no questions asked.
Em, do you mind if I, uh, have a moment alone with Ethan? Okay.
We'll be right outside.
Let's go outside.
Let's go outside.
You were right, Ethan.
I better step it up, and I'm going to.
I promise.
I'm glad to hear that.
There is, uh, one thing you can help me out with.
Name it.
Lately, I've been having trouble sustaining an erection.
What? It's called erectile dysfunction, and there's medication that That can possibly help.
I'm reluctant to write you a prescription.
You should really talk to a urologist.
Thank you.
Thanks for everything, Ethan.
Dr.
Charles I know you're upset with me.
But I just wanted to thank you for what you did today.
We prevented a suicide.
Have we, though? I mean, two doses of Prussian blue won't be enough to neutralize the thallium.
She's gonna need dozens more.
When Meadow wakes up tomorrow morning, the battle to get her to take them, it starts all over, and I'm just worried that we haven't really prevented a suicide as much as we've postponed one.
Natalie, um this is the second time in as many months that you've, um, well, you've misstepped, and I'm just wondering, is is everything okay? Yeah.
Okay.
Well, um, I will see you tomorrow.
Hey, Phillip.
Oh, hey.
Waiting on Natalie? Yeah, she's picking Owen up from daycare.
Look, man, if I seemed weird earlier, I'm sorry.
What do you mean? I was just thrown when you mentioned your ranch to Owen.
I'm so sorry, when I mentioned my Your ranch.
Oh, yeah.
That.
Well, look, uh, the kid loves horses.
I was just playing.
So you don't own a ranch.
No.
no.
Oh.
But I figured that Owen got a pretty big kick out of it, right? Yeah, I guess.
I'll see you around.
Yeah, take care.