Good Sam (2022) s01e05 Episode Script

Wake Up

Previously on Good Sam I spoke with the board.
They're not just gonna hand you the reins at the end of this.
They're gonna choose between us.
The next time you want to help me, don't screw my best friend! It was good back then.
We cannot go back to the way it was.
She's starting a war she can't win.
You let Lakeshore lose an eight-figure donation.
And pinned it on me.
I did tell you that the lesson was gonna hurt.
I assume you're here to collect on our agreement.
What exactly do you have planned for my father? This isn't about your father.
It's your mother we need to talk about.
The day your whole life changes starts like any other day.
You wake up and life is just how you left it.
- Morning.
- Morning.
Sometimes that's a good thing.
Sometimes it's not.
Mostly it's just another day.
And that's when it happens.
55-year-old male, single gunshot wound to the chest and hypotensive.
Inbound now.
Someone points a gun, pulls the trigger.
Next thing you know, you're being supervised by a surgeon decades your junior, whose experience and expertise bear no comparison to your own.
It is tragic, really.
Kind of making it all about you, aren't you? Well, gunshot wounds have that effect on me.
Thank you for your insights, Doctor.
Perhaps we can focus on today's case.
Yeah, you're right.
Got to fix him up before a subordinate swipes his job.
Deep down, he doesn't really mean that.
Deep down, yes, he really does.
30 caliber GSW to the abdomen.
His hunting partner accidentally shot him from about 30 feet.
- Exit wound? - No.
Start a large-bore IV.
Get all the O negative you can carry.
There's so much blood.
How bad is it? Please don't let me die.
Single shot from behind.
Bullet exited through the abdomen.
- Prep an OR! - Dad.
Try not to talk.
Don't don't let me die.
I won't.
Dad? Dad.
Dad? Are you with us? Let's get him on the monitors.
Hang two units.
- How's the FAST? - Hemopericardium.
We got to remove the blood from around the heart.
Pericardiocentesis, needle and syringe.
Carl? I'm his wife.
The paramedics took forever to get here.
Is he okay? - Carl! - No, no.
He's coding.
- Carl! - 18-gauge needle.
60cc syringe.
Skin prep.
- Skin prep! - No! No.
You do not have privileges to touch patients, do you understand me? I'm doing it.
Stand down, Doctor.
Let's get him to the OR.
Not you.
- What? You need me in there.
- You're family.
You need another set of hands.
- I mean, hemorrhage control alone - It's a no.
I'll scrub in.
- I got him.
- Okay.
Two units are in.
He's still tachy, - but his pressure's stabilizing.
- Okay.
Let's get him to imaging.
I need to see how much damage this bullet did.
That was intense.
Thank you for stepping in.
Gunshot wounds are hard enough without him grabbing instruments behind my back.
He was just trying to help.
I'm not defending him.
He can't touch patients, and he shouldn't.
But, you know, sometimes instinct takes over.
I get that.
I really do.
But he acts like this proctorship is something that I'm doing to him and not for him, and - Is it weird to talk about him? - Yeah, it's weird.
But I think we have to talk about it if we're gonna get back to normal.
Probably right.
For the record, I'm glad we're talking, - even if it's weird.
- Me, too.
- Why are we hiding? - Rhonda.
I owe her a favor, and I have been trying to put her off as long as I can.
How are you gonna do that when you have the department chiefs' meeting today? Oh, that's right.
It's a good thing.
It's your first year representing the department.
I know, and I'm very excited about it.
- Mm-hmm.
- But, you know Rhonda.
Why is my mom paging me? Why is your mom paging me? Why is Pyne in the surgeons' lounge? He is a doctor here.
Psychiatry is not surgery.
Psychiatry is not surgery.
So do you, uh, mind explaining to me what just happened in the ER? Difference of opinion.
It was a tug-of-war over a pericardiocentesis needle, and it is not acceptable.
I've asked Dr.
Pyne to come here today to make sure this doesn't happen again.
Thank you.
Let's begin with a deep, cleansing breath.
First we inhale.
Then exhale.
Pyne, that was, that was That's an inhale and then an exhale? No, he said exhale first.
So n not inhale? Would you go over it again? I think we're a little confused.
If you two were as unified with the patient as you are in your dislike of me, perhaps we wouldn't be here in the first place.
Can we just agree it won't happen again and move on? That's a good start, but I'm interested in why it happened.
If we can excavate some emotions, I feel we can Sorry.
Carry on.
We can prevent future incidents.
Pyne is offering his services to anyone who would like to talk, and so, I suggest you take him up on it.
I can't have your emotions clouding your judgment.
That's absolutely right.
You should book a double session with him.
Humor as a defense mechanism.
It's understandable, given how much you have in common with this patient.
I have nothing in common with him.
Really? A father, in his prime, shot through no fault of his own.
I could be describing you.
Well, as you're talking, I'm struck by the fact that you you actually charge for this stuff.
You don't see the similarities.
Then what happened in the ER? - Ask her.
- How is this my fault? You stepped between me and a patient.
To prevent you from violating the legal terms of your proctorship.
- To show me who's boss.
- That is not what this was.
You want to know the difference between me and this patient? - Enlighten us.
- The bullet exited my body.
It's stuck inside his.
He's semiconscious.
I was comatose.
He was out hunting.
I was shot in my place of work.
The list goes on, culminating in our presumably opposing stances on gun control, but the biggest difference is that his family saw his shooting as a tragedy, and mine saw it as a career opportunity.
Griffith, I handed your department a multimillion-dollar donor.
We had a deal.
Our deal was about my dad.
Our deal was I help you, you help me.
I never specified the nature of the favor.
Let's get this over with.
As you know, I own a chain of surgical centers under the Lakeshore banner.
They make a lot of money.
But most of that money goes back to the hospital.
Well, the hospital's name is over the door.
That's what brings all the patients in.
My skill at crafting the perfect breast is what brings them in.
Lakeshore gets 60% of what I make.
Does that seem fair to you? I have been trying to renegotiate my profit split with your mother for years.
I just keep getting the Heisman.
So, you want me to talk to my mom? No, I want you to bring it up at the chiefs' meeting.
She can say no to me, but not to a room full of chiefs demanding fair pay.
I don't have a surgical center.
Just bring it up, and your debt to me will be paid in full.
First, I'm gonna help my patient, and then I will help you.
See you at the meeting.
Tim's checking in again about the gunshot case.
I already told him we don't know anything yet.
Well, maybe he's checking in on you.
Why? Because he loves you.
Because it was traumatic.
He's a paramedic.
Trauma pays our bills.
People get shot every day.
Indeed they do, Dr.
I'd like an update on the patient's blood volume and an updated creatinine to see how his kidneys are responding to the fluids.
Thank you.
- How you doing? - Hmm? Oh, I'm always a little on edge after a shooting, and Griff isn't even my father.
Are you saying I'm on edge? No, no, no.
Not saying that.
Just saying that if you were, and if you wanted to talk about it, we could.
But you aren't, so we won't.
CT scans just came in.
The bullet's lodged at the bottom of the aortic arch.
Wow, a millimeter further and he'd be dead.
Looks like the impact injured the vessel wall.
Mm, you're right.
Luckily, it's small and asymptomatic.
For now.
He's still coagulopathic from the trauma.
If we go in to remove that bullet, we risk uncontrolled bleeding.
He's being transfused with packed red blood cells and clotting factors as we speak.
So we wait.
We'll monitor the pseudoaneurysm closely.
Leave that bullet in, it could erode to the aortic wall or dislodge entirely.
Both highly unlikely.
If we give him time, his hemostatic abnormalities could correct on their own.
The worst thing a heart surgeon can do is hope for the best.
The bullet has to come out.
The bullet stays in for now.
I want Q1 hour updates on his labs so we can get him in an OR when he's stable.
What are you doing? The only thing I can do: nothing.
If you're going to put protocols ahead of patient care This proctorship is not a punishment.
I am trying to help you get there.
By tying my hands during an emergent procedure? I understand how you feel.
You couldn't possibly.
You don't think that I felt helpless after you got shot? I know exactly how devastating it is to want to help and not be able to do anything.
Well, you seem to have got over it.
You don't have to keep checking up on me.
You aren't answering my texts.
I just couldn't find the right emoji for "gunshot patient stable, as am I.
" Well, it's okay if you're not, you know.
Even Sam and Griff were rattled by that whole scene.
Well, they lack my advantage in times like these.
What advantage is that? The fact that I'm well-suited for stress.
So, you sat up talking to yourself the night your Uncle Terry died? Or when your passport was stolen in Rio, you talked yourself out of a panic attack at the U.
Embassy? - Okay, hold on a minute - Yeah, and you-you got yourself through these last three years of residency by, what, being naturally well-suited for stress? - I never said that you had - The thing is, Joey, is that people actually believe this act of yours.
Costa, he doesn't need anybody.
And they don't know that I have been here the whole time, supporting you, holding you up.
They don't see me.
But I thought you did.
- Tim.
- Don't.
Well, good work, everyone.
- Any other business? - Uh, I'm new here, but I do have a topic to raise.
Go ahead, Dr.
It's about the outpatient surgical centers affiliated with Lakeshore.
- What about them? - Well everyone works equally hard to run those centers.
And, um, shouldn't everyone be compensated equally? The, uh, budget committee meets, when, next quarter? Let's table it until then.
Who says we aren't being compensated equally? How would we know? You can't.
Not without violating confidentiality agreements.
It's fine.
I'm sure we all make the same 40%, so 40? - I get 30.
- I only get 25.
- This makes no sense.
- I get 35.
- I don't see how this can be fair.
- Did you know about this? Uh Rhonda's cut is the highest here.
- Mm-hmm.
- My eyes have been opened.
Katz, how do you explain this inequity? I asked the question.
My mother shouldn't have to answer I want to renegotiate my deal.
What are you gonna do about it, Vivian? I will take this matter into consideration.
Meeting adjourned.
I told you not to get involved with Rhonda.
This is a political nightmare for me, Sam.
I didn't know she had the biggest split.
You also don't know that the splits are based on the profit each center generates.
Giving everyone the same split sounds good, but it doesn't make financial sense.
You're right.
I am the CMO.
This is my lane.
Do I tell you how to perform your surgeries? I want to help make this right.
There has to be a solution.
There is, an expensive one.
I need to find half a million dollars in my budget that I already know I don't have.
Unless I want to face a mutiny.
I'd like to wait for the swelling to go down before removing the bullet.
We just don't want to put him under more stress - than he can handle.
- That's good.
Let's wait.
It'll give my son time to get here.
The visibility was so bad today, I told him not to go hunting.
If I had known how this day was going to end It's not over.
He just needs time to heal.
Someone came to ask if he has a DNR.
That can't be a good sign.
We are doing everything we can.
Why are they asking about his DNR? H-He just got out of surgery, Anders said that it went well.
He also said that your father's DNR is, um It's not on file.
We have to find it, and I, um I just I don't even know where to look for it.
I don't know where our divorce papers are.
It's been so long.
I will find the DNR.
Thank you.
We're not gonna need it, but I will find it.
I, uh I should go upstairs.
I've got a million fires to put out.
Are you coming? No, I'm gonna stay a little longer.
Just in case anything changes.
Okay, I've got a good one for you.
68-year-old male with worsening shortness of breath found to be in advanced heart failure.
Now, I know that you would say he's a classic LVAD candidate, but what if his decline is related to his thyroid condition? If we can get his A-fib under control, it might allow for some cardiac recovery.
Thoughts? Did you sleep here again? Something can change at any moment.
I just don't want to miss it.
Sam, it's been weeks.
And with you down here, I am out a department head and a surgeon.
The department is unraveling.
I just I just need to know what your plans are here.
I don't - Shh.
Do you hear that? - What? The tempo changed.
I need a crash cart in here, now! - Sam, what are you - He's about to code! Do we know his orders? I never found a DNR.
Go! Charging to 200.
Charge it again.
Okay, he's back in sinus tach.
Come on, Dad.
Come on.
Come back.
Um I've been thinking about what happened earlier, and I think it is time to give you this.
Instruments and manual assessment.
You've passed your motor skills and your dexterity assessments.
I'd planned on signing off on implements next week, per the schedule, but you're ready now.
- Mm-hmm.
- And after this, you'll advance to second assist during surgery, then first assist I know how it works.
I thought you would be happy about this.
Happy? You get to lay hands on patients again.
I get to take blood pressure, change bandages.
This is supposed to feel like a win.
Compared to what I've lost? - Okay, I'm doing the best I can here.
- Well, I'm not.
I'm not doing anything.
This isn't a win.
It isn't even a consolation prize.
If you gave Picasso finger paints, you think he'd say thank you? - I am sorry what I said upset you.
- No.
- I'm sorry that you feel upset? - Still no.
Oh, come on, Donna, give me a break.
I'm sorry, Dr.
I'm just not buying it.
How can he think I take him for granted? We live together.
That doesn't say it all? Mm.
Not necessarily.
You could be roommates.
Or cellmates.
Rhonda Glass please.
This is the third time I've called.
Tell her to call me back.
Have you considered just telling him that you appreciate him? When was the last time you thanked him for everything he does? I thought it was implied.
Carl's numbers are not what we'd hoped.
He's still acidotic.
His INR is elevated.
I want to rerun his labs.
And I'd like to increase the dosage on his TXA drip.
Why don't you handle that? - You cleared him to administer meds.
- Yeah.
Among other things.
That's a big step.
Will you let me know when you have those labs please? Thanks.
What's going on here? I don't know, I I was just The shooting.
There was a shooting.
It was a doctor like me.
Uh, no.
- Much better than me, actually.
- Lakeshore.
Yeah, we got the call about that.
Did he make it? You would know if you weren't passed out in this parking lot all night Dr.
I see so many bodies, cut open, but you know, seeing him like that, I just I couldn't take it.
I need to go.
Step out of the car, please.
I just I really need to get back to the hospital.
Either I take you home, you get cleaned up and get yourself some help or I bring you in on suspicion of a DUI and have the court order you to do it.
They say, "When you hit rock bottom, stop digging.
" So I did.
I have wondered what happened to you that day so many times.
Failing you was my low point, but it made me turn my life around.
And I've been sober ever since.
You've been in recovery for months? I'm sorry I didn't tell you sooner, but I want you to know that you can talk to me.
I've changed, and I know that that's probably hard to believe.
So I thought hearing the whole story might help.
It does help.
Thank you.
How could you drag my mother into this? Her practices are unfair, and she got caught.
Oh, please.
You don't care about fair.
Your rhinoplasties alone make more money than Dr.
Bhatt's entire GI center.
I didn't pick the man's specialty.
There's no money in bowels.
And what, getting ten grand a tummy tuck isn't enough for you? I charge more than that.
And being told how much of my money I get to keep really chaps my ass.
Hey, Mom.
I have an idea how to undo this whole Rhonda mess.
Okay? Call me back.
I don't mean to brag, but you're basically getting a sponge bath from a world-class surgeon.
You got a raw deal, pal.
But you've got a family that needs you, so there's still time.
Things can turn around.
How long has his hand been twitching like that? He's having a seizure.
Pseudoaneurysm is throwing off microthrombi.
I need two milligrams IV lorazepam and Fosphenytoin in here.
Tell the OR we're coming.
We got to get the bullet out now.
All right, let's get him open, and find that bullet.
Griffith, will you do the honors? Spreaders.
There you go, like riding a bicycle.
Let's do this.
More light.
Bullet's gone.
It's migrated into the circulatory system.
Well, we have to find it fast.
Looks like the rupture was self-contained.
I'm gonna fix the hole in the aortic arch while Dr.
Griffith finds that bullet.
Do you think you can do it without going on pump? I'm gonna try.
Side clamp.
Tell me you can see it.
Descending aorta's clean.
What about the arms? Diminished pulse in the left arm.
It's lodged in the left subclavian artery.
- Very bad.
- Not good.
- Can't see to get primary control.
- There.
Thank you.
Sponge forceps.
BP is dropping.
I need a - Potts scissors.
- Thank you.
- Increase the patient's - Norepinephrine drip.
I'm running out of time.
This is a needle in a haystack.
You can do this.
There's still time.
Got it.
Let's get him closed up.
After reflecting upon the tremendous value each of you brings to Lakeshore, the hospital has agreed to raise all your profit splits - to 40%, matching Dr.
- Thank you.
Effective immediately.
I thank you all for bringing this to my attention.
That must've cost a pretty penny.
As do your tummy tucks, Dr.
The post-op complications of which have been deemed too risky to allow outside a hospital setting.
You can't force me to stop doing these procedures at my centers.
Yes, we can.
So, you're gonna use my tummy tucks to pay for everyone else's raise? Mm-hmm.
What do I get? Continued affiliation with this hospital.
And, of course, the satisfaction of contributing to a much fairer compensation plan.
That'll be all.
It was good to have you in there, Dad.
As your scrub nurse? I'm glad you enjoyed it.
Forget it.
What is wrong with you? Aren't you happy you just got back into surgery? I was, actually.
And then I got back out here.
Can you be grateful for one second? I know things have changed.
Nothing changed.
Not for me.
- I blinked.
- We talked about this.
I blinked and everything else had changed.
There was a scar on my chest, and everything was was-was gone.
My job, my office, my standing in the hospital that I put on the map.
Even you.
All gone.
I woke up to discover just how easily I can be replaced.
So, I got another case for you, Doctor.
Female in her 30s.
Her boss took an, um unexpected leave of absence.
His department is not doing so great, and they want her to fill in, which may seem like a good solution.
You know, she knows the hospital, knows the drill.
She she knows the job.
Problem is, she doesn't want to do it.
Don't make me do this.
You can't just leave me here, you know.
You have responsibilities.
Your department needs you, and your daughter needs you.
I'll look out for everything for now, okay? But you you have to wake up.
Do you hear me? Please wake up.
I'll wait.
Good thinking using Rhonda's profits to even out the pay gap.
I'm sorry it happened in the first place.
I'm sorry I didn't listen to you about Rhonda.
We can't let her drive a wedge into this family.
Well, I think the wedge is already there.
Whose fault is that? I'm tired of this fight, Dad.
You had a successful surgery today, Griff.
I successfully held a retractor.
I have the paperwork to prove it.
Signature, please.
By your good grace, I might get to be a doctor again someday.
I advanced your proctorship ahead of schedule.
I let you assist on a surgery, because I want you to succeed, Dad.
- Sure.
- I always have.
Pens are in the right drawer, unless you jumped to change that, too.
That is not how it happened.
Really? How did it happen? Hmm? Exactly I'm just curious.
H-How long could you bear to wait before you stepped into my shoes? Was it a month? Was it a week? Enough, Griff.
I didn't want to have to show you this, but here.
You had it all this time? You said, "Don't let me die.
" And if I'd handed that over, they wouldn't have revived you.
So I lied, to everyone, including Mom.
I violated the oath that we both took! A daughter is not supposed to have to prove that she loves her father.
But there you go, Dad, there's your proof.
How long did I wait? I would've waited forever.
Get me a crash cart! Sorry.
Where is the ICU? Up those stairs.
I need one gram of calcium and another gram of epi.
One more.
Come on.
Come on.
Come on.
Dad! Sam.
Call it.
Time of death, 17:45.
You ready? Ready.
To Carl.
To Carl.
This part never gets any easier.
Today was harder than usual.
I just want to call Tim, but You haven't talked to him yet? I haven't figured out what to say.
You got the booze? I, um I thought we could try something new.
Better for our livers, worse for our teeth.
Thank you.
You're welcome.
So friends? Friends.
- Hey.
- Hey.
Where weren't you at the lake? Dr.
Trulie? Are you okay? Yeah.
Um Sam is waiting, uh, for an update, and I have to tell her that Griff is stable.
Though we are monitoring the hemorrhaging, and, um, his pressure is, uh Take a breath.
- Hey.
Just breathe.
- No.
It's my job, and I have to do it.
Look at me.
Look at me.
Deep breath in.
Hold it.
There you go.
Now let it out, slowly.
I will make you a deal.
I will update Sam and Vivian right now.
Thank you.
If you come see me in my office tomorrow after work.
Okay? O-Okay.
Why didn't you tell Sam about you and Griff? I didn't know what to tell her.
I didn't know what it was, if it would last.
And then? I didn't want to make things harder for her.
So you made them harder for yourself.
This isn't just about the shooting, Lex.
You carrying a secret, alone, for months, it's taken a toll.
And it will continue to, unless you get the support and love you need to be whole.
My sister Mia She's been wanting me to come visit.
I could, um, do that.
Take some time.
Clear my head.
That sounds like a really healthy choice.
I was hoping we could talk.
Me, too.
It's about my dad.
They, um, they asked me to be chief.
They did? I mean, interim chief, but That's great.
It's an honor.
I just I just finished my fellowship.
I don't know the first thing about being chief.
So you'll learn.
They wouldn't have asked you if they didn't think you were up to it.
I think I could be up to it, if you're with me.
- With you? - If this door is gonna open for me, it can open for both of us.
We could do this together, and Sorry, do you need to get that? No.
It's just my sister.
But I am with you.
Really? Of course, Chief.
We keep talking about getting our friendship back to normal, but normal was a problem for me, Sam.
What do you mean? I wasn't just your subordinate at work.
I was your subordinate in life.
The more you advanced at the job, the more my needs came second to yours.
That's not how I saw our friendship.
Maybe not, but it's how it was.
You don't even know what I was going through a lot of the time because I didn't tell you.
- I - You had a lot on your plate, and I wanted to be there for you.
I want to be there for you, too.
I No job should ever get in the way of that, Lex.
I Sam, I cannot put myself second to you anymore.
Okay? I need to do things differently.
Whatever you need, I support.
You should never come second, especially in our friendship.
I really hope you mean that.
First surgery together, and we lost the patient.
Not a good sign.
Well, his odds were slim to start with.
As were mine.
That patient could've easily been me.
I made it thanks to you.
You had a lot of good doctors.
Well, you gave me a second chance, and I I would like to use it.
What does that mean? There's a reason I want this job back.
And it has to be this job, this department, - this hospital.
- Because you built it.
I built it.
It's bricks and mortar, bedsheets that could go anywhere.
So what? Because it's the natural order of things? Because it's where you are.
- You've never said that before.
- I want to be chief, but I also want to be your father.
I want to start over, do things differently.
From the day I woke up.
You have a time machine I don't know about? Okay.
Go with me.
- Wow.
- What are you doing? Waking up from a coma.
Oh, Lord, it's a miracle.
Where am I? What day is it? - Who won the Super Bowl? - Dad.
How are you? That's what I should have asked.
How are you doing? Instead, I asked about work.
- Maybe work's all we have.
- No, Sam.
I'm your father.
What do we have in common besides medicine? Why don't we try, and find out.
Over breakfast.
Breakfast? Do you eat breakfast? - Yes.
- See? There you go.
Something we have in common already.
The day your whole life changes starts like any other day.
You wake up, and life is just how you left it.
Just hear me out.
There's nothing to say, Joey.
You're right.
There's nothing to say.
Or, at least, I can't say it.
Because I don't have the words to describe what you mean to me.
But today, I saw a woman lose her husband, and it made me think about losing you.
Or, at least, I tried to, but I couldn't because I don't know what life would be like without you, and I don't want to find out.
So Here's something better than words.
- And that's when it happens.
- What? Marry me.
Just kiss me, you idiot.
In an instant, the life you knew is gone.
"But maybe that's okay, "because maybe it's time to start something new.
- Something better.
" - Mm.
Kind of making this all about you, aren't you? Exactly.

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