Private Practice s04e04 Episode Script

Curtain three.
Dr.
Wilder is on call.
Got it.
What's happening? Is the baby okay? That's why I paged Dr.
Montgomery.
This is Elana Stone.
She's Presented with diffuse pain localized more in the abdominal area.
I think I'm having a miscarriage.
Okay, Elana, I'm gonna do an ultrasound, try to figure out what's going on.
She's had chronic pain for the last five years, sensitivity to touch, migraines.
Seven doctors, no one could find anything.
- Ow! - Elana, I need you to hang in a little longer, okay? - Okay.
- Okay.
Ow! Ow! Is our baby okay? He looks just fine.
But the pain Lately even breathing's been hard.
Well, it's possible that the pregnancy - Ow! - Is exacerbating the underlying condition.
I'm sorry.
Please.
You have to help me.
A cluster of unrelated symptoms including severe pain with no obvious cause? You think it's fromyalgia? I've had patients with it before, and it's maddening.
You can't give them a definitive diagnosis, treatment's complicated.
Yeah, we can't give her anything too strong over the long term.
It'll hurt the baby.
Alternative treatments can work.
That'd be great if we had time, but she needs help right now.
Well, if we can't give her meds and alternatives are too slow, then what do you suggest? Yeah.
Thank you.
Betsey.
Hi.
Hi.
It's so good to see you.
I'm Monica Bratton, Betsey's aunt.
Hi.
I I'm Violet Turner.
I'm so sorry for your loss.
We all are.
You know, Dell was he he was family.
I spoke to a Dr.
Freedman on the phone when Betsey first came to live with me.
He said if we ever needed anything, to be in touch.
Yes.
Uh, he well, he's with a patient right now.
- Would would you like - I suppose I could just tell you.
Look, I don't have kids.
It's a choice I made a long time ago.
Uh, yes.
I I understand.
It can be a big adjustment, but sometimes And when Dell died and I took Betsey in, I did it because it was the right thing to do.
But I can't keep her.
Is it wrong that I want to punch aunt Monica? On several levels, but so do I.
Look, despite what is clearly a limited emotional capacity, I think aunt Monica did what she thought was best for Betsey.
Come on.
She left her in our office like Paddington bear.
The only thing missing was a note pinned to her jacket.
She brought her back to the only family that she has left.
But we're not her family.
She needs Naomi.
Well, Nai was the only one who really bonded with Betsey.
Dell and Betsey lived with her.
Well, she's away on foundation business for the next month, so Maybe we could take her home for a couple nights? She's not a puppy, Cooper.
The department of children and family services is set up for situations like this.
- You know, I I have a friend - We're not placing Betsey in the system.
Everybody in her life has abandoned her.
They died, Violet.
- I understand that, Charlotte, but in her mind, they - The system is there to protect kids exactly like Betsey.
And more often than not, it still screws them up.
Either way, Betsey's gonna have some serious problems.
Her mother was an addict.
Both her parents are dead.
Betsey needs Help.
She needs help, which Dell would've given any one of us without a second thought If he were still alive.
What's going on? It's worse.
I can't you have to give me some drugs, a shot, something.
Unfortunately, anything strong enough to help you would wind up harming the baby.
So what, she just has to suffer? If the pregnancy's making this worse, - can't you just take the baby out? - No, the baby's not viable yet.
But there are alternative treatments that could help for the remainder of your term.
I would be with you every step of the way, and once you deliver, the level of pain might subside.
That's another three and a half months.
No.
If you can't take away the pain, I can't have this baby.
She can't abort our baby.
Elana's in agony.
If she doesn't feel she can carry to term She didn't want a kid.
I pushed her, and finally she agreed, but I've never I've never felt my son kick.
Elana won't let me touch her because of the pain, but that's my baby.
And I won't let you kill him.
I'm not crapping in a cup.
It's the only way to find out what's wrong with your stomach.
I'm not doing it.
Okay.
How about the truth then? Come on.
Everybody knows that a stomachache is the best way to get out of school.
You can't prove it.
You can't disprove it.
- Why are you faking? - But I'm not faking Ah, th it's the truth or the cup.
Your choice.
All right.
There's these kids at school.
And they don't really like the stuff that I'm into, - so they do things to me.
- Like? Like I had pictures in my locker, and then they tore them down.
I'm assuming they weren't pictures of girls.
Anime.
You know, they're Cartoons, yeah.
People with big eyes and impossible-to-pronounce names.
Well, they're Japanese fantasy and action animations, but - Yeah.
- Yeah.
Anyway, so I was trying to get my pictures back, and then the ass-hats dragged me out to the quad and duct taped me to a flagpole.
Oh, that's, uh, not good.
Yeah.
It was my dad that got me into all this stuff.
If he hadn't died, he'd probably help me kick their asses.
Yeah.
Look, can't you just write me a note? Then what, homeschooling, witness protection? I mean, you know, teenagers can be jerks, but you can't hide forever.
So find the other kids that are into anime and, you know, you're gonna be fine.
Yeah, I'm trying.
But what am I supposed to do right now? Well, what would the hero from one of your stories do? Oh, please don't tell her.
She's just gonna make it worse.
Does he need a cuddle or a kickin' in the backside? Um Well, a bug's been doing around, but I think he's on the mend.
Um, just to be on the safe side, I'd keep him home for the rest of the day, - make sure it's out of his system.
- Okay.
Sound good to you? Yeah.
She's in unbearable pain, and it's gotten worse with the pregnancy.
But do you think it's bad enough that she should terminate a pregnancy that's almost viable? That is a decision for Elana.
But there are treatments she hasn't tried yet that alter the release of neurotransmitters and increase her pain tolerance.
Pete, I am not eager to terminate her pregnancy, but I'm also not gonna look her in the eye and tell her she needs to be tougher.
Is she having trouble breathing? Yeah, she mentioned that.
Swallowing? Yeah, it's in her chart.
Order an M.
R.
I.
Yep, I'm brilliant.
Get used to it.
And get me that brain scan.
Hey, I was looking for you.
Feel like getting a snack? This is my daddy's office.
He used to have crayons and paper.
Yeah.
I remember.
You two had a lot of fun in here.
You know, he loved you so much.
And I know that when someone you love goes away, it feels icky.
And it's confusing because you have all these big feelings that you don't understand.
But I want you to know that all of us here care about you so much and that you can tell anything to me.
Okay? Anything at all.
Where am I gonna sleep tonight? How about you come home with me? Should we have offered Mnh-mnh-mnh-mnh-mnh.
Don't don't even say it.
Oh, come on, Sam.
Addison Betsey needs more than we can give her.
And it's not our place.
Really, it's it's not Violet's place either.
Yeah, but it's only for a few nights.
I mean, I took care of Lucas for months.
I know, but Lucas was a baby, and and all due respect, I mean, you were warm hands to hold him.
Oh.
Wait.
I didn't mean for it to come out like that.
I I'm just trying to say that for you, when you had to let go, how'd it feel? She's old enough to understand and get attached.
And it would be brutal.
Why isn't Lucas crying yet? Because he understands that I worked a long shift at the E.
R.
last night, and there's another kid in the house.
And he's thoughtful just like his daddy.
Good morning, boo-boo.
Rise and shine.
Good morning.
Pete! Pete, Lucas is not in his crib! My daddy and I used to watch cartoons together.
I thought maybe Lucas would like them.
Try to relax, Elana.
We're almost done.
The sedative is helping.
Too bad we can't keep her doped up.
Well, there's always herbal tea and Chinese gongs.
Okay.
That's a little harsh.
Come on, Addison.
We're surgeons.
You're not saying that you really buy into his whole bad-juju-caused-my-cancer rap, do you? - Pete helps a lot of people.
- Mm.
And just because you disagree with him doesn't mean he's wrong.
Well, he's wrong this time.
Elana doesn't have fibromyalgia.
She's got a chiari malformation.
The herniation's putting pressure on her brain.
You think that's what's causing her pain? I do.
What can we do about it? What I do best Cut.
Hey.
How was your first night with Betsey? Good.
In fact, when I woke up this morning, she was watching cartoons with Lucas.
That sounds fun.
It was sweet, actually.
Yeah, she, uh, she took Lucas from his crib while I was sleeping.
That sounds uh, unnerving.
No.
I mean, w it was for a minute, but I know she'd never hurt Lucas.
Yeah, well, we hope, you know, but Betsey is troubled.
She needs help.
She needs someone to care.
That's all.
What I mean is, you need to be cautious.
I think you're blowing this out of proportion, Sheldon.
She's a child.
Betsey does need help, okay? Years of help.
And those aren't going to be easy years.
Now come on.
You know that, right? Well, I think we owe it to her and to Dell to do whatever we can for her.
But the best thing you can do for her is to help her start a new life as soon as possible.
Meaning without me? I think you'd help Betsey most by letting her go.
So you want to do brain surgery on a woman who's almost six months pregnant? Yeah, if I release the intracranial pressure, it should reduce her pain.
If we don't help her now, - she's gonna terminate the pregnancy.
- I can help her.
Not fast enough, Pete.
You think surgery is the better option? Apart from the fact that it might not help Elana, it could also kill her.
It could kill her baby.
This is not a complicated procedure, and there is a huge upside.
For chiari malformations, inversion therapy has the same upside.
It can relieve the pressure on the cerebellar tonsils and diminish her pain for weeks.
You're gonna keep her upside down for the rest of her life? I can get her through the pregnancy.
- Then you can cut as much as you want.
- All right, look, either way, Elana and Steven are gonna need some guidance here.
Fine.
He makes his pitch, I make mine.
I'm horny.
Want a quickie? Well, Emily Post would be proud.
Mm.
Mm.
Hey, do you think we should, um less talk.
More hands.
Mm.
Do you think we should do something? I'm trying to do something.
I mean about Betsey.
I mean, you know if it was our kid, Dell would step up.
We don't have kids, Cooper.
Okay, if we did It's just, she's here, and every time I look at her, I think that Yeah, you hate me right now, don't you? A thousand things about you that make me want to pull my hair out but you caring too much is not one of them.
I'm not gettin' laid, am I? When you're feelin' Randy, you know where to find me.
They called me to come get my son because he brought a knife to school! A knife, Dr.
Freedman! - He says he's being bullied, and that's your sage advice? I never said How could you not tell me what was happening? - He's only 14.
- Mom, please.
- No - Jackie, Jackie, let's sit down and we can talk and and do what? What are you gonna tell him next? - I'm trying to help.
- Really? You could've gotten him killed.
Let's go.
Ma'am, hi.
My name is Dr.
Wallace.
I'm a psychiatrist.
- Can we talk for a minute? - No.
What do you want from me? I'd like to help you if I can.
- There's nothing wrong with Kenny.
- I'm not suggesting there is, but you did arm yourself.
And I think I can help you work through some of your issues.
My son can talk to me.
I'm sure he can, but does he? Elana's brain is too large for her skull, and like any body part that gets shoved into an area that's too small, it can cause pain.
But if I shave off a small part of the bone at the back of the skull, remove a patch of the brain covering, - and sew in a new, bigger one - Her pain goes away? - Maybe.
- Likely.
But there are risks.
What are they? Elana could die, or your son could.
But there's another option.
I can position your body to relieve the pressure that's causing the pain.
I would work with you every day for the rest of your pregnancy - to help you manage it.
- Dr.
Montgomery? What do you think? I think that both options are viable.
Oh, please.
Don't be diplomatic.
Just tell me what we should do.
I think you should have the surgery.
I'll be there to monitor the baby the entire time.
How soon can we do it? Elana, no.
I don't want a life without you.
With all this pain, what kind of life have you had with me? Oh.
I want the surgery.
That's an interesting choice of T-shirt.
It's anime.
"Takao's turn.
" Genius kid finds a pen, and anyone whose name he writes with it dies.
- You're a fan boy? - I'm an action guy.
What about you? Well, fantasy, mostly.
I like the ones where the bad guys get what's coming to them.
Well, that makes sense.
Is there something wrong with that? - Not in theory.
- I was protecting myself.
A weapon seems excessive in response to humiliation.
Well, they did more.
You want to tell me about it? They kicked me, and they wouldn't stop till I took off my anime shirt.
Look, I don't want their acceptance, Dr.
Wallace.
What do you want? I guess I just want what Dr.
Freedman said, to stay in one school long enough that I can find kids like me.
How many times have you changed schools? Six times in two years.
That's why I didn't want my mom to find out, 'cause she just keeps freaking out.
Do you know what it's like to be the new kid in school over and over again? Posterior fossa decompression, that's risky on a pregnant woman.
Yeah, she's in a lot of pain, and if we can't help her, she says she wants to abort.
Dad's desperate.
It's just it's a bad situation.
Y - you see how hard all these people work to become parents, and the lengths that Naomi goes through to get them pregnant, and everything that you do, and you wonder I wonder you know, is it even worth it? How can you think that? You have Maya.
Yeah, Maya who is 16, has her own baby, and is married to a guy named Dink.
I mean, Naomi and I, we did everything that we could, a and Maya had so many advantages, but still I don't know.
I I look at Maya, and I look at Betsey, and I think sometimes, it's just futile.
Okay.
I'm not gonna repeat this speech to the mother who's about to have brain surgery to save her baby.
I'm sorry.
I look, I feel really really bad about Betsey.
I do.
But I just want to make sure that we're on the same page about her.
What do you mean? I mean that if Violet didn't take her, that I still would've said no.
I already have a child, Addison, and a grandchild.
I don't.
Well, can you even I don't know, Sam.
- But you want to? - I don't know that either.
Well, then why are you putting me on the spot? Because I want to believe that if I did want to have a child with you, that you would.
Give her a minute.
You you want to try? Aah! Oh! Can I stay with you forever? - Hey.
- Hey.
So he he's a good kid, right? He's a cool kid actually.
Well, in his way.
Were you a Kenny growing up? Smart but kind of different, couldn't really find your place? Actually, I bedded the prom queen three years running, and the last one's sister, too.
Okay.
But I I'm assuming you were.
Well, I was pretty into magic for a while there.
That was, you know, cool in its way.
Okay, I got pushed around, took a lot of dead arms, the occasional linebacker stuffing me into a garbage can until the summer after tenth grade.
I grew 5 inches.
I traded in my trick cards for a date with Norma Jacks, and no one ever screwed with me again.
Kenny's dad bought him his first deck of Pokemon cards when he was 7.
Now anime is a world he can go to where his dad is still alive, and the dimwitted bullies don't get to win.
That sounds like a better place for him to be.
They're hurting him, Cooper, and it's not the first time.
And Kenny says Jackie's response is always to pull him out of school.
Well, she wants to keep him out of the line of fire.
Yeah, but figuring out how to adapt, learning how resilient you can be, I mean, those skills are essential to developing into a competent adult.
I told Kenny to stand up for himself until he could find his people, there'd be safety in numbers.
But if Jackie's never gonna give him that chance well, then he'll never learn to cope.
That's a point I'd like to make to Jackie, but talk about worrying someone's gonna kick your ass.
Kenny will be home soon, so say whatever you have to say and go.
He mentioned you were pulling him out of school.
The school where he was beaten? Wouldn't you? We know why you want to shield him, but No "but".
It's my job.
No, this has happened before.
Right? The bullying? Jackie, the worst in people, it starts in high school, but it doesn't stop there.
And part of growing up is learning how to deal with that.
Now if if you don't give him time to adapt I will not send him back to be attacked.
It takes everything I've got not to go in there and kill them.
As tempting as that may be, if you let me, I can help Kenny develop the skills to handle this.
Skills? He's 14 years old, and he comes home and cries every day, like a baby.
It kills me, but it also drives me crazy.
After my husband died, I I let it go for a while.
But now I love him, and I would do anything for him.
God knows, I've tried.
Everything pep talks, and and karate lessons, and Look, um Kenny's a wimp.
Right? He's, uh, he's just He's just weak.
You know what that's like, knowing that you raised a a weak little baby? Mom.
It was the only thing I could think to do.
Well, it seemed like it worked.
Oh, just to see her smile She'll need daily therapy, at least at the beginning, but I think we could see real improvements in a few months.
Wait.
You want her to stay with us all that time? I think we should adopt her.
Violet, that's not a good idea for any of us.
When you think about it, we are exactly who should be doing this, 'cause I'm a therapist, and and even more than that, I get Betsey.
That sense of being damaged? I know what that can turn into.
We're building a family.
And there's no reason that Betsey can't be a part of that.
We can do this.
Can we? Absolutely.
You don't think I can do this.
You don't think I have it in me after I'm fine.
I am fine now.
- Violet, I'm not - She's a child.
She needs someone.
She needs us.
And I am fine.
If we could just get Kenny to realize that the rest of his life is not gonna be like this.
Yeah, well, we will.
I will.
Oh, yeah? You think Jackie will let you? - Well, I can be persistent.
- Hey.
- Hey.
Where are you off to? - Hospital.
Amelia's doing brain surgery on my pregnant patient.
Don't ask.
Well, good luck.
Oh, hey, uh Can I ask I need your help with Violet.
Uh, it'll have to wait till my next night with her.
- I only get two a week - She wants to adopt Betsey.
Wow.
And you don't? We're just getting into a rhythm, the two of us, and with Lucas I think it's too much.
Have you told her that? If I try to explain this to her, she's just gonna think it's an excuse, like I'm being selfish, but I have to think about all of us.
Am I wrong? Pete, I'm her best friend.
You Am I wrong? No, you're not wrong.
There.
Nice work on the craniectomy.
Look at the lady doctor, all up on the neuro.
Your brother used to like to talk shop at home.
Well, I hope Sam is more imaginative.
Heart rate's good.
Everything okay with you two? Fine.
I don't think he wants kids.
Do you? I want the option.
Well, what's it worth to you? Hey.
You want to adopt Betsey? Look, I am trying to separate out my feelings about Betsey from my professional judgment.
And I know, I know the reason I'm having a hard time letting this go is because it's my do-over.
Last year, I was aunt Monica.
Oh, you're not Aunt Monica.
You could handle this.
Which is why I should.
Don't you think? Oh, go on.
Say it.
Lord knows Pete isn't.
I think you could do this, but I don't think that Pete can.
He just got you back.
You just got married.
You gotta cut him some slack.
Well, if we don't take Betsey, then where is she gonna go? We will find her somewhere.
- We need to find her someone.
- We will.
I don't know, Cooper.
I don't know.
What if What if I'm supposed to help Betsey to make up for what I did to Lucas? Your do-over is not with Betsey.
It's with Lucas.
No news yet.
When I met Elana, I fell hard and fast.
She had this thing.
Been there.
But then, she changed.
And maybe it's the disease.
I don't know.
But I woke up one day, and the thing was gone.
Been there, too.
I sit in the car at night, hoping when I go inside, she'll be asleep.
I know what that makes me, but Elana doesn't smile anymore.
When I try to hold her hand, she pulls away.
It's the pain.
But The person I fell in love with left.
"Sickness and health.
" I meant it.
How long am I supposed to wait for her to come back? How long would you want her to wait for you? Violet wants to adopt her.
Pete doesn't.
Pete's a smart man.
You realize I was adopted? That's what this is about some kind of pay-it-forward obligation? I don't want Betsey.
Then why'd you offer to take her home? Because part of me knows what a difference we could make in her life.
But the other part of me knew you'd never let me do it.
Nice to know I'm that predictable.
I got lucky.
A great family found me.
It made all the difference.
Every kid should at least get a chance.
Betsey? Kenny? For both those kids, it will get better.
We don't know that.
Maybe Betsey will get adopted by a nice family, and they'll all die.
Maybe Kenny will go to a new school, and this time the bullies will have a knife or a gun.
Listen to me.
Two years ago, if someone had told you we'd be engaged, in love Things change, Cooper, when you're not lookin'.
Ooh.
Don't answer it.
Just go faster.
It's the hospital.
Elana made it through.
And, uh my baby the baby's gonna be fine.
Did it work? Well, time will tell.
Listen, I I hope you know that I didn't mean any disrespect when Elana asked me what she should do.
You gave her your honest opinion.
Amelia's good.
I never doubted it, and I didn't take it personally.
Okay.
It just felt it felt a little tense.
It's not that.
Is it Betsey? Yeah.
It's brought up some issues for Sam, too.
Because he didn't want to take her? I'm not even sure if I do.
I probably don't, but yes.
Violet wants to keep her.
Well, that's not surprising, right? But she can't.
We can't.
It's hard being a family.
Call neuro down.
Where's Kenny? The doctors are working on him, but they won't let me in there.
I'm so sorry.
I thought the school would be able to stop them.
It wasn't the bullies, Dr.
Freedman.
Kenny tried to kill himself.
They're still working on him.
Uh You're good with kids for an hour.
I'm with my kid every day, and I do my best.
But a boy needs his father, and you waltz in, and you give him bad advice, and now he is in there Kenny gave up, Jackie.
He just he gave up.
What the hell kind of therapist are you? Why didn't you know? He didn't want me to.
I knew Kenny was struggling, but he kept me in the dark just like he did you.
Oh Yeah, because if, um if he dies, oh, my God, if he dies, I'm, um it's my fault.
I did this.
I did I did it.
Dr.
Freedman? The hard part's over.
She's not in any pain right now.
She's just got a headache, which is normal after brain surgery.
It's okay.
Come be with your wife.
You did good today.
I know.
Elana? The baby he's kicking.
What the hell did you do? I stabbed myself in the stomach.
What were you thinking? Suicide is never the answer.
It is never, ever the answer.
Yeah, I know that now.
Life is long, and your horizons are gonna get bigger.
But to try to get out of it early, it's a huge when I was your age, I was a runt, I had, like, two friends, and it felt like it was never gonna get better.
But you know what? It did.
Somehow, when you're not looking, things change.
Now I'm, you know, I'm a doctor, I'm engaged to this ridiculously beautiful woman, and I can beat the crap out of, um Well, you know, some people.
Anyway, the point is, it gets better.
If you hang around, it gets good.
But you don't get to see that if you're not here.
Dad would be so pissed at me.
Yes, he would.
Look, I I just I don't want to switch schools, all right? Please just give me a chance.
Um, only if those boys are expelled, - and every teacher there knows exactly - Mom, mom, no.
I'll talk to Dr.
Wallace.
I want to.
And I'll be careful.
But you have to let me do this, okay? You have to.
Okay.
Cooper already talked to me.
I just asked his opinion.
I didn't ask him to No, you didn't, but you kinda did.
He made the point, Pete.
I wanted to talk to you.
I did.
But things have been so good between us, I just didn't want to risk Cooper's not my husband.
And this tiptoeing around me, it's n gonna work.
You know, I mean, we're in this, we're not going anywhere.
We need to be able to get mad and fight and And know that we'll get through whatever we need to get through.
You don't want to adopt Betsey.
It is what it is.
As much as I feel for Betsey we need time.
I know.
But you have to know that That I'm fine.
I am fine.
You are.
I miss Dell.
Hey.
Hey.
So Pete and Violet aren't going to adopt Betsey.
That's good for Betsey and for everyone.
Dell used to make me crazy.
But the thing is, he was there For Maya.
He died taking care of my child.
Sam, no one expected you to take Betsey, including me.
No, but you still want to know about us And if I don't need to know.
Not now.
I I need to ask if anyone here is willing to take Betsey.
Please.
Because I can't, and, um One of us needs to step up.
Please.
Don't you want to take care of me? I love spending time with you.
Where will I go? Um I don't know exactly.
But here's what I hope will happen.
I hope that you will get to go to a home, a home with a mom and dad who have always wanted a little girl, a mom and dad of your very own, who will love you so much because they're gonna see how special you are.
And that will be better for you than living with us, because your new family they have been waiting just for you.
Doesn't that sound good? Okay.
You must be Betsey.
My name is Gladys.
We did a bad thing here.
You all know it.
We did a bad thing.