Royal Pains s04e11 Episode Script
Dancing With The Devil
Previously on Royal Pains Ah! Padrino? Please, we are ready.
Godfather coming through.
The blue door, Friday night, 7:00.
I'll meet you there.
I have to go.
Would you like to go eat now together? Thanks to our patient, uh, I've lost my appetite.
Rafa is he the one who's riding the beautiful chestnut quarter horse? You know, you and I have a lot in common.
That would surprise me.
What if I can prove it to you? All right, well, how are you going Wow.
Intriguing.
Shouldn't we wait for Divya? Uh, she sent me a text, she's running a little late.
We'll catch her up.
Why are we watching an Ava video? Oh.
Because she's Hankmed's newest client.
Where did that come from? - Hey, Divs.
- Oh, dear God.
I'm sure you've heard all the rumors about her hard-partying, drug-fueled lifestyle, the diva behavior, the fact that no one's supposed to look her directly in the eye.
But look, guys, this is by far the most famous client we've ever had.
She's going to expect an entourage, so I want all three of you there to meet her in one hour.
How is it only 9:00 A.
M.
, and I am already tired? Yeah, Divya, I can hear you.
Anyway, I've uploaded all the pertinent information to your phones.
Try not to act too starstruck, and I'll be back tonight.
And, Divya, in the future, I'd prefer If only Evan came with a mute button in real life.
That's genius.
Hey, do you own two of these outfits? 'Cause I recall you wore one just like it yesterday.
No.
You're mistaken.
I'm needed at Shadow Pond right away.
Is Boris okay? I haven't seen him recently.
I guess I'll find out.
Hold still.
You have something in your hair.
Huh.
Piece of straw.
See ya.
- Hello.
- Aah! Hello, Udo.
Uh, would you please let Boris know that I have an appointment in 30 minutes, and Mr.
Kuester Von Jurgens Ratenicz will not be joining you.
He won't? Then who am I Marisa.
I'm so happy to see you.
We got in last night from Zurich.
I'm speaking at a small research conference.
Welcome back.
Look at how cute he is.
- I know - May I? Of course.
El padrino.
Yes, I am.
Carlos, it's your godfather.
I'm so happy to see that your first child is a masculine child.
Sorry.
I'm kind of surprised you called me.
Hank, what happened with Boris, that's between you two.
It has nothing to do with us.
I need a doctor I can trust.
Of course.
What's wrong? I know my baby.
His oral intake is diminishing, and he's not feeding well.
I've had my milk tested, I brought in a lactation consultant, but nothing is making a difference.
Acid reflux, maybe? His pediatrician in Zurich prescribed Prilosec, but it wasn't helpful, and neither was he.
How about a urine culture to rule out a UTI? It was negative.
- Stool analysis? - Nothing there.
Well, you just exhausted my pediatric rotation.
Then, who's the best pediatrician in the Hamptons? I don't know.
But I'm going to find out for you.
Will someone call me back? Anybody, anybody.
Divya.
God.
First they mute me, now no one's returning my calls.
Why didn't you stay in the Hamptons? I mean, I know you wanted to meet Ava.
And besides, I can totally handle this by myself.
I know.
I'm here to support you As you handle it by yourself.
All right.
Okay, this is it.
This is this is what? Oh, my God, I'm so nervous.
Is that a bulletin board? Did we go back in time to the '80s? Professor Laskey is old-school.
He's got a rotary dial phone in his office.
Okay, I I can't look.
Just tell me if I'm on there.
Excuse me.
So I'm just gonna say this fast and get it over with you're on it.
What? What? I got into interactive prototyping! Shh, you're gonna make all the other kids jealous.
Just calm down.
Evan, nobody gets into that! Not in their first semester! Nobody but my fiancee.
Ohh.
You know what? I actually don't think we're going to have time to go to my parents' after all.
What? No, we have plenty of time.
Well, it's all the way up in the east 80s.
So what? We'll take a taxi.
I haven't got my books yet.
The bookstore's open late.
Yeah, but then we'll hit traffic leaving the city, and, Evan, it's it's too much.
Do you not want to go up to your parents' apartment? Is this about your adoption? No.
Evan, come on, we we talked about this last night.
I mean, my parents explained why they didn't tell me, and I wish it hadn't been that way, but I'm fine.
Really, I'm not gonna let this derail me.
Okay.
Look, if if if you're not ready, like, if it's too difficult it is so not about that.
You know what? Taxi! Can I help y'all? Hi, I'm Dr.
Hank Lawson.
Can you tell me which one of these women is Ava? Uh, I'm Ava.
You? Ava, you wanna run it again? Uh no, not now.
Let's take five.
Great idea.
Everyone, Ava says take five! Three doctors.
Okay, uh let's see.
I have, uh, headaches, cramps, and I get tired.
That's enough symptoms to go around.
But still, seems like overkill.
You know, why don't we go somewhere a little more private, so we can talk? Yeah, sure.
Whoa.
Royal Pains 4x11 - Dancing With The Devil Original air date August 29, 2012 Really, I'm okay.
Look, I was just dizzy.
Oh, thank you.
How long has this been going on? I don't know, six weeks? Yeah, it started about the time I came back from Bald Knob - and began rehearsing.
- Uh, back from where? Bald Knob, Arkansas.
It's about 60 miles northeast of Little Rock.
You've been there? No, in the sixth grade I came in second in the National Geography Bee.
Nicely done.
Divya, did you get a BP? Uh yeah! Yeah, ri right away, yeah.
So what have you been doing the past six weeks that you weren't doing in Arkansas? Well, getting ready to go on tour.
I dance and work out about eight hours a day, a nutritionist keeps me on a strict low-calorie diet, so I can fit into my costumes.
Is that bad? For someone your age, yes.
Well, it could explain the dizziness.
Do you smoke? Drink? Do drugs? To be honest, I I enjoy a beer now and then, but I don't smoke, and I don't do drugs.
Despite my reckless image, which has been completely made up by my management.
Well, why would they do that? Because a bad girl is more marketable than a church-going hick from Bald Knob.
Ava, what you're feeling may be caused by a combination of too much work, too little food, and a big dose of anxiety about your upcoming tour.
We'll need some urine.
Right.
We'll also do a blood test to see if we can find out anything more definitive, but in the meantime, you need to rest and eat something.
Was she wearing an ankle monitor? Was she drunk? Hey, Henry, I'm gonna call you back.
Okay, bye.
Paige? Are you kidding me? Well this is amazing! You never told me you grew up here.
Well, I I really only lived here in the fifth and sixth grade, when my dad was a military attache at the U.
N.
Look at that view! Ohh! You got a terr hold on.
You have a wraparound terrace! I'm gonna come in every Friday night.
I'll be going against traffic, anyway.
Everybody from the city will be going to the Hamptons, I'll be driving straight into Manhattan! This is so awesome.
Well, yeah, it's a beautiful apartment.
I just I wish it were closer to school and to other students.
What babe, the 6 train is around the corner.
- Yeah - 30 minutes to school, tops.
It's gonna be great.
It wraps around to that side too? Oh, my God.
I'm sorry, you'll have to talk to the nurse.
Of course.
Bye.
Dr.
Lawson.
I wasn't expecting the referring physician to be here.
Then you'll be blown away by the fact that I also brought my P.
A.
Divya Katdare.
Hi, I'm Dr.
Kubelick.
And you've got the baby, so Dr.
Casseras, I presume? Call me Marisa, please.
Marisa.
Hello, Carlos.
I reviewed his chart, and although his head circumference and height have stayed steady, his decline in weight percentile is problematic.
I'd like to do a feeding test without mom present.
Is that okay? Dr.
Lawson is welcome to join and observe.
Of course.
Okay, here you go, sweetheart.
We'll just be a minute.
So much to look at, huh? Who is it? Who is who? I've seen that look before.
I've had that look before.
So tell me, what's his name? His name is Rafa.
- He's Argentinean.
- Ooh.
And he is amazing.
We spent the entire night together, just talking.
Kissing.
It was very romantic.
And when are you seeing him again? Tomorrow.
He is only here for the week.
Do not waste a minute of it.
Speaking from experience? Oh, I had a few summer flings with latin lovers in my day.
Go to La Perla.
Talk to Yvette.
Tell her I sent you.
Funny bumping into you here.
Hey, this is a completely professional referral.
Who knew you were the top pediatric fellow at Stanford Children's Hospital? I did.
Family, friends Uh-huh.
People at Stanford.
Right.
Yeah, I got it.
You don't mind that I came, do you? Why would I mind? Well, just 'cause the last time you saw me, I stood you up.
Well, you did actually show up, you just didn't actually stay.
And now, here you are.
You're enjoying this, aren't you? Hmm.
He didn't eat that much.
Barely 2 ounces.
What do you think about doing a videofluoroscopic swallow study at the hospital? I'm sorry, which one of us was the top pediatric fellow at Stanford? You're right, I This is your turf.
What would you suggest? A videofluoroscopic swallow study.
Oh, could you say that again? I'm sorry, I didn't get that.
Yeah.
Okay, let's go! Places, dancers.
- Ava, you cool? - Okay.
Great.
Here we go! - Ow! - Ooh! Are you okay? Well, you're lucky.
You didn't break anything.
What about Michaela? Just a bruise and a cut.
Pupils equal, round, reactive to light and accommodation.
- You're okay.
- Thank you.
Uh, Jeremiah are you free tonight? Yes.
Uh, com completely free.
Great.
Could you cover for me? I am supposed to be on call, but my plans for tomorrow just became my plans for tonight.
You're covered.
Thank you.
I don't know what happened.
All of a sudden, my arms got so weak, I just couldn't hold on.
Well, your blood work isn't back yet, but I'm hoping it'll give us a better idea of what's causing this.
In the meantime, you clearly haven't taken my advice to rest and eat something.
I'm sorry, Hank.
These are our last few days to rehearse before the tour starts.
Just tell me a little more about this diet they have you on.
Oh, it's mostly kale and, uh kale.
Have you had any blurry vision, dry skin, or, uh, irregular menstrual cycles? Uh, yes to the last one.
Are you pregnant? Lord, I hope not.
I'd like to get married first.
Well, we'll we'll check that out, but our concern is that you're not getting enough calories.
That can cause irregular periods also.
I'll begin packing up.
Okay, good.
It's no longer a suggestion, it's now doctor's orders.
Home-cooked meal.
There's nothing I'd like more, but I'm a long way from home.
You miss home? More than you know.
I'm surrounded by people 24/7, but I don't have any family here with me.
It's just a lot of people saying things they think I wanna hear.
Hmm.
I know, I sound ungrateful.
No, no, no, no, no.
Not at all.
You're far away from the people you love, you're about to begin a long tour makes perfect sense.
Why don't you come to my house for dinner? That way you get a home-cooked meal, and we can supervise your treatment in person.
Can we do it Bald Knob style? All depends.
What's that? You shop, I'll chop.
Done and done.
The good news is I don't see anything abnormal.
Food is traveling to his stomach, not his airway, and his throat muscles are functioning normally.
We've ruled out all the simple stuff which means it's something complicated.
- Not necessarily.
- Ohh.
We should run a full panel of blood tests to rule out glycogen storage disease, cystic fibrosis, and persistent pulmonary hypertension.
Let's just take this one step at a time.
So far, your baby isn't ill.
Yes, he's not growing fast enough, but let's not start thinking zebras just yet.
You're right.
Carlos has had a busy day.
Why don't I come to you tomorrow, and we can do a blood draw at your house? I think that'll be more convenient for you and less stressful for the baby.
Thank you.
Both of you.
So I'll see you tomorrow? Yes.
Vamos, Carlos.
Bye, Carlos.
Adios, hombre.
Bye.
What are you thinking? Well, I still really want to see the baby in his home environment.
Mm-Hmm.
You still think it's something social between Marisa and Carlos? Honestly, I'm not ready to rule anything out just yet.
Right.
What? Why are you smiling? The ringtone? I think Ava is incredibly talented.
Are you free for dinner tonight? It's not what you're thinking.
It's definitely not what you're thinking.
Thank you, Ava.
Pleasure, darlin'.
Enjoy.
Oh, my God.
Mmm.
Oh, my God.
This is terrific.
I can't believe you made all this from scratch.
It's unbelievable.
Really.
My grandma Dollie taught me how to cook when I was knee-high to a grasshopper.
You have a grandma Dollie? With seven brothers.
Alton, Elton, Lyman, Gleamon, Herman, Thurman, and Clyde.
What - You're making that up.
- No, honest.
Really.
Gleamon Lawson.
What do you think of that? - Um, no.
- Okay.
With all due respect to kale, it's just nice to eat real food for a change.
Mm-hmm.
This is actually my grandma's recipe.
What's in it? I've never tasted anything with flavors like this.
It's, uh, possum pie.
Oh.
But apparently, you can't get decent possum at Citarella, so I just used chicken.
- Oh, chicken.
- Ah.
Hank, did you not check in the critter aisle? - I did not.
- Go ahead, no.
Poke fun, you know.
I know a lot of people look at us folks from Arkansas like like we're related to Larry the cable guy, but I love where I'm from.
It's important in this business to have a strong identity, so you don't get carried away and Because of my family, I know exactly who I am.
Hmm.
You're very lucky.
Your possum chicken is better than anything I cook.
- Anything.
- He is not kidding at all.
Hank, when we were little, he used to cook fish sticks.
That was his thing, fish sticks.
- Okay.
- All the time.
One summer, every single night he baked fish sticks.
- Not every night.
- I genuinely believed Mrs.
Paul was a member of my family.
Seriously.
Ev, you don't remember, but mom was the terrible cook.
Where do you think I learned? She had three appliances in the kitchen a toaster, a microwave, and a de-flavorizer.
She was a really bad cook, wasn't she? Really bad.
Excuse me.
Uh, your blood results are in.
So the tests came back, and the results look good, but there were issues.
Some of the blood cells ruptured during the potassium test, which is why we're taking another sample.
But the other tests showed low renin and low aldosterone, so it could be pheochromocytoma or maybe Cushing's.
- Mm-hmm.
- What does all that mean? There may be problems in your pituitary adrenal system.
Your body might be producing too much cortisol.
I think we should do a 12-hour cortisol test.
Cushing's typically presents with weight gain, which Ava doesn't have.
Why don't we get an MRI in the morning, and this potassium test will give us a better picture? You know, if we start tonight, then we won't have to wait another 12 hours.
I could do the overnight draws.
- You sure? - Sure.
I don't sleep more than three hours at a time.
I read a lot.
Uh, okay.
The test is simple.
You just have to spit into a cup every four hours for the next 12 hours.
Okay.
Where's the cup? Uh, we can't start until at least an hour after you've eaten.
I'll come by your hotel at 11:00 and then return at 3:00 A.
M.
and then again at 7:00 A.
M.
Well, okay.
I'll see you then.
Good lord willing and the creek don't rise.
I I just want to thank you all again for making me feel so at home and letting me cook.
- Thanks for cooking.
- Oh, my God, our pleasure.
Thank you so much.
- Bye.
- Bye.
That was so fun! I can't believe Ava.
She's so down to earth.
I know, she really is.
I couldn't help but notice that you didn't share any bizarre family stories of your own.
That bad? That good.
I have a great family.
We're close.
I talk to them all the time.
Makes for very boring stories.
Well, that's the good kind of boring.
I mean, look, no family's perfect, but my parents set the bar pretty high.
They were both professors, but they traded off being home with the kids.
Sharing the responsibility was important to them.
Now it's important to me.
That's why no doctors.
Let's face it.
They always put work first.
"They"? Doctors who aren't me.
And when it comes to counting on them for social obligations I was kind of hoping we could forget about that.
You made up for it tonight.
I mean, where else in the Hamptons am I gonna get good possum chicken pie? Well, I'm glad we can still be friends.
Me too.
Thanks again for having me.
I had a really great time.
Me too.
Whoa! Uh, you really are a big fan.
Sorry.
Huge.
And I didn't geek out once during dinner.
I'm very proud of myself.
You should be.
- Bye.
- Bye.
Rafa? Rafa? Close your eyes.
Now turn around.
Let your hair down.
Can you feel how close I am? Tell me.
I can feel your breath on my neck.
How does it feel? Warm.
Cool.
Uh-uh.
You're cheating.
Close your eyes.
Or do I have to blindfold you? You can try.
Ava? Uh, it's me, Dr.
Sa Hey, Dr.
J! Come on in.
Uh Wow.
Either that's a, uh, a very fancy nightgown, or you're going somewhere.
I'm going somewhere.
My publicist insists that I have an image to live up to and that I live up to it at least twice a week.
- Uh-huh.
- Hey, could you do me a favor and grab my earrings? They're on the sink in the bathroom.
Okay let's do this.
I have been dying for a beer, but I knew I had to spit first.
Yeah, um, now, I I will need a rather large sample.
Y yes, that'll work.
Hey, uh, zip me up.
Ahem.
Uh, now you will need to provide another sample - in exactly four hours.
- Yeah, no problem.
So, uh, where will you be at 3:02? I have no idea.
I guess you'll have to come with me.
Come with you where? Hey! Uh, he's with me! It's okay.
Wow! Heh.
That was crazy.
Ah.
Are you all right? You seem a little out of breath.
Uh, yeah, yeah.
I just need some water.
Oh, uh, I don't have any water What happened to my medical supplies? Oh, don't worry.
I brought the spit cups.
Yeah, thank goodness you had this bag.
Do you know what my stylist would say if he saw a tabloid photo of me carrying a purse with this dress? I'm so glad you're here, you know? I feel really comfortable around you.
- You do? - I do.
You're direct.
- Uh - Let's dance.
Um to be direct I I actually don't know how to dance.
Um, I'm actually quite concerned about the contents of that medical bag.
Because if something hap Ava, if something hap Ava? Uhh! Divya, if you get this message, will you call me back, please? Although this is not an emergency, and it's your day off.
I'm sorry for yelling.
It's just it's the only way you'll hear me.
I am at a nightclub! Okay.
All right.
Hey.
Thanks.
Jeremiah? Hank uh, I can't do this.
Uh, can you come and take over, please? It's just 'cause I don't have my medical equipment.
It has nothing to do with the fact that there are a lot of sweaty people here.
And they're touching me, and it's very loud and and they're dancing around me.
Okay, where are you? Uh, at The Underground.
It's a nightclub.
I'm with Ava.
We're clubbing! You're what? Is she okay? Um, I can't properly assess her condition.
I don't have my pulse ox.
She removed everything.
Um, but earlier she experienced shortness of breath.
Okay, I want you to take a deep breath.
Just concentrate on your patient.
I know this is hard for you, but I also know you can do it.
I'm coming to relieve you.
Just don't leave before I get there.
Okay, Hank, I won't.
I hope.
Babe? What are you doing out here? What's wrong? I just can't stop thinking about my family.
I'm grateful to my parents for everything they've given me, but I am so angry that they didn't tell me I was adopted, and I feel guilty about feeling angry.
You shouldn't feel guilty.
How can I trust them anymore? They've taken away all sense of home.
I'll give you that.
Start from scratch.
We you and me we'll start a home together.
Come on, Dr.
J.
Just one dance.
Hey, just relax! Like, move your hips.
Whoo! Yeah.
Hey, just do what I do.
Come on.
Oh, yeah.
That's it.
No, that's it.
Yeah.
That's great.
Hey, you looked like Clark Kent in that phone booth, minus the glasses.
One thing I never got about Superman why the cape? It would only increase the drag coefficient when he's flying.
Whoo! Hey, try this one.
Ready? Oh.
And then and then you.
Whoa.
Sorry.
Ava, Ava? You, call 911.
No, back! Get back! Give us some room.
Back! Excuse me.
Jeremiah! Excuse me.
Jeremiah.
She's not breathing, but she has a pulse.
Okay, I've got an ambu-bag.
Ava's potassium results came back, and her levels are very low.
They've started her on a potassium I.
V.
, but she's stabilized and sleeping.
- You did good.
- Huh.
But we still haven't figured out what her problem is.
No.
Cushing's was a reasonable diagnostic path to follow, but there were no diurnal variations in cortisol levels.
- Right.
- We just need to square her low potassium with her other symptoms while factoring in her smoking.
Wait, wait, Ava said she didn't smoke.
What makes you think otherwise? When I gave her mouth-to-mouth, I I tasted tobacco.
Are you sure? Why would she lie about that? Maybe she was embarrassed.
Everyone knows how foolish it is to smoke.
True I wonder if she's a heavy smoker.
The answer could be in my medical bag.
Th this probably isn't diagnostically relevant.
Let's hope not.
No cigarettes.
Well, she wasn't lying about not smoking.
She chews.
- Chewing tobacco.
- Mm-hmm.
That would explain her expectorating proficiency as well as the empty soda can.
She took hers with her after dinner.
What kind of reaction to tobacco would cause her symptoms? This brand is heavily flavored with licorice.
Glycyrrhizic acid.
Licorice poisoning.
It lines up.
Look at you.
It's Boris.
Oh, why don't you take the call? I'll put his diaper on.
Papa.
Thank you.
Okay.
We got it.
I haven't seen one of these in a while.
What kind of pediatrician are you? The kind that hasn't seen one of these in a while.
Okay.
But I can do it with your help.
Here.
Hands.
Right.
Okay.
Let's do this.
Let's do it.
- Legs.
- Legs.
- Yes.
- Okay, lifting.
- Good job, Carlos.
- Good work, bud.
This goes here.
Uh, I don't see any safety pins.
They don't use safety pins anymore.
Oh, so now you're the expert.
Of the two of us, yeah.
Yeah? I'm not so sure about that.
Step aside, my friend.
- Let a real man at it.
- All right.
Vamonos.
It's gonna be okay.
Uh - I know, sweetheart.
- It's okay, bud.
Started crying the second I stepped in.
It's okay.
Ohh.
His suck is unusually weak.
I can't believe this.
What? Ankyloglossia.
Yeah.
You're right.
His lingual frenulum is unusually short.
Oh, what a relief.
And a frenectomy is simple.
Once the membrane is cut, Carlos will have normal range of motion - with his tongue.
- Nice work.
How many pediatricians would have caught that? Not many concierge doctors would have helped me put a diaper on.
All right, so the bad news is neither of us is very good with cloth diapers.
Heh, no kidding.
But the good news is we have a diagnosis.
You do? What? Ankyloglossia.
He's tongue-tied? That's right.
And, Marisa, it's a simple fix.
Ohh.
Aww.
You guys make a good team.
Mwah! This one's my favorite.
Oh, they they got my name wrong.
Actually, it's not even close.
At least you weren't photographed carrying a purse with that dress.
Hey, for once, the headline is true.
I did O.
D on licorice.
Well, as soon as we get your potassium levels up, you'll be dancing with the devil in no time.
You saved my life, and I don't think I properly thanked you.
How do I thank you? You can give up tobacco.
Ah, it's easier said than done.
I've tried before.
Actually, this may help.
Oh.
"Dugout chew bubble gum.
" "Chew, spit, and adjust" "like the real big league ball players.
" Well, I don't know about that last one, but thank you.
I didn't see your message until I got out of bed.
I've never done that before.
I am so sorry.
Wait, you're sorry about not answering the phone in the middle of the night on your day off? Is that crazy? It's a little crazy.
You have nothing to feel guilty about.
Or do you? No.
I'll make a call, okay? I'll see if something else is available.
- I love it.
- Me too.
It's gonna be perfect.
So convenient.
Surrounded by other students and and it's all mine.
Really? What you said last night you were right.
I want to start from scratch, and part of that is having my own space.
I don't want to live in the past anymore.
I'm ready to start my future.
This is gonna be great.
I know.
Do you have another patient for me? Uh, no.
I'm here for me.
Hank I hate to break this to you, but, uh I think you need a big boy doctor.
I just can't find the hidden lobster.
What's this? It's a backstage pass to Ava's concert at Madison Square Garden.
Oh, my God.
What's the catch? No catch.
Yet you're still here.
I am.
I been thinking about what you said, about who you wanted in your life someone who has a life, someone who's not a workaholic.
Someone who gives me backstage passes to see Ava.
I know I'm a doctor, but I think I can be that guy.
I want to be that guy.
What do you say?
Godfather coming through.
The blue door, Friday night, 7:00.
I'll meet you there.
I have to go.
Would you like to go eat now together? Thanks to our patient, uh, I've lost my appetite.
Rafa is he the one who's riding the beautiful chestnut quarter horse? You know, you and I have a lot in common.
That would surprise me.
What if I can prove it to you? All right, well, how are you going Wow.
Intriguing.
Shouldn't we wait for Divya? Uh, she sent me a text, she's running a little late.
We'll catch her up.
Why are we watching an Ava video? Oh.
Because she's Hankmed's newest client.
Where did that come from? - Hey, Divs.
- Oh, dear God.
I'm sure you've heard all the rumors about her hard-partying, drug-fueled lifestyle, the diva behavior, the fact that no one's supposed to look her directly in the eye.
But look, guys, this is by far the most famous client we've ever had.
She's going to expect an entourage, so I want all three of you there to meet her in one hour.
How is it only 9:00 A.
M.
, and I am already tired? Yeah, Divya, I can hear you.
Anyway, I've uploaded all the pertinent information to your phones.
Try not to act too starstruck, and I'll be back tonight.
And, Divya, in the future, I'd prefer If only Evan came with a mute button in real life.
That's genius.
Hey, do you own two of these outfits? 'Cause I recall you wore one just like it yesterday.
No.
You're mistaken.
I'm needed at Shadow Pond right away.
Is Boris okay? I haven't seen him recently.
I guess I'll find out.
Hold still.
You have something in your hair.
Huh.
Piece of straw.
See ya.
- Hello.
- Aah! Hello, Udo.
Uh, would you please let Boris know that I have an appointment in 30 minutes, and Mr.
Kuester Von Jurgens Ratenicz will not be joining you.
He won't? Then who am I Marisa.
I'm so happy to see you.
We got in last night from Zurich.
I'm speaking at a small research conference.
Welcome back.
Look at how cute he is.
- I know - May I? Of course.
El padrino.
Yes, I am.
Carlos, it's your godfather.
I'm so happy to see that your first child is a masculine child.
Sorry.
I'm kind of surprised you called me.
Hank, what happened with Boris, that's between you two.
It has nothing to do with us.
I need a doctor I can trust.
Of course.
What's wrong? I know my baby.
His oral intake is diminishing, and he's not feeding well.
I've had my milk tested, I brought in a lactation consultant, but nothing is making a difference.
Acid reflux, maybe? His pediatrician in Zurich prescribed Prilosec, but it wasn't helpful, and neither was he.
How about a urine culture to rule out a UTI? It was negative.
- Stool analysis? - Nothing there.
Well, you just exhausted my pediatric rotation.
Then, who's the best pediatrician in the Hamptons? I don't know.
But I'm going to find out for you.
Will someone call me back? Anybody, anybody.
Divya.
God.
First they mute me, now no one's returning my calls.
Why didn't you stay in the Hamptons? I mean, I know you wanted to meet Ava.
And besides, I can totally handle this by myself.
I know.
I'm here to support you As you handle it by yourself.
All right.
Okay, this is it.
This is this is what? Oh, my God, I'm so nervous.
Is that a bulletin board? Did we go back in time to the '80s? Professor Laskey is old-school.
He's got a rotary dial phone in his office.
Okay, I I can't look.
Just tell me if I'm on there.
Excuse me.
So I'm just gonna say this fast and get it over with you're on it.
What? What? I got into interactive prototyping! Shh, you're gonna make all the other kids jealous.
Just calm down.
Evan, nobody gets into that! Not in their first semester! Nobody but my fiancee.
Ohh.
You know what? I actually don't think we're going to have time to go to my parents' after all.
What? No, we have plenty of time.
Well, it's all the way up in the east 80s.
So what? We'll take a taxi.
I haven't got my books yet.
The bookstore's open late.
Yeah, but then we'll hit traffic leaving the city, and, Evan, it's it's too much.
Do you not want to go up to your parents' apartment? Is this about your adoption? No.
Evan, come on, we we talked about this last night.
I mean, my parents explained why they didn't tell me, and I wish it hadn't been that way, but I'm fine.
Really, I'm not gonna let this derail me.
Okay.
Look, if if if you're not ready, like, if it's too difficult it is so not about that.
You know what? Taxi! Can I help y'all? Hi, I'm Dr.
Hank Lawson.
Can you tell me which one of these women is Ava? Uh, I'm Ava.
You? Ava, you wanna run it again? Uh no, not now.
Let's take five.
Great idea.
Everyone, Ava says take five! Three doctors.
Okay, uh let's see.
I have, uh, headaches, cramps, and I get tired.
That's enough symptoms to go around.
But still, seems like overkill.
You know, why don't we go somewhere a little more private, so we can talk? Yeah, sure.
Whoa.
Royal Pains 4x11 - Dancing With The Devil Original air date August 29, 2012 Really, I'm okay.
Look, I was just dizzy.
Oh, thank you.
How long has this been going on? I don't know, six weeks? Yeah, it started about the time I came back from Bald Knob - and began rehearsing.
- Uh, back from where? Bald Knob, Arkansas.
It's about 60 miles northeast of Little Rock.
You've been there? No, in the sixth grade I came in second in the National Geography Bee.
Nicely done.
Divya, did you get a BP? Uh yeah! Yeah, ri right away, yeah.
So what have you been doing the past six weeks that you weren't doing in Arkansas? Well, getting ready to go on tour.
I dance and work out about eight hours a day, a nutritionist keeps me on a strict low-calorie diet, so I can fit into my costumes.
Is that bad? For someone your age, yes.
Well, it could explain the dizziness.
Do you smoke? Drink? Do drugs? To be honest, I I enjoy a beer now and then, but I don't smoke, and I don't do drugs.
Despite my reckless image, which has been completely made up by my management.
Well, why would they do that? Because a bad girl is more marketable than a church-going hick from Bald Knob.
Ava, what you're feeling may be caused by a combination of too much work, too little food, and a big dose of anxiety about your upcoming tour.
We'll need some urine.
Right.
We'll also do a blood test to see if we can find out anything more definitive, but in the meantime, you need to rest and eat something.
Was she wearing an ankle monitor? Was she drunk? Hey, Henry, I'm gonna call you back.
Okay, bye.
Paige? Are you kidding me? Well this is amazing! You never told me you grew up here.
Well, I I really only lived here in the fifth and sixth grade, when my dad was a military attache at the U.
N.
Look at that view! Ohh! You got a terr hold on.
You have a wraparound terrace! I'm gonna come in every Friday night.
I'll be going against traffic, anyway.
Everybody from the city will be going to the Hamptons, I'll be driving straight into Manhattan! This is so awesome.
Well, yeah, it's a beautiful apartment.
I just I wish it were closer to school and to other students.
What babe, the 6 train is around the corner.
- Yeah - 30 minutes to school, tops.
It's gonna be great.
It wraps around to that side too? Oh, my God.
I'm sorry, you'll have to talk to the nurse.
Of course.
Bye.
Dr.
Lawson.
I wasn't expecting the referring physician to be here.
Then you'll be blown away by the fact that I also brought my P.
A.
Divya Katdare.
Hi, I'm Dr.
Kubelick.
And you've got the baby, so Dr.
Casseras, I presume? Call me Marisa, please.
Marisa.
Hello, Carlos.
I reviewed his chart, and although his head circumference and height have stayed steady, his decline in weight percentile is problematic.
I'd like to do a feeding test without mom present.
Is that okay? Dr.
Lawson is welcome to join and observe.
Of course.
Okay, here you go, sweetheart.
We'll just be a minute.
So much to look at, huh? Who is it? Who is who? I've seen that look before.
I've had that look before.
So tell me, what's his name? His name is Rafa.
- He's Argentinean.
- Ooh.
And he is amazing.
We spent the entire night together, just talking.
Kissing.
It was very romantic.
And when are you seeing him again? Tomorrow.
He is only here for the week.
Do not waste a minute of it.
Speaking from experience? Oh, I had a few summer flings with latin lovers in my day.
Go to La Perla.
Talk to Yvette.
Tell her I sent you.
Funny bumping into you here.
Hey, this is a completely professional referral.
Who knew you were the top pediatric fellow at Stanford Children's Hospital? I did.
Family, friends Uh-huh.
People at Stanford.
Right.
Yeah, I got it.
You don't mind that I came, do you? Why would I mind? Well, just 'cause the last time you saw me, I stood you up.
Well, you did actually show up, you just didn't actually stay.
And now, here you are.
You're enjoying this, aren't you? Hmm.
He didn't eat that much.
Barely 2 ounces.
What do you think about doing a videofluoroscopic swallow study at the hospital? I'm sorry, which one of us was the top pediatric fellow at Stanford? You're right, I This is your turf.
What would you suggest? A videofluoroscopic swallow study.
Oh, could you say that again? I'm sorry, I didn't get that.
Yeah.
Okay, let's go! Places, dancers.
- Ava, you cool? - Okay.
Great.
Here we go! - Ow! - Ooh! Are you okay? Well, you're lucky.
You didn't break anything.
What about Michaela? Just a bruise and a cut.
Pupils equal, round, reactive to light and accommodation.
- You're okay.
- Thank you.
Uh, Jeremiah are you free tonight? Yes.
Uh, com completely free.
Great.
Could you cover for me? I am supposed to be on call, but my plans for tomorrow just became my plans for tonight.
You're covered.
Thank you.
I don't know what happened.
All of a sudden, my arms got so weak, I just couldn't hold on.
Well, your blood work isn't back yet, but I'm hoping it'll give us a better idea of what's causing this.
In the meantime, you clearly haven't taken my advice to rest and eat something.
I'm sorry, Hank.
These are our last few days to rehearse before the tour starts.
Just tell me a little more about this diet they have you on.
Oh, it's mostly kale and, uh kale.
Have you had any blurry vision, dry skin, or, uh, irregular menstrual cycles? Uh, yes to the last one.
Are you pregnant? Lord, I hope not.
I'd like to get married first.
Well, we'll we'll check that out, but our concern is that you're not getting enough calories.
That can cause irregular periods also.
I'll begin packing up.
Okay, good.
It's no longer a suggestion, it's now doctor's orders.
Home-cooked meal.
There's nothing I'd like more, but I'm a long way from home.
You miss home? More than you know.
I'm surrounded by people 24/7, but I don't have any family here with me.
It's just a lot of people saying things they think I wanna hear.
Hmm.
I know, I sound ungrateful.
No, no, no, no, no.
Not at all.
You're far away from the people you love, you're about to begin a long tour makes perfect sense.
Why don't you come to my house for dinner? That way you get a home-cooked meal, and we can supervise your treatment in person.
Can we do it Bald Knob style? All depends.
What's that? You shop, I'll chop.
Done and done.
The good news is I don't see anything abnormal.
Food is traveling to his stomach, not his airway, and his throat muscles are functioning normally.
We've ruled out all the simple stuff which means it's something complicated.
- Not necessarily.
- Ohh.
We should run a full panel of blood tests to rule out glycogen storage disease, cystic fibrosis, and persistent pulmonary hypertension.
Let's just take this one step at a time.
So far, your baby isn't ill.
Yes, he's not growing fast enough, but let's not start thinking zebras just yet.
You're right.
Carlos has had a busy day.
Why don't I come to you tomorrow, and we can do a blood draw at your house? I think that'll be more convenient for you and less stressful for the baby.
Thank you.
Both of you.
So I'll see you tomorrow? Yes.
Vamos, Carlos.
Bye, Carlos.
Adios, hombre.
Bye.
What are you thinking? Well, I still really want to see the baby in his home environment.
Mm-Hmm.
You still think it's something social between Marisa and Carlos? Honestly, I'm not ready to rule anything out just yet.
Right.
What? Why are you smiling? The ringtone? I think Ava is incredibly talented.
Are you free for dinner tonight? It's not what you're thinking.
It's definitely not what you're thinking.
Thank you, Ava.
Pleasure, darlin'.
Enjoy.
Oh, my God.
Mmm.
Oh, my God.
This is terrific.
I can't believe you made all this from scratch.
It's unbelievable.
Really.
My grandma Dollie taught me how to cook when I was knee-high to a grasshopper.
You have a grandma Dollie? With seven brothers.
Alton, Elton, Lyman, Gleamon, Herman, Thurman, and Clyde.
What - You're making that up.
- No, honest.
Really.
Gleamon Lawson.
What do you think of that? - Um, no.
- Okay.
With all due respect to kale, it's just nice to eat real food for a change.
Mm-hmm.
This is actually my grandma's recipe.
What's in it? I've never tasted anything with flavors like this.
It's, uh, possum pie.
Oh.
But apparently, you can't get decent possum at Citarella, so I just used chicken.
- Oh, chicken.
- Ah.
Hank, did you not check in the critter aisle? - I did not.
- Go ahead, no.
Poke fun, you know.
I know a lot of people look at us folks from Arkansas like like we're related to Larry the cable guy, but I love where I'm from.
It's important in this business to have a strong identity, so you don't get carried away and Because of my family, I know exactly who I am.
Hmm.
You're very lucky.
Your possum chicken is better than anything I cook.
- Anything.
- He is not kidding at all.
Hank, when we were little, he used to cook fish sticks.
That was his thing, fish sticks.
- Okay.
- All the time.
One summer, every single night he baked fish sticks.
- Not every night.
- I genuinely believed Mrs.
Paul was a member of my family.
Seriously.
Ev, you don't remember, but mom was the terrible cook.
Where do you think I learned? She had three appliances in the kitchen a toaster, a microwave, and a de-flavorizer.
She was a really bad cook, wasn't she? Really bad.
Excuse me.
Uh, your blood results are in.
So the tests came back, and the results look good, but there were issues.
Some of the blood cells ruptured during the potassium test, which is why we're taking another sample.
But the other tests showed low renin and low aldosterone, so it could be pheochromocytoma or maybe Cushing's.
- Mm-hmm.
- What does all that mean? There may be problems in your pituitary adrenal system.
Your body might be producing too much cortisol.
I think we should do a 12-hour cortisol test.
Cushing's typically presents with weight gain, which Ava doesn't have.
Why don't we get an MRI in the morning, and this potassium test will give us a better picture? You know, if we start tonight, then we won't have to wait another 12 hours.
I could do the overnight draws.
- You sure? - Sure.
I don't sleep more than three hours at a time.
I read a lot.
Uh, okay.
The test is simple.
You just have to spit into a cup every four hours for the next 12 hours.
Okay.
Where's the cup? Uh, we can't start until at least an hour after you've eaten.
I'll come by your hotel at 11:00 and then return at 3:00 A.
M.
and then again at 7:00 A.
M.
Well, okay.
I'll see you then.
Good lord willing and the creek don't rise.
I I just want to thank you all again for making me feel so at home and letting me cook.
- Thanks for cooking.
- Oh, my God, our pleasure.
Thank you so much.
- Bye.
- Bye.
That was so fun! I can't believe Ava.
She's so down to earth.
I know, she really is.
I couldn't help but notice that you didn't share any bizarre family stories of your own.
That bad? That good.
I have a great family.
We're close.
I talk to them all the time.
Makes for very boring stories.
Well, that's the good kind of boring.
I mean, look, no family's perfect, but my parents set the bar pretty high.
They were both professors, but they traded off being home with the kids.
Sharing the responsibility was important to them.
Now it's important to me.
That's why no doctors.
Let's face it.
They always put work first.
"They"? Doctors who aren't me.
And when it comes to counting on them for social obligations I was kind of hoping we could forget about that.
You made up for it tonight.
I mean, where else in the Hamptons am I gonna get good possum chicken pie? Well, I'm glad we can still be friends.
Me too.
Thanks again for having me.
I had a really great time.
Me too.
Whoa! Uh, you really are a big fan.
Sorry.
Huge.
And I didn't geek out once during dinner.
I'm very proud of myself.
You should be.
- Bye.
- Bye.
Rafa? Rafa? Close your eyes.
Now turn around.
Let your hair down.
Can you feel how close I am? Tell me.
I can feel your breath on my neck.
How does it feel? Warm.
Cool.
Uh-uh.
You're cheating.
Close your eyes.
Or do I have to blindfold you? You can try.
Ava? Uh, it's me, Dr.
Sa Hey, Dr.
J! Come on in.
Uh Wow.
Either that's a, uh, a very fancy nightgown, or you're going somewhere.
I'm going somewhere.
My publicist insists that I have an image to live up to and that I live up to it at least twice a week.
- Uh-huh.
- Hey, could you do me a favor and grab my earrings? They're on the sink in the bathroom.
Okay let's do this.
I have been dying for a beer, but I knew I had to spit first.
Yeah, um, now, I I will need a rather large sample.
Y yes, that'll work.
Hey, uh, zip me up.
Ahem.
Uh, now you will need to provide another sample - in exactly four hours.
- Yeah, no problem.
So, uh, where will you be at 3:02? I have no idea.
I guess you'll have to come with me.
Come with you where? Hey! Uh, he's with me! It's okay.
Wow! Heh.
That was crazy.
Ah.
Are you all right? You seem a little out of breath.
Uh, yeah, yeah.
I just need some water.
Oh, uh, I don't have any water What happened to my medical supplies? Oh, don't worry.
I brought the spit cups.
Yeah, thank goodness you had this bag.
Do you know what my stylist would say if he saw a tabloid photo of me carrying a purse with this dress? I'm so glad you're here, you know? I feel really comfortable around you.
- You do? - I do.
You're direct.
- Uh - Let's dance.
Um to be direct I I actually don't know how to dance.
Um, I'm actually quite concerned about the contents of that medical bag.
Because if something hap Ava, if something hap Ava? Uhh! Divya, if you get this message, will you call me back, please? Although this is not an emergency, and it's your day off.
I'm sorry for yelling.
It's just it's the only way you'll hear me.
I am at a nightclub! Okay.
All right.
Hey.
Thanks.
Jeremiah? Hank uh, I can't do this.
Uh, can you come and take over, please? It's just 'cause I don't have my medical equipment.
It has nothing to do with the fact that there are a lot of sweaty people here.
And they're touching me, and it's very loud and and they're dancing around me.
Okay, where are you? Uh, at The Underground.
It's a nightclub.
I'm with Ava.
We're clubbing! You're what? Is she okay? Um, I can't properly assess her condition.
I don't have my pulse ox.
She removed everything.
Um, but earlier she experienced shortness of breath.
Okay, I want you to take a deep breath.
Just concentrate on your patient.
I know this is hard for you, but I also know you can do it.
I'm coming to relieve you.
Just don't leave before I get there.
Okay, Hank, I won't.
I hope.
Babe? What are you doing out here? What's wrong? I just can't stop thinking about my family.
I'm grateful to my parents for everything they've given me, but I am so angry that they didn't tell me I was adopted, and I feel guilty about feeling angry.
You shouldn't feel guilty.
How can I trust them anymore? They've taken away all sense of home.
I'll give you that.
Start from scratch.
We you and me we'll start a home together.
Come on, Dr.
J.
Just one dance.
Hey, just relax! Like, move your hips.
Whoo! Yeah.
Hey, just do what I do.
Come on.
Oh, yeah.
That's it.
No, that's it.
Yeah.
That's great.
Hey, you looked like Clark Kent in that phone booth, minus the glasses.
One thing I never got about Superman why the cape? It would only increase the drag coefficient when he's flying.
Whoo! Hey, try this one.
Ready? Oh.
And then and then you.
Whoa.
Sorry.
Ava, Ava? You, call 911.
No, back! Get back! Give us some room.
Back! Excuse me.
Jeremiah! Excuse me.
Jeremiah.
She's not breathing, but she has a pulse.
Okay, I've got an ambu-bag.
Ava's potassium results came back, and her levels are very low.
They've started her on a potassium I.
V.
, but she's stabilized and sleeping.
- You did good.
- Huh.
But we still haven't figured out what her problem is.
No.
Cushing's was a reasonable diagnostic path to follow, but there were no diurnal variations in cortisol levels.
- Right.
- We just need to square her low potassium with her other symptoms while factoring in her smoking.
Wait, wait, Ava said she didn't smoke.
What makes you think otherwise? When I gave her mouth-to-mouth, I I tasted tobacco.
Are you sure? Why would she lie about that? Maybe she was embarrassed.
Everyone knows how foolish it is to smoke.
True I wonder if she's a heavy smoker.
The answer could be in my medical bag.
Th this probably isn't diagnostically relevant.
Let's hope not.
No cigarettes.
Well, she wasn't lying about not smoking.
She chews.
- Chewing tobacco.
- Mm-hmm.
That would explain her expectorating proficiency as well as the empty soda can.
She took hers with her after dinner.
What kind of reaction to tobacco would cause her symptoms? This brand is heavily flavored with licorice.
Glycyrrhizic acid.
Licorice poisoning.
It lines up.
Look at you.
It's Boris.
Oh, why don't you take the call? I'll put his diaper on.
Papa.
Thank you.
Okay.
We got it.
I haven't seen one of these in a while.
What kind of pediatrician are you? The kind that hasn't seen one of these in a while.
Okay.
But I can do it with your help.
Here.
Hands.
Right.
Okay.
Let's do this.
Let's do it.
- Legs.
- Legs.
- Yes.
- Okay, lifting.
- Good job, Carlos.
- Good work, bud.
This goes here.
Uh, I don't see any safety pins.
They don't use safety pins anymore.
Oh, so now you're the expert.
Of the two of us, yeah.
Yeah? I'm not so sure about that.
Step aside, my friend.
- Let a real man at it.
- All right.
Vamonos.
It's gonna be okay.
Uh - I know, sweetheart.
- It's okay, bud.
Started crying the second I stepped in.
It's okay.
Ohh.
His suck is unusually weak.
I can't believe this.
What? Ankyloglossia.
Yeah.
You're right.
His lingual frenulum is unusually short.
Oh, what a relief.
And a frenectomy is simple.
Once the membrane is cut, Carlos will have normal range of motion - with his tongue.
- Nice work.
How many pediatricians would have caught that? Not many concierge doctors would have helped me put a diaper on.
All right, so the bad news is neither of us is very good with cloth diapers.
Heh, no kidding.
But the good news is we have a diagnosis.
You do? What? Ankyloglossia.
He's tongue-tied? That's right.
And, Marisa, it's a simple fix.
Ohh.
Aww.
You guys make a good team.
Mwah! This one's my favorite.
Oh, they they got my name wrong.
Actually, it's not even close.
At least you weren't photographed carrying a purse with that dress.
Hey, for once, the headline is true.
I did O.
D on licorice.
Well, as soon as we get your potassium levels up, you'll be dancing with the devil in no time.
You saved my life, and I don't think I properly thanked you.
How do I thank you? You can give up tobacco.
Ah, it's easier said than done.
I've tried before.
Actually, this may help.
Oh.
"Dugout chew bubble gum.
" "Chew, spit, and adjust" "like the real big league ball players.
" Well, I don't know about that last one, but thank you.
I didn't see your message until I got out of bed.
I've never done that before.
I am so sorry.
Wait, you're sorry about not answering the phone in the middle of the night on your day off? Is that crazy? It's a little crazy.
You have nothing to feel guilty about.
Or do you? No.
I'll make a call, okay? I'll see if something else is available.
- I love it.
- Me too.
It's gonna be perfect.
So convenient.
Surrounded by other students and and it's all mine.
Really? What you said last night you were right.
I want to start from scratch, and part of that is having my own space.
I don't want to live in the past anymore.
I'm ready to start my future.
This is gonna be great.
I know.
Do you have another patient for me? Uh, no.
I'm here for me.
Hank I hate to break this to you, but, uh I think you need a big boy doctor.
I just can't find the hidden lobster.
What's this? It's a backstage pass to Ava's concert at Madison Square Garden.
Oh, my God.
What's the catch? No catch.
Yet you're still here.
I am.
I been thinking about what you said, about who you wanted in your life someone who has a life, someone who's not a workaholic.
Someone who gives me backstage passes to see Ava.
I know I'm a doctor, but I think I can be that guy.
I want to be that guy.
What do you say?