The Resident (2018) s02e23 Episode Script

The Unbefriended

1 - Previously on The Resident - A few weeks ago, a wonderful man who loved me proposed.
I took so long to decide that he changed his mind.
- Wait, is this for us? - Yes, of course it's for us.
- We can get a hot tub.
Raise chickens.
- What? I don't move in with you, so you just leave me.
If you're not interested in going forward, for me, - it's time to take a step back.
- So my kidneys will never work again? You have to stay on dialysis - for the rest of your life, Jess.
- Come on.
There's got to be another option.
It's not that you can't give Jessie your kidney, it's that you won't! Why can't you for once, for once, do something that is not selfish? (SIGHS) (MUFFLED): That's exactly my point! Don't you know I'm no good for you - (CRYING) - I've learned to lose you Can't afford to - Tore my shirt - (LINE RINGING) To stop you bleeding KYLE: Hey, this is Kyle.
You know what to do.
(BEEPS) But nothing ever Stops you leaving Quiet when I'm coming home And I'm on my own I could lie, say I like it like that Like it like that I could lie, say I like it like that Like it like that (SIGHS) Don't you know too much already? I'll only hurt you If you let me Let's just let it go (NIC EXHALES) What's wrong? Everything okay? Can I come in? Quiet when I'm coming home And I'm on my own.
Look (EXHALES) I've been thinking a lot about us.
And I realized something, so just hear me out.
- Of course.
- (SIGHS) Life is hard.
And the problems keep coming.
And I keep trying to solve them all by myself.
Jessie, my dad, our patients.
I seem completely incapable of asking for help.
I don't know why I do that.
Well, you lost your mom - as a kid.
- No, no, I don't I don't want to do that.
I don't want to make excuses.
I want to see the pattern, take responsibility, and change.
(SIGHS) Okay, I'm listening.
You said you want to move forward in our relationship.
I want that, too.
I just need you to meet me halfway.
- What do you mean? - It means I want to start talking about moving in, marriage, a family, all of it.
But you can't push me.
You can't rush me.
Let me do this at my own pace.
I can do that.
(BOTH CHUCKLE) This is a big deal.
(EXHALES) I'm in.
(CHUCKLES) I just I just only have one request.
What? I really want those chickens.
(CHUCKLES) No chickens.
(CHUCKLES) (SIREN WAILING IN DISTANCE) Your company, Red Rock Mountain Medical, is the top health care conglomerate in the Southeast.
Your motto? "We're like family.
" But your family is missing a crucial piece.
We now own every major hospital within a hundred-mile radius.
We don't need Chastain.
But you do.
- To control pricing.
- (CHUCKLES) You need to eliminate the competition.
Chastain is in no position to undercut our pricing.
You're $100 million in the red.
We have an amazing staff.
Talented doctors and nurses.
We're a top facility.
We're unmatched.
But our research shows the words most closely associated with Chastain are "Dr.
Lane Hunter" and "QuoVadis.
" That's behind us.
It's old news.
And, in fact, I view it as a success story.
We were instrumental in exposing corruption.
We helped bring down QuoVadis.
We will be stronger together.
Well we will discuss internally and get back to you.
In the meantime, Dr.
Bell, do avoid any further PR disasters.
A bit of news for you.
I'm putting a pacemaker in Micah today.
Alert the media.
I know.
AUSTIN: It's minor.
So, don't worry.
You don't need to be there.
Why wouldn't I assist? Because you're emotionally involved with the patient.
No, I'm not.
Our engagement ended weeks ago.
"Weeks"? Well, that's hardly enough time to get over heartbreak.
Take it from the heartbreaker in chief.
Oh, please.
AUSTIN: Shira, we're closed here.
We have another surgery.
All good.
Let's pack up the patient and take him to ICU.
We'll never make a 7:30 show.
And, anyway, I'm not going to the Atlanta Gore Fest.
Oh, well, if you love your boo, you will.
Hmm? Hmm? Hard out at 6:45.
Love is complicated.
Sacrifices must be made.
Horror movies aren't my thing.
I see enough gore all day long.
Want to take my place? Jessica wouldn't want to hold hands and scream with me in the dark.
And I have a previous commitment.
- Oh? - Double shift.
This place is my main squeeze these days.
You're aware that's pathetic.
Adult male.
Age unknown.
Found him in Piedmont Park.
- Put him in two.
- GCS 11, BP 95/60, blood sugar 82, possible broken left arm, minor scrapes and bruises.
Let's start another large bore IV and hang another liter - of normal saline.
One, two, three.
- One, two - (GROANING) - Okay.
Can you tell us your name, please, sir? (GROANING SOFTLY) I.
No wallet.
No phone.
Torn clothes.
Dirt under his fingernails.
He could be homeless.
- Sir, your name, please.
- (GROANING) Okay, let's add LFTs, coags, UTox, aspirin/acetaminophen levels, and a blood alcohol level.
IRVING: Page social work.
See if they recognize him.
If not, have them call local shelters, see if anyone's missing or fits the description, while we try - to get his pain under control.
- I'll order an X-ray and get Dr.
Voss to take a look at that arm.
Must be very rewarding to be a transplant coordinator.
It is, but it's frustrating.
We need more donors to step up.
Too many people die waiting for an organ.
That's my biggest fear with my sister.
How is she doing on dialysis? (SIGHS) Not well.
Um, she's in early heart failure.
It's causing a lot of problems.
A new organ could help her heart.
But we can't wait years to get one.
Excuse me.
Welcome to Chastain.
- Can I help you? - Yeah, maybe.
I'm looking for a doctor.
Her name is Shira Smook.
Shira Smook.
Would you like me to page her? Nah.
I'll call her myself, tell her I'm here.
- (MONITORS BEEPING) - (WHEEZING) They had to abort dialysis because her pressure dropped.
Your sats are a little low.
Please-please make it stop, Nic.
Gonna do our best.
This should help.
First order of business is to switch up your heart medication so you can tolerate dialysis.
(WHEEZING) All right, Nic and I need to discuss our options.
Then I'll be right back.
It's gonna be okay.
Just give me a sec.
(WHEEZING) Elevated JVP.
And I saw signs of hepatojugular reflux.
Her heart failure is getting worse, more rapidly than we expected.
This is a disaster.
(SNIFFLES) Treatment of dual organ failure is challenging, not impossible.
Heart failure alone could kill Jessie.
She needs a new kidney.
There are cases where that alone improves heart function.
She might not need a new heart for ten years.
Your father's still the most logical donor.
He's here.
He's a match.
Kyle refused to donate.
And now I can't find him.
He's disappeared.
- I-I've called him over and over again.
- Which is why I asked my dad to try and track him down.
He put his private investigator on him, and now I have an address.
You want it? (GROANING) Trying, um, i-ingman (GROANS) Dad bum.
He has expressive aphasia.
He knows what we're saying, but he can't speak.
Maybe when he fell and broke his arm, he-he hit his head.
Still no kin we can find, no proxy to tell us who he is.
Squeeze my hand.
Squeeze my hand.
All right.
There you go.
We're up to the letter "S" now? We're calling him Sunflower One.
Nothing personal, my friend.
When we can't identify patients, we name them after flowers.
He needs a CT.
Bell's been tightening the screws down here.
He told me, and I quote, "Platinum care is reserved for those with platinum credit cards.
" DEVON: Since when do we do anything - but try to work around Bell? - (SUNFLOWER GRUNTING) Her herb.
IRVING: Given his age and how he was found, he might have dementia.
In which case, this is his baseline.
We need to take care of this man.
Whether or not he's homeless, - or whether or not he's insured.
- Mm-hmm.
DEVON: If there is an underlying diagnosis, like a brain bleed or a tumor, delay could cause irreparable damage, even death.
At the bare minimum, a CT is standard of care.
Let us know when we have the results.
Take it from there.
So it's definitely a type 2 second-degree heart block.
Which explains my dizziness.
Electrical impulses aren't getting through to your heart.
How serious is the surgery to - implant a pacemaker? - Oh, it's no big deal, bruh.
Quick procedure; in an hour, you'll be a new man.
Thank you.
So, otherwise everything okay? You seem to be in good spirits.
Man, I have never been better.
Seriously, on top of the world.
- Nice.
- Yeah.
- (KNOCKING) - Sorry I'm late.
- Traffic was terrible.
- MICAH: Yeah, yeah.
Come in, come in.
This is Dr.
He's going to be putting in my pacemaker this afternoon.
- Jolene Landis.
- Hi.
Thank you for taking such good care of my Micah.
- Hey, I've been looking for you.
- What are you doing here? You promised me.
(SMOOK CLEARS THROAT) Leave or I'll call security.
I'll meet you in the parking lot in an hour.
My ex.
He's a stalker.
Terrible choice in men, working on that.
I've been trying to reach you.
I didn't want to be reached.
NIC: (SIGHS) Look, I know things ended badly and I'm sorry if you've been upset.
But you're not sorry for what you said.
Look, can we just can we go inside? - Can we talk? - No, I just moved in, it's, um it's a mess.
Nice, huh? I'm the caretaker.
Free rent.
Good job.
Want a beer? It's a little early for me.
I've got a a long drive back, so (SIGHS): So what's this about? You know what this is about, Kyle.
She relapsed again? No.
No, she's she's sober, and she's determined to stay that way.
But her situation has changed.
It's not just her kidneys anymore.
Her, um her heart's failing.
Wait, what what does that mean, her heart is failing? We're trying to stabilize it so she's still eligible for a kidney, but the truth is, she has a very narrow window right now, so If you would reconsider donating, she might have a chance.
I know you wanted her to be sober six months to make sure she doesn't relapse, but she doesn't have six months.
How long do we have? Days.
I don't know.
But what I do know is that right now you're the only person who could save her.
I'm 63.
I smoked.
I still drink more than I should.
I can't believe that my kidney is her best option.
It's her only option.
(SIGHS) KYLE: Strange I ended up by a lake.
Never learned how to swim.
I hate dark water.
You're scared.
Is it so wrong of me? I mean, the risk is is pretty low for the donor.
But it exists.
There is a risk.
I'm sorry.
(TAKES DEEP BREATH) Next time I see you will be at Jessie's funeral.
And it'll be the last time that I see you.
He does have a ruptured aneurysm.
But it's small, right there in your Broca's area.
Which could explain why he can't speak.
Or all his symptoms are caused by dementia, so we'll ask for a neuro consult.
What if they say he needs surgery? (SIGHS) He's uninsured.
He's been classified as "unbefriended.
" No living relative, no proxy.
Which means the hospital decides all his care, and Bell is the hospital.
Let's be conservative a little while longer.
Take him to the ER for observation.
If Sunflower gets worse, then we have a stronger case to make to Bell, one that will be harder for him to refuse.
Where you been? (GROANS) Nowhere good.
But now I'm here with you.
What's this? It's my advance directive.
You're my proxy.
(NIC SIGHS) All my wishes are spelled out.
The hospital has a copy, too.
Nic? - (SIGHS) - Let's be brave and honest, okay? That's what I want.
The truth.
We're in a bad spot, aren't we? (SOFTLY): Yeah.
No one's giving up.
- (TAKES DEEP BREATH) - If I die I know you'll find a way to blame yourself.
- This is not your fault.
You went to see Dad, didn't you? Conrad found him, and, uh I went to let him know where we stand.
I was hoping he'd step up.
I don't understand.
He can't.
He's not a match.
(TAKES DEEP BREATH) He's a match.
He's, um he's scared of the surgery.
(NIC EXHALES) How is this not infuriating to you? I'm disappointed.
But I understand.
I'm a lot like him.
You are not.
You're like Mom.
He's not a bad person.
He's just weak.
We have to keep fighting together.
Okay? You promise me? (NIC SNIFFLES) We will.
But if we lose the battle there's just one more thing I'll ask, okay? Try to forgive Dad if you can.
(EXHALES) And let him know that I forgive him, too.
(QUIETLY): Okay.
4:30, OR Two.
Is that the surgery you and Dr.
Austin were talking about earlier? With your ex-fiancé? You're doing it with us? Yep.
See you in there.
- I have a request.
- Same here.
I wish this corned beef was more tender.
Shira is the anesthesiologist on Micah's surgery.
I need you to take her off the case.
- Why? - Gut instinct.
Something's up with that girl.
I do not trust her.
And you want what's best for Micah.
I'll get Paul Chu on it.
You still planning on scrubbing in? Yes.
Micah has a new girlfriend.
She's here at the hospital.
She's very pretty.
And he says he is happier than he has ever been.
I'm sorry, Mina.
I did not enjoy delivering that ten-blade to your heart.
But I had to see if you still had feelings for your ex-fiancé, and by your reaction, you do.
So no, you will not be scrubbing in.
And for what it's worth you deserve better.
Anybody who could replace you so quickly doesn't deserve you.
All right.
Thank you so much.
Jessie just gave me her advance directive.
I can't bring myself to read it.
Anybody need a kidney around here? (SIGHS) (QUIETLY): Thank you, Dad.
(SIGHS) I've got some good news.
Thanks to Dr.
Hawkins, your heart failure has improved for now.
We can move ahead with the transplant if we move fast.
So what's next? First, we'll bring you to the OR.
Uh, as we're removing your kidney, a second transplant team will prep your daughter in a separate OR.
When she's ready, we'll implant your kidney into Jessie.
Six to eight hours from now, you should both wake up, ready to make a full recovery.
Six to eight hours from right now? Right now.
Well, you guys, um you don't fool around, do you? (CHUCKLES) It can't wait.
See you on the table.
Voss, I need your help.
Bell, meet Sunflower.
Sunflower? - We don't know his real name.
- SUNFLOWER: It's It I can't even (BELL SIGHS) Unbefriended and uninsured.
- Yes.
- But you understand I have a patient like Sunflower on every floor of this hospital.
This is exactly the kind of case that's bankrupting Chastain.
Sunflower has a brain bleed, and his symptoms are getting worse.
Well, it could be sundowning, nighttime confusion.
It's common with dementia.
It's possible, but I don't think it's dementia.
Well, I You can't be sure.
This bleed is small.
Well, it could be the cause of all his symptoms.
It could be curable, Dr.
We had a neuro consult, and he recommended surgery.
Are you going to deny it? Look at this man.
(BELL SIGHS) He was found in Piedmont Park, wearing sweats.
If he was jogging, had a fall, that could explain why he had no wallet or I.
There is no police report, no missing persons file.
Yeah, he could be from out of town.
Even if he's homeless, what does it matter? Pravesh, a hand! (BELL SIGHS) What about the health of this hospital? We can't keep doing this.
Chastain is on the brink of a disaster.
I need to save it, too.
Just stay with him for five minutes.
That's all I'm asking.
See the human being and not the numbers this time.
(SIGHS) Want to beg beg What are you trying to say? This awful.
I I-I-I can't even You can't what? Help.
What's that What is that for? That's to start an IV, Dad.
My-my-my my mouth is so dry.
Can you give us a second? We have an excellent transplant team.
Great doctors, great staff.
Brave is not my resting state.
(SIGHS) You're gonna come out of this just fine.
And for the rest of your life, you are going to be happy that you did this, I promise you.
For Jessie.
- (SIREN WAILING) - NOLAN: I was leaving for the day, and I saw this guy breaking into a car.
He says he's a friend of a doctor here, but nobody has this amount of drugs unless they're dealing, or using or both.
Who is this registered to? Shira Smook? Hey, man, come on.
I forgot my phone.
Shira, you all right? Yeah.
Just tired.
I'll get a coffee.
I've been working long hours.
All good.
D-Dad, thank you.
Thank you.
Nothing I'd rather do, no place I'd rather be.
You're my baby girl.
I'll s I'll see you in a few hours, okay? (SOFTLY): Yeah.
Nic? Nic, there's something that I really need to tell you, s-something I should have told you a long time ago.
You can tell me on the other side.
- No, no, sweetheart, this is important.
- Dad.
It's gonna be okay.
SMOOK: Hello there, Mr.
I'm Dr.
Shira Smook.
I will be your anesthesiologist tonight.
(MONITOR BEEPING) (NIC SIGHS) They're about to ligate the vessels and remove the kidney.
Bell? - Yeah? We have a problem.
SMOOK: I've been working long hours.
TRENT: You promised me.
SMOOK: I'll meet you in the parking lot in an hour.
The recipient is open and ready to receive the donor kidney.
YEE: Ten-blade to me.
Time to give this kidney (ECHOING): a new home.
- What the hell? - (ALARM SOUNDS) Lap pads.
JESSICA: We lost his airway.
IV's out.
Oh, my God, he cut an artery.
She's not breathing! CONRAD: Call a code! Start bagging Shira! NIC: Get another anesthesiologist! He's crashing! Jump in.
My hands are full.
NIC: Tubes and lines are all pulled.
CONRAD: I'll re-intubate.
His airway's full of blood.
Suction! NIC: He can't go much longer without oxygen.
It's too swollen.
I can't get the tube in.
Sats are 60 and dropping.
He's gonna code.
We need to do a cric.
It's the only way.
Give me that.
- Ten-blade.
- Okay.
- Trach tube? - Got it.
(QUIETLY): Ah, got it.
CONRAD: Thank you.
- Done.
- All right, we're in.
NIC: All right.
Come on, Dad.
Come on, come on, come on.
Come on, Dad.
Come on, Dad.
Oxygen levels are still really low.
Bilateral breath sounds.
Tube is in place.
(NIC PANTING) His sats are climbing.
- What happened? - CONRAD: Shira collapsed.
DEVON: Let's load her on a gurney, and we'll take her to the ER.
(ELEVATOR BELL DINGS) What the hell is that? An IV port.
She's an addict.
That's her Dr.
What-what the hell happened? She OD'd in the OR.
Tell the ER we're gonna need Narcan! Can we proceed with harvesting the kidney? The risk is higher, but the bleed is stopped.
Are you sure? Because he's been through a lot.
If we get him to the ICU, he could fully recover before we move on.
But Kyle is currently stable.
Airway is secure.
- BP is holding.
- Jessie's window for a kidney is closing.
Her best shot is now.
I say we go on.
Administering Narcan.
Come on, come on, come on.
(GASPS, PANTING) Wh-Where the hell am I? You can't do this.
I'm a doctor.
DEVON: You OD'd in the OR in the middle of surgery and you almost killed a patient.
SMOOK: Let me go, get away from me! YEE: Thank you for covering for me while I was stuck in the other OR, Dr.
Looks good.
Stand by to reperfuse the kidney.
(EXHALES) How's it going? - So far, so good.
- (SIGHS) They're about to see if Jessie's new kidney works.
MINA: Unclamping.
(ALARM SOUNDING) - CHU: She's in V-tach.
- AUSTIN: Get the defibrillator.
- Give 300 of amio.
- BP is dropping.
I'll reclamp until she stabilizes.
AUSTIN: Charged to 120.
Charge at 200.
- Clear.
- Her heart is too weak.
MINA: V-fib.
We need to get that rhythm under control now.
We're at max joules.
Charge again.
- MINA: Okay.
Sinus tach.
- All right, that's what I like to see.
YEE: Let's unclamp these vessels and, uh, try this again.
MINA: Unclamping again.
CHU: Rhythm's holding steady.
AUSTIN: All right, it's showtime, baby.
That is a beautiful thing.
MINA: It's urine.
The new kidney is working like a champ.
Her heart took a beating, so she's still not in the clear, but (EXHALES) this is good.
BELL: Hey.
Devon told me you okayed the surgery on our unbefriended patient.
And good on you.
Yeah, well, it's gonna go in the red column for Chastain.
That column is already very long.
Why did you do it? I saw myself in him.
I should probably let you know I'm, I'm back with my ex-husband.
Oh, um Okay.
But I care about you and I believe in you.
Nurture the man I see right here.
Well, I will if I can.
Any change? The same.
(SIGHS) I still can't believe all this happened.
- Nic.
- (EXHALES) Take a break, get some air.
I'll keep watch.
I promise I'll page you if anything changes.
He's in fine health.
Good news.
What have we got next? Lung biopsy.
I'm Dr.
You just had surgery.
It went very well.
Do you know where you are? You're at Chastain Park Memorial Hospital.
And we've been taking care of you.
Can you tell us your name? George.
DEVON: George Wilson.
- BELL: Well, it's nice to meet you.
- (CHUCKLES) Is there someone we can call for you, Mr.
Wilson? To let them know where you are? (SIGHS) M My wife.
For the record, Dr.
Smook was not our fault.
I've learned the medical board of Pennsylvania pulled her license for drug abuse, so she moved here.
Doctor's records don't travel.
They can lose their license in one state and just move to another.
I know.
You are fortunate that your original pitch was so well received.
Red Rock Mountain is still willing to move forward with some conditions.
Well, I remain as CEO, that's nonnegotiable.
But your authority would be curtailed.
All administrative decisions about the running of the hospital would shift to Red Rock Mountain Medical.
Your signature, please.
I have to read this, I have to consider it carefully.
No, you don't.
There's nothing left to consider, Dr.
KYLE: Nic.
This time I'm here.
For her.
For you.
There you go.
(CHUCKLES) Anybody need a kidney around here? Quiet when I'm coming home And I'm on my own KYLE: I'm afraid.
You're gonna come out of this just fine.
But nothin' is better sometimes KYLE: You're my baby girl.
Once we've both said - D-Dad, thank you.
Thank you.
- Our goodbyes - Let's just let it go - (PAGER BEEPING) Let me let you go (MONITOR BEEPING RAPIDLY) Quiet when I'm coming home.
(PANTING) Get the pads, one of epi.
(PANTING) Where's the crash cart?! - (PANTING) What happened? - Nic, no, don't go in! Conrad's running the code.
He's got it.