The Resident (2018) s05e02 Episode Script

No Good Deed

Previously on The Resident The child you gave up when you were 13, he's-he's out there, he's looking for you.
Well, I wrote back and I told him I wanted no contact.
Hey, how's it going so far? - Just enjoy the spa retreat.
- Okay.
I got this.
I'm Super Dad.
Hey, do you want to get a bite? That's really sweet, but I am just whipped.
You know, it's not like I meant anything by it.
I'll wait for you, and we can talk about moving in together.
Excuse me, I've been waiting to get a cast.
Our tech just went home sick.
I'll have someone with you as soon as possible.
And I don't feel great myself.
Hey, I don't see that Winston ever checked out.
I'm gonna go down and check on my patient Winston Robards, okay? Hi, it's Devon.
I can't get to the phone right now.
Leave a message and I'll call you back.
It's Leela.
This is the third time I've called or texted.
Call me back when you can.
I'm starting to get worried.
Kit, I just wanted to talk to you about last night.
Me asking you to dinner.
Of course, but can it wait? I've got eight full hours of bureaucratic nonsense in my future.
A board meeting, two high-end donor phone calls, and a mandated kitchen hygiene inspection.
- The board.
- Oh, thank you.
Oh, and I've almost landed Dr.
Browner from St.
Paul's Hospital.
Browner? The neurosurgeon? He's a specialist in skull-based tumors.
He'd be a Barrett Cain replacement.
Expensive, but I'd love to have him at Chastain.
Browner is a star with a national reputation.
He would burnish our image.
Oh, come on.
Another item to add to the list: call Custodial about the elevator.
- Yancy.
- Yeah? Elevator two is stuck at the roof.
Go take a gander.
Have either of you heard from Devon? - I've been calling him all morning.
- Probably overslept.
- Coffee? - He doesn't oversleep.
And he said he'd quit after he rounded on his last few patients last night, and then he didn't text me after that.
Might have turned off his phone and fallen asleep in a spare room.
I've done that.
More than once.
I'll try the on-call room.
That's probably the answer.
That's odd.
Oh, my God.
This is Yancy.
I need help.
By the helipad.
I need a doctor.
Hurry! Hey, watch out! She's ODing.
We need to get her to a hospital.
No, no, no.
We drop her back at the dorms.
Campus security will find her.
Yeah, yeah.
Good idea.
They'll take care of her.
They'll take care of her? With what Band-Aids and a flashlight? Dude, if we take her to the ER, they're gonna call the police.
Then they're gonna drug test her and us.
Then they'll call the school and we'll all get expelled.
So you'll let her die to protect your B.
in French Literature? You know you'll lose your scholarship, too.
He doesn't care, okay? He can go - anywhere he wants.
- Okay, you guys can bail.
I'll take her to the ER myself.
Hospital, now! Okay! Okay, okay, okay, okay.
- Hello.
- Ah.
Look at that no crying.
The perfect drop-off.
Oh, my gosh.
When your mom comes over tonight, mm, she's gonna be so impressed.
Ooh I love you, GiGi! Say, "Bye, Da Da".
Hey, man, are you a doctor? My friend OD'd.
She's still breathing but she needs help.
OD incoming! Need some help in here.
What did she take and when did she take it? Uh, I d-I don't know.
I just found her like this.
- What's your name? - Trevor.
Trevor, listen to me carefully.
I need to know exactly what drug she took, otherwise I can't help her.
Two milligrams of a generic 3,4 methylenedioxymethamphetamine.
A party drug, like ecstasy.
But it wouldn't cause respiratory distress like this.
So, maybe opiates, too? No, no, no.
She told me she wasn't using those.
It's Devon, he's hurt.
He's in Bay Ten.
Give her O2 and Narcan.
Let me know if she doesn't wake up.
We'll take care of her.
What the hell happened? They found him collapsed in the elevator on the roof.
- Is he responsive? - Unconscious, localizing to pain.
Devon? You know where you are, buddy? - He's seizing.
- Push two of Lorazepam.
Hold him steady.
- This better work.
- Done.
He's settling.
We need a scan.
I'll take him.
I'm going with you.
Irving, can you take the OD in Bay Two? Sure.
Hundley, with me.
Oh, my God.
Why are you here? - I'm not here to see you.
- Please just - lower your voice.
- W-Wait, wait, you think I'm stalking you in an ER? Are you really that self-absorbed? I know this is hard, but I can't have you in my life right now.
I told you that.
- I thought we had an agreement.
- Get a grip.
I am not trying to reconnect with my birth mother.
I gave up on that.
The sign out front said this was a hospital.
My friend's ODing.
She's dying.
So maybe do your job and help her? I am a neurosurgeon, not an ER doctor.
But our team here is great.
They'll take good care of your friend.
Oh, and nobody here knows about you, so please, if you would just respect my privacy.
Give her another dose of Narcan and double the dose.
If she doesn't respond, we intubate.
Giving .
This is dose number three.
Sleeping Beauty awakens.
What the hell? Who are you? Oh, damn it! Son of a bitch, my head.
I was fine.
- I was - You weren't fine, you were dead.
I doubt that.
Doctors are always saying how they saved your life, but it's crap.
Actually, it was your friend that saved your life.
You OD'd.
He carried you into the ER.
Trev? Hey.
You feeling okay? I'm good.
You really carried me in here? You're the best.
My hero.
Knight in shining armor.
Okay, here's the deal.
Hospitals freak me out.
I feel fine.
I'm leaving.
I've got a sick doctor going to C and I see ten ODs a week.
I don't have time for your nonsense.
You leave when I say you can.
Could be the drugs you took, but have you been having any fevers at home? Any cough or cold? Mm-mmm.
Anyone ever tell you you have a heart murmur? No.
Why are you asking? Page Raptor.
We need an echo.
There's a lot she's not telling us.
We just heard.
How is he? Still profoundly altered.
Bradycardic, hypotensive.
Well, a nurse told us he might have been assaulted.
- Was there head trauma? - Bruising and lacerations, but I'm reserving judgment until that CT comes up.
If he was assaulted in our hospital, I have to call the police.
Scans are coming up now.
Well, that's a normal head CT.
No evidence of stroke or bleed.
Which rules out brain injury as the primary issue.
I don't think he was assaulted.
Look at his lungs.
Bilateral infiltrates.
You know, he could have aspirated when he was down, and that would explain the hypoxemia.
He might have, but that wouldn't explain the seizure.
I just don't know.
Let's review the differential.
We ruled out brain bleed.
- And stroke.
- What about an arrhythmia? Maybe it made him pass out and hit his head.
It's possible, but his EKG was normal.
Nothing strange on telemetry.
Are his labs back? Uh, his potassium and magnesium are okay.
His urine tox was negative, but his lactate is sky-high.
He's got profound metabolic acidosis.
No, he's septic? That makes no sense.
White count's normal, his abdominal scan was benign.
No, it doesn't read like an infection.
Must be something else.
Look at his watch.
His dad gave it to him, but it was silver and now it's black.
It's tarnished.
It's blood.
A tarnished watch.
Frothy, blood-tinged secretions.
It's a chemical reaction.
His airways are involved.
And whatever it is crossed the blood-brain barrier.
That's why he seized.
And if it's in his airway, chances are It's a gas.
But which one? Carbon monoxide doesn't fit.
Yeah, but hydrogen sulfide would.
Yes, that's a possibility.
We'll keep him on oxygen, bolus fluids and give him the antidotes to hydrogen sulfide.
We're getting there.
Something poisoned him at Chastain.
If it was hydrogen sulfide, then there is an imminent threat - to patients and staff.
- Yeah, I know, I agree.
You stay, and I'll cover for you with Browner and the board.
Are you sure? I know all about wooing arrogant doctors.
I won't blow it.
So I see you've had an aortic valve replacement.
Your scar here in the ultrasound tells the tale.
- What does that mean? - Well, it means your friend needed surgery to replace the valve that allows the blood to exit the heart.
Sophomore year.
I thought I had the flu.
I I'd been partying.
A lot.
And I collapsed in my dorm.
When I woke up in the hospital, they told me I had an infection in my heart.
Well, now the new valve is infected, which is why you have a fever.
And I'm guessing the source is recent IV drug use.
You told me no more dope.
Junkie broke a promise.
I'm shocked.
I'm gonna go check on Devon.
My head's pounding.
Can we move on? Sure.
You see that bright spot on your heart? It's called vegetation.
It means there's a mess of germs and clot on your valve.
And these infections travel fast in the bloodstream.
And given that you have a headache, my guess is your heart is not the only thing in danger.
So I'm going to page a neuro consult.
How's he doing? He's on oxygen and fluids.
We gave him the potential antidotes.
Fingers crossed they work.
He's waking up.
Devon? Can you hear me? Can you hear me? W-Where am I? Oh, my God.
You're at Chastain.
You're okay.
You're gonna be fine.
Did I almost die? Definitely almost died.
Welcome back, brother.
How do you feel? Like I drank a bottle of gin.
Three bottles.
It really, really hurts to breathe.
I got to go.
You scared us.
Hang in there.
What happened? Do you remember anything from yesterday? Nothing.
That's okay.
It'll come to you.
Just take it easy.
We'll figure it out.
Get some rest.
If your breathing gets worse, you tell me right away.
He can tell me.
I'm not leaving his side until he walks out of this hospital.
Probably not after that, either.
You called a neuro consult? Yeah.
Yeah, the patient is Janey Moore.
Prosthetic aortic valve endocarditis with headache.
Excuse me.
Any trouble with your eyesight? Double vision? If I study all night.
Follow my finger.
Tell me about the headache.
Just a migraine, I think.
- No big.
- You've had one every day this past week.
Exam suggests a possible sixth nerve palsy.
She'll need a CT angiogram of her head and neck to rule out stroke, aneurysm or abscess related to the infection.
Moore, I'll see you in imaging.
Hey, hey, hey, hey, hey, hey, hey.
Is she gonna be okay? - I'll need to see her scans.
- Okay.
But do you think there's something wrong - with her brain? - I don't know.
I mean, she's a junkie, so there's that.
- What, is she your girlfriend? - Not really.
Well, if I were you, I'd count my blessings - and move on.
- Oh, well, you don't know her.
And I'm not taking romantic advice from you.
For obvious reasons.
You don't know what you're talking about.
Well, you got that right.
Because I don't know where I come from.
I don't know why I am the way that I am.
I thought maybe you could explain - given the fact that you're - Excuse me.
Bro, you want to you want to explain this? Oh.
- Yeah, right.
- Wait a minute.
Hold on.
Where you going, bro? It's, uh, it's an entactogen.
A dopamine agonist that bonds to the serotonin receptors but with zero effect on the GABA receptors.
So it's a schematic for a drug that you created? Yeah.
It's recreational.
For parties.
You know, emotional connection.
Bring people out of their shells.
And if I'd known she was using, I would've synthesized a Suboxone equivalent, given her that instead.
Hang on, how do you know how to do all this? I'm a medicinal chemistry major.
I formulated the drug so she wouldn't get too high.
It's totally safe.
You can clutch your pearls, act all outraged.
I don't care.
The only reason I was cooking that stuff was to keep her happy and off dope.
You think it matters if your motivation is to keep your dream girl off heroin? You're a drug dealer.
That's just the truth.
I don't sell drugs.
I'm a chemist.
I create them for fun.
What I made didn't put Janey in the hospital, because my science works.
Now, I'm fully prepared to accept the consequences of my actions.
- Can you say that about yourself? - Oh, you are not as clever as you think you are.
- Oh, did I ask for your opinion? - And you sure as hell haven't earned - the moral high ground.
- What gives you the right to talk - about a moral high ground while you - Hey, hey.
This is not the place, all right? Uh Trevor, why don't you go in the waiting area and just give us a few minutes, all right? I'm calling the police.
Do it.
You know, if I wasn't a semi-observant Buddhist, I'd punch him in the throat myself.
But it occurs to me that if someone called the cops on me every time I deserved it, I wouldn't be standing here.
Triple Board-certified all-star.
Now, clearly, you two know each other.
Want to tell me what the deal is between you two? No, I don't.
What I want is to run the scans on Janey's head and be done with both of them.
Does Devon's recovery mean he was poisoned by hydrogen sulfide? Unclear.
But seems most likely.
Hydrogen sulfide mostly comes out of septic tanks and manure pits.
Devon didn't leave Chastain yesterday.
That means whatever he got in his lungs hydrogen sulfide or something else he inhaled inside the hospital.
Well, if there's a poisonous gas leak in the hospital, it could be devastating.
People could die.
We may have to evacuate.
But no one else is sick yet.
If we retrace Devon's steps, account for every second of the day, there's a decent chance we'll run into the source.
I'll talk to security.
I'll check with the nurses.
We have to figure this out.
Hey, Bailey, what time did Dr.
Pravesh badge in yesterday? Start of his shift.
7:00 a.
And he never badged out? Nope.
Here all day.
- Thank you.
- How many patients - did he see? - Yesterday in the ER? There were too many to count.
Well, any out of the ordinary cases? - Toxins? Poisonings? - No.
- I'd remember that.
- Does he show up on any of the CCTVs outside the ER? - Getting onto the elevator? - We don't have cameras in the elevators, and all of our other CCTVs went down - because of the ransomware attack.
- So Devon was in the ER - all night? - Yep.
Well, all of my time.
- What do you mean? - I had a half shift.
Uh, Shelly, the night nurse she finished up.
Hi, Shelly.
It's Kit Voss from Chastain.
I'm so sorry to wake you, but we're trying to track down Dr.
Pravesh's movements in the hospital last night.
Did you ever see him leave the ER? Do you remember the name of the patient he went to check on? Winston Robards.
Fractured wrist.
Devon sent him for X-rays.
And a cast? - Casting room.
- Thanks, Shelly.
You're an angel.
Andrew! Grab the wheelchair.
One, two, three.
I'm gonna take him to the ER.
Call Kit Voss, tell her to seal off the basement.
I'll notify hazmat.
No, I know Dr.
Voss was sorry she couldn't be here.
- Something serious came up.
- Honestly, it's a chance to meet the famous Dr.
Bell, so, uh, no worries.
You know, I-I'm-I'm gonna spare you the small talk.
Chastain is a fabulous hospital.
It's full of smart, hardworking doctors, and yeah, we're a public hospital, so no, you won't make as much money as you're used to.
But, you know, I look at that as a chance to give back.
To our community, to our young residents.
And, you know, and at this point in my career, it This feels like the right thing to do.
So come to Chastain.
You'll never be sorry you did.
That was considerably easier than I expected.
Voss will be overjoyed.
You mind if I just make a few calls - just to do my due diligence? - Would expect nothing less.
Uh, I'll text you some phone numbers.
Janey's scans are up.
What you got? Mycotic aneurysm.
The bacteria from her heart valve - lodged in her anterior cerebral artery.
- Well, - that explains the vision issues and the migraines.
- Mm-hmm.
And she has a sentinel bleed.
The aneurysm has started to leak.
So you'll repair it? Sure.
But not until we make a decision on replacing her heart valve.
Until you make a decision.
Look, I know some surgeons who would refuse a valve replacement on a drug user.
Some of my mentors, even.
But I say, look, if she's strong enough for surgery, this might be the second chance she needs.
Third chance, actually.
She was born healthy, used, got repaired, then used again.
And we have proof.
Her urine tox screen came back positive for opiates.
- She's a chronic user.
- Great.
I recommend clipping the aneurysm, continue antibiotics and hold off on the valve surgery until she's logged - some sober hours.
- Which could kill her - before she has a chance to recover.
- Whoa, hold up.
You get to decide whether she lives or dies? - You cannot be a part of this discussion.
- What? Who made you God? Because that's what you're doing right now.
You're playing God.
Am I missing something? You're not the patient and you're not family.
Go sit in the waiting room.
Oh, I am not leaving.
And you're missing everything, dude.
All you see are these lab results.
You don't even know her.
Janey, who's literally the best person I know.
I'll call security.
Hold up, Irving.
Listen to me, dude.
It's not as simple as her being a good person.
All right? If I replace Janey's valve, her recovery's gonna be tough.
Not just physically but mentally.
She's got to stay clean.
That valve gets infected, she won't live long enough to get another one.
Without rock-solid support, even my masterful surgical skills are useless.
Then I'll make sure she stays clean.
No, she already had you fooled once.
What makes you think she can't spin your head again? This is not about her, Dr.
I never abandon the people who need me.
Bay 2, Doctors.
Janey is hypotensive.
She's crashing.
Her pulse pressure wasn't this wide before.
I'm hearing crackles half the way up.
Fluid is backing up into her lungs.
I see a new paravalvular leak.
- This valve is shot.
- I can still repair the aneurysm, but we all know that won't save her life.
What's the call, Dr.
Austin? You fixing her valve or not? It's not up to me to decide how many chances a person gets.
Brain first, then heart.
Let's book an OR.
- I'll start prep.
- I'll get transpo.
I-Is she gonna be okay? No guarantees.
They need to get her to prep.
That's gonna take a minute.
Meanwhile, let's you and I have a talk.
Get him on 100% O2.
Bolus a liter and give him what we gave Devon sodium nitrate and hydroxocobalamin.
It might be too late to work, but it's worth a try.
Confirmed it was hydrogen sulfide.
Rotten egg smell all over the casting room.
I called hazmat response.
The basement's being sealed off.
Do we know how long he was exposed? Since last night.
Best hope is the exposure was low-level.
Someone vented the room he was in, so it's possible he got a small dose.
Well, here's hoping.
Look, if this is gonna be a lecture on addiction, spare me, okay? I know it's a disease A disease that you can't cure no matter what drug you make.
Yeah, yeah, yeah.
Seriously, man, uh, there's nothing you can tell me I don't already know.
Are you gonna fix her heart or not? Of course.
And you won't let Dr.
Sutton talk you out of it? What's your beef with Dr.
Sutton, huh? Home come you keep coming at her? She's my mother.
That's why.
She gave birth to me and then wanted nothing to do with me.
So, if it seems like I'm coming at her, there's your reason.
Um Look, there's a, uh, a surgery waiting room on the fifth floor.
All right? You go there.
And I'll call you when the surgery's over.
You must have been quite young when you had him.
I should have figured it out myself.
Watching you and Trevor go at it is like watching someone fight with themselves in the mirror.
I don't want to talk about it.
I told you that.
And I heard you.
But we're going to be operating on your son's friend.
I know you've had a complicated day today, and I want to respect that, but I must point out the elephant in the room and ask I'll be able to do my job? Well? If you want to know, I was 13 years old.
- Hey.
- Hey.
Winston's recovering.
He's awake.
He breathed in a small dose.
That's a huge relief.
It's good to hear your voice, Dr.
Hawkins says you don't remember yesterday.
I don't.
But I thought if I saw your face, I would.
Maybe if you just listen to my voice.
I've been blind my whole life, so that's how I remember people.
Your voice.
Your father's remedy for everything is to rub dirt on it.
I thought that was hilarious.
I sent you to get a cast.
You didn't come back.
So I went down to the casting room because I thought you were lost.
Hello? Hello? Then you were out on the floor.
I could smell the gas.
Hey, can I get some help in here?! I vented the room.
I tried to drag you, but I got very dizzy.
I-I just, like I remember I couldn't breathe.
I thought if I could get to the elevator, get to the ER, I could call for help.
Then everything went black.
You turned on the vent.
That cleared out the worst of the hydrogen sulfide.
Winston had limited exposure.
That saved his life.
You saved his life.
Thank you.
First brain, then heart.
That way, we get in and out safely.
You okay with that, Sutton? You don't need to worry about my focus.
Regardless of what's going on outside of this room.
Good to know.
Okay, removing the skull cup.
Opening the dura.
Working my way down through the fissure.
Cannulating the femoral artery.
Okay, I see the aneurysm.
Just need to establish control around the blood flow.
Clip applier to me.
Damn it.
The aneurysm ruptured.
I need your hands.
Get up here.
All right.
What do you need? Consider me your assistant.
I need you to suction the field.
Come on.
Sutton, I watched you operate on my mother.
You got this.
All right.
Bleeding stopped.
I think I've got control.
- Straight clip, please.
- Great work.
What'd you do? Not sure.
Sometimes you get lucky.
Or else We didn't actually fix it.
Her heart is failing.
She doesn't have enough blood pressure to bleed from the aneurysm.
- Chu, how we doing? - Not good, team.
Maxing my pressors.
It's the valve.
It's blown.
Wide-open regurge.
I'm gonna have to crack her chest open, put her on bypass before we lose her.
And this time, Sutton, I'm gonna need you to help me.
Browner raked in the money for us at St.
He was a publicity machine, as well.
- And his outcomes? - Strong.
- Plays well with others? - I think you'll be happy.
Well, that seems to be the consensus.
Thank you.
Long time.
What's up? Tina.
Quick question.
I know you worked with Jim Browner over at St.
Paul's, and we're thinking of hiring him.
Don't do it.
- Excuse me? - He's got millions in lawsuits against him.
Bullying residents.
Sexual harassment of nurses.
He threw a cell phone at a PA.
Broke the guy's nose.
He's a walking court order.
Every doctor I spoke to at St.
Paul's gave him glowing reviews.
They're trying to unload him on you to get him off their payroll.
Classic pump and dump.
He's costing them a fortune.
I have one word for you.
All right, I'm inside the aorta.
This valve is totally destroyed.
Leaflets this thick and inflamed, patient's been sitting on this infection for a while.
And yet she was determined to keep it from those around her.
Even as her heart started to fail.
Some secrets need to be kept.
But they can corrode nonetheless.
Hold my valve for me.
What made you decide to give her the valve? I'd always intended to if it became necessary.
People make mistakes, right? And like Trevor said, no one should get to play God.
Not even surgeons.
In my OR, there is no room for judgment.
Not for Janey.
Not for anyone.
Well, you were right.
Fits perfectly.
Now, listen, when we leave this OR, you don't have to see Janey or Trevor ever again.
I'll handle the post-ops.
And I won't say a word.
To anyone.
It was hydrogen sulfide gas.
How the hell did that get into Chastain? The hazmat team says it's happened in hospitals before.
Techs dump plaster of paris from casts down the drain.
It clogs the pipes, so janitors use acid-based cleaner to cut through the sludge, - and the - And the acid, um Mixes with the sulfate in the plaster, and you get hydrogen sulfide.
And how about the patient Conrad found? - He's gonna make it.
- Oh, fantastic.
But for all the good we do here, sometimes running this hospital feels like a Sisyphean task.
Ransomware attacks, gas leaks.
So come on, give me some good news.
How did it go with Browner? You can't hire him.
He's got a raft of problems.
HR issues, lawsuits.
Paul's was just trying to dump him on us.
- How did you find out? - Every doctor I talked to at St.
Paul's did nothing but sing his praises.
Not a single bad word, and it just s-seemed off, so I called a friend, and friends tell you the truth.
Oh, bloody hell.
Well it's disappointing, but at least we know the truth.
Thanks for having my back.
Yeah, l-listen, I've been I've been meaning to talk to you about this all day.
Uh Just wanted to apologize for yesterday, asking you out.
We have such a good thing together, and I I don't want to mess that up by stepping over the line, so I promise, it won't happen again.
Really? Because I was I was wondering if you would want to have dinner with me tonight? Yes.
I know this great Italian place.
Open late.
Hey, it's me.
Just trying you again.
Call me back.
- Nic? - Yeah.
She's driving back from the spa.
I got to pick up GiGi.
She had a long day at the nursery.
I love my girls.
Thought we were gonna lose you there for a second.
I didn't like that at all.
Me, neither.
I'm really happy you're okay.
See you.
- See you guys tomorrow.
- Thanks, Conrad.
So I was thinking Maybe we should move in together.
So you can look after me? If you're gonna keep being a hero, somebody has to.
I'd love that.
Surgery was a success.
She's looking good.
The recovery is going to be a beast, but I'll check again in the morning.
I get it.
No, really.
I do.
The defining experience in your life is abandonment.
I don't know what you're talki Just shut up.
I was the same way, bro.
I was hurt.
I was alone.
I lashed out.
See, I used my words and my intelligence like a bully uses his fists.
And it worked for a while.
I felt good.
But it never gave me the one thing that I really wanted, which was to belong.
Look, you're loyal.
You care.
Everybody sees it.
But in the long run? That's not going to end well, and I know you know that.
But you don't know me, so I'm not gonna be the one to tell you don't go down that path.
But I will tell you that if you do, brother, you aren't gonna end well, either.
See you in the morning.
I have to go check on a patient.
How about I give GiGi a big kiss? Oh, my gosh.
You ate all your food.
Let's see.
Let's see where she is.
Mommy's gonna be so impressed with you.
Ate all your dinner.
Where are you going? What? I just Oh! Who's that? Who's there? Is it Mommy? Yes! Mommy.
Mommy's home.
Let's go.
Whee! Let's go get Mommy.
Conrad Hawkins? There's been an accident.

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