Transplant (2020) s01e03 Episode Script

Your Secrets Can Kill You

1 My university might never release my medical school transcripts.
But sir, I am the doctor I told you I was.
I'm here about your former colleague, Khaled Abdullah.
Abdullah is wanted for an immigration violation.
So if you see him, call me.
Everything alright? I have these for you.
Transcripts? I thought you were just going to look into them.
My friend said they were easy to reproduce.
So I told him just go ahead.
Forgeries, corruption.
That was supposed to be behind us.
These are your grades, brother.
You earned them.
Who cares where the paper comes from.
Did you pay him for these? Yeah, they were asking about you at the hospital as well - Did you tell them where I was? - Of course not.
My claim for asylum was denied.
Can you appeal? What if you got a lawyer? Can I stay with you just 'til I figure out what to do? If it was just me, it would be different.
But I have Amira to consider, and if we were caught I understand.
(DISTANT SIRENS) (KEYS JANGLING) I'm working overnight.
Amira's with a neighbour.
Thank you.
I'll leave at dawn.
Your sister will never know I was there.
And use the transcripts, Bashir.
Nobody needs to know.
(SPEAKING ARABIC) (SIRENS WAILING) Intra-nasal foreign body removal.
- Interesting new hobby.
- Yeah.
Jealous? I'm almost done if you want to borrow it.
Uh, no time, I'm headed home for the night.
Eight hours of driving for one day at home.
Huh, somebody's hard up It's Abby's piano recital tomorrow.
And Melissa lets the girls sleep in our bed when I'm gone, so that won't be happening.
- Worth it to be with your family.
- Yeah.
Amira, she spending the night solo? Amira? Girlfriend? Daughter? My younger sister.
She's with the neighbours.
Hamed, by any chance, do you speak Urdu? No.
But I think my great-grandmother did.
Call the translator.
Do you see non-surgical patients too? Only when it's busy, which is always, unless my surgical attending needs me upstairs.
Imagine they paid us by the patient? What is the pay schedule here? - Every third Thursday.
- When I first started, it took 'em four weeks to get me on the payroll.
Any chance they've gotten faster? (LAUGHING) Do you guys know a doctor? Dr.
Hamed will take you to triage.
Actually Dr.
Curtis will.
Hamed and I need a word.
Legal's up in arms about your missing transcripts.
They won't accept that you can't get the originals out of Aleppo.
Any chance they watched the news in the past five years? Apparently not.
They want to see you before making a decision.
- A decision? - Render judgment? Call it what you will.
They've asked to talk to you tomorrow.
Anything in particular they want to know? About the Syrian doctor who showed up out of nowhere wielding a power drill.
I think they're gonna want to know everything.
To them, you're just a giant flashing neon sign that reads: Liability.
Do not proceed.
Tomorrow, 6pm, and wear the kind of tie you wear when your entire future hangs in the balance.
Heading home, Dr.
Bishop? Well, I can always stick around Oh, no we're fine.
You've been here all day.
Wendy loves it when I insert myself and disrupt her shifts.
I still remember when 36-hour shifts were the expectation.
That's how I trained.
(CHUCKLING) Turns out we function better when we're awake.
Well, have fun tonight, people.
What happened with the Blakemore can't happen again.
I'm aware you have skills and experience, but in order for us to move forward, I need to be convinced that you understand our protocols.
You don't want me seeing patients? Only the basics.
Anything beyond that, I'm looped in.
Understood? (MAN): Cardiac arrest, pulling in now.
Cardiac arrest aren't the basics? A kid with a fever is.
(BACKGROUND COMMOTION) (BASHIR): How long has Tristan been sick? Well, he had the flu for a couple days, but tonight things just got way worse.
What happened? He wouldn't drink the juice that I got him, and then he just stopped answering me even though his eyes were open.
So I-I don't know.
(SIGHING) Are your parents around? Um yeah, my dad, my dad is working.
I called him, but he didn't answer, so Temp's 38.
BP's 110 over 70.
Let's get his fever down and put a line in.
IV, fluids, CVC, lytes, CRP.
Tristan? Can you hear me? I gave him a bath to try and cool him down, but he You did all the right things.
It's a good thing you brought him here.
His veins are flat due to dehydration.
It's gonna be tough getting an IV in.
Don't worry, Claire's an expert with IVs.
You can hold his hand if you want.
Buddy? The doctors are gonna help you feel better, okay? Got it.
I'm going to call your father again, - get him to meet you down here.
- Okay.
- (MEN LAUGHING) - Alright, what do we got here? - You ready? - Mm-hmm.
Yeah, we're gonna have to stitch you up.
We're also gonna need a serum tox with an alcohol level.
- Yup.
- We We were not drinking - (MEN CHUCKLING) - That's why it reeks like beer in here.
(CHUCKLING) What's your name? Well, what's yours? Did you, did you wanna have dinner with me sometime? His name is Brett.
He got hit in the head with a lacrosse stick.
Alright, Brett, follow my finger.
So you guys like to play lacrosse at night? Open your mouth.
No, it's actually pledge week, so we Wait.
Dude, that's not gonna hurt my chances, right? Dude, dude, shut up.
You took a vow! Uh, you took a head wound to get into a frat? I'm already in.
I just caught a backswing by accident.
I definitely would've taken that hit if it meant I'd get in.
You geniuses do realize that even a minor head wound can be dangerous, especially when combined with drugs and or alcohol? I told you, we weren't drinking.
We're a holistic frat.
No booze.
No drugs.
We even meditate.
(CHUCKLING) Well, you seem very enlightened.
I'll be back.
Oh, shit.
Oh! Last night was fun.
You gonna hold the door for me too? You're welcome.
I'm Doctor Leblanc.
What seems to be the problem today? I don't know why I'm here.
I'm not hurt, as far as I can tell.
Okay, uh, what is the last thing you remember? They told me a cab driver brought me in.
But I don't remember where I took the cab, or why.
I don't even know my own name.
And you don't have any ID on you? Wallet, phone? I don't know the password to unlock it.
What kind of person leaves their house without a wallet? Okay.
Um, look at my finger.
Well, doesn't seem like you've been drinking.
In any other case, I'd take a complete medical history, but obviously that's not an option.
Do you have any idea why this is happening to me? Uh, head trauma, even mild, can cause memory loss, but your pupils aren't dilated, so concussion's unlikely.
Could be lifestyle related.
A substance you ingested, maybe.
Do you think you can help me? Yeah, well, we'll run some tests, and narrow down the diagnoses.
If anything comes back to you, you let us know.
(SIGHING) (MAN): I wasn't home when they brought him in.
Max was worried.
He's a great older brother, but sometimes he's a little overprotective.
What, I wasn't Dad, you know he's really sick, right? - (KNOCKING) - Dr.
Hamed, this is Jared Abott.
He would like to take his son home.
- Where's his fever? - 39 now.
That's up from before.
Sir, taking him home is not a good idea.
He's been unresponsive and has a high fever.
We need to give him antibiotics.
How do we know the fever isn't a reaction to something that you have given him here? Dad, no, I He had a fever before I took him in.
That's why he's here.
I don't want him taking any unnecessary drugs.
Tristan doesn't react well to them.
How would you know? You never give him any.
Sir, this could be more than a simple flu.
We don't know what's causing your son's fever to spike.
It could be a serious infection.
- He's not vaccinated.
- Max! They have to know, Dad! - Is that true? - Which vaccinations is he missing? All of them.
(SUSPENSEFUL MUSIC) (THEME MUSIC) We must shift Tristan Abbot in negative pressure isolation.
Gloves, gowns, masks on everyone, staff or family, until we know what he has.
You're back? Unvaccinated child with a mystery illness? More interesting than my flat screen.
I know that look.
She's already writing a paper in her head.
So, what's the case? Seemingly healthy male, no idea who he is and no ability to retain new memories.
Think it could be Transient Global Amnesia? - What about a concussion? - No headache, dizziness, nausea.
No evidence of a fall or head trauma.
Order a tox screen and C just to rule out anything more serious.
He's out for both right now.
Usually with TGA, a patient still knows their name.
Well, studies show some cases are more acute.
Could even be brought on by stress.
So should I call neurology? No, they'll only come down if the CT shows something.
With TGA, we're told to just wait until he remembers, or someone comes looking for him.
The Abbott boy's fever is still holding.
The father wants to know when we're discharging him.
Of course he does.
Get set up for the lumbar puncture.
With your permission, I'd like to do it.
I will do it.
Page me when you're ready.
Get to work, both of you.
Most first years don't get to do spinal on their third shift.
I may be a first year here, but this is not my third shift.
Do you see a lot of unvaccinated children? More than we should.
People afraid of side effects, primarily autism.
That study was retracted.
Yeah, and a tonne of misinformation is taking its place.
Are there antivaxxers in Syria? People there are desperate for vaccines.
We fight to get them into the country.
ABBOTT): The spinal needles you're giving Tristan Explain to me why you have to do this.
We need to rule out life-threatening infections like meningitis or encephalitis.
And the blood tests you've already done can't do that? There's a limit to what blood work can tell us.
Is it going to hurt him? We'll freeze up the skin to minimize any pain, and make sure it's over as quickly as possible.
Max got one vaccination when he was a baby.
It left him paralyzed for a week.
Half his little face was frozen.
Reactions like that are rare, and almost never serious.
Until they are.
We were lucky that he bounced back.
After that, we were done with it.
The body builds its own immunity.
Then neither of your sons are vaccinated? Mr.
We only want to help your son.
We'll be as non-invasive as we can moving forward.
Their mother was a natural with this.
Together, we got Max through colds, flu, even measles.
We lost her suddenly in a car accident.
Tristan wouldn't even remember her.
I'm sorry to hear that.
(HEAVY BREATHING, TUBES HISSING) Is everything ready, Dr.
Hamed? - Mm-hm.
- I'll insert the spinal needle.
I'm Dr.
A taxi brought you in and you couldn't remember who you are.
And we've already met.
How can I not remember a single thing about myself? Well, we do know a few things.
Your imaging and blood work aren't showing any significant abnormalities.
So we know you're basically healthy.
There's no pill you can give me? Jar my brain into recalling some facts? I wish there was.
Give me your arm.
That's quite a scar.
It's weird A stranger putting your life under the microscope this way.
Well, how about we widen the field? - You can cross-examine mine.
- Are you serious? Okay.
Um Young doctor starting out? Entry level BMW, a tiny perfect condo and, uh and a couple cats you rescued from the shelter.
Couple cats? Now I'm offended.
I still live in my studio walk-up.
Turn around for me please? You don't want to put down roots? I'd rather spend on experiences.
Live while there's time.
Toussez deux fois ? (COUGHING) Well, we just found out you speak French.
- I do? - Yeah.
You responded to my request, en français.
The only thing you need to know about me is that I don't give up.
And I love my car.
So, uh Couple more hours, then we can release your friend.
Is there anyone you can call to wait with him? You could go home.
No one even supposed to know what we're doing, so if I leave then I'll never get in.
(SIGHING) Ethan.
I mean, is it is it really worth demeaning yourself just to be accepted by a collection of entitled assholes? I'm here on scholarship, and half the alumni get the kind of finance jobs I want after business school, so Yeah.
It is.
You'll really take any excuse, won't you? You're not happy to see me? You need to be able to trust your staff.
I do.
I only hire the best.
Then why are you back here instead of getting the rest you need? Sound of an empty house is too loud for you? (BISHOP SIGHING) It's my department, Claire.
I can come and go as I please.
But it's touching that you worry about me.
I'm too busy to worry about you.
Can't decide? My dad says it's all chemicals.
He may have a point about that.
He's not happy with me.
I know.
But you did the right thing by telling us about Tristan.
You know, he He talks about getting me through measles as if him and my mom were heroes.
You know? But it wasn't like that for me.
At all.
I never told them, but I I was so afraid that I was gonna die.
And, I don't know You know, after my mom it's just gotten even harder to talk to him, so (SOFT MUSIC) (COINS JANGLING) I won't tell if you won't.
Theo, I thought you were with your family.
Made it halfway home.
Atwater wants all her pediatric resources close by.
Well, I guess she just doesn't trust me.
You mind taking a listen to that? (HEAVY BREATHING, TUBES HISSING) Onset of stridor, right? It's faint but it's definitely there.
Open his mouth.
(MEDICAL MACHINES BEEPING) - Whoa, that's - a pseudo-membrane.
If it grows, it could obstruct his airway.
- I didn't think that existed here.
- It shouldn't.
There have been two or three cases in the past decade, but it's extremely rare.
- I've never seen it.
- I have.
And even people with immunity can be carriers We need to start treatment now.
There's an antitoxin.
Which we don't stock due to vaccines.
I'll get someone from Public Health on the phone but they'll have to mix a compound.
It's unlikely we'll get anything until tomorrow afternoon.
Do we have that long? If the membrane is already forming, his airway will be compromised.
We'll watch him closely and keep pushing antibiotics.
'Til then, we just need to keep him hydrated and on O2.
We need to inform the father.
He's put this whole ward at risk.
Alright, field trip's over.
If you vomit, come back.
If you're dizzy, come back.
No alcohol, mm? And no sports.
And you.
You think you can help him stick to that? Ethan? You with me buddy? Ethan? Ethan? (BRETT): Ethan! You okay? What did he take, Brett? I need help over here! He doesn't have a pulse.
We have to get him to trauma.
On three.
One, two, three.
- What did he take, Brett? - I don't know, I swear! We have a cardiac arrest! Claire! Claire, call Atwater.
Get everyone to trauma! We need Atwater, and we need Leblanc.
(SUSPENSEFUL MUSIC) We did a tox screen but only on the injured one.
Let's get a line going.
Push epi.
Let me know when you've got a read.
- (MACHINES BEEPING) - Come on Pulse check.
He's in V-Fib, we need to defibrillate! Defib, 200 Jules.
Brett, what did he take?! - (BRETT): Uh - Charging.
Pads on.
- Ready.
- Brett, what'd he take?! - It-It wasn't dangerous.
One amp epi.
Whatever it was, he did it to impress you, alright? So if you don't tell us now, Ethan is gonna die! Soy sauce.
He drank soy sauce.
We make all the new pledges do it.
If they don't, they get the lacrosse stick.
Most people just drink a few sips and take a whack, but Ethan drank the whole bottle.
- Hypernatremia? - Made worse by alcohol consumption.
The sodium is pulling water from his organs and his brain.
(BRETT): You can fix him, right? Start an infusion of D5W.
(BEEPS ECHOING) I'll take over compressions.
(CONSTANT BEEP) Rhythm? Asystole.
Does anyone have any other suggestions on how to save this patient? (CLAIRE): Time, Dr.
- Time of death, 4:17 AM.
- What? (EQUIPMENT CLATTERING LOUDLY) We can't save them if they don't tell us what's wrong.
(CONSTANT BEEP) (CARS PASSING, DOGS BARKING) (SPEAKING ARABIC) You had a busy night? We made dinners for the whole week.
Hey, can you use your key, I forgot mine.
(KEYS JANGLING, DOOR SQUEAKING) Are we going to have to leave? It says rent past due.
No, no, this is not a big deal, Amira.
What about Pavel's daughter Nadia? I could offer to babysit.
I've done it before.
If we need money, I can help! Your job is going to school and learning English.
Okay? I'll go talk to Pavel right now and sort it out.
Okay? It's not Here.
Take this.
You could have just talked to me directly, Pavel.
Amira saw the notice.
Landlord asks me, I ask you.
I just need a little more time.
Who was the stranger with your keys? Just a friend.
I'm allowed to have visitors.
Visitors come when you're at home.
Your lease is for two people.
Look Bashir, you know I like you.
Okay? I'm just trying to keep you out of trouble.
You'll have the rent tomorrow.
(SOFT PIANO MUSIC) (DOG BARKING IN THE DISTANCE) (AMIRA): My brother says it's okay, but if we have to leave, I would not see you anymore.
I would miss you.
Everything okay in here? We're fine.
You barely slept.
I know.
I have to go back to the hospital.
Are you ready to go? - Hi, Daneesha.
- Hi.
(DISTANT SIRENS) (SOFT PIANO MUSIC) (KNOCKING) (JUNE SNIFFLING) We did everything we could to save that boy.
I just had to tell that kid's parents their only son just died trying to get into a frat.
- Stupid, meaningless way to die.
- (LOCKER SLAM) It doesn't make it any easier when they die for a reason.
For those of you just coming on shift, let me reiterate.
We have an active case of diphtheria in an unvaccinated child.
If you work here, you're already inoculated.
If someone you know isn't, they should be.
We're running a vaccination clinic, Rhoda will have the details.
The child is being kept, under strict isolation so make sure you follow procedure.
If you have had direct contact, see Claire for cultures and prophylactic antibiotics.
Hunter is primary, and Dr.
Hamed, who has actually treated this disease, is a good resource.
Make sure that we use him.
- Yes? - Mm-hmm.
Legal in an hour, you ready? (INDISTINCT CHATTERING) Hmm.
What was that for? Nothing.
You sure? My place later? Um, if Tristan's awake, could you just tell him I'm right outside? I know it must be hard not being able to help him, but Your father and your brother need you healthy.
Is it true that he could die? I don't think my dad can handle losing somebody else.
We're doing everything we can to make sure that doesn't happen.
Mm? - The antitoxin's ready.
- What's next?! All you people have been doing is pumping him full of God knows what, and it isn't helping.
We've been keeping him on antibiotics, waiting for the right medication to arrive.
Now that it has, we're able to target his infection.
You're telling me this one will help? I'm asking you to trust us.
What are you doing here? You're not on tonight.
I know how to figure out who John Doe is.
I figured out the scar on his elbow was from a UCL replacement.
The surgeon probably used a tendon from a tissue bank.
Anyway, the point is, only a really skilled baseball player would ever get a surgery like that.
And, you know, like a pitcher with prospects.
And we know he speaks French, so according to the age of the scar he could've played AAA in some affiliated minor league Mags.
He's gone.
He's discharged.
He got his memory back? Yeah.
A few hours after you left this morning.
I guess that's good.
I just, uh was I right? Who is he? Uh, Brian something? He remembered his name, he called his wife, she came to get him.
That's all I know.
Well I can stick around, looks like you might need the help, so It's your day off.
Go do whatever it is you do when you're not here.
(HEAVY BREATHING, TUBES HISSING) Do we have to lower the dosage? We'll slow the infusion and desensitize him.
And if that's not enough? (MR.
ABBOTT): What's going on? What's happening to him? He's having an allergic reaction to the medication.
It's a side effect, but one we can manage.
You need to stop.
Don't give him any more.
This is exactly what I was worried about! Tristan is in very critical condition.
His throat is closing.
He can't fight this off on his own.
You said that you'd help him.
All you're doing is hurting him! You're the one who hurt him.
By leaving him vulnerable to this.
All I did was try to protect him! But you didn't! And if you stand in our way now, Tristan is going to die, and it will be your fault.
(SIGHING) This place is a madhouse.
I've been on the phone all day.
Want to switch jobs for an hour? I spoke with Tristan's home daycare, Public Health notified his community.
No one else the kid came into contact with seems to be symptomatic.
I heard you had a few choice words with the father.
I find that having an outlet helps keep the frustration from boiling over.
- What's yours? - Boxing.
Sometimes bourbon.
You good? If someone with very few resources needed a place to stay.
Would you have advice for him too? It's not for me.
Um Any other info to go on? The details aren't really mine to share.
Does this person have a history of violence? Substance abuse? Give it time.
Any place I find on short notice is sure to turn him on to both.
(PAGER BUZZING) I have to get going.
- I'll get back to you.
- Thank you.
- Hey.
- Labs are back on the Abbott kid.
- Which one? - The older brother.
They screened for diphtheria but you ordered a broader panel? (INDISTINCT CHATTERING) Max.
You have antibodies that your brother doesn't, but I think you already knew that.
It's a gown for the quarantine room.
If you want to be with Tristan you can be, but your father's gonna figure it out.
I know you think he's stupid and ignorant.
But he's not.
He's just stubborn, and he's lost without my mom.
Tristan needs me, so I'm gonna go in there and be with him.
What are you talking about? You are not going in there.
I got vaccinated, Dad.
Like, the day I turned 16.
You and Mom decided for me.
And I didn't agree with your choice so I made my own.
You hid this from me? I had to! You were wrong, Dad.
Hamed? We need you in there, now.
His airway's nearly blocked.
(MACHINES BEEPING) His neck's too swollen.
Bag him.
- He needs a cric.
- Now.
We can't wait for an OR.
Tristan needs an operation immediately that will allow him to breathe through a hole in his neck.
- Dad.
- Please, save him.
We'll come and get you as soon as we're done.
Go ahead.
We work as a team, here.
I can't feel any landmarks.
His neck is too swollen.
Make a large vertical incision and I'll talk you through the anatomy.
Palpate through the tissue 'til you feel the cric membrane.
Careful, it'll be small on a child his age.
- Make a horizontal stab incision.
- I'm in.
- Sats are 75% and falling.
Keep going, Dr.
Use your finger to confirm you're in the trachea, then thread.
- I'm feeling resistance.
- BP's crashing.
- He's going to arrest.
- (ATWATER): Stay focused.
It's likely in the subcutaneous tissues, don't force it.
Use your finger to confirm you're in the right place.
Tell me what you need.
- The bougie isn't threading.
There it goes.
Railroad the tube.
(PUMP HISSING, ALARM STOPS) Sats are climbing.
He's stabilizing.
- (BASHIR SIGHING IN RELIEF) - Well done, everyone.
I'll go tell his father.
(DISTANT SIREN, CARS HONKING) (SOFT PIANO MUSIC) (MAN): We understand that you completed medical school in 2011.
Then specialized as trauma surgeon and emergency medicine doctor practicing at various state and field hospitals in Syria, before moving onto a clinic in a refugee camp in Turkey.
(BISHOP): I thought I'd sit in.
Oh, we were just discussing Dr.
Hamed's work history.
He has more experience than a few of our attendings.
What happened after Turkey? - I came here.
- Without your original transcripts.
I have documents proving my identity.
But not your credentials.
Without those, the hospital assumes a serious risk.
One we can't afford.
How can we be sure you're truly qualified? (BASHIR SWALLOWS) I suppose you can't.
No actually you can.
Because I hired him.
I'm sitting here because of him.
With respect Dr.
Bishop, that's not enough.
I'm not diminishing anything he did for you but He just performed an emergency cricothyrotomy on a kid who has a disease that shouldn't even exist here.
Even still.
This is about us needing a paper trail that proves he is who he says he is.
They targeted doctors.
In Syria.
Especially ones who smuggled vaccines into the country to try to prevent typhoid, dysentery, diphtheria.
It's simple.
The state controls the universities.
And I am an enemy of the state.
There is no paper trail because of who I am.
Let's be clear.
What you're saying is that you can't get your transcripts because you're an enemy of the state in Syria.
You know this could expose us to all kinds of scrutiny that we No, no, hold on.
That's not what we're saying.
Hamed and I are going to pause and think this through.
(SUSPENSEFUL MUSIC) Ty, we'll circle back to you soon.
Yeah? You've opened up a real can of worms with that confession of you.
Well, it's the truth.
Some truths are better left unsaid.
Either way, both of us are out on a limb now.
Tristan's responding well to the cric.
- Great job.
- You too.
You're, uh, you're back tomorrow? Yeah, then I got two days off.
I'm not on tomorrow, so I'll take your shift.
Go get an extra day with your family.
- Really? - Mm-hmm.
Thanks, man.
(SIGHING) (SOFT MUSIC) (SIGHING) He's stable now.
We're going to continue a modified treatment regimen, but he's going to recover.
(CRYING) I almost lost him.
But you didn't.
Max is so mad at me.
There's still time to fix that.
And Max is a great kid.
So you are doing something right.
I never wanted to lie to you.
I'm sorry that I made you feel like you had to.
I love you, son.
(SOFT MUSIC CONTINUES) (CARS PASSING) Hi! - I thought it was your day off.
- Yeah! Mm-hmm, yeah, it is, it is.
It's just, um I just, I focus better in here, so This might be the strangest thing I've heard all day.
(CHUCKLING) Bye, Bash.
Is he going to tell anyone? You know, this isn't a safe place for you anyway.
I know.
(INDISTINCT BACKGROUND CHATTERING) It's a shelter you can go to.
That's all I can do right now.
Maybe we shouldn't talk for a while.
You're a good friend, Bashir.
(SPEAKING ARABIC) (DISHES CLINKING) You said you've babysat before.
I didn't ask you when.
After Mama and Papa had to send me to live with the cousins we went to the camp in Turkey.
There were many kids younger than me.
Warda and I used to take turns watching them all the time.
You and Warda were close.
You must miss her.
You weren't there, so you wouldn't have known about the babysitting.
Now I do.
Amira, we're okay.
You'd tell me if we weren't? I promise.
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