Transplant (2020) s01e11 Episode Script


1 If you leave against medical advice, I need you to sign something - that says you understand the risks.
- No problem.
If you want to apply, you'd have my recommendation.
Theo, you didn't say yes, did you? I treat a lot of patients who come from war zones.
- (GUNFIRE) - I hesitated.
I think we both know it was more than that.
MITCHELL): As physicians, we're trained never to show weakness.
This, despite the long hours patients' lives in our hands, their deaths on our minds.
We're taught to suck it up, and roll on to the next.
But that's unrealistic.
The weight of the job gets to us all.
Not just doctors who've come from war zones.
Have you been to counseling before? - No.
- Okay.
Then let's start with why you're here.
I was told I had to be here.
You don't think you should be? That's what we're here to figure out.
The day that building down the street exploded, I understand you were affected? Lost focus during a medical procedure? (SIRENS WAILING) It was an intense day.
I'm sure it was.
Was it the first time something like that has happened, or have you lost focus before? Maybe even lost time? It's been a few weeks since you were referred to see me.
I'm curious, why come now? (MEDICAL MACHINE BEEPING) (BASHIR): Patient's stab wound is causing intensive internal bleeding.
BP's crashing! Sats are 70% and falling.
She's gonna need blood.
Activate massive transfusion protocol.
On it.
Putting red cells through the rapid infuser.
With an aortic bleed this severe, we need to put in a REBOA? Let's X-ray first, rule out thoracic aortic injury.
Can I get a plate, please?! One, two, three! One, two, three! (MACHINES BEEPING RAPIDLY) Exposing.
I need a catheter, 14 gauge needle, introducer, REBOA kit, and 30 cc's of saline and contrast, stat.
X-ray's up.
- Status? - Zone one, no widened mediastinum.
Patient is 35 years old, penetrating wound to the abdomen, hypovolemic, and percutaneous cannulation is possible Good.
Curtis, take point.
Sir, I've done a REBOA before.
Then you're not missing out, are you? Dr.
Curtis? Uh Start an art line? - Art line's in.
- Alright.
Puncturing femoral artery.
Inserting guide wire.
(SUSPENSEFUL MUSIC) Inserting introducer sheath.
- Mm-hmm.
Then you inflate the balloon inside the artery, and it stops the bleeding.
Alright, I think I'm there.
Inflating now.
- I think we got it.
- (CLAIRE): Pressure's coming up BP's stabilizing, 90 over 60.
Alright good, let's get her to OR.
I'm gonna need that shiv for evidence.
They'll take it out it in the OR, sir.
You'll just have to wait.
I had a patient recently.
A prisoner.
She got me thinking.
Who wants pancakes? - Me! - Me! Me! Okay, Abby, go get the bowls.
Grace, you get the milk and the eggs.
Okay? Get going! And you, you get the day off.
Did you want to take Grace swimming? She's been asking for some one-on-one before you leave.
You know, actually I was kind of hoping for some one-on-one with you.
- Hmm.
- Uh You know, I feel like we haven't really had a chance to talk.
(PHONE RINGING) (THEO SIGHS) Hunter residence.
Hi, Caitlin.
Okay, how long has he had the fever? Alright, well I'll swing by and take a look.
Okay? Alright, bye.
I forgot I promised your dad I'd take his Saturday house calls.
Good for him to practice letting go, since you're taking over soon.
Uh, Mel Don't worry, we'll save you some pancakes! (UNCOMFORTABLE CHUCKLE) (CARS HONKING, TRAFFIC PASSING) (CLAIRE): Okay, this might sting a bit.
What do we have here? Uh, this is Chris and Camille, who were on a pretty ambitious bike ride and had a wee mishap.
My fault.
I got a cramp and swerved right into Cam.
- We rode all the way from Montreal.
- Mmm.
We're making a pilgrimage to Niagara Falls.
I've always wanted to see it.
On bikes? May I ask why? Ask Cam.
I wanted to drive.
I used to go as a kid, and Chris never did.
It's the cheesiest place on Earth, and I do love that kind of thing, so I told him the deal was we ride, and stop at every tourist attraction along the way.
We saw the giant apple on the 401, a steam engine museum in Kingston - Until today when he took us both down.
- (CHRIS CHUCKLES) Well, you're gonna need stitches Ah Your range of motion is okay.
Let's ice it, and see when the swelling goes down.
Cam fell harder than I did.
She cracked her helmet.
(CLAIRE): You didn't mention that.
I-I feel fine.
Well, you can't be too careful when it comes to a head injury.
Take a seat, please.
We'll do a CT just in case.
I'll call radiology and find them a room.
(WOMAN SPEAKING INDISTINCTLY OVER PA) Stomach cramps, broken toe, and some kind of rash.
Take your pick.
Leblanc, my overnight resident has to miss today and tomorrow.
Can you cover ten to six? Is there someone else that can do it? What? I'm taking less doubles, is that so hard to believe? - Yeah.
- You were my first ask.
But I'm sure I can cover.
But I will take all those patients.
Thank you very much.
Let me know if you can't fill it.
Is she back down here for good, now? I guess.
She was only up in Internal for, like, a week.
You didn't ask her? Why would I? It's personal.
- Hello again, Mister? - CO Roberts.
I'd like to update Ms.
- The nurses tell me she's awake.
- Yeah, come on.
Someone's popular.
Doctors don't count.
I'd like to do a quick physical exam, Ms.
I think he wants you to leave, Marty.
- Behave.
- Oh, come on, I'm reformed! (SCOFFS) He seems nice.
Mm How are you feeling? Like I lost the fight.
I'd have to see your opponent to know for sure.
I guess if I don't make it, we'll know she won.
Well, let's not call it just yet.
Deep breath.
(SLOW INHALE) (PAINED EXHALE) The wound to your abdomen sliced an artery which we sealed in the trauma bay and repaired in OR.
You lost a significant amount of blood, but you're stable now.
Feels like I was hit by a truck.
Pain at this point is normal.
My vision's blurry and there's, like, pins and needles in my arms.
Is that normal too? Give me your hands.
Just this one.
Okay, good.
Those symptoms are common lingering effects of anesthesia.
We'll keep an eye on it to make sure nothing's wrong, and hopefully you'll be in good shape before you go home.
Go back.
I've been in lock-up my entire adult life.
It is home.
A nurse will be here to give you something for the pain.
In the meantime, if there's anything you need, you let us know.
Hey, um, actually yeah.
Do Do you think maybe someone could um, get in touch with my mother? We're not exactly on the best of terms, but maybe if you tell her I was on death's door and all that - Are you allowed visitors? - If she's willing to come.
I think Marty will let her in.
Curtis, can I borrow you for something? - You need a surgical consult? - Regular exam.
It's pediatrics.
The on-call pediatrician is swamped today.
Good news is the boy's vomiting seems to have stopped.
Hi, Glenn, I am Dr.
I hear you've been throwing up at the Royal Ontario Museum this morning? How long have you been feeling sick buddy? Okay, uh It says here you refused to call your parents? Is there a reason for that? My mom's in New York for meetings.
She's gone a lot.
Got it.
What about Dad? 'Kay.
Uh, why don't you lie down for me? Does that hurt? Did you eat anything at the museum? No? So you were just hanging out by the bat cave and started vomiting? The fossils.
- What? - I like the fossils, not the bats.
Do you remember about what time you started feeling sick? Listen, you gotta give me something, alright? Oh! Nurse! (WOMAN SPEAKING INDISTINCTLY OVER PA SYSTEM) (WOMAN COUGHING) (COUGHING) Hi.
Jessica Brown.
Oh yeah, we've met before.
Your O2 sats were 88%, your lung capacity was low, but you didn't want to stay for more pulmonary tests.
Good memory.
(COUGHING) You're not coming from a fire.
Captain said if I'm out of breath on the treadmill, I'm not cleared for active duty.
It's been getting worse for days, and he made me come and get checked.
Breathe in.
- (JESSICA BREATHES DEEPLY) - Cough for me, please.
(COUGHING) (SOFT MUSIC) Any other symptoms? A fever on and off.
And I've been pretty tired lately.
Okay well, I'd like to run full labs and get you a new chest X-ray, and consult with a respirologist this time if you're open to it.
Guess I knew that was coming.
(INHALES) Yeah, okay.
- I'll be right back.
- (JESSICA COUGHING) Do you know what kind of crime she committed? Murder, I think.
At least that's what the paramedic heard from the prison transport crew.
Guess it's gotta be pretty brutal to land you in max security.
Apparently she was only 18 years old.
- Eighteen? - Hey.
We should respect her privacy.
Hmm? (BEEPING) She can't feel her arms or legs.
Can you wiggle your fingers for me? I can't.
Is it still the anesthetic? That's unlikely.
Are you on any other medication? No, nothing.
Narcotics? Would I find anything in your system? - Jesus, you didn't.
- No, I didn't.
But I did get in a fight with Gina.
More fights? When was this? Yesterday.
Gina stabbed me with a needle.
(ROBERTS SIGHS) - Where? If someone has it out for you, you need to come to me! I started it, okay? - Nicole, where were you stabbed? - In my left thigh.
(ROBERTS): What are you doing, Nic? This is infected.
Any idea what was in that needle? Heroin at some point, probably.
This is from an infection? Possibly.
We'll aspirate and run a tox screen to confirm.
- Can you stop it? - Depends on what we're dealing with.
(SIGHS) You're almost getting out.
What are you thinking? I get it.
You're pissed.
You made your point, okay? Are you trying to blow your release? Because that's what you're doing here, Nic.
I'll be right back.
(SUSPENSEFUL MUSIC) So I figured, you know, maybe this is a flu or, like, food poisoning, but Glenn's anemic and his BP is high.
Maybe it's a dietary issue or nutritional deficiency.
I don't know.
Viv's trying to track down his mom.
Has he told you anything helpful? He's not exactly a big talker.
Then get him to open up.
Of course, get him to open up Okay, Glenn, I'm gonna need some answers, buddy.
Glenn? Glenn.
Look, the blood tests are telling me that you aren't getting enough iron.
Okay? - Does your mom cook vegetarian? - No.
Are you eating enough red meat at home? - Yes.
- Does your head hurt? Is anything else that is off, or weird? I am weird, okay?! (SCOFFS) I don't think you're weird.
Do you sometimes have a hard time hearing? How's your concentration? (MUMBLING): I don't know.
You're gonna have to show me your teeth.
Come on.
Like this.
There we go.
This is really important.
Alright? Do you live in an old house? The paint on the walls, is it peeling or anything like that? (TENSE MUSIC) It's getting worse.
I I can't feel my arms, and it's harder to breathe.
The tox screen confirmed you have what's called wound botulism, from whatever bacteria was in that needle.
- Botulism? - That's why she can't move? Botulism can cause double-vision and paralysis of voluntary muscles You can give her antibiotics With an infection this serious, we use a targeted antitoxin.
It's being prepared right now.
- What? - (ROBERTS): What? The medication is time-sensitive.
Without knowing how far the infection has progressed, we can't be sure it will work before paralysis takes a hold of your major body functions, like your heart and lungs.
Which means she stops breathing? She dies? Guess I might lose that fight after all.
We're going to do everything we can to make sure that doesn't happen.
You are not losing this fight.
You got that, Nic? (TENSE MUSIC) Dr.
Hamed! - Yes, sir? - Hey.
When are we gonna know if this drug you're giving her is gonna work? Once we start the infusion, we keep an eye out for negative reactions.
After that, it's wait and see.
And there's nothing else we can do in the meantime? No, sorry.
Nicole asked me to contact her mother.
Our social worker is trying to reach her.
Thirteen years she's been in max.
Mother never showed, not once.
You said earlier that she was getting out.
Her release is soon? Statutory after two thirds of her haul.
Never slipped once, until now.
Nic was a kid when she came in.
My own daughter was just born at the time.
Anyway, she worked hard to change.
But bringing this trouble on herself? You see that when they don't wanna go.
When they're scared to.
(SOFT MUSIC) Alright, thanks.
You're tired because your body's not getting enough oxygen.
Unfortunately, this tissue here in your right lung, is dead.
And the dead tissue caused an infection that's led to sepsis.
Can I fight that off? The infection, yes.
But the underlying cause I'm sorry, Jessica.
There were indicators before, but now it's confirmed.
You have COPD.
Chronic Obstructive Pulmonary Disease.
It's a progressive disease, and we are seeing signs of emphysema.
(JESSICA SIGHS) Go on, say it.
If I'd seen a specialist before No.
There's no guarantees it would have changed anything.
But it is stage three, which means you have to take it seriously.
I'm only 32.
I have my whole career ahead of me.
I'll start you on IV antibiotics right now, to deal with the infection, and I'm gonna set you up a surgical consult to see what the options are beyond that.
What do you have? Thirteen-year-old boy with severe lead toxicity.
You ever treated that? No, but normally it's chelation therapy to flush it out.
You'll need to source out the cause of the exposure to make sure it's not ongoing, though.
- Do you have time for a consult? - What do you have? COPD with progressive emphysema.
She's a candidate for bullectomy, which could improve her breathing significantly.
So if you already know that, what do you need me for? I just thought that if you do the consult, aren't you more likely to assist with the procedure? I can ask someone else if you're busy.
No, I'm good.
(CHUCKLES) Thank you.
(NICOLE WHEEZING SLOWLY) It's not working.
You're not responding to treatment as well as we'd hoped.
Did you get in touch with my mother? Uh Our social worker spoke with her, but She's not coming.
(WHEEZING) I'm sorry, Nicole.
MITCHELL): That's heartbreaking.
She shut down.
She wouldn't discuss any other treatment options with me after that.
Why do you think that was? With her prison term coming to an end I think that she thought if her mother would forgive her, that she would deserve to get out.
Same reason she was starting fights.
Because your patient didn't think she deserved her release.
And knowing that her mother wouldn't come, even when she was so sick, made her give up on life.
Alright, so we finally got ahold of your mother.
She's gonna take an early flight back.
Says she has no idea what could be causing this.
But if you do, you should tell me.
You won't get in trouble.
Okay, what if I tell you there's a twenty in it for you? (THEO): Wait.
You, you bribed him? (JUNE): I tried, it didn't work.
(SCOFFS) So you're saying he was thirteen? Chelation therapy's not gonna be easy for a kid his age, but given how extensive his lead poisoning is, he may need it.
Okay, so then why are you calling me? Because he won't talk to me.
You you called me to ask how to talk to your patient? Well, I mean, normally I deal with adults, okay? I really need help.
- Well, look - (GIRL): Dad! You have to find a way to make it seem like you're not trying.
You know? They usually wanna talk.
They just need to do it on their own terms.
But look, I gotta go, June.
So good luck, okay? Bye.
Hey! Camille Beaudry's CT is clear.
So they will be able to carry on their cycling trip.
Oh, God.
There's not enough money in the world to make me wanna ride a bike down a highway days on end.
Oh, come on, it's romantic.
Spandex and semi-trucks? No.
Not my idea of romance.
So you'd prefer Sonoma Valley? Mm-mm.
Burning Man.
No phones.
No rules No showers.
(CLAIRE CHUCKLES) You'd really want to be stuck in the desert for three days? And you'd rather be touring some stuffy medical museum in Paris? (BISHOP SIGHS) Latvia.
Nights on the Baltic.
Why didn't you ever do that with Katherine? Same reason you didn't do Burning Man.
Lives burdened by glorious purpose.
(BAGS JOSTLING) Mel, I've been trying to find the right time to tell you something.
I just, I need you to keep an open mind.
That permanent position I told you about I applied, and Bishop offered it to me.
Why didn't you tell me? I tried, Mel.
You just, you got upset.
And you walked it back and you never even brought it up again.
When do you have to give him an answer? You already said yes.
Okay, and I-I I know that was stupid.
Alright, but babe I haven't been this excited about something in a long time.
I thought you were excited to come home Of course I am.
I-I just I can see a future there too, Mel.
For all of us.
It's not just the job.
It's the people the kids would meet.
The opportunities.
My job is here, my parents, our whole lives are here! You would You'd get a job in a second.
(SOFT MUSIC) Hey look, I know.
I know that if you just gave it a chance, you'd love it.
(SCOFFS) Mel Say something.
What am I supposed to say? You wait until five minutes before you leave to drop this on me, and I'm supposed to what, get on board? - Mel - No! Just You better leave.
You'll miss your flight.
(SOFT PIANO MUSIC) I reviewed your imaging with the surgical team.
We can perform a procedure called a bullectomy.
Essentially, we're gonna remove the diseased air sacs from your lung.
Take out part of my lung? It'll help the surrounding healthy tissue grow, and it would make a big difference on your breathing.
You're young enough, Jessica, we really feel this will have a positive effect on your disease, it can help slow progression, and - (WHEEZING) - Jessica? - (JESSICA): What's happening - (WHEEZING) Her heart rate's 200.
I need a crash cart here! Jessica, I need you to stay with me, alright? Everything's gonna be okay, just stay with me.
Jessica, COPD can trigger heart problems, and right now, your heart's not in a normal rhythm, and we're gonna need to address that.
- Okay? - What do we have? Jessica Brown, newly diagnosed COPD, and now regular narrow complex tachycardia, looks like SVT.
A re-entrant tachycardia.
Recourse? Block antegrade conduction and try to break it.
Okay, good.
Prep 6 milligrams adenosine IV push with 20 cc saline flush.
(MACHINES BEEPING RAPIDLY) Okay, Jessica, I'm gonna give you some medication that's gonna pause your heart, but don't worry, it's gonna start back all by itself.
(WHEEZING) Pause my heart? But won't that kill me? No.
It's a very quick procedure.
But your heart will stop beating for a few seconds.
It's like hitting the reset button What if it (COUGHING) What if it doesn't restart? It will.
We have the defib here just in case, but it will.
Heart rate's still 200.
You run into fires every day.
This is nothing compared to that.
Trust me.
Let's do it.
You're gonna feel a discomfort in your chest, and a warming sensation.
Come on, come on, come on.
- (MACHINE BEEPS) - Regular sinus rhythm.
Welcome back.
Good work, everyone.
You okay? (BREATHING HEAVILY) (INDISTINCT CHATTERING) Sir? My botulism patient isn't responding to the antitoxin.
- Options? - I want to try a newer drug.
A higher potency synthetic compound.
Which is still relatively untested, and therefore comes with a higher risk.
- It's shown results.
- What does your patient say? Not much.
She's afraid, - disengaged from her treatment.
- Mm.
People don't always want the things they need.
Huh? Talk to her.
Get her consent.
How's it going? So, uh speaking of weird The kids thought I was weird too.
I know, right? I was like a foot taller than everyone else, which I hated.
And I didn't like talking to people.
Things at home weren't great.
I felt pretty alone.
You know? You sure talk a lot now.
So look, as you get older, the thing you realize is that, you know, the weird kids grow up to be the cool kids.
(SNORTING) You wanna see something awesome? (SOFT MUSIC) Ready? You said you liked fossils, right? Eh? Cool, right? I mean, he's not real, but he's to scale.
We use him for teaching.
The residents call him Maurice.
Say hi.
Shake his hand.
Have you been eating these? I like the way they taste.
- What are they? - Fishing weights.
How long have you been doing this? About a month.
I got them from my grandfather's tackle box.
He used to take me fishing.
Before he died.
We used to talk about stuff.
I bet you miss him, huh? I feel alone too.
No, you're not alone.
But Glenn, how many of these have you eaten? A lot.
I tried to stop, but I can't.
I didn't know they were made of lead.
It's okay.
It's cool.
I can help you with this.
Can I stay here a bit longer? Definitely.
You should chill with Maurice.
Hairline fracture of the patella.
- It'll take 4 to 6 weeks to heal.
- Ugh Can't you give me a steroid shot? You can walk on it, but a long ride is definitely out of the question.
I'm sorry, Cam.
- What? - I booked a tour company to the falls on the New York side, and they have something I've never seen.
A chicken who does math.
(CAM LAUGHING) I'm serious.
She counts out little kernels of corn with her little, little beak! Well, only a madman could turn down that offer.
Then I guess I'm not.
Listen to the doctor.
All he wants is your consent.
What's the point? Isn't it shift change? Don't you gotta punch out? The infection isn't stopping.
It's going to reach your respiratory system.
What happens if she doesn't take the new medication? If things continue as they are, she's going to stop breathing - within the next 24 hours.
- You hear that? - He says you'll die.
- I don't care.
Don't say that.
Don't do this.
- Doc, please, you gotta talk to her.
- He's right, Nicole.
You don't have to give up.
You don't deserve to die from this.
(STRUGGLING TO BREATHE) You don't know me.
You don't know what I deserve.
(ROBERTS): But I do.
I killed someone, Marty.
I took an innocent man away from his family, his two kids, just for the cash in his till.
It was a different person who did that! (NICOLE WHEEZING) The law says you paid your debt.
Well, I don't! He's dead.
Why do I get to live? Just just go, home.
Just leave.
(NICOLE CRYING) (DOOR OPENING) - Hey, I'm home! - Hey.
- What are you doing? - Homework.
We had an algebra test, and I didn't finish.
Now my teacher says I have to do these extra problems for Monday.
Algebra still gives me nightmares.
I bet you finished your tests on time.
Not always.
And I went to school in my first language.
Amira, you're doing great.
And whenever you feel like you're not You come find me.
Homework on a Saturday? - How was work? - Long.
How'd it go? Mel wasn't thrilled about the idea of us moving here.
Give her time.
She'll change her mind.
What will you do if she doesn't? - Amira.
- (THEO): No, it's okay.
I don't know.
Sounds like we could use a pizza.
- Oh, yeah.
I'm in.
- Me too.
(SIRENS WAILING, TRAFFIC PASSING) (SOFT MUSIC) Uh, Nicole Spencer? Where is she? They moved her to ICU overnight.
She lost consciousness.
(TENSE MUSIC) Blood pressure's low.
O2 sats are still falling.
They upped the infusion of antitoxin, but She's not responding.
She's going into respiratory failure.
Do you want to intubate? Dr.
Hamed? We're going to try a synthetic adenovirus.
(TENSE MUSIC) Glenn's mother agreed to the chelation therapy.
That should flush out the rest of the lead toxicity.
He'll just be here a few days.
Okay, well the X-ray confirmed all the lead weights have passed from his system.
The way he described it, it sounded like a compulsive habit.
That could be Pica.
It's an eating disorder brought on by anxiety and major stress events Glenn's grandfather just passed away.
They were close, and now it's just him and his mom, so Yeah, it's never easy.
Well, she's committed to helping.
So I'll refer them to a psychologist who's worked with teens before.
More talking? The kid's gonna love that.
(CHUCKLES) Well, looks like you made a new friend.
You really like doing this stuff every day? Yeah.
I really do.
You put her on the adenovirus.
She was unconscious when I started the infusion.
I had no choice but to make an informed decision.
- Meaning? - Meaning, I'm trying to help her.
You said yourself that people don't always want the things they need.
Wouldn't you have done the same? Wasn't it three weeks ago I asked you to go see Dr.
Mitchell? Have you gone? I'm trying to help you, too.
(TENSE MUSIC) As soon as my infection gets better they said they'll get me up for surgery.
You'll be up and around in no time.
No more fires, though.
Not if you want to slow the progression of your disease, no.
(SOFT PIANO MUSIC) Fighting fires was was the thing I picked.
Not marriage, not kids.
You're still young, Jessica.
You've got your whole life ahead of you.
But I cut everything else out.
Without my job I'm not sure I know who I am.
Leblanc, I'm still looking for someone to cover tonight 10 to 6.
You said to tell you if I hadn't covered it? Yeah, um I'm sorry, Dr.
I can't.
Hi, Dr.
- What? - Nothing, you have other plans? - No, why? - Well, good.
Just, you know, don't make any.
- Hey.
- Mr.
(SIGHS) Nic's on the new meds? And her deterioration is holding.
She's still critical, but we're hopeful.
She did shoot that man, but what she didn't mention was the abusive boyfriend who dragged her into it.
He's doing life for that, and another crime that she had nothing to do with.
Nic never had anyone to look out for her.
Her first year inside, she was too scared to sleep.
So we sat up nights playing Scrabble until she could.
(LIGHT PIANO MUSIC) Give that to her when she wakes up? I guess she did have someone looking out for her.
- Theo! - Hey, Joanie.
I heard from my shift supervisor you put in for a ride along? I'm starting here full-time.
And you need your EMS field experience.
Yeah, all permanent staff need to log 20 hours.
Okay, well, if you can do next Thursday, we'll take you with us.
That's perfect.
Great! Thank you.
- Hi.
New nurses schedule.
I've added a second overnight to Saturday.
- Wanna take a look? - Claire, uh If I If I were to ask you to come to the Baltics with me, would you? I thought you were too caught up here, burdened with "glorious purpose"? Well, it wouldn't kill me to take a vacation.
Burning Man? Well (CHUCKLING) Possibly.
I know I know you wanted some time on your own to figure things out, Claire.
I just wanted to let you know I'd follow you anywhere.
Even the middle of the desert with the great unwashed.
(SOFT MUSIC) (GIGGLING) Well, why don't we start small? Take the same day off? Go from there? (DISTANT SIRENS WAILING) So, Singh's going to let me scrub in on the bullectomy.
Wait, is that is that why we're here? - No.
- Is that why we're hanging out? Listen.
Don't don't make a big deal out of this.
Well, last time I had a beer and pretzels, I was with my sister.
(CHEWING) She was getting married the next day, and panicking about it.
Oh, okay, so Overthinking runs really strong in your family? - (LAUGHING) - Yeah.
- You have a brother, right? - Yeah, uh, Charlie.
We have a strong text-based relationship.
My sister and I, we used to we used to talk every day.
- Every day? - Mm-hmm.
Well, since my residency started, it's been more like every, uh every few weeks, I'd say.
She used to let me pretend to defibrillate her.
(LAUGHING) What?! - I know.
- Are you serious? Poor kid.
So, I guess you were one of the weird kids too, then, huh? Mm-hmm.
Hmm, nice.
Well, cheers to the weirdos.
- Cheers.
- (GLASSES CLINKING) (SOFT MUSIC) What happened? You survived.
(SIGHS) I survived, or You saved me? I made a judgment call when your life was in danger.
Yours was a fight I refused to lose.
Marty bring these? - You ever play? - With my little sister, when she was learning English, it helped with her spelling.
Good to see you up.
Good to be up.
You got time for a quick game, or what? Yeah, I could carve out a few minutes.
Okay, I'm gonna beat you, though.
Yeah, well, there's a first for everything.
Good? Why don't I let you pick first.
Your patient struggle to forgive herself.
It affected you.
It made you finally come see me.
Many of my patients who come from war zones live with survivor's guilt.
(SLOW EXHALE) You asked me what I saw that day that building across the street exploded, and I lost focus during a medical procedure.
I saw my mother.
There was a bombing in the clinic that my parents built.
The clinic they ran since I was a child, and I was too late to save her.
And you can't forgive yourself for that.
Every time I see my little sister, I'm reminded of what we lost.
Reminded that the one thing she needs is the one thing I can never give her back.
Our parents.
(SOFT MUSIC) What happened with Amira? Was everything okay? There was an incident with another student.
I tried talking to her but I guess I'm saying all the wrong things.
A BREAKDOWN AT HOME - I hate it here! - You hate it here? You're the only reason were here.
It gets harder.
- Sir? - Dr.
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