Transplant (2020) s02e05 Episode Script


- You should be at the hospital.
- I can't be there.
You don't have papers.
After everything over these years, I'm not worried about leaving her home alone.
- Stop.
- Come on! How's she doing? Somewhere between didn't happen and can't stop thinking about it.
I get to her office with a bouquet of flowers.
Hoping she'll say yes to coffee.
But she thinks I'm the delivery guy.
She didn't remember you? So I pretended to be the delivery guy and I got out of there.
She gave me a good tip though.
How is Rania settling in? She's great, although she'd rather be teaching than serving coffee.
Amira loves that she's here.
I guess I'm a better father than I am a mother.
Who said you were any good at either? Tell me again Khaled.
You tried for asylum two years ago.
Why does your new lawyer think it will be any different today? He does this for people whose first claim was denied.
He says even though I've been living here without papers, he can make the case it's not safe for me in Libya.
There's too much fighting and violence.
And he knows this official in the office in Ottawa? He's confident? That's why my interview is there.
What about you, Bashir? Do you love having Rania here too? I do.
Of course I do.
They don't tell you on the spot if your appeal is successful? No, but Mr.
Kline says I can work legally while it's being processed.
And if it isn't successful? Thank you, brother.
For the money, and for getting me here.
Gupta? I'm Dr.
Like loop.
Gupta, I hear you have a puncture wound.
You make it sound like I was stabbed.
Not so exciting as that Dr.
I turned into an exposed nail.
How long ago did that happen? I only ask because it looks infected.
Three days ago.
I dressed it myself, but I guess not very well.
When you last get a tetanus shot? When I came from India, four years ago.
Where are you from, Dr.
Hamed? Syria.
Two and a half years ago.
And you are already a doctor? Good for you.
Well, back home, I was already a doctor.
Here, I'm still a resident.
Still, so fast.
Right place at the right time, I suppose.
I'm fortunate someone gave me an opportunity.
What do you do for work, sir? I am trained as an electrical engineer.
Will you need to stitch? Because of the infection, I think we should leave it open.
We should order some blood work just in case, and get you started on antibiotics.
My company needs a form saying I'm fine to go back to work.
You'll sign it? Let's wait and see what your labs say.
You break that, you buy it.
Jake Cooper? I'm Dr.
Wow, you're young! I mean, this is my first hospital rotation and I wasn't planning on making a terrible first impression? Don't sweat it.
How's third-year med school treating you? Good.
I'm glad to be getting a break from exams though.
So why pediatrics? It wasn't my first choice.
My first choice was full, but I figured I should probably just keep my options open.
Then I'll save you the sales pitch.
Except to say that like any calling, it chooses you.
- No missed appointments? - No.
No fluctuations in your rhythm.
If this holds, we can push your pacemaker another year, - maybe two.
- That's great.
One more thing.
Any interest in a part-time resident practice? - Really? - Emerg would come first.
I could use a resident with your experience in cardiology.
I know your own cardiac history isn't something you spend a lot of time dwelling on, but these experiences are formative.
And who better than someone who knows what it's like to be a cardiac I don't think so.
I mean, thank you.
That's a great offer, I just, um I don't think it's the right time to take on more.
You're busy.
I figured.
No problem.
You've been my mechanic for 20 years, Frank.
First time you've come to me for medical help.
- More pain, yeah? - Yeah, yeah, yeah.
- Yeah.
- I'm a fix-it-myself type of guy, Jed.
Is whatever this is gonna mean more problems for me? You mean like coming in with an oil leak and needing an engine rebuilt? No, it's just a dislocated shoulder.
You're pawning me off.
Eh, an apprentice, same as you.
Claire starts a new role soon and needs a Guinea pig? Trust me and just lie back already.
I got it.
So it's like a handshake, you know, and you'll slowly work it up to 90 degrees.
- There's resistance.
- Well, there should be.
Frank, are you with us? - Um - Frank.
- Huh.
- His pulse is strong.
Yeah, you just got to, um just gotta hyper-extend it.
There we go.
It's alright, Frank, just breathe.
Okay, well, I'm getting an irregular heartbeat, and so, for a man your age, we're gonna want to rule out anything like cardiac arrhythmias, hypoglycemia or blood pressure issues.
You said it was just a shoulder, Jed.
The loss of consciousness changes that.
We'll keep you a little longer, run some tests.
Was it necessary to steamroll Claire like that? I just I wasn't sure if she needed help and I thought - I wasn't sure if you - Let me set the record straight.
I'm not hands on, but if I need anyone stepping in on a patient I'm overseeing, I will ask.
Any questions? Which one of you is Dr.
Hunter? - That's me.
- You've been served.
Guess that's one way to announce I'm getting a divorce.
I'm so sorry.
In other news, has everyone met Jake Cooper? Hey, Theo.
I knew it was coming.
Didn't think it would be in front of all my colleagues but, uh I still get to see plenty of the girls.
Even got myself an apartment.
A divorced dad's apartment in Sudbury.
If you have to take that.
Yeah, sorry, just one second.
Hello? I've got an urgent walk-in in here! What happened? These two got out the back of a car and they just My neighbour fell through the glass doors of our building.
We couldn't tell how bad it was until we got him in the car.
I'm scared if I move my hands they'll pop out again.
His insides.
Let's go.
I need help in here! Okay Alison, we've got you.
Claire will take over - after I count to three.
- Standing by.
Let's give our good samaritan a break, Dr.
On it.
One, two, three.
Airway is patent! Pulse is weak and rapid! Prepare for MTP! - Will he be okay? - He has a chance, now, thanks to you.
We'll update you as soon as we can.
Heart rate is 140, BP is 90 over 50.
Scratch that, 80 over 60 - Tell me what you're seeing! - Penetrating hepatic trauma.
Patient rolled through a glass door.
Narrow pulse pressure, hypotensive, tachycardic, and hemodynamically unstable.
- That is one exposed liver.
- Possible laceration? Gonna have to retract, to be sure.
- I've only done that once.
- That never stopped you before.
Janie, the retractors for Dr.
You'll need to find the bleed.
You're going to gently suspend the organ to look underneath.
- Arnold, one gram TXA.
- Yeah.
And putting packed cells through the level one now! Talk to me, Mags.
Blood's pooling underneath the liver.
Are you asking me or telling me? I'm telling.
I can't see where the blood is coming from! Arnold, see if you can get more light.
Claire, give her a hand to get a better look.
- Right in there.
- The hepatic artery is inferior, anterior, and to the right.
- Mags? - I've got the hepatoduodenal ligament.
- Pressure's dropping, guys! - Possible tear in the artery.
I'm gonna perform the Pringle maneuver.
- Yup.
- We need to clamp the porta hepatis.
Satinsky clamp! - Oh, I got it.
- Good, good.
Cover the wound with soaked dressings, get him up to OR now.
I couldn't see where the bleed was coming from.
I understand the way your confidence is rattled.
I know you took a couple of days off, but if you need more time.
No, I'm fine, sir.
I just want things to go back to normal.
Our new family doctor thinks it's an allergy.
Put us on a food challenge, but every time we I mean, we rule something out the vomiting comes back, and he threw up bile this morning.
That does not sound fun, but why don't you open up and let me take a look, okay.
No offense to the hard-working doctors in the room, but our GP isn't doing enough.
You know? We need real results from real tests, as soon as you can get us in.
A scope, MRI, blood work, someone to take this seriously.
Well, any recurring fever or headaches? No.
Why don't you lay back for me? How about stress? 'Cause that can really do a number on your stomach.
We just moved from Winnipeg.
First year of high school in a new city.
But Dima here, he's kicking ass and taking names.
Gets straight A's, he always has.
He's been a real trooper about all of this.
We're gonna get through this, pal.
- Chronic gastritis? - That's rare in teenagers.
Appendicitis? There's no localized abdominal pain.
What'd you think about the dad? I mean.
Nice guy.
He didn't exactly let his son get a word in? And exhaustion and gastrointestinal symptoms can all stem from anxiety.
Well, if it's psychological, would Dimitri know that? I may not be ready to say.
Even well-meaning parents can have blind spots.
Especially when their life's in transition.
- These things can be delicate.
- I guess you'd know.
As a doctor, not as a parent.
I'd I don't even know if you have kids.
We'll check for an ulcer, with a barium swallow, but that'll have to wait until tomorrow.
Hopefully, Dimitri will be ready to open up by then.
In the meantime, you get to learn how to order GI tests.
The glass sliced an artery under his liver, but we got to it in time because you kept him alive.
I've lived down the hall from him for years, but I don't even know Warren.
Well, thank you so much for everything.
Are you saying I should leave? I mean, it's just, there's not much else you can do for him.
I have his phone, I could let his family know what happened.
Our social worker can do that.
Unless you know them, maybe? It's just I'm always at work, first thing.
Only today, I was late.
Trust me, I'm an accountant, I'm the last one to go down this road, but it's like the universe put me there at that exact moment.
And now, I've held his liver in my hands.
I need to see this through.
I heard you had a major liver laceration in trauma? Apparently, the universe put me there just to fix it.
You don't believe in fate? I mean, no, but the universe doesn't reward or punish us for who we are.
Right, that was Dr.
Novak's job and thankfully he's gone now? No, it's now what I I don't know.
Hello again, Mr.
So your wound seems under control.
We saw an elevated white blood cell count in your labs.
So I'll be giving you a prescription for antibiotics, as well as instructions for regular cleaning and redressing.
- Then I can leave? - You can And the form? My employer needs it for insurance purposes.
You said you were an electrical engineer, but on the form it says that you work on a construction site? I said I was trained as one.
Right now I work as an electrician's apprentice.
Is this work physical in nature? I pull cables, lay wire.
If you're bending, lifting, doing strenuous activity, it could aggravate your wound So you won't sign it? I will, if you agree to rest for 72.
They'll replace me if I take that long.
You can help me, but you won't? Sir, I'm trying to help you by doing what I can to keep you from risking further injury.
Someone's forgotten what it's like when he's not at the right place at the right time.
What about you, Bashir? Do you love having Rania here too? I do.
Of course, I do.
I wish we got to stay where we were.
Live our lives from then.
If I'm more than five hours, just go.
Go back to Toronto? Without you? I missed hearings after my first asylum claim was denied.
There's a detention order against me.
They may hold me.
What? For how long? Mr.
Kline doesn't think it will happen and I said I would risk it.
I gave him your number just in case.
Khaled, you're telling me this now? I didn't want you to try to talk me out of doing it.
Bashir, I don't work, unless it's under the table.
I am tired of living like a fugitive.
Always looking over my shoulder like my life is on hold.
I am not a real person! Thank you.
You've reached the voicemail of Jack Kline BP is 130 over 100, temp is 38.
3, O2 sats 98! Mr.
Gupta, tell me what happened.
- You know this man? - Yeah, I saw him yesterday for an infected puncture wound on his right thigh.
No pulse, leg's ischemic.
- Was it cold and pale yesterday? - No, but his wound has been slow to heal.
Gupta, did something re-aggravate your wound? Sameer, I need to know what happened.
They didn't even want the note.
When I climbed the ladder, it started.
Five milligrams morphine! There's no flow in the dorsalis pedis artery, - Dr.
Thrombosis? - Arterial dissection? Pseudoaneurysm can develop at the femoral artery after trauma.
We need more imaging to confirm.
What is happening to me? There's a blockage in an artery in your leg, and the blood supply is being cut off.
You need a procedure to resolve it, Sameer, or you're going to lose this limb.
Okay, put in an IV, I need two grams ancef, one liter of NS.
And let's him to CT angio to check out the blood vessel.
Is there someone you'd like us to call for you, Mr.
Gupta? Dr.
Leblanc! An ER nurse said you'd be in today.
Have you been here all night? His son is flying in, but he doesn't land for a while.
Warren's opened his eyes a couple times, but he just drifts off right again.
Totally normal after the trauma and surgery he went through.
Isn't there some place else you need to be? I don't want him to be alone when he does wake up.
I feel like even the half-stranger from down the hall is better than no one.
That's admirable, but Also, I heard a nurse say that his blood pressure is low, but I know he takes meds for high blood pressure.
How do you know that? I found some pills in his pants.
I left them for Dr.
Weir, but he just had a nurse tell me that they have everything in hand.
No one tells me anything because I'm not family, and you were so great yesterday.
So I thought maybe if I told you about his blood pressure Alison, um you need to trust his team to handle it.
You should go home.
Get some rest.
Morning, Mr.
So, yesterday, they tell me my shoulder needs an operation, but they need to run a bunch of tests first, and now the nurses are saying it might not even happen today? Right.
Well, that's what I wanted to discuss.
Blood work is showing that your kidney function is impaired.
Okay, that's my own damn fault.
I eat like crap.
Drink too much, I know.
Actually, I was concerned about a condition called aplastic anemia.
What does that have to do with my shoulder? Nothing.
It's a potentially serious condition that prevents your body from producing new blood cells.
How concerned are we talking here? Enough to want to rule it out with a bone marrow biopsy.
So a hematologist will be by soon and we Hold on.
Hold on.
Hold on.
You want to stick a needle into my bone because you have a hunch? It's not a hunch.
You're a mechanic.
Benzene in gasoline is one of the known causes.
This is why I don't go to the doctor! You come in with one little thing and leave with a whole other set of problems! This is a potentially life-threatening condition - we're talking about.
- Or it could be nothing.
That's what I'm saying.
Can you talk some sense here, Jed? Give us a minute, Dr.
Take this form to the third floor, and then take one turn left, and then one right.
Can I stay with him for the X-ray? How's it going, guys? Mr.
Furst, we were hoping you could take me through all the foods that Dmitri ruled out during his allergy tests.
While I walk him upstairs, make sure the techs know what to look for.
It's cool, Dad.
He can take me.
Okay, I'll see you after.
I am looking for my husband.
Sameer Gupta, someone called.
That was me, Ms.
I'm Dr.
Bashir Hamed.
Right this way.
You called her, Dr.
Hamed? I didn't want to worry her! He said it was an emergency! Of course I should be worried.
Anju, I'm fine.
There was an aneurysm in my leg, but they fixed it.
Tell her.
Um, yes.
Surgeons fed a small wire through Sameer's artery to clear an obstruction caused by an exposed nail.
He's recovering, but because the wound's still infected his temperature is elevated.
A nail in your leg? And this happened at the office? You said you were promoted.
No more crawl spaces or ladders.
There are nails at the office! Would you lie to your wife about your job, Dr.
Hamed? He doesn't have to.
He's doing the job he was meant to do! And all my husband does is punish himself because he's not! Can we fight about this when I feel better? Before you were fine.
When things get real, you're sick? Anju.
- I want to go home, Sameer.
- Yes, okay.
The doctors have it handled.
I'll be home in no time.
You know what I meant.
Our home.
Jaan, it's time.
You're the only one who can't see it.
I'll give you a minute.
I need a blood test.
Anju, why? Are you okay? I'm pregnant, Sameer.
Or at least I think I am.
Now you see how it feels to be kept in the dark.
You know, I took two home tests, but I didn't trust them.
We tried for so long.
Would you like to see your baby? Lie back for me.
You know, in my faith, you tie a door when you ask for a blessing.
And we asked one before we came here.
But I'd given up, but Sameer never gives up.
Yes, I noticed.
It's going to be a little cold.
Heartbeat is strong.
I'd say about eight weeks.
It wasn't his dream to come to Canada, it was mine.
I said that there would be more opportunity for us.
It is always like that.
I dream and he does.
Sameer worked so hard to make it happen, and we were both so excited.
But the reality Was, uh, not what you expected? I'm not saying it would be easy to go back but We had a life in Delhi.
And we have family we miss.
And he could be an engineer there.
Will Sameer be okay, Dr.
Hamed? He's still very weak.
And he needs a lot of rest, so his body can fight the infection.
We wanted this for so long.
What if it happened at the wrong time? So barium is harmless, but gross.
So for every sip you get down, I'll take one too.
Deal? Just think of it as a milkshake.
A radioactive chalk milkshake.
So, how you liking Toronto? Your dad seems to think you're getting used to it.
Him and my mom really want me to.
When I started at this hospital, I remember knowing no-one.
I used to eat alone in the caf and I'd pretend to read.
I don't even go to ours anymore.
Because the food sucks? I almost never feel like eating.
Just because when I don't have to - I feel better, like - You're in control? I found this group online.
Other people who feel the same way.
We sort of set goals for each other and cheer each other on when we make them.
What kind of goals? Eating less calories.
And, um Throwing up if we eat something bad.
I know it shouldn't feel good, but it does.
Why do you think you're telling me this? I know that if I tell my dad I know I should stop, but Dimitri, do you want to stop? I don't know how.
Well, I can help with that.
And I can be there when you talk to your dad, if you think that would make it easier.
Frank's testosterone is low.
You're thinking andropause? And when you give him the results of his scope, you should tell him that too.
I won't be giving him either of those results.
I'm pretty sure he doesn't want to see me.
And you seem to have a problem with how I deal with him, so Frank's afraid, June.
And like most of us, he covers with bravado.
You may have to peel back yours to make room for him to do the same.
So you want me to act weak so he can feel strong? Maybe there's a way for you to meet him in the middle.
A stressed-out resident of Dr.
Weir's was looking for you.
Something about needing a consult for the exposed liver patient you had yesterday.
No, it's not Weir who needs me, it's Alison.
The bystander who saved Warren's life.
She heard his blood pressure was low and she's now convinced I'm the person to interrogate it with her.
Do you think she's right? No, I think I should stay out of it, and so should she, but she won't let it go.
So her relentlessness irritates you? Yes, I see the irony.
Should I let them know you're coming? Dr.
Leblanc, you came.
Well, you left me no choice.
I have a roster of patients in Emerg, but senior surgeons are dragging me here because of you.
Who? Weir? I haven't seen him all day! Just different residents every three hours and each time I'm the one bringing them up to speed.
Alison, I spoke to Dr.
Weir myself.
Warren's blood pressure is low, but in the acceptable range.
But it's dropping in waves, and each time it levels, it's a little bit lower and his breathing gets shallow.
Okay, stop.
You just have to stop! I can't.
Look, maybe you don't understand, but I know that if I walk away when I could have made a difference That's just not the kind of person that I want to be.
Look I've been watching him more than anyone else for a full day now, and I'm telling you, he's paler than he was before.
Now, you're the one who found the injury underneath his liver.
If you tell me that he's okay, I promise I'll accept it.
Okay, Alison.
One more look.
Thank you.
It's impossible.
What? A foreign body near Warren's heart.
Could be glass from the accident.
They would have imaged his abdomen where the wound was.
But maybe it travelled through his bloodstream.
What does that mean? That you may have just saved his life again.
Khaled? Dr.
Hamed, this is Jack Kline.
Is Khaled okay? Tell him I haven't left.
Unfortunately, Khaled's in immigration hold for now.
He's been arrested? He told me you said that wouldn't happen.
Well, when an appellant is in violation of a previous order border services can request detention.
I was hopeful they wouldn't go that route, but it is where we are.
- You have to get him out.
- We're working on it.
The good news is that Khaled's not a security threat.
I'll petition release pending processing of his appeal.
It just may take some time.
How much time? 24 hours at least.
Go back to Toronto, Dr.
There's really nothing else you can do here.
Gupta, what are you doing out of bed? Anju hasn't come to see me.
I need to talk to her.
Anju is fine.
She just needs a little bit of time.
Okay, I'm concerned that your infection has spread to your blood stream.
It's called bacteraemia and it could be lethal.
Let me take you back to your room.
I promised her a future here.
If we go home now, I fail my wife and my child.
Do you understand? The life I built and the home I knew doesn't exist anymore.
I would give anything to get that back.
Let me take you back to your room.
Hey! His heart-rate's elevated and he's cold and clammy.
Tell the intensivist he could be in septic shock.
Go! Sameer! Sameer! Since when aren't we honest with each other? Why won't you talk to me? Whatever it is, I need to know.
Guys? Is everything okay? Because I got the results back from imaging, there's no signs of obstruction or ulcers.
So it is psychological then? That's what the other doctor, the kid, just told me.
I am I'm very sorry.
You never should have heard that from him.
Dima? Whatever it is, we can fix it.
There's nothing to fix! He just told you, the tests didn't find anything.
Can't we just go? No.
Not until one of you tells me what's going on.
We all need to just take a deep breath and we'll talk this through, okay? The lab rushed your biopsy and it's not aplastic anemia.
I know it's been a stressful time, but uh, we had to check.
Let me guess, you have another theory about why I'm anemic.
Actually, we know why.
You have low T.
Sometimes it's called andropause, but basically it just means that your testosterone levels are declining.
I mean, sometimes, this happens when men get older.
You know, this is pretty good news considering the alternative, Mr.
That I'm basically less of a man? You just supplement your testosterone, make some lifestyle changes, and on the surface, it just looks like you're taking better care of yourself.
But underneath, I'm a blubbering mess.
I mean, show me someone who isn't, right? I can't remember the last time I let a woman see me cry.
Same here.
Look, you'll be fine.
And I'll get that shoulder fixed ASAP.
Thanks, though.
It's very serious, Mrs.
The surgeons need to cut out the infected tissue from beneath his original puncture wound to keep it from poisoning his bloodstream.
Will that save him? We'll do our best.
Sameer! Anju! I don't care where we are, as long as we're together.
There's my husband.
It's time.
You come back to your family.
I realized I hadn't eaten all day.
What? What happened? They did everything they could, but the glass pierced his heart.
Warren's dead? Were we too late? I'm so sorry, Alison.
His body was still weak, recovering from trauma, which makes it harder to survive a major surgery.
Then, if I hadn't pushed for us to do something Did I cause this? No.
This was not your fault.
But I got involved.
And now I'm grieving someone I don't even know.
Do you know what that's like? If I was never going to be able to help him, then what was the point? Frank found out about his low T? How'd he take it? No, he handled it.
But you think maybe you could just pretend I didn't tell you? I don't think he wants anyone to know.
Good point.
Do you know if Sameer Gupta's still in surgery? Uh, I haven't heard anything.
You want me to call? - Yes, please.
- Do you have any idea what you did? Breaking Dmitri's confidence like that? Dr.
Hunter, that wasn't The father kept asking so many questions about what else it might be, - I didn't know.
- No.
You don't know.
- You know nothing! - Dr.
You have charts to finish.
Tell Mr.
Kline it's Bashir Hamed calling again.
I'm waiting for his call.
- Hey.
- Hey.
Where are you going? To check on a patient.
You? Uh.
I don't know, actually.
I was supposed to get off on one, but I didn't.
I, uh I heard about your liver laceration.
He died? Yeah.
How's your good samaritan? Blaming herself.
Asking why she even got involved at all.
Because that's who she is.
And no one else would have.
It's not fair.
How you see me.
You left this for me? Yes, a letter to your program director, and a formal offer for you to do your clinical hours here when they officially start next month.
So I don't get to even consider any other options? Thank you for deciding my future for me.
I'm not deciding anything, Claire.
I'm just I'm just making an offer.
No, you're trying to hold on to me.
I know you don't want things to change, Jed, but they already have.
And you're acting like you're facing all this head on, but you haven't once told me what you feel about the fact that you can't work on patients.
I'm adjusting.
You're deflecting.
There's a difference.
Heard you were looking for me? Yeah, you, uh, you got a minute? Didn't have you pegged as a smoker.
A secret and very infrequent vice.
I really messed up there.
No, I did.
Putting the dad on you, knowing how he is.
And then losing it on you? It's not cool.
Did I tell you both my parents are surgeons? So you're used to perfectionist doctors? Perfectionist, divorced doctors.
They split when I was 14.
And when the myth of perfection ended, they got to just, I don't know, be themselves, I guess.
I'll see you tomorrow, Jake.
I was glad to hear how well you're responding, Sameer.
Your surgeons tell me you'll likely be discharged in a few days.
Thank you.
The next time I ask for a blessing, it will be for you to find your way home again.
I'm sorry I haven't gotten back to you.
It's been two weeks, Mr.
- I know.
- You said Khaled would only be - in detention one day.
- I know.
But he's okay.
His spirits are good, considering, and we are doing everything we can.
Whatever it takes.
If it's a question of money, I'll pay it.
Khaled asked me to pass along his thanks.
And I continue to believe our appeal has a chance.
But Well, you may want to get your head around the idea that if things don't work out, he could be deported.

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