Transplant (2020) s02e06 Episode Script


Any interest in a part-time resident practice? It's not fair.
How you see me.
The committee agreed that I won't be working hands-on with patients.
- I didn't know - No, you don't know! You know nothing! About my dad.
I'm not up to date on his condition because we don't talk.
I wish we got to stay where we were.
Live our lives from then.
Nah, you serve coffee all day.
Soy butter? Amira seems really intent on giving up meat, huh? Are these pads? What? Nothing.
You don't trust me to handle it? No, I'm glad that you were there for her, I just thought you would have told me.
- Ah, there's my bag.
- Lunch is packed.
I'll walk you to school.
Have you seen Dr.
Hunter? Not since you asked me five minutes ago.
Hi, uh I'm just transcribing here, but do you know why Dr.
Hunter keeps saying to ad lib? At liberty.
As in, I'm at liberty to remind you they teach that in first year.
Are you hiding from your student? I forgot how much work it was managing people.
- Preach.
- Juney! Oh, hi, Charles.
I thought I said I would call you.
Yeah, and you didn't, but we need to talk.
Okay, so this is Mags and Theo.
Well, that was half an introduction.
Good to meet you guys, I'm Charles, - June's little brother.
- Mags, June! GSW coming in! - Sorry, gotta go.
- Uh You think I should start calling her Juney? Oh.
Well, that depends, do you consider yourself a smart man, Theo? Dylan Carter, 19, gunned down while filling up his car! Counted two entries, but there could be more! Wrapped what we could, gave him saline and morphine.
Hang on, Dylan.
You're in a hospital.
- We're going to help you.
- This kid's only 20? Activate MTP, I need two large bore IVs, two litres of saline and one gram of TXA! He's got a right-sided pneumothorax, I don't see any fluid in the belly on the eFAST.
Where does it hurt most, Dylan? - My chest.
- Okay, I have, uh one entry in the right side of his chest and another in the abdomen, right lower quadrant.
- One more in his thigh! - His head wound is superficial! Dylan, can you feel your arms or legs? I didn't see who shot.
Okay, log roll, check for exits! Quickly! Okay, one, two, three.
Okay, three entries, I have an exit on his chest and abdomen.
Nothing on the leg, bullet rule's uneven.
One, two, three.
Someone call my gran? - Is he gonna make it? - Dylan? LOC is decreasing! Let's shoot a chest and pelvis to look for fragments or bullets.
Before you move him, I'll need a blood sample.
This kid's no victim.
I need a DNA sample before anything else.
Officer, we don't have time for that and you don't have consent.
Out! - He's crashing! - You heard him.
Start oxygen, push fluids and more blood products.
Let's give him a chance.
Colton Parker, seven years old.
Heart rate is 150, BP is 80 over 50, bradypneic breathing at every 10 minutes.
He ate the parents' edibles.
They're Heather's edibles, not mine.
- You mean cannabis? - I keep them locked up! I only use them to fall asleep.
I don't know how he found them! - How much did he ingest? - I don't know! I brought the empty package with me, but don't remember how many were in there.
He must've thought they were candy.
What's important right now is that we get Colton breathing.
Once we have him stabilized, we can assess the toxicity in his system, okay? We'll update you when we know more.
Dylan's BP isn't moving.
80 over 60.
Let's run it down in order.
Head wound seems minor, we'll CT to be sure.
The bullet wound to the chest has caused an extremely large pneumothorax.
X-rays are showing a distance of more than three centimeters to the apex.
He's got persistent hypotension, and his shock index is 1,6.
Abdo's positive now, significant internal bleeding.
He needs the OR or an emergency laparotomy.
- And the bullet he kept? - Trauma film shows it's subcutaneous on the posterior left thigh.
Where it's clear of his femoral.
But still remains a risk until we know how close.
One wrong shift could kill him.
Choices made now dictate his options in the future.
I've seen a pneumothorax this large before.
He needs a VATS to make sure his lung doesn't recollapse.
No, the pneumo should be drained now to stabilize him, then thoracics can do a VATS.
He needs the OR for uncontrolled bleeding and we can get him there safely - if we decompress his lung.
- I think you're wrong.
It's Dr.
Hamed's patient so it's his call.
And her? Chest tube first, then you and I will talk to her.
His O2 SATS aren't climbing.
We need to intubate now.
Move, Jake.
Did you do any that reading I gave you on difficult airway intubation? - Yeah.
- Good.
Next steps? - Uh, lift the epiglottis? - Stabilize the larynx.
I can't get a good visual.
His neck's stiff as a board, paralytic wore off? Could be an atypical seizure.
Stiffening of the muscles can happen with THC ingestion.
I can't risk going in there without damaging his airway.
Damn it! Bag.
If his neck's too rigid, we need to make the tube more flexible.
We need a gum bougie and more paralytic agent.
Give him 30 of succs.
Doesn't that mean going in blind? A messy solution's better than no solution.
That's too big for a pedes patient.
Urinary catheter with a coude tip.
Urinary for intubation? It's more flexible for smaller windpipes.
Just stand back and watch, Jake.
Take over.
Off the bag.
I'm past the epiglottis.
And then, past the larynx.
Grab the tube, Claire.
Slide it over the proximal tip.
Good, almost there, hand back control and we just Rotate anti-clockwise and re-route? You got it.
We're in.
Inflating the balloon.
SATS are climbing.
He needs an OG tube and activated charcoal.
No way to know the damage until we run more tests.
And the parents? I'll loop in a social worker.
Hey, did I see Mr.
Willis is back? Yeah.
He is.
Patellar instability after tripping over his sleeping cat sent him down the stairs three weeks ago.
Page ortho, he might be a candidate for trochleoplasty.
You keep all that at the top of your brain? - Still can't find Dr.
Hunter? - No.
He wants me to redo some reading.
So I don't think I'm impressing him much.
Well, then maybe you need to find a way to be more impressive.
Okay, wait, hold up.
Hold up, hold up.
- I can't.
- You're the tough love type.
I appreciate that.
How do I do that? Well, for starters, if Dr.
Hunter doesn't need you, find someone who does.
Use this place to, you know, expand.
Practice running every differential you can.
No one's gonna open doors for you, Jake, so don't be afraid to open them yourself.
Did you - I'll consider that.
- Is everything okay? - Sorry.
This room was empty.
- No, it's fine.
Sit down.
Did you burn yourself? Just had a minor fight with the pressure washer.
Hmm, well, steam burns even hotter than boiling water.
And, perfect place to get it looked at.
I still have four floors to do.
Oh no, trust me, people come in for way less.
And you don't want to mess with a burn.
I'll be quick, I promise.
Dylan Carter's in surgery now.
Does that mean he'll survive? Depends how he responds, but we hope so.
You do realize this is gangland retribution.
There are two actually innocent bystanders at St.
Luke's because of the choices the suspect you're protecting made in life.
We're treating a patient.
How he got shot has nothing to do with our duty of care.
Dylan's known associates are responsible for a house party shooting where three people died last month.
Witnesses put him there too, but his DNA could tie him to it.
- Is he under arrest? - No, he's not.
We have our protocol, you have yours.
You want his blood, show us you have a legal right to it.
Kid requires multiple surgeries.
He's not going anywhere.
Meanwhile, my father's waiting a year for a hip replacement.
I'll be back with a warrant.
Thanks for backing me up.
Patients first, Dr.
You're not even gonna sit? I've been here 10 days and you already managed to break two dinner dates and not call me once.
I've just been busy, with the new role.
And I'm working remotely from a city I don't live in, taking care of an increasingly cranky father, being an absent husband Oh, and the Facetime parent to the nephew you never see.
- Okay.
- And yet I'm still making time - to come visit you.
- Easy on the guilt trip, right.
Besides, it's not like you're here to see me, you're here to ask me about Dad.
There's supposed to be perks to having a doctor for a sister? His, um his treatment's getting complicated.
That's why I hired him a nurse.
Who he promptly pissed off and now refuses to come back.
I thought about giving her mom's number so they could compare complaints.
- Sounds like a you problem.
- I'm flying blind here.
This is me asking, not Dad.
I've already told you, I don't want anything to do with him.
He's dying, Juney.
You didn't know.
They say six months barring some kind of miracle.
I just I don't I don't know what it changes, so That's cold.
Even for you.
I have patients I have to go see.
I've put a little extra milk in there for you.
Working doctors tend to brew it strong.
Shockingly, I have missed our monthly check-ins.
Well, we are heavy on bed occupancy, but we've been turning them around fast.
We've been running effective simulations on trauma protocols.
I've been reading the reports.
- Everything upstairs okay? - The usual.
Plenty of ideas, very little money.
Should I keep making small talk, Joan? Because it's like I tell my residents, time is function.
Take this in before you react, Jed.
The board wants you to start thinking about who should lead, once you step down.
You've built this department from the ground up.
It's a reflection of you and you should be proud of that.
But the last thing we want is for that growth to stagnate.
We need to stay ahead of the curve.
We've been functioning perfectly in the three weeks I've been back.
This is not about performance.
But at the same time.
You've had two major health incidents in one year.
How long have you known this was coming? Why did you even bring me back? The best way to protect what you created is for you to a part of the transition process.
By choosing my own replacement? By choosing your own eventual successor.
And by shaping the future of this department.
If this is really about preserving institutional knowledge, there are less drastic ways to go about it.
Why don't you take some time to get your head around this, but we'd like to have a name to float when the board meets next quarter.
How long was your hand in the steam? Not even sure.
I guess it took a second to register.
I'm always telling the new people to double-check the valves, but you know, do as I say and all that.
How long have you been working here? I took this job after my divorce because I needed the money.
Somehow that was 10 years ago.
You're gonna want to notify your health and safety rep and fill out an incident report.
Is that necessary? It's standard protocol for workplace injuries.
They'll want to fix the pressure washer so no one else gets hurt the same way.
Veronica, is someone going to give you a hard time about this? I've seen people get edged out for less.
But it's not your fault if a piece of equipment threw a tantrum.
If you need backup, they can come see me, okay? You're all done.
And don't be invisible.
If you need something stronger for the pain, you let me know.
His lung collapsed twice during his lap and I just had to eat it from thoracics 'cause they had to redo his chest tube to correct placement.
- But he pulled through.
- Barely.
If you want me to tell the surgeons it was my call I don't care about that.
The kid nearly died, Bash.
Now his recovery might be twice as long.
You were there.
We had two bad options.
Punishing me for picking the wrong one won't help Dylan.
That's not what I'm doing.
His health card is in here somewhere.
You can just give it to the triage nurse, Ms.
Found it.
I think it's expired though, does that matter? Got him that shirt for Christmas.
Little punk wore it once.
Four bullets and he's still alive? He had surgery to repair a lacerated appendix and a collapsed lung.
We need time to see how he responds.
I haven't seen or heard from Dylan in two months.
I've seen the cops though, they've been here too, I bet? They don't care who did this to him.
One less problem for them if he gets what's coming to him.
When can I take him home? Rita, even if the surgery goes well, the recovery will it will be involved.
I'll take care of him.
I always do.
Look, he's been living with me since he was 12.
I love my grandson, but I'm not blind.
Shoplifting at 14, carjacking at 16.
Drugs, violence.
I could say he comes by it, honestly, knowing his dirtbag parents as I unfortunately do, but he made his choices.
A lot of people been by lately, looking for Dylan.
Some of them cops, some of them definitely not.
He needs someone he can trust taking care of him.
When he came in, finding you was all he wanted.
Because it's the one thing I could do for him, the one rule we had.
No matter what, he could always come home.
You make it so he still can.
Bottom line is Colton is extremely lucky.
The charcoal's having a neutralizing effect and we're not seeing any signs of brain damage.
So he's going to be okay? We need to observe him for the next six to eight hours.
And, uh I would like to introduce you to Iris Kowalski.
She's a social worker here at Memorial.
I knew it.
You called Children's Aid? I just have to ask a few questions.
Has Colton ever been exposed to your marijuana products before? Never.
I only bring them out when he's asleep and we keep them in the highest cabinet.
I've told Heather it was a hazard to even keep them in the house.
So is alcohol or a hot stove or Which is why we keep alcohol locked in the cabinet and the stove off! You promised me you would be more careful! - I thought I was! - Yeah, clearly not enough! Whoa! Look.
Colton is recovering well.
Let's all just calm down.
Look, I do have to notify CAS, but since you have no history of endangering your son, I doubt they'll pursue any formal action.
But we will come up with a prevention plan before you leave to make sure this doesn't happen again.
Thank you.
Both of you.
Well, that was intense.
I mean, yeah.
Can you blame them? Not at all.
But I was talking about you, throwing it down with the husband.
He was out of line with his wife.
Wasn't he? So you're a pediatrician who fixes the marriages of strangers? Interesting cross-practice.
Was that how I came off? I'm going through a split.
Then you have a lot to be pissed off about.
- Divorce can be ugly.
- Ours isn't.
I've just been trying to keep it from bleeding over, though my student would probably say my success has been varied.
Well, I gotta get back.
Have you ever been to Wreck Bar? Uh, nah, I've never heard of it.
Unsolicited advice? Blow off some steam.
Tonight if possible.
I'll email you the address.
Hey, uh, she's interesting, isn't she? Iris.
Uh, I guess, sure.
Gown and glove reqs.
We go through almost double during flu season.
I just need you to approve next month's overages.
On my desk.
I'll deal with it later.
Come on.
How does this work? - Do I need to know about this? - Well, one of our cleaning crew burned herself on a pressure washer.
And I treated her, but I hate the idea that they're working with something so unsafe.
Did she report it to her supervisor? I advised her to, but she's scared it'll backfire.
I thought maybe I could do it for her, keeping her name out.
So you're Health & Safety Rep for the cleaning department now? How many other departments do you plan on joining? I guess that means you don't want me taking some of Dr.
Fisher's cardiology patients? Because she assures me that emerg would take absolute priority and she hasn't heard back from you on sign-off, so You can't solve every problem in the building, Mags.
How are you feeling, Dylan? They said I took four bullets? Feels more like eight.
I tried to stand, but I couldn't.
Doctors had to remove your appendix, re-inflate your lung and repair a tear in it.
What about my leg? The bullet stays in for now.
It's not an immediate threat to your femoral artery, but our vascular surgeons will need to reassess once you're feeling stronger.
- And what about the police? - Gran.
They were here, he spoke to them.
He's not gonna talk in front of me unless you say he can.
She's cool.
What did they say? We told them they'd need a warrant to take a blood sample and they said they'd be back with one.
When? Then I need to get him home before they get back.
Is that possible? No.
I'm not coming home with you, Gran.
And what are you gonna do? Go to your idiot friends for help? The cops will just come find me at your place.
So let them! This doctor's been telling me all day how serious this is.
You're gonna need someone to look after you.
The people who put me here, they're gonna try again.
I don't want you getting mixed up in that.
I can take care of myself.
I can take care of both of us.
No, you can't! Not anymore! We're way past you helping me, Gran! What, you wanna get shot for me? Aren't you even gonna ask what they think I did? If you think you can scare me into letting go, you're dumber than I thought.
Will he be ready to leave before that cop gets back tomorrow? Given Dylan's condition, I'm not comfortable making any promises.
Just get him to where you can, leave the rest to me.
And I don't want to hear anything from you but "yes, ma'am".
Okay, Gran.
Hi, uh.
I'm looking for Wreck Bar.
You found it.
Pick your poison.
Sorry, one sec.
I think I'm in the wrong place.
20 bucks for as much as you can fit in the basket.
It's not for me.
Found it! I had the form a week, but forgot.
I need to bring it back signed to practice tomorrow.
You have a dance competition in Peterborough? Next month, the 15th.
Yeah, we'll all go.
Family trip.
Is that okay? There's a pool at the hotel where they're holding rooms, but they did say one room per family.
That's no problem.
I'm sure there's a couch there too.
Dylan, you have to be in bed.
Okay, if you want something just ask.
Get this tube outta me or I'll do it myself.
Even if I thought you were ready for that, you still need monitoring.
No, Dylan, hold on.
Just stop.
Just stop! That cop could be back any second! She said she'd have a warrant this morning, right? Think about how serious this is.
Okay? Your lung could collapse again, or your wound could tear or the bullet in your leg could be infected? At the very least, wait for Rita to come back.
No! I meant it when I said she can't be involved! Is running from this really what you want? You heard Rita, she's never going to let me go, and I can't be the reason something happens to her.
You can try and get in my way, man, but I'm leaving.
Just please.
No, no, no, no.
Stop, stop, stop.
Five minutes.
Okay, just five minutes.
So you think it's a good idea to take out his chest tube? No, but it's better than if he leaves with it in.
Okay, I checked his charts and drainage is less than 10 cc's per hour for the last four, and no increased work of breathing.
Yeah, okay, but he's still recovering from multiple surgeries.
He made it clear he's going, June.
But what if he did what the cops really suspect of him and he shot someone? Look, I don't know what you're asking me to do here.
I don't know if you want me to talk you out of this or if you want me to help you.
Maybe both.
It's fine, June, I'll deal with it.
Wait, wait.
So, Wreck Bar's totally not a bar.
I never said it was.
So what'd you break? I prefer to find more constructive ways to deal with things.
I wish I was half that restrained when I found out my wife was cheating on me.
Yeah, that place saved me from destroying my own TV multiple times over.
I will keep it in my back pocket.
- Hey! - I don't know where Theo is if that's what you're wondering.
He's on his way to a staff meeting.
You said that I need to figure out myself inside this place, but I feel like that's half the equation.
You've got this bank vault of a brain, you remember every patient you've ever seen.
How do you manage to keep that up? Are you ever not working? Are you running a differential on me? You said to go in on everyone that I can.
- This is so not what I meant.
- It's just - Nah.
- I'm done work, I shut off.
I see family, I see friends, I play basketball.
No wonder you're behind on your reading.
Hey, woman in five said you saw her yesterday for a burn? Veronica's back? Uh, can I tag along on this one? - Just keep learning? - Don't say anything.
You're back.
Is it the pain? No.
By this morning, it had stopped hurting.
But it looks like this.
There's no way this is a steam burn.
You have to tell me exactly what happened.
I spilled ammonia on it.
This is a chemical burn? We used to get the solutions prediluted.
Someone decided it would be cheaper to order in bulk and have us mix it ourselves.
The containers are heavy and it slipped.
Go get Claire to help you book an OR for a possible debridement.
You think I need surgery? When ammonia gets in your tissue it kills the cells, necrosis.
I have to assess how far in it went.
But I googled it after the spill.
It said to flush it, which I did.
But chemical burns need prolonged irrigation.
Why didn't you tell me the truth? I didn't want my supervisor knowing I messed up.
Can you feel this? Well, you have what's called a full thickness burn.
The ammonia got through every layer of the tissue.
A simple debridement won't be enough.
What do you mean? It'll be up to the surgeons, but likely they'll try something called an escharotomy to release the pressure and try to save some tissue, but There is a possibility that they'll have to amputate.
I'm sorry, Veronica.
I'll be back.
Warrant to take bodily substances for forensic DNA analysis.
- Where is he? Where's Dylan? - Ms.
You said you'd help him and you let him leave? Wait.
Dylan Carter's gone? You told me he needed medical assistance for days.
It's been 24 hours! How is he gone? Oh, don't act like you care about him! Rita, he told us he was leaving whether we wanted him to or not.
It's not our job to hold suspects for you and you know that.
Ma'am, if you really care about your grandson, you'll work with me to find him.
Oh, piss off! He didn't shoot anyone! You seriously think I'd help you? You failed him.
All of you! Ma'am.
You took out his chest tube when his condition was still acute? We did.
He said he was gonna leave either way and it was the right thing to do.
Sir, there wasn't enough time to ask you.
Would you not have done the same? Yes, but it wasn't me, Dr.
Hamed, it was you.
- Amira! What happened? - She tripped at dance and hit her head on the edge of her stage.
Why didn't you call me? I was rushing to bring her here! Amira? Okay.
It looks like one wound, lots of blood.
Let's do a neurological exam to make sure.
I don't think that will be necessary.
We'll get someone to stitch her up.
Look, sir, I need to do this, okay? Bashir, you can't with family.
You know this.
We'll ask Dr.
Hunter, shall we? Very dramatic way for us to get a visit from you, young lady, but we'll take it.
So you are telling me you did this dancing? Sure you didn't join a fight club since the last time I saw you? Ha ha ha.
- Was that a pity laugh? - Definite pity laugh.
Well, I will take it.
Hey, uh, why don't you give your brother a little wave there so he gears down? How you liking the new place? Must be nice having another girl around.
I miss you.
I miss you too.
Let's take a look.
It looks pretty badass.
How about I bandage that up and then uh maybe you and me, we we go in there and we let him off the hook? Can I stay here a few more minutes? You wanna learn how to apply a dressing? Sir, Veronica Garcia lied about her burn.
She spilled ammonia on her hand and was too afraid of losing her job to tell me.
It was chemical? Now it's progressed? Full thickness with necrosis from the radius to the proximal phalanx of the thumb and forefinger.
Sensation? - Minimal.
Circulation too.
- What's the plan? Escharotomy, but given the prognosis, the surgeon is considering amputation.
He says it would take a miracle to save her hand now.
This woman spent the last 10 years making our jobs easier and if she hadn't burned herself, I wouldn't even know she existed.
And I know you said we can't solve every problem in this place, but this place is going to cost her a limb and I have a hard time What are you doing? Well, we can't solve the problem in the hospital, we have to widen our reach.
With an analog phonebook? Dr.
Karen Balaji.
She's a plastics specialist at St.
I've published with her.
They call her the tissue resurrector.
So you'll ask her? No, you will.
While I speak to maintenance about chemicals.
It's good for you to build these relationships, Mags.
But this thing with Dr.
Fisher Haven't we both lived through the perils of biting off more than you can chew? That's not what this is, sir.
I mean, I don't exactly know what it is yet, but Do you not think I should do it or? I want you here.
With us.
You better get on that.
- Time is - Function.
She's alright.
We'll need to do some more imaging, but it's likely just a small concussion.
Thank you for getting her here.
It wasn't fair to shout at you.
If you don't love me anymore, you need to tell me.
Hey, uh, thanks for taking care of Amira.
Of course.
Hey, why don't you guys come by for dinner? I'll make comfort food.
You can bring Rania too.
Amira should rest.
She, uh mentioned that things at home were kinda tricky.
You doing okay? - What did she say? - Nothing.
No, just that you and Rania are still figuring things out.
You talk to her about that? No, I wasn't trying to talk to her.
All she needed was sutures, Theo.
Look, Bash, I'm just saying.
They read things.
God knows my daughters are full of questions, especially now that their mother and I are just talking - to lawyers - I'll take care of it myself.
Yeah, fine! Sorry I stepped in where I'm not needed.
Balaji's seen your imaging and spoken to our team.
If she thinks she can save your hand, that means she can.
Your sister's gonna meet you at St.
Luke's, and I'm gonna call in once you're through to check in.
Thank you, Mags.
For everything.
Of course.
And I know they have better food there, but don't get too comfortable, we want you back.
What? Are you free tonight? Free for what? Dinner.
Anything you want really, that's just not here.
Are you asking me on a date? You're asking me on a date.
You're the one who said to find doors and open them, so that's what I'm doing.
Okay! It's, uh, torture trying to figure out what's going on in your head right now.
Well, right now it's whether I find you charming - or annoying, I - Okay.
Which way are you leaning? Two sugars.
I hope there's a better reason you called me back here than a crappy apology coffee.
I'm not apologizing.
You can call me cold if you want, it's up to you.
I don't need you to understand my choices with Dad.
But seriously, Charles, you know that doesn't mean that I don't want you in my life, right? So if you can separate the two, I know I can.
- Is he dead? - No, no.
That's not why I'm here.
Then, why the hell are you here? I haven't seen him.
Not that I'd tell you if I did.
I just wanted to give you this.
Stocked with sterile gauze, gloves, antibiotics, antiseptic, and a list of things to watch for in case you do see him.
I know that letting him go was your way of helping him.
What are the chances he'll need that stuff? He's strong.
The fact that he got up after surgery the way he did - is encouraging, but - He'll need to be looked after.
I kept telling myself that it was a good thing, keeping my house safe for him.
Was it just me enabling him? I'm not ready to lose him.
Thanks for this.
Is it a bad idea to date a med student? You talking about Jake? Politically, probably.
Personality-wise Probably.
Did he ask you out? Yeah.
- Okay.
- I think I'm gonna say yes.
Your brother seems nice.
You two close? You know if you ever need to talk.
Good night.
My dad's dying.
I've been made redundant.
They told me yesterday to start start thinking about a transition plan.
They're pushing you out? When? As soon as I choose my replacement, according to them.
I'm so sorry, Jed.
I don't know what to say.
I'm not done, Claire.
Amira? She went to sleep an hour ago.
Look, uh, I know this this hasn't been fair to you and, uh I'll do better.

Previous EpisodeNext Episode