- Thank you. - You're welcome.
Dr. Goran.
Dr. Kinney.
You look good today.
I don't feel good.
I haven't slept in three nights,
I have a 10-year-old who wants to get her navel pierced,
and I just got off the phone with our lawyer.
Shawn Price...
your very first surgical case here at the hospital...
they just settled his lawsuit.
- How much? - $50,000.
Well, that's basically like a win.
It cost us double that in legal fees.
Okay, listen to me. I made a decision.
You made a bad decision, right, because you're not thinking.
- You gotta think. - No, actually, I was thinking.
You were thinking about yourself.
No, I was thinking about my patient, Dana.
- Uh-huh. - Thank you very much.
- About... - About saving his arm.
Against his wishes, which the court recognized.
So moving forward, if you're ever in doubt again,
I want you to replace that voice in your head with mine.
Charlie, can you open your eyes for me?
No, I can't, Doc.
Frankly, I wish you'd quit asking me to.
It's getting a little hard on the old ego.
So, any change?
The diagnosis is he's screwed.
He's still a 6. I'm sorry there's no improvement.
The TMS worked, Shahir.
We don't know that.
Uh, there was radical movement.
Which could have been a seizure.
It wasn't a seizure. He moved.
You have done deep brain stimulation...
- Alex... ... on patients with Parkinson's
and had success.
Okay, deep brain stimulation is a highly experimental thing.
By stimulating parts of the thalamus, you have found that certain patients
have been aroused to the point of being unable to sleep.
Now, with a coma patient, that same procedure
could induce waking, right?
- Keep pushing him, Alex. - You've been doing your research.
Am I right or not? Is it possible?
- It's a completely different... - Shahir, is it possible?
Yes, theoretically, it is possible.
But it could cause brain damage, Alex.
We could hit the middle cerebral artery.
He could bleed out fast, and he could die.
You won't let that happen.
He responded to the TMS. This is our next move.
I want you to book an OR.
That's my girl.
- It's okay. - Good?
- Yeah. - Better?
- Reycraft. - What's happening?
Uh, Stacey Harrison...
36-year-old jockey injured in a fall at the racetrack.
Friggin' bug boy put me in too tight.
- What is a bug boy? - An apprentice jockey.
They're like junior residents, except...
I'm impressed.
My uncle was a hot walker. I grew up at the track.
Anyway, Stacey, this is, uh, Dr. Goran.
He's the man I came to see.
- Really? - Yeah.
- And what are we looking at? - Pelvic ring injury.
Yeah, it's definitely busted.
I've broken every bone in my body. I know the feeling.
Right. Well, we'll need to stabilize it.
Somebody get me a binder, please.
If I miss the Oaks Stakes because of this,
I swear, Angel Martinez is a dead man.
Okay, Stacey, you need to calm down.
Uh, you should give me more drugs.
Okay, let's give her five more milligrams of morphine.
And maybe a sponge bath from him.
Well, that will be between the two of you, Stacey.
Rub a dub-dub.
Ah.
Oh, here. - Thank you.
- This is gonna hurt a little, all right? - Okay. Yeah.
Center the velcro complex over the greater trochanters.
That's it.
Okay. - Okay.
- Sorry about this. - Don't be.
Aah!
Aah.
Okay.
Okay. She's good to go. Let's move her upstairs.
Thanks, Doc.
See you in the tub.
You have a gift.
You should have waited for the next elevator.
Yeah, you're right. There's too much baggage in here.
All right, Alex, you know what?
Whatever this thing is that's happening between us right now,
it's real.
What do you want from me, Joel?
I know I haven't handled myself too well lately.
- I know that. - No. No. I just don't...
I don't understand. What do you want?
Do I leave my comatose fianc�, then we get back together again?
- And then what? - That's not what I'm saying at all.
- What I'm trying to talk... - No, no. I just... I need you...
...to stop.
So this is it, huh?
Midfield, 4th and long.
Time is running down.
Wish I would've known he was having surgery.
It was a last-minute decision.
Hail Mary time.
Would've cleaned him up, given him a shave.
Dr. Hamza's waiting in the OR.
- Can I bring him down with you? - Of course you can.
Deep brain stimulation.
After this...
...there's nothing.
How many children do you have, Roy?
Easy. Same as her.
We have one son, and he knows that.
You know that, Roy.
How about the year, Mr. Goldbach?
I don't know.
How about the date?
Day? Month?
Haven't the faintest idea.
Well, that's an easy one, Roy.
Maybe for you.
You should really try to answer.
Dr. Murphy.
Just try and remember.
I- I don't...
Yesterday was Monday.
Then Tuesday...
That's right. Tuesday. He got it.
Mr. Goldbach, you scored 18 out of 30
on your mental status exam.
I'm obliged by law to take away your driver's license.
Now how am I gonna get to bridge?
And how am I going to get to work?
You don't work anymore, Roy.
Of course I work. I work every day.
I have a shop downtown.
This is your memory issue that we've discussed.
Sorry. Right.
Well, our time's up.
But... wait.
Dr. Druckerman.
Um, we didn't get any individual therapy time with Esther.
- We have another patient coming. If I'm late for work...
I think she could really use some new tools.
There's a clinic that I was reading about in Oregon.
- The Hewitson Center. - Yeah, they have...
They take their lead from the Alzheimer's patients.
That's because they have a 1-to-3 physician to patient ratio.
We don't.
You really want to do something to help? Get the Goldbachs a taxi.
Esther, I'm so sorry we ran out of time.
No, thank you. You've been very kind.
Well, now, why isn't she my doctor?
Hello, there.
Roy, Esther, this is Maggie.
You'll have to excuse my husband.
Nothing brings him to life like a pretty young girl.
- Pleasure to meet you. - You too.
Hey, I forgot.
Here, my card.
I'm gonna put my personal cell number on the back.
I'm never in my office.
You don't have an office.
I guess that's why.
Uh, call me anytime.
I'd rather have her number.
We're all right from here.
Come on, Romeo.
Isn't it against the rules
to give your personal cell phone number out to patients?
Well, last time I checked, it wasn't against the rules to care.
Hm. Badass.
Shut up.
Good luck.
You can do it. You can.
Because I know you can.
Because I know.
Okay.
Okay. Okay.
Call me back. All right.
Your new girlfriend?
- She's not my girlfriend. - Does she know that?
'Cause a girl kinda likes to know these things.
Still hurting from your breakup with Goran?
So, your new girlfriend,
is she jumping out of a plane or what?
No, a haircut.
What?
Not everybody looks good in short hair.
I mean, not you.
Oh, my God.
I'll grab a pair of mayos from the OR and do it myself.
Hello.
Uh, this is Esther Goldbach.
Mrs. Goldbach.
We got back from the appointment,
and, um, Roy said he was going to work,
so I hid the car keys, and now he's going crazy.
What should I do?
Can you bring him back in?
Well, I don't drive.
Should I give him the keys?
No, don't do that. Uh...
What about a taxi?
Oh, I'll never get him into a taxi.
Where's the keys? - He's just too upset.
Okay, I'll try.
Esther?
It's the Alzheimer's couple.
She's freaking out. She wants me to come over, I think.
You're still on shift.
Yeah, I can't just cut out.
She's not answering.
What am I supposed to do?
I say go.
- But what about Druckerman? - Worry about him later.
You're right. You're right. Thank you.
- What are you doing? - I'm coming with you.
I'm on break, and like she said,
nothing brings him back to life like a pretty girl.
Stacey.
You have a pelvic fracture.
- I called it. - Mm-hm.
Open book?
Sacroiliac joint on the right is disrupted
in keeping with an open book injury.
Widened pubis symphysis.
Wow.
Bones are my business, too.
Well, you could give some of my young residents
a run for their money.
Speaking of running for money, the Oaks Stakes is in two months.
I got a mount with a real shot.
I need to be back for it.
Well, two months...
That's a tall order.
Why do you think I came here?
Okay, Stacey, well, we could go the conservative route with this one,
you know, partial weight-bearing crutches, physiotherapy.
I'm on the shelf how long?
Six months.
No way.
Or we could do surgery.
I'm talking about a percutaneous screw fixation.
Will get me back out on the track.
Only if the surgery is successful.
You see, you're running the risk of infection here.
You could damage blood vessels and nerves. It's...
I'm willing to take that risk.
Okay.
What happened? They turn you into a gelding here?
A stallion with no balls.
I know... Uh, thank you... what a gelding is.
Stacey, without surgery, you'll be out only six months.
I'm a 36-year-old journeyman rider.
Six months off, I lose all my connections.
My career is over.
Okay, I don't think the career is necessarily...
It's all I ever wanted to do...
ride.
Nothing like it.
That feeling of being in a race, that rush.
You ever get that feeling?
Every day.
At the OR.
And if someone threatened to take it from you, what would you do?
I don't know.
I mean, what would you risk to get to keep doing it?
Just trust your gut on this.
If your gut says operate, I wanna take that risk.
Yeah, I'll call down.
I'll tell them to book the OR.
I'm so glad you've come.
Are you okay? Did he hurt you?
No, but he's still looking for his keys because he wants to leave.
- Can you calm him down? - I think I can help you do that.
When you criticize him for not remembering things,
he can get aggressive,
so we're gonna try something completely new
and try going along for the ride with him.
You mean like pretending that what he's saying is true?
Exactly. Because it is true... for him.
Okay. I'll take your lead.
Roy?
Where are my keys?
Who are you?
My name is Gavin.
It's your doctor, Roy.
I've never seen these people before in my life.
Oh, come on, Roy. You remember Dr. Murphy.
Esther.
Tell him to get the hell out of my house.
I've got to get to work.
I've got to go.
Now, I'm aiming for the central thalamus.
Well, more specifically, the intralaminar nuclei.
The brain is like Europe.
Each region has its own language.
And once we find the right wave pattern,
I'll know where to leave the electrode.
- And then you start stimulating? - Uh-huh.
We pass the rod into the brain...
...and then feed this electrode through the rod.
And then you're in.
And then we're in.
- Now, do you hear that? - Yeah.
That is the distinct auditory signature of the thalamus.
Can you start it at one volt, please?
One volt.
Thank you.
Okay, how quickly...?
Alex, this isn't an appendectomy or anything like that. Please.
Right.
Why don't you let us brain nerds do our thing for a while?
I'll page you the minute anything changes.
- Promise? - Mm-hm. I promise.
Charlie, can you look up for me?
Now, to your left.
The other left.
Thank you, Charlie.
There's nothing wrong with him.
I'd say there is, Doc. He doesn't talk.
- Since the accident? - Hasn't said a word.
Well, apart from a small contusion on his forehead,
there's nothing physically wrong with him.
So, what, he's just a mute?
Mike!
If we could, um, uh...
Um, what Charlie witnessed...
Sometimes after a traumatic event, a child stops talking altogether.
- So what do we do? - There's not much we can do.
Just be patient, do your best to keep him safe,
and hope he gets better.
Increase it to two volts.
Two volts.
Did he go in the barn? - I don't know.
Charlie!
- Charlie! - You guys seen Charlie?
Uh, he's up there.
Charlie!
Charlie, where are you?
Charlie!
Charlie, are you in here?
He must be hiding somewhere else.
We got a house full of people, and he just runs off?
He's six, Mike.
What the hell are we gonna do with him?
Whoa. What kind of question is that?
- Beth, I loved your sister. - You hated my sister.
That's not the point.
Are you ready to be a parent?
I'm not.
- He's my nephew. We can't... - We just scrape by as it is!
We take Charlie, and I have to get a second job.
I can barely keep the one. Besides...
What?
He's weird.
He is not weird.
He doesn't talk. He doesn't do normal kid things.
It makes you wonder...
Wonder what?
This is empty. I'm gonna grab another one.
My customers are gonna be standing on the sidewalk waiting!
I've got to find those keys!
Don't argue with him.
Try to find a way to say yes instead of saying no.
I have responsibilities.
Of course you do. You have the shop.
What kind of shop is it again?
Well, it's a clothing shop.
Uh, Roy worked... uh, he works in menswear.
Menswear.
Wow, I am desperately in need of a new suit.
- Maybe something like a... - Brown corduroy.
Wide lapel?
42 long.
That's right.
Huh. You can tell that just by looking at him?
When you've been at it as long as I have...
Uh, Roy, um, I- I-I just remembered to tell you.
I think that that, uh, new kid...
- What's his name? - Nathan.
Nathan. That's right. He's holding the fort today.
So... so I don't have to go in?
That's right. It's your day off. Right.
So, you know, you can just relax.
What are we waiting for? Why don't we...?
Why don't we get these two some coffee? Hm?
So, 42 long. Are you a golfer?
Come here, come here. I have something I want to show you.
- Here. - Good.
Do you, uh...? Do you know what that is?
We're gonna stabilize the sacroiliac joint,
navigating away from the great vessels anteriorly,
and then...
...the spinal canal.
Dr. Goran?
Uh, is the image intensifier in place?
In place.
Drill.
The bad news is...
...you're teeing off next Thursday.
Roy's an excellent golfer.
- I bet. Hole in one. - Mm-hm.
18 holes, you know, every Sunday, rain or shine.
But not so much lately. Am I right, Roy?
I'm sorry. Uh, do I know you?
I'm Gavin, and this is Maggie.
And you're friends of my wife's?
Yes, we are. We're... we're friends with Esther.
Yeah. It's nice to see you again.
He's just tired. Aren't you, Roy? Hm?
Where are my car keys?
You've had quite the day, haven't you, Roy?
I- I-I've got to, uh...
Oh.
Excuse me. Who are you? The mother?
- What? - Our boys.
Our boys must...
Yes, they do. They know each other from school.
I'm sorry, but I can't do this.
Gav.
Roy, I am your wife, and we've been married for 55 years.
Don't yell at me.
- Okay. - Look at me!
I have a baby at home to support!
I think I hurt my leg.
- I think she broke a hip. - Ooh.
This is Dr. Murphy.
I have an elderly patient who's had a fall.
I need an ambulance.
So much scar tissue. It's like a minefield in there.
Do you want to pull the wire out and start again, Doctor?
No, I'm past the SI joint and the S1 body.
Ah, damn it.
Get me a partially-threaded cancellous screw, please.
Okay.
- No. No, no, no, no. - Dr. Goran?
The wire's advanced too deep.
I think I just perforated an artery.
Removing the wire right now.
- Dr. Goran. - Get me some sponges, damn it.
Pressure's dropping. Systolic at 60.
I need a general surgeon.
Can somebody get this thing out of here, please?
Pour fluids. Get me two units of O-neg.
Massive transfusion protocol.
Get me Dr. Reid in here right now.
- BP 60 over 40. She's gonna arrest.
Okay, we're gonna do a midline laparotomy
to find this retroperitoneal bleeder.
I need vascular instruments...
cooleys, satinskys, 3-0 silk ties, and plenty of suction.
- Vitals are good? - Yes, sats are holding.
She's managing so far.
Ready?
- Yep. - Let's do this.
Okay, start packing.
Sponges. Keep 'em coming.
I need to establish proximal vascular control,
so I have to cross-clamp the aorta.
And...
Okay, aorta clamp.
Give me the retractors.
- In? - Yeah.
Great.
Okay, I have to get down in there nice and low.
And...
Okay, I've got proximal control.
Give me a second.
Okay, we're going to identify the ureter and the iliac bifurcation,
then we're gonna get down into the internal
and find the laceration.
Then tie off the artery that I hit.
Lactate is up to 4.8.
If she suffers an infarction to her anterior spinal cord, she...
She could be paralyzed.
What the hell?
She still has some feeling in her legs.
But she won't be able to use 'em.
- What happened in there? - I hit an artery.
Dr. Goran isn't responsible.
The wire was bound within the drill
and advanced into the retroperitoneal space.
I caused the laceration to the internal iliac artery,
and I couldn't control the bleeding.
And I was called in. We opened her up and got control.
Why did you go ahead with this surgery?
You told me you wanted me to start listening to my patients,
and this is what the patient wanted.
- So this is my fault? - That's not what I'm saying.
- It was a freak occurrence. - Yeah, you mentioned.
Okay, I discussed the various options with my patient, Dana,
and this is what we decided upon together.
Well, tell you what.
For the next few months, I want those options discussed with me, too.
Every surgery you book, you walk me through it first.
Fine.
Then, we're done.
It's not your fault, Joel.
We all have recognized complications.
You couldn't have done anything more.
My head's just not in the game right now. It hasn't been for a while.
It's just a rough patch. Every surgeon goes through them.
I just feel like working here is destroying my instincts, you know?
Okay, you know what? It wasn't your fault.
My patient is paralyzed.
You are a great surgeon, Joel.
Well, a great surgeon wouldn't have let what happened today happen.
You saved her life.
Thank you.
This way, Mr. Goldbach.
- Where are they taking him? - To admitting, Esther.
They can't take him to jail.
No, he's not going to jail.
He'll forget to take his baby aspirin.
He's just gonna spend the night in the hospital. He'll be fine.
Do you know what the problem with my wife is?
I've forgotten the details.
Because of your memory issues,
without meaning to, you got a little angry.
- With Esther? - Yeah.
She's a saint.
What I've put her through...
It's not you, Roy. It's the condition.
Son of a bitch.
If... if another guy did the same thing to his wife,
I'd say lock him up!
Hey. Uh, ninth floor, guys. We'll be right up.
Just with these gentlemen here, Mr. Goldbach.
Uh, I have a tee off time tomorrow, 8:00 a. m.
We'll get you there.
Dr. Murphy.
My office, when you have a moment.
Let's try increasing the frequency.
Nothing.
The electrodes have been in almost two hours.
I know. It's a disappointment.
I got your page.
Was there activity?
We've been zapping different areas of Charlie's brain.
There's been a host of activity...
Good. That's good.
But none inducing arousal.
Well, what is it doing?
That's the thing. I don't know.
And I don't like not knowing.
Well, then, just stimulate another part of his brain.
Okay, what part?
I don't know. I'm not a neurosurgeon.
Alex, I can't keep randomly sticking electrodes into Charlie's brain
without risking brain damage.
Shahir, you can't give up on us, please.
The chances of hitting a vein or an artery...
This is our last shot.
Shahir, please. It...
It can't be over.
It is too dangerous.
I'm taking the electrodes out. I'm sorry.
Hey. Mind if I sit?
How's Charlie?
It's not over.
Feels like it is.
Shahir's taking out the electrodes. Another failure.
I don't have any more fight left.
Yeah, you do.
You don't have to be nice.
I know.
Get out of here.
Go fight.
I want you to keep going.
And if you can't or won't do it, I will find somebody who will,
but I'd rather it was you.
Now, what part of the brain controls consciousness?
Okay, there are several.
But in this trajectory, there's the pedunculopontine nucleus.
Then, let's go there.
Alex, because of the location, there's a chance it could kill him.
You won't.
I've never been that deep in the midbrain before.
Then, don't say I've never done anything for you.
This will be our last chance.
Do you understand?
Okay, I'm setting the coordinates for the PPN.
Come in.
And close the door behind you.
Well, I've committed Mr. Goldbach.
Okay.
What you did today...
went so far beyond the call of duty in such... such a wrong-headed way.
- I was just trying to help. - Well, you didn't.
I think this new treatment model has merit.
I'm not interested in what you think, Gavin.
You don't want your residents to have opinions?
Not at the moment, no.
You gave out your cell phone number.
You received a call from a patient... a call you never told me about.
- Two rules broken. - Dr. Druckerman, we...
Then you left hospital property while you were still on call.
That's number three.
You missed a consult. There's four.
You walked into their home...
I mean, the risk you took going into their home...
Do I need to keep going here, or...?
You need to talk to the wife
and you explain to her where we go from here.
Of course.
I'm late for rounds with Kinney. I'm screwed.
- Are you okay? - Yeah.
No.
I don't know.
What's up?
Thank you for coming.
It was a complete disaster, but you had my back, so...
I owe you one.
Then, dump your new girlfriend.
Sorry.
Dump her. Marry me.
We'll be together 60 years.
Gotta burn it.
You're awake.
I don't sleep much. It's a jockey thing.
- I shouldn't have operated. - I asked you to.
I begged you to.
Right, but it was my decision, and my decision has now cost...
My legs.
You can say it.
Stacey, you will recover some more feeling in your legs.
It...
They say there's even a 20% chance that you'll be able walk again.
4 to 1 against. I've beaten longer odds.
But I'm never gonna ride again.
I'm afraid not.
You followed your gut...
...unlike me.
The trainer had asked me to choke off my colt,
make my move late up the rail,
even though he knew that's not the way I like to ride.
I didn't follow my instincts, and it cost me...
...everything.
Why am I not waking up?!
Hey, Charlie.
Why don't you wanna wake up?
John!
Look at that.
- Is everything okay? - No.
What?
I mean, that is a very strange signal.
- Are we stopping? - No.
Shahir, talk to me.
Something is happening to the signals in his midbrain.
Something I've never seen before.
Okay.
How is Roy?
Good. Yeah, they gave him something to go to sleep.
They knocked him out, huh?
Well, that's good.
Yeah. Uh...
I heard you broke your hip.
Well, the rite of passage.
All my friends are doing it.
So, as soon as I get better, I can bring him home.
- Esther... - Don't say it.
Roy needs supervision. He needs 24-hour care.
I'm his wife. I'm his care.
He belongs with me.
He needs to be in a safe environment,
for both of you.
We took vows, you know?
Till death do us part...
...even if...
even if we can't remember who the hell the other person was.
Esther, there's an excellent care facility
that's not far from your house.
But what if I refuse and I take him home anyway?
Then, the next time something happens,
we're obliged to call the police.
Roy goes into the system.
You don't want that.
No.
Can I spend one last...
...night with him?
He's in a locked ward.
I know, but he's been drugged out of his mind.
So, you know...
He won't be violent, hm?
I'm sorry.
It's against the rules.
God, I've tried so hard for so long to think, you know, for both of us.
What are you looking at?
A patient advocate web site.
Couldn't you say "porn" just once?
You're such a good boy.
Not that good.
Is that right?
A couple of, uh, first-year residents are gonna go get beers.
You wanna go?
Nah, I think I'd rather stay here.
And look at nerdy web sites all night?
Nope.
Then, do what?
I don't know.
Maybe...
...start our 60 years off right.
What can I do for you?
Let me do my job.
You make that very difficult sometimes, Joel.
And that's not gonna change.
If you can't let me make my own decisions...
Then, what?
Then, you should fire me.
I'm not gonna fire you, Joel.
But if you think I am going to let you do whatever the hell you want,
then, you're crazy.
Then, I quit.
Joel!
Okay, we got a significant response from the PPN.
Let us stay on this trajectory.
Can we increase the amplitude to three volts, please?
Nothing's happening.
Four volts.
Dr. Hamza, you're gonna fry his brain.
Shahir.
Four volts.
Come on, Charlie.
Charlie.
Come on, baby, you can do this.
Looks like you've been in quite an accident.
Um...
Get your license and registration, sir.
I wasn't driving.
Well, I've seen quite a few of these.
You're lucky to...
You're bleeding.
Do I know you?
Sergeant Howard.
Jimmy.
I didn't do anything wrong.
Of course not.
No, I just need to ask you a few questions.
Hey, you have any, uh...?
Children? No.
Good.
'Cause what's out there...
Let me tell ya.
Nothing but backstabbers, scumbags, and lies.
Charlie?
Did you hear that?
You're better off coming with me.
Charlie.
Alex?!
No.
You're just tired, Charlie.
I am.
I know.
It's been a long road with no turning back.
Come on.
Where we going, Jimmy?
Home.
Time to go home.
That's Alex.
You come with me. It's the best thing.
Come on.
I have to go, Jimmy.
Charlie.
I have to go.
Take it to five volts.
Alex.