.
- She's out. - I'll take it from here.
- Dr. Blake. You're a transplant surgeon.
I got this. - She tried to scrub in.
- How'd you guess? - I know my mom.
- You need a roof over your head, heat, running water.
- You just wanna call the shots.
You owe me $1,200.
- Do what you want with it, Mom.
- I screwed up everything today.
- I know how tough internship can be.
- Boards aren't gonna study for themselves.
- You pulled my patient's Vas-COM?
- I just think we should err on the side of safety.
- It did seem medically warranted to get her
on better monitoring.
So I just put in another Vas-COM.
- Is something going on?
- Dr. Halstead tells me you're progressing well.
- I have excellent doctors to thank for that.
- And we're very impressed with your staff.
- Well, Dr. Halstead is one of our finest.
- Don't forget Dr. Cooper. - Hey, there, what'd I miss?
- We were just discussing Eleanor's marked improvement.
How she looks much less edematous.
- Yeah, right, it's terrific.
I've been able to strategically manage her fluids
using the Vas-COM.
Sorry, I didn't mean to interrupt.
I just came in to take a quick peak at her cardiac output.
- It's all right. I have to go anyway.
I have a meeting.
- I'll walk you out, Miss Goodwin.
- You two take care.
- Still can't believe Cooper put in another Vas-COM.
- I thought it was confirmed that Vas-COM
didn't contribute to her embolic events.
- It didn't, but with Eleanor's clotting issues, it's risky.
[apprehensive music]
♪
- I heard you were here late last night.
- I had a difficult septic patient.
I didn't wanna just leave him for the night shift.
- They can handle a septic patient.
- I wanted to see it through.
- Did you get any sleep?
- Didn't we just have this conversation a week ago?
- And I'm allowed to ask you if you're taking care of yourself.
- Mom, you know you're parked in a red zone.
- Oh, no one cares.
You wanna see what I've done?
- Sure.
- I found those pillows off a couch
someone left on the sidewalk.
And look what I pulled out of a dumpster
behind Merchandise Mart.
It's silk. Feel it.
- Wow.
- And back--back there, I--I hung up a prism.
Remember that one when you were little?
All the Rainbows?
- Yeah, I remember.
And I see you have a cooler.
I brought some groceries with me,
some fresh fruits and vegetables.
What's with your arm?
- Oh--oh no, it's not-- it's not a big deal.
- Mom, let me see.
Oh, what did you do?
- I was working on the van and I--I knocked aside
that stick thingy that holds the hood up.
It got me pretty good.
- Oh, you're burning up.
- I'm wearing layers.
- Oh, mom. Oh, man. This is infected.
- No, I washed--I washed it.
- No, we gotta get you to the hospital.
- No, no, no, no, it's fine. I can take care of myself.
- Mom--Mom? Mom, Mom. No, I'm calling an ambulance.
Mom?
[tense music]
- I don't care if it's your hospital.
I don't wanna be here.
- I can hear you fine, Mom.
- But you won't listen to me.
- Hey, Maggie, can we get a room,
and is Vanessa available?
- Sure, Vanessa, you're going to treatment 3.
♪
- Hey, this is my mom, Terri. She cut her arm pretty badly.
- Hi, Terri, I'm Dr. Taylor.
- Good for you. - Mom, please.
- I don't like hospitals.
- What?
All right, on three.
♪
- The IV's for fluids. You're dehydrated, Mom.
- So get me a glass of water.
- You happen to catch them when they came in?
- I did, yeah.
- Not at all what I imagined.
In med school, Stevie was the one who had it all together.
Head of the class, full scholarship.
I just figured she was raised by some genius scientists
who made her in a lab.
- Huh.
I thought scholarships are usually for students
in need of financial aid.
- Your bilirubin levels are high
but they seem to have plateaued at the moment.
How are you feeling, Sheldon?
- Like every second could be my last.
A real thrill.
- I know how difficult this has been.
I want you to meet Dr. Marcel.
He's taken an interest in transplant surgery,
and he's been shadowing me.
- Hey, Sheldon.
- Dr. Marcel, are you going to get me a liver?
- Oh, well, uh, we're working on it.
- You're at the top of the transplant list.
So there's a good chance that the next one
that matches has your name on it.
- Okay, I'll try not to die in the meantime.
- You do that.
- Bye.
[pensive music]
He got his humor. That's a good sign.
- I'm not sure if it's really humor
or his hepatic encephalopathy.
- How long has he been waiting?
- Eight months.
- Wow.
Kinda makes you feel helpless.
- It's definitely not the ED.
Someone lands here, and you can't just get right to work
resetting a bone.
In transplant surgery, unfortunately,
it's all about waiting.
- Dr. Scott, you're up.
You're going to treatment 4.
And by the way, we're short-staffed today,
so I'm gonna be assisting you. - Oh, let's do it.
Who's the patient? - 9-year-old Siobhan Murphy.
She fell down a flight of stairs.
- Those her parents?
- Yeah, Kate and Brandon. - That guy looks familiar.
Mr. and Mrs. Murphy. I'm Dr. Scott.
This is our charge nurse, Maggie,
and you must be Siobhan.
Uh-oh, I know that look.
- We're pretty sure Siobhan broke her arm.
- She fell down the stairs of our apartment complex.
Do I know you?
- Oh, I don't think so.
All right, Siobhan, what happened?
- I guess I tripped.
- She's never been the world's most coordinated person.
- So just a normal run-of-the-mill trip?
Nothing in front of you but you're own two feet?
- I don't really remember much. When I fell, I hit my head.
Since then, it's all been a little foggy.
- So we need to get a head CT
to check on that brain fog, yeah?
- Okay. - May I look at your arm?
Let me see.
Get an X-ray on the arm.
- Uh-huh.
- Okay, Siobhan, so we are gonna take a few pictures
of your arm and the inside of your head.
Sound like a plan?
Okay.
- I will be right back with an X-ray technician.
[apprehensive music]
Hey, what was that between you and the dad?
- I realized how I know him.
I arrested him for assault and battery 10 years ago.
- Really? Hey, is that gonna be an issue?
Are you sure you should be on this case?
I can call peds and get somebody else.
- Oh, no, no, no. It's fine. I'm good.
♪
- I'm sorry, you're missing a whole column over here.
You need to re-do this. Okay, I'm sorry.
- Dr. Marcel, you made it. - Hey, sorry I'm late.
I got caught up with a patient in the ICU.
- Remember, there's a reason why it's called
the Emergency Department, yeah?
- Dr. Archer, Dr. Marcel, we have trauma incoming.
Nancy, you're good? Lacey, talk to me.
- John Doe, age unknown,
most likely a long-distance swimmer.
Crew team found him floating in Lake Michigan,
fished him out and performed CPR.
CFD defibrillated him once,
got a rhythm, and intubated in the field.
- Why are you still doing compressing him?
- I lost pulse about 30 secs ago.
Gave him a milligram of epi.
- Okay, here we go. Nice and easy, okay?
All right, we're gonna transfer on my count.
One, two, three.
Continuing compressions.
[tense music]
Pulse?
- No pulse. - Continue CPR.
[sustained high-pitched tone]
- He's in V-fib.
Give me the paddles, charge to 200.
- Charging.
- Okay, clear.
[machinery beeping]
We got a pulse. Sinus rhythm.
- All right, he's hypothermic.
Can we get some warm blankets, please?
♪
All right, pupils are fixed and dilated.
- That brain's been without oxygen for a while.
Nancy, CT for a panscan, please.
- And also, let's call CPD up in here.
They can run his prints. Maybe they can identify him.
- Hey.
I just wanted to say I'm sorry about your mom.
- You're surprised. - Surprised?
- She looks like a street person, right?
You weren't expecting that.
- If you need any help...
- Thank you.
It's nice of you,
but I've been dealing with this a long time.
- Just forwarded your mom's labs.
- Yeah, it's about what I expected.
- Are you sure you don't want an attending instead of me?
- This way I can stay on top of her case.
- Okay, well, how do you wanna handle this?
- You take the lead.
She's more likely to listen to you anyway.
- Terri, you definitely have an infection in your arm
that has spread to your bloodstream.
We have to treat it like MRSA until your cultures come back.
- We already knew it was infected.
- Yes, Mom, but this particular type
of infection is resistant to most forms of antibiotics.
- I thought she was my doctor.
- We can still treat it, Terri.
We'd like to put in a PICC line.
- It's a catheter we'll leave in your arm.
- Because if you do have MRSA--
- It's a minimum of six weeks of intravenous antibiotics.
- Out of the question. - It's not really optional.
- You can't force me to take some medicine I don't want.
- We have no intention of forcing anything.
- But if the infection goes untreated, then it could spread
to your heart valves and turn into endocarditis.
Which could kill you.
- Six weeks I have to keep coming back to the hospital?
No.
- We could also make arrangements
for a home health nurse to come to your house.
- Or wherever you're staying.
- She's ashamed of me because I live in a van.
- Once the infection is cleared, then we can--
- No, no, I'm not letting you put some thing in my arm
so you can reel me back like a fish whenever you want.
.
- How long has this been going on, Gordon?
- Just a few days-- - A week.
- Marielle's been nagging me to get this looked at,
but sure it's just a cold.
- What kind of cold makes it hard to breathe?
- It's called a chest cold, hon.
- COVID PCR test came back negative.
- Let's get a CBC, BMP, ABG,
blood and sputum cultures and chest X-ray.
- You got it.
- We're gonna get to the bottom of this, Gordon.
You sit tight.
- Don't worry. I won't let him go anywhere.
- She's a tyrant, doc.
Wouldn't even let me get a motorcycle.
- 30 years, he still talks about that.
- Just my two cents.
But you should keep listening to her.
- [chuckles] - Thank you.
- And here is your large green tea
with extra honey, Dr. Charles.
- Thank you, Olivia.
- Dr. Charles, do you have a minute?
- Yeah, of course. What's going on?
- Uh, my, uh, my mom came in earlier.
I think you saw. - Yeah, I did.
- Yeah, I was hoping that you might talk to her.
She has a MRSA infection,
but she won't get treatment for it.
- Oh, boy.
- Yeah, she's always been this way.
I can't even get her to commit
to taking her blood pressure medication,
much less intravenous antibiotics.
- Frustrating, right?
- Yeah.
She and I kinda speak a different language.
It's kinda why I was hoping that you might have
a better chance of changing her mind.
- Happy to give it a shot.
Anything else you think that I should know?
- You'll see pretty quickly what you're up against.
- Okay, it's just, you know,
don't wanna be flying blind, that's all.
- It's complicated, my mom and I.
My dad left before I could even remember.
We spent my childhood bouncing from apartment to apartment.
Sometimes leaving in the middle of the night
to avoid paying the last month's rent.
- Pretty chaotic.
- Yeah, at the time I thought it was normal.
It was all I knew.
And she wanted to make a home for us.
She really tried.
She just couldn't get out of her own way.
- How--how do you mean?
- She couldn't hold down a job.
She'd mouth off to a boss, get fired.
- Right. - She started drinking.
Started using.
We wound up on the street. - Oh, man.
- I'm pretty sure she has some undiagnosed mental illness.
- Right. - Yeah, you'll see.
- I thoroughly appreciate how absolutely brutal
this must be for you.
And I also get how it might really simplify your ability
to treat your mom if I were to declare her incompetent.
- If that's what it takes.
- But you also know that in order for me
to take away a patient's decisional capabilities,
it's--they just have to meet
a very specific set of criteria.
I just--I just don't want you to get your hopes up, okay?
But I'm only too happy to speak to your mom,
and I--I really appreciate all the detail you give me, okay?
- Thank you. - You bet.
[pensive music]
♪
- It's an isolated fracture of the ulna,
but it should heal up just fine after
about a month and a half in a cast.
The good news is, Siobhan, you get to pick the color.
What's your favorite color? - Purple.
- You know, I always forget what two colors make purple.
I know it's blue and---
- Red. - Ah, okay.
We got a purple expert, y'all. [chuckles]
It seems like the brain fog has lifted.
So there's no problem there. - Thank God.
- I did wanna ask about Siobhan's history.
I saw in the electronic medical records that she landed
at East Mercy's emergency room about a year ago.
- That was another terrible accident.
- Siobhan just doesn't pay attention sometimes.
Her head's in the clouds.
- We'd come inside from the grocery store.
It had been raining, and I was unloading the groceries,
and I--I left my umbrella on the kitchen tile.
And when I finally went to pick it back up again,
there was this puddle of water underneath and--
- That's all we can think of.
- I--I thought that I cleaned it up,
but I guess I must have missed some and--
- Yeah, she had a head CT then too.
- Yeah, she--she fell and hit--hit the back
of her head on the kitchen counter.
It took four staples to...
- But like we said, Siobhan's always been kind of clumsy.
[apprehensive music]
- And what do you think, Siobhan?
Are you clumsy?
- I guess I do fall down a lot.
- We'll have an orthopedic resident coming soon
and cast Siobhan's arm.
- And we'll go make sure he brings his purple casting tape.
- Call DCFS.
- Wait, what are you talking about?
- There's a pattern of suspicious injuries.
- Yes, but they explained what happened
and--and Siobhan confirmed it.
- What do you think she's gonna say, huh?
If there's one thing I learned from my days at CPD,
is that the more convoluted the story sounds,
the more likely it is not true.
- Yes, but to call DCFS on that with what little we saw?
Do you know what it could do to those parents?
- If you won't call them, I will.
- No, I--
[sighs]
- So your mom is-- she's depressed.
She--she's definitely anxious.
I wouldn't be surprised if a proper clinical evaluation
would yield a bipolar diagnosis.
But right now she has capacity.
- Even if she refuses to take care of herself?
- It doesn't disqualify her
from making her own medical decisions.
- What if it kills her this time?
- She seems to be aware of the risk.
- I didn't wanna suggest this before running it by you first,
but there is a pill form of antibiotics
that's had some success with MRSA.
- Linezolid, I know, but she'll never stick to the regimen.
- You know, could be different this time.
- Why?
- Well, for instance, with her blood pressure medication,
right, that she won't take,
we don't experience high blood pressure physically.
But your mom, she has a high fever.
Her arm is swollen. She's in a lot of pain.
It's possible that her physical symptoms
could compel her to act.
- And if they don't?
- Unfortunately, it's her decision to make.
- I'll talk to her. I'll see what I can do.
- Thank you. - Of course.
♪
- So how's our John Doe?
- Well, head CT is really tight,
brain is very swollen, bad anoxic injury.
I mean, the prognosis is not good.
Any word from CPD?
- Only that his prints didn't turn up any records.
- Oh. So what now?
- There's gotta be somebody out there
looking for this poor man.
Let's give 'em a chance to come out of the woodwork.
- Right.
- Just the man we're looking for.
- Oh, there she is.
Heard you're being discharged today.
How you feeling?
- I'd feel better if I were walking
out of here on my own two feet.
But my mother is taking me home and insisting
on the wheelchair. - Ah.
- A little overly concerned about
adhering to hospital policy, if you ask me.
- I am afraid you'd sue
the hospital if given the chance.
- Uh-oh.
- I wanted to thank you again, Dr. Marcel.
- Yeah, it was my pleasure. Just happy it all worked out.
- Is that the John Doe that I heard about?
- Yeah.
- How's he doing? - Not good.
He suffered major oxygen deprivation
for an extended period of time.
So likely looking at irreversible brain damage
at this point.
- Avery, I'm gonna call you an Uber.
- A minute ago you're insisting I stay in the wheelchair.
- I'm sorry, sweetie.
I just remembered I have some charting to do.
I'm gonna circle back.
I'm interested in seeing what happens with this patient.
♪
- What's going on, Mags?
- DCFS. Suspicion of child abuse.
- Yeah, that is always hard.
- I just hate seeing families go through this.
[alarm blaring] - Somebody help!
Something's wrong.
- Give us some space.
Sats down to 64, not responsive.
- Start bagging. We have to intubate.
- What's happening to him?
- He's not protecting his airway.
He can't breathe.
- Why--why?
- I don't know yet. 20 of etomidate, 100 of sux.
- Oh, God. You've got to save him.
- Hey, I promise. I'll do everything I can.
- Gordon is all I have, please.
[machines beeping]
.
- Vanessa, come here.
You remember how I said my mom won't take her pills?
- Mm-hmm. - Check this out.
- What am I looking at?
- New technology called a nanodrug.
It's a smart drug that works
with the digital feedback system.
- I don't understand.
- It's for patients that forget to take their medicine.
Their caregivers can track the exact date and time
that a patient ingest their pills on a phone app.
- How? - Watch.
Each pill is embedded with a microscopic nanosensor.
When it dissolves in the stomach acid,
the sensor then sends a signal
to a patch on the patient's body.
And that patch tells the phone app.
I could track whether my mom's taking them or not.
- But her antibiotics don't have nanosensors.
- Well, researchers at Med are working
on their version of this.
They said they can add nanosensors to any pills.
So when my mom's are ready at the pharmacy,
let me know, okay?
- It's--it's cool, I admit it.
But how are you gonna get her to sign off on this?
- I mean, does she have to know?
[apprehensive music]
- What is it? What's wrong?
- I'm having trouble oxygenating him.
- Hi, there. I'm Dr. Cooper.
- Matt, there must've been a mistake.
I asked for the pulmonologist on call.
- Your request came to my unit,
and as the critical care doctor on call, you got me.
Excuse me. Are you the patient's wife?
- Marielle.
- Marielle, this is what I do. Okay.
I'm--I'm confident I can address your husband's issues.
All right.
- Gordon came in with a bad case of pneumonia.
I had to intubate him.
But I'm having difficulty achieving
adequate gas exchange.
I thought he was fighting the ventilator,
so I sedated him with propofol
but his airway pressures are still up.
Not--not exactly sure what the problem is.
I think an early ARDS.
Already started him on the ARDs net protocol.
- ARDS?
- Acute Respiratory Distress Syndrome.
There are tiny elastic sacs at the base of the lungs.
It seems Gordon's are not properly exchanging oxygen.
- So to improve his gas exchange, we need
to sedate him more deeply and then paralyze him.
- Paralyze him?
- Yeah, I know that sounds extreme.
In this case, it's necessary
to reduce the pressures inside his chest.
- And to do that, you need to paralyze him?
- Hey, can I talk to you outside for a second?
- Sure, yeah.
- Marielle, we'll--we'll be right back
- Paralyzing people in this context often leads
to increased morbidity and mortality.
I mean, there must be something else we can do.
- Believe me, Will, I wish there were another way.
But unless we paralyze him and get him oxygenated, he'll die.
Put him on an atracurium drip.
Use dexmedetomidine instead of propofol
and, uh, I'll be back in a little bit, okay?
♪
[alarm blaring]
- What do we got? - Heart rate's 30. Dropping.
- Milligram of Atropine. Let's go.
I don't feel a pulse.
Are you in?
- Atropine's in. - Okay.
Okay, we got a pulse.
- Heart rate's 60.
80.
Holding at 84.
- Good, good.
- Nice work.
You know, I can see from his labs
that his bilirubin levels are good.
That's good news for his liver.
You should check his blood type.
- Nancy. - Yeah.
- Look, I'm not so sure about that.
- Crockett, we gotta think about Sheldon.
- Dr. Blake, you know, unless this patient
has a relatively legal representative
to speak on his behalf, his organs are off-limits.
- Which is why we got to track down a relative
or a legal representative.
- Pamela, I don't believe this is your patient.
- He isn't, Dean. I'm just passing by.
- Oh, in that case, I'd prefer you keep passing as Dr. Marcel
is very busy keeping this man alive.
- I'll be in touch, Crockett.
- Boy, I had no idea you
and the renowned Dr. Blake were so chummy.
- I've been assisting her on some cases.
- Oh, right.
Is that why you were late this morning?
- I'm considering applying
for a fellowship in transplant surgery.
- That's good for you.
But when you're down here, you represent the ED,
and these patients deserve just as much care
and concern as any patient upstairs.
[tense music]
♪
- Kate, Ms. Gastern's ready for you.
- Brandon would do anything for Siobhan.
He's a great dad.
- Oh, it's not for me to decide.
- It was one bar fight.
It was the wrong place at the wrong time.
He hasn't even had a drink since Siobhan was born.
- So Brandon recognized Dr. Scott this morning?
- It was the only crime that Brandon ever committed.
Of course he would recognize the officer who arrested him.
And--and that's why we were when eggshells when Dr. Scott
was asking us all those questions.
- I understand.
- If we lose our little girl, I don't know what we'll do.
- I've known Madeline Gastern for a long time.
She'll give you a fair shake.
- Okay.
- Dylan, I have to ask you.
Is your relationship with Brandon Murphy
affecting your perception of this case?
- Listen, all the evidence we found today
points to child abuse.
It's all right here in Siobhan's medical files.
- Dylan, all I'm asking is that
you take a look at everything that's gone down today.
Are you absolutely sure there's no other explanation?
♪
- How can you stand it here?
The smell, and -- and it's freezing.
Will you please just let me go?
- We were waiting on your prescription to be filled,
but good news, it's ready.
Your antibiotics. Twice a day with food.
This is a 14 day supply,
and you need to refill your prescription twice.
- I'll take care of the refills, mom.
- I can do it.
- If you could just lift your gown a couple of inches
for me, Terri, I'm gonna place this patch.
- What--what do I need a patch for?
- It helps track your meds. - Tracking?
What are you talking about? Who's tracking them?
You?
Get that away from me and these too.
Stop telling me what to do. - I'm just trying to help you!
- I'm not taking your pills,
and I'm not staying in your hospital.
Get me out of here now.
♪
.
- Yeah, paralyzed him as you suggested,
but I'm not seeing any improvement.
Oxygenation is still extremely poor.
- Okay, let's try some vent changes.
I'll do a recruitment maneuver.
- What's that?
- So I'm going to expand Gordon's lungs to allow
for a better exchange of oxygen for CO2.
- I'm--I'm sorry.
- If you think of Gordon's lungs like two balloons,
I'm going to blow them up so they can take in more oxygen.
- Is that safe?
- You know, it's not a procedure I've done before.
- Look, Dr. Halstead is an excellent doctor,
but he's not a lung specialist.
He doesn't have experience using the ventilator
in this manner.
We're all going to do this together.
All of us, okay?
Time me, Dr. Halstead. 30 seconds.
[apprehensive music]
♪
[knock at door]
- You saw that, right?
- I did.
- I don't know what to do anymore.
- Say you--you've essentially been parenting your mother
for most of your life, right?
- I never thought of it like that, but yes.
- It's hard work.
- And for what?
So stupid to think that I could ever get her to change.
Obviously, that's not gonna happen.
- Okay, now that you're not asking me for my advice--
- No, I am.
- Okay, well then maybe it's time for a different approach.
Something perhaps less parental?
- Like what?
Let her just do whatever she wants?
Just walk away?
- Well, you see the thing about taking a step back, though,
is that it might benefit the both of you.
- Well, it seems pretty optimistic.
- I don't know, I mean, at the very least,
you would be getting a very much-deserved break.
And I think that might be a really good thing.
- In three, two, one.
[machine beeps]
- No change. Set the timer 30 again.
Wait, sats are climbing.
80, 84.
89.
91 and holding.
- That's good, right? - Yes.
[heartwarming music]
- Yeah. - You did it.
- So is he okay?
- He's much better than he was. I'm hopeful that he will be.
- Thank you so much, Dr. Cooper.
- Yeah, I'm happy I could help.
- All right.
♪
- Here we are, Mr. Sussman.
- Uh, what's all this?
- Dr. Archer, this is Marc Sussman.
- And he's here because-- - That's him.
That's my cousin, Ricky.
Oh, man.
- We'll give you guys some space.
- How?
- Did you see the scar along Ricky Sussman's hip?
- Yeah, I thought it might've been from a hip replacement.
- Yeah, it was.
When I looked back at the CT
I saw his prosthesis had an identification chip.
So I had it scanned,
called around several device manufacturers
until one claimed the chip's serial number.
- That got you to his name.
- From there, tracking down his cousin was pretty easy.
- I suppose if his cousin decides
to withdraw life support and donate his organs,
then you and Dr. Blake might just get
what you've been hoping for.
[tense music]
- Now, hold on.
We had a moral obligation for Ricky's sake
to find his next of kin.
- You tell yourself that.
♪
- Hey, Maggie, can you get Brandon Murphy
and bring him into the consultation room?
I think I might've figured out what's been happening here,
and it's not child abuse.
- Uh, should I step out?
- Actually, if you don't mind,
I'd like Ms. Gastern to hear this,
as I believe Siobhan's medical status might clear things up.
I went back and took a look at her scans.
This is Siobhan's head CT from East Mercy last year.
And this is the one we took this morning.
- They look exactly the same to me.
- That's what I initially thought too.
But then I noticed this.
Siobhan's cerebellum has shown some signs of atrophy
in this last year.
- Atrophy?
- Meaning there's been a loss of brain cells.
It's subtle, but if you look really close,
you can see that this part of the brain
is somewhat smaller in appearance.
Might explain why she's always been a little clumsy.
Has that gotten worse this year?
- I--I suppose so.
- I believe that that is a result
of these changes in her cerebellum,
which is the part of the brain that controls coordination.
- Are you saying Siobhan has a brain disorder?
- Not exactly.
I believe she has an illness which causes her
to not produce an important enzyme called HEXA.
The name of the disease is Tay-Sachs.
- Tay--Tay-Sachs? I think I've heard of that.
- With your permission,
I would like to test Siobhan to see if she has it.
- Of course.
Anything to figure out what's causing this.
- I'm gonna help you figure this out.
[pensive music]
♪
- I hated having to put my faith in Cooper,
but he did everything right.
And without him, I would have lost my patient.
What if he's not the guy we think he is?
What if all our suspicions around dubious consulting fees,
kickbacks, malpractice, what if it's just projection?
- Well, that's why we have to be absolutely positive
before we make any public accusations.
- I just hope we're doing the right thing, that's all.
- I hear the relative met with Organ Donors of America.
- Since the patient suffered an irreversible brain injury,
cousin wants us to withdraw support
and pursue DCD organ donation.
- All fingers crossed his liver is a match for Sheldon's.
- Mm-mm. - It's not?
- Nope, Organ Donors of America will be transporting
the patient's liver to a recipient in Milwaukee.
- Well, I guess we'll just have to keep on waiting.
- You know, I have to say,
I'm not exactly comfortable with what I did today.
[tense music]
- Your patient had no chance of recovery.
And now thanks to his cousin, both you and the hospital
are relieved of any ethical concerns
regarding his end-of-life decision-making.
More importantly, someone in Milwaukee gets
a chance to extend their life.
What's the problem?
- Just not sure whose interests I had at heart today.
- Crockett, it's a sad fact, but in this business,
only 7% of transplants come from living donors.
For someone to live, someone else has to die.
If you can't handle that, then maybe you weren't cut out
for transplant surgery after all.
♪
.
- Finishing up the discharge paperwork for Siobhan.
Finally get them home.
- How are they doing? - They're coping.
But it's tough. There is no cure for Tay-Sachs.
But the fact that it's late-onset is a good thing.
The decline is much more gradual,
and Siobhan's symptoms aren't really that severe.
- You did good today, Dylan.
It was a nice catch.
- Yeah, wouldn't have happened if it wasn't for you.
Sometimes you gotta check yourself.
Thanks for reminding me.
- I have officially filed your paperwork,
and you're free to leave.
Here are your clothes.
- When you see Stevie, tell her I--
Actually, don't tell her anything.
- Hey, listen, I might've been a little abrupt this morning.
- You? No.
You were in the right. I was being nosy.
- No. It's--it's no big deal.
- No, I was mothering you, and I--I shouldn't.
I won't do it again.
- I don't know.
Maybe you looking out for me isn't such a bad thing.
[pensive music]
- In that case, get some sleep.
- Okay.
♪
- Dylan, I wonder if you can help me out.
- Yeah, what's up, Stevie?
- Do you know anyone I can call
to get an illegally parked van towed?
I'm not getting anywhere with the city.
- Yeah, I know a dude over at
Department of Streets and Sanitation
that could probably have it towed.
Texting you his number right now.
- Great, thank you. I appreciate it.
♪
- Hey, Stevie, how's your mom doing?
- She's gonna be okay. Thank you.
- Good. - You know what, I gotta run.
- Yeah. [phone dings]
- Time of death, 19:34. - No!
- I'm so sorry. - No, no, Ellie!
Ellie, no, no.
[somber music]
♪
- Is there any chance the Vas-COM caused this?
- Eleanora was hypercoagulable.
If she had another embolic event,
it's certainly possible.
- Then Dr. Cooper may have killed her.
♪
- What are you doing here?
- Waiting, like you.
I think I wanna do this.
Help people like him.
[apprehensive music]
♪
- No, no, no!
- Mom? - It's gone! They towed it!
- What?
- They said a tow truck came and took it!
- Hey, it's okay.
Hey.
So what are you gonna do? - All my stuff was in there.
My tent, my blankets, everything.
- Hey, Mom, stay with me tonight, okay?
Please. No, it's cold out here. You can't stay out here.
Please, come on. Let's go.
- [sobbing]
- Mom, please.
♪
Hey, I know how upsetting this is, okay?
But we'll figure it out, okay?
- Just go.
- And I'm--I'm sorry about before.
I never should have tried to trick you.
And I was coming here to try to persuade you
one last time to take your antibiotics.
But here.
Mom, whatever you decide, it's up to you.
♪
[dramatic music]
♪
[wolf howls]