09x03 - What Happens in the Dark Always Comes to Light

[bunniefuu]

[DRAMATIC MUSIC]

Oh, what do you think you're doing?

Sorry, I didn't' feel like
we had another choice.

Dr. Ahmad, your residency here

will be on a probationary basis.

What the hell's going on?

Walking off the floor without
notifying a supervisor?

There's not gonna be another warning.

Ben is the one who pulled
the plug on this marriage.

Come on, Maggie.

We're almost at the finish line.

I really just wanna move on.

Get me out of here!

- Get away from me!
- Dr. Ripley,

What you did today was reckless.

Reckless?

Impulse control disorder?

Isn't that what you called it back then?

I'm an attending physician
at this hospital,

not the boy you knew 20 years ago.

[ROCK MUSIC PLAYING]

♪ ♪

Yo, Asher! What are you doing here?

Mitch, what are... hey.

What are you drinking?

Um... I'm... I'm not.

- It's club soda.
- You don't drink?

I do not.

I'm a recovering addict.

Which... I will tell you
all about that another time.

But right now, you have to go away.

You do realize this is
a public establishment, right?

I'm... I am waiting on a date.

First date.

And he's going to be here
any minute, so...

What? No.

No, you...

I got my eyes glued to the door.

I will split the second he gets here.

Fine.

So who's the guy? How'd you meet?

[CHUCKLES] His name is Kyle.

And he's an architect,
and we met on a dating app.

Commercial architecture? Residential?

What's the name of his firm?

OK, what are you doing here, hm?

You don't seem like the type to
venture out on a school night.

Is that your polite way
of calling me a loser?

[LAUGHS] No.

You're always working late,
running at some ungodly hours.

Those degenerates, they dragged me out.

I've known most of them
since grade school.

I didn't know you were a Chicago boy.

Born and raised.

Just been away a lot of years.

It must be nice being home.

I think Romeo has landed.

♪ ♪

Whoa, that was...

Nice break, bro.

[INDISTINCT CHATTER]

[LAUGHS]

♪ ♪

Somebody call 911!

I need help!
My girlfriend just passed out!

We're doctors!

You got to help her. Please.

Somebody's calling 911.
Paramedics should be on the way soon.

Her breathing's slow and shallow.

Eyes are pinpoint. What's her name?

- Uh, Becca.
- Becca?

- Hey, wake up, Becca!
- Did she take something?

We need to know so we can help her, man.

Come on! What did she take?!

Coke. But just a hit.

Is this an overdose?

How do you OD off just one hit?

- You wouldn't.
- No, Unless...

Cocaine was laced with fentanyl.

I have Narcan in my purse.

The blue bag under the bar on the hook?

It's OK, I'll get it.

Hey.

- Hey, you doing OK?
- I... I don't...

- OK, OK.
- I don't feel so good.

Did you take a hit, too?

Here.

Thanks.

You're OK. You're OK.

Mitch?

Yeah.

[TENSE MUSIC]

Come on.

♪ ♪

Welcome back, Becca.

- Take a breath.
- Come on.

It's OK. Just breathe.

Tim?

What's wrong with him?

Got any more Narcan? This didn't do it.

- He needs another dose.
- No, I don't.

Does anyone have Narcan?

I'll ask around.

Airway's open, but he's not breathing.

Baby, you have to wake up.

I'm gonna start rescue breath.

No, no, Mitch, wait!
You don't have a mask.

- Wait for the paramedics.
- Hannah!

He could cough up blood.

- He could...
- I know the risks.

Hey, doc, what do we got?

Suspected fentanyl overdose.

We already administered
one dose of Narcan.

♪ ♪

Baby, open your eyes.

♪ ♪

[CRYING]

Welcome back.

♪ ♪

CPD tested their dr*gs.

Came back positive for fentanyl.

There's been a huge uptick
of overdoses in the ED lately.

Yeah, a lot of them
just like Becca and Tim.

They're recreational users,
no clue their dr*gs

are laced with fentanyl.

I'll make sure they go home
with some fentanyl testing strips.

Thank you, Juliette.

Your date's waiting.

He is?

Your 6 o'clock. Just be cool.

[LAUGHS]

Well, uh, see you tomorrow.

- Yeah.
- Yeah.

Yeah.

Get some sleep tonight, Asher.

Wow.

You're... you're like
a real-life superwoman.

No.

No, I'm just glad everyone's OK.

Yeah.

So what do you say we, um...

we pick up where we left off?

I actually... I have to get going.

I've got kind of
an early start tomorrow.

Oh.

Yeah, I mean, I get it.

But it was really lovely
to meet you, Hannah.

[SOFT MUSIC]

♪ ♪

Big plans tonight?

No.

I, uh, got a board meeting later.

- Giving a presentation?
- No.

I'm actually joining the board.

Well, I must have missed
the announcement.

Well, there wasn't one. My request.

Not big on fanfare.

So the board just
created a seat for you?

Well, for a hospital physician, so...

But they asked you?

Seems that way.

I'm just glad I get to,
uh... to advocate

for the medical staff.

Well, congratulations.

You must be very popular with the suits.

Dr. Ahmad!

Got an ambo pulling up,
going to treatment three.

Duty calls.

By all means.

[ALARM RINGS]

- We're going into three.
- Got it.

Vince Gonzalez, 38-year-old male,

briefly lost consciousness
after vomiting.

BP 85 over 52,
gave two liters in the ambo.

Hi, Mr. Gonzalez. I'm Dr. Ahmad.

[GRUNTS] It's Vince.

Do you know if he hit
his head when he passed out?

No, Vince was already on the ground.

He just kind of slumped over.

And he wasn't out long,
just a few seconds.

Thank you. And you are?

Ty. I'm Vince's husband.

We'll take good care of him.

♪ ♪

OK, on my count... one, two, three.

[GROANS]

OK, Vince, do you mind leaning forward?

I just want to listen to
your lungs from the back.

[PANTING]

Clear breath sounds bilaterally.

Oh, honey.

Oh.

I am so sorry.

It is so fine.

It happens more than you think.



I'm on it.

Excuse me.

Hey.

[WHISPERING] You, um... you
have some vomit in your hair.

Dennis Washington.

- How you been?
- Hey, Dan.

- How are you?
- Dr. Washington.

Good morning. What can I do for you?

I wanted to follow up on that
matter I emailed you about.

Oh, right. Of course.

We can talk in my office.
We'll see you later.

I'll see you at the Exec
Med Committee meeting Friday.

Only if I can't get out of it.

You forgot it by the toaster.

[CHUCKLES] Stop.

I got to stop leaving my things.

Hey, I don't mind.

[CHUCKLES]

It gives me an excuse to
come see you during the day.

Dan doesn't know about us, huh?

Dennis.

I know, I know, I know.

You're not telling folks
for the time being.

Have you told anyone?

No. I'm confused.

I mean, would it be the
worst thing if people knew?

No, no.

Of course not.
It's just that you're the...

you're the chief of a department,

and I'm a member of hospital leadership.

It's not prohibited.

Sharon, colleagues date all the time.

- It's not a big deal.
- Yeah, but it is to me.

I've always had this strict
policy of not mixing my work

life with my romantic life.

Until now.

And I appreciate you
making that exception.

Believe me.

[CHUCKLES]

There's no rush.

We'll take our time
integrating both worlds.

Besides, it's kind of fun
sneaking around.

[LAUGHS]

[HOPEFUL MUSIC]

♪ ♪

Got a minute?

Need a surgical consult.

Uh...

Patient's name is Vince Gonzalez.

He's got metastatic abdominal
sarcoma, presented to the ED

with nausea, abdominal distension,

and severe belly pain.

Poor guy can't keep anything down.

Does he have an obstruction
or perforation?

- Free fluid?
- Not on CT.

But the tumor is severely compressing

his stomach, hence the nausea.

Yeah, I'm not seeing why
you need a surgical consult.

I mean, if the tumor is metastatic,
it must have been inoperative.

Correct.

And if he's not completely obstructed,
what do you need me for?

Well, if you debulked
a portion of the tumor here,

then it would allow food to
pass into the small intestine.

So would a feeding tube.

He doesn't want a feeding tube.

Surgery would afford him
a much better quality of life.

Or it could cost him
whatever time he has left.

I mean, we're talking about a patient

who underwent multiple rounds
of chemo, I'm sure, right?

With zero complications.

He's remarkably fit and
healthy, despite the cancer.

I know this isn't
exactly a sexy surgery.

Whoa. I beg your pardon.

"Sexy surgery"?

I know surgeons
don't like to get involved

in palliative care.

Well, that's quite
a generalization there.

♪ ♪

All right. Let's have a look.

Send me the chart.

Don't be brave, OK?

Tell me if it hurts when I push.

I'm all right.

OK.

Well, your CT didn't show
an obstruction,

but just wanted to confirm.

So, Dr. Marcel?

- Yeah.
- Here's the thing.

My husband and I are supposed to fly
to Italy in three weeks.

My grandmother was from Positano.

I've always wanted to go,
and we figured,

no time like the present.

You know, how are you doing
with daily activities, Vince?

Things like dressing,
housework, driving?

Before I started vomiting my supper?

I was totally functional.

I can attest to that.

Most days, Vince has
more energy than me.

You ever had complications from surgery?

Post-operative issues,
issues with anesthesia?

No, I had my appendix out when I was 25,

but I didn't have any problems.

Good.

I'm glad to hear it.

Because there is a surgical option

that could get your GI system
working again.

I like the sound of that.

Why don't you present it, Dr. Ahmad,

since it was your suggestion?

OK.

Morning.

Your night turn out all right?

It did, actually.

It ended up being
a pretty good first date.

- Oh, yeah?
- Yeah.

Dr. Ripley, we have a potential wrist

fracture in treatment six.

You mind starting the workup?
I'm just finishing up with a patient.

You're lucky I like you.

For now.

Thank you, Maggie.

Mm-hmm.

OK.

So, Mrs. Moore,
I understand that you fell

getting out of your car.

Mind if I take a look?

I just want to check if it's swollen.

I'll be gentle.

Pam, let her look.

My wrist is fine.

I didn't fall.

What?

I don't understand.

I'm sorry, honey.
I didn't have any other choice.

What are you talking about?

[SIGHS]

My husband is depressed
and refuses to get any help.

Pamela!

And I am so afraid
he's gonna hurt himself.

[TENSE MUSIC]

♪ ♪

Look, I appreciate you have
to do your due diligence.

My wife mentioned the
possibility of self-harm,

so you can't just send me on my way.

Yeah, she mentioned to Nurse
Lockwood a comment you made.

Right.

I said something stupid
like, "Going to bed

and never waking up sounds
like a nice way to go."

Huh.

Come on. I was speaking generally.

A nice way to go, as opposed to,

I don't know, getting hit by a bus.

OK.

Um, apparently, you have
been losing some weight.

I was diagnosed with type 2
diabetes not long ago.

I've been pretty diligent about my diet,
getting regular exercise.

Frankly, I'm glad
the hard work's paying off.

Well, then, Paul, help me out.

I mean, why do you think
that your wife's

so concerned about you?

[SIGHS]

I admit I haven't been
in the best mood lately.

My fuse is probably shorter.

Yeah.

I mean, she's... she's concerned that,

you know, you've been isolating,

withdrawing from her, your friends.

I haven't felt like socializing lately.

So when was the last time...

Let me save you some time, OK?

I have no intention
or desire to hurt myself.

And I'm glad to hear it.

So ask whatever questions you need

to cover the hospital's ass.

I am not suicidal, Dr. Charles.

Pam is just making something
out of nothing.

Her specialty.

Mm.

♪ ♪

Within an hour
of posting Vince's surgery,

his insurance company denied it,

rejected it on the grounds of it
not being medically necessary.

There are alternative treatment options.

The feeding tube Vince doesn't want.

Yep.

Man, I am so fed up
with prior authorization.

About a dozen times a month,
my patients get screwed by it.

What insurance does Vince have?

Berninger Health Network.

Of course, one of the worst.

They deny more patients
than any other company,

pay physician reviewers
six figures to look at charts

and find reasons to deny.

[INDISTINCT CHATTER]

I guess we should tell him
before he gets a form

email from his insurance.

Yeah.

[SOFT MUSIC]

♪ ♪

So what's the verdict?

Is his wife right
that he's a danger to himself?

You know, I don't know yet.

I mean, he's adamant
that he's not, right?

But about 50% of the people
with suicidal ideation deny it.

I'm more concerned by his
wife's concern, if that makes sense.

I mean, she pulled off
a pretty elaborate ruse

to get him through our doors.

Exactly.

So what's the game plan?

I want to talk to her
some more, all right?

I also want to just look at his
medical history a little more

carefully, you know, find out
what kind of access, if any,

he has to firearms, to see if I can come

up with any evidence at all
that he's planning to hurt himself.

All right. I'll keep him comfortable.

All right, and Mags, if he
gets antsy and starts talking

about getting out of here...

- I'll page you.
- Thank you.

Yeah.

Where is Hannah Asher?

Excuse me?

Where is Hannah Asher?

She's probably with a patient.

Ma'am.

Ma'am, you can't do that.

Ma'am.

OK, this is gonna feel a little cold.
OK?

You're Hannah Asher?

Do you know this woman?

Um, no.

Do you want me to remove her?

- I'd like to see you try.
- Hold on.

Hold on a second.

I'm Dr. Hannah Asher.
Is there a problem?

Problem?

Well, you went on a date
with my husband last night,

so yeah, we've got a problem.

♪ ♪

Vince, we're submitting an appeal
to your insurance company, OK?

We've been through the appeals process.

When Vince's doctor first
suspected something was wrong,

he ordered a CT.

Insurance wouldn't approve it initially.

Said there wasn't sufficient
evidence to warrant it.

It took them three months
to finally get it authorized.

- Yeah.
- Who knows how much

the tumor grew in that time?

Vince.

I know you were trying
to avoid a feeding tube.

No.

No feeding tube.

Look, we could place a temporary one.

No.

Without a feeding tube...

I'm gonna lose time.

I understand that.

You could die in weeks,

possibly days.

♪ ♪

When we first got the news
that nothing more could be done,

that this was terminal,

we came up with a model for how we were

going to approach this next...

phase.

[GROANS]

Quality over time, right?

No feeding tube.

♪ ♪

OK.

Get some rest.

Be back in a bit, OK?

Yeah.

Thanks.

I'm gonna talk to a
utilization review specialist,

see if I can expedite
the appeal process.

You really think that's gonna
make much of a difference?

Worth a sh*t.

♪ ♪

I did go out last night, but it wasn't

with anyone that was married.

All right, guys. Come on.

Show's over, huh?

I went out with Kyle.

- Kyle?
- Yeah.

Yeah, that's him.

His name is Nick Dunn.

He's not an architect.
He's a general contractor.

I'm so... oh, God.

You really didn't know he was married?

No, I swear.

I... [SIGHS]

♪ ♪

I'm gonna k*ll him.

Well, I...

How could he do this to me?

I'm carrying our child.

It's absolutely terrible.

- I agree...
- I knew something was up.

I thought it was just
new dad jitters, you know?

In a million years, I never...

oh.

Are you OK?

I think my water just broke.

♪ ♪

[GASPS]

How many weeks are you?



I would like to get you on a monitor.

No, no, no, no,
I'm going to see my own doct...

- oh!
- Hey, hey, hey, breathe.

- Breathe with me.
- I know how to breathe.

This can't be happening.

[BREATHING SHAKILY]

Can you put your
knees up for me, please?

You're gonna feel
a little bit of pressure.

OK.

OK, so, Tessa, you are fully dilated.

What?

Yep, which means there
is no time to move upstairs

or wait for your doctor.

No, no, no. I can't have my baby here.

The ED is fully equipped for delivery.

No, I can't have you deliver my baby.
I'm sorry.

Look, I get that I'm not
your first option.

In fact, I'm probably your last.

But I am a board-certified OBGYN,

and I have delivered hundreds of babies.

And I will get yours out safely
if we work together.

[TENSE MUSIC]

♪ ♪

OK, change of plans.

Tessa's ready to deliver now,
so we're gonna do it here.

Oh, OK.

Yep, so get me another nurse,
a delivery table,

and grab another doctor,
whoever's available.

We'll maybe need an extra set of hands.

We got this, OK?

OK.

Where are we at?

Long and short of it, Paul is depressed,

but his risk of su1c1de is low.

Couldn't find any evidence
of any kind of intent

to harm himself.

All right, so I'll get his
discharge paperwork ready.

Do you want to include a psych referral?

You know, Mags,
I'm actually not quite ready

to discharge him.

OK.

Here's the thing, right?

He gets diagnosed with
sudden-onset type 2 diabetes

six months ago.

No family history, low BMI, right?

And we all know that when you
get diagnosed with type 2,

you don't lose weight.

No, you gain weight, right?

And then, there's
the sudden-onset depression.

Again, no history, right?

No triggers.

I'm just wondering
if we're not missing something,

you know, some underlying
medical condition.

Do you want to order a set of labs?

Let's start out with a CBC and a CMP,

and I'm gonna dig into the literature,

see if I can't find
some kind of common thread.

You got it.

After lambasting them for
denying the patient's surgery,

Dr. Ahmad goes on to tag you,
Dr. Marcel.

"Berninger is the worst.

"Not only do they deny
more patients than anyone,

"they also pay physician
reviewers six figures

to find reasons to deny."

Now, while Dr. Ahmad is entitled

to express her personal
opinions on her social media...

You, sir, are a representative

of the board now.

I had no idea she was gonna post this.

She didn't ask you
before she publicly quoted you?

No. She did not.

We are on the eve of hammering out

a new three-year contract
with Berninger.

And antagonizing them
with a PR nightmare

is not exactly the tone
we wanted to set.

We're talking about one post here.

I'm sure no one's even gonna see it.

It's going viral, Dr. Marcel.

- What?
- Yeah.

So we are gonna need
to do major damage control

at the board meeting this afternoon.

Just follow my lead.

[TENSE MUSIC]

♪ ♪

What is this?

Now, I share something with you
in a clinical setting,

I don't expect to see it plastered

all over social media, you understand?

I should have checked
with you before I posted it.

Yeah, that much is obvious.

I don't mean to sound ingenuous,

but I didn't think that you would mind.

Being publicly quoted
without my consent?

Yeah, I mind, a lot.

- But what you said was true.
- That isn't the point.

Look, you want to have a viral moment?
Be my guest.

But don't do it at my expense.

This isn't about having a viral moment.

I... this strategy might seem
unorthodox, but it works.

Strategy?

Since when did venting on social media
become a strategy?

Public shaming is a way
to get companies' attention

and move them to act.

Case in point, after
the post started trending,

Berninger sent notice, and
they escalated Vince's appeal

for a peer-to-peer call.

Really?

Yeah, which is why we can't
let up on public pressure.

I got a DM from a local news reporter.

She wants to interview us
on Vince's case.

What are you, out of your mind?

I can't do that.

Why not?

Because the hospital's
got an upcoming contract

negotiation with Berninger.

Ah.

So this is why the post
was such a big issue?

That has nothing to do with my issue,

which is your total disregard
for professional courtesy.

♪ ♪

You should know that the post
wasn't just liked or reposted.

People shared their hellish
experiences with Berninger.

Hundreds of people, including MDs.

What you said resonated.

It needed to be said.

OK, Tessa, the head is coming.

You're crowning.

I am?

- You're doing great.
- Thank you.

Hannah?

What... what's going on?

The head is out, but the
shoulders aren't coming.

What? She's stuck?

This can happen with bigger babies.

Don't worry, we will
get her out, Tessa, OK?

Nancy, I need you to switch
with Dr. Ripley.

Put her into McRoberts.
Dr. Ripley, I'm gonna need you to apply

suprapubic pressure from above

- while I maneuver the baby out, OK?
- You got it.

All right, Tessa, you got this.

When I say push, you push
as hard as you can, OK?

Let's go.

Go.

[SCREAMS]

Here we go, here we go, here we go!

I got her!

[BABY CRYING]

There's your baby girl.

- Oh!
- Oh, my baby.

[BABY WAILING]

Thank you.

[SOFT MUSIC]

♪ ♪

[LAUGHS]

♪ ♪

Look, just... just hold on.

Because it says here on my...
what do you call this?

Patient portal... that my blood
work all came back normal.

I understand.

So why can't you discharge me?

Because Dr. Charles needs
to sign off your chart.

Well, then go get Dr. Charles.

Paul, don't yell at her.

Don't tell me what to do.

This is all your fault. If you had...

Dr. Charles?

Dr. Charles, I'd like to go home now.

I understand
you have to sign off on that.

I do. And look, Paul, I know
you've had a really long day.

I certainly have.

But I'd like to order
just a couple more labs

and actually get a CT of your abdomen.

Why? My blood work came back normal.

You know, there are certain illnesses

that, early on, they just
kind of fly under the radar.

Like what? What are you looking for?

Well, certain medical conditions, right,

can raise inflammation in the body,

which can cause depression.

Yeah, but you've clearly
narrowed that list down now.

Why are you looking at my stomach?

There is evidence that
disruptions in the physiologic

functions of the pancreas...
in this case, neurotransmission...

can alter mood and anxiety levels.

And in very rare cases,
sudden-onset diabetes

has been known to be caused
by a growth in the pancreas.

[TENSE MUSIC]

♪ ♪

What, you...

♪ ♪

You think I have pancreatic cancer?

I'm more thinking about this
as something I'd like to rule out.

♪ ♪

Well, I want to start by welcoming
our newest member to the board,

Dr. Crockett Marcel.

[APPLAUSE]

All right, then. Let's dive right in.

Barry, if I may,
I'd actually like to address

the elephant in the room.

Sure, Peter.

I think we're all aware of
the social media firestorm.

Strike that... "firestorm" is
making a mountain out of a...

Peter.

Get to the point.

An overzealous resident
misquoted Dr. Marcel

to serve her own agenda.

No, that's not...

- Dr. Marcel...
- I was quoted accurately.

OK? Let me start by owning that.

And Dr. Ahmad was not
serving her own agenda.

She was trying to help our dying patient

battle his insurance company,

which is a fight
doctors typically avoid.

Trust me, I know, it's not our lane.

We don't deal with insurance.

And honestly, I feel it's time we did.

Because these companies
are stepping into our lane.

[TENSE MUSIC]

Take the patient Dr. Ahmad posted about.

Now, he was diagnosed
with stage four cancer

three months after his doctor first
suspected something was wrong.

Why such a long gap?

Because the CT his doctor ordered
required prior authorization,

and Berninger denied it.

That's the crux of the issue.

♪ ♪

[KNOCKING]

Paul, Pamela, I want to introduce you

to Dr. Washington,
who is our head of oncology

here at Gaffney.

Oh, wow, top dog. This must be bad.

Don't read in to the title.

While you do have a small mass
in your pancreas...

OK.

It's confined to the tail,

which means it's resectable.

That's good, right?

It's really good.

Surgery is far and away the best
treatment for pancreatic cancer.

And it's rarely an option.

The cancer is usually too advanced
by the time we catch it.

I advise a few rounds
of chemo to shrink the tumor

and then the distal
pancreatectomy to remove it.

Few doctors would have
connected the dots here.

You're lucky you ended up
with this one, Mr. Moore.

I'm realizing that.

Thank you, Dr. Charles.

Absolutely a team effort.

[SOFT MUSIC]

♪ ♪

Thank you, Pam.

It's not lost on me
if you hadn't conned me

into coming in here today...

You're gonna be OK.

That's all I care about.

♪ ♪

Hey. I'm looking for my wife.

Hannah.

Nick.

H-how do you know...

I just delivered your baby.

What?

- Does Tessa...
- Oh, she knows.

- Oh, no.
- She hacked into your phone,

found your messages,
and tracked me down.

Oh, my God.

- Is that why she's here?
- Shh!

She's sleeping.

What did she say?

Is this why she went into labor?

Well, it's definitely
possible for emotional stress

to induce labor.

But regardless, Tessa gave
birth to a healthy baby girl,

and both mom and baby are doing well.

Oh, thank God.

[DRAMATIC MUSIC]

♪ ♪

Look, Hannah, I'm...

I'm not a cheater.

Yeah, well, last night
would suggest otherwise.

You were the only woman
I messaged on that app, OK?

And I had no intention
of ever seeing you again.

Don't flatter yourself.

Look, I made a horrible mistake.

I was freaking out about
becoming a dad, you know,

and I just thought,
one last night of freedom...

OK, save your
rationalizations for your wife.

Or better yet, spare her.

I think that your time is best used

begging Tessa for forgiveness.

♪ ♪

[SIGHS]

Hey.

What is it?

Vince just started vomiting blood.

Dr. Charles?

Mrs. Moore?

Are you all right?

Look, we know it's a scary diagnosis,

but in terms of pancreatic cancer,

his prognosis could not be better.

And that's largely
because of your efforts.

You saved his life
by bringing him in today.

Well, he has quite a way of thanking me.

He wants a divorce.

♪ ♪

Vince, we're concerned
you may be developing

a tear in your lower esophagus
from all of the vomiting.

I'd like to place an NG tube, Vince.

- No.
- Just for the time being.

No, no tubes.
How many times do I have to tell you...

Hear me out.

It's not a feeding tube.

It's just gonna stop you from vomiting,
and it'll help during surgery

to decompress your stomach, OK?

Wait.

Did you just say surgery?

Yeah, I heard "surgery,"
too, Dr. Marcel.

Mm-hmm.

That's right.

The board voted unanimously
for the hospital

to cover the costs of Vince's surgery.

[DRAMATIC MUSIC]

♪ ♪

Seriously?

The hospital is just gonna pay for it?

Yep.

I can't believe this.

Is this real?

It's very real.

In fact, I got you scheduled in the OR

for 8:00 a.m. tomorrow.

Hey, you guys are going
to Italy in three weeks.

We got no time to waste.

[LAUGHS]

How can I begin to thank you?

To thank you both?

Well, how about you let us
place this NG tube, OK?

All right.

Do you think it was
the depression that made him

make such a rash decision?

You know, I don't, actually.

But what possessed him
to do it right now?

I mean, he couldn't even wait
until they were home?

Your mortality can be
a pretty powerful motivator

to do all the stuff
that you put off doing, right?

I think that Paul had been thinking
about this for a while.

I wonder if he's gonna regret it.

I mean, speaking from experience,

he's got a long road ahead of him.

One that's not easy to walk alone.

Yeah, but I mean, given his
feelings about the marriage,

is it really...

really fair to Pamela
to put her in the position

of being the support system?

I'm sorry.

No apology necessary.

I've been through enough divorces

to be able to say with some authority,

spontaneous weeping
is a part of the deal.

[SOMBER MUSIC]

Tonight's my annual MRI.

Make sure that my cancer
hasn't returned.

I've been dreading it all day.

Ben and I always made our
appointments together.

Yeah.

[SIGHS]

When I saw the appointment
approaching on my calendar,

I almost texted Ben.

I wanted to see if he wanted to keep

the tradition alive, but...

then I remembered...

♪ ♪

He's not my support system anymore.

And I'm not his.

♪ ♪

Dr. Ahmad, hey.

What's going on with that interview?

Why?

Did the board give you
approval to join me?

Oh, no.

The board would appreciate
it if the interview

went away altogether.

There it is, the catch.

This issue is bigger
than just one patient.

And the board recognizes that,

which is why they're making
prior authorization

a key issue in negotiations
with Berninger.

And you trust they'll follow through?

I'll be holding their feet to the fire.

I agreed to serve as an advisor
on prior authorization

for the negotiating committee.

So am I still in the doghouse?

Now, you went to the mat for a patient.

Not a grudge-worthy offense in my book.

But for what it's worth.

Here we go.

Look, there's a benefit

to being taken seriously by management.

You get invited into rooms
where you can actually have an impact.

I'm not sure that's the kind
of impact I'm trying to make.

I'm not saying it is.

But maybe you want
to keep your options open.

Thanks for the pearls, Obi-Wan.

Oh, anytime.

[SOFT MUSIC]

♪ ♪

[SIGHS] Well, today settles it.

Joining a nunnery?

Deleting all dating apps.

Ah.

Probably for the best.

All that swiping,
head buried in your phone.

Might get a crick in my neck.

Might miss out
on meeting someone in the...

what do the kids say?

IRL?

In real life?

- Hmm.
- Have a good night, Asher.

♪ ♪

[KNOCKING]

Come in.

- Hey.
- Hey.

I know we're supposed to be
meeting at the restaurant,

but I thought you might need a ride.

Close the door.

I was just about to call you,

because I'm gonna actually

need a rain check tonight.

- Oh?
- Yeah, something came up.

This is not because of our
conversation this morning,

- I hope?
- No, no, no, no.

Because if it is,
I didn't mean to pressure you.

You didn't at all.

In fact, I think we should
start telling people.

- I'm sorry, what?
- [CHUCKLES]

You know,
I've always carried myself with

a sense of propriety,
and I spend a lot of time

encouraging my colleagues
to do the same.

But I just think if you feel strongly

about something in private,

you should own it in public.

"Strongly," you say?

"Strongly," she said.

♪ ♪

You sure you don't want
to join me for dinner tonight?

[LAUGHS]

I'm suddenly very much
in the mood to celebrate.

I can't, I can't.

But I'll tell you what.

If you're up late,

I will stop by for a nightcap.

Then I most definitely will be up late.

[LAUGHS]

♪ ♪

I'll see you later.

See you then.

♪ ♪

[CHUCKLES]