01x02 - It's Your Friendly Neighborhood Spider Silk Surgery

Previously on Pure Genius...

If you place your thumb on the tablet, I can give you full access to the hospital.

Dr. Wallace, welcome to Bunker Hill.

This is mission control for every patient.

CT scans, MRI, all the labs. Anything that you need to know or the patient wants to know is available at any time.

I didn't build this hospital to deliver bad news.

I have the same philosophy here as I did building my company in Silicon Valley. There's no hierarchy, no offices; best idea wins. We are pairing the most brilliant minds in medicine with the most brilliant minds in technology.

This is the revolution.

Why don't you just ask her out?

Who?

Dr. Brockett.

My youngest will be graduating in a year.

Until then, I'm not leaving Ohio.

The trial period is up. I need to know whether you're gonna take the job.

I want to be part of this.

Your family?

I'll go home every weekend.

I'll make it work.

(kettle whistling)

Wallace: I know it's far from home, but you'd like it out here in California.

Luke (via Skype): Dad, it's like 2,500 miles away.

Wallace: I know, I know. Well, anyhow, how you doing, kiddo?

I really miss you and Mom and home.

Oh, how's your SAT class?

It's fine.

“Fine”? That's all you got?

I'm tired. It's like 7:30.

I'm barely awake.

I-I gave you a lot of different times.

This is the one you chose.

I know. You have a tight schedule.

That's not, um...

Look, I know it sucks that I suddenly just moved halfway across the country, but I needed to take this job, Luke.

Okay, well, I should go. I have to study.

Okay, yeah.

I love you.

I love you, too.

(sharp crackling)

Well, here he comes. Man of mystery.

Morning.

Hey, Scott.

Good morning.

Oh, he is definitely living some kind of lie.

Oh, my God, you're obsessed.

He's always so calm and innocent looking.

Always eating apples. Yeah, well, tell me this, apple man, where were you between 2002 and 2006?

You're still on that?

He disappeared, okay?

No address, no social media, no Google, no job, no home, nothing.

I mean, who disappears for five years, unless his rich Connecticut family found him drugged out in a ditch somewhere, sent him to rehab, then paid to scrub the Internet of any sign of it.

Yes, that is clearly the only possible explanation.

Bell: Brockett, good morning.

And Angie.

How are you, Angie?

Ready for the big electronic nose day, Angie?

Huge development in disease diagnosis.

I-I know. I'm excited.

Me, too, Angie.

Why did you call her Angie five times?

Brockett was upset that I couldn't get her name right.

Ah, how's it going with Dr. Brockett?

Subpar, but this is the week that I get ahead of it.

Ask her out for a drink.

I mean... I know how it's done.

It's not like I haven't dated before.

(chuckles)

I've dated super models, W, and they've dated me back.

Hmm, maybe don't mention that when you ask her out.

Hmm.

Brockett: This is so wrong, betting on a man's future.

Verlaine: Yet here you are.

Oh, my God, even Talaikha bet?

And all the nurses and support staff.

$20 can get you $1,000.

Fine.

I'll take Christmas.

Wallace goes home and doesn't come back.

I like your chances, Dr. Brockett.

(computer beeping rapidly)

I feel gross.

Her blood pressure's elevated.

Oh, that's not good. E-Hub has been using sensors to monitor her remotely for hypertension and arrhythmia.

What's the location?

Sinus tach right now... it could be a heart attack.

Or a stroke.

Call the paramedics, I'll meet them there.

Hey, is it cool if I go with you?

Yeah, of course. Of course.

Channarayapatra: And it hasn't been improving at all.

Dr. Wallace, this is Amelia Fischer.

She's generously agreed to take part in a volatile organic compound trial.

Nice to meet you, Amelia.

Wish it were under better circumstances.

Amelia's been diagnosed with vanishing bile duct syndrome.

Such a poetic way of saying my liver is basically useless.

We believe she got her liver disease by cycling on and off her depression medication.

Going off the meds is what got me sick.

Cruel irony, huh?

Thank you for participating in this trial.

So, Amelia's a candidate for a liver transplant.

What's the timing look like?

Right now, her MELD score is 17, which puts her very low on the transplant list.

Statistically speaking, her liver has a 94% chance of holding out for another three months.

But I don't like the fact that six out of a hundred patients will be dead by that time, which is where... this comes in.

(clears throat)

I call it the Nose.

Amelia: That's it?

That doesn't look anything like a nose.

Well, it's a metaphorical nose.

When I found out that dogs can smell different types of cancer... did you know that dogs can smell cancer?

Anyway, I said to myself, we have to be at least as efficient as a basset hound. (laughs)

MELD scores rely on, uh, common lab tests and can be misleading.

We're working on finding a more precise way of analyzing liver disease.

Wallace: How's it work?

Well, the Nose uses particle detection to track hundreds of volatile organic compounds at the cellular level.

It's way more accurate than the markers currently being used to detect liver disease.

Just breathe into this normally, okay?

(electrical chiming)

What do those numbers mean?

Hello?

What is going on?

This is really bad. If this number is accurate, her MELD score shouldn't be 17, it's more the equivalent of 37.

Her liver is no longer clearing toxins from her blood.

Until accepted measuring tools show a change in her MELD score, she stays where she is on the list.

Strauss: That'll be three months minimum.

Could be a year.

She won't survive long enough.

We need a plan B.

We need it now.

(dog barking)

Home sweet home.

I grew up three blocks away from here.

(siren chirps)

(sirens wailing)

(indistinct radio transmission)

Sir, you can't go in there.

I'm a doctor. That's my patient.

Tanya!

Tanya?

He's trapped!

They have to get him out of here.

Okay, okay, they're doing that, but you need to calm down, okay?

Your blood pressure is skyrocketing... your monitor went off.

They've got to do something!

It's my son! I understand.

We're gonna help him, but you need to stay calm, okay?

Okay, we're gonna lift the car.

Man: Here we go.

Come on.

Hey, kiddo, what's your name?

Klay.

Okay, like Klay Thompson, cool.

We were just playing baseball.

I just never saw the car coming.

Don't worry, we're gonna get you out of here, okay, Klay?

We're gonna help you out.

Okay.

All right. Okay. We're ready to move.

Now, stabilize the neck.

Be ready to put pressure on anything that bleeds when you lift this thing, okay?

We're gonna move him on three. One, two, three.

(yelling)

All right, buddy, you're doing great.

Bring in the board.

Okay, no bleeders, bilateral extremity deformities, two liters normal saline, wide open, right?

Yes, sir.

All right, let's put him on the board.

(yelling)

Klay, you're doing a great job.

Okay, we're gonna get you to the hospital, all right, Klay?

Oh, God.

I'm okay, Mom. Just... don't freak out.

She's gonna be okay, right?

She's fine, she's fine.

Let's just focus on you, all right?

You're doing a great job.

(Klay moaning)

Come on.

Where are you taking him?

County's ten minutes out.

God, that's a shame. I've seen it before.

Those things are gonna have to come off, aren't they?

No.

And he's not going to County.

Take him to Bunker Hill.

(Klay moaning)

Man: Bunker Hill.

Hey, champ.

How's the pain?

Better?

Not as bad.

You can still wiggle your toes?

All right, excellent.

That's good, right?

I mean, maybe the breaks aren't that bad.

Well, as soon as we take a look at the X rays, we'll know and we'll make a plan.

Klay: I'm gonna get casts, right?

I've always wanted a cast.

Drew broke his arm last year.

He's my best friend.

We'll know pretty soon.

You just get some rest, okay?

Bilateral comminuted tib-fib fractures with multiple fragments.

A repair would take nearly a hundred screws.

And even if that worked, with the risk of infection, the paramedic was right... his legs have to come off.

It's worse than I thought.

I just don't understand how people can let their kids play in a busy street like that.

I see it all the time.

It's child endangerment.

We're not gonna amputate.

Malik, we're doing great work with prosthetics.

No.

I came to Bunker Hill because my community always gets second class treatment.

That boy deserves a shot at the best.

Yeah, and right now, that's prosthetics.

No.

We're not chopping off that boy's legs.

Liver buds. They're constructed from human stem cells.

They take on many of the functions and structures of organic livers.

But not all of 'em.

It's shown some promise in mice, but it's not yet viable.

What about a synthetic organ?

Scientists are producing functioning liver tissue in the lab, even using 3D printing.

But a fully functioning liver?

Can't be done yet.

Wallace: I'm new to this case, so let me ask the obvious.

We've double checked for living donors?

She has a very rare mix of blood antigens so she struck out on the general donor population.

She needs close relatives to match and she has none.

So we expand the circle?

Angie, tap into Amelia's Facebook, Twitter, Snapchat.

I want a network of friends, friends of friends, cross reference with EPIC to get blood types.

We will find a candidate who can be talked into donating a portion of their liver to save this woman's life.

Um, setting aside privacy concerns, from what you're proposing, just with O-neg blood type, we're talking 5% of the population, at best.

Wait a minute.

Got one.

Great.

I am sorry, but how is that possible?

Well, Amelia's forms said her father is deceased.

But, the EPIC database showed he made a visit two weeks ago to a hospital in Gilroy, California.

Which tells me he's not dead and his blood type is O-negative.

He could be a match.

A living donor?

We think it's our only option.

Unfortunately, we don't believe we can get UNOS to change their policy and move you up the donor list.

Uh, the living donor is the best option.

Take a piece of someone's healthy liver, transplant it, and it will grow inside of you, into a healthy liver.

I know about living donors.

(scoffs) I also know I have a very rare blood type.

I don't know anyone who would do that for me.

Well, there is a possibility.

Um... your father... was mistakenly listed as deceased on your medical records.

And he is also O-negative.

Of course, we would still need to make sure he's a match, but we need your permission to...

No.

I'm not going to ask...

Amelia, this may be your only option...

James, let her talk.

I'm no longer in contact with him.

That's all I want to say about it.

And he's been a chronic alcoholic for 30 years.

His liver wouldn't do me any good anyway.

Macrophage.

Eaters, the Pac-Man of the human immune system.

And macrophage colony-stimulating factor stimulates a cascade of events that causes the liver to expand and form new... healthy cells.

Yes, we're all doctors, we know what they are.

But macrophage therapy's not gonna cure Amelia's vanishing bile duct syndrome.

I realize that, my question is can it clean her father's cirrhotic liver?

That's... interesting.

That's very interesting.

The father's not an option. Amelia was very clear about that.

But she said that on the assumption that her father wasn't a viable option because of his alcoholism.

She said no, James.

And we don't know if the father's gonna donate.

He would, I called him.

He said he'd do anything to help.

If he's in then this is worth a shot.

Wait...

Channarayapatra: We could draw healthy cells from his bone marrow.

Use growth factor to grow them into microphages.

And then we inject the microphages back into the alcoholic liver...

And they'd repair the damaged liver from within.

Wouldn't they, Dr. Wallace?

You're talking about causing a huge inflammatory reaction in her liver, and hoping for a good outcome.

This is really risky.

It's never been done in a human.

Woman: James?

Mr. Fischer is here.

(clears throat)

James, may I have a moment, please?

I have to talk to Malik.

Think I need to move up by bet on Wallace's exit date.

(door opens)

James, she made it clear, she did not want us to call her father.

It's the only way to save her life.

This is a highly experimental treatment that could end up doing nothing for the daughter and impose considerable risk to the father.

Or it could cure Amelia and fix her father's liver to boot.

Bonus points, W.

Ding, ding, ding, ding, ding!

James, you cannot keep making these rash decisions that undermine both, your patients, and your chief of staff.

You're playing with people's lives.

W, you're sounding like that beaten down doctor from Cincinnati.

This is Bunker Hill, Dr. Wallace.

We don't give up on our patients even when they've given up on themselves.

Just... fix Mr. Fischer's liver, I will talk to Amelia.

Don't worry, W, I can talk anyone into doing anything.

I mean, you're here, aren't you?

(chuckles) There he is.

The man. Mr. Bell, I am a huge admirer of yours.

Aw.

Thank you, Prini, and great luck with the trek.

She's gonna hike the Pacific Crest Trail.

That is an extraordinary young woman.

This is...

Dr. Wallace?

I've done my homework.

(Bell and Fischer laugh)

Seventh best surgeon in the world.

It's an honor to meet you.

You're welcome, Mr. Fischer.

Oh, Simon, please.

You know, I was shocked to hear what's going on with my baby girl, but to know that she is in you guys' hands, can't tell you what this means to me.

Thank you for getting here so quickly.

When can I see her?

Well, why don't we get you checked in first.

Hmm, right?

Wallace: Then he totally ignored the fact that the patient specifically asked him not to contact her father.

He just does whatever he likes.

Dad, I'm just kind of busy.

Do you want something?

Is everything okay, Luke?

Yeah.

It's natural that you have a reaction to me taking this job, Dad... but you seem on edge, have you, um... um, (door opens) are you still taking your meds?

I'm almost 17.

I know, it's just...

Please stop treating me like a child.

(door closes)

Uh, it's just, um... you know, I'm not there, and...

Yeah, that's pretty clear.

So...

Um, hey, how's Samantha?

She's fine.

Did you ever tell her about that Snowden doc?

No.

Oh, I'm telling you, it's right up her alley.

We broke up.

Like, a week ago.

So, no I didn't tell her about the new Snowden doc.

Oh, hey, uh...

I'm sorry, buddy.

It's fine, it's not a big deal.

I got to go, okay?

Yeah.

Cheng: Spider silk web is one of the strongest naturally occurring fibers.

Pound for pound, it could be stronger than steel.

I've been working on medical applications.

Yeah, that's actually why I'm here.

I want to know if this silk can help fix this.

Cheng: Ouch.

Bell: This is for the boy.

The car accident.

You're worried about the chance of infection so you want to use spider silk screws. Brilliant.

Cheng: Spider silk screws have been used before, but there are too many small pieces here.

What if we created a webbing, hold all the pieces in?

Exactly what I was thinking.

Huh.

Like a scaffolding.

Mm-hmm.

It would allow the cells and tissues to regenerate over and around, so as Klay grows...

The bones would fuse back together, the webbings and the screws would dissolve.

Leaving him with a whole leg.

Verlaine: Now, our plan is to harvest the silk spiders use for their webs to create a biodegradable frame on which we can lay the fragments of Klay's bones.

As he grows, the fragments will fuse together, the nerves will grow and reattach along the silk webbing, and, in time, his legs will be able to support his weight, and he will be able to walk again.

So, you're saying you're gonna put spider webs inside him?

And it's never been done before?

It's been done, just not in quite this way.

So it's an experiment.

You're experimenting with Klay.

There is another option.

Prosthetics today are very advanced.

And the recovery time needed to be up and walking is short, four to six months.

And there's less risk for infection.

The safest course of action is prosthetics.

But... that's cutting off his legs?

Brockett: It's removing the parts that are so damaged, yes.

Ever since that boy could walk, he just... runs.

Can't keep him in the house, can't get him to sit still.

(voice breaking): The thought of him without his legs...

Putting spider webs inside him...

What would you do?

Would you risk infection, risk surgery?

If he were yours.

It's something...

That's absolutely what we'd do.

No question.

We'd save his legs.


Hey.

I want to discuss the treatment plan for our patient.

We have a plan.

He's keeping his limbs.

It's the patient's choice, not yours.

You hijacked that meeting.

It was not fair for the patient to not let me make the argument for prosthetics.

I hijacked that meeting because I didn't think you could be objective with Klay's mother.

What are you talking about?

That thing you said about moms letting kids play in the street.

Yeah, what about it?

She was with her son in the ER, who just had a horrible accident.

An accident.

And your first reaction is it's her fault.

She's a bad mom because she let her kid play in the street.

Are you kidding me? I'm a pediatrician, I see this a lot, and it's frustrating. Of course I never would've said that to her.

No, but you thought it.

Oh, come on!

You let kids play in a busy street, it's gonna happen again and again.

Yeah, you're right.

Look, if you think this is about race, I would never...

Klay's neighborhood.

My neighborhood.

Tell me what you don't see on this map.

Brockett: I...

I don't know.

Green.

There's no green.

These kids aren't growing up in some nice suburban neighborhood in Illinois.

They padlock the schoolyards after school.

There's no park, no... anything.

This is what they have.

So you tell me, Zoe, where is a kid supposed to play?

Bell: When I opened Bunker Hill,

I made a promise to myself, that I would do... everything humanly possible to save everyone who came through these doors.

Which is why I brought your father here.

Nobody is forcing you to see him, nobody is forcing you to accept anything from him.

But he is a match.

And he's willing to donate part of his liver.

How is this... (chuckles)

How is this even possible?

What about his drinking?

We found a way to possibly undo 30 years of drinking.

Restoring enough function in the liver for it to grow.

You can't undo 30 years of what his drinking did to me.

(scoffs)

My father, he... he doesn't just do things for people.

There's always something in it for him.

Maybe he's here to clean out his liver.

Maybe he wants something from me.

But believe me, he's here for a reason.

Look, Amelia... you got this disease because you kept trying to go cold turkey off your antidepressants.

You wanted to live your life.

Live it on your terms.

And... that is what I'm offering you right now.

And somehow I don't think allowing yourself to die to punish your father for whatever the past is, I don't think that's living life on your terms.

Is it?

(monitor beeping rhythmically)

Channarayapatra: I worked with our tech team to develop a camera small enough to work on rat brains.

It was easy to adapt it for a human liver.

Wallace: Advancing past the cystic duct.

Everything okay with your son?

Yeah.

I didn't mean to barge in before.

My wife's okay with the move.

More or less.

My daughter's at UCLA, so it didn't hit her the same way, but Luke, uh...

Luke has an anxiety disorder.

It's under control now, but... the move was tough on him.

And that makes it tough on you.

Okay, in position at the bifurcation of the right and left hepatic ducts.

Should be in view of the treatment field now.

(rhythmic beeping continues)

Injecting dye.

It's working.

His damaged cells are regenerating.

We're actually going to heal his liver.

I know you had your reservations about this, Doctor.

You have no idea.

(birds chirping)

Oh, Scott, wait up.

Hi, Angie.

Hey, Scott.

All good?

Yeah, you?

Yeah. Very good.

I was gonna grab lunch in the caf, if you wanted to join.

Poke bowl day. Extremely exciting stuff.

Great. Yeah, I'll meet you there in 15 minutes.

I'm just gonna go clear my head.

Oh, clear your head.

Great.

Doesn't sound at all mysterious.

Okay.

Yeah.

Our Father, who art in Heaven, hallowed be Thy name.

Thy kingdom come, Thy will be done on Earth as it is in Heaven.

Give us this day...

Brockett.

I like what you and Malik are doing with the spider silk... intriguing.

Oh. Good.

Listen, I had...

So look, I wanted...

Sorry.

Sorry.

You go, you go.

No, no.

It's, a... favor. What do you need?

Klay Jackson got hurt because there isn't a single park in a three-mile radius of where he lives.

He's not the first and he won't be the last.

But I found a company that'll provide everything you need to build a park in a day, if we have the land.

You want me to build a park?

Not only will it prevent accidents like this from happening in the future, it's really great community outreach.

(sighs)

Let me read through this.

Okay. Yeah, no.

Yeah, I'll...

Thank you.

...see what I can do.

Amelia.

You look so wonderful.

Thank you.

How is your art?

If you could see her paintings, she is a genius.

Mixed media, just really special.

Oh, won awards. I still have a few hanging on my walls.

I'm working, so I haven't had time.

Uh, Amelia, Mr. Fischer, why don't we...

Yeah.

Why don't we get started.

First of all, Mr. Fischer, we need to make sure that, uh, the risks of this procedure have been described, and you understand those risks, and, um, consent to moving forward.

I understand. I consent.

I need to ask that you are planning to donate a portion of your liver, and you are free of coercion or inducement, and free to decline to donate at any time.

We can all save ourselves a lot of time.

I'm ready to sign. I have been paid in full.

I am sitting here with my daughter.

Great. Well, I'm all for short meetings, let's sign.

Hold on.

You can't buy me back with this.

What are you talking about?

I need you to understand that this doesn't go anywhere from here, okay?

There are no conversations, there's no Thanksgiving dinners.

Do you get that?

Well, honey... I am your father, and I can't promise I'm not gonna try to reach out to you, to connect with you.

Let's face it, you can use me, too.

I mean, you should be doing your art...

Maybe you don't remember why I left art school, Dad.

Because right in the middle of a semester, you bottomed out, and I had to come down to Florida to pick you up again.

I told you those days are over.

For you! Maybe for you they're over, but I still live with them every single day!

I don't know if I can do this.

Bell: Amelia, this may be your only option.

Wallace: This is your choice. You have control over this.

When I was eight years old, you dropped me off at a third-grade party, and you disappeared for ten days.

You disappeared.

Are we gonna go there?

Pumpkin, I told you those days are over.

There I was making up some story to the parents at the party about how you got called away to a big meeting.

And I spent the next ten days figuring out ways to feed myself.

Getting our neighbor to drop me off at school every day, wondering if I was ever gonna see you again.

Then you came back, and you were so sorry.

And you swore it would never happen again, and you've been telling me that my whole life, that this time it's gonna be different.

“This time I've really changed”"

Well, maybe you can fool all these other people, but you can't fool me.

I'm done. I'm done!

I'm sorry. I just...

I would rather die than owe him anything.

I am not your pumpkin!

So, what are we gonna do?

Right now, I'm going to stabilize Klay Jackson's legs to prepare him for the spider silk surgery tomorrow.

About Amelia.

James, you were brash.

You saw a medical problem and you found a fix, which was brilliant but there are two human beings involved.

I've been doing this 26 years.

You need to listen to what I have to say.

So what are we gonna do?

We're gonna do the best we can to clean up the mess.

Wallace: So what else about Klay?

Verlaine: Uh, he loves his mom.

He takes care of her 'cause the dad's not around.

Oh, and most important, he likes double pepperoni pizza.

All right, sounds like you did your homework.

That's what he wants after the surgery.

All right, well, let's get this done, get this kid his pizza.

Wait.

His foot. It's clotting.

No pulse.

Compartment pressure needle right now.

You think it's compartment syndrome?

The blood's filling the spaces of tissue between the bone fragments.

If it's over 30, it's choking off the blood flow.

Wallace: 36. Can we stabilize it?

I can buy us some time. Get this thing off.

Wallace: All right.

Number ten blade, please, now!

Number ten.

This should relieve some of the pressure, at least for a little while.

Laps, straightaway.

Are we gonna have to amputate?

If Angie doesn't get the silk ready soon, yes.

Or we won't be just trying to save his leg, we'll be trying to keep him alive.

Bell: It's an algorithm to calculate the least amount of screws and silk we can use.

It won't work. I mean, even if we cut corners, we still don't have enough.

(sighs)

Bell: We need to find another way to get more silk.

Verlaine: Put the damn spiders on steroids.

What if we did?

We need to find something to expedite the process.

What if it's not steroids?

What if we use E. coli?

You-You're saying there's a way to grow silk in a petri dish?

It could work.

“Could” is not good enough.

It has to work.

Hey. You okay?

No...

I'm not.

You were right.

We weren't ready.

I-I didn't want to listen.

You know, I saw this kid...

And now we're not talking about trying to save his legs, we're trying to save his life.

I messed up.

No.

He's gonna be okay. This is gonna work.

Hey...

This is gonna work.

(indistinct chatter)

You were never discharged.

As Bunker Hill patient, we can find you anywhere.

So you've come to tell me what a bad human being I am?

No need, I know.

You fix my liver, and here I am with a drink.

Which you haven't touched.

I can tell your blood alcohol level as well.

It's just... right on my phone.

What are you doing here, Walt?

A big save the day speech?

You heard my daughter.

She would rather die than be in a room with me.

I believe that's a quote.

Well, I'm the last man to judge you.

Truth is, I'm living 2,500 miles away from my kid right now, and even though I could explain why I'm not there, and what I've been through, and why I made the choices I did, my son doesn't care about that.

He's just pissed off.

And I have to let him be pissed off.

I keep trying to tell myself that, uh... when he's saying “I don't need you” or “I don't want you...” uh... what he's really saying is, “I'm pissed because I... I do need you.”

♪ ♪

So, my job is one simple thing.

I have to show up.

Even when he says he doesn't want me to.

I have to keep showing up.

♪ ♪

Tanya: I'll tell you what,

I'm not riding any more roller coasters.

Klay: I gonna get on roller coasters.

Hey. What's going on, little man?

How you holding up?

Where's my pizza?

Uh!

I, uh... I don't have pizza.

But I do have something even better.

That's gonna help bring your bones back together.

It's made from spider web silk.

How cool is that?

It's ready?

Relax, Mom.

You know how fast I heal.

I'm gonna be fine, okay?

I'm gonna be like Spider-Man. A real live superhero.

Look who I found.

Uh...

I don't expect a relationship with you.

I don't expect anything, I haven't earned... anything, but... you deserve... a good life after what I've put you through.

So, just let me do this, and you never have to see me again.

Let me do this one thing right.

♪ ♪

(monitor beeping rhythmically)

Verlaine: Acceptable perfusion with bilateral pulses.

It's thready, but it's there.

Then, let's do it.

Screws are ready.

Silk wrap ready.

Time to put this puzzle back together.

♪ I wasn't born this way ♪
♪ I've been living a lie, they say ♪
♪ So, when it brought me to my knees, well ♪
♪ I had everything, so tell me ♪
♪ Would you please ♪
♪ How could I possibly have needed ♪
♪ So much more? ♪

(drill whirring)

♪ The thing I was craving then ♪
♪ Was some kind of laboring ♪
♪ So I might find a friend ♪
♪ In all the aching in my muscles ♪
♪ As they hurt, oh, won't you put my hands to work ♪
♪ To ease my mind ♪

(monitor beeping rhythmically)

♪ And you, you realize ♪
♪ In a moment's grace ♪
♪ You've been unraveling ♪
♪ The fabric of your coat ♪
♪ And you pick a line down the wall ♪
♪ And trace ♪
♪ Until the end ♪
♪ And when you walk back sorry ♪
♪ With a folding body ♪
♪ Like you should ♪
♪ No, I am not ♪
♪ Gonna die this way ♪
♪ Maybe it was the mold you see ♪
♪ That was knocking the wall in me ♪
♪ And I forgot just what it was that ♪
♪ I had needed to be for all the time I'd given ♪
♪ Maybe I'd forgot what living was now for ♪
♪ And you, you realize ♪
♪ In a moment's grace ♪
♪ You might just already ♪
♪ Be on to something good ♪
♪ And you pick a line down a cord ♪
♪ And trace ♪
♪ Because you can ♪
♪ And when it comes back heavy ♪
♪ You'll be more than ready ♪
♪ Like you should ♪

(laughing, shouting)

♪ 'Cause I am not ♪
♪ Gonna die this way. ♪

(Brockett chuckles)

Look at this. This is incredible, don't you think?

Cheng: No, it is.

It's exactly what this community's been praying for.

Yeah.

I'm gonna get some lemonade.

You want some?

Yeah. Sure.

All right.

Thanks.

♪ It's all right, I'll believe ♪
♪ Love you, love you, love you, love ♪
♪ Love you, love you, love you, love ♪
♪ Love you, love you, love you, love ♪
♪ Love you, love you, love you, love... ♪

How did you make this happen so fast?

You know what they say, money talks.

You're amazing, James.

Seriously.

So...

Uh... uh, have you heard about that new Snowden doc?

Huh?

Um... I'm sorry.

Can I just... one second.

I'll be right back.

Yes. Of course.

I understand we have you to thank for this.

Oh, no, no, no.

That was all James Bell.

Not according to Malik.

Everything you did for my son and now this.

I just don't know what to say.

Thank you.

Of course.

(exhales)

Verlaine: James wrote the check, but, uh... this was all you, wasn't it?

There was no green, I mean, where were they supposed to play?

(chuckles)

(clicks tongue)

Thank you.

You bought Zoe a park?

Most people just buy flowers.

(inhales sharply)

Thank you for talking to Amelia's dad, getting him back on side.

(clears throat)

You were right. I made a mistake.

But then on the other hand, If I hadn't created the electronic nose, we'd have never known about the urgency of the liver transplant, so... I suppose I can't beat myself up... too much.

Wallace: Here comes Dr. Brockett.

Go for it. I'll see you Tuesday. I need Monday off.

Uh... not approved. (chuckles)

Okay. Approved.

Sorry. What were you about to say?

Um...

I... was...

I was gonna tell you, um, that there are six.

Six what?

Six of these.

I bought six lots.

So, you better keep your Saturdays free for the next month, or so, uh...

Oh, my God.

Oh, my God, James.

I don't know what to say.

No need to say anything, Brockett, it's...

A good idea is a good idea.

Uh...

♪ ♪

(announcer speaking indistinctly on TV)

(whistle blows on TV)

Hey.

You want some company?

That'd be exhausting, Mom.

To have to explain the rules. Again, and again.

Oh, I didn't mean me.

What are you doing here?

Well, I'm here to watch the game and eat some pizza.

I hope there's pepperoni in there.

What am I, an idiot?

(Julianna chuckles)

Double pepperoni.

♪ ♪

Oh, they got ten points on them already.

Third quarter? Yeah. This one's in the bag.