01x07 - A Bunker Hill Christmas

[bunniefuu]

Previously on Pure Genius...

When I opened Bunker Hill I made a promise that I would do everything humanly possible to save everyone who came through these doors.

I want to be part of this.

Bell: Julianna Wallace, Executive Consumer Safety Officer for the FDA.

You married up, W.

You kissed me.

Really?

Cheng: This is Louis Keating.

He's been diagnosed with Gerstmann-Straussler-Scheinker disease.

Bell: It's like ALS on steroids.

I did have the genetic test done, and it came back positive for GSS.

I'm so sorry, James.

♪ ♪
♪ Do you feel electric in your ♪
♪ Hands and legs? ♪
♪ I sense the gravity shifting ♪
♪ Inside our heads ♪
♪ All the thoughts go up ♪
♪ Never settle down ♪
♪ In these chaos caves ♪
♪ No relief to be found ♪
♪ Working on ♪
♪ The appetite till dawn ♪
♪ Burning forests, forests ♪
♪ How long till they're all gone? ♪
♪ I feel you move me ♪
♪ To another world... ♪
♪ We fly ♪
♪ Over mountains and ride ♪
♪ Through the sunset ♪
♪ I'm just so excited ♪
♪ When I got you by my side. ♪

(laughs)

This is Madeline Sorenson from Wichita, Kansas.

She's 15 years old... high-risk acute myeloid leukemia.

Terminal.

She's been everywhere. I've checked her scans and her history.

Unfortunately, James, there's not much we can do for this patient.

Well, what about... CAR T-cell therapy?

It's brand-new, and we've been given approval for a one-time trial through the FDA's Compassionate Use program.

Cytotoxic T-cells.

The green berets of our immune system.

Exactly.

James, it's shown a lot of promise in fighting lymphoid-type blood cancers, but this type of leukemia, it's a different beast altogether.

Unfortunately, T-cells don't have antibody detectors that fit into a protein on the surface of the leukemia cell.

Which is why we're... gonna engineer one.

Well, we'd have to design a very specific key, which could take time.

And her latest labs are not good. Hemoglobin; 5.8; platelets: 64.

She has a month, maybe two at best.

Okay, I get it, it's a Hail Mary pass, but... before I hear all the naysayers speak up, let me remind you of two things.

This face.

And it's Christmas week.

Okay, naysayers, speaketh.

Yeah. Let's bring her in.

Why not?

Tina, send the plane for Maddie and her family.

And merry Christmas, everyone.

And, Rebecca, happy Chanukah. Shalom.

And...

Christian.

So we're all covered. Good. Carry on.

Dr. Verlaine.

May I have a word?

Yes.

(whispers): Um... about that kiss.

(whispers): What kiss?

Our kiss.

A few weeks ago.

I'm joking.

(laughs): Oh. Right. Hmm.

It's amusing.

So, as I said, I was sleep-deprived, I wasn't thinking straight, and we had just attended a wedding...

Look, I hear it.

Let's just forget that it ever hap...

But upon further review, I realize it was not entirely fair to make you feel like it was all one-sided, so I take... some responsibility for what happened.

Look, Brockett, it's kind of hard to have a conversation here.

Mm-hmm.

What if we grab dinner off campus?

Din... dinner?

Yeah.

Talk this through.

I'll do brunch.

(chuckles)

Brunch works.

Okay. Good. Thank you, Dr. Verlaine.

Dr. Brockett.

Woman: You see this woman?

Andrea Cocciano.

Born Andrew Cocciano.

She identified as a woman from the time she was six years old.

She's brilliant. MBA from Harvard.

And she's about to be fired by a major equities firm because she's transgender.

This is a precedent-setting case of national importance. I can win this.

But I need your help to cure me first.

We are well aware of your work as a civil rights attorney.

I have to admit, I'm a fan.

Thank you. Okay, let's talk quickly, 'cause I'm a ticking time b*mb.

I wasn't diagnosed until six months ago.

The theory is I've had these petit mal seizures my whole life.

As a child, they would come and go, but they never affected me.

Now I have an average of ten per hour.

I can't go to trials like this.

I can barely even get through a deposition at this point.

I need someone to take the bull by the horns or I am out of business.

And so are all the people who are depending on me to feel heard and represented.

(teeth clicking, scraping)

(clicking and scraping stop)

It just happened, didn't it?

Wallace: Let's give him another course of Gent and make sure to monitor his creatinine.

Yes, Doctor.

Thank you.

Merry Christmas, Dr. Wallace.

Honey.

Yes, it is.

(laughs)

What-what are you doing here?

Oh, well, I know that you only had two days over Christmas, so I... played around with my schedule.

I don't want you to be alone over the holidays.

This is a wonderful surprise.

And don't worry, I brought plenty of my own work.

In fact, some of it is, uh, right here.

Here?

Yeah, Bunker Hill has a request to, uh, approve a trial for a drug for GSS...

Gerstmann-Straussler-Scheinker syndrome.

I know about the trial.

I would normally have somebody else at the office do it, but I pulled a few strings and here I am.

Well, we're gonna have a wonderful holiday.

BFF!

What on earth are you doing here?

(laughs): Hi, James.

Are you here for business or pleasure?

Actually, I'm here for the presentation on the GSS trial.

Oh.

Wonderful. Didn't know the FDA would send out the big g*ns for our tiny little study.

May I borrow your husband for just a moment?

Sure.

Yeah.

Perseus, would you help Julianna with her luggage?

I'll take your bags for you.

Oh, thank you.

Wish you'd mentioned that the grim reaper was coming here to ruin our GSS trial.

I was expecting to get someone lower on the food chain so I could push it through.

I had no idea she was coming.

But don't call her that the grim reaper, even if it's a joke.

I felt it, W.

You felt what?

The tremor.

What kind of tremor?

A not particularly distinguishable tremor in my right hand. Tremors are typically the first signs of the symptoms of GSS taking a hold on the human body.

James...

Mild tremors followed by more intense tremors followed by tics to slowing of the muscles to attacking and eventually destroying of the brain.

(whispers): I felt it, W.

I don't want you to jump to any conclusion...

W...

Will you be my doctor?

Of course.

Excellent.

Ah, here she is.

You must be Maddie.

You must be James Bell.

Hi. I'm Dr. Wallace. Nice to meet you all.

Hi. Thank you so much for accepting our application.

Nice to meet you.

Are you ready to kick your cancer's ass?

So ready.

Let's get you checked in.

Welcome to Bunker Hill.

Right this way.

♪ ♪

Today we have proven that this public elementary school knowingly put its own students' health at risk by using a food vendor that provided absolutely zero food choices that met with FDA nutritional standards.

And the court ruling today comes a long way to once and for all stop these profit-seeking food vendors from harming our nation's children.

That lady is good.

Giselle Overman has become a voice in this country for people without a voice.

Her petit mal seizures have increased in intensity and frequency to the point where she no longer can function in her daily life.

What can we do?

I call it the neural pacemaker.

I borrowed technology from the cardiac pacemaker.

The neural pacemaker monitors electrical activity in the brain.

When the cluster of neurons responsible for a seizure start to show increased activity, it basically snuffs out the seizure before it occurs.

Be still my heart.

When can we install that puppy?

There's a hitch. I've done a functional MRI, a diffusion MRI and an EEG, and I haven't been able to isolate the area of her brain where the seizure cascade begins.

So we have a fix, but without a seizure focus, we can't use it.

How do we find the focus?

Without a new way to look at the brain, I have no idea.

So find a new way to look at the brain.

(laughs): Obviously.

(chuckles)

Obviously.

Cheng: These are projections of Maddie's cancer cells from the bone marrow you collected.

So that protein is the lock.

Exactly. But we're working on a key. The problem is the leukemia protein has a similar structure to a lot of the other proteins in the body, so making our key fit that lock and only that lock hasn't been easy.

Hmm.

Elody, how's it going?

I can show you something in one minute.

So, how's the Malik sitch?

(whispers): He asked me to dinner.

And?

I panicked... I said brunch.

Ooh. The brunch downgrade. Been there.

Exactly. I just thought, take it slow, you know?

It's not like a date or anything... it's brunch, it's casual.

Please, I don't care if it's a five-course meal or an Egg McMuffin... once food is being ingested, it's a date.

So you're saying I shouldn't go to brunch?

No, I'm saying you're going on a date.

Elody: Yeah, I agree.

It's definitely a date. Here, check this out.

So, these are Maddie's T-cells, which we've modified by adding our artificial antibody detector.

The blue ones are her modified T-cells, and the red ones are her leukemia cells.

Oh, my God.

This might actually work.

Maddie: So... you're infusing me with some kind of GMO, which means if this works and, you know, I actually live, I will never be able to walk into a Whole Foods again.

Not exactly. Um, these are your actual cells.

We're just giving them the enhanced ability to detect your leukemia cells.

Hmm. So, super cells.

Yeah, super cells.

Do your work, super cells.

You ready to pick a little?

Pick? Oh, yeah, no.

Uh, not a picker.

Then I'll play, you sing.

(exhales): No.

(laughing)

Maddie, I don't think that's a good idea for anyone involved.

Dr. Brockett, I have been to... five hospitals in four different cities over the past two years.

I mean, my life has just been about staying alive.

So whenever someone sticks a needle in me or does a scan or pokes me or prods me, doing music is what gets me through it.

So I'm afraid I'm gonna have to insist.

♪ ♪

I promise you you're gonna regret this.

(chuckling): Uh-huh.

Mm-hmm.

♪ If you are falling ♪
♪ Then I would catch you ♪

Catch... Oh, I can't.

♪ If you need a light ♪

(both singing) ♪ I'd find a match ♪
♪ 'Cause I ♪
♪ Love the way you say good morning ♪
♪ And you take me the way I am ♪

Maddie: Mm-hmm!

Okay.

♪ If you are chilly ♪
♪ Here, take my sweater ♪
♪ If your head is aching ♪
♪ I'll make it better ♪
♪ 'Cause I ♪
♪ Love the way ♪
♪ You call me baby ♪
♪ And you take me the way I am ♪

Oh, wow.

Okay, this takes me back to the old days.

Does it kind of remind you of the office they gave me when I was a surgical intern at the Cleveland Clinic?

Mm-hmm. I remember showing up at midnight, because if I didn't I would never get to see you.

If I recall, some of those visits weren't half bad.

Mmm.

I think I figured out how...

(laughs)

I am so sorry. I'll come back.

No, it's okay. This is my wife, Julianna.

Jules, this is Dr. Channarayapatra, my, um, office mate.

(door closes)

Oh. Uh, Dr...?

Channarayapatra. Oh, it's-it's... it's wonderful to meet you.

I have heard so much about you and the kids.

Oh, thank you.

I will leave you two, to, uh... to carry on.

(laughing): Find me later.

Please, this is your office; it's... well, it's both of your offices, right?

So, please, go ahead.

Okay.

I was just thinking, maybe we don't actually need to find a new way of imaging the brain. We need a new way to process the data we've already gotten from the brain.

So what if we took the fMRI, which localizes brain functions and laid it...

Laid it over the EEG, which would give us a picture of the seizure activity.

That should point us to the right area of the brain.

Exactly. And if we merged that composite image with the Diffusion Tensor MRI, we should be able to follow the neural pathway back to the seizure focus.

Both: Then we could see the seizure manifest itself in real time in three dimensions.

This is brilliant.

Sounds like writing some tricky software.

Channarayapatra: I'll talk to James.

He could do it in his sleep.

It's great to meet you.

Oh, you, too.

Just... just tell us if it isn't working.

We can handle bad news.

It's good news.

Wait. It is? Really?

In fact, it's looking a little bit like a Christmas miracle.

(laughing): Oh, my God.

Her numbers improved?

These are your latest numbers.

Your white cell count is 11,000.

11,000?

Are you serious? (laughing)

Oh, my God.

I was at 45,000.

Nothing we've done has ever brought her white cell count down.

This is far better and faster than anything we could have ever imagined.

Oh, my God.

See?

It was because you sang with me.

(laughing): I mean, you're my good luck charm.

(laughing): No, I'm not.

(laughter)

Oh, baby.

You guys are the best.

Uh, James.

Uh, not to get ahead of ourselves, but there's a concert coming up in a couple of weeks, Phillip Phillips is playing.

He's been a huge hero to Maddie throughout all of this.

I want to buy tickets, but I need to know if there's any way you think she's gonna be strong enough to go.

Don't buy the tickets.

Okay.

Let me.

(chuckles)

(exhales)

I hear the FDA is here to rule on the treatment for GSS.

Yes.

What are the chances of getting approved?

I feel our chances are sky-high, Louis.

(laughing)

Bishop to queen's rook five.

(Louis laughing)

Louis, the bishop doesn't move that way.

It moves diagonally.

GSS is caused by abnormally folded proteins called prions building up in the brain.

These prions stick together in clusters called oligomeric aggregates, which are toxic to brain cells.

We've been working on a new medication called PAI 120b.

It's a prion aggregate inhibitor.

This drug sticks to these abnormal prion proteins so they can't clump together in these toxic aggregates.

Cheng: We've been producing it right here in our pharmacologic sciences lab.

It's in compliance with all FDA standards.

Our patient, Louis Keating, is getting worse.

This disease is attacking his body and his mind, and before long, even his shadow of an existence will come to an end.

But our drug has a chance to change all that.

Worst case scenario, this is a huge leap towards curing this insidious illness.

Best case scenario, we give a man his life back.

I-I mean, this is just a remarkable presentation.

It-it's one of the strongest applications I've seen for a Phase One Clinical Drug trial.

Bell: Great. So we can move towards human trials.

But it's not ready yet.

You have eight weeks of safety data in your animal models, and I totally agree the numbers are really promising, but, James, that's only eight weeks.

But we have a patient here who has an urgent need.

I'm sorry.

I need more data from the animal models for approval of a human trial.

You're looking at six to 12 months, at least.

♪ ♪

This is for you.

Hmm.

Oh, my God.

These are first row tickets to Phillip Phillips.

Mm-hmm.

(chuckles)

No.

And backstage passes?

Mm-hmm.

But how did you know?

Your dad told me.

Wait, so you think I'll actually be able to go?

I'm very hopeful.

Oh, my God.

Do you know what I was just doing?

No.

I was writing a song.

I mean, I-I stopped writing songs five months ago, because what was the point, you know?

But for the first time in so long, I can actually see past being a patient.

So... tell me, Maddie, what's in your five-year plan?

I have this stupid fantasy, really, that one day, I'll open up for Phillip Phillips and, you know, he'd invite me onstage and we'd sing a song.

(chuckles)

♪ Just know you're not alone ♪
♪ 'Cause I'm gonna make this place your home. ♪

Sorry. I know it's so dumb.

Sorry.

It's not dumb at all.

I really should go to a concert some day.

You've never been to a concert before?

Not really.

How is that even possible?

I don't know.

I always thought I wanted to go see Beta Band, but then, uh, I heard they broke up.

(both laugh)

So what's your five-year plan, then?

You know, after you've saved everyone's life on the planet.

What are you gonna do then, James Bell?

Well, I guess if you're really asking, uh...

When I was a kid, I'd walk through my neighborhood and I'd look through the windows, and I'd see all these families gathered together around the TV, and I thought, that looks really beautiful.

Mmm.

My mom used to work a lot, and, uh, when she was home we could never agree on a TV show.

So I watched alone.

So I guess when I grow up, what I want is to have a family to watch TV with.

Do you have someone to do that with?

No. (laughs)

I mean... uh...

I have this stupid idea, but...

But what?

I wouldn't even know where to start.

Well, maybe start with what you just said, because it was awesome.

Bell: Brockett.

James.

I've never been to a concert.

Oh?

Ever.

I don't know why, I like music.

I just like to be able to hear the song that I want to hear when I want to hear it.

The idea of having to watch a band and hope that they play the song I want to hear just seems so frustrating.

(chuckles)

(sighs)

What if I'm sitting next to some drunk person who keeps trying to lean on me?

Or someone who has to sing along to every word at the top of their lungs?

You know, James, if you're not enjoying a concert you can always just leave.

This has nothing to do with concerts, Brockett.

Oh, it doesn't?

Concerts is just one example.

I'm talking about life.

About watching TV with your family.

About have a family to watch TV with.

Life's short, Brockett, so short.

And I've waited so long, too long.

James, you're really not making any sense right now.

I want to go to a concert with you, Brockett.

What?

I want to go out with you to a concert.

You know, like on a date.

I get if I'm your boss...?

No, it's not that.

I just, um... Oh, I did... I didn't know, James.

I... I didn't know.

And?

And, um...

(sighs)

I'm really sorry, James, but I can't.

James.

Not now, W.

Just need a minute.

I'm attempting to write a multi-modal imaging program that merges three unique computer languages in the hopes of increasing image clarity down to a tenth of a millimeter to avoid frying Giselle Overman's brain.

Does it sound like I have a minute?

Well, when you do have a minute...

Damn it!

Keyboard!

Okay.

(sniffles)

(clears his throat)

I apologize.

That was very immature.

Man: James?

Thank you. Sorry for yelling.

I want to run some tests. I'll need you to fast tonight.

We'll run some blood work and I'll schedule an MRI, okay?

Okay.

We don't know anything yet, James.

We don't need to panic.

Debatable.

Maddie: I can't believe James did that. I mean, the first-row tickets, the backstage passes.

It's amazing.

So... do you know who it is?

Do I know who what is?

James kind of hinted that there was someone he was into.

So, do you?

No, I don't.

Lucky girl.

Yeah, she is.

When did you start having bleeding in your gums?

Uh, last night, when I was brushing my teeth.

It's just a little bit of spotting.

I haven't been to the dentist in a while.

Start on 4.5 grams of IV pip-tazo every eight hours and hang a unit of aphaeresis platelets.

Yes, Dr. Brockett.

Is everything okay?

Yeah. Just want to be thorough.

She's pancytopenic.

The CAR T destroyed a lot of the leukemia cells, but it's also targeting her healthy cell line.

With all this collateral damage, she won't live long enough for us to get her into remission.

Maybe we refine the antigen receptor.

It was the only target we could find, and it had a lot of common antigens.

I can't make the key any more specific.

If we keep going with these treatments, we'll k*ll her.

What are the other options?

So, what, are we saying Maddie's gonna die, that's it?

James, we all knew this was a Hail Mary pass.

W, I need you.

It's happening, left hand this time. Right here, this spot.

Describe what you're feeling. Tingling, not as strong as last time.

Gone.

It's over.

I'm scared, W.

Yeah, I know.

Okay, what's happening?

I have no idea.

I do not accept that this girl is gonna die here.

Not in our house. There is no such thing as a death sentence in Bunker Hill, so... ideas, pitches? Anything. Please.

We just don't have anything else to offer at this point.

At this point? At this specific moment in time, but maybe in a year, maybe in six months or maybe even a couple weeks we might have something better, right?

No, a couple of weeks is not a reason...

Am I correct?

Yes.

So what we need here is to buy time to find a cure that won't k*ll her. How do we buy time?

James. Right now, she's at risk for continued infection, severe bleeding, anemia that could effect her organs and her heart.

If her white cells get high enough...

Stop the negativity, please.

What can we do to keep her alive?

I suppose we could cover her with a broad spectrum of IV antibiotics... long term.

And if we put in a central line, we can continue with regular blood and platelet transfusions.

We need to support her anemia with oxygen.

And if she has any respiratory distress, we could intubate her and put her on a ventilator.

Think of what you'd be doing to her, putting her through.

Think about her family.

I'd be saving her life.

Giselle: That's my brain?

We combined three scans to create this image, and we were able to locate the source of your seizure.

Dorothy, we're not in County anymore.

Unfortunately, your seizure source is in your thalamus, deep in the brain. Close to the brain stem, near, uh, vital arteries.

Meaning?

Meaning if we're even thinking about going in there we need zero margin for error.

So we set up a real-time interoperative imaging.

Now Dr. Channarayapatra can track electric impulses in the brain in real time during surgery.

Like a deadly game of Operation.

This surgery isn't going to be easy, but we think we can get to it if we follow a carefully planned route.

We do need you to understand, um, there is a real possibility you may not wake up from this surgery.

I understand. It is frightening.

I'm-I'm not upset because I'm scared.

I'm moved.

I'm willing to take the risk.

I don't have kids. I-I don't have a husband.

I have my clients.

And what good am I if I can't help them?

Thank you.

Then, with your permission, we'd like to schedule this for tomorrow morning.

Tomorrow morning.

Merry Christmas, huh?

Let's do it.

Let's do it.

I hope to hell this works.

Oh, you'll do great. This will work.

Dr. Wallace.

This is the first time this kind of surgery's ever been attempted.

I would be honored if you would scrub in with me.

My wife just flew all the way out here to see me.

Tomorrow's my only day off, so...

Of course. You guys have fun.

Yeah.

Bring this one home, Doctor.

We could all use a win right now.

♪ ♪
♪ I'll have a blue Christmas ♪
♪ Without you ♪

...your cells built up a resistance to the CAR T cell therapy...

♪ Without you ♪
♪ Decoration of red ♪
♪ On a green ♪
♪ Christmas tree ♪

So there's no chance of trying that again?

♪ Won't be the same dear ♪
♪ If you're not here with me ♪

That strategy is no longer viable.

♪ And when those blue snowflakes ♪

We are meeting and talking and doing everything we can to try to find something that will work for you.

♪ That's when those blue memories ♪
♪ Start calling ♪
♪ You'll be doing all right ♪
♪ With your Christmas ♪
♪ Of white ♪
♪ But I'll have a blue ♪
♪ Blue Christmas ♪

(lock beeps)

What are you still doing here?

Um...

I'm gonna stay the night.

Maddie's numbers don't look good.

I don't want to be far.

I hope your patients know how hard you work for them, Dr. Brockett.

You okay?

Yeah.

Hey.

What's going on?

I was just thinking about my mom.

She had cancer.

Breast cancer. Came back three times, it spread everywhere.

I was 14 when she d*ed.

That's when I decided to become a doctor.

Somehow Maddie has just brought it all back to me... how helpless it feels.

It's so unfair, Malik.

Yeah.

Sorry. This is so embarrassing.

I'm a doctor, patients die. I just...

No, hey, hey, come here.

It's all right.

You okay?

Mmm.

Good?

Wow, yeah.

I hope not too dry.

No, it's perfect.

Oh, good.

Hardly done any cooking. I've been working crazy hours.

Yeah. Um, that doctor...

Channaray...

Channarayapatra.

Yeah.

She mentioned that.

She's really talented.

Yeah. And a former Miss India.

(chuckles) I'm not kidding.

She really was Miss India.

For real.

She was?

According to Google.

Why would you google her?

Oh, I don't know, Walt. Why would I do that? She's only a gorgeous and brilliant single heterosexual that you're sharing an office with and you never mentioned her.

I never mentioned her because there's nothing to mention.

Mm. I see.

Are you really upset by this?

I'm not upset about her specifically, no.

Well, you're upset about something.

Okay, I'm upset.

Maybe I-I think I'm upset because this started out as a job that you had to take. It was a stopgap measure because of what happened in Ohio, because you couldn't get a job anywhere else.

And suddenly you're working all hours of the night and your sharing an office with-with a brilliant and exotic beauty queen.

Jules, I...

This is what I need to know: if you are so happy here... where does that leave our family?

Luke's going to college in a couple of months...

No, us! Where does it leave us?

It leaves us in love with each other and working in different places.

People make it work.

Oh, all right.

So then you've decided to stay. That's it.

I have not decided to stay.

Yes, you have, you have.

You just... you don't know it yet.

Fine. I do like it here.

I like that Louis Keating has a rare disease that nobody cares about and we're fighting for him.

I like that we don't just throw up our hands and say, "We give up."

And this isn't some new me, this is the old me.

The young, idealistic medical student that you fell in love with, Jules.

And this is the man who risked my job to save that kid's life in Ohio.

What are you doing here?

I didn't want to wake you.

That's only slightly creepy.

I'm sorry.

How are you feeling?

They already explained things to me, James.

I get it.

You tried.

And I love you for that.

We have a plan. I want to keep you alive long enough to find a way to make this work.

We came close. We can do this.

What it will take will be a little drastic.

And some discomfort.

You'll need regular blood transfusions and possibly a feeding tube to help James, no.

With nutrition...

James, listen.

And I need you to really listen to me, okay?

Okay.

I've waged my battle.

You helped me do that.

And I fought hard.

I fought really, really hard.

And I'm ready for whatever comes.

I've made my peace.

Okay, James?

I don't know if I'm ready.

How's your plan going?

The one about watching TV with a family.

Not... so great.

Hmm.

Okay. Well... maybe you need to stop thinking about the big five-year plan and just start thinking one step ahead.

You know?

Like... go to a concert.

And an actual concert, not for some band that broke up 1,000 years ago.

Go to a concert right now.

Live your life, James.

♪ ♪

Hey.

Hi.

Hey.

Jules, um, can we just... move past last night?

This is our only day alone together.

Yeah, I want that, too.

Good. Well, if we leave soon, we'll b*at traffic and be in San Francisco in a half hour?

Uh, museums open at 10:00.

Then the Golden Gate Park.

I was gonna have James call in a favor and get us a table at Chez Panisse for lunch.

Or we can do something else.

You know, what I think I'd really like to see is, uh, Bunker Hill hospital.

Because I hear they're performing an amazing surgery there today.

Show me the miracle, Walt.

(door opens)

(water running)

What about your day with your wife?

She couldn't miss this.

Neither could I.

(steady beeping)

Those are the thalamocortical radiations.

The key determinants of consciousness.

Wallace: If we know they're there, we know how to avoid them.

I thought a lot about what I truly want my first concert to be.

Part of me would go with the legends...

Paul McCartney, the Stones.

Another part of me would just turn up to a little club on the Haight, just watch some guy trying to make it.

And then I thought it's probably less about who you're seeing and more about who you're with.

So I decided I want my first concert to be with you.

(muffled shouting)

Oh, my God.

(chuckling): Oh, my God.

Heather, what are you doing here?

Aunt Meg, hi!

Hi, guys. I love you guys.

H-How did all of this happen?

It was all James.

He sent a plane for everyone.

James?

(guitar playing)

♪ Hold on ♪
♪ To me as we go ♪
♪ ♪
♪ As we roll down ♪
♪ This unfamiliar road ♪
♪ And although this wave ♪
♪ Is stringing us along ♪

Come on, help me out.

(chuckles)

Maddie/Phillip: ♪ Just know you're not alone ♪
♪ 'Cause I'm gonna make this place your home ♪
♪ Settle down ♪
♪ It'll all be clear ♪
♪ Don't pay no mind to the demons ♪
♪ They fill you with fear ♪
♪ The trouble, it might drag you down ♪
♪ If you get lost ♪
♪ You can always be found ♪
♪ Just know you're not alone ♪
♪ 'Cause I'm gonna make this place your home ♪
♪ ♪
♪ Now, ooh... ♪
♪ Ooh... ♪
♪ Ah-ooh... ♪

The study wasn't approved.

I won't stop fighting for you, Louis.

Do you understand me?

I will not give up.

I'm fighting for you.

I'm fighting for me, too.

We're in this together, Louis.

I might be running out of time, James.

♪ ♪ ♪ ♪

(laughs) My mouth's bleedin', Bert!

My mouth's bleed... Zuzu's petals.

Zuzu... There they are!

Bert, what do you know about that?!

What are you doing here?

I sent the team home. It's Christmas Eve.

Your tests came back.

Your tremors aren't from GSS.

That kombucha you're drinking, it's heavily caffeinated.

Your tremors were probably a combination of sugar, caffeine, and too little sleep.

Need to take care of yourself, okay?

How's Giselle Overman?

Eight hours, no seizures.

Already turned her recovery room into a temporary office.

We did it, James.

See?

It is a wonderful life.

Yeah.

Merry Christmas, James.

Merry Christmas.

W?

Will you sit with me for a few minutes?

Sure, James.

♪ ♪
♪ Have yourself ♪
♪ A merry little Christmas ♪
♪ Let your heart be light ♪
♪ From now on ♪
♪ Our troubles will be out ♪
♪ Of sight ♪
♪ ♪
♪ Have yourself ♪
♪ A merry little Christmas ♪
♪ Make the Yuletide gay ♪
♪ From now on ♪
♪ Our troubles will be far away... ♪
♪ ♪
♪ And here we are ♪
♪ As in olden days ♪
♪ Happy golden days ♪
♪ Of yore ♪
♪ Faithful friends ♪
♪ Who are dear to us ♪
♪ Gather near to us... ♪
♪ Once more. ♪

(on TV): Merry Christmas!

Merry Christmas!

Merry Christmas!