02x10 - Wishbones

[bunniefuu]

Look. There are his feet and there's his head.

They're exactly where they should be for 22 weeks.

Two babies. Gonna be a handful.

Two handfuls, actually.

(beeps)

Okay.

Now it's time to leave the good stuff.

You've been having increased pain and vomiting?

Yeah. This morning I could barely stand up.

All right. Let's have a look at the tumor.

(heartbeats continue)

Tumor is mid-sigmoid.

(beeps)

Proximal sigmoid looks free.

(beeps)

What?

The trick is to get it out without disturbing the uterus.

But we can do it.

(exhales)

(hearts b*ating)

You're enjoying that sound. (laughs)

Yeah, I'm addicted.

Dr. Kalfas hooks me up every time.

That's nice.

Sorry I'm late and sweaty. The game went extra innings.

Hey. You are... you must be the lucky dad.

Carrie: He's my doctor.

Jason Kalfas.

Maggie Lin.

You're an O.B.?

Mm-hmm.

No way. Baseball jersey threw me off.

Can we talk for a sec?

Yeah.

Okay.

(indistinct conversations)

It's a clean cancer, but it's still cancer.

The tumor's grown significantly in the last two weeks, and she's starting to show signs of bowel obstruction.

We can deliver those babies in less than two months.

Are you sure we can't wait?

We should operate today.

Since this is an emergency procedure, I can get an O.R. in an hour.

What's your approach?

Normally, I'd do an extensive node-clearing excision.

But in this case, our objective is get the tumor out and take a limited resection.

In and out as fast as possible?

Absolutely.

If you don't mind, I think I'll stick around.

Sure. You might want to hit the showers first, jeter.

Okay. You didn't find that weird?

What?

He is an obstetrician/gynecologist.

What woman would want a drop-dead gorgeous man like that staring between her legs?

You know what I mean.

I need to book an O.R.

Could you talk to Dr. Kalfas about Carrie's prenatal history?

Charlie and I are supposed to have a quick lunch.

Sure. Leave me alone with the good-looking O.B.

See if I care.

♪

Alex: We only have a half an hour.

Charlie: That's enough.

So, what were you guys talking about this morning?

Who?

Get out of here.

Woman: Sorry.

Um... uh... does...

You and my brother.

You were very secretive when I walked in on you this morning.

It was nothing. Um...

We'll talk about that later.

(both moaning)

Aah.

What's wrong?

(exhales)

Um, nothing. I just... I remembered something.

What did you remember?

Nothing.

That always seems to be an answer with you lately.

Well, some things you don't want to know.

If Luke's in trouble, I need to know.

I didn't say he was in trouble.

I said that...

Well, what is it?

Come on. We only got a couple minutes.

Let's just...

No, no, no, no.

Not until you tell me.

(exhales)

I handed him his jacket this morning, and a bottle of pills fell out.

What kind of pills?

It was vicodin.

He said they weren't his, but...

He's a liar.

Alex, he's already scared enough of me as it is.

Why don't you just wait a couple days, and maybe he'll tell you himself?

Yeah, right. Come on, Luke. Answer the phone.

Weren't we in the middle of something fun here?

The fun has coded.

You pissed?

You think?

You're pissed.

(police radio chatter)

Luke! You should wait for the cops!

Luke: Hey. (cell phone ringing)

You gotta talk to me, man. You gotta tell me your name.

Craig.

(rings)

What's up, Craig? How you doing?

(ringing continues)

Who's calling you?

I don't know. It's my... sister. (ringing stops)

I'm gonna call her back.

Luke, I thought you were working your program, which does not include carrying around a bottle of downers.

Did you think he wouldn't tell me?

I'm going to call until you answer, and then I'm going to yell.

(sniffles) This job was it.

It was all I had, and then they canned me.

Okay.

Hey.

Craig, who needs this job, you know?

Let me ask you something...

Are you familiar with the, uh, principles of LD50?

No.

No? Okay. Well, I'm gonna tell you.

LD50 is a dose of a toxin that'll k*ll 50% of a tested population.

Now we're up, what, 40 feet?

That's LD50 for a fall.

Do you know what that means, Craig? Craig, that means you only have a 50% chance of dying.

Understand that?

I'll take those odds.

You sure about that?

Because if you don't die, Craig, do you know what happens?

I'm gonna tell you.

You're gonna break your neck, you're gonna break your back, okay?

Massive internal injuries.

I'm gonna go down there, I'm gonna throw you on a stretcher, I'm gonna take you to the hospital, and they're gonna save you, Craig.

Just so you can spend the rest of your life in a wheelchair, sucking food through a straw.

Is that what you want, Craig?

That's not what you want.

You don't want that.

Right?

(crying) I don't know...

Okay. Okay.

You're not high enough, pal.

You understand?

So let's go down. Let's think about it.

You might change your mind.

And if you still want to go for it, we can just find you a higher spot, all right?

You're not high enough.

Come on.

All right.

Yeah.

All right. Good. Go slow. Go slow.

(shouts indistinctly)

(men shouting indistinctly)

(cell phone ringing)

(gasps)

Man: Stay still. (ringing continues)

Okay. This is not funny, Luke.

I'm heading into surgery now.

I'll be out in a couple of hours, so call me.

(coughs) Don't move!

(groans)

Luke, don't move!

Aah.

Aah!

(gasping)

(sirens wailing in distance)

Luke: Any vitals?

No, man, he's V.S.A.

You gotta let me dress your wound.

(breathing heavily) Listen to me.

I need a bone doctor. It's a segmental fracture, okay?

We gotta get you stabilized first, and then we can discuss...

Clayton, shut up!

Look. This is my bone.

What do you want me to do?

I need you to call someone, okay?

Okay.

Zach, you busy?

No, what's up?

Let's move.

What's going on?

Got a 40-foot fall. Leg impalement.

Fracture of the proximal femur.

Multiple abrasions. That's just for starters.

And you know this how?

'Cause I took the call.

It's Luke Reid.

There you are. I've been looking for you. I need to talk.

Uh, sorry. I got group session in one minute.

I gotta run.

Please? It's important.

Come find me after?

I'm feeling weird.

Okay.

(rips) Hmm.

You're eating your cup.

(clacks)

Oh, sorry. I-I'm hungry, I guess.

Oh. Maybe we should grab some lunch after the surgery, then.

Um, I... I have a boyfriend.

No, I didn't mean it that way.

He's handsome, too... in a different way than you.

Okay.

(monitor beeping steadily)

Carrie. Hi. You ready?

My babies are gonna be okay, right?

Yes. But during the surgery, my priority will be you.

I'm a 42-year-old pregnant single woman with bowel cancer.

Operable, garden-variety bowel cancer.

You're lucky.

No, what I am is terrified.

I'll be lucky if I come out of this surgery with both babies, and the cancer gone.

And any other story is a tragedy.

This is a straightforward procedure with a very high recovery rate.

Hello.

Dr. Kalfas.

I'll be watching from the gallery.

If you need anything, just shout, I'll fly in.

Like superman.

I'll see you when you wake up.

(door closes)

We'll scrub in.

(chuckles softly)

Maggie.

(police radio chatter, men shouting indistinctly)

(siren whoops)

Okay, give us some space.

Clayton: He's A.O. times three.

Good distal C.F.M. pulse is tachy at 110.

Thanks for coming.

I wouldn't miss it, pal.

Miller.

Luke.

He's lost a lot of blood. Pulsatile.

It's okay, man. I got it. Thank you.

Luke: Aah! Aah!

Luke, can you feel your toes?

Ugh. I think so, yeah.

Crepitus, the chest. Probably a fractured rib.

Looks like a distal radius fracture, as well.

Good news, that neurovascular bundle's intact.

Oh, I'm finding it hard to get excited about that right now.

Well, at least you won't be paralyzed.

Okay, difficult news...

We pull you off this thing...

I'll empty like a water balloon.

We have to cut it.

Cut it?

Alex: Liver is clear.

(air hose hissing, monitors beeping steadily)

So is the rest of the peritoneal cavity.

I'm gonna check the primary area.

Maggie, are you able to tell me the components of the tumor?

Maggie?

What?

Wow. I'm a space cadet today.

Um, 'cause I... Sorry. Not focused.

Um, T.N.M. components include tumor size, positive nodes, and metastatic disease.

Just checking. Stay with me here.

Mm-hmm.

Alex: Okay.

No inter-abdominal metastases.

Proximal sigmoid is mobile.

Rectosigmoid's clear.

Okay.

Ugh.

Part of the tumor is stuck to the side of the uterus.

Can you get under it?

I think maybe if I can get my fingers in there... might be able to peel it off.

I just have to...

Do you mind backing up a little bit? I need some room.

Umbilical tape?

Mm-hmm.

Okay.

Kelly.

Yeah.

And pull up on it.

Mm-hmm.

Cautery, please.

(exhales)

I don't like being this close to the uterus.

(beeping)

Got it. You did it.

I did. Now let's get that tumor out.

Uh-oh. (beeping)

It's amniotic fluid.

Her water just broke.

Kalfas.

Did you nick the uterus?

I might have.

Can the fetus survive this?

I don't think so.

(exhales)

Don't worry. We're gonna get you out of here in no time, man.

I'm gonna call Alex.

No.

Don't, Joel. I mean it.

I'm not gonna put her through it.

Just get me out of here, I'll talk to her in person.

(saw motor revving)

(man) Step back.

(loud buzzing)

Aah!

Aah!

Aah!

(siren whoops)

Fall from heights.

Impaled and through the proximal thigh.

Open segmental fracture of the femur.

G.C.S. 15, heart rate 125, B.P. 80/50.

Put another line in. Bolus saline, amp of Tetanus, gram of Cefazolin.

We can't put him in the C.T. like this.

Yeah, no kidding. Let's prep a lateral X-ray, please.

On three. One, two, three.

♪♪

Yeah, that soft tissue injury's gonna be bad.

Yeah, that lower fracture's clean, but the proximal one's...

Hey, Charlie.

Look at that. Four, five pieces.

Hey, you page me?

I did. Let's walk.

Wow.

Pretty much my sentiment.

That your best view?

Unfortunately, angles are limited for obvious reasons.

What would you do?

What can you do? You pull it out, see what happens, react.

Joel: Yeah.

I don't remember the last time you paged me for a consult.

I'll do you one better. You wanna scrub in?

The patient is Luke Reid.

Does Alex know?

He doesn't want her to know.

Hey. Charlie.

See you in the O.R.!

(monitor beeping steadily)

(hearts b*ating over monitor)

Hey, uh, how's it going in here?

Not now.

(monitor beeps, hearts b*ating)

Fetal heartbeat's slowing.

Indicates cord compression.

At least they're in separate sacs.

Baby's dead within a few hours.

She can still have one healthy baby.

What about caesarean?

Look, we-we can't do anything with the compromised fetus without putting the healthy one at risk.

The chances of survival outside the womb right now are basically zero. I'm sorry. They're just not viable.

So there's nothing we can do?

She has to go around with a fetus dying inside of her?

We can induce in six to seven weeks, where she'll most likely have a healthy baby.

Considering her case, that's already b*ating the odds.

You know what, Dr. Kalfas? If you have nothing else to offer, I need to finish this surgery.

(hearts b*ating out of sync)

Let's get the leads off. I can't concentrate.

Okay. Cautery.

Joel: So I take it you didn't tell Alex?

No. She needs to concentrate on her job and we need to concentrate on ours.

Looks like we're clear of the mess now.

Let's get a retractor in there to protect that neurovascular bundle.

Thank you.

Okay. That should do it.

I pull, you pounce.

You got it.

On three.

One... two... three.

(squishing)

(monitor beeping rapidly)

Ligating. Suction.

(suction whooshing)

That is a mess.

A lot of missing bone.

It gets worse. The proximal side's completely shattered.

By the time we fish those bits out, I bet there's, I don't know...

15-centimeter gap in that bone.

As much as the kid drives me up the wall, I don't feel like chopping off his leg.

Taylor spatial frame?

No. There's not enough there to work with.

No one's ever lengthened an adult more than a couple centimeters.

What about replanting the missing bone?

Mnh-mnh. It's not viable.

I mean, there's no longer any blood supply in there.

What is your success rate on a total femur replacement?

20%, if I'm being generous. You?

Yeah. It's thereabouts.

Okay. Let's build this kid a new bone.

You wanna do a masquelet?

I don't see another option. You ever done one?

Yeah, I have. Once.

And?

The pig seemed very satisfied.

Okay. That'll have to do.

(monitor beeping steadily)

(inhales, exhales)

(knocks)

Carrie. Hi.

I wanted to check on you, and to, uh, fill you in on how the surgery...

I know how it went.

I guess Dr. Kalfas talked to you?

He told me one of my babies is... dying inside me.

(cries) And nobody's doing anything about it.

I am so sorry.

But we will make sure your other fetus is healthy.

We will put you on antibiotics, monitor both of you.

You know he's still alive, right?

(crying) His heart is slowing down, but he's still alive.

I think that he's a fighter.

I do. I think he wants to live, and I think... I think that we should induce labor.

But I'm sure Dr. Kalfas already explained to you... they're pre-viable.

They won't survive.

(crying)

I can't... I can't lie here and just... I can't let him just die inside me.

How am I supposed to do that?

How do I do that?

(sniffles)

I know it's awful.

But your other baby will continue to grow and develop.

Carrie, you had a very difficult problem.

It was threatening your life, and we've looked after that.

It'll be a while until the pathology results are in, but I'm very confident that we got all the cancer out.

So you will be around to raise your baby.

(breathes deeply)

(crying)

I'll be back in a little bit.

Dr. Reid.

Hey.

You all right?

No. I'm a general surgeon.

I see a problem, I intervene.

That's the difference between general surgery and obstetrics, I guess.

(exhales)

Smallest baby I ever delivered was under 500 grams. She was 24 weeks along.

She was born blind, she had bronchopulmonary dysplasia, and she spent the first and only month of her life in an incubator.

Before she d*ed of heart failure.

But for that one month, boy, did I ever want to do something.

Carrie's been trying to get pregnant for four years.

She sold her house to afford the fertility treatments.

Sorry. I shouldn't be taking this out on you.

Hey. Uh, I've been reading about inter-amniotic injection of platelets.

I think we should try it.

Uh...

What's that?

It's the amniopatch.

You inject fluid and plasma into the amniotic sac.

It can create a patch to prevent further leakage.

Why are we not considering this?

Because it's still experimental, and it's not widely practiced.

But basically, it's like doing a reverse amniocentesis, right?

Uh... I guess.

What are the risks?

Uh, well, for one, the substance can cause a drop in the fetal blood pressure and heart rate, which can be lethal.

But if the baby's dying anyway, isn't it worth it?

Okay, but the truth is, I've never done one.

So?

Let me take a look at this.

I'm thinking that's a "yes."

Do you mind if I borrow?

Bor...

Oh, sure. Borrow. Borrow whatever you need.

I can't think straight around that man.

(indistinct conversations, baby crying)

Hey.

Hey.

Isn't Charlie working trauma today?

I... I don't know. He-he was.

Well, where is he?

I don't know. He's... (exhales) probably with Joel.

Okay. And where's Joel?

With Charlie?

(chuckles)

Zach, you have exactly five seconds to tell me what's going on.

Joel: Lisa, give me the vancomycin.

(monitor beeping)

(suction whooshing)

Alex. He's fine.

Honey.

He's fine.

Is he gonna lose his leg?

Not if we can help it, no.

Why didn't you tell me?

Because he specifically asked us not to.

And you listened to him? Charlie?

You were in surgery.

So what? I'm scrubbing in.

Alex, you can't operate on a family member.

You have nothing to offer this surgery.

You will only slow us down.

So please get out of here and let us work.

(sighs)

Okay. (suction whooshing)

Charlie: Suction.

(suction whooshing)

(whirring)

(whirring stops, monitor beeping)

Why am I not surprised that we're here?

This kid attracts trouble.

He was trying to help someone.

(beep)

Guess he should have waited for backup, then.

He's in a million pieces right now, mate.

He's irresponsible.

Right, but it might not be the time for you to be mad at him.

Look, he's not a bad kid.

You knew him when he was 19, Joel.

Yeah. It's okay to be a mess when you're 19.

He's pushing 30.

(whirring)

(beep)

She worries all the time.

You don't know what it's like.

I do know what it's like, actually.

(whirring)

She worries about a lot of things.

(whirring stops)

(whirs, stops)

We're stabilized here.

His heart's in the right place.

Okay? This is bad luck.

I don't know.

Fell five stories, he's gonna live to tell about it.

His luck's not all that bad.

(monitor beeping steadily)

(door opens)

He's all good. Joel's just closing him up.

(inhales and exhales sharply)

He's okay?

Yeah, come on.

These... capable hands?

Next time, you tell me. Okay?

(sighs) Your little brother's in one piece.

That's what matters.

Thank you.

Gavin, I need therapy.

(door closes) I'm all ears.

I'll even give you a discount.

Something is wrong with me, and I need to get it off my chest.

Okay.

Today, I have had to work with a really good-looking...

I'm talking sex symbol... obstetrician, and he's really thrown me off my game.

I'm-I'm all sweaty and weird, and I started to think, wow, maybe I'm lacking vitamins.

But, no, I think... actually it's-it's Dr. Kalfas.

And you're telling me this because...

Because-because you're my guy, and I don't want to keep secrets from you, and I think that you are very good-looking, in a real, sweet way.

As... opposed to the manly sex symbol way?

Exactly.

(siren wailing in distance)

I feel better.

Cool.

You're good.

Thanks for coming by.

Love you.

Yeah.

Mm-hmm.

(monitor beeping steadily)

(breathing deeply)

(exhales)

What were you calling about?

It doesn't matter.

Is there anything I don't screw up?

Not much.

You stir life up.

(exhales)

That's why people love you.

(chuckles) is that right?

Mm-hmm. (inhales deeply)

(exhales) Half the time I don't mean to.

I'm just unlucky. (sighs)

Hmm.

It's like the wishbone, you know?

Remember the wishbone?

(laughs)

(chuckles)

(snickers)

You always got the big piece. You remember that?

I never did, not once.

Ah.

It's not like my wishes always came true.

Well... they mostly did.

Well, the only thing I'd wish for right now is for you to get better.

(exhales) You know what?

I can't get my hands on a chicken bone right now.

Maybe this will do.

Make a wish?

(exhales)

Got it?

Pull.

(snaps)

(both chuckle)

(continues chuckling)

(groans) Ah, you see what I mean?

(chuckles)

I'm unlucky. I'm... cursed.

No, it's just a... (clatters) stupid piece of plastic. It was a dumb idea.

It was a dumb idea.

Yeah.

But you know what I wished for?

What?

I wished...

I wasn't a drunk.

And that we can go back to the old man's camper.

Some beer. Just a little bit.

Some caps, a little game. You know?

Those were good times.

(chuckles and sighs)

(exhales) Are you ash... are you ashamed of me?

Are you kidding me?

No.

No.

Okay.

Then what were you calling me about?

Hmm.

Let's not talk about that now.

(indistinct conversations)

What, Gavin?

Can I ask you a question?

Yes.

You're a good-looking dude, don't you think?

Yeah.

I think I'm a good-looking guy, you know?

But I'm not objective, so...

On the good-looking scale, what would you...

What would you think that I am?

Like, objectively. If you had to rate me.

7.38 if you had your shirt tucked in.

(elevator bell dings)

Hi.

Hey.

Now that is a good-looking dude.

That's like a 9.2.

(monitors beeping steadily)

(groans)

Okay, let me check your arm.

Ah, stop fussing.

What would you like me to do?

Just... ah, just help me sit up.

(groans) All right?

That's fine. That's fine, that's fine.

How about your leg?

I know you know about the pills.

They weren't mine, Alex.

They weren't mine, all right?

Okay.

You don't believe me.

It doesn't matter.

All right, well, we're in a hospital.

It's a perfect time for a confessional.

It doesn't matter.

No, no, no. You wanna know... the truth.

I'll tell you the truth.

Remember pop's, uh, big scratch on his old buick?

You got blamed for that. That was me.

Grandma's gaudy ring that went missing... that was me, too.

Luke.

No, no, no, no, no.

Remember when I found your wallet on the ground?

I stole 20 bucks from it before I gave it back to you.

And Yolanda, your old pal, you remember her?

Yeah, she dropped you like a hot potato. You know why?

Because... I slept with her.

And I didn't call her back. (chuckles)

I'm-I'm gonna go.

The pills aren't mine, though, Alex.

Doesn't matter.

Say you believe me.

Fine.

I believe you. All right?

Alex!

Yeah?

I love you.

(exhales)

(heartbeat on monitor) Okay, so we have plasma, platelets, and the clear solution is ringer's.

We'll alternate 20 ccs of each until they've filled the amniotic sac with enough fluid.

And what about the tear? What if it starts to leak again?

It shouldn't. The platelets will act like glue, find the leak, and seal it up if all goes well.

And, uh, what if they don't? I mean...

Well, you need to remain still, okay? Very still.

The needle can't move. You understand?

Yeah. Yeah.

You okay?

Yeah.

Hi. Do you mind if I join?

Sure. If you could watch the monitor.

You ready?

I'm ready.

All right. (beep)

(exhales)

Hey. Welcome back.

(exhales)

Where's Alex?

She okay?

Yeah, she's fine. She's, uh, worried about you.

Yeah? Okay. Yeah.

(exhales) What's going on with my leg?

Just investigating that right now, Luke.

Yeah.

Good. That's good. Where's Alex?

She-she's fine, buddy.

Something doesn't feel right. Uh... (monitor beeping faster)

Okay, your SATs are low. Hey, Luke...

I need to get up.

No, no, no. No, no, no, no.

I need to get up.

No, no, no. Hey. Hey.

I need you to help me up, Joel.

No, no, no. I'm not gonna do that.

Why don't you relax? Just-just lie back.

I need you to help me get up...

Hey. Listen to me. You need to...

Yeah. Yeah.

Hey. Hey! Hey... get me a nurse in here, please!

(monitor beeping, second tone beeps)

(rapid beeping)

Somebody get me a crash cart!

(tone beeps)

(woman on P.A.) Code blue, I.C.U., med three.

Code blue, I.C.U., med three.

Code blue, I.C.U.

(monitors beeping rapidly)

Neck veins are distended.

He's got pulseless electrical activity.

C.P.R.'s not gonna help him. It's a cardiac tamponade.

Get me the ultrasound.

(beeping continues)

(beeps) There's a ton of blood around his heart.

We have to drain it.

Get me an 18-gauge spinal needle and a 20 cc syringe.

We should call cardiac.

There's no time.

Okay...

(beeping continues)

It's filling up. So far, so good.

(heart b*ating on monitor)

Kalfas: Now the plasma.

Yep.

Fetal heartbeat's slowing.

What's going on?

Vaso-spasm? The vessels are contracting.

What's going... what is that? What does that mean?

Carrie, we know this isn't a sure thing.

What is happening?

Why is that happening?

Carrie, you need to be still.

Why is his heartbeat dropping?

Carrie, don't move.

We can do something, right? You can do something, right?

Give her a sh*t of propofol now.

Do something.

Carrie, sit back.

No, no, no, no. No, no, no. No dr*gs.

No. Don't knock me out. I promise I won't move.

I won't move.

Carrie, listen to my voice.

Yeah?

Breathe.

I won't move. I won't move.

Okay, look at me.

Be calm.

You're gonna be fine.

It's gonna be okay, right?

It's gonna be fine. Just breathe.

It's gonna be a okay.

(breathes deeply) Breathe.

Please, please, please, please, please.

Come on. Please, please, please.

Come on, baby. Come on.

Please, please. (beep)

There we go.

Yeah.

(heartbeat increases)

He is a little fighter.

Yeah. Yeah. (laughs)

(laughing) You're in the clear.

You're gonna have a devil on your hands.

I hope he's a little hell-raiser.

(laughing)

Alex, come with me.

What is it?

It's Luke.

He went into P.E.A. and the ultrasound showed blood from his chest cavity.

Charlie?

You...

(grunts indistinctly)

(James Blake) ♪ I don't know about my dreams ♪
♪ I don't know about my dreamin' anymore ♪
♪ all that I know is ♪
♪ I'm falling, falling, falling, falling ♪
♪ might as well fall in ♪

(electricity surging)

(echoes) Clear!

(electricity crackles)

♪ I don't know about my love ♪

(rhythmic panting)

Clear!

♪ I don't about my ♪ (electricity crackles)

♪ loving anymore ♪

Alex, you shouldn't be here.

Get out of here.

♪ all that I know is ♪

Come on, pal.

♪ I'm falling, falling ♪
♪ falling, falling ♪

Clear!

(electricity crackles)

♪ might as well fall in ♪

Hey! Look at me!

Look at me! Alex!

Get out of here!

I need to be here. (electricity surging)

Clear! (electricity crackles)

Come on.

Clear!

Luke...

(electricity crackles, monitors beeping rapidly)

♪ I'm falling, falling, falling ♪
♪ falling ♪ (panting rhythmically)

(panting continues)

You old dog.

I knew there was something weird about you.

Listen to me.

You're not dead yet. There's still time.

You don't know that.

And to be honest... This feels all right.

No, no, no, no, no. No. Are you crazy? Come on.

We need to go right now.

I don't think that I should.

Do you have any idea what this is gonna do to Alex?

She's done enough for me. I've done a lot to her.

It's got to be hard to always be disappointed.

She's better off.

♪

You're saying your sister would be better off if you d*ed?

Yeah, maybe.

Maybe it's better for me.

(sighs and chuckles)

I'm tired.

I've always been scared.

Right now I'm not afraid. Do you have any idea...

What that feels like?

It feels good.

Charlie, I need you to do something for me.

♪ I'm falling, falling, falling ♪ (sighs)

(electricity surging)

(Joel panting rhythmically)

Clear! (electricity crackles)

(monitors beeping rapidly)

(panting rhythmically)

(gasps)

(monitor beeps twice)

(flat-lining tone)

He's in asystole.

♪ I don't know about my loving anymore ♪

(sighs) No. No. Don't give up.

Joel, keep trying.

Alex, it's been almost 30 minutes.

(crying)

(flat-lining tone continues)

I don't understand.

(breath quavers)

6: 17 P.M.

♪ I don't know about my ♪

I'm so sorry, Alex.

♪ dreaming anymore ♪
♪ all that I know is ♪
♪ I'm falling, falling, falling, falling ♪
♪ might as well fall in ♪

(exhales)

When you were playing around in there doing your journal-worthy surgery, were you paying attention to his SATs?

Prolonged surgery as a risk factor is well known to anyone who practices medicine.

(exhales) I know it's not your fault.

I just have to be mad at somebody. (exhales)

Wake me up, Charlie.

Please tell me this isn't real.

I don't know what to say.

He d*ed thinking I was mad at him.

It doesn't matter.

(sniffs)

He knew you loved him.

But I didn't tell him.

I knew.

He knew.

(exhales) How do you know?

(sighs)

Uh... he told me lots of things.

I lied.

He lied.

The dr*gs were mine.

The dr*gs were his.

Tell her I'm an idiot.

And he's sorry.

Yeah.

You know, when I look at him, I just...

I see this little boy who used to jump out from behind the couch and scare the crap out of me.

You know? And then make me pee in my pants laughing.

And then, bam, he would just push my buttons and piss me off.

But then he would turn around and say the most thoughtful, wonderful things.

Every time I thought that I had Luke figured out, I was wrong, right up until the very end.

(sighs)

He was so full of life, and I was so proud of him.

And now he'll never know.

That was really nice work today.

Yeah. Thanks. Um...

I'm sorry if I've been moody today.

I'm having a weird one.

I'm emotional, I'm flushed and hungry and thirsty.

It's just... crazy, actually.

I can't believe as a doctor you don't see what's going on here.

What?

The signs are pretty obvious, right?

Mm?

I mean, you were chewing on your cup because you have pica.

You have pica for the same reason that you're thirsty and flushed and feeling weird, and... no offense, but your areolas were also very, um... pointy, but...

(chuckles) Excuse me?

(chuckles)

Congratulations, Dr. Lin.

You're pregnant.

(clicks tongue)

(exhales)

(exhales)

(clicks tongue)

(knocks on door)

Hi.

There you are. (heart b*ating on monitor)

Hey. Thank you.

So it went well.

So far.

(heartbeat continues on monitor)

Dr. Kalfas just came to check in on us, and it seems to be working.

(paper on chart rustling)

Looks good. Congratulations.

Yeah. So far.

Mm-hmm.

(sniffles)

Oh, god, listen to that.

(heartbeat continues)

(sighs) Isn't it beautiful?

Yeah.

It really is.

Hey.

Hey.

How are you?

I'm fine. How are you?

I'm okay.

Something wrong?

Maybe.

Sexy doctor still on your mind?

Yeah. Sexy doctor.

The hot, steamy, sexpot, rock 'n' roll, fourth-year psych resident that I sleep with on a regular basis...

He's on my mind.

What's that from?

Blood test.

Routine?

Mm-hmm.

You ready to go home?

Uh, I got a lot of paperwork to do, but you go ahead, and I'll see you later.

Okay.

Hey, um... do you ever think about getting a dog?

A dog?

You kidding? We're way too busy for pets.

Yeah.

That's what I thought.

(door closes)

(sighs)

Alex.

I'm going home.

I know.

Luke did know.

What are you talking about?

He... he heard you.

Maybe there's something more... to this life, you know? Maybe.

I-I think when I was in my coma, I realized that.

I'm not sure what you're talking about.

Just...

What would you say if I told you that when I was... when my body was in the I.C.U., that part of me wandered these halls?

I talked to... I talked to spirits.

I talked to other coma patients. I talked...

Charlie...

I talked to dead people.

Charlie.

No. Uh, uh, I thought I was dreaming.

I thought... I thought it was all in my head and I was gonna wake up, but when I woke up...

It's still happening.

Charlie...

It's still happening. It's still happening.

I know that your brother can hear you because he's standing right there.

Stop it.

He's right there.

Stop it!

Alex...

You can talk to him.

You wanted to know what's happening to me.

I see ghosts.

This is insane.

(exhales)

I feel like I'm going crazy.

No, no. You're not.

(gasps) Don't-don't go.

(kisses)

(breath quavers and exhales)

(exhales)

(screams)

(gasps and sobs)