02x01 - No Such Thing as Idealized Genitalia

[bunniefuu]

Getting On - 02x01

No Such Thing as Idealized Genitalia (Mumbles) There's lights.

Do you see bright lights, Mrs. Decker?

(Mumbles) There's Herb.

Herb is there? Who's Herb?

Didi: Who's Herb?

What is Herb wearing, Mrs. Decker?

Does Herb have on a heavy jacket?

Or some shorts? Or...

Didi?

What about pets?

Or scenery, Mrs. Decker? Mm?

(Loudly) You hear music, Mrs. Decker?

(Heart monitor flatlines)

Didi: Mrs. Decker?

What?

Someone's loved one was passing away, and you were hogging all the limelight, making it all about you.

Can you undo her I.V. please?

There is an art to dying, Didi.

It's not just a chatty séance.

Right this way.

Take all the time you need.

We do need this bed by 11.

(Glass shatters)

That's very sensitive research equipment.

If you could just... more gently.

Oh, Paul, Paul. (Giggles)

I was just headed to your neck of the woods to see you.

Well, good morning, Jenna.

What brings you in so early?

Um, my studies. Have a seat.

I'm well into phase two of the geriatric component of an anogenital study for the Human Genome Center.

This is potential groundbreaking stuff on gender flips.

And then you know that I've been working with big pharma and the vulvet quarterly on a comprehensive study on vaginal atrophy, with all the obvious commercial implications...

Lubricants and creams, and stuff.

So I wanted to drop off these receipts...

For some equipment that's been arriving.

Wow, this isn't, um, small potatoes anymore.

Well... uh, J-Jenna?

I... I just...

I don't think I can slide this through, Jenna.

Well, I kinda think that we should try.

After all, we did decide that I should be allowed to pursue my interests.

I'll try to be a good girl. I'll try to keep it down from here on out.

I promise. Thank you, Paul.

You smell especially rancid today.

Like a little fish left out on the counter overnight.

Didi, Didi. Uh, good morning.

Good morning. More packages came for my research institute.

Could you see that those get run up to six for me?

Yes, ma'am.

Thank you. Dawn, good morning.

Were you able to get over to the men's ward and measure my perinea?

Um, you know, I came in early so that I could go... get that done, but then my caliper broke.

And I ordered a new one, but supplies was out.

You do know that both gentlemen are being released today.

Their consent would be for not.

Yeah, it's just... I have my annual physical at two.

And I have been feeling very run-down.

So after the physical then?

I guess that'd be all right. Great.

You know what? I really appreciate the opportunity...

I... I wonder if there's someone else.

I'm not very good at research...

No, Dawn.

No, Dawn. You are a very talented Nurse.

That's why I chose you.

You just need to learn to believe in yourself.

Fellas? Ready?

Hello, I'm Dr. Jenna James.

Director of medicine here at Billy Barnes.

You're in our fancy, new bed, in our new comfort suite.

What brings you here to us today?

Mrs. Van Horn has congestive heart failure.

Secondary to cardiomyothopy.

CHF, wasting of the heart muscle.

Uh, yep, she's here for a bit of rehab.

Well, welcome. CMS has just approved Medicare coverage for rehab for congestive heart failure.

Until quite recently, they felt it was just all pretty much a waste of time.

Actually, Mrs. V came in for a heart transplant yesterday, but it was a false alarm.

Oh! Well, nuts to that.

She was actually a research chemist until just a very few years ago.

Really?

I came rushing in last night...

Oh...

Unfortunately, in most cases, in bad accidents, when the steering column smashes into the donor's sternum, we can't really tell how badly bruised the heart is until we actually open up the donor's chest, so...

Can I have a little listen?

Okay, everyone... perfect example of end-stage CHF.

The sloshing sound.

Andrew, come, come in here.

Yes, yes. Thank you.

Jenna: Very distinctive.

Doctor: Sloshing?

Yeah.

All right. Good.

Come on in.

It's tight. I'm studying gender flips.

Do you know what that is?

No, I'm not sure I do.

Men's perinea are shrinking in length with a corresponding decrease in motility and sperm count in their ej*cul*te... why?

Well, we think that phthalates and chewing on vinyl toys are producing these genetic changes that are just being passed down from generation to generation.

Well, this will interest you too.

Male frogs exposed to herbicide develop full ovaries and actually lay eggs.

They do?

Yes.

Why are males turning into females?

Closely monitor her O2 and notify Dr. Ung if it drops below 93 or 94.

And good luck with the new heart.

They do come in fairly regularly, so...

Fingers crossed.

Dawn?

Right.

Our recently-installed sani-cams recorded 97 contaminate events and 64 cleansing events.

Now, these numbers are recorded...

Marguerite, shh. What?

These numbers are recorded in real time at an offshore real time tabulation center, for an effective hand-washing rate of...

Good job, everybody. Good job! (Applause)

Yeah!

Patsy: Thank you, Didi.

(Knocks on door)

Ms. Ortley? Come in, come in.

Congratulations, your hygiene rate is nearly 100%.

Have you personally tried any of the motion-sensitive lights in any of our low-occupancy areas yet?

I tried it in a linen closet... nice.

Thank you. What can I do for you this morning?

Uh, a raise.

Yes, and I took the time to list all the reasons why.

It's just... it's a really, really bad time.

The Committee asked every department to lower its budget by 15%.

Right, but I only make $12.55 an hour, and I was told I would get a raise after four months, and it's been way past that now.

Also, you'd be opening us up to claims of discrimination, unfairness.

If you got a raise, and nobody else did...

Right, but that's not discrimination if I deserve it.

It's just the entire Medical Center is on financial pins and needles right now over the whole Waverly malpractice suit.

Right, I understand what you're saying, but what I'm talking about is a small raise.

Pension and benefits are all on the chopping block.

The LPNS at memorial are making $17 an hour.

Okay, you know what?

I will see what I can do.

Okay? But I need you to strengthen your case.

Give me more tools to work with.

Build an "attagirl" file, fill it with all the great things that your patients have to say about you.

Okay?

Attagirl.

Attagirl.

(Slurping loudly)

I have such a headache and my stomach is still...

You know, I had a bagel and cream cheese earlier.

Do you think maybe I've developed like, a gluten intolerance?

Or celiac's disease?

Maybe.

Or... or dairy. The cream cheese.

I didn't even think about that, or both.

It could be both.

Do you think maybe I have an autoimmune thing?

Maybe I should go vegan again.

Huh? Maybe, Dawn.

It's a spectacular day out, isn't it?

I put a curse on you.

Yes. We've been all through that before.

Mrs. Carmaglia, we have enjoyed having you, and I wanna thank you for volunteering to be a part of my research.

But you were discharged 36 hours ago, and you cannot simply refuse to leave a hospital.

I'm sorry if we got your hopes up about a surgery, but there's really nothing more that I can do.

We'll see about that.

The next encounter you have with his hospital may very well be with security.

Okay, Mrs. Van Horn, we're gonna try to lift you up a little bit.

We don't want the fluid to build up in your lungs.

Plant Services said they were coming at 3:00 to do a demo on this.

Didi, it's a bed. Okay?

Now tell us when you feel less pressure and when it's a bit easier to breathe, okay?

Let's go.

(Cranking, whirring)

See? That's great.

Okay.

Better.

That's better.

Stop now, stop.

Okay, w...

Stop.

Oh, it's not responding.

Okay, wait, wait.

Dawn: There you go.

It's coming up. Didi, you're gonna squash her.

Didi, the knees, the knees.

Didi, she is not a piece of taffy.

(Sighs) That's better.

That's it.

Why is turning that way?

Can you stop it from turning...

I don't know... that way, please?

Don't!

I'm going to topple off of the bed, Didi.

Wait, wait, wait.

The thing is stuck, Dawn.

Why is it stuck?

I don't know.

Get your finger off of it, that's what's stuck.

Can you move it back?

Why are you up there?

That's great. Thank you.

Can you stop?

The thing won't stop.

All right, get that I.V.

If I hold this...

Do you have her?

No, Didi, I don't have her.

I'm basically saving her life with my butt.

You're fine, ma'am. You are secure.

Don't yell at me. I was the one who said let's wait for Plant Services.

This actually is good. It helps loosen the... the fluid in your lungs.

Look for a button on there that maybe looks like it will reset it.

Okay. But it looks like an ejector switch, so I don't know.

Why would there be an ejector switch on a hospital bed?

I don't know.

Would you please just push the button?

I will push the button.

Push too many buttons is what you did and you sent the thing mixed messages.

Let's just... let's just do your pillow.

Patsy: You still feeling donsie?

Yes!

You know, I think it might be my sinuses.

I feel like I suffer from inflammation anyway.

I just hope it's not like a fibromyalgia thing.

Dawn, I think we both know what it is.

It's Dr. James.

You're in an abusive, toxic relationship with a woman who hates women, and she's taking it out on you.

I think you have difficulty maintaining firm boundaries and saying no.

I say no to her all the time.

She runs you ragged, hon'.

I say no all the time, even though it's very hard for me.

It's true that I am sensitive and it is true that I let people take and take and take and take.

And I am not very comfortable. It doesn't come natural for me to focus on me.

Which is why we need to work on your mindfulness training.

You can't be solid in life until you're solid with yourself.

Okay?

I take care of me first, then you.

I put my seat belt on, then yours.

Mindfulness is my... fullness.

I looked at another apartment over the weekend.

This one had jack and Jill sinks in the master bath.

But you could... you could use the Jill sink every once in a while.

Really?

Well, thanks...

For listening.

You're my lover and my friend.

Okay.

I will be home by 7:45.

Okay, you pick up the cake and the candles at Vons.

And I got a really nice card from the gift shop.

(Indistinct)

At least working there on my lunch hours was a good move.

No, no. No. Carmen is not going out.

No, she has to be home.

This birthday is important.

He's turning 16.

Let me call you right back.

Dr. James, uh, Suzi Sasso called to confirm your meeting with her about hospice.

Oh, there's nothing to confirm.

I'm not meeting with Suzi Sasso.

What's this?

That's the invoices that you gave me yesterday to send up to the Committee.

They were returned, so.

Returned?

Huh? Yeah, sent back.

Well, that's imposs... did you mark them Dr. Paul Stickley?

Yes, ma'am, I did.

Well, I don't know who would've returned that.

What do you want me to tell Sasso?

That I will meet with her when hell freezes over.

Didi, sorry, sorry. You have to understand.

Suzi Sasso represents greed-based, numbers-driven corporate hospice.

I am pro entrepreneurial, but corporate hospice are vultures...

Out to squeeze a buck under the guise of humanism.

Administration let her get her grubby paws on that one bed...

That insipid comfort suite.

I'm not turning any more of my ward over to some Suzi Sasso.

And any healthcare company based in Texas or Tennessee is real bad news.

Well, I just wanna make sure that Paul saw them.

Yeah, but did he actually see them?

He is?

No, I didn't know.

Yeah, I just wanted to make sure that the problem wasn't on my end.

I'm just saddled with nurse incompetency.

Dr. James: One's worthless, the other less worthless.

Okay.

Oh, thanks, Rick.

All right, see you at the meeting later.

(Phone clatters)

All right, Ms. Birdy, it's time to walk you for five minutes, okay?

You and I need to exercise you necrotic toe.

Ms. Birdy?

Ms. Birdy, we need to walk you.

Ms. Birdy.

Let's just get this over with.

Mr. Wymann, your knee is healed and you are being released today.

Yes, I am.

That's wonderful news.

I bet people call you "Jimbo."

No.

No? Oh...

We are gonna measure you today, okay, sir?

Could you please go get the calipers?

Yeah.

Dawn: You already signed your consent.

Yeah.

I am going to have to grab your scrotum.

We're gonna lift your scrotum, that's what's gonna happen.

Marguerite: Uh, the... the...

There you go.

Okay, all right.

Okay, hold both of those like that. No.

I need the calipers.

Nurse: Oh, the calipers.

But I'm holding the calipers.

Okay.

Marguerite, I will hold this.

Go get the caliper.

Oh. Ch... I'm so confused.

Let's switch.

All right.

Okay, sir, I'm gonna open your legs up a little bit.

(Man groans)

Okay. There you go.

Just so you know, my name is Marguerite, can you grab this, please? Put the camera down, and grab this please.

I just wanna...

Yeah.

That's perfect.

Marguerite: Maybe... okay.

Oh, Christ almighty.

For the love of...

(Grunts)

(Sighs)

(Jenna exhales)

Is somebody there?

Is that you?

Yes.

Nurse De La Serda and his f*cking motion sensor lights.

Can you just continue doing that till I finish up?

(Toilet flushing)

Sorry.

It's all right.

I'm done.

(Sighs)

Well, surprise, surprise.

What?

All I can say, Dawn, is, uh...

Good luck. (Chuckles)

Mrs. Roth?

Mrs. Roth, I need to annoy you for just a minute, okay?

Okay.

Okay.

That your daughter?

Yes, it is. That's Charlotte.

She's pretty.

Thank you for saying that.

You have children?

Yes, ma'am, I do.

Two of mine and four of my sister's.

And they're all like baby birds with their mouths open, wanting something.

Shoes, mostly.

Your folks raised you to be responsible.

Well... my father.

He's passed now, but I sure do miss him.

You can... you can talk to him again if you want to.

Well, we still kinda communicate.

No, in person, I mean.

You just get a piece of his jewelry, and go to the place where he passed away.

And just leave it there and wait.

He'll come back for it.

Then he can go home with you again.

Well, I didn't know that. Thank you very much for that advice.

Most people don't know.

It's never too late.

I went to the Hilltop where they found Charlotte.

(Sighs) 15 years later to the day...

She came back for her rings.

Hmm. And we went home together.

I got her back.

And, uh, that must have been a beautiful day for you, Mrs. Roth.

The best day of my life.

What is this?

Sorry?

This.

That is Mr. Wymann's perineum.

Where? Because all I see is an indeterminate orifice.

(Stammers)

What are these?

Closeups of an anus, and all of them out of focus.

These photos were to go to the Human Genome Center, and for all I know, this could be a snapshot of Carlsbad Caverns.

(Stammering) He kept moving, and then he was...

He kept jumping from the calipers, and then his wife came to get him, and then Marguerite...

All right, we have unique access to grown bodies... male and female...

That very few others have.

Pristine, vintage, pre-phthalate perinea, and yet I stand here with a set of blurred anuses.

I'm really sorry.

Mrs. Janice Carmaglia, please.

Oh, yes, officers. Oh, thank God.

All right, uh, it's right this way.

I'm Dr. Jenna James.

I'm sorry it's come to this, but she absolutely refuses to leave.

Truthfully, she's a hateful patient.

And we have to deal with these tragic people in both of our lines of work.

Mrs. Janice Carmaglia?

You better believe it.

You dialed 9-1-1, ma'am?

And the Department of Health and the Attorney General.

She's the one.

I'm "the one" what?

This woman filed a formal complaint.

You're negligent, you've been abusive and you're an old liar.

I am not a liar. I'm none of these things.

I suffer from multiple chemical sensitivities.

Disinfectants trigger my symptoms.

I vomit, they leave me in it.

She's a trespasser, a malingerer.

Ma'am, stand down.

I'm... okay. The whole thing...

This entire thing... she wants to rejuvenate her vag*na.

All right? That's what the whole thing's about.

I don't know what she's saying.

For my age... she'll say anything.

She'll lie. She's a big liar!

I took a picture of her vulva for my study, and I told her that she had an asymmetrical, extremely oversized labia minora.

I let her take pictures of my privates.

Dr. James: So, naturally, we discussed vaginoplasty.

I paid for insurance for all my life, I paid for social security...

My whole life!

But elective vaginoplasty is not covered by Medicare or by her insurance. It's only pelvic prolapse and incontinence.

You promised me!

I did not promise.

We all want idealized genitalia.

The classic vag*na.

But it really doesn't exist.

You said I'd drive off with a brand-new vulva.

Because I sincerely hoped that that would be possible.

Well, I got news for you.

My p*ssy is getting fixed.

And I'm not getting out of this bed until you do it.

My periodontist recommends two pieces four times a day.

The xylitol neutralizes my PH.

Anybody?

Okay, let's dig in.

From Nurse Ortley.

"The halls are too long.

If they could be made shorter it would be more efficient."

That would be a big help to me.

Okay, uh... Dr. James.

"Could Nurses' bandage kits contain individually-wrapped sterile bandages, so Nurses wouldn't waste unused sterile bandages..."

They actually do have individually-wrapped ones, but if you need a longer bandage...

Can we just let management consider a suggestion, rather than open it up to discussion ad nauseam?

Anonymous. Uh...

"Could Doctors, especially Directors of Medicine, kindly stop abusedly coercing Nurses into serving as unpaid research assistants?"

Patsy: All right, duly noted.

No. Well, I'd like to know exactly what that means.

I think someone is merely reminding us that Nurses deserve our respect.

No, I think it means more than that.

Dawn, what do you think it means?

No, I don't think an anonymous comment can be attributed to anyone in particular.

Dr. James: Well, clearly, it wasn't anonymous.

It wasn't me, either.

As to its intended target, I'm being accused of abuse and I think that I deserve a fair trial.

I don't know if this is the right forum for this.

No, Rick, Dawn and I are both wearing our big girl pants.

Dawn?

If I may, Nurse Forchette has asked you on several occasions to limit her involvement in your research.

No, no, no. She has expressed gratitude for being included in activities well beyond her scope and skill set, so I think that somebody might be telling tales out of school.

You called me less than worthless.

You called Didi worthless and me less than worthless.

Simply not true. When? Absolutely not.

On the phone, with someone who is here at this meeting, now.

When I jokingly referred to certain Nurses as being worthless and less worthless...

And mind you, I did not say "less than worthless."

Which is worse than worthless.

I did not mention which Nurses I was referring to, nor in what order I was disposing of them.

If everybody's gonna say what's on their minds, then let me say...

I want the raise that I was promised.

All I was asking for was an extra 28 cents an hour.

28 cents!

Right. Which works out to be $1200 a year.

28 cents. Right.

And, Dawn, surely you call me names too.

"Dr. James... she's a meanie.

She's a battle-axe.

Oh, what a stickler for detail that old bitch is."

I can't even look at you.

Because if I look at you, then I'm gonna feel bad about myself again.

I am allergic to you. You have psychologically overwhelmed me.

I am physically ill!

I am nauseous all the time.

I don't wanna do your research!

I just want you to leave me alone, so I can do my job!

(Door closes)

(Knocks on door)

Oh, Paul. Paul! Wow!

Congratulations are in order.

I hear the Committee successfully settled Waverly, and you're the new Director of Medicine for the entire hospital.

(Chuckles) Well, it's... oh.

I do wish it was under other circumstances, rather than at someone else's misfortune.

Of course, Dr. Garber had to step down.

It's unfair. It was an unfortunate, honest mistake.

It was the Nurses and the staff.

They're the ones that brought the wrong child into the O.R.

About these receipts...

I'm just naturally wondering why they were returned.

Sit down, Jenna.

Okay.

We need to, um, hit the pause button on this until I can settle into my new responsibilities.

Well, I'm counting on you to approve them, with our special understanding based on a certain slip of your tongue in the break room.

I'm not sure that special understanding still applies.

Well, you did admit that, had I not taken the job, that you would have joined the Committee in f*ring me, so that you didn't have to take the job yourself.

And I think we both thought that that was a rather inflammatory admission.

Yes, but any complaint you might have brought would have been to Dr. Garber.

Whereas now, you'd be complaining about me to me.

If you see what I mean.

Mm. Well...

Well... but... Paul.

I'm just right in the middle of setting up my very modest research institute, including a mouse hospital, along the lines of Columbia Presbyterian.

I can collect baseline data, but without co-clinical mouse trials and staff... I don't think that you realize that a proper mouse exam is very difficult.

It takes two people just to hold their legs apart.

Geriatrics leaks money like a sieve.

There have been proposals to close down Billy Barnes and lease it to a food court.

I am no longer indulging your appetites to the tune of 20, 30 thou a month.

No. Your carte Blanche research ride is over.

And I have to say, Jenna, I've never seen this horrible, greedy side of you.

Dr. Killigrew?

Dr. Killigrew, you wanted to see me?

Dawn, yes. Come in, come in.

I got some of your lab reports back from your physical earlier today.

Miss Birdy, give me your hands.

Okay, listen, you can't just fake a coma every time you don't want to do something.

You can't ignore the things in life that scare you.

Believe me, I tried, and it don't work.

(Sighs)

Dawn, you okay?

Yeah. It's... Mrs. Van Horn took a turn for the worst and had to go to ICU.

And she's not doing so good.

You should go. You're gonna miss your bus.

I'm fine.

Okay.

What's wrong?

Oh, God.

Dawn.

I'm gonna have a baby.

Um...

Is this a good thing?

I'm just surprised.

Do you know who the father is?

No.

I'm gonna make us some coffee.

And we can do handover notes together, 'cause I'm sure I missed my bus by now.

Honey, it's me.

Yeah, I'm gonna be late.

I... yeah.

Tell him I'm sorry, and I'm gonna try to get there as soon as I can.

Try not to light the candles without me.

Okay.

Okay, bye.

(Sighs)

(Line ringing)

Hello?

Hello, Suzi? Suzi Sasso?

Uh-huh.

It's Dr. Jenna James.

Director of Geriatrics at Mount Palms.

Yeah, yeah, Dr. James.

Hello. I'm surprised to hear from you.

I was just getting ready to check out and head back to Nashville.

Well, we are just so delighted with our one new hospice comfort suite that, naturally, we'd like to discuss how other patients might enjoy that extra level of care.

Well, wonderful. And I'm very happy to discuss all the ways a more vigorous partnership with LBAG Hospice would enhance your bottom line.

Like how?

Well, full-on hospice-hospital partnership really allows you to tap into reimbursements from patients' unused Medicaid Hospice benefits.

How many patients would I have to enroll to make 20, 30 thou a month?

Well, 1200 people d*ed in your Medical Center last year, so enroll 50% into hospice for one, even two days, and that's more than one mil in Medicaid billing, flat-out.

And the tip of the iceberg...

There are very fine legal and ethical lines that we can't cross...

Sure.

But we make our profits on this side of the line, not on that side.

Uh-huh.

The general rule of thumb is to get 'em early, keep 'em longer, and elevate them from regular care to continuous care as soon as that's practicable.

Right.

(Patriotic theme plays)