01x03 - Comrades in Arms

[bunniefuu]

Previously on The Resident...

Everything you thought you
knew about medicine is wrong.

All the rules you followed, we'll break.

You don't have the right
to play God, Conrad.

CONRAD: I will do whatever
it takes to get you back.

Chief of surgery.

Resident. Try to remember that.

Dr. Okafor.

Don't be nervous.
I'll talk you through it.

Acute leukemic, on chemo.

CONRAD: Lily means a lot to all of us.

She's been in and out of the ER
so often we're all invested.

- NIC: Where's Lily Kendall?
- NURSE: She went home.

Her count improved substantially.

♪ ♪

♪ You're getting way too ♪
♪ big for your boots ♪

♪ You're never too big for the boot ♪

♪ I've got the big size s on my feet ♪

♪ Your face ain't big for my boot ♪

♪ Kick up the yout, ♪
♪ man, know that I... ♪

- We're in third place.
- Now or never.

Sir, yes, sir.

(WHOOPS) Second place.

Oh, I know how you feel about losing.

♪ How dare you twist ♪
♪ up the truth, look ♪

♪ I'm too hot ♪

♪ Lunch money in my shoebox ♪

♪ Still steal meat from the stew pot ♪

♪ Mandem go sick when ♪
♪ my tune drops, little man ♪

♪ That's a Hublot, not a Hublot, wait ♪

♪ Wait, I'm bound to ride for Flipz ♪

♪ Real Gs gonna ride around... ♪

- We got this.
- We do?

I do.

♪ I never left ♪
♪ my : to : for this... ♪

- (GRUNTS)
- (GRUNTS)

(GRUNTING)

- (UPBEAT MUSIC PLAYING)
- (INDISTINCT CONVERSATIONS)

th Marine Expeditionary.

Valor, honor... Whoa...

- Victory.
- Yo!

Dudes. Awesome race!

MAN: Of course... random drunk guy.

DRUNK GUY: Cold ones on me.

- (GRUNTS, SHOUTS)
- (BONE CRUNCHES)

Aah... aah!

My leg! (CRYING): I need a doct...

It's broke.

Doctor!

(CRYING, GRUNTING)

Right fibula. Compound fracture.

- (MAN GROANING)
- We need a splint.

- Oh, it hurts. It hurts so bad.
- Deep breaths, buddy,

we don't want you going
into shock. What's your name?

- Ooh. Hank.
- That's the best we got.

- We'll just wrap him up.
- Like old times... medic and surgeon?

He's about to tell us
how much he misses

the good ol' days when we were
in Afghanistan together.

Give me some credit, hey.
All right, listen,

this is gonna sting.
Might want to bite down on that.

- But I do miss it sometimes. Don't you?
- I don't miss

being sh*t at. No sane person would.

Not trying to take that personally.

Setting the leg...

- now! -(CRUNCH)
- (SHOUTS, CRIES)

There we go. All right.

- Doing great, buddy.
- (MOANING)

♪ I was born for this ♪

- Let's go!
- (TAPS WINDOW)

♪ Baby, I was born... ♪

♪ ♪

(INDISTINCT CONVERSATIONS)

Lily, hey.

Oh, hey, Nic.

You left Chastain so abruptly
the other day. I was worried.

Yeah, I'm fine. Thank you.

Just grabbing a prescription.

- (CLEARS THROAT)
- You feeling okay?

You want to come upstairs?
I can take your temperature,

- make sure you don't have a fever.
- No, no, I'm good.

Yeah, I'll stop by Dr. Hunter's
clinic if I need anything.

- You sure?
- Mm-hmm.

- 'Kay.
- Thanks.

(PAGER BEEPING)

Come on, Mr. Rosenthal.

I got to take you for some
fresh air, and then to PT.

No, thanks.

What I need is a drink and smoke.

Good morning, Mr. Rosenthal.

Lucky you... a free ride with Louisa,
our most popular transpo worker.

Ah, just a quick spin.

Don't want a spin around nothing.

- You need sunshine.
- Vitamin D,

helps you absorb calcium.

Which promotes bone density.

You don't want to
break your hip again, do you?

You know, you should really
listen to Louisa. You know why?

- No, why?
- She's studying to be a doctor.

ROSENTHAL: Med school, huh?

You got a ways to go.

How old are you, ?

Ah, close. .

And she volunteered at Chastain
all through high school.

- Hmm.
- Hi, Louisa.

- Hey.
- Nic, seriously,

what is this mandatory meeting about?

I have patients to see.

- Billing.
- LOUISA: Billing?

Whoa, sign me up. Love me some billing.

ROSENTHAL: Enough already.

- (LOUISA GROANS SOFTLY)
- You okay?

Yeah. Diagnosed myself with
a muscle pull this morning.

Some kind of softball injury.

Might have to, uh, skip out early today.

Plus, I have to cram.
Midterms next week.

Bio and calc.

Well, if you need any help at all,

I got a on the bio section
of my MCATs.

Kid brags a lot, doesn't he?

LOUISA: Thanks, Dr. Pravesh.

I might take you up on that offer.

(PUSHES BUTTON)

(SIGHS)

(GROANING)

Compound fracture of the right fibula.

Now, we reset it in the field,
but he might need surgery.

All right. I'll be right there.

- We'll see you inside.
- Okay.

- Thanks, Doc.
- Let's go.

- (HANK COUGHS)
- You did great, Hank.

Yeah, except for the crying.

- And screaming for a doctor.
- And breaking all those beer bottles.

The truth? That was like old times.

Well, you miss it so much,
why don't you go back?

Yeah, I've been meaning to tell you.

Jude, I was joking.

Thinking about re-enlisting.

- Back into the Marines?
- Yeah.

- Do boys ever grow up?
- Yes.

- No.
- Mandatory meeting, we're late.

I thought you were gonna
get us out of this?

Yeah, well, I told her
we had seven open cases...

- All residents, all nurses. Let's go.
- (CONRAD SIGHS)

NIC: You smell like a barn.

- I like barns.
- Never been in one.

What? I grew up in Queens.

I've smelled worse, trust me.

- Excuse me.
- BARB: Morning, everyone.

We're here today
to talk about reimbursement.

No one's favorite part
of the day, right?

Okay, put that away, sweetie.

Now, to simplify,
doctors and nurses at Chastain

need to charge more per procedure.

For example: ear infection.

Typically billed to insurance
as service code one

at about... yeah?

$ .

BARB: But what if that ear infection
took a trip to the brain?

That's now a code four. Serious.

Costly.

We can bill in the thousands.

Illness is unpredictable,
so billing must be proactive.

Right? It's called upcoding.

Think... CUTE.

Code. Up. To. Excellence.

- (DEVON GROANS)
- Enjoy. I'm out.

Third year. First year.

Welcome to American healthcare .

BARB: Okay, what are we
all concerned about?

How much did you have to drink today?

Not really sure.

You were at the race all morning?

Which Conrad and I won, by the way.

I had a beer before the race.

Jaundiced skin, scleral icterus.

I'm sending him for
a liver panel and an ultrasound.

How's our number one fan?

JUDE: You see this?

This is a stateside doctor,
doing what he was born to do...

running liver function tests
in a cushy, big-city ER.

(IRVING CLEARS THROAT)

♪ I am the very model ♪
♪ Of a modern major-general ♪

♪ I've information vegetable, ♪
♪ animal and mineral ♪

♪ I know the kings of England and I
quote the fights historical... ♪

I was also born to sing.

You get out on the boat this weekend?

Yeah, the fish weren't biting. You?

Well, a little golf.

You know, actually,
I had a question for you.

Old guy I was playing with has
developed a bit of a tremor.

And it's giving him the yips. And
I prescribed the standard...

beta blockers... but it hasn't helped.

You know, I know there's surgery,
but it seems a little drastic.

Well, cracking open his head for a
missed putt is a bit much, huh?

Yeah, what about benzodiazepines?

Last resort, he can try 'em.
But the side effects are gonna be...

- Aggression and cognitive impairment.
- Yeah.

I guess it just depends how
desperate the guy is, though.

- Cheers.
- Cheers.

(EXHALES)

Rosenthal in ...
catheter out and discharge.

Anderson ...

Monitor her rhythm. Where were
you and Dr. Silva deployed?

Afghanistan.

If she spikes a fever, you add...

IV piperacillin.

My brother was in the army,
two tours in Iraq.

He came back a very different guy.

Did you see any action?

I was a corpsman in the Marines.

Jude was a base surgeon.

We tried to save lives, not take them.

But mostly, we had each other's back.

Now let's move on to medicine.
We have a busy day ahead of us.

Let me know if there's anything
in the marketing department...

(WHISPERS): Look busy.

- RENATA: ... the upcoding system.
- BARB: Don't forget testing.

A well-insured patient should be tested

for all possible outcomes,
no matter how unlikely.

Dr. Hawkins, have you met Barb Olsen?

She's our billing consultant.

Here for two weeks to help
Chastain become more efficient.

(LAUGHS): Of course. The bike shorts.

Yeah, I already saw you at my
presentation... well, briefly.

I got paged.

Didn't I get paged?

I didn't hear anything.

Well, nice meeting you.

Barb, there's, um...

Payback. For making me sit
in that presentation.

What's your problem?

A strong kid like you...
can't you go any faster?

I got a life to lead.

Hey, Louisa, how's my man
Rosenthal treating you?

Like the daughter he never had.

A nightmare.

The Chastain softball team
crushed Emory yesterday.

Yeah, we did. (GRUNTS)

Is your back still bothering you?

Uh, yeah, it's no big deal.

Now I'm thinking it's
a pinched nerve, lumbar spine.

Pain that, uh, radiates along
the affected nerve.

That's impressive, but you're not quite
a doctor yet. Let me have a look.

Uh, maybe later.

I told Joey in Ped Onc
I'd take him to the play area.

Man, that munchkin is cute.

(ELEVATOR BELL DINGS)

Check back in with her in an hour.

I just want to examine her
and make sure...

- (LOUISA GRUNTS)
- (LOUD CLATTERING)

ROSENTHAL:
Hey! We need some help in here!

- Oh, my God, I'm sorry.
- It's okay.

(GROANS)

It's okay, stay still.

We got you.

I'm too young for kidney stones.

I'm thinking it's just a gas bubble.
It's really no big deal.

How long have you been short of breath?

Just a few days.

I was thinking it was from the pain.

Your lungs sound congested.

We need a full workup.

This could be serious.

No, I'm okay. I swear.

I can't be sick,
they'll send me back home.

And I need every dime to make ends meet.

And a CT scan as well.

MRI's probably the better option.

Actually, maybe we should
check her insurance first.

- Uh, can this wait?
- No.

Can I have moment with
the patient, please?

We're conducting an exam here.

Dr. Hawkins, the administration
has given me license

to inspect all hospital finances.

You're a subcontractor
to the hospital, right?

Yes. Is this really necessary?

I'm feeling better.
I just want to go home.

Rest up.

She wants to go home. Great.

She can't. She needs an MRI.

Do you know if your company
will cover an MRI?

Does anyone know that stuff?

Then if it doesn't, an X-ray
is more than sufficient.

Actually, it isn't.

Louisa is part of the Chastain family.

- She deserves our best care.
- Well, I can see

that she's a wonderful young woman...

I can't do this. (GRUNTS)

I'm sorry, thank you,
but I'll just leave.

It would be wise for you to let her go.

Wow. Really?

Louisa...

(PAINED GROAN)

Easy. Easy.

There you go.

Pulse is weak.

Distant heart sounds,
distended jugular veins.

Cardiac tamponade.

Too unstable to move.

I need -gauge spinal needle
with a cc syringe.

I'll prep the ultrasound
in exam room four.

Good. Go.

Louisa, you have fluid
around your heart.

We're going to relieve the pressure.

You cut, I draw.

(GASPS SHALLOWLY)

Quickly, we're losing her.

Ready.

Now, Louisa, you're gonna feel pressure
and then stinging.

(GASPING, GROANING)

(BREATHING EASIER)

You're okay, Louisa.

- (BUZZING)
- DEVON (ON SPEAKER): Another loud noise

and we're almost done.

Don't worry, just a few more minutes.

(DOOR OPENS)

Get her out of that machine.

- We're almost finished.
- She's not insured.

She can't pay for her treatment,
that's why she ran away.

Or maybe she didn't want
to burden the hospital.

Well, it's a little late for that,
'cause Chastain is gonna have

to eat the cost of that MRI.
That's $ , .

$ , is what
they charge the insurance company.

It doesn't cost the hospital
anything like that.

- Are you offering to pay?
- (SIGHS)

BARB: Here, for your intake files.

I will call her employer,
see what I can negotiate.

God, I hate that woman.

You and I will run point
on Louisa's care.

We need to get as much done as we can

before the administration
pulls the plug.

We can't let them kick her out.

Well, don't panic yet.

Worst case, we guide her
to another hospital.

Where she never even
makes it past ER triage.

Trust me.

(SIGHS)

JUDE: LFT panel.

Hank, you have acute hepatitis.

Is that bad?

It means that you've
consumed so much alcohol

that your liver's temporarily paralyzed.

- It's quite a feat, actually.
- Exactly how many beers did you have?

- Two...
- Two beers?

Two dozen.

If you don't cut back, your
liver's gonna stop functioning.

Your stomach will swell, you're
gonna become confused, then sleepy,

you slip into a coma, then you die.

I'm not trying to scare you,
it's just the truth.

You're drinking yourself to death.

I know.

Help me?

I can get you into a rehab facility.

I can't do rehab.

I'd lose my job.

But the rest of it, yeah.

I'm ready to quit.

I am. I've struggled
with alcohol my whole life.

Look, the moment I walk out of there,

I swear, I will go
straight to a meeting.

I'll get a sponsor, I'll stay
in AA the rest of my life.

That's easy to say, pal.
It's hard to do.

Atwood, Henry,
two of Lorazepam for withdrawal.

Thank you, Doctor.

You can do whatever you want,
it's not gonna help.

His problem is self-inflicted.

Hell, % of the patients
that come in here

have done stupid stuff to themselves.

Remind me how you got
that scar on your thumb.

- Wasn't it field-dressing a possum?
- I was nine years old.

And I treated the injury myself.

Of course you did.

It still doesn't explain
why you eat possum.

JUDE: Yeah, we all didn't have moms
who would shop and cook for us.

Or dads who were sober enough
to drive us to the ER.

Exactly, and that's why I'm here...

to help whoever walks in that door
who can't help themselves.

It doesn't matter whether they
eat lobster or road k*ll.

I take care of them.

All right.

Let me ask you this.

What is the most fun
you have had in the last week?

My guess?

You and me fixing up Hank
in the back of that pickup truck.

Seat-of-our-pants medicine.
Nobody telling us what to do

or making us fill out forms.

Then what happens?

We come back to work,

and a patient is trying to run away
because she doesn't have insurance.

We can't even treat someone
who's worked at Chastain

for the past two years.

How many wounded Marines did you
ever ask for proof of insurance?

Well... (SIGHS)

I guess I got my work
cut out for me, then, don't I?

You keep tilting at windmills, huh?

- Currently on any medications?
- No, but I'm...

Have you eaten anything
in the last eight hours?

I'm not having surgery today.

It says here, "Reynolds,
hernia surgery, : ."

- I'll be assisting.
- I'm having some more tests.

- Excuse me?
- A very nice lady came in

and talked my doctor into
ordering some more blood work.

Another CT scan and an MRI.

You don't need an MRI,
you need hernia surgery.

She said I needed it
to be on the safe side.

She was very convincing.

Why is my hernia patient
having more tests?

- He doesn't need more tests.
- Another Barb victim.

Profit before patients...
the new healthcare mantra.

Barb is like a migraine.
You can feel it coming,

but you can't stop it.

Then it gets worse and worse,
and you throw up.

What do you guys think
of the name "Say Ah"

for a resident-nurse a cappella group?

"Say Ah"?

Yeah, you know, to serenade patients.

No one wants you to sing them a song.

The meaner she is to me,
the more I'm in awe of her.

Yeah, that's kind of how it works.

Wow.

You got Louisa's results?

This is a T hyperintense,

enhancing mass, encasing
the spleen, kidney,

and vertebral bodies.
Most consistent with...

A retroperitoneal sarcoma.

Which would explain
the fluid in her heart.

She lied to us. And to her employer.

She didn't run away because
she doesn't have insurance,

she ran away because she's
an undocumented immigrant.

She has a highly aggressive tumor.

If she doesn't get surgery
right away, she dies.

No more tests,

no more treatment on our dime.

This hospital isn't a charity.

I felt this was important enough
to bring to the CEO's office

right away.
Ms. Rodriguez is an uninsured,

undocumented immigrant.

She has no family in this country.

She was brought here
from El Salvador as a child.

No one can take her
once she leaves the hospital.

State rules are clear on this.

Ms. Rodriguez cannot be released
into her own care.

That means Chastain would be
stuck with her for a long time.

She'd be living here at our expense.

She would be a Perma Patient.

Not every CEO knows that term.

Claire is not your average CEO.

Dr. Bell, what's her prognosis?

Well, the five-to ten-year
survival rate is excellent

if we operate right away, but...

the longer we wait, the worse her odds.

And if her surgery is
successful, what's the rehab?

Six months to a year.

Okay, best-case scenario,

what is Louisa's care gonna cost us?

Chastain does the surgery,
it goes well, post-op,

she can walk with a physical
therapist down the hall...

half a million dollars.

And worst case?

Post-op, Ms. Rodriguez can't
even get out of the bed...

two million dollars.

Hang in there, your count is
moving in the right direction.

Lane.

Hey, Conrad. How are you?

I'd like to call you in
for an oncology consult.

Okay. Who's the patient?

Louisa Rodriquez, transport
worker here at Chastain.

Good person. She's uninsured
and an undocumented immigrant.

Um, a full course
of radiation and chemotherapy

is, uh, very expensive.

I understand,
but don't you have a foundation

- for cases like this?
- Yes, I do,

but it's not for the undocumented.

Look, I'll make some inquiries,
but I can't make any promises.

- That'd be fantastic.
- Conrad.

Administration just put Louisa's surgery

- on indefinite hold.
- Lane...

- Louisa's all alone.
- I'll see what I can do.

I forgot to tell you I saw Lily earlier.

She didn't look good.

Nic, she has cancer.

I know we've been through this,

and I'm sure Lane had every
reason to discharge Lily,

- but my instincts are...
- Lane will take care of her.

Lily's in good hands.

Okay, well, I'll be going...
Oh, excuse me.

Oh, Nurse Nevin.

If I could just have a moment?

I'm actually really busy right now.

Okay, but I don't think
the nurses are getting the hang

of the upcoding system
and the multiple-test vectors.

Our nurses are laser-focused
on patient care.

That is their primary responsibility.

NURSE: ♪ Too late to go back to sleep ♪

- ♪ It's time to trust my instincts ♪
- Excuse me.

♪ Close my eyes ♪

♪ And leap ♪

♪ It's time to try ♪

♪ Defying gravity ♪

♪ I think I'll try ♪

♪ Defying gravity ♪

♪ And you can't hold me down. ♪

A little flat.

You're a little flat.

(MONITOR BEEPING)

Next!

Claire, this is Jim Phillips,
CEO of Atlanta General,

and Stuart Green from our Lady of Mercy.

The three of us go way back.

Ms. Thorpe took over as CEO of Chastain,

- what, six months ago?
- Yes.

They're all yours.

Gentlemen, it's lovely to meet you both,

and thank you for coming in
on such short notice.

I'll get right to the point.

We have a patient,
uninsured, undocumented,

with a retroperitoneal sarcoma.

Possible six months to a year rehab.

Given our fixed costs per bed,

this patient represents a
considerable burden on Chastain.

As they would for Atlanta General.

Yes, but Atlanta General and
Our Lady of Mercy's fixed costs

are much lower than ours.

What are you suggesting, Ms. Thorpe?

If either one of you will take
this patient off our hands,

pre-surgery,

we'll pay a fee, one-time, of $ , .

If you can funnel us five
Medicare patients

and up the fee to $ , ,
we'll consider it.

What if I offered you

five Medicaid patients and $ , ?

Medicaid reimbursements are junk.

Ten Medicaid and grand.

(PEN SCRATCHING)

I'm offering seven Medicaid and .

Too low. We're out.

Stuart, Our Lady of Mercy
has a charity fund.

What if we did the surgery
and you did the rehab?

We could give your fund $ , that
you could use at your discretion.

We just built a new cardiac wing.

CLAIRE: Which is a-a beautiful wing.

Cost us $ million.

And I am sure that you will make
that back in fees in no time.

My board would k*ll me if
we took another Perma Patient.

- I'm gonna to have to pass.
- (GRUNTS)

I'm sorry.

DEVON: Who can we call, Louisa?

You must have family here.

My parents brought me here
when I was three years old.

My mom d*ed two years ago,

and my dad moved back to El Salvador.

I'm alone.

And you support yourself?

Yeah.

I guess I was crazy to think
I'd make it to med school

without being found out.

If Immigration gets their hands on me,

they'll send me back,
no questions asked.

But this is the only country
I've ever known.

And to be a doctor...

that's my dream.

I'm so sorry to cause
all this trouble, Dr. Pravesh.

Everyone at Chastain
has been nothing but good to me.

Louisa, we're going to help you,
and you deserve better than this.

I looked up the surgery on my phone.

Cancer wrapped around a lot of organs.

Pretty dangerous stuff, huh?

Yes.

It is.

But we both know
it is the only road to a cure.

Do you know how some people say
they're not afraid of dying?

That's crazy, right?

It scares the hell out of me.

Louisa, you're going to be
a doctor someday.

Helping you get there...

that's our dream.

(LOUISA EXHALES)

(SNIFFLES)

Hey.

I, uh, checked with my foundation,

and got a fast, hard no.

Our donors expect their gifts to pay
for the treatment of U.S. citizens.

There are plenty of deserving Americans
out there waiting for a chance.

Ugh.

I hate to disappoint you,
Conrad, that's the hardest part.

Thanks for trying.

You know, we do the best we can,

as often as we can.

But we can't save everyone.

You're all post-surgery,
and you all want to go home.

So today, we're going to have a race.

Whoever gets to the end of the
hallway first gets discharged.

No more poking, needles, BP checks.

You can cook your own meals,
take a warm shower. Sound good?

If you can't walk
to the end of the hallway,

you're here for another week.

One, two, three. Go.

(GRUNTING)

Too slow, Mrs. Pill. You're done.

- (SIGHS)
- (GRUNTING)

Mr. Farragut, the same.

(GRUNTS)

No time to treat a heart att*ck,

Mr. Smith, off you go.

Discharge the winners.
The losers can go back to their rooms.

NURSE: Take it easy, all right?
You're gonna be fine.

- Culling the herd?
- Yep.

Administration won't allow.

- Louisa's surgery.
- Unfortunate.

But I heard she is undocumented.

Rules are rules.

Am I crazy, but aren't
you and me supposed to be

in the trenches together
on situations like this?

Please, tell me this is not
actually how you feel.

What I feel doesn't matter.

What I feel doesn't help.

I deal in facts.

Okay. Fine.

Because the hospital is trying
to save money, Louisa might die.

Fact.

She might die from surgery, too. Fact.

Love the optimism.

How dangerous is it, Mina?

Very intricate, very demanding.

Seven, eight hours.

But glorious.

Sounds like it's right up your alley.

(SIREN WAILING IN DISTANCE)

- (EXHALES)
- (KNOCKING ON WINDOW)

(SIGHS)

Conrad, we all feel terrible for Louisa.

She's an enormous liability.

As much as two million dollars
over the course of her treatment.

Look, I get that
it's a bottom-line world.

You made that clear.

But I want you to think back
for a moment,

- to when you were in med school.
- (LAUGHS)

It wasn't all about making money.

That was a long time ago.

Healthcare has changed since then.

We need to deal with the new reality.

I think we can both agree

that every doctor
has that singular moment

when they decide
they're going into medicine.

For you, to be a surgeon.

And even if it was decades ago,
I'd bet everything I got

you remember it like it was yesterday.

And I don't buy for one second

that it had anything to do with money.

It didn't.

I fell in love with cutting.

I fell in love with the OR.

I love it.

Still.

But the money
has to come from somewhere.

If we treat Louisa,
our other patients will suffer.

Services will be cut.

Hours, staff.

You know, I don't like the idea
of putting a price tag

on a life any more than you do.

But the system doesn't run on air.

No matter how much we love Louisa,

her price tag

is not two million dollars.

Don't say anything.

Nothing.

(SIGHS)

Catch you at a bad time?

I'd like to shove CUTE right up her...

Throw it in the trash.

You'll feel better.

Look at that.

Stress management.

I'm guessing you didn't come up here
to talk to me about upcoding.

No.

It's about your boy, Conrad.

Look, he's taking things hard.

If he doesn't start to choose his
battles, he's gonna burn out.

Yeah, well, I can't control Conrad.
Never could.

And he's not my boy.

Not anymore.

Sorry to hear that.

Alabama Shakes is playing
Terminal West next week.

- Oh, yeah?
- Mm-hmm.

I got an extra ticket.

I remember you saying
you liked their music.

I do.

It's not a date.

- (LAUGHS SOFTLY)
- Just a concert.

Have a little fun.

(RAPID BEEPING)

Rapid response, . Let's go.

NIC: She's crashing.

- CONRAD: Blood pressure?
- DEVON: / .

- Cycling right now.
- Her IV blew in the MRI.

We haven't been able
to get another line since.

- She's bleeding internally.
- Now it's / .

She's a hard stick.

Her vessels are clamped down,
she's too volume-depleted.

Emergency IO.

- Yeah, I've never done that before.
- Get the kit.

You're doing it now.

(DRILL WHIRRING)

Push the needle in.

Once you hit the bone, drill.

(MONITORS BEEPING RAPIDLY)

Keep it steady.

Drill.

Okay, release.

Flush.

NIC: Running in fluids.

We're in the clear.

- For now.
- DEVON: She'll keep bleeding

until we get her to surgery.

There are four
oncology surgeons on call.

Why can't we ask one of them
to do the operation?

Good idea. Let's practice that.

I'll be Dr. Hillis.

Go ahead, pitch me the surgery.

Hi, Dr. Hillis,
I need a surgical oncologist

to operate on a patient right away.

- Okay, sure, who's the patient?
- Louisa Rodriguez.

(GRUNTS) Actually, I forgot.

I'm booked solid today.

Ask Dr. Miller.

Dr. Miller,
I need an oncology surgeon...

Would love to, but I'm headed
to Aruba today with my fiancée.

Dr. Singh says the failure rate
for this surgery is through the roof.

Dr. Weiss heard the administration
is dead set against it...

- The administration is wrong.
- Maybe they are,

but Dr. Weiss makes K a year,
really wants to keep his job.

Okay.

They're gonna wiggle their way
out of it any way they can.

But we know someone dying
to do the operation.

CONRAD: But it's not in your specialty.

So? I'm arrogant enough
to believe I can do it.

And I'm your only option.

Just get an attending to sign off.

CONRAD: I need you to sign off
on a surgery.

It's not in your specialty.
You'll just be supervising.

Yeah, and what's the catch?

No catch.

Look, I know you, pal.

What rules am I gonna break?

Not breaking. Bending.

Bending, okay.

- Who's the patient?
- Louisa Rodriguez.

Oh, I'm in.

Surgery's a go. Mina's on deck.

Conrad, someone called Immigration.
They're coming for Louisa.

How can I help you, gentlemen?

- Sir, you need to move aside.
- CONRAD: I will,

if you tell me what's going on.

DEVON: Hospitals are sensitive areas,
along with schools and churches.

And sensitive areas cannot be
accessed by immigration officials

without arrest warrants
or under investigation

of an imminent national security thr*at.

ICE policy letter, October , .

You're interfering with the actions
of authorized federal agents.

- You're gonna regret this.
- I doubt that.

Well then, you better drag us
both out of here.

Conrad.

CLAIRE: Stop.

Step aside or you will both be fired.

It's okay. Let them pass.

♪ ♪

♪ Daylight dims into grim ♪

♪ The pressure higher ♪
♪ than the tallest steeple ♪

We need to hurry.

♪ For my sins your caved in ♪

♪ The house of glass ♪
♪ I filled with empty people ♪

♪ It was a black and stormy night ♪

Dr. Okafor, you may proceed.

♪ The kind that's ♪
♪ always pulling you in ♪

♪ Pulling you in again ♪

NIC: Surgery's underway.
Sterile environment.

You cannot enter under
any circumstance. No one can.

♪ The kind that's always
pulling you in ♪

♪ Pulling you in again. ♪

... Pushing us to charge more,
and order endless tests.

Yeah, Dr. Pravesh wants
the feeding tube out for .

Barb called Immigration. I'm sure of it.

MRI order from Dr. Williams.

Wait. Give that back to me.

- Is this scheduled for right now?
- Mm-hmm.

- Pull him out.
- What are you doing?

Did you push his doctor
to order this test?

- I did.
- Without checking the patient history?

Open the microphone.

Mr. Reynolds, do you know
how an MRI works?

It has incredibly powerful magnets.

Magnets that will rip
anything metal out of your body.

Anything at all.

Do you have anything metal
in your body, Mr. Reynolds?

Mr. Reynolds has a penile implant,

a metal-based penile implant.

How much is your penis
worth to you, Mr. Reynolds?

Say, in a lawsuit? A million dollars?
Five million dollars?

Stop the machine!

You are not a doctor
and you are not a nurse.

Not every test is safe.
Not every procedure should be billed

for ten times what it's worth.

You're gonna end up
getting someone k*lled.

- Now wait just a second...
- I'll be filing an incident report

with the Comptroller's office
and the CEO.

Good luck getting hired
at Chastain again.

DEVON: Louisa.

Do you have any nausea?

No.

I feel okay.

You've been so kind to me, all of you.

I'll never be able
to repay you for this.

But I'll still need some help
on my bio midterm.

Anytime.

JUDE: So...

the operation came off without a hitch.

You had a spectacular surgeon.

Cake.

What are her rehab markers?

Well, if she can walk to
the door, we're in the clear.

If not...

Hey. Well, you look good.

You know, it's really important

that we get you up
on your feet right away.

So... how about you get out of bed

and show us how you can
walk to the door?

- Okay.
- Let's really concentrate.

Here we go.

(GRUNTS)

I'm so sorry.

(WHISPERING): Two million.

It's okay.

You'll be fine.

Louisa,

rehab is gonna be a long, hard road,

but we all know how tough you are.

NIC: You'll get through this.

DEVON: With some time and care,

you'll be right back
where you were in a year or so.

We've got your back the whole way.

(ELEVATOR BELL DINGS)

Hey, Art.

Randolph.

(EXHALES LOUDLY)

Hey, uh, how's your golfing buddy doing?

The one with the tremor?
He sink any more putts?

Oh, uh...

He just started taking the medication.

- Probably too soon to tell.
- Okay.

Well, keep me updated.

Yeah. Yeah. Will do.

Jude and I are gonna go grab a beer.

You want to join?

DEVON: She's a lot cuter
than either of you guys.

True enough.

Enjoying your victory, Dr. Hawkins?

Did you call Immigration?

You had your billing consultant
do it for you.

Barb Olsen's contract
with this hospital has been suspended.

But I have to pull two million
dollars out of thin air.

- I understand...
- No.

You will understand full well
when I take that money

out of the Internal Medicine
and ER budgets.

Be prepared to be woefully understaffed
for the next months.

By the way, thank you for today.

- Yeah.
- (CHUCKLES)

Thorpe could've had you
canned on the spot.

Well, I get fired, it makes
the decision for me, right?

I show up tomorrow
at Fort Benning, : a.m.

Hell, you could be there with me.

Hmm?

All right, so you're
starting to come around.

What are you so damn happy about?

Because I know exactly where
I'm supposed to be tomorrow,

and it's at Chastain.

Yeah.

Valor, honor...

Victory.

Mm.

I got these.

So, you know, I've been meaning
to ask, you and Nic...

that still a thing?

(SIGHS) She doesn't think so, but...

I think she's worth
fighting for. Don't you?

Oh, hell yeah. Game on.

(LAUGHS)

♪ ♪

♪ You gave me scars ♪

♪ Beautiful scars ♪

♪ On my back and all ♪

♪ You see how far I come ♪

♪ You gave me scars,
beautiful scars... ♪

PARAMEDIC: -year-old female.
Cancer patient.

Short of breath and vomiting.
BP's dropping.

Volts and a liter of saline right now...

(PARAMEDIC CHATTER
CONTINUES INDISTINCTLY)