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I'm sick. I may not die today, but it's coming, and there's nothing I can do to
stop. So how'd it feel, staring down the barrel of a gun?
Wish I could say I'd gotten used to it.
Lennox, on the other hand, she didn't care if she got shot or not.
You haven't really seemed like yourself recently.
Is everything cool?
It's not every day you find out your colleague was a teen heartthrob.
Parents stole a lot of money from me. I worked basically my entire childhood,
and I have.
Nothing to show for it. Oh, man. I'm sorry.
Sorry, man. I didn't realize anyone was in here. I just thought I left my phone
charger in here yesterday.
No, it's all good. My shift starts in a few minutes anyway, so... Wait,
did you... Did you sleep here last night?
What? No.
I caught all the lights on the way in, so I thought I'd get a few extra minutes
of shut-eye before my shift.
Man, I wish I could fall asleep that fast.
What can I say? We're not all born with a gift, right?
People lie.
They hide their true feelings, and sometimes they don't even know how to
express those feelings.
As psychiatrists, we are relying on our own personal assessments, which are
riddled. with mistakes and biases.
And unlike other medical disciplines, we base our treatments on conversation and
observation.
Nothing more.
Oh, come on.
That's a bit of a reductive assessment of what we do, isn't it?
But is it? What other tools do most psychiatrists employ?
We use any number of clinical tools, but as aids to our initial assessment.
I mean, it sounds like you're proposing that we lead with this stuff.
You want me to let a machine tell me what's going on with my patient? No, I
am proposing that we endeavor to give patients effective and efficient care.
In a world where there is constant pressure to increase patient turnover
rates, where there is so little time, we can rely on fMRI to help doctors
instantly diagnose bipolar disorder, depression, schizophrenia, and we can
push psychiatry into a true science.
where we replace the guesswork with hard facts.
The guesswork? I'm only referring to certain types of... Right. Okay, look.
First of all, from what I've read, fMRI, diagnostically speaking anyway,
according to the statistics, it's just not there yet. But even if it was, a lot
of the psych patients coming into myED are experiencing their first episode.
You know, their initial set of symptoms, and they're disoriented.
Sometimes they're terrified.
They don't even know they're psych patients yet. And what they need in that
moment more than anything is human contact.
Right? Empathy.
Compassion. I am not trying to challenge your methods.
Trust me when I tell you that in addition to its efficiency, there is a
tremendous amount of potential in this tech.
And I would love nothing more than to continue my research right here at
Gaffney with you.
How we doing, Cora?
Pretty good.
She's coughing a lot.
I'll order another albuterol nebulizer. That should help.
Doing okay?
I know the first few days in the isolator takes some getting used to.
I keep thinking about this pet fish I had in kindergarten.
Octavio. Yeah.
I used to stare at him in his little fishbowl.
Seemed so cozy with his castle and treasure chest.
Doesn't seem so cozy now.
Look, I know it's not ideal, but this is the best way to keep you safe.
Your immune deficiency disorder means that your body can't protect itself from
infection.
Inside the fishbowl, no germs can get in, so all you have to worry about is
getting better.
Okay. I mean, plus, it doesn't feel cozy in there because you haven't done any
decorating yet.
Decorating? Yeah.
I mean, I'm thinking some curtains in here, maybe a few black-pink posters,
huh?
You're being sarcastic.
Maybe a little.
But it doesn't mean we can't find ways to make you feel more at home, okay?
So how about we both think on it?
Okay.
She's getting worse, isn't she?
Her blood pressure is dropping and lactate is rising, which are markers for
sepsis. But the only thing that's going to make her better in the long term is a
stem cell transplant.
Any word on the test results?
There's nothing from the registry.
And your test results aren't back yet, but I will let you know as soon as I
hear. But if I am a match with Cora, how soon can we do the stem cell transplant?
Hopefully within hours.
I don't understand how this happened so fast.
She was such a healthy girl, and then suddenly these past few months... When I
decided to have her on my own through IVF, I was so scared.
But then she arrived, and all the worry went away because she was perfect.
And we were perfect.
Just the two of us.
What's going on? They said to bring it.
I kept it cold.
Oh, my God.
What is it?
Lionel Blake, 37-year-old male, left hand severed off in a circular saw
accident at a shop.
The heart rate's 126, BP's 95 over 54.
Coworker found him, used his blood as a tourniquet till we got there. Complete
amputation? How much blood was there at the sink?
A lot. And we got the hand.
All right, we'll get it in a sterile bag.
Okay, I'm on it.
All right, on my count.
Ready, one.
Two, three.
Oh, it hurts.
100 microfentanyl.
Let's get a cardio monitor and oxygen. And let's get another IV and hang a unit
of... O negative. Got it. You are going to surgery, Mr. Blake.
Page, hand to vascular, please. We need help getting this hand reattached. Wait.
No, no, no. Lie back down, sir. Lie back down. Let me go. Blake, come on now. You
don't understand.
What don't I understand, sir? I don't want it reattached.
Excuse me?
I cut it off on purpose.
So it's a no on the reattachment. Yeah, a hard no.
They won't engage much beyond that.
Some kind of woodworker?
Makes high-end furniture.
The guy that brought him in said that they were working together. He heard a
shriek. He ran in.
Found him in a pool of blood. Any mental illness in here? No, no. Nothing is
charged.
Could this be... What is that called? You know, when a person wants to...
Remove their healthy limbs. Oh body integrity identity disorder and it could
be hard to say without talking to well Got less than an hour before the hand
dies from lack of circulation.
Oh, man Okay Just squeeze my universe.
It's not too bad. Okay, okay
Oh, I'm fine.
Just do her first. I'd really like to take a look at the arm, Mr. Carter.
Yeah, when the kettle exploded in the kitchen, we both thought a bomb went
off. I guess the water was too hot, or... No, it wasn't water.
It was just a cheap-ass wedding gift from my Uncle Benny.
Everything the dude buys is a knockoff of a knockoff. Of a knockoff.
These look like superficial partial thickness burns. Let's do a gentle
irrigation with some cool water, and then we'll need to apply some silvadene.
And a suture kit for that lack.
You okay?
What's hurting?
Hey, babe. You all right?
Yeah, I'm sorry. I think the skin's just a little bit tender.
Okay. Well, let's get you gowned and sutured and bandaged. I want to do an X
-ray to make sure there's no glass that we missed and some basic blood and urine
tests. Can I have a nurse help you in the bathroom? Oh, no, I'm okay. I can do
it. Okay.
And no more gifts from Uncle Benny.
I was doing a little internet snooping on your shop. That's some beautiful
furniture you make.
No wonder demand is so high right now. I mean, those Windsor chairs with the
blonde sugar maple, the mortise and tenon joints, that's impressive.
Like a magic chair. Yeah.
But I tell you, one thing that I can't really figure out is why a guy who's as
talented as you are would want to get rid of one of your most important tools.
It's better for everyone.
For everyone?
What do you mean when you say everyone?
I'm a bad person.
I'm gonna hurt someone.
Have you hurt somebody before?
No.
Well, what makes you think you would now?
I could control it before.
Control what?
I keep...
picturing the same thing over and over.
Okay. What is it that you keep on picturing?
Wrapping my head around someone's throat.
Killing them.
And I was gonna do it.
I was gonna hurt someone.
No, I can't.
Hey, crazy question.
Do we have any glitter glue?
Why, are you going to a slumber party we don't know about?
No, I'm just getting some supplies for Cora so she can screw some place up a
little bit.
Aw. How are you still single?
Commitment issues.
Oh. Excited to unpack that tomorrow night at your place.
Sorry, what?
She means poker night. It's tomorrow.
You're hosting.
Sorry, I can't do that, actually. I'm gonna have to rent check.
What?
Something came up. You can't bail on us. Your bad decisions at poker not paid for
my manicures last month. I just can't.
Okay? Okay.
Okay. Dr. Frost, this just came up from pathology for Cora Cooper.
Thank you.
Whoa, whoa, whoa. This is for Cora Cooper. Are you sure?
Yeah. That's what they said.
She's not my daughter.
How is this possible?
You mentioned to Dr. Frost that you conceived Cora through IVF. You think
there was a mix-up at the clinic?
Well, it's possible.
We've been in touch with them.
It looks like 10 years ago, on the day Cora's embryo was transferred, there was
one other woman who received an embryo, though hers didn't take.
Are you saying that Cora is her biological child? We just don't know
yet. These answers will take time.
But if this woman is Cora's genetic parent, then there's a 25% chance she is
a match for the stem cell transplant needed to save Cora's life.
So, do we have your permission to contact her to see if she'll come in to
get tested?
So you're saying that he's got OCD?
Most people think that OCD is just about, you know, repetitive hand
-watching, light-switch behavior. But at its heart are these intrusive thoughts,
right, that compel people to behave a certain way.
In Lionel's case, they revolve around hurting people. It's actually a very
specific subset, which is harm OCD. Trust me.
He's got all the hallmarks. That explains why he's not mentioned it to
anybody. Well, it's a tough thing to admit to, right? Yeah. But, I mean, the
lengths that he went to, cutting off his own hand, I mean, the guy didn't want to
hurt anybody.
Yeah. Right?
We all have violent impulses, right? But we have the ability to filter them out.
Poor guy thinks he's a killer and really just got a leaky valve.
Mm.
I feel like we could just show him the valve, right?
Yeah.
No, you know, but we just show him the busted part just like we do with broken
bones You get him to understand that that's not who he really is, right?
Anyway, you could keep this hand alive for a little bit longer.
Yeah, I'll consult Lennox. I'd appreciate it buddy. Just Need to run
something down. Of course How much time you think this will buy
Well, in a lab setting, a perfusion system has kept a limb viable for up to
24 hours. But given that this isn't a lab setting, and we're doing most of
this on the fly, I'd say considerably less than that.
Did you ever reattach any limbs while you were in Afghanistan?
I mostly cut them off.
It's hard to imagine anybody doing this to themselves on purpose.
Maybe.
But I can understand wanting to deny your own impulses. I spent most of my
life doing that.
Why do you think that is?
I guess I didn't really understand the world or how I was supposed to act or
what was acceptable or cool or kind.
And to avoid making a mistake, I just didn't take any chances.
And I'm starting to think that that stopped me from experiencing life fully.
If I had a bitter self-control, I wouldn't be having a baby right now.
Maybe losing control occasionally isn't the worst thing in the world.
Sorry, Dr. Lennox, I wanted to... I was in the bathroom collecting the urine
sample from the woman who had the kettle accident, Mrs. Carter.
Yes.
Well, she'd asked for a second cup to use, and I didn't think anything of it
until I went in there and I found the original cup in the trash.
Had this on it.
You all right?
Yeah, just... this is so weird.
Ms. Patrick, this is Vivian Cooper and Dr. Frost, who's running point on Cora's
care. It's nice to meet you.
Thank you so much for coming down here so quickly.
It's a lot. No, of course I... Sorry,
what happens now?
Well, the first thing we need to do is a blood draw, which is right down the
hole. Okay.
And we should be able to get back the results within a couple hours.
Is that her?
Yes.
Can I meet her?
I haven't told Cora about all this yet.
I didn't want to upset her until we knew for sure.
Oh. Why don't we do the blood test to start?
Right, of course.
It's just... Afterward, I really, um... I would love
to meet her.
We don't even have to tell her who I am.
I don't know.
I'm sorry, but that... might be my biological child in there, and she's
sick.
Please?
It will be. Dr. Ripley, you have a second?
Uh, not exactly. Well, I was wondering if you've noticed anything off with Dr.
Frost.
What do you mean?
Like, he's acting kind of weird.
You know, cagey.
He totally bailed on hosting poker night and he's like dropping out of stuff
randomly I Think it might be meth
Meth yeah, I've seen it before Hey
Casey, um, dr. Frost does not have a methamphetamine addiction, but he is
acting weird
Maybe. I need to go deal with something. Let's talk later.
Hey, man, can I grab you for a sec?
Yeah, what's up?
Oh, admin.
They can't seem to find your insurance info. Just need you to fill out a few
forms. It's a pain, I know, but... No, it's fine. We're just playing around.
Faye, can we talk?
Sure. Everything okay?
Uh, just waiting on your lab results.
But that's not why I came by.
You got married recently, right?
Almost seven months ago, but yeah.
How's it going?
Good. What do you mean?
I guess I mean, um, how are you guys getting along?
Sorry, why are you asking this?
We found this in the trash.
The red sticker on it.
I'm sorry, I don't understand. What's that supposed to mean?
We have signs up in the bathroom that say if you're experiencing partner abuse
or domestic violence, that you can place a sticker on your cup to notify us.
But I didn't turn that one in.
I understand.
I'm wondering...
If you are considering asking us for help.
I want to make sure everything's okay.
And nothing you say to me is going to leave this room.
I don't know. I'm sorry.
I just... Stay.
Can we talk about the kettle?
I told you it... It was an accident.
It just exploded.
But is that what happened?
Did he hit you with that?
It was an argument.
We're both hot-tempered. I just don't want to get him in trouble.
This isn't about getting anybody in trouble. This is about making sure
you're safe.
Please don't.
We have resources we can provide.
We have a social worker who can connect you to safe housing.
Please.
Faye?
A little help in here?
She's losing consciousness.
Let's get her on a monitor. Faye, can you hear me?
Faye, I'll give you an oxygen mask to help you breathe, okay? She's really
diaphoretic. I'm going to need some tape. Here we go.
Just breathe. We got you.
Dr. Lennox, you need to see this.
Oh, my God.
Dr. Arbari.
Hey. You have a minute?
You come to arrest me?
Look, I got out a little heated this morning, and I apologize for that, but
I'm wondering if I could ask for your help with something.
Sure. What do you got?
I'm in a bit of a time crunch. Can I explain on the way?
Yeah. The bolus and blood seem to have helped.
Vitals are stable.
Tell Transpo she's ready to move to IR.
Hey, her husband's in the waiting room. I've been holding him off, but he wants
to know what's going on.
He knows exactly what's going on. He beat the hell out of her.
He may be next of kin, but the fact that we have to treat this prick like he's
any other family member is absurd.
I get that, but if we let on what we know, we would feign even more danger.
Yeah, I get that.
Is Faye okay? Your wife suffered a laceration to her spleen, causing her to
hemorrhage slowly into her abdomen.
We are doing something called a splenic artery embolization to stop the
bleeding.
But she's going to be okay? We hope so, yes.
Okay. Thank God.
Sorry, I'm a little confused, though. She was fine when I left. What happened?
Well, that's what we were hoping that you could help us with.
Generally, it's the kind of injury that only occurs with blunt trauma, but Faye
didn't mention anything like that.
Any idea what might have happened?
I mean, when the kettle exploded, she did fall.
Hit the counter.
In the chaos, we must have forgot to mention it.
She fell.
Right, so that's all.
Can't think of anything else?
No. We're asking because we just want to make sure, you know, we have a clear
picture and there's nothing we're missing.
Right. Of course.
Uh, yeah.
Nothing else that I know of.
All right, Lionel.
We're going to get started.
First, we're going to warm up the machine a bit, so if you could tap your
index fingers to your thumbs.
I mean, with your right hand, of course.
Color represents the parts of the brain that are active. And your research is
centered on this?
Yeah. We compare what we're seeing in a given patient to a healthy brain, and
the differences will help tell us what we're dealing with.
Okay, but Dr. Charles has already diagnosed Mr. Blake.
He just didn't believe it.
Well, we're kind of conducting an experiment, repurposing the technology
in an attempt to show Lionel.
per your suggestion his leaky valve okay we're ready
okay laniel i want you to shut your eyes
and picture standing right in front of you the person that you care about that
you love most in the world okay
now i want you to imagine taking your hands wrapping them around their throat
and strangling them.
Hey, Cora.
Decorating's coming along nicely.
Right, except I'm running out of blue marker.
Oh, we can taste that.
You didn't touch your lunch.
I'm hungry.
You gotta eat.
Keep your strength up, okay?
I'll try.
Cora, I'd like to introduce you to a friend of mine. This is Lily.
She's shadowing me today.
Hey.
My zebra.
Thanks. It's actually randomly my favorite animal.
Hey, Cora, I think we should put your cannula back on, okay?
Oxygen levels are dipping a little bit.
I wanted to do this trip to Africa last summer, but...
We couldn't afford it, so my mom wrote me an email to the zoo and convinced
them to let me come and feed them.
Sounds cool.
She has a black streak in her hair.
I've had it since I was a baby.
It's pretty rare, I think.
Yeah, no, I know. My mom had the exact same thing.
You're my daughter.
What? What are you doing? I think we should step out, maybe. She's my
daughter. I'm sorry, but I'm sure of it.
You are way out of line. Ladies. I didn't mean to say it. We don't even
know if you are. We do know, and I know you can see it. Can we just calm down?
I don't want her anywhere near my daughter. She's my daughter, too.
I have rights. Is this crazy?
I don't want this anymore. Let's... Wait for the marrow registry results. Stop
her blood test. No, we're not stopping it. Then I'm going to call a lawyer. All
right, it's enough. Look, I understand that emotions are running high and that
this is a very unusual situation. I can't imagine what you're going through
right now, and you either. You both must be reeling.
So, Ms. Cooper, you can call a lawyer, and I promise you I would understand.
As hard as this is...
That's not the best thing for your daughter right now.
Of course.
Okay, look.
There is no closing this Pandora's box.
So if you both care for Cora, we need to put her first.
How are you doing after that ambulizer?
Feeling a little shaky?
No.
I'm okay.
And Dr. Frost?
That woman?
Can she take me away from her, Mom?
I wish I could tell you what was going to happen, Cora, but I can't.
What I can tell you...
is that family has nothing to do with genetics or blood.
It's about who loves you and who shows up.
Is that what your parents were like?
No. Actually, mine weren't always very good to me.
They weren't always putting me first, you know?
Your mom, she's nothing like that.
All she does is think about you and how best to take care of you and that kind
of love.
She's going to be your mom no matter what any test says.
All right?
I guess I'm just scared.
We're in this together, all right?
I got you.
This is a picture of your brain after we asked you to think of somebody you cared
about.
My sister. Your sister.
See this red area here? That's called the ventral tegmental area.
It's a part of your brain that processes love and reward.
And it's where you hold your personal values.
You see how it's all lit up when you're thinking about your sister?
Yeah. Okay, good. Now, this is a picture of your brain after we asked you to
think about hurting her.
That's the amygdala.
It's where your brain processes fear.
Okay, now, buddy, if you were somebody who enjoyed hurting people, your brain
would not look like this after confronted with those triggers, okay? It
would, in fact, look like this because you'd be experiencing joy.
and pleasure in anticipation of hurting somebody.
Now, the really cool part is to actually show you why this is happening.
See this little area here?
This is called your caudate nucleus.
It's dark.
Yeah, because yours isn't working.
And that's all this is. That's what I've been trying to tell you. This little
tiny part of your brain is malfunctioning.
Maybe. I don't know.
Buddy, look.
This is you.
It's the guy who deserves to be made whole again.
I know you feel unsafe, okay?
And that's terrible.
But we can fix that.
Look, it's not going to happen overnight, okay? But I promise you, when
we get to where we're going, you're going to want your hand back. So you're
going to keep doing what you love doing.
The problem is, buddy, is that we are up against it right now.
All right? So in this moment, I just...
I need you to trust me.
Okay? I need you to trust me, and I just... I need you to trust this
science.
Okay.
Okay?
How are you feeling?
Groggy.
A little sore.
Uh, what happened?
You had a lacerated spleen.
We embolized the artery that was bleeding into your abdomen.
You should be okay.
But it could have killed you.
There was a moment earlier today when you were alone in the bathroom.
You had an impulse to reach out, ask for help.
You should listen to that.
I'm so stupid for loving someone who could do this.
I don't think that at all.
It's just... He's not always like this.
I believe you.
But situations like this don't just get better.
Not without help.
I... Took this out of your bag.
I put my number in it.
It's under Katie with a C.
Yeah, thanks.
But really, I'm fine.
It was just a mix-up.
I just need it today.
No, I don't care about the money.
No, text me his number. I'll cut him a check today.
Is this really how this goes?
Let me call you back.
Excuse me?
I get that you might feel upset right now. That you might feel cheated.
But that little girl in there is dying.
And she's not going to spend whatever time she has left terrified that the
only family she knows is about to get torn apart.
You don't get it.
I don't? No.
I did IVF for years.
So many times I got pregnant.
But the embryo... My body couldn't keep
it alive.
And this happens?
That this little girl is mine?
And I've already missed so much.
So I can't just walk away.
Infertility is cruel.
We never get to know why one person gets lucky while the other one doesn't.
I can imagine that in a situation like this, it is easy to feel like you've
been robbed of something, and maybe you have.
Maybe this is the only way this could have happened.
You having a kid.
Maybe Cora wouldn't even be here if it weren't for the both of you.
Okay, but either way, Cora is in a crisis right now.
And I know that the only way to get through a crisis is to find a way to
work together.
What is it?
Pathology. Your test results are back.
Cora.
Cora.
Mom.
What's wrong?
Nothing's wrong, baby.
It's good news.
You and Miss Patrick?
You're a stem cell match.
Really? Really, yeah.
You're gonna be feeling a lot better very soon.
You're gonna be okay, sweetie.
You're gonna be okay.
Miss Patrick is getting ready to make her stem cell donation.
And she thought it best for you two to have your space right now.
Yeah.
Hey.
I'm headed out. I want to check on Lionel. How's he doing?
Uh, you know, Dean's just finishing up now. Come in.
Have a seat.
He was able to keep the hand viable, so it looks like the reattachment's going
to be a success.
Thank you.
I'm glad to hear it.
It's cool what you did back there.
I haven't used FMR like that.
Hey, look, I am not anti-innovation, okay? Far from it, trust me. But it just
seems like every day we get hit with another technological advancement that
further obliterates our need to connect as humans.
You know, we might have gotten off on the wrong foot, but I enjoyed working
with you today.
Right back at you.
Really.
Theo, um... I've been thinking... You can't deny
the potential of this technology, right? I mean, look what happened today.
And... Look, if you were willing to put people
before technology, maybe there is a place for you in your research.
You're a Gaffney.
Hmm.
What do you think?
Yeah.
It's this way.
They'll just need you to change into a gown, and then we'll get you to pre-op.
And how long does the procedure take?
Usually one or two hours.
Okay. Lily, I just wanted to say thank you in person. It means
it's everything.
Of course.
I tried to get a zebra from the gift shop for Cora.
All they had was a bear.
Probably stupid. I don't even know if ten-year-olds like stuffed animals.
I guess I don't really know that much about kids.
She'll love it.
I'm sorry about earlier.
It wasn't my best moment.
No, it wasn't.
You know, Cora asked about you.
She has questions I can't answer.
Maybe we can have another conversation with the three of us later, under better
circumstances.
Yeah?
Yeah.
Bubba's looking pretty good.
It's too bad we're gonna have to kick you out of here soon.
I made you something.
Oh, yeah? What's that?
That's me.
That's you.
You put me in the fishbowl? You said that we were in it together.
That maybe you could hang it up in your house.
You like it?
Yeah.
I love it.
So Faye got moved to the ICU?
Mm-hmm.
You did everything you could.
Right.
Oh. What?
I left my iPad in post-op.
Want me to hold the elevator? I'll get the next one.
Casey thinks you're on meth.
What? Nurse Casey.
She thinks you're acting weird because you're on meth.
Oh, I'm not on meth. I know.
But you are acting weird.
I'm not trying to. I'm just tired, I guess.
Okay.
I got kicked out of my sublet.
What's that?
My apartment.
I sublet it. And two days ago, the guy that I sublet it from decided to move
back, kicked me out.
So, you were right.
I did sleep here last night because I don't have a place to live.
That sucks, but can't you just get another apartment?
It's not that simple.
But if you need cash, I'm more than happy to help. It's not a money thing,
really. It's a credit thing.
I had to file bankruptcy to get out from under all the debts my parents racked
up. So that's why I always sublet.
It's just hard to find one on short notice, so.
Well, why don't you just come stay with me, then?
Just until you find a place to live. I appreciate it. I am fine. I'm at Sadie's
half the time anyway.
Okay, then.
Thank you. Okay.
All right.
There's no meth in the apartment. I'll just keep doing it in the hospital.
It'll be all right. Yeah.
Dr.
Lennox. Oh, hey.
Faye was moved to the ICU.
I know. I was looking for you, actually.
I just wanted to say thank you for saving her life. I really appreciate it.
I know how much attention you paid to her.
Well, I wish I could have done more.
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