Patient is a 65-year-old male,
admitted with lymphedema and hidradenitis suppurativa.
Patient is also...
This food is crap.
... combative.
Dr. Kenney and Dr. Gilani, the pleasure will be yours.
Hello, Mr. Tuverson.
I'm Dr. Kenney, this is Dr. Gilani.
Have they stopped letting men be doctors now?
Mr. Tuverson, hidradenitis suppurativa refers
to this cluster of boils in your groin area.
Now, your lymphedema
is what's creating the swelling in your leg.
I don't like your voice.
Oh, gosh.
Well, I guess we'll just have to get your ears checked, too.
As I was saying...
Your tone is a little naggy.
Does your husband tell you that?
- I-I'm divorced. - That's a shocker.
Okay, I'm sorry, but have you heard your own voice?
Because you're no Josh Groban.
As a matter of fact, you're a real piece of...
Dr. Kenney, let's take this outside, shall we?
Mr. Tuverson, you can page
the nurses' station if you need anything.
(DOOR CLOSES)
I have news for all of you.
Mr. Tuverson will not be the last difficult patient
you encounter in your careers.
He won't even be the most difficult.
Just last week, I had a patient ask me
if I was here as part of a "reparations" program.
(GASPS) What did you do?
I saved her life.
(CLEARS THROAT)
As doctors, you'll meet patients
who are rude, offensive and mean.
Your job isn't to judge them, it's to treat them.
- Understood? - (OTHERS MURMUR ASSENT)
Good. Moving on.
Dr. Kutcher and Dr. Sommers,
you'll take the patient in Room 410.
Got it. I'll take the lead on this one, newbie.
We've been here the same amount of time.
You two will also be covering the slip-and-fall
admitted this morning. Remember,
it is essential that we present a calm, professional face
- to our patients at all times. - Understood.
Patient's name is...
- Phyllis! (LAUGHING) - Carol!
- Oh, my gosh, Carol. - I've missed you so much.
- Mwah, mwah. - Oh, my gosh.
To be fair, for Carol, that is calm.
Oh, Carol.
♪♪
- Synced and corrected by Firefly - - www.addic7ed.com -
(BEEP)
- You look wonderful. - Never better.
- I cannot believe you are here. - How are you?
- You're so professional. - Well...
My God, there's two of them.
Good luck, Dr. Gilani.
Ooh! Where are my manners?
Dr. Gilani, this is Phyllis.
Oh, we're old friends.
- Yeah, I got that. - Phyllis and I
were science teachers together.
Do you know, we actually started on the same day.
I did not!
It's true, we did.
I was so nervous.
- And then I saw this petite brunette... - That's right.
- ... walking through the cafeteria, - Mm-hmm.
and I thought she was a student skipping out,
- but she wasn't. - (LAUGHS)
- It wasn't. It was me. - It was her.
One year, we even rewrote
- the whole science curriculum. - That's right.
No frickin' way. Just the two of you?
BOTH: Yes.
- Who else was gonna do it, Mr. Damelin? - Oh!
(BOTH LAUGHING)
- I mean, can you imagine? - I cannot.
- Oh, it is so good to see you, Dr. Carol. - Mm-hmm.
Oh, it's so impressive.
Oh, it's nothing.
- Do you like my coat? - Yes.
And this badge lets me go
almost anywhere in the hospital.
Speaking of hospitals, should we talk about why you're in one?
Oh, it's silly, really.
I-I fell doing sun salutations in my succulent garden.
- This whole side is just sore. - Oh.
Yeah, the, uh, hip pain you reported
may indicate a small fracture.
CAROL: We'll send you for an MRI
along with a standard senior blood panel.
Get a load of the doctor lingo!
Yeah. Right?
(LAUGHING) Yeah. Oh, my gosh.
You look so rested, and happier than I have ever seen you.
- Is it the yoga? - It's retirement.
- Oh. - I also started
- a wine-pairing class, plus... - (GASPS)
I'm taking French lessons three times a week.
- Ooh la la. - (LAUGHS)
Oh, Phyllis and I used to fantasize about going to France.
- Just the two of us. - Yeah, well,
- who else were we gonna go with? Mr. Damelin? - (LAUGHS)
Yeah, if you want someone to ruin it.
- Yes, that's right. That's right. - Yeah.
So, hold on to your beret, Dr. Carol,
because I'm going.
- Seriously, you're doing it? - Mm-hmm. Mm-hmm.
The Louvre? Versailles? A baguette crawl?
Two baguette crawls, and a fromage-a-thon.
(EXCLAIMS)
Tell me everything.
Okay, Dr. Carol, we need
- to get those tests ordered. - Okay.
- Okay. When you come back, - Yes.
- I'll show you pictures of the hotel I'm staying at. - Okay.
- This quaint little Marriott, - Yeah.
right off La Rue de l'Airport Highway.
The CT was negative.
I'm not sure why his neck pain is so persistent.
I think his new blood pressure meds could be interacting
with his olanzapine, causing spasmodic torticollis.
It sounds like a pasta, but it's actually
a tasty little muscle spasm.
Where'd you learn that, Burning Man?
No, if you do it right,
you don't remember what you learned at Burning Man.
We should try baclofen and an anticholinergic.
All right, gentlemen, what's the differential diagnosis?
- Uh, actually, we... - The patient is suffering
from spasmodic torticollis caused by a drug interaction.
I recommend treatment with oral baclofen and an anticholinergic.
Excellent observation.
Write up the order, Dr.Kutcher.
Very good work.
I know I took credit, but you can't hesitate
when a life is on the line.
He's having a neck spasm.
Doesn't matter. Medicine is a competitive field.
You snooze, you lose.
Okay.
Okay?
I'm gonna grab a snack.
I don't like how that ended.
(SIGHS) Phyllis just seemed so relaxed.
Like if you picked her up and listened,
you'd hear the ocean.
Yeah, like a loud, crashing ocean.
Yeah.
She does make retirement look good.
Isn't it crazy you did this instead of that?
No. It wasn't crazy.
I wanted to follow my dreams.
All I know is, as soon as my period goes away, so do I.
Dr. Kenney.
I know that face.
Is it that obvious?
I guess at our age, it's normal to question your life decisions.
Oh, is that what you're doing?
I just thought you'd forgotten where you parked.
Tell me more.
Well, it's just an old colleague showed up
and gave me a vision of the road not taken.
And I got to say, it looked really nice.
Aren't you already taking the road not taken?
Yes. Yes, I am.
And I am pursuing what I love.
It's just, I also love a lot of other things that we never
have time to do on our schedule, like travel.
Oh, there are some very nice conferences in Delaware.
I-I was thinking Europe.
But Delaware is also... a place.
Look, I am sure after I practice medicine for a while,
I'll retire and-and eventually get some traveling in.
Well, statistically speaking, probably not.
Studies have shown that the first year of residency
takes six years off your life.
You're really washing that yogurt cup.
You're mad.
Yeah. I'm furious.
It's 2019 and we still live in a world with single-use plastics.
No.
About before with Dr. Jacobs,
when you nailed the diagnosis, but I took credit for it?
(CHUCKLES): Oh, that?
No worries, all good.
I see what's going on here.
You're pretending you're not mad, but you're pissed.
You're hatching a little revenge plan right now, aren't you?
No.
Yeah. You are.
All right, Caleb. Two can play at this game.
Oh, Lexie, I have had a day.
My gout patient has uric acid nephropathy,
Mrs. Murray sneezed into my mouth,
and then I dropped my I.D. badge down that little gap
between the elevator and the floor.
I looked so good in that photo.
(GROANS) Well,
forget your troubles 'cause I got you a bagel.
With extra cream cheese. Oh.
You are a lifesaver.
I... (GASPS)
Five-second rule.
(SIGHS) In a hospital?
Lexie, you know what's on the floor of a hospital?
Yeah, your bagel.
(LAUGHING): I know. I know.
Oh. Bonjour, Carol. J'avais fini mon MRI.
(LAUGHING)
Voilà, croissant. (LAUGHS)
Carol, did you used to be as fun as your friend?
Yes, and I'm still fun.
- Oh, yeah, but not as fun as your friend. - Oh.
"Fun"? What's more fun than living my dream?
A bientot, mon amie.
(LAUGHING)
Great. Skirt One and Skirt Two.
Technically, I'm more of a "skort".
Now, there's a small chance we might be able
to treat your hidradenitis suppurativa
with laser therapy.
We're just waiting for approval.
What is it with women and approval?
No wonder you're divorced.
For your lymphedema,
I am going to walk you through a manual drainage technique.
It's essentially a massage so I'll demonstrate for you.
Oh, now we're talking.
(FORCED LAUGHTER)
Okay. You'll just need to use gentle pressure
moving up the leg like this.
Push in, then up. In, then up.
Less talky-talky, more rubby-rubby.
Mr. Tuverson, more shushy-shushy.
CAROL: It's okay, Dr. Gilani.
Mr. Tuverson is a human being and our patient.
(SIGHS) It's our duty to treat him, and we enjoy it.
- Do you have any questions? - Yeah.
Do you two ever kiss?
Mr. Tuverson, that is not appropriate.
So uptight. Maybe you need a massage. (CHUCKLING)
Crossing a line.
I hope it's a panty line.
(LAUGHING) You know what?
I did not spend the last six years of my life
working days, nights and weekends
to be talked down to by a pervert.
I could be in France
on mile six of a fromage-a-thon,
but no, I became Dr. Kenney.
And so here I am massaging your thigh
and draining your boils.
And I'm not doing this because I have to,
I'm doing it because I love it.
This is my dream, and second-guessing my dream
would be insane and I am not insane.
This is your "I'm not insane" speech?
I hate to agree with Tuvie here,
- but maybe you should take a breather. - Oh, no.
No, thank you. No break for Dr. Kenney.
Just work, work, work until I die
six years before I'm supposed to.
Probably in this hospital.
Possibly in Delaware!
As I was saying, it is push, then up.
- What is she doing? - Push, up.
She's living her dream!
Push, up.
Lexie, I-I'm fine. I just need to get back to work.
No, you need to rest.
You just tried to massage a man to death.
(SIGHS)
- Not my finest moment. - No.
Your finest moment was when you parallel parked
- that school bus downtown. - Yes.
I can take care of our patients for a bit.
I think you should just retire with Phyllis, okay?
Have fun, you two.
(SIGHS)
Pull up a chair. Sit with me.
(GROANS) Thanks.
Today was a day.
It's nice to take a minute.
- You know, when I need to get my zen on, - Yeah.
I work on one of these.
- A coloring book? - No,
it's an adult coloring book.
You brought smut into the hospital?
No. Carol, it's for adults.
- Oh. - It's detailed patterns and images.
That one with the pandas is a little suggestive,
but... I'm sure they're just wrestling.
Go on.
Give it a try.
You get focused on staying within the lines, huh?
So what do you think?
Carol?
I'm making this panda blue.
I don't think they're wrestling.
They're not wrestling.
Sounds like the common cold,
but his cough has lasted way too long.
Mm, fatigue, weight loss.
I know it's uncommon, but I'm thinking TB.
Plus, his chart shows history of a positive PPD.
Nice call, man.
When Dr. Jacobs comes in, you should lead with that.
Great, I'll start...
Wait a second.
You don't think it's TB at all, do you? No.
I see what's going on here.
You know it's not TB,
but you want me to tell Dr. Jacobs, so I look like an idiot.
Then you can swoop in with whatever brilliant diagnosis
you're hiding in that sick little brain of yours.
- I really think it's TB. - I know your game.
Dr. Jacobs.
Patient was admitted with fever, night sweats, severe cough...
I can read the chart, Dr. Kutcher.
What's your diagnosis?
Um...
We were thinking tuberculosis.
TB? Huh.
Would explain the weight loss.
Excellent catch, Dr. Sommers.
Oh, actually, it was Dr. Kutcher who came up with the diagnosis.
Okay.
Seeing some really great work from you today, Dr. Kutcher.
Nice job, man.
What is wrong with you?
WOMAN: Les chevaux mangent les fraises.
BOTH: Les chevaux mangent les fraises.
See? Isn't that fun?
Yeah. What did we just say?
"The horses eat the strawberries".
Well, not super helpful.
I was looking for more travel stuff,
like, "Where's the bathroom?"
"What time is it?"
"Help, my daughter's been taken".
No. It's mostly horse stuff.
- Mm. - You want another coloring book?
Nah. I'm kind of colored out.
That tropical bird forest
- really took it out of me. - (CHUCKLES)
Time really flew when we were doing that.
What's it been, like, a couple hours?
- 20 minutes. - Oh.
Get ready to really relax.
It's magazine time.
Uh-huh.
Oh.
Okay. Celebrities.
(CHUCKLES)
I am really out of the loop.
Who are these people?
Oh, no.
Look at that girl in the bikini.
Yeah, she's a dirty bird.
Well, that may be true,
but that spot looks like basal cell carcinoma.
Carol, you're not supposed to practice medicine
when you read these things.
You're supposed to drink a couple glasses of rosé
and judge everyone.
Okay, okay.
And how long do we do this for?
Until everyone's been judged.
We need some wine. (SIGHS)
Is there any rosé in the gift shop?
Uh, we discourage our patients from drinking in the hospital.
Mm. Okay, you're not into this.
I know just the thing.
Well, look who isn't hysterical.
Just letting you know, Tuvie's boils were approved
for laser therapy treatments.
Really? A carbon dioxide laser excision?
Yeah. But don't worry. I got it.
You stay here.
Sorry.
I can't miss this.
I've never seen a carbon dioxide laser excision before.
It's the Rolling Stones of lasers.
I really don't get it.
Yeah, I'm stumped, too.
Not the patient. You.
First, you let me steal credit. Then you give me credit.
I mean, what kind of sick game are you playing here?
I'm not playing any game.
I'm just not that competitive.
Oh, I see your angle.
You're trying to be less competitive than me.
No, I am less competitive than you.
Right. Because we're a "team".
We are a team.
Oh, you are good.
Daniel, we're just different, okay?
I genuinely don't care about getting credit.
Since when?
Not even a tiny bit of you wants to be better than me?
Look, everyone in my family was very competitive,
and it did not make them happy.
My parents got divorced over a game of Scrabble.
It's just not who I want to be.
So can we please just figure out
what's causing Mr. Singh's low blood sugar?
Fine. But you didn't notice the pancreatic lesion on CT?
We'll have to run tests for fasting insulin
and C-peptide levels, but I'm pretty sure it's an insulinoma.
That would explain the episodes of confusion.
Good catch.
Ugh, I never would have gotten that.
Gentlemen!
I understand Dr. Jacobs assigned you to Mr. Singh.
Tricky case.
Tell you what,
whoever cracks it first joins me for lunch
with the senior attendings.
Pretty good opportunity for some face time...
It's an insulinoma. I mean, we'll...
have to confirm with fasting insulin and C-peptide levels,
but I'm pretty sure.
Insulinoma.
That's genius.
Well, Dr. Sommers,
I hope you like steak and vibrant conversation,
because you're about to get all you can eat of both.
Uh...
Caleb.
What happened to "I'm not competitive"?
Oh. No, no, no, no, no.
I said I'm less competitive.
Which is true.
You just have to know when to take your shots.
Good job, Dr. Kenney.
Thank you.
Mr. Tuverson, I want you to remember
that the person you're insulting one minute
could be holding a laser to your groin the next.
Sounds naughty.
Still holding the laser.
What happened?
Did you have to say the word "stat"?
They always say "stat" on TV.
Yeah. (CHUCKLES) Nothing that exciting.
I do have the results of your MRI,
and the good news is you don't have a fracture.
- Oh, that's a relief. - Yeah.
So I'm good to go?
Uh, well, I also checked the results of your blood work.
I want to talk about some elevated liver enzymes
- that showed up in your labs. - Oh, my God, it's cancer.
- So this is goodbye. - No, Phyllis,
you're fine.
Physically.
Um, but levels like these
can indicate that the liver is being asked
to process more alcohol than it can handle.
- Huh. - Um, I just want
to talk through your fall again.
- I was doing yoga. - Right.
Um, anything else you'd like to tell me?
Um, I may have had a glass of wine first.
Okay.
Um, is this a daily thing?
No.
Maybe.
Yes.
I've always had a glass of wine at dinner.
But, lately, dinner has become afternoon
and afternoon has become lunch.
But never before lunch.
Except on Sundays.
(EXHALES)
Do you think you have a problem?
'Cause if you need help, we can find you some resources.
Thank you, Carol.
Honestly, I don't think the problem is wine.
- I think my problem is boredom. - Mm.
Wine makes yoga interesting.
Wine makes a lot of things interesting.
Retirement has been very hard for me.
I have had no structure, no obligations.
I've felt aimless.
You know, I went from talking to a-a hundred kids a day
to no one.
Mm.
Except maybe the Amazon delivery guy,
but they switch 'em up all the time,
- so it's hard to make a connection. - Yeah.
But you're going to France.
Yeah, for a week and a half. And then what?
You know, I looked at the whole life you have here, and...
I guess I got a little jealous. (SCOFFS)
You know what's funny? I was jealous of you today.
- Me? - (CHUCKLES): Yes.
I mean, I know that this hospital
is the right place for me,
but that doesn't mean that some days
I wouldn't rather be doing sun salutations
than wiping pus from an old man's groin.
Is that not true on all days?
- I know it's crazy, but-but no. - (CHUCKLES): Yeah.
I mean, to get through med school,
you got to really love this stuff.
I was lucky. I found my path.
But I know you're gonna find yours.
You were always the most interesting person
- on the faculty. - Wait, what about Mr. Damelin?
- Don't get me started on that guy. - (CHUCKLES)
He's living in a motor home now.
Oh, so he's doing better.
(BOTH LAUGH)
- Oh, Carol. - Oh, Phyllis.
- Oh. - Oh. (CHUCKLES)
- Oh, you two. - (CHUCKLES)
This has been a lot.
Dr. Kenney, I heard about your work
with the carbon dioxide laser.
Yeah. So, how did it feel?
- Powerful. - Yes, I know.
There's something so satisfying
about cutting off part of another human being.
Yes.
If you're into skin conditions,
we have a cardiac patient who's presenting
with eruptive xanthomas that you simply must see.
Dr. Frost,
there is nothing I would rather do
and no place I would rather be.
I'm glad to hear that.
This place wouldn't be the same without you.
Now, let's go see something heinous.
- Yes. - (CHUCKLES)