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Summary for "Chicago Hope," the Premiere 2 page

The two twins are split, but one starts bleeding too much. Phillip explains the complications to the parents. Angela waits with them. Geiger finishes working on his baby and then works his magic on the one with heavy bleeding. Both girls will be fine.

TOP Facts:

Song: Midnight train to Georgia - Indigo Girl - from their album "12000 Curfews Part One"

TOP Quotes:

ARTHUR: This is my procedure!
JEFFREY: You'll get full credit doctor, I promise--especially if he dies.

JEFFREY: This heart feels broken. Maybe his wife filed. Oh, Camille, hi, whats new?

CAMILLE: Take Aaron's side, I expect it. But leave the attitude out of the OR.
JEFFREY: You know me, I'm Mr. Neutral!

ALAN: This is not respect.

CAMILLE: Thank you. I know if you wanted me out of here all you'd have to do is blink funny.
AARON: Contacts. It hurts to blink.

Geiger before operating on the Siamese twins:
"For those of you expecting music or my razor like wit, I apologize. The size of the room makes communication more difficult today ... and for those of you with God in your lives, please make contact now."

2.

"Over the Rainbow"

In Short: Dr. Geiger clashes with the hospital's executive committee after he performs an experimental procedure on a deceased patient. Dr. Shutt takes on a hapless HMO representative who insists that a less experienced, (and less expensive) surgeon perform a complex operation.

TOP Summary:

Jeffrey clashes with a young doctor who seems to have let a woman die too easily. He asks her husband, McTeague, if he can test a new artificial heart on her. Distraught, he agrees. Jeffrey asks Winslow, a doctor assisting on his procedure, to go out with him on a toilet fettish; she agrees. Arthur begs for his job back--if he can't operate, he'll die. Aaron sees a young mother with a massive tumor, a neurofiber sarcoma, and if she doesn't have it removed she'll die. But even if the operation is successful she may be permanently blind. Phillip informs Jeffrey McTeague is suing him, but the device does work.

Aaron wonders about Jeffrey dating Winslow--he's still married to institutionalized Laurie. McTeague confronts Jeffrey and spits on him, then Phillip tells Geiger he's going before the executive committee. Then he goes head to head with Thurmond, who will not remove his finger when Jeffrey asks him to get it out of his face so he bites it, which doesn't look good to the executive committee. He reminds the committee that the rule for consulting the subject protection committee before doing human experimentation diesn't apply if the next of kin gives consent. A HMO provider, Saunders, won't let Aaron do Mrs. White's surgery even though it's an extremely difficult procedure. He wants to meet with Euclid Park's neurosurgeon. At dinner with Winslow Jeffrey sees Camille on a date and ruins it.

Aaron asks Alan to help him with the HMO guy. Jeffrey gives Arthur a prescription that will cure the shakes that have kept him from operating. Alan tells them that even the smallest complication resulting from the procedure if the other surgeon does it will result in a lawsuit since Aaron has expressed reservations. In the end, it would be cheaper for them to let Aaron do it. Saunders reluctantly agrees. Jeffrey refuses to apologize to the board and Phillip warns him he may lose his job for it. Aaron tries to tell Jeffrey it'll never work with Winslow, or anyone else, because he'll never divorce Laurie.



Yvette White's children say goodbye to her and she's taken into surgery. Aron promises her he won't let her die. McTeague tells Jeffrey that his wife didn't need to test his device to count for something. Jeffrey apologizes to the committee--not for bypassing their rules, but for devaluing a human life. Arthur sticks up for him. Jeffrey apologizes to Camille too.

Yvette's surgery goes fine, but they're not sure about her eyesight. "I saw the light", she says--Aaron realizes she means the light he's shining in her eyes. Jeffrey goes to visit Laurie. She apologizes for drowning their son and he comforts her.

TOP Facts:

Song:I dreamed a Dream (from the musical: Les Miserables - 1987) can be found on Mandy's CD "Experiment".

TOP Quotes:

AARON: There's no charming way of telling someone they're going to die.

PHILLIP: Excuse me, are you crazy?
JEFFREY: A little. Thorazine (sp?) helps.

ARTHUR: Do you know what I think?
JEFFREY: No but if you concentrate I'm sure it'll come to you.

PHILLIP: I find in these situations it's best to breathe deeply and count to five.

CAMILLE: I have taken all the crap I am going to from you!
JEFFREY: I've got so much more to give!

JEFFREY: You'll be able to operate again, kill people the old-fashioned way--with negligence.

ALAN: Bottom line, it is cheaper for you to let Dr. Shutt and Chicago Hope do this procedure. Cheaper. Let me say it once more, cheaper. Twice more--cheaper, cheaper. And as an afterthought, the patient will have a better chance of surviving. Of course, don't let that notion distract you from the real issue--cheaper.

JEFFREY: I'm sorry. I said that twice today. It's a new record.

When Jeffrey visits Laurie in the clinic:
"Laurie had a bad week. She bit someone."
"So did I." Jeffrey replies.

TOP Transcripts:

Jeffrey asks Nadine out to facilitate a public bowel movement
JEFFREY: I get you twice this week, Winslow, to what do I owe the pleasure?
NADINE: Luck.
JEFFREY: I dont want to sound blunt, Winslow, but I've always been uncomfortable using public restrooms. Anyway there's this new restaurant on Russ Street, Thompson's? It's supposed to have these incredible facilities, made to practically induce regularity. I was thinking that's probably the perfect place to conquer my little phobia. Except you can't use the facilities unless you're a patron, and I got another thing about eating alone. Have dinner with me tonight? You can wear something nice.
NADINE: I beg your pardon?
JEFFREY: I can pick you up here.
NADINE: You just asked me out to facilitate a public bowel movement.
JEFFREY: What I'm detecting in your voice, Doctor, shock, surprise, maybe even a little outrage. That's the thing about bluntness. It intimidates the weak and engages the strong. If I've overestimated you I sincerely apologize.

JEFFREY: Before you begin could I just say one thing? Because I think it's important.
HACKETT: What?
JEFFREY: You have a little booger hanging.
HACKETT: I've witnessed you in surgery, Doctor, I admire your talent. Unfortunately you've come to believe somehow that you are bigger than this hospital and that is a gross misjudgement.
JEFFREY: I acted in the interests of medical development, which I believe is commencerate with the goals of Chicago Hope.
HACKETT: I'm hearing a very unapologetic tone. Before any artificial device is used for experimentation you are required to appear before the subject protection committee.
JEFFREY: An exception being consent from next of kin.
HACKETT: A grieving spouse moments after the fact has no capacity to give real consent and you know that. The man's wife just died, he was in shock and you used reprehensible duress. Aside from a despicable lack of sensitivity it was ethically debase.
JEFFREY: Look, I could argue that mankind was more served than insulted by testing my device, I could perhaps avail myself of the Hippocratic Oath which I also believe would favor interest of life versus dignity of death. But I realize I'm sitting before the executive committee, a panel that never bothers to factor humanity or ethics or even compassion into its decision making. It's all about regulations. Legislation, policy, that's all that matters. So let's get right to the procedural handbook. Chapter 14, paragraph 5: Human Experimentation. "Authorization from the subject protection committee need not be obtained in the case of a deceased subject whereby the next of kin has provided consent." You claim his capacity to consent was compromised. Problem is, you weren't there. I was. Bottom line: you can't get me on this one. Now, as for biting Dr. Thurmond, there's nothing in the handbook whick expressly prohibits it, I read it twice. Am I sorry, of course I am. Is there a lesson to be learned, absolutely. Keep your fingers away from my mouth. Don't ever try to feed me. Especially what you've been feeding me here!
(He leaves)
PHILLIP: I find in these situations its best to breathe deeply and count to five.

FERENGER: I've assisted on this procedure three times.
AARON: Assisted. You've never actually performed it yourself.
SAUNDERS: Tell me, Dr. Shutt, what was the result the first time you did this operation?
AARON: It was successful.
SAUNDERS: But you won't allow for that possibility with Dr. Ferenger.
AARON: Of course I do. But given the difficulty and the risk of the procedure, I want Mrs. White to have every conceivable advantage.
SAUNDERS: Dr. Ferenger, will Yvette White be taken care of?
FERENGER: Yes.
AARON: I just can't help but feeling that the welfare of the patient is secondary to your need for cost-control.
ALAN: Excuse me, forgive me Aaron, I know I'm supposed to be on your side here, but you have really screwed them! I think unfairly.
AARON: I beg your pardon?
ALAN: You have guaranteed a lawsuit against them.
SAUNDERS: What are you talking about?
ALAN: Patients sue all the time Mr. Saunders. Even if Dr. Ferenger successfully removes the tumor there's still a likelihood of blindness. If not then maybe some paralysis, maybe just a facial tic or two. Whatever. The patient is already predisposed to think she did not get the best treatment because of Dr. Shutt's reservations. The complaint's already being drafted, I promise you.
SAUNDERS: What if there's no negligence?
ALAN: It doesn't matter. Now think about this: we have a doctor going on the record before the operation saying "I have doubts". Then the HMO goes forward anyhow? And HMOs have all the sympathetic appeal of insurance companies as far as juries go. You're dead. (laughs) Even if that man performs expertly you will be sued. Ooh, God, I just thought of something else. Suppose it comes out during trial that doctors at HMO facilities feel pressured to say they can perform certain procedures that they know deep down they cannot. I'm not saying that's what happened here, Doctor, I'm sure you're an honorable mam. But if the jury thinks that's what happened, imagine the punatives they'll tack onto the verdict. Bottom line Mr. Saunders, which I know you're devoted to, it is cheaper for you to let Dr. Shutt and Chicago Hope do this procedure. Cheaper. Let me say it once more--cheaper. Twice more--cheaper, cheaper. And as an afterthought, the patient will have a better chance of surviving. Of course don't let that notion distract you from the real issue--cheaper. Oh, one more thing, and then I will shut up, I promise. If that woman is not operated on at Chicago Hope, I will give her or her estate, depending on how good he is, everything they need to crucify you. I will testify that from my vantage point, I saw a penny-pinching corporate cow, computing how much more fiscally responsible it would be for a patient to die in his hospital than survive in another. And I'll make sure Dr. Ferenger is subpoenaed and put on the stand, if for no other reason than so the jury can see his face, so they can see the expression that I'm seeing right now, the expression that says "I should not be performing this operation!" Well, have a look at his face, Mr. Saunders. Take a good look. That's your boy.
SAUNDERS: Maybe the woman would be better off here.

 

3.

Food Chains

CHICAGO HOPE, EPISODE 1.3"Food Chains" Air date: 9/29/94Written by David E. KelleyDirected by Jeremy Kagan PROLOGUE: I SING THE BODY MAGNETIC Business as usual at Chicago Hope. Drs. Phillip Watters and Aaron Shutthurry to the scene of the latest crisis. They burst through "crime-scene"tape and enter a room containing an MRI scanner, halting before adistressed-looking Camille Shutt. Protruding from the "tunnel" of the MRIare the shod feet and bunched-down trousers of Austin Hackett, erstwhileChief of Staff of the surgery department, and the completely mortified headof Shutt's assistant, Angela Giandamenicio. As Angela does her best to hide, Camille briefs Watters and her husband,Aaron. Apparently Hackett had a heart attack and seized, and he and Angelagot stuck in the machine. Uniformed personnel advance on the scanner with the Jaws of Life, onlyto be stopped by an appalled Watters, who begins to lecture them on the costof the machine. Meanwhile, Shutt patiently tells Angela to pinch her legstogether and straighten out. He starts the machine and the platform slidesfree. Paramedics remove the moaning Angela. "That's Hackett, all right," Watters remarks, eyeing the body. "I gavehim that tie for Christmas." * * * A short time later, Watters, now Chief of Staff pro tem, tells Dr.Jeffrey Geiger about the incident. Geiger is characteristically fascinatedand amused by the sordid details. When Watters protests it's not funny,Geiger merely remarks, "I gotta see a patient." But as he walks away, hisshout of laughter echoes down the corridor. * * * PLOT LINE 1: DISGRACE UNDER FIRE (PART 1) Two emergency patients arrive simultaneously in the trauma center. Oneis a man suffering injuries from a car accident; the other is a prostitutewho has been stabbed by a client. Dr. Danny Nyland checks each of them out, but when the hooker tells himshe has AIDS, he quickly orders another surgeon to be paged and turns hisattention to the accident victim. The hooker notices. Dr. Arthur Thurmond answers Nyland's stat page and begins examining thehooker, Dina Russell. When he asks Nyland if he has checked for perforationof the peritoneum, Nyland replies shortly that he has his hands full.Thurmond orders cutting instruments, and Nyland warns him Dina has AIDS. Thurmond merely continues his preparations and orders an OR. "This patient is nearly dead," he snaps. "What in the hell are YOUworking on, Doctor?" * * * After Thurmond's surgery on Dina, Nyland stops by the scrub room to askif Dina will make it. Thurmond, his eyes full of censure, replies that shewill. "This afternoon. Get your ass in my office," he barks. Worried, Nylandleaves. Thurmond visits Dina to tell her that everything will hurt for a whilebut that she's repaired. "What about the AIDS?" she jokes weakly. "I don't suppose you got rid ofthat?" She tells him he probably should have let her die. "You want to die, don't get stabbed on my shift," Thurmond says. Heturns serious. "You warned the doctor that you had AIDS. Do you warn yourclients?" She tells him no, but she makes sure they wear condoms. If they wearcondoms, they survive. "I gotta survive," she adds. Thurmond eyes her speculatively. "*Do* you want to survive, young lady?" She just cries quietly. * * * Some time later Nyland goes to Dina's room, wanting to explain hisactions to her. She stops him cold. "I can't imagine anyone making themselves more clearthan you did." She's seen "that look" of disgust on her clients after theyfinish with her, and she always wonders what the big deal is. They can goback to their nice lives, she says. "I still end up being the hooker." So "Cheer Up," she tells Nyland. He walks away. * * * Nyland reports to Thurmond's office and tries to explain himself. "I froze," he says. "She said she had AIDS and I froze. I would havejumped in if you hadn't come along . . . but first I wanted to see if someoneelse *would* come along." He says he has treated lots of AIDS patients, he doesn't know why hehesitated with this one. Thurmond is unmoved. He is ready to recommend Nyland's dismissal, butsays, "Tell you what. You come back with a satisfactory answer and maybe I'llchange my mind." * * * PLOTLINE 2: DEATH BECOMES HIM (PART 1) Angela apologizes profusely to Watters, but it's not good enough, hesays, what with the damage to the MRI. The MRI was Hackett's idea, Angela replies somewhat defensively. BecauseHackett was Chief of Staff, "I thought, you know, there *was* permission," she says. Angela adds that she doesn't think Hackett suffered. "He just let outthis kind of yelp," she recounts mournfully. "I thought he'd arrived, butinstead he went." * * * As Shutt and Angela walk down the hall together, he tells her that shedoesn't have to resign. At the door to their offices, she turns. "I intercoursed a man to death, how can I face people?" she wails. Unnoticed, a petite woman sits inside the door. She introduces herselfto Angela as Vicki Hackett and Shutt beats a hasty retreat. Vicki assures Angela grimly that she's not there to seek retribution,but there are rumors that she needs to know how to handle for her kids' sake. Was Angela with Hackett when he died? she asks. Yes, Angela answers. Was it long-term? No. Vicki walks out. Angela closes the door and sags against it. * * * PLOTLINE 3: A FAR, FAR BETTER THING (PART 1) Although Dr. Jeffrey Geiger's patient, Mr. Lanier, is Status One on theheart transplant waiting list, Geiger must tell him that "his" donor hearthad gone to someone Geiger had expected to die, but "the son of a bitch hungin there." This leaves Lanier, a middle-aged black man, with few options andlittle time. There might be a way to buy some time with a temporary heart, Geigertells him. "What are we waiting for?" Lanier asks. "Well, there's a catch," Geiger says. The temporary heart would comefrom a baboon. He explains that the procedure has been done on infants, neveron an adult, but "right now it's our only hope." * * * Geiger, Camille and a trainer surround a large plexiglass cagecontaining a baboon named Marty. Geiger remarks that Marty looks like hisbookie. "Nice monkey," he says. "Not much of a future." Camille asks if the procedure really has a chance of working. Not much,Geiger admits, but Lanier will die if he doesn't try. * * * Wheeling Lanier into the lab to meet Marty, Geiger explains that theexperimentation board may prohibit the procedure even with Lanier's consent,so he wants be sure Lanier is committed to it before he even goes to bat.There'll be a lot of publicity, he cautions, and then there's the "dignityfactor" of having a monkey heart. "Ain't no dignity in dying," Lanier replies. There's another thing, Geiger says. If the procedure doesn't work,death would be pretty sudden. "I hate to be brutal," he adds, but if thereare affairs to put in order, farewells to make, now's the time. "For someone who doesn't mean to be brutal, you're pretty good at it,"Lanier remarks, then says that he's divorced and his kids are across thecountry. "Just fix me," he tells Geiger. "OK, Mr. Lanier, I'll do that." Marty watches them leave. * * * Hospital counsel Alan Birch waylays Watters. Geiger has a monkey in the hospital and is preparing to "end-run" theregulations, Birch charges. Watters, however, knows nothing about thetransplant plan, only that Geiger had scheduled a meeting of the subjectprotection committee. There are already animal rights groups protesting outside, Birch says."This falls to you, you know. You're Chief of Staff." Watters mutters, "God, my first day." * * * Reporters swarm around Geiger as he hurries down the main staircase. Asthey assault him with questions about the monkey heart transplant, he tellsthem brusquely that this is premature, that he hasn't even gotten approval ofthe operation yet, and that they shouldn't *be* there. They persist, however. "How big is a baboon heart?" someone says. "Small," Geiger replies. "Tiny, like a lawyer's. Leave me alone." He rushes off, reporters still dogging him. Maneuvering alongside Geiger, one asks, "How long would the heart stayviable in a human?" "Not long," Geiger says, handing the guy piece of a candy bar. Withoutbreaking stride, he continues conversationally, "The main thing to rememberis that this hospital has many exits, and I'm leaving. Come back and see usagain." He speeds up and rushes through the doors, smack into a crowd of animalactivists, who advance on him and force him back into the hospital. "Buncha wackos!" he says, fending them off. They become louder andangrier as the security guards start pushing them back. As the securityguards hustle him away, Geiger, ever belligerent, yells, "I eat meat! I wearfur just for the vanity! I don't *walk* in a shoe unless it's leather!" One of the guards picks him up bodily and starts carrying him away. "AND I KILL ALL THE DOLPHINS I CATCH IN MY TUNA NETS!!" * * * INTERLUDE: IN THE BREAKDOWN ROOM A dejected-looking Camille enters the observation room above theoperating theatre. She doesn't notice that Birch is sitting in a cornerbehind the door until he clears his throat, startling her. They find they'rethere for the same reason: they need a moment to cry. He doesn't want theembarrassment of being seen mourning Austin Hackett; for Camille, it's Martythe monkey. "Well," Birch concludes, "I guess if you need a place to cry, this isit." Abruptly, Angela bursts in, sobbing. She looks at them, says "I'm sorry.I'm sorry" and backs out. * * * A FAR, FAR BETTER THING (PART 2) In the subject protection committee meeting, Watters admonishes Geigerfor antagonizing the animal rights group. Geiger objects to their havingcharged into a place where people are trying to save lives. "And by the way," he adds, "I happen to like this monkey. I already feelmore for it than I did for whatshisname, Hackett." A board member named Williams protests, saying that kind of poor tasteis a problem. What with interspecies experimentation "people are quick toliken us to Nazis. If anything, you may consider erring on the 'sensitivity'side of the fence." Geiger, looking pained and quietly furious, says levelly, "Please don'tever *dare* compare what I'm doing in this hospital to Nazi experimentation." Williams says he's not but others might. "Well, if they do to my face," Geiger says, "don't expect me to err onthe 'sensitivity' side of the fence." Watters and Geiger begin to argue about public opinion and politics:Geiger says he doesn't care about politics, Watters says he'd *better* care,Geiger reminds Watters that *he* hadn't cared in the case of the conjoinedtwins, Watters starts talking about "preposterous cross-speciesexperimentation." It looks as though the two of them are about to come to blows, but Shuttquickly interjects that the real question is whether the procedure really hasa chance. "Would I be sitting here if it didn't?" Geiger says. Shutt replies unhesitatingly, "Frankly, yes. You had a very quicktrigger finger with your artificial device; you would lo-o-ove to be thefirst heart surgeon to transplant a baboon heart into an adult." Geiger is annoyed, but when asked point-blank if it can work, he admits,"Probably won't work. Could work." He explains that the baboon has alreadybeen injected with human adenoviruses and is already expressing human genes. Williams doesn't understand why Lanier can't be put back on mechanicalassist, and Geiger explains that Lanier produces antibodies to his ownplatelets when on heparin, constant doses of which are required on mechanicalassist. Thurmond belatedly enters the meeting, announcing "I want that monkey"-- in order to provide bone marrow to Dina Russell, since baboon marrow isHIV-resistant. He and Geiger start arguing about who needs it more, whose itactually is and whose procedure is more likely to succeed. A shouting matchensues. Geiger is adamant. "YOU'RE NOT GETTIN' THAT APE!" But Watters wants to know more about Thurmond's plan. Thurmond explainsthat he'll inject the baboon marrow after abating Dina's own marrow, so thebaboon marrow won't have to compete with different growth factors. If itdoesn't work, he can reinfuse a sample of her own marrow. It won't kill thepatient for trying, Thurmond says, but Geiger's procedure will. Williams protests that these are two "grossly experimental" proceduresfor which there is very little evidence that the patients will be helped anda great likelihood that they'll radicalize the hospital's reputation, "not tomention the negative effects on the baboon." Thurmond says his procedure won't kill the monkey but Geiger's will.Geiger counters that Thurmond's could throw the baboon into cardiac arrest,in which case it will be no good to *him*. "I'm on a clock here," Geiger says. His patient is Status One, he's notgiving up the monkey even for a day. The shouting resumes. * * * In a corridor, Dina and Lanier sit in wheelchairs awaiting tests andlooking vulnerable in their skimpy hospital gowns. Dina tells a nurse she's alittle cold, but the nurse just tells her they'll be coming to get her soonand walks away. Left together again, Dina and Lanier look tentatively at eachother. "Hi," they say. * * * Geiger tells Lanier that someone else wants the monkey, that Lanier willhave to go before the committee and convince them that he wants the heart,and that while both procedures *can* be done with the same monkey, it'll taketime -- one commodity Lanier doesn't have. * * * Meanwhile, Thurmond explains his procedure to Dina. He'll injectcentrifuged baboon marrow into her in a few weeks, after destroying her ownmarrow with strong chemotherapy. It's an ordeal, he tells her, very painful,and likely to fail. "What's in it, then?" she asks. Hope, he replies. "Hope," she says. "Something new." As Thurmond turns to leave she mentions that the police haven't evenbeen by to question her. "Can't be bothered to find out who stabbed a hooker,I guess." Thurmond leaves the room. "Hope," she mutters. * * * Shutt and Geiger enter an elevator in mid-conversation. "What are you talking about?" Shutt says. "In the back. Dead center," Geiger replies. He feels Shutt betrayed himin the committee meeting by not backing him fully. Shutt thinks Geiger is going too fast. "You start fast-forwardingthrough research, you end up killing more than you save," he says. They're still debating as they emerge from the elevator and Birchaccosts them. "WHAT??" they snap in unison. Birch asks if either of them have seen the baboon. It's missing. * * * "OK, hand it over!" Geiger demands, bursting into Thurmond's office. Thurmond doesn't know what he's talking about. "The baboon. It's missing, gone, vanished, like your wits. What's this?"He snatches a banana out of Thurmond's pocket. "It's mine, I get potassium lows," says Thurmond, grabbing it back. Geiger says he's got a dying patient he's trying to save. "You're not the only one -- " Realizing he's shaking his finger inGeiger's face, Thurmond quickly jerks it back. " -- in this hospital withpatients." Geiger again demands the monkey, Thurmond again insists he doesn't haveit and Geiger storms out. * * * In the children's ward, Marty and her trainer are performing as Camillelooks on. Shutt comes in. "This ape is a fugitive, you know," Shutt says. "Special circumstances," she replies, watching some obviously very sickchildren laughing. "It's all gonna be worth it, right?" she asks quietly, "Sacrificing thisanimal to save human life -- it's all gonna be worth it?" Shutt replies drily, "No doubt." * * * The committee reconvenes with Lanier in attendance. Watters tells Lanierapologetically that they have to be sure he understands the procedure beforethey even consider approving it. Lanier asks him to speak in shortersentences. "I could be dead before you get through the next one," he says. Geiger, sitting behind Watters, covers a smile, but Watters chidesLanier that his tone is not constructive. Williams asks Lanier if he understands the odds, and Lanier replies,"Odds these days depress me." When Lanier begins to get angry at the committee's obstructionism,Watters suggests that anger won't solve anything. Lanier is impassioned --he's dying, he has one last chance, how dare they tell him he hasn't got theright to take it? "I'm trying to survive, and you're making me jump through hoops! Who areyou people?" "This may not be what you want to hear," Williams begins, and tells himbluntly that the hospital has bigger concerns than his individual health.It's there to serve the masses, and it can't be jeopardized for the sake ofone life, especially one not likely to be saved anyway. "So," Williams concludes, "since you're down to your final breaths, Isuggest you not waste them trying to influence us on policy. The purpose ofthis meeting is to establish your consent and that's all." Lanier stares at him. "I *consent*, you putrid, pompous ass!" he bitesout. The ass looks stunned; Geiger laughs to himself; and Watters, who haslooked increasingly appalled during Williams' comments, apologizes to Lanier,and assures him Williams' remarks do not reflect the attitude of the board. Lanier says drily, "No, I'm sure not." * * * Watters, in his office with his old friend Williams, pours himself adrink and selects a cigar. Williams says that the final decision about thetwo operations rests with Watters as acting Chief of Staff. Either will be apublic relations nightmare: The heart transplant is "aberrant if notperverse," and the marrow procedure, while less radical, "isn't sound on arush-rush basis." Watters points out that they *have* to rush it in order to get the heartto Lanier. Williams argues that Chicago Hope has a reputation that could bejeopardized, not to mention programs that depend on Hope's pedigree. Wattersis confident that with Geiger and Thurmond operating, the hospital'sintegrity would remain intact. One other thing. "It may be the spirit of Hackett living on inside me,"Williams begins, but neither procedure is covered by insurance, so thehospital would be eating $1 million right after the $2 million it ate for theconjoined twins. And, he adds, "If you harbor some hope of being madepermanent Chief of Staff. . ." Letting that thought finish itself unspoken, he makes his final bid."They're both gonna die anyway; you know it, I know it, even they know it." Watters settles slowly back on the couch with his drink and cigar. "I'llmake a lousy Chief of Staff," he sighs. * * * Dina and Lanier find themselves sharing a hall once again in betweenvarious tests. "You the lady after my monkey?" Lanier asks. "Sorry -- their idea," Dina says. "AIDS?" he asks. "Uh-huh. Heart?" "Uh-huh." "Trade?" she offers. "Hey, you got at least a month. I could be gone tomorrow," Lanier tellsher. "Trade?" Dina insists. "Uh-uh." * * * DEATH BECOMES HIM (PART 2) In the morgue, an attendant opens Hackett's drawer at Birch's request,protesting that the body was supposed to be on its way to the mortuary halfan hour ago. Birch asks for a moment and the attendant leaves. "Hi, Austin," he says. "I don't really know how to talk to dead people,whether I should look up to the sky or. . .?" He settles on looking into the middle distance. "You always stood by me.Everybody here, they call me the Eel. Not respect. You -- you'd always callme a li'l bug, but you stood by me." Angela enters the morgue. "Not many people liked him, Alan," she says. Birch maintains that Hackett was misunderstood. "But when absorbinglitigation as an expense of health care, he was a beacon," he says withfeeling. "And I'll tell you this: There was no greater crusader for clinicalfiscal management on the outpatient level. He was there by *himself*." "I killed him," Angela moans. Birch consoles her, "This place killed him. You just happened to be ontop of him when it happened." Paying their final respects, they leave. * * * Some time later, Angela is sprawled in a chair near Shutt's desk. "You're drunk," he says. "Damn right" she confirms, and volunteers her opinion that the hospitalhas sucked his and Camille's insides out, that their marriage was killed by"a place that *sucks*." "I'll keep that in mind," Shutt says warily, moving to call her a cab. Angela is not finished. Hackett liked to make love in the hospital, sheinsists, because it was his power center. But he wasn't making love to *her*,he was making love to the hospital of which she was merely a prop, and shehad gone along with it because "it put me higher on the food chain." So what if Hackett's family might get hurt, she says bitterly, "thisplace comes first!" * * * DISGRACE UNDER FIRE (PART 2) Nyland pays a visit to Dina. Everybody who works in Trauma automatically assumes that everybody whois admitted has AIDS, he explains. But subconsciously he may have consideredher -- a hooker, possibly a junkie -- not worth saving. "I'm going have my share of screwups in my time," he tells her, "and Imight even kill someone -- I hope not -- but I'll *never* owe a patient abigger apology than the one I owe you." Dina looks at him for a long moment. "OK," she whispers. "Thank you." * * * Nyland finds Thurmond in the locker room. "I have no satisfactory answer," Nyland tells him, "so if I'm finishedhere, I'm finished." Thurmond has heard about his conversation with Dinaand asks him if he knows the exposure he's cost the hospital by saying whathe did. Nyland does know, but maintains that Dina deserved an explanation. "You put her before the hospital?" Thurmond charges. Nyland nods. "There's hope for you," Thurmond says. "Scrub up and assist with themarrow." Nyland is paralyzed by surprise. "Hurry up! I'm old! I change my mind a lot!" Nyland rushes off to scrub. * * * A FAR, FAR BETTER THING (PART 3) As demonstrators and reporters crowd the hospital entrance, Marty isbeing prepped for the marrow extraction. Camille soothes, "It's OK, sweetie." "Hang in there, young monkey," Thurmond says. * * * In his OR, Geiger has Lanier open and on bypass. Going to the tablewhere Marty is anesthetized he says softly, "Some monkey," and begins hiswork. He painstakingly removes Marty's heart, puts it in a basin of ice, thenremoves Lanier's heart and replaces it with Marty's. * * * In the other OR, Thurmond begins the marrow procedure on Dina, withNyland assisting. * * * As Geiger finishes the transplant, he orders the bypass discontinued.The baboon heart in Lanier starts fibrillating. Geiger administers thepaddles, orders lidocaine and tries the paddles again. "Come on, come *on*," he urges, staring at the monitor. Finally, a blip, and sinus rhythm resumes. Throughout the OR, heldbreaths are expelled. * * * At a news conference in the hospital foyer, Thurmond tells reportersthat his procedure was a complete success, although it's much too early totell what its benefit will be. Watters stands up and says that Dr. Geiger is"fairly exhausted" and will be available to answer questions tomorrow. Hesays Lanier is resting comfortably and will be undergoing anti-rejectiontherapy, and that it is hoped that a permanent donor heart will be availablesoon. * * * In the recovery room, Geiger leans over Lanier. "Hey, how ya doin'?" he whispers. "Still alive? Tomorrow we start rightin with the powdered eggs and watery Jell-O." Lanier's eyes are closed, but he raises a hand. Geiger grasps it for along moment, then turns and walks away. In an adjacent bed, Dina looks over at Lanier. He opens his eyes andlooks at her. They smile a little at each other. * * * In the darkened OR, Geiger watches the orderlies bag Marty's body andwheel it out on a table. Camille, watching from outside the OR, holdsGeiger's gaze for a few seconds, then turns sadly away. Geiger stares bleaklyinto space for a while, then turns and walks very slowly out of the OR. ****************************************************** DIANE'S RANDOM NOTES AND OBSERVATIONS: Yet another episode with an issue to present: the ethical treatment ofanimals. Being generally sympathetic to animal rights groups, I was pleasedthat the demonstrators were not played as villains or lunatics. (Sure, Geigercalls them wackos, but consider the source!) And that last scene, in which itbecomes obvious that, for all his pragmatism, Geiger has some remorse for thebaboon, was really well done. I did think it was kind of manipulative to makeMarty a *performing* monkey, though. Alan's speech about Hackett's grasp of the legalities of health care washilariously reminiscent of Stuart Markowitz's eulogy, in the first episode of"L.A. Law," for his deceased colleague who was "a damn fine fiduciary" orsomething similar. The repeated scenes between Dina Russell and Mr. Lanier gave a real feelfor the vulnerability of the patient in the world of modern medicine. It'salmost as though they -- the whole point behind all the uproar -- aretemporarily forgotten as the juggernaut of medical technology and innovationrolls obliviously over them.

"Food Chains"


Date: 2015-12-11; view: 709


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