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So, Lauren, where are you from?
Ann Arbor. Ah, Wolverine. Yeah, go blue.
Tell me something about you.
Any hidden talents I should know about?
Yes, actually. I can guess any dog breed, anytime, anywhere.
That's impressive.
So, why are you here?
I've had some bad luck with guys, one guy in particular.
Yeah, I'm here because I've always wanted a family of my own.
Me too.
How many kids do you want?
I... I'm sorry.
I think I've had enough, okay? I want... I want to get out.
Hey, unlock the door.
I can't. I said let me out. I'm done. Okay. I said I quit.
You can't keep me here. I know my friends.
So he left.
Again.
Oliver.
I'm so sorry.
You didn't know that time.
No.
At least he had the decency to leave a note.
Carol would call that growth.
Your father has always been impulsive at this.
I should have expected it.
Leaving is what he does best.
You get one time to say I told you so.
This is the last thing I want to be right about.
But I can't say I'm not somewhat relieved.
You were giving up so much for him.
And I don't want you to blame yourself.
I did everything I could. He has to live with that, not me.
Honey, you're allowed to feel hurt.
I'm good, Mom.
You don't have to worry about me anymore.
And you can finally live your life unburdened by Dad.
And I can get back to the patients who actually need me.
I think Carol would call that growth.
Allison Whitaker sought me out under false pretenses.
She used our therapy sessions to pursue an unhealthy preoccupation with my
husband. Once I became aware of the history, I ended our relationship.
Ended your relationship with whom, Ms. Whitaker or your husband?
Both.
Did you not continue to have formal sessions with the patient on hospital
premises after you became aware of the conflict? I immediately referred Allison
to another psychiatrist.
She refused and became emotionally distressed. Out of concern that she may
engage in self -harm, we had two additional sessions.
But Ms. Whitaker did self -harm, so you weren't successful in helping her.
Did you alert the medical board, your supervisor, or any other therapist about
your concerns?
I did not. You were unlikely then, but your failure to establish clear
boundaries played a contributing role in her attempted... No! Stop!
Cut!
I'm out!
Josh, what the hell?
You're supposed to be helping me prepare, not destabilizing me. We've got
hours to get you ready. These board hearings are no joke. They will try to
you just to cover their own asses. I genuinely didn't think that what I did
that wrong.
Have I been delusional about this whole thing?
Your grip on reality is stronger than most.
Are we referring to our mutual friend, Wolf?
How's that going?
What, did you alert the medical board? Or the whole damn world that you may
still have feelings for each other? You know Wolf, whatever he's feeling, all
going into his work.
Three, two, one.
Since when do you do stroke codes? And didn't I put your intern on that? Well,
it seemed like Dr. Nash could use a hand, and my schedule unexpectedly
up. Lauren?
I'm looking for my sister, Lauren Brooks. Has anyone seen my sister?
Oh, my God.
Hi. There you are.
Lolo. Lolo, hi.
What happened? What are you doing here? You're not supposed to be here.
What is she in for? Head trauma? Seizure? A show.
Claims she heard herself escaping from a reality TV set. My guess is drugs
aside, probably both. Either way, I'm turning over that bed in an hour, so
do your whole... I don't want you on it.
On what? What does that even mean?
Hi.
I'm Dr. Wolf.
Did you know that foundation can harbor facial bacteria?
It's best not to put that on an open wound.
Would you mind taking it out to our waiting area where we'll get your sister
patched up? We'll come find you.
Okay. I'm going to be right outside. Let's go.
Hi, I'm Lauren. Lauren B.
Nice to meet you.
Nurse Carter's on me to update the EHR.
I'll trade you for your rounds.
Wolf needs us in the ED. I don't want to go to there.
A full zero dark 30, but with less Chastain and more Thorn.
I don't want to waste so much yelling. Why the yelling? Dana, you are stressing
me out. It's fine.
I'll go. But you're helping me with the EHR later.
Deal.
Meet you down there?
Okay.
Ladies need help in the ED?
I think we'll manage.
Where's the LaGuardia?
Before the renovation.
Hey, there's that guy again. A little frequent flyer. Except there's never
anything wrong with him. Which I guess is sort of like the loyalty point
equivalent of flying every day from Newark to Allentown.
God, that's good.
Oh, that's painful.
I know these questions are strange, Lauren, but you're doing great. Can you
me where you are right now? Yeah, I'd be worried if I couldn't.
We're at Bronx General in the Bronx.
Are you taking any medication that requires subcutaneous injections?
Insulin, blood thinners, GLP -1s? No.
I told them that I didn't want to be on the show anymore, but they wouldn't let
me leave. It may be helpful if we knew which show you were on, Housewife.
Next job?
Summer house? I would kill on the trailer. Okay, um, why don't we just
right now on how you feel? And all of your initial labs... appear
normal.
Why are you putting on your glasses like that?
Like what?
Like you're on a TV show.
This is still a part of it?
Of course, of course, I knew, I knew. I knew that this wasn't a real hospital. I
know all the trouble. Okay, I know. I know I'm still being filmed. What makes
you say that, Lauren? Maybe the hidden cameras that are all over the place.
There's one right there.
In the stethoscope?
Yes, there's one there.
And there.
And there.
Um, Dr. Robes, should we... Don't act like you don't know what I'm talking
about, okay? I know.
I know. I know what's going on. I know.
I get it. Okay.
I know.
Cut.
Let's stop filming.
And let's put down all of our props.
Let's just take five.
I think our patient is experiencing Truman Show Syndrome.
This is actually a first for me. These delusions can manifest in various ways,
but in each case, the patient believes that they are under some sort of...
Constant surveillance.
Is there a specific trigger? It's usually meth. My guess is meth, too.
Weren't you on that peripheral neuropathy? Just finished up. Thought
out here. Can I be part of the wolf pack? When Lauren's feeling up to it,
run a talk screen, but I don't suspect drugs. Sustained illusions can be caused
by environmental factors, biochemical imbalances, even the meth.
Could be psychological.
Maybe she's a technophobe whose conspiracy theories took over. Of
Truman Show Syndrome is a relatively new psychosis named after some movie about
a detective... No, that was Ace Ventura. He was a pet detective.
A pet who solves crimes. That's ludicrous.
Delusions associated with new technologies have a long history. In the
people believed radios could read their minds. In the 14th century, a revolution
in glass production led many people, including King Charles VI of France, to
believe that they were made of glass and could shatter. Seriously?
This is what you do in neuro all day? Historical story time? A patient came in
off the street. Nine times out of ten, that's a history of psychosis. This
be an average Tuesday for her. Not according to the sister. We need to
out what triggered this, and history can provide a valuable context.
Why don't you play pet detective after you give her antipsychotics and her
delusions subside? I wouldn't want to.
Hi,
Lauren. I'm glad to see your sister's here with you.
We are just going to run a few tests, okay?
Yes. I explained to her we're not being filmed, and this is all to help her.
Nice try.
Lo, just let the doctors work, okay?
I cannot believe that you're with them now. I mean, I tried to keep you out of
this, Harper, but you're just a part of it, too.
What are you supposed to be, the concerned family member?
I'm concerned.
Because you're making things up that don't make any sense.
Where are you getting this? Do any of these people look real to you?
They're actors.
No, we're not actors. Maybe not a good one.
I mean, that birdie guy with the glasses from before. He's a torture genius who
cares too much about his patients.
She got that right. Let me guess, the only person he can't heal is himself?
And you three are what? His protรฉgรฉs? The interns?
The type A brainy one? The comic relief?
Hurtful. This guy is way too hot to be a doctor, so why isn't he here?
Oh, to be my love interest.
Forbidden romance with the patients. Lauren, stop.
These are your doctors. I will not be humiliated on camera for the whole world
to see and judge me, okay?
Nobody's judging you here.
Ma 'am?
I am in pain, okay? I need real help from real doctors in a real hospital.
if you're not going to give me that, then you can just get out. Well, we need
that. You too, Harper.
If you're just going to lie to me, Harper, then leave.
Okay, okay, I'm going to be right back. Okay.
Can you think of any recent stressors in her life?
I mean, she broke up with her tech pro boyfriend, but Lauren doesn't let that
shake her.
She's always on top of everything.
Always. I can't believe this is happening.
You know what? The ED has the best vending machines.
Why don't you go grab something and take a seat? Take care of yourself while we
take care of your sister.
Okay.
Sorry. No, it's all right.
I'm waiting on you. It'd be great to get some answers. If only Lauren would let
us do like one teeny tiny LP.
Maybe she'll let her love interest do it. Huh. God, I always attract the crazy
ones.
We don't use that word here.
It's dehumanizing and stigmatizing, and it trivializes everything we do on
behalf of our patients. Relax.
It's not like I said it to her face.
So, how are you holding up?
I'm fine.
I lived without my dad for 30 years, Carol. I'm happy to go another 30 the
way. It was a blip on the radar. I am fine.
You said fine twice.
Should I do my thing, or just let you keep twisting reality?
The only reason that he came back was to use me to fix him, and when that didn't
happen fast enough, he left.
I am ready to get back to my real life and the people who actually deserve my
time.
What's going on with the trial?
Oh, well, Josh put me through the ringer this morning.
He went full Army General on me.
So annoying.
Annoying, but also kind of hot.
Okay. I don't want to hear it. Just keep me out of y 'all's thing.
Obviously don't. But Josh, I wasn't knowingly right, Wolf.
You are an incredible doctor. You made one mistake.
Who are these bureaucratic pencil pushers to judge you?
Yeah, well, I think the only way to get my job back is if I lie to the pencil
pushers about what happened.
It's my word against Allison's. So if the system is wrong, then you've got to
everything in your power to make it right.
Hey, Wolf, you're going to want to see this.
NYPD just sent it over.
What is this?
Your patient's reality show.
I've had some bad luck with guys.
Well, one guy in particular.
Yeah, I'm here because I've always wanted a family of my own.
How many kids do you have?
I'm sorry. I think I've had enough.
I want to get out.
Unlock the door.
I can't.
I said let me out.
She wasn't on a reality show. She was in a cab.
Please, lady, calm down.
Delusions have already caused one violent episode.
She needs Mads. I just want everyone to stop watching me.
Keep going.
There she is.
Mads. Lauren, she was headed for the west exit. On it.
Lauren, wait.
Lauren, stop.
Lola, it's okay.
Everything's okay.
Everything's okay.
Come with me.
What are you doing?
Please don't have her. Please don't have her.
We're supposed to help her get better. Why can't we just take her to New York?
She eloped during a mental health crisis and nearly harmed herself.
Despite Thorne's maddening pursuit of expediency as correct in protocol, the
seclusion room is a safety measure. And it's making her worse. She thought she
was on camera being watched, and now she is. Well, in psych terms, this is a
self -fulfilling prophecy.
Cool, cool. Thanks, Dr. Drew. Okay, Thorne wants to wait and see if psych
out of hiding, but Carol's replacement is basically a potato with a clipboard.
Even if he shows up, he's just going to force meds on Lauren. And traumatize her
even more.
On the flip side, prolonged psychosis is toxic for the brain. Which is why she
needs antipsychotics. Her brain is on fire.
Let's turn down the temperature psychologically and literally.
That's your solve?
Blast the AC? Dr. Dang is right. Her brain is on fire. The threat response in
her amygdala is on high alert. We need to cool her physiological response.
And then what?
Then we meet her where she is.
He missed one.
Oh.
Good catch.
It's Lauren. Lauren.
B, right?
I'm Oliver.
Oliver W.
Okay.
Oliver W.
Don't you hate this constant surveillance?
It is tiring.
But the abundance of particle board furniture exhausts me more.
I'll admit I'm terrified of what's on the other side of this.
So what's your story? Why haven't you found love yet?
Overworked doctor.
Too committed to my patients, I guess.
It's so hard.
And it just feels like everyone is always judging you. Like, you're not the
person they want you to be. You can't be because you're, like, broken.
Can I let you in on a secret?
I heard everyone watching is rooting for you.
Come on. It's true.
You're the fan favorite.
Everyone wants to see you win.
But you gotta keep playing the game.
Even on this hospital set.
Cooperate with the doctors.
Take your meds.
Everyone wants to see you get better.
On your terms.
Okay.
Yeah, I'll do it.
And for what it's worth, I hope you find love, too.
Hey, by the way, I know you're not a real doctor.
You're right.
I just play one on TV.
Wolf, Nickel.
Hey.
Do you want to grab a drink tonight?
Sure.
So it's your assertion that you did nothing wrong. You discontinued
the patient as soon as you discovered the inappropriate relationship.
continued to treat her for a short time after I knew.
As psychiatrists, we're taught to maintain a healthy emotional distance
clients, but it's not always realistic.
Not when you've given a widow a reason to get up in the morning after her
husband died.
Not when you've guided a family through the hell of alcoholism and watched them
make it to the other side.
Not when you've treated a young girl with anorexia for years and rejoice with
her family when she no longer wants to restrict.
I care deeply about my patients.
I see myself in them.
And they deserve a doctor who will fight for them the way I fight for the people
in my own life.
I am committed to my patients.
Always done the best I can, even when circumstances get complicated.
If you fire me, you lose an employee.
They?
They lose a hell of a lot more.
I'm very proud I got her to take her meds willingly.
It's great to get the win.
I know the feeling.
Thank you for celebrating with me. I needed this.
I'm happy to be here.
What?
Are you okay?
Why wouldn't I be okay?
Your dad... I know he just left.
I didn't know that you knew.
Carol told me.
I thought you asked me here to maybe talk about it. No, I don't want to talk
about it.
I don't want to talk about him.
I want everything to go back to the way it was before he came.
You told me you wanted to wait until your house was in order.
And your dad just left, and if I were to take a wild guess, I don't think
anything is in order. You'd be guessing wrong.
Look, I can be your friend.
But I don't deserve to be jerked around.
It's the hospital. I gotta go.
Yeah, yeah.
I'm sorry.
Sorry you forgot.
Okay, she woke up like this. You guys said it was all in her head, but she's
real pain now. We paged Dr. Wolf. He's on his way.
Is it all right if I take a look at you, Lauren? Yes.
We can't wait for Dr. Wolf.
Page the on -call. Get them here now.
Copy that. Okay.
A quick examination revealed the patient's distended abdomen. That, in
combination with acute pain and shallow breathing, suggests internal bleeding.
That's the work in theory, but I page critical response team.
There's got to be something that we're missing. That's great. Good work.
Ow, ow, ow, ow, ow, ow, ow, ow, ow, ow.
Are you going to be okay, Lauren? Yeah. Here we go.
Hey, hey, hey, hey.
I am so sorry. I don't know how I didn't hear my phone. Not right now, can you?
What could have caused the bleed?
Ultrasound shows free fluid in the lower pelvis. Exact source is unclear, but
we're hoping IR can stop the bleeding and give us more answers.
All right, let's go.
What's happening? Is she going to be okay?
Let's give them some space to work, and I'll explain to you what I know. Come
with me.
I am such an idiot.
Far from it.
This is a night shift.
Happens to the best of us.
Well, it doesn't happen to me.
Maybe take it easy on the Benzos every time.
Her ovaries are cystic and enlarged. That hematoma Erica found on Lauren's
abdomen, I don't think it's from GLP -1s. I think she's been injecting
with hormones for... In vitro fertilization, which is why her ovaries
massively stimulated, and that bleed's location must be associated with a
egg retrieval. But that still doesn't entirely explain the psychosis.
I'm going to try the IVF lab now that they're open and see what they can tell
me. Let me know.
Dr.
Bull!
Just a heads up, I took care of all your discharge summary.
Oh, well, it's good to see you awake.
Everything okay?
Yeah, of course. I just know how much you hate charting. Also, I found a case
think you might be interested in. At minimum, he's schizophrenic, but I think
there is something more going on.
As you can see, every physician's note is just a copy -paste from the last.
Everyone just writes him off. So I am thinking we should give him a fresh
workup. But this guy's in and out of the ED every other day.
Isn't that all the more reason we should help him?
Lauren B. has one break, and it's all hands on deck. I just think we're being
very biased about who should and shouldn't receive care. Listen, Erica, I
appreciate your passion.
Truly, I do.
But no matter how hard we try to help, some patients will always leave, and
that's their right. We cannot force care onto those who don't want it.
I'm sorry I didn't tell you about
IVF.
It's okay.
I just wish I had known so I could have helped.
Lauren's abdominal pain was from a complication with the egg retrieval
Unfortunately, we were focused on the psychological break, which is a separate
issue. Lauren, can you explain what you've been going through these past few
weeks? Yeah.
Jake left, but I always wanted to be a mom, so I kept going. I did
my research. I picked a sperm donor.
I can't believe you're doing all those injections by yourself.
Yeah. So expensive.
And I had to bill so many hours I couldn't even sleep.
But I wanted to tell people when it was a success.
And I want them to judge me or think that I was doing it the wrong way,
Everything's wrong, so... A big breakup going through the IVF process, working
too hard, not sleeping enough, with huge hormonal fluctuations that provokes the
worry.
Stress, the tonnage of those elements created a perfect storm for a mental
for you. You put enough pressure on a bone, it will break.
The brain is just as fragile. It can only take so much.
Do you see something?
Um... No, no.
It's nothing.
Do you think there's a camera there?
I don't know. I don't know.
I thought that this was better, that this was fixed. While her delusions
aren't real, in a sense they are real to her. She has memories of them. We have
to think of Lauren coming out of this like the sun rising after a heavy rain.
It'll take some time for all of the water to dry, but it will.
Good news from the fertility clinic.
Despite the complications, the retrieval was a success.
Three embryos made it through the fertilization process, Lauren.
Major silver lining.
Hey, that's amazing, Lolo.
Can someone please tell the fertility clinic that they can discard the
I'm not interested in proceeding.
You went through how to get those, okay?
I think it's best if you go be with your family.
I've got so much trouble. Please, I can't.
I'm just going to rest.
Please, no. You really don't need to be here.
I don't know how to help her.
Continued medication will help, but this is a normal process.
She can be discharged soon with support in place.
Pepper, it's not normal.
I want to be there for her.
I'm a toddler at home. I don't do in eight weeks.
Hi there.
Hello? Amelia Fredericks. I'm the clinical director at Hudson Oaks
Facility. I got word that we may need inpatient treatment. Got word from whom?
We're always trying to help out our busy city hospital, so I just happened to be
doing my rounds here today in Bronx General.
What is this?
Please take our brochure.
I'm so sorry that your loved one is dealing with a mental health episode.
It can be so hard, especially on the family.
And you are clearly about to be very, very busy. Boy, girl?
We don't want to know.
I love a surprise.
There's so few good surprises left in life.
But there are no surprises at Hudson Oaks.
And yet you managed to surprise me in my hospital on my floor, so there must be
a couple. You have so much to do here.
And that's where a facility like ours comes in.
We can ease the burden on you.
And the patients love it.
Gives them a safe place to be while they recover.
I don't know, maybe this is the right thing for her. I just never thought we'd
be one of these families.
dealing with something like this. Thank you for all of these materials.
An inpatient facility might be the right option for Lauren, but you and I can
review all of this privately together. You don't need to make any decisions
right now.
It's time to make a decision.
If there's no new evidence to present, let's take a vote.
All in favor of restoring Dr. Pierce to her position?
All in favor of terminating Dr. Pierce from her position.
Looks like we're split.
So,
what's the verdict?
Well, since you decided to heroically tell the unvarnished truth,
the jury was split.
But the decision is final.
I'm stepping down as chief medical officer.
Effective immediately.
What? I told the board that I advised you.
To continue treating Allison.
Head of psych is yours, if you accept.
No.
No, I'm not letting you do that.
Well, with all due deference, I am well past the age where anyone lets me do
anything.
For most of my career, I've been making the hard decisions about what's right
for this hospital.
And that's what I'm doing right now.
Muriel, Bronx General needs you. It needs you more.
And so does Oliver.
I'm leaving the hospital.
Not my son.
And look, he says that he's fine, but you and I both know that's not true.
And when he finally realizes that, he's going to need you here.
Not me.
I don't know what to say.
Because we both know that I'm right.
I'm not going to wander off into the wilderness.
I have been contemplating retirement for a while now.
To tell you the truth, Carol, I'm tired.
And I'm ready.
Well, I think you've earned a break.
Oh, honey, I hope so.
Welcome back, Dr. Pierce.
What you're doing is very brave and difficult.
I know.
But it really is the right thing for your family.
You're going to be a perfect fit at Hudson Oak.
And our team is perfectly equipped to take care of people with problems like
yours.
What do you think, though?
I think it's probably best for everyone.
Well, if you hold a sign here, then I can start getting the transfer set up.
Lauren.
Whatever you decide to stay or go, this is up to you.
I know how difficult it can be to feel like a burden on the people you love the
most and to feel like...
Everything would just be easier if you were gone.
But that isn't always true.
Are you sure that this is what you want?
I'm not sure.
Then maybe we should get a second opinion.
Dr. Wolf filled me in, and I understand you've discussed staying in inpatient
care for the near future.
I don't know how I can return to my life after this.
I certainly can't have kids.
I'm crazy. I completely understand why you feel that way, but I wouldn't use
that word to describe you. I had my psychotic episode after I had a baby,
don't even consider myself crazy.
I didn't realize.
I mean, you seem so just the same as you.
Just the same as anyone.
Inpatient care is the right solution for some people, but having a psychotic
episode is just like any other illness.
Lots of people have them, and lots of people go on to resume normal lives
afterwards. Like with any illness, people can be susceptible to certain
vulnerabilities. They can have headaches or nosebleeds. It doesn't make you weak
or flawed.
It makes you human.
We've both treated plenty of patients and helped them get back to their lives
after something like this.
You could start by seeing me twice a week, stay on your medication, and we
monitor how you're doing. But there's no reason to believe you have any type of
permanent psychosis.
But if things get bad again, that's okay too.
You'll now have the tools in place to help you get through it.
That sounds good to me, Lolo.
Can I still freeze my embryos? Of course.
Many times people who have dealt with mental illness, they make the fiercest
protector of their own children, especially when they have the right
system in place.
It's hard to predict what will break a person.
That,
the Dr. Pierce touch, we've been missing around here. Thank you.
Oh, thank you.
This doesn't feel real yet.
I honestly wasn't sure I would be back here.
Well, a friend in high places told me it helped that one of your patients
testified on your behalf.
What?
Who?
Alice.
She came forward, said you saved her life.
Went a long way with the board.
But I thought she was the one who reported me.
Welcome, Allison.
Life is always throwing us for a loop, so we cling to the people who make us
feel whole, hoping they can hold us together.
I can carry a plastic bag.
Get enough on your hands.
My OB says it's important to stay active.
Keep up on my workout routine.
Okay, workout routine.
Chasing a two -year -old around New York City is a workout in and of itself.
Okay? Okay.
There you go.
Mom,
you do know that there are people who will do this for you, right?
I'm supposed to trust strangers with my most precious belongings?
Thank you.
For what?
For sticking around.
Especially when he made it so hard for you.
So it took me retiring for you to say thanks?
After all these years? Oh, my God.
Mugwum.
Don't make a big deal of this.
I'm not.
Actually, I was thinking it'll be nice to have you as my mom and not my boss.
Oh.
I won't make excuses for your father.
He made huge mistakes, and he was never the easiest man to love.
But it devastated him seeing how his condition affected his family.
It was so hard on you and it was hard on me.
But I can promise you it was hardest on him.
I know.
He was alone.
But everyone breaks.
And sometimes what breaks you has been lurking inside you all along, waiting to
shatter your world.
Dr. Wolf, are you all right?
Well, you'll remain with us here for an observation period, under our care and
supervision, so that we can best determine a treatment that's suited for
Hey, even those of us... Who give care, need care sometimes.
Bye, my dear.
Go ahead, Wolf.
It's for the best.
We'll get ahead.
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