Original subtitles

It's a fact. Women think about having sex up to 34 times in the average workday.

Where'd you read that? Cosmo? Recent survey.

Right. And men think about sex every seven seconds. Five.

And human beings only use 10% of our brain. Often quoted, never proven.

I hear she pitches for your team. Shut up.

Hey, guys. Hi, Chloe.

Hi, Aimee. You asked for a psych consult?

Yeah. Uh, patient is stable.

He's a young man, 23. Industrial accident at a tool and die factory.

Lost two fingers. Do you have the fingers?

Yeah, although some dimwit at the factory...

put them in the same plastic bag as the ice, so there's some damage.

But it was a nice, clean cut. Thanks, Aimee.

Surgeon on call said he could sew them back on, however--

What? The kid is completely freaked out.

He says he's never had an operation before, never been to a hospital.

He's refusing surgery. He says he'll live without the fingers.

Tomophobia, fear of surgical operations, can be a significant anxiety.

I was hoping you guys would talk to him. No problem.

His name is Brian Jennings. Let me know. Those fingers won't stay fresh forever.

Bite me.

Brian. How you doin'?

Are you guys the psychiatrists they called?

I'm Dr. Arturo Suarez. This is Dr. Chloe Artis.

Look, you're wasting your time. I'm not having surgery. No way.

So we understand.

I just... can't handle the thought of it.

I know if they put me under I'm not gonna wake up.

Brian, do you have any family in town? Anyone you'd like us to call?

Mom and Dad are retired. They live in Palm Springs.

I don't want to bother them with this.

Look, I'm over 21. Do you have to call them?

By law, no, but you have had a serious accident, so you have a big decision to make, Brian.

I've already made my decision.

[ Chattering ]

Hey, Dr. Gallagher, can you help me with a situation?

Not now, Malc. I'll catch you later.

[ Arturo ] Look, here's the thing, Brian.

You're a machinist, right? That's what you do for a living.

By not allowing the surgeon to reattach your fingers,

you're literally cutting off your ability to work.

It doesn't make any sense. Sure, it does. Makes all the sense in the world.

Who are you? I'm his boss.

I own the tool and die factory where he works,

and this little son of a bitch did it on purpose.

He deliberately cut off his fingers so he could collect disability the rest of his life.

He's a damn thief.

[ Woman On P.A. ] Janitorial, please call Nurses' Station 5-3-6-0.

Janitorial, please call Nurses' Station 5-3-6-0.

[ Chuckles ] Good morning. Good morning!

[ Laughing ] How are you? You look great.

I feel good. I feel great. [ Laughing ]

Mum was here. She brought me croissants and coffee.

I had a shower. I must've been in there for an hour.

It was like soft rain falling down on me.

And I need a nail file.

Not 'cause I want to break out of the joint. I just need to file my nails.

Mum's gone shopping to buy me some new clothes.

Really? You gonna let her do that?

Oh, you know her. She'll probably go overboard.

But I want to wear something new.

You know, new.

I must've looked a fright.

- Yeah, you did. - Thanks for the support.

Shocking. Ah!

How are you? Your meds working?

Yeah, they're good.

It's not just the meds though. It's being here with you. It makes me feel at home, safe.

- Uh-huh. - Yeah.

Come here.

That's good.

I had a worker who cut off his thumb two years ago. Collected two mil for it.

- Luckiest bastard alive. - Okay--

There's no way I'm gonna let this little punk burn me too.

I'm gonna file a complaint with the cops. He did this on purpose, and I have proof.

Can we talk about this outside? Please.

What makes you think he did this on purpose? You said you have proof?

Yeah. I gave him two weeks' notice on Friday.

He knew he was gonna be out of work. Now he's got his retirement package.

Look, we're not judge and jury. We're psychiatrists.

But assuming Brian agrees, we'll admit him on a 72-hour hold, do an intensive intake.

We should be able to tell rather quickly whether or not he did this on purpose.

[ Jack ] Here's what you need to know, little sis.

Yes, Doctor. I trust you. Whatever you reckon.

I'm going to be adding a small amount of Abilify to the Risperdal.

And then we have to get you transferred out of here into another facility.

I've been thinking about it an awful lot.

Beck, it's okay. I'll be with you all the way.

I've been consulting with the doctors--

Watch out! They're after us. They're gonna be here any minute.

Rebecca.

The doctors are going to need my--

I can hear them. They're coming to take us!

- [ Rebecca ] They're here! - Rebecca, what's happening?

Oh, my God. They're at the door.

- Who's there? - They're at the door!

There's nobody there. Rebecca, it's just you and me. Here it comes!

Everything is okay. They're here.

Rebecca, it's okay. Becky. Becky!

- No, it isn't! - You have to stop them!

[ Rebecca Screaming ]

Jack! Jack! It's okay!

[ Screaming Continues ] They'll get me! [ Groans ]

[ Screaming Continues ]

Rebecca, calm down. It's okay. [ Sobbing ]

Calm down. [ Sobbing Continues ]

Yeah.

It's okay.

It's okay now.

[ Dings ]

[ Woman ] See if anything works for him in particular.

[ Man ] I'm trying to get out of here--

What's up? Have a seat.

I'm assigning Veronica to be the attending on Becky's case.

The purpose of this meeting is not to discuss the matter,

just to inform you of my decision.

Okay.

You knew it was against hospital policy to treat a relative,

so you assign Chloe to the case.

Then you tell her to back off when she comes up with any treatment suggestions.

I take it you're not too happy about this assignment either.

Well, if I do become the attending, I need you to step back.

You gave her a nail file, Jack.

I was with her the whole time. It was just a scratch.

Would you have given any other patient one?

All right, I'll take a step back. Just keep me informed. Is there anything else?

Oh, thanks a lot.

It'll be fine. He's a professional.

No one's professional when it comes to family.

God, this is a lose-lose situation for me.

I make a recommendation regarding Becky's treatment, he's gonna bite my head off.

I let him ramrod me the way he did Chloe, you're gonna rip me a new one.

Have a nice day.

I got a call from the surgeon.

They can keep the fingers refrigerated for another day. Then they gotta throw 'em out.

So, what's the consensus? Did he do it for the money?

I don't think so, no. Brian's only 23. To lose two fingers and--

Personally, I would not put it past him.

Just got fired.

Figures the way the country's goin' to hell in a handbasket,

might be tough finding another job.

He doesn't seem the type. I believe him.

I'm not sure.

He didn't seem like he was lying, but I didn't think he was telling the truth either.

Brilliant.

Well, there's one sure-fire way to find out.

People in this country, they don't even get tattoos unless they're drunk.

Tox report.

If he woke up this morning and decided to frame his boss by cutting his fingers off,

he probably took something right beforehand to deaden the pain, yes?

I'll order a blood panel right away.

We're also going to check out the machine he works on and talk to his coworkers.

Hey, why two fingers?

I mean, if you're planning it, why not just the one, huh?

[ Knocking ] [ Door Opens ]

[ On Speaker ] Hi, Becky.

I'm Dr. Veronica Hayden-Jones.

How are you feeling?

[ Rebecca ] Where's Jack?

He shouldn't be treating a family member, right? Correct.

- Is he okay? - He's fine.

Um, I have a couple of questions for you.

I've been seeing psychiatrists for 20 years. I know the routine.

[ On Speaker ] Well, that takes me right to the first one.

What is it that you would like from us? From me?

Well, treat me like you would anyone else.

Listen.

Help me.

You have my word.

It says here you've been having auditory hallucinations.

Is there a particular voice that you-- that you hear?

I know he's not real.

[ Veronica ] Well, he is to you, and that is all that matters.

[ Chattering ]

That's his station up there.

There was a lot of blood, but I took a bunch of pictures before I had it cleaned up.

You know, for evidence.

That it was actually his blood?

Can you show us how the machine works?

Oh, sure. Julio!

Julio worked alongside Brian about the past year or so.

I'm sure he can tell you all about him.

Julio, these are the shrinks I was telling you about. Can you give them a demonstration?

You got it, boss.

First thing they teach you in the training is,

no matter what you do, keep your hands out of this danger zone.

If you don't, and your hand gets caught when this blade gets dropped,

you can forget about those piano lessons, if you know what I'm sayin'.

You're in control. This thing doesn't operate unless you turn it on.

You just lower the handle...

and make your cut. [ Click ]

That's about it.

Weirdo. How so?

I don't know. Kept to himself. Didn't say much.

Bunch of us would go out for a cold one after work and, uh, invited him a few times.

Never went.

- Did he ever mention having a girlfriend? - Him? No.

The girls here at work wouldn't touch him. Something creepy about him.

Off.

And you know, at lunch, he'd sit by himself, writing and drawing.

- Writing? - Yeah, like in a diary.

Did you or any of the other workers ever see what he had in this diary?

No, but we tried to steal it once. Thought it'd be funny.

But after that, he never brought it back to work.

So I'm assuming you and the guys think Brian did this to himself on purpose?

[ Chuckles ] No. Not a chance.

Brian's a total wimp. He would've never done it.

We made a list. Pros and cons.

Pros: We live 10 minutes from the facility, and I'm not working.

I can see her every day, and she can come home for weekends.

And the cons?

It's obvious. You're a doctor.

You can monitor her treatment.

But you can do that on the telephone or through the Internet.

James and I took all of this into consideration.

The last time James took Becky into consideration, he threw her into an institution,

first one he could find, and it didn't work.

Jacky, that was years ago.

I think it's best if she stays with me.

It's not your decision to make.

[ Sirens Wailing ]

[ Door Opens ]

Mr. Jennings. Dr. Belle.

- I believe you've already met Drs. Suarez and Artis. - Yeah. Hi.

How you feeling? I'm feeling fine.

Am I going to be released soon?

Well, we'd like to get to know you a little better before we do that.

Listen, I know what my boss said. It's not true.

Brian, we've spoken with some of your colleagues at work.

Julio, in particular.

Yeah. What'd he say about me? I'm a nutcase, right?

I just don't have anything in common with those guys.

I work the machines. It's just a job.

I see. Loftier goals, eh?

I'd like to go back to school and study architecture.

That sounds like a great idea.

It might be tough drawing blueprints and putting together models without all your fingers.

- You thought about that? - Yes.

But I'd rather deal with that than have surgery to put them back on.

I'm afraid of anesthesia.

Your boss says you're trying to defraud him. You say it isn't about the money.

It isn't. Look, I was thinking, does he want me to sign something?

Something that says I won't sue him?

It's not about the money.

Gallagher.

Decided to release Brian Jennings, the kid who cut off his fingers.

The tox report came back clean. He's willing to sign a release for the company.

The boy's telling the truth. Got a pen?

Well, you want to look at the file, or interview him, or--

He's your patient, right?

That's my, uh, suit.

[ Murmurs ]

Jack.

I contacted a psychiatrist at the University of Pennsylvania...

regarding this new implant device.

Zyprexa. Yeah. The implant can last for up to one year.

Which makes it very difficult for Becky to choose to go off her meds.

That's part of the problem. I think it's healthy for Becky to be in charge of her treatment.

Right. But she has a history of going off her meds, and we know what happens when she does.

This way, all she needs to do is turn up once or twice a year, get the injection--

I'll consider it. How's it going?

Good.

I think we had a good amount of self-disclosure in the first meeting.

She definitely allied with me.

She say anything more about the auditory hallucinations?

Uh, no, but I think I'm getting close.

Thought I might take her for a walk around the grounds.

She's your patient.

[ Veronica ] He's not-- He's not letting go.

He's not. He's--

He's trying to save the one person in the world he really loves.

Okay, the bottom line is this.

I think she's more stressed when he's around.

She needs someone to treat her who is without history, pity, judgment,

or any of that-- that sibling crap that we all know is there.

Okay. I'll talk to him.

Something's just weird. We pushed Brian through here too fast.

I agree.

You got a minute? Actually, no, I don't. Can I call you later?

No, actually you've got a minute.

- Go home. - Let me guess. Veronica said something.

Jack, you can't take care of Becky and your parents and the patients all at the same time.

I'm perfectly capable of doing my job while Becky's here.

No, you think you're fine. You're not fine.

You've been looking for Becky for four years. You can't act like this is business as usual.

[ Malcolm ] Apparently this wasn't his first time.

Where is he?

Brian? He's been discharged. You signed off.

What is it?

Find him. Find him now.

[ Dings ]

What did the parents say?

Clueless. Don't know and don't care.

Not true. At least not the mom. She was worried.

They lost touch with him over a year ago. Said Brian just kept moving.

They don't know where he lives?

They don't have a number for him? What did the police say?

After I told them we were worried Brian was going to chop off another body part,

and they had to find him before he did, not much.

But they're looking for him. Said he has a debit card and bank account.

They're looking.

Weybourne Clinic, just north of San Diego.

It's got 30 acres, swimming pool. It's really nice.

Is it near the water? Yeah, absolutely. Right beside it.

I thought I could maybe rent a place down there. We could spend weekends together.

What do you think? I think it sounds great.

Um, but I-- I don't know where my watch is. I had it when I came here.

Did you see it?

No.

I've had it forever. Mum and James gave it to me. Did they?

You, uh-- You weren't wearing it when you showed up at my place.

Yes, I was. I'm positive I was.

Maybe one of the staff put it in the patient bag when you came here.

I had it here!

Okay.

Becky, think about San Diego for me.

Somebody must have stolen it.

I'll see if I can find it.

What just happened in there?

She was trying to find her watch, which, of course, she never had.

So that was you just taking your step back?

That wasn't a therapy session.

That was me telling her about the facility that I want to transfer her to.

And, yeah, I've taken a step back.

Jack. She's not going with you.

Jack-- W-Wait a minute, Jack.

Margo, uh, can you just give us a minute? I'll meet you in the lobby.

Okay? All right? All right.

Is there someplace you and I can go and talk?

Really? [ Laughing ]

A macho thing? Yeah.

That's so funny. Hi.

Hi. You want to join us?

Uh, sorry, I-- I can't. They found his apartment.

I gotta run. I'll talk to you later? Yeah.

Bye.

[ Clears Throat ] Not a word. Not one word.

I spent four years looking for her. I moved to Los Angeles.

I hired private investigators!

So did I. I've hired a whole slew of people on and off over the years.

Why, Jack? Because I care.

I-- I adopted you and Becky. I raised you like I would raise my own flesh and blood.

You raised us like a pair of recruits you just enlisted.

Okay, yeah, fair enough.

Look, I was over 40 years old when I met your mother.

What the hell did I know about raising children? I did the best I knew how.

We all just want what is best for her.

When Becky first got sick, your first response was to throw her into an institution.

How much care was involved in that?

What was she, an embarrassment? My only intent with Becky--

Color this any way you want, but that was the worst day of my life, and hers. It still is.

I've gotta get back to work. Hey!

Have you asked Becky what she wants to do?

[ Woman On P.A. ] Dr. Vichel to Consultation Services.

Dr. Vichel, please report to Consultation Services.

I spoke to the nurse. She's going to look for my watch.

I know. I spoke to her too.

I could get you a new one.

I don't want a new one. Just a thought.

Mmm.

What we were talking about earlier--

Very serious.

Mum and, uh, James,

they want to take you to Florida with them.

There's a facility about 10 minutes down the road from the house.

Oh.

They have power of attorney.

So, what's happening with you?

Girlfriend?

Why not? You're what Mum would call a very good catch.

Oh, yeah?

I thought you were going to marry Gwen. I really liked her.

I liked her too. So?

Well-- What?

No nieces and nephews for me to spoil?

[ Laughing ] Not unless you pop some out.

Oh, yeah, right.

"Hi, honey. Let's have a couple of schizophrenic kids together."

Not going to happen.

Ball's in your court.

Hmm.

I'm not that great a catch. Mmm.

That's true.

[ Man ] There you go.

[ Arturo ] Thank you.

Look at this.

[ Gasps ]

[ Carl ] He cut off his own hand.

Thought he could stop the bleeding, but he panicked.

Is he okay? Somebody better call his parents.

I will.

Brian. How are you?

How am I?

Better than I've ever felt.

Like a great weight has been lifted.

My body's finally right.

Complete.

I'm whole.

[ Dings ]

Any person who deliberately cuts off a healthy limb is insane.

Insane's a legal term, Carl. It's not a medical one.

Don't patronize me.

You know damn well what I'm talking about. He's delusional.

No. People with Body Integrity Identity Disorder say nothing else works other than surgery.

Psychotherapy doesn't work, psychiatry doesn't work, medication doesn't work.

The only thing that works is getting rid of the body part they say doesn't fit.

And it's difficult, if not impossible,

to find a surgeon in this country who will perform a voluntary amputation.

Well, thank God. Doesn't anyone here remember the oath they took? "Do no harm."

If Brian sews his hand back on, the likelihood is that he's going to cut it off again...

by freezing it off, by an illegal amputation, by blowing it off with a shotgun,

and get gangrene and die.

I say by supporting his decision we are following the oath to do no harm.

Then where does it stop?

What if a month from now he still doesn't feel that his body's right,

and he wants to chop off his legs, his other hand, his arms?

Are we going to let him do that too?

Did you listen to the kid, Carl? He just turned around and told us that he was whole.

I don't believe it's going to happen. Okay.

Forget about them.

You know better.

Are you really going to sit here and tell me...

that you are not going to try and convince this obviously mentally ill young man...

to sew his hand and his fingers back on?

That's exactly what I'm telling you.

Our goal as physicians is to heal the injured, not to encourage--

Our goal, our only goal, is to alleviate suffering.

Look at the person.

You look at him.

He's 23 years old, and he's missing a hand,

a hand that is ready to be sewn back on,

and I will do everything within my power to make that happen.

[ Rebecca ] I think he thinks he can save me.

What does he say to you?

He tells me things.

Warns me.

He wants to protect me and wants me to protect him.

What do you think?

Sometimes I think I never want to see him again,

and, uh, other times I can't let go.

What does he look like?

Young. A street kid-- 18, 19.

That was about the age you were when you first got sick.

Yeah. I never thought of that.

Does he have a name?

Gabe.

Did you ever know a Gabe?

Uh, I don't know.

What is it, Becky? What's going on?

When I was living on the streets, so many things happened.

Some of them I-- I know were real.

But others I don't know.

It's okay, Becky.

No, it isn't.

I was hurt.

I was, uh, screaming,

and he r-- [ Sobbing ] he ran away.

I-- I was so scared. I couldn't tell anyone. [ Sobbing Continues ]

Uh, Mum.

Mum. [ Sobbing ]

When I was a kid, I used to dangle my arm out the car window...

hoping somehow I'd get sideswiped.

Once my dad was in the garage fixing the car.

I thought about trying to crush it, but the jack didn't collapse right.

Hmm.

Sounds like you've known what you wanted for a long time.

Once, I saw this man with one leg, walking with crutches.

He smiled at me.

I remember...

thinking he was brave, you know.

I admired him.

How did you cut your toe off?

I waited a long time. Did my research in chemistry class in school.

Wrapped it in dry ice.

Kept it on for a couple of hours, till I was sure.

A few days later it turned black,

so I cut it off with my mom's meat cleaver.

I researched how to stop the bleeding right away too.

How old were you? Sophomore in high school.

[ Chuckling ]

It's funny, 'cause afterwards I got kind of popular.

And the girls, you know. I had this tragic accident.

It, uh, didn't last long though.

Did you ever get close enough to any of those girls to tell them the truth?

There was-- There was someone once.

Cara.

She was really nice. Went out a couple of times.

I thought I should tell her.

You know, she'd understand.

Then-- I kept this diary. I always have.

And one day I left it out, and she saw some of the pictures I drew.

That was that.

Can't blame her.

** [ Calliope ]

[ Boy Laughing ] Mom! Mom, look!

Here it is! Whoo! Whoo! Yeah!

Hey! Come on, Mom! Whoo!

Why did you cut your fingers off first?

I just-- I wanted to make sure I'd feel better once they were gone.

Sure enough, without the fingers, I started to feel good right away.

I could only imagine how good I'd feel with my whole hand gone.

Do you think I'm crazy?

Absolutely not.

Some of my colleagues disagree.

They think you should have your hand sewn back on...

and begin an intensive course of psychotherapy.

They believe you have a choice.

Oh, I had a choice.

My choice last night was to cut my hand off...

or blow my brains out.

I made the right one.

[ Typing ]

Brian was a "change of life" baby.

I didn't have him till I was in my 40s.

Our daughter Madelyn is 10 years older than Brian.

We have two beautiful grandchildren.

And Madelyn teaches art.

[ Sighs ] She's normal.

- Alan. - So Brian wasn't normal?

I wouldn't say that. Well, he was nothing like Madelyn.

He didn't have any friends.

He didn't play any sports.

He was just quiet. Just kept to himself.

He'd come home from school, go into his room, stay there.

He was very bright. Did well in school. He was just fine.

He was not fine.

And obviously, he's still got some problems.

Listen to me. Brian is sick.

Now you're his parents, his family.

It doesn't matter how old he is. You have to take responsibility for him.

This is the attorney I was telling you about. He's a good man. The best.

He'll file a motion to have Brian declared incompetent.

You'll get power of attorney.

Brian'll have to do as you say. He'll have to allow the surgeon to reattach his hand.

We don't have that kind of money.

I think it's reasonable.

Call him. Don't wait.

Brian's hand will be gone in two days.

** [ Guitar ]

You got better in the last four years.

Give me a break.

[ Laughing ] Well--

** [ Strumming ]

Jack in the box.

Yes, little sis?

I'm gonna go home with Mum.

This is entirely my decision. I want to go with Mum.

Okay.

I miss Florida.

What?

Okay, um, I don't.

Um, I really like the beaches there.

I, uh--

I'll be able to go home every weekend.

Every one.

Okay.

Then again-- Mmm?

You need help.

Please don't patronize me.

I'm not patronizing you. You need the best help you can get.

There are other doctors in the world, Jack.

Getting you better-- This is it--

Getting you better is the most important thing in my life.

You know,

maybe it shouldn't be.

[ Dings ]

[ Arturo ] Just because we don't agree with him doesn't mean he's going to listen to us.

He's going to do what he wants to do. We need Jack on this.

I'm serious. He's right here.

Jack, where have you been? We called you, we paged you, we e-mailed you.

You're never late for work. It's past noon, you know.

Really? Whew. Thanks for that. What can I do for you?

Carl's convinced Brian's parents to retain a lawyer to declare Brian incompetent.

They're planning on reattaching his hand tomorrow morning after the judge signs the order.

Carl's going to screw this kid over. Jack.

Where are you going?

[ Sighing ] Ay-yi-yi-yi.

[ Laughing ] [ Woman ] May I help you?

Yes, he is. Hold, please.

My God, Alan. He's laughing.

He's really laughing.

We have never seen him like this before.

He's not in pain? Far from it, no.

No, the brain controls the body.

His brain is telling him that...

with one hand and nine toes he's actually complete.

Dr. Belle said that he might want to cut something else off,

that it's just a matter of time.

I don't think so, no.

You just have to look at his diary.

See, Brian's pictured himself with one hand since childhood.

And now that that obsession is gone, he can lead a normal life.

But to cut off his hand--

I know.

I know it's difficult to imagine.

But sometimes--

sometimes you need to give up a part of yourself in order to feel whole.

Do you think we could see him?

Of course.

Hey, Carl. Social call or business?

Come on. Don't be shy.

You may have won this round,

but you're a sad excuse for a director of Psych Services.

I think you're mentally unstable, unfit to be anyone's superior.

Least of all yours. Least of all mine.

Must be tough, spending every day with people that are far less intelligent than you.

It's not easy, no.

And yet here you stay, waiting for me to trip up,

to go that little bit too far so you can step in.

As I should have to begin with.

Uh-huh.

Jack.

How is she today?

She's okay.

I don't know. Are we doing the right thing?

I hope so.

When we first found out about Becky's condition,

I didn't know what to do.

I didn't know what to say.

But I need you to know, Son, that not a day goes by...

that I don't regret putting her in that institution and how I went about it.

I--

Come here.

Malcolm, is her, uh, release form ready?

Uh, yeah. Got it right here.

Thank you.

You check out that place they're taking her to in Florida?

Yeah. It's good.

[ Chattering ]

[ Giggling ] [ Woman On P.A. ] Janitorial, call Nurses' Station 5-3-6-0.

Janitorial, please call Nurses' Station 5-3-6-0.

Call me?

Yeah. You can call me too.

Take care.

Your chariot awaits, young lady.

Bye, Mum. Bye, darling.

- I'll call you as soon as we arrive. - Sure.

Jack. James.

Can I give you some advice?

Of course.

Get therapy.

I know a lot of good people I could refer you to.

Yeah.

Yeah, you're right.

I need help.

[ Dings ]

[ Child ] Show's on!