Summary for "Food Chains"
From DinnyR@aol.com Sun Jul 16 22:22:08 1995
Date: Sun, 16 Jul 1995 20:05:55 -0400
Subject: Re: HOPE - "Food Chains" Summary, Ep. #3
The following summary was written by Diane Rosenfeldt and edited by Yolette
Nicholson. We share responsibility for all grammatical and continuity errors,
but all opinions are the writer's alone.
CHICAGO HOPE, EPISODE 1.3
Air date: 9/29/94
Written by David E. Kelley
Directed by Jeremy Kagan
PROLOGUE: I SING THE BODY MAGNETIC
Business as usual at Chicago Hope. Drs. Phillip Watters and Aaron Shutt
hurry to the scene of the latest crisis. They burst through "crime-scene"
tape and enter a room containing an MRI scanner, halting before a
distressed-looking Camille Shutt. Protruding from the "tunnel" of the MRI
are the shod feet and bunched-down trousers of Austin Hackett, erstwhile
Chief of Staff of the surgery department, and the completely mortified head
of 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 Angela
got stuck in the machine.
Uniformed personnel advance on the scanner with the Jaws of Life, only
to be stopped by an appalled Watters, who begins to lecture them on the cost
of the machine. Meanwhile, Shutt patiently tells Angela to pinch her legs
together and straighten out. He starts the machine and the platform slides
Paramedics remove the moaning Angela.
"That's Hackett, all right," Watters remarks, eyeing the body. "I gave
him 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 fascinated
and 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, his
shout of laughter echoes down the corridor.
* * *
PLOT LINE 1: DISGRACE UNDER FIRE (PART 1)
Two emergency patients arrive simultaneously in the trauma center. One
is a man suffering injuries from a car accident; the other is a prostitute
who has been stabbed by a client.
Dr. Danny Nyland checks each of them out, but when the hooker tells him
she has AIDS, he quickly orders another surgeon to be paged and turns his
attention to the accident victim. The hooker notices.
Dr. Arthur Thurmond answers Nyland's stat page and begins examining the
hooker, Dina Russell. When he asks Nyland if he has checked for perforation
of 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 YOU
working on, Doctor?"
* * *
After Thurmond's surgery on Dina, Nyland stops by the scrub room to ask
if Dina will make it. Thurmond, his eyes full of censure, replies that she
will. "This afternoon. Get your ass in my office," he barks. Worried, Nyland
Thurmond visits Dina to tell her that everything will hurt for a while
but that she's repaired.
"What about the AIDS?" she jokes weakly. "I don't suppose you got rid of
that?" She tells him he probably should have let her die.
"You want to die, don't get stabbed on my shift," Thurmond says. He
turns serious. "You warned the doctor that you had AIDS. Do you warn your
She tells him no, but she makes sure they wear condoms. If they wear
condoms, 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 his
actions to her.
She stops him cold. "I can't imagine anyone making themselves more clear
than you did." She's seen "that look" of disgust on her clients after they
finish with her, and she always wonders what the big deal is. They can go
back 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 have
jumped in if you hadn't come along . . . but first I wanted to see if someone
else *would* come along."
He says he has treated lots of AIDS patients, he doesn't know why he
hesitated with this one.
Thurmond is unmoved. He is ready to recommend Nyland's dismissal, but
says, "Tell you what. You come back with a satisfactory answer and maybe I'll
change my mind."
* * *
PLOTLINE 2: DEATH BECOMES HIM (PART 1)
Angela apologizes profusely to Watters, but it's not good enough, he
says, what with the damage to the MRI.
The MRI was Hackett's idea, Angela replies somewhat defensively. Because
Hackett was Chief of Staff, "I thought, you know, there *was* permission,"
Angela adds that she doesn't think Hackett suffered. "He just let out
this kind of yelp," she recounts mournfully. "I thought he'd arrived, but
instead he went."
* * *
As Shutt and Angela walk down the hall together, he tells her that she
doesn'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 herself
to 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?
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 the
heart transplant waiting list, Geiger must tell him that "his" donor heart
had gone to someone Geiger had expected to die, but "the son of a bitch hung
in there." This leaves Lanier, a middle-aged black man, with few options and
There might be a way to buy some time with a temporary heart, Geiger
"What are we waiting for?" Lanier asks.
"Well, there's a catch," Geiger says. The temporary heart would come
from a baboon. He explains that the procedure has been done on infants, never
on an adult, but "right now it's our only hope."
* * *
Geiger, Camille and a trainer surround a large plexiglass cage
containing a baboon named Marty. Geiger remarks that Marty looks like his
"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 the
experimentation 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 "dignity
factor" 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 there
are 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 the
country. "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" the
regulations, Birch charges. Watters, however, knows nothing about the
transplant plan, only that Geiger had scheduled a meeting of the subject
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. As
they assault him with questions about the monkey heart transplant, he tells
them brusquely that this is premature, that he hasn't even gotten approval of
the 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 stay
viable in a human?"
"Not long," Geiger says, handing the guy piece of a candy bar. Without
breaking stride, he continues conversationally, "The main thing to remember
is that this hospital has many exits, and I'm leaving. Come back and see us
He speeds up and rushes through the doors, smack into a crowd of animal
activists, who advance on him and force him back into the hospital.
"Buncha wackos!" he says, fending them off. They become louder and
angrier as the security guards start pushing them back. As the security
guards hustle him away, Geiger, ever belligerent, yells, "I eat meat! I wear
fur 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 the
operating theatre. She doesn't notice that Birch is sitting in a corner
behind the door until he clears his throat, startling her. They find they're
there for the same reason: they need a moment to cry. He doesn't want the
embarrassment of being seen mourning Austin Hackett; for Camille, it's Marty
"Well," Birch concludes, "I guess if you need a place to cry, this is
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 Geiger
for antagonizing the animal rights group. Geiger objects to their having
charged into a place where people are trying to save lives.
"And by the way," he adds, "I happen to like this monkey. I already feel
more for it than I did for whatshisname, Hackett."
A board member named Williams protests, saying that kind of poor taste
is a problem. What with interspecies experimentation "people are quick to
liken 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't
ever *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 on
the '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 conjoined
twins, Watters starts talking about "preposterous cross-species
It looks as though the two of them are about to come to blows, but Shutt
quickly interjects that the real question is whether the procedure really has
"Would I be sitting here if it didn't?" Geiger says.
Shutt replies unhesitatingly, "Frankly, yes. You had a very quick
trigger finger with your artificial device; you would lo-o-ove to be the
first 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 already
been injected with human adenoviruses and is already expressing human genes.
Williams doesn't understand why Lanier can't be put back on mechanical
assist, and Geiger explains that Lanier produces antibodies to his own
platelets when on heparin, constant doses of which are required on mechanical
Thurmond belatedly enters the meeting, announcing "I want that monkey"
-- in order to provide bone marrow to Dina Russell, since baboon marrow is
HIV-resistant. He and Geiger start arguing about who needs it more, whose it
actually is and whose procedure is more likely to succeed. A shouting match
Geiger is adamant. "YOU'RE NOT GETTIN' THAT APE!"
But Watters wants to know more about Thurmond's plan. Thurmond explains
that he'll inject the baboon marrow after abating Dina's own marrow, so the
baboon marrow won't have to compete with different growth factors. If it
doesn't work, he can reinfuse a sample of her own marrow. It won't kill the
patient for trying, Thurmond says, but Geiger's procedure will.
Williams protests that these are two "grossly experimental" procedures
for which there is very little evidence that the patients will be helped and
a great likelihood that they'll radicalize the hospital's reputation, "not to
mention 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 not
giving up the monkey even for a day. The shouting resumes.
* * *
In a corridor, Dina and Lanier sit in wheelchairs awaiting tests and
looking vulnerable in their skimpy hospital gowns. Dina tells a nurse she's a
little cold, but the nurse just tells her they'll be coming to get her soon
and walks away. Left together again, Dina and Lanier look tentatively at each
other. "Hi," they say.
* * *
Geiger tells Lanier that someone else wants the monkey, that Lanier will
have 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 take
time -- one commodity Lanier doesn't have.
* * *
Meanwhile, Thurmond explains his procedure to Dina. He'll inject
centrifuged baboon marrow into her in a few weeks, after destroying her own
marrow 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 even
been by to question her. "Can't be bothered to find out who stabbed a hooker,
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 him
in the committee meeting by not backing him fully.
Shutt thinks Geiger is going too fast. "You start fast-forwarding
through research, you end up killing more than you save," he says.
They're still debating as they emerge from the elevator and Birch
"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 in
Geiger's face, Thurmond quickly jerks it back. " -- in this hospital with
Geiger again demands the monkey, Thurmond again insists he doesn't have
it and Geiger storms out.
* * *
In the children's ward, Marty and her trainer are performing as Camille
looks on. Shutt comes in.
"This ape is a fugitive, you know," Shutt says.
"Special circumstances," she replies, watching some obviously very sick
"It's all gonna be worth it, right?" she asks quietly, "Sacrificing this
animal 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 Lanier
apologetically that they have to be sure he understands the procedure before
they even consider approving it. Lanier asks him to speak in shorter
sentences. "I could be dead before you get through the next one," he says.
Geiger, sitting behind Watters, covers a smile, but Watters chides
Lanier 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 the
right to take it?
"I'm trying to survive, and you're making me jump through hoops! Who are
"This may not be what you want to hear," Williams begins, and tells him
bluntly 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 of
one life, especially one not likely to be saved anyway.
"So," Williams concludes, "since you're down to your final breaths, I
suggest you not waste them trying to influence us on policy. The purpose of
this meeting is to establish your consent and that's all."
Lanier stares at him. "I *consent*, you putrid, pompous ass!" he bites
The ass looks stunned; Geiger laughs to himself; and Watters, who has
looked 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 a
drink and selects a cigar. Williams says that the final decision about the
two operations rests with Watters as acting Chief of Staff. Either will be a
public relations nightmare: The heart transplant is "aberrant if not
perverse," and the marrow procedure, while less radical, "isn't sound on a
Watters points out that they *have* to rush it in order to get the heart
to Lanier. Williams argues that Chicago Hope has a reputation that could be
jeopardized, not to mention programs that depend on Hope's pedigree. Watters
is confident that with Geiger and Thurmond operating, the hospital's
integrity 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 the
hospital would be eating $1 million right after the $2 million it ate for the
conjoined twins. And, he adds, "If you harbor some hope of being made
permanent 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'll
make a lousy Chief of Staff," he sighs.
* * *
Dina and Lanier find themselves sharing a hall once again in between
"You the lady after my monkey?" Lanier asks.
"Sorry -- their idea," Dina says.
"AIDS?" he asks.
"Trade?" she offers.
"Hey, you got at least a month. I could be gone tomorrow," Lanier tells
"Trade?" Dina insists.
* * *
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 half
an 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 call
me 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 absorbing
litigation as an expense of health care, he was a beacon," he says with
feeling. "And I'll tell you this: There was no greater crusader for clinical
fiscal 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 on
top 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 hospital
has 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, she
insists, 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 she
had 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, "this
place comes first!"
* * *
DISGRACE UNDER FIRE (PART 2)
Nyland pays a visit to Dina.
Everybody who works in Trauma automatically assumes that everybody who
is admitted has AIDS, he explains. But subconsciously he may have considered
her -- a hooker, possibly a junkie -- not worth saving.
"I'm going have my share of screwups in my time," he tells her, "and I
might even kill someone -- I hope not -- but I'll *never* owe a patient a
bigger 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 finished
here, I'm finished." Thurmond has heard about his conversation with Dina
and asks him if he knows the exposure he's cost the hospital by saying what
Nyland does know, but maintains that Dina deserved an explanation.
"You put her before the hospital?" Thurmond charges.
"There's hope for you," Thurmond says. "Scrub up and assist with the
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 is
being 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 table
where Marty is anesthetized he says softly, "Some monkey," and begins his
work. He painstakingly removes Marty's heart, puts it in a basin of ice, then
removes Lanier's heart and replaces it with Marty's.
* * *
In the other OR, Thurmond begins the marrow procedure on Dina, with
* * *
As Geiger finishes the transplant, he orders the bypass discontinued.
The baboon heart in Lanier starts fibrillating. Geiger administers the
paddles, 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, held
breaths are expelled.
* * *
At a news conference in the hospital foyer, Thurmond tells reporters
that his procedure was a complete success, although it's much too early to
tell what its benefit will be. Watters stands up and says that Dr. Geiger is
"fairly exhausted" and will be available to answer questions tomorrow. He
says Lanier is resting comfortably and will be undergoing anti-rejection
therapy, and that it is hoped that a permanent donor heart will be available
* * *
In the recovery room, Geiger leans over Lanier.
"Hey, how ya doin'?" he whispers. "Still alive? Tomorrow we start right
in with the powdered eggs and watery Jell-O."
Lanier's eyes are closed, but he raises a hand. Geiger grasps it for a
long moment, then turns and walks away.
In an adjacent bed, Dina looks over at Lanier. He opens his eyes and
looks at her. They smile a little at each other.
* * *
In the darkened OR, Geiger watches the orderlies bag Marty's body and
wheel it out on a table. Camille, watching from outside the OR, holds
Geiger's gaze for a few seconds, then turns sadly away. Geiger stares bleakly
into 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 of
animals. Being generally sympathetic to animal rights groups, I was pleased
that the demonstrators were not played as villains or lunatics. (Sure, Geiger
calls them wackos, but consider the source!) And that last scene, in which it
becomes obvious that, for all his pragmatism, Geiger has some remorse for the
baboon, was really well done. I did think it was kind of manipulative to make
Marty a *performing* monkey, though.
Alan's speech about Hackett's grasp of the legalities of health care was
hilariously reminiscent of Stuart Markowitz's eulogy, in the first episode of
"L.A. Law," for his deceased colleague who was "a damn fine fiduciary" or
The repeated scenes between Dina Russell and Mr. Lanier gave a real feel
for the vulnerability of the patient in the world of modern medicine. It's
almost as though they -- the whole point behind all the uproar -- are
temporarily forgotten as the juggernaut of medical technology and innovation
rolls obliviously over them.
Go to the next summary
Go back to the summaries list
Back to the Chicago Hope Homepage
Back to Steen's Homepage