"Previously on pure genius..." "My mom hasn't been feeling well lately." "If you're really concerned about your mom, why don't you just have a real and honest conversation with her?" "Yeah, we don't do that." "Angie, your mom has cervical cancer." "Unfortunately, it's spread to her other organs through her bloodstream." "I wish you'd mentioned that the grim reaper was coming here to ruin our gss trial." "I need more data from the animal models for approval of a human trial." "The study wasn't approved." "I will not give up fighting for you." "I'm fighting for me." "I might be running out of time, James." "Do you regret the decision you made back in Ohio?" "Giving the boy with leukemia the unapproved drug?" "What the fda doesn't know can't hurt them." "Can't hurt me." "My god." "It worked." "Whoa." "Whoa!" "What's going on?" "Fremont Jones, a new patient." "His oxygen level is low and his body temperature's dropping." "What's he being monitored for?" " A clotting disorder." " Look at his body temp." "That's not a clotting issue." "And his oxygen sats are plummeting." "Wait, where is he?" "On the bay bridge." "He's not on it." "He's under it." "He's in the water." "Call the coast guard." "Now." "W." "I didn't know if you were, um..." "What was happening just then?" "I was thinking." "Deeply." "James, I just, I want to let you know that over the next few days" "I might be out of the hospital a bit." "Of course." "Nothing wrong I hope." "No, no." "Just Julianna's coming today." "I wanted to ask her to move out here once Luke leaves for college in the fall." "It's just something I..." "Your wife is here today?" "Yeah, is that a problem?" "No, not a problem, nothing we can't manage." "It will make what I need to tell you more complicated." "What is it?" "I wasn't even sure if I was gonna tell you this, but I just meditated on it, decided that you need to know and not telling you will only make matters worse, so..." "What is it?" "Look." "Cyanotic and hypothermic on scene." "Six minutes." "Multiple extremity fractures with an open tib-fib on the right." "And pressure's 60 over palp." "Bilateral breath sounds, no pneumothorax, so he's hemorrhaging somewhere." "Yeah, but nothing external." "Then get him into a bay;" "It's probably internal." "Two liters ns bolus, then o-neg, and I need a fast ultrasound to look for a hemoperitoneum." "He's losing blood volume faster than we can replace it." " My god." " Fast positive." "Blood in morison's pouch and left pericolic gutter." "Ruptured spleen." "Lacerated liver." "He needs surgery now." "Yeah, but he's gonna bleed out before we get there." "The darpa foam." "Yeah." "All right, prep, clean the field." "Yes, doctor." "Field prepped." "On three." "One, two..." "The foam should expand to keep him from bleeding out." "It's working." "Yeah, for now." "But all we did was buy ourselves a little time." "Can't fix anything until we remove the foam, and when we do..." "Bleed out all over again." "I still don't understand why I need to check in." "Because we're running tests and you'll feel more comfortable having your own room." "It's like a fish bowl." "Which is why we have this." "Look, you can make this room any setting that makes you comfortable." "Like this." "Okay, okay, that was just an idea." "How about this?" "Now I just feel cold." "Really, mom?" "Why can't we have a normal hospital room?" "With blue walls a-and curtains?" "And that smell." "That awful smell?" "It makes it feel like a real hospital." "It doesn't matter what's on the walls, the important thing is you're here, so we can get you..." "Better." "You know, Mrs. Lee had cancer." "She went to ucsf, they cured her." "They are affiliated with the university." "Everyone here is the best in their field." "Your grandmother had cancer." "She drank this tea..." "Mom, tea did not get rid of grandma's cancer, and it won't fix you." "Look, ucsf, they're gonna give you a 50/50 shot." "My people, we're gonna make this go away, period." "Gone." "So just pick a setting for the wall, and let me do my job, okay?" "Come on." "You gave Louis the treatment that's banned from human trials." "I acknowledge I made that executive decision." "That was not your decision to make." "You saw him." "Couldn't speak or move, now he's walking, he's talking, clearly he's thinking." "Clearly." "Great, my wife's arriving." "Okay, I think we need to keep her off-campus for the moment." "You think?" "Look, w, I'm sorry, but you saw him." "He was, he was dying." "I had to do something." "You realize what this could mean." "I realize what it means to you, yes, but I don't think you realize what you did." "The fda prohibited use of that drug in human subjects, and it's only been a few days, so we don't know the side effects." "W..." "And my wife was the one who explicitly..." "Julianna." "Julianna!" "Hi." "Wonderful surprise." "Hi, honey." "Nice to see you." "Hi, thank you so much for..." "Hi." "Dropping everything and coming out here." "Well, it sounds like big things are happening." "Yeah, listen, you're really exhausted from that flight." "Yeah, and we have a really crazy day today." "Our, um..." "Angie." "Angie Cheng." "Yeah, her mom just got a... terrible diagnosis." "Cancer." "Wow, I'm sorry." "So you can imagine it's just..." "So, well, we shouldn't have lunch, then, after all." "If that's okay." "Yeah, it's..." "Of course, it's fine." "I, I brought a lot of work." "I'll just, you know, I'll find a place to stay and... hang out." "Great." "Or..." "Yeah." "Or, um, you could work at our place 'cause we're gonna work really late tonight." "Yeah." "Really late." "Yeah." "Really late." "That's okay." "I can wait." "The cab just left, so..." "No problem, you know, to get you a car home." "Yeah." "Okay." "Fine." "I, I can work from your place." "Yeah, good choice." "Great." "Yeah." "The patient fell off the bay bridge this morning." "Jumper?" "Painter." "Fremont Jones, known as "free."" "The graffiti artist?" "I know his work;" "He's brilliant." "Well, right now he doesn't have much hope." "We used the darpa foam to stop his internal bleeding, but when we remove it for surgery, he'll bleed out." "The water from the bay lowered his body temperature." "We tried to warm him up, but his toxic metabolite production went through the roof." "So we need to keep his body temperature down or those toxins will destroy his healthy tissues." "What do we do?" "I don't know." "But whatever we do, we can't wait." "He doesn't have long." "My god, fremont?" "You family?" "Henry Jones, his brother." "Is-is he gonna be okay?" "No, no, no." "You have to save him;" "He's all I have." "Mrs. Cheng has metastatic cervical cancer." "Unfortunately, it has spread to her uterus, her bladder, her bowel and the pelvic lymph nodes." "No." "No looks of pity, no "I'm sorry about your mother's diagnosis,"" "just... tell me how we fix this." "What if we used a linear accelerator to enhance radiation?" "Well, the incremental gains would be outweighed by the unknowns." "I wouldn't recommend that." "We could use the gold particles we used in Georgia ray to locate the exact location of the cancer and combine it with robotic surgery." "Sure, find more of the cancer, increase the accuracy as it's removed." "Well, that's adding technology, but it won't materially improve the odds." "The truth is, Angie, that traditional treatment, chemotherapy and radiation, that's highly successful." "In my opinion, that's the best course of action for your mother right now." "Wait, y-you're telling me that giving my mother a-a 50/50 chance at surviving the next five years is the best we can do?" "Us?" "Bunker hill hospital?" "What do your ads say, James?" ""Changing the world, one patient at a time"?" "What about my mom?" "How about everyone gives this some more thought?" "We can reconvene later." "Um, step forward." "Yeah, um, hold out your hands, please." "Okay." "Now grab my hands." "I used to donate my time at a homeless shelter." "And again." "They had these big ladies." "You'd dish out soup and feel like you were, giving back." "Then I stopped being able to even lift the ladle." "But now..." "Look at me." "It does look excellent." "I would like to run a more comprehensive study." "A brain biopsy would give us a picture of what's happening on the cellular level." "Whatever you need." "I am grateful beyond what you know." "James... all of you." "You've given me my life back." "Okay, Louis." "So, how does he seem?" "Not now." "Those books look awfully familiar." "You applying to med school?" "Yeah." "Yeah." "I have my mcats this week." "Good for you." "We need more young blood in the profession." "We're gonna try to do everything we can for your brother, Henry." "Thank you." "Come here." "Looked at his history;" "This isn't the first time you've been to the E.R. with him, is it?" "It's-it's not." "Um..." "He's had accidents before." "But that doesn't seem to stop him." "I mean, my brother takes his art very seriously." "Honestly, it gets frustrating being around someone who thinks they can break all of the rules because they believe they have a greater purpose." "Yeah, I know someone like that, too." "Tell me, is there any way out of this for him?" "We're gonna try as hard as we can, Henry." "But I want to explain exactly what we want to do, so that you understand the risks." "I want you to be okay with this." "Okay?" "Yeah." "Free's body systems are in crisis, so we want to lower his temperature even further;" "So far, in fact, that it'll shut his body down, preventing further damage." "While he's hooked up to the suspended animation machine, we'll have the chance to replace his blood with a blood substitute that'll carry oxygen to his tissues while we work to save him." "At the end of this process, his heart will stop." "All brain activity will stop." "But the progression of the toxins in his body will also stop." "So, essentially..." "You-you want to kill my brother?" "On purpose?" "And then we're gonna bring him back." "Release the solution." "All right, his heart's stopped." "Let's get him to surgery now." "James?" "Yeah." "I have an idea to treat Angie's mom." "Okay." "It's a little crazy, but I think it's worth pursuing." "What if we use nanobots?" "DNA nanobots?" "The problem with most cancer drugs is the stronger you make them to kill all the cancer..." "The higher the risk they'll kill all the healthy cells, as well." "Exactly." "So what if we use the nanobots..." "To deliver the cancer drugs specifically to the cancer cells." "How would you get them to recognize..." "They've added a triggering mechanism to nanobots." "It recognizes proteins unique to cancer cells." "So I was thinking maybe you could..." "I could write a program..." "Yes." "To teach them to deliver the drug payload only when they come in contact with those proteins." "That way, it would allow us to use the strongest..." "The strongest drugs available, while mitigating the health risks." "Can we really do this?" "You promised your mom a bunker hill miracle, ang." "It's what we're gonna give her." "Let's start the clock on the cold ischemia." "Even in his hibernation state," "I'd expect permanent tissue death at around four hour mark." "I agree, that's as far as we can push this." "We'll have to move fast." "Okay, Dr. channarayapatra's team will be handling the splenectomy." "Dr. verlaine's team will fixate the leg fracture, and our team will coordinate the liver repair." "Okay, ten blade." "Electrocautery knife." "Orthopedic drill." "Ortho drill." "This man's life is in our hands." "Good luck, everyone." "Traditionally, cervical cancer such as yours would be treated with chemotherapy, followed by radiation to try and eradicate the cancer in your body." "But we're not gonna do that." "Well, that is an option." "And that treatment would be followed by surgery to remove any remaining tissue." "But we're not gonna do that, either." "Angie." "Sorry." "Continue, doctor." "Okay." "What, Angie is referring to is that there is another option." "An awesome option." "It uses nanobots." "Nanobots?" "This is one of your computer things?" "No, no." "No computers." "Let me explain." "Actually, Scott, I-i made a presentation." "If it would help." "Sure." "Okay, so, each nanobot is a stand of DNA folded up like a clamshell." "Like origami." "Inside the clamshell, we put really strong medicine." "Way better than chemo." "And we can use it because we can program the nanobots to attach only to the cancer cells." "It-it shouldn't hurt the healthy cells." "I mean, you shouldn't even get sick." "It's like pac-man." "It eats the cancer." "And you walk away." "Good as new." "Well, it's not quite that simple, Angie." "Believe me, my mom does not need to get into the weeds of this stuff." "Is this real?" "It's brand-new." "So, we have no data." "So... it has never been done?" "Look, you'll be the first, mom." "Look, you're a special patient here." "We created this just for you." "Don't do that, mom." "Nanobots?" "Mom, don't do that." "Nanobots is the same in English as it is in mandarin." "Tell her that" "I'm trying to save her life." "What did she say?" "Tell her." "Tell me what?" "Your mother would like to thank you and me for everything that we've done, but she wants to go to ucsf." "The surgery's finished." "But now you have to bring him back to life." "We're recirculating his blood." "we believe his heart will resume normal function." "There's one thing you'll learn about human anatomy:" "There is a biological will to survive." "Don't underestimate that." "My brother is always hanging from some building or a bridge, or in a tunnel." "He almost got ran over by a Bart train six months ago." "I just wish he could be normal." "My god, it worked." "You just saved his life." "Can you believe her?" "Second-guessing everything I did." "You know, the truth is, she just can't believe that something I worked on could be real." "I mean, she still thinks I'm a little girl." "Well, you know what?" "Too bad, she's doing this." "Okay, Angie, you know what?" "I'm about to tell you something that's probably not gonna make you very happy, but, you need to stop." "Yes, you need to stop trying to fix her." "What, you want me to just let her die?" "Look, you're scared." "I get it." "I'm not..." "No, no, no, no." "You are scared, all right?" "And your way of dealing with your fears is falling back on what you know." "Digging into the science, finding an answer, that's who you are." "That's what makes you amazing at what you do." "But your mom is scared, too." "And right now, she's alone in her fear." "Which makes her fall back on what she knows:" "The traditional things, things that she understands." "Yeah, but she's not alone." "I'm doing everything I can." "To treat her, yes." "But right now, she needs you to be her daughter." "Not her doctor." "No, I can be both." "No." "No, you proved to me in there that you can't." "But-but that's okay, all right?" "If you really want to help your mom, just listen to her." "Don't tell her what to do." "Don't tell her what she's feeling, ask her, and then let her talk." "And then try to meet halfway." "Okay?" "You live in a world of nanobots and triggering mechanisms, but most people don't." "I think we have a problem." "Is he bleeding internally again?" "No, that's thrombophlebitis." "Small clots in the superficial veins." "But what if it's just the tip of the iceberg?" "Free gets a lot of clots." "What if everything that you did sets off clots everywhere?" "That's why we're watching so closely." "I'll elevate his legs, put on a compress, double the checks, but we're not gonna let this get out of hand." "I got this." "Holy crap!" "What are you doing?" "That was mandarin?" "I know, I suck." "It was a beautiful effort, but what is all this?" "Well, this is, um, baozi, um, jianbing, and this is..." "Zhou?" "I see." "It looks..." "Wonderful, Angela." "But you don't cook." "I know." "I don't cook, and I-i don't speak mandarin." "And how am I gonna learn if you're not here to teach me?" "Look, I know that I've been pushing you, but it's because, honestly..." "I'm scared." "I need you, mom." "I mean, first off, I need you to teach me how to make baozi, because I tried it, and, spoiler alert, it-it's terrible." "Also, I'm gonna have a wedding someday, and it's gonna be very nontraditional, and you'll probably hate it, but..." "I need you there." "And I'm also planning on winning a turing award or a MacArthur genius Grant, and I need you in the audience, because you're the person" "I practice my pretend speech to." "And I hope I have a kid someday, and then I'm gonna really need your help because, who knows, I'm gonna be a mess with that." "Angie..." "So..." "That's what I'm scared of." "What are you scared of?" "I'm not scared." "Mom..." "I don't like throwing up." "Okay." "What else?" "I don't like it when they take blood, and they cannot find the vein, and they poke you like a pincushion." "I know." "But we have this-this nurse, brie." "She's like the vein whisperer." "I don't want you to see me sick." "I'm your mother." "I know you don't." "But it's okay." "I can handle it." "And I don't know who Mr. pac-man is, and what he has to do with-with curing cancer." "Can I try and explain it to you again?" "I'm so sorry." "That's okay." "I got thai food." "Great." "How did everything go today?" "Um... well, I had to kill a man." "Pulled out all his blood, put him on suspended animation." "Did three surgeries and brought him back." "Wow." "You, really are becoming quite the cowboy." "Cheers." "Cheers." "So, do you want to tell me what's going on?" "What's going on is..." "Well, this has been a hard year for you, for us." "And the last time you were out here, you told me I'd already decided to stay." "You were right." "I do want to stay." "I like it here." "Which is why I asked you out, because I was hoping that you'll consider seeing if you might like it here, too." "You want me to move?" "Well, Luke's leaving for school in a couple of months." "And, I mean, I know, we love our life in Cincinnati, but look at it, it's beautiful out here." "The weather's always perfect year-round..." "No, I know, Walter, Walter." "But, you know, my job." "I know." "I..." "I know." "But there is a research institute at Stanford that's right up your alley;" "You've always talked about" "And if not, the fda has a field office in San Francisco, and they really value you." "I know they'd make it work, if that's what you want." "The main point is I..." "I'm not liking this being apart." "I miss you, Jules." "So what do you say?" "Well..." "I say it's a lot better than you telling me you want a separation." "Which is what I thought you were gonna say." "I miss you, too." "Yeah." "It's a big, big change, so I just..." "I need a little time to think about it." "Okay." "This is Louis's brain a month ago." "The red prion clusters are where the gss cause the proteins to fold incorrectly." "This is Louis's brain yesterday." "The clusters are healing." "Looks like the neurological damage is being repaired." "W, it's..." "It's really good news." "Unless I'm missing something." "Maybe just that you risked the doctors in this hospital losing their jobs." "You risked sanctions." "You made it so we have to have a secret meeting in an empty O.R." "Because what you did was out-and-out wrong." "I cured Louis keating." "How can that be wrong?" "You didn't do it for Louis, you did it for yourself." "And the irony is what you did just slowed us down." "There's no way to use any of that data to prove anything." "If we show Julianna what's happened..." "That's not happening!" "What's happening is that we're gonna discontinue Louis's treatment immediately, and we'll go back to lab trials until we know it's safe and it's approved." "No." "We don't know any side effects." "Louis has only been better two days." "That's progress, but it's nothing." "We gave the man his life back." "I'm not taking it away again." "I'm not gonna continue to lie to my wife." "If she finds out about this, she will shut you down." "And then it won't only be Louis who suffers." "Think about it, James." "If we were shut down, all the people who we worked so hard for, the good that we're doing, that you were doing, it will come to an end." "This has to stop, James." "Now." "Do nothing." "Is that clear?" "I won't let you ruin what you've started." "He's hypoxic and tachycardic." "Could be a pulmonary embolism." "There's a clot blocking flow to his lungs." "Henry, you got to trust me, okay?" "Do you trust me?" "I got this, okay?" "Okay?" "Think it's safe to start tpa to dissolve the clot?" "Well, blood thinner could cause a cascade." "We don't want him bleeding internally again." "So a catheter embolectomy." "Clot's too big." "It's blocking both his lungs." "We're gonna do a clamshell thoracotomy." "Bring me the tray." "Knife." "Yes, sir." "Suction." "Okay, you got that?" "Watch his lung." "Yep." "Okay, massage the pulmonary artery there." "Toward the trunk, and use your fingers as a tourniquet to prevent distil flow." "Forceps." "Okay, stop." "It's moving." "Okay." "All right, good." "It's out." "Sutures." "Sats are coming up, and heart rate's normalizing." "That was badass, Dr. Wallace." "Can you close up the rest for me?" "Sure." "There you go." "Hi." "Hi." "Hey, man." "Angie's mom agreed to your nanobot treatment." "That's great news." "Excellent." "What are you looking at?" "It's just, this place, it's so amazing." "I had an idea in my mind of what this could be, but this is just so much better than anything I could have dreamt." "It is amazing." "Did I ever tell you how I recruited Angie?" "No." "She was working at Google." "She created this algorithm to let Google glass diagnose retinal disease." "It was so simple, and the code was seamless and..." "Suffice to say, it was a work of art." "And..." "I just knew I had to have her." "And James bell gets what he wants, right?" "No." "No, no." "No?" "I gave her the whole bunker hill sales pitch, she turned me down flat." "Medicine was boring." "She only wrote the code because it seemed so obvious to her." "So, what did you do?" "I took her mom to dinner." "Really?" "That's sweet of you." "Not really." "I knew she wouldn't listen to her mom..." "The girl has a mind of her own." "But I wanted to show her how much she was wanted." "Without her, we wouldn't be able to do half the things that we do." "There's really no other place like this." "Yep." "Hey." "You ready?" "Yeah." "We're gonna go to lunch." "Taco Tuesday." "Yeah." "We love taco Tuesday." "Hungry?" "Um..." "You guys go ahead." "Catch up with you." "All right." "Good, Louis." "Give me another week or two," "I'll go ten rounds with you in the ring." "I wouldn't dare get in a ring with you, Louis." "Too good a fighter." "You're here." "Where else would I be?" "W-was it bad?" "Yeah." "Yeah." "As bad as it gets." "This is the man that saved your life." "Hey, free." "Believe me when I say that without him and his team, you wouldn't be here right now." "Thank you, doctor." "I can't tell you how nice it is to hear your voice." "Hey." "I want to show you something." "I got your best people on it." "They finished it from your design." "That's beautiful, Henry." "That's just beautiful." "Well, have some time with your brother." "I'll come back later and check on you." "Hang on." "Dr. Wallace." "Look, what you did..." "Thank you." "You know, Henry," "I know you're proud of your brother..." "And he's a great artist, I admire him, too..." "But he just about killed himself." "Maybe you can talk to him." "Tell him what it costs you and everyone around him when he takes those kinds of risks." "The thing about someone like my brother is it doesn't matter what I say." "He's going to do whatever he decides to do." "At some point, I realized I just have to live with that." "You know someone like that?" "Mom, um..." "I think I figured out what to put on the wall." "Home sweet home." "What's your sweater doing on the kitchen island?" "Have you ever heard of a closet?" "Just like home." "Okay, what are you saying?" "I just told your mom that we're gonna do right by her." "You're here." "I was just getting my things to come meet you." "Tell me about Louis keating." "I saw him." "Standing, exercising." "The only way I can possibly explain what I saw is that you used the drug that I specifically prohibited you from using." "We did." "All right." "So, um, now tell me this was all James." "Please tell me that you had nothing to do with this." "It was me." "I made the decision." "You told me there was nothing that you were hiding from me." "You lied to me." "This is what happened in Ohio." "You broke the rules, you lost your job." "Our family suffered, our marriage suffered, we lost half of our friends, we got uprooted." "Now you're just, you're just doing it all again!" "against your orders, but this treatment, it's working." "The first bio... the results of the early biopsy..." "God." "Stop it!" "Damn it, just stop it!" "Stop!" "I just can't even believe that you would ask me to move here, knowing what you were doing." "I don't even know you anymore." "Hey." "You okay?" "Yeah." "What if it doesn't work?" "The nanobots." "Angie..." "I just..." "What if I just sold my mother on some snake oil cure that fails?" "Angie." "Listen to me." "You have done everything that there is to do." "You've been amazing." "You pushed us to come up with a treatment, you..." "You got your mother on board." "Right now we just have to... trust in our plan." "We have to have faith." "W, I know what you said..." "She knows, James." "Julianna knows." "Look, w, I know..." "You've jeopardized my marriage, you're jeopardizing the hospital, and now you're about to give this treatment over my specific orders!" "W..." "You're not a doctor, James!" "Excuse us, please!" "Privacy!" "I'm sorry about Julianna." "I truly am." "But I'm not sorry about Louis." "I made a promise to him that I would do everything I could to give him as much good time as possible, and I'm not gonna go back on that promise." "And I will face..." "No..." "The consequences." "Do not do this, James." "If you do..." "It's okay." "Whatever you have to do, I understand." "I could never be upset with you, Walter." "Captioning sponsored by CBS productions captioned by media access group at wgbh access.Wgbh.Org"