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Medical Investigation
     Episode #3 - Coming Home


In a crowded bar, a girl kisses a young man named Dennis.
Girl: 
Welcome home.
Dennis: 
Yes, ma'am.  God Bless America!
Dennis
to Bartender:  Another seven and seven.
Bartender: 
Coming up, soldier.
Dennis
begins to cough and says to the girl:  Excuse me, darlin'.
He stumbles through the crowd and someone says:  Oh, watch it, man!
Another girl
grabs hold of him:  Buy me a drink?...Oh, my god, what's wrong with you?
Dennis: 
I don't know.  It's my...it's my chest.
He opens his shirt and staggers over to his friends.
A friend: 
Dennis, what's up, man?
Dennis: 
Get me out of here.
Friend: 
Dude, we all want to get out of here, man, but the Army has our asses, right now.
Dennis stumbles away and grabs someone's beer:  Hey!
He guzzles the beer and then, starts coughing.  He begins to cough up blood.
A friend: 
Let's get him out of here.
Other friends: 
You got him?   Come on, come on.  Everybody move.  Get out of the way.
They help him out of the bar.


Dr. Stephen Connor and his son, Jack, are leaving a movie theater.
Jack: 
Wasn't that part when the helicopter crashed into the roller coaster cool?  It was (he makes the sounds of multiple explosions.)
Stephen: 
Maybe next time, we'll see a comedy.  What do you say?
Jack: 
Yeah, I want to see that new Adam Sandler movie.
Stephen: 
Sure...as soon as you turn 18.
Stephen's
cell phone beeps.  He looks at it:  Huh.
Jack: 
Something wrong, Dad?
Stephen: 
No...eleven messages.
Jack: 
Are you going to answer them all, now?
Stephen: 
Nope, I'm going to wait until we get to the car.  We're going to get some ice cream, right?
Two soldiers approach them.
Soldier #1: 
Dr. Stephen Connor, we're from the Walter Reed Medical Center.
Stephen: 
How did you guys...
Soldier #2: 
Your wife told us where you were.  We've been trying to reach you, sir.
Jack: 
Dad, what's wrong?
Stephen: 
I don't know.
Soldier #1: 
We may have a medical Code Yellow, Doctor.
Stephen: 
How sure are you?
Soldier #2: 
Sure enough to alert the Pentagon, sir.
Stephen to Jack: 
Look, buddy, I have to go to work now.  We'll get ice cream next time, okay?
Jack
nods.
Stephen
to the soldiers:  All right, let's go.

Walter Reed Medical Center - Washington, D.C.
Stephen and Frank Powell are being escorted through the hospital by Lt. Col. Bartek

Bartek: 
Pfc. Richard Henderson of the First Calvary, Fourth Brigade, had just finished his rotation guarding munitions stockpiles outside of Fallujah.
Stephen: 
When did he arrive stateside?
Bartek: 
About five days ago, along with three others in his unit.
Stephen: 
What diagnosis are you working from, sir?
Bartek: 
Possible exposure to a biological or chemical agent during their recent deployment in Iraq.
Frank: 
What was the contaminant?
Bartek: 
Backtracking, the Army believes it was an unexploded ordnance the four soldiers came into contact with.
Stephen: 
Where's the shell, now, sir?
Bartek: 
That's the damn thing.  No one thought the shell was hot until the soldiers became ill.  Reconnaisance in Fallujah is trying to locate it, but I don't have to tell you what a cluster-job that's turning out to be.
Frank: 
The four soldiers, did they all have the same exposure to the shell?
Bartek: 
No, Pfc. Henderson and Private Van Horn had the most direct contact. 
He
indicates an empty room:  This is where they were placed before being put in isolation.
Stephen:  Has the room been secured?

Bartek: 
Knowing what a pain in the ass you were flagging the Gulf War Syndrome, what do you think, Captain?
Stephen: 
How are the soldiers' conditions, Colonel?
Bartek:
  It's easier to explain it, if you see for yourself.
They follow him down the hall.
Frank:  Were any of the soldiers symptomatic before leaving Iraq?
Bartek: 
Not according to the transfer papers or reentry exams.
Stephen: 
Normally, chemical exposure doesn't have an incubation period.  If they were exposed to a chemical agent, they would have been down in the first 24 hours.
Bartek: 
Our fear is we're dealing with a new kind of agent.  Perhaps, a biological weapon with an incubation period.

They enter the Intensive Care area and see the four soldiers in their beds.
Stephen: 
We're going to run our own tests at the NIH, but I expect full access to all medical records...
Bartek: 
You'll have whatever you need.  The Army doesn't want to be on the wrong side of this one.
Frank: 
Like they were in the Gulf War Syndrome...sir?
Stephen
to Frank:  Call Eva.  Get her up to speed.  I expect a full press lockdown on this one.
Frank walks away.
Stephen
to Col. Bartek:  Colonel, why aren't there more reported cases overseas?  We've been there for over a year.  Why now?
Bartek: 
Stephen, the truth is, we don't know.  But, if this is the result of some undiscovered biological agent...
Stephen: 
Then the war has entered the next phase.

Back at NIH
Eva Rossi catches up with Dr. Natalie Durant:  Here's a cheery way to start the day.  The Institutional
Review Board is threatening a review of our clinical trial.
Natalie:  Now what?
Eva: 
They're concerned that this round of experimental drugs isn't effectively minimizing patient suffering.
Natalie: 
Tell the IRB brain trust there's a reason they're called...
Eva: 
Experimental drugs.  Yeah, I'm not sure how long that song and dance is going to last.  They mean business.

Eva and Natalie pass through a room where several of the clinical trial patients are waiting.  Natalie scans the room.
Eva: 
Looking for Barrett Fidler?
Natalie: 
I'm just wondering how he's doing.  I haven't heard from him in a while...How did you know I was looking for Barrett?
Eva:
  Everybody has their favorites.  Personally, I always look forward to seeing this one reporter from the Post every time we have a national health alert.
Stephen enters the room, clears his throat and indicates that he wants them to join him.

The entire team is gathered in a room.
Stephen:  All right, what about the idea that this agent could be transmittable through touch or bodily fluids?
Natalie:  No one at Walter Reed has reported pulmonary problems similar to the soldiers, including staff who had direct contact with them.
Frank:  The bartender said Pfc. Henderson danced with, at least, a dozen women last night.  So, if it is possible, we should have seen a spike by now.
Dr. Miles McCabe:  If it has an incubation period, maybe it's coming.
Eva:  I'll alert ERs in the D.C. area to look for any spike in Acute Respiratory Distress Syndrome.
Stephen:  ARDS...all right, Miles, run tests on the soldiers for biological agents found in Iraq.
Miles
stands up:  I'll start with the bacterial culture for anthrax.
Stephen: 
For everything.  Order antibody tests for anything even thought to be present in the Persian Gulf.
Miles leaves the room.
Eva: 
Fortunately, the Pentagon doesn't want this leaking any more than we do.  Not until we know absolutely what we're up against.  They're sending someone to liaison with you - a Gladys Halperin.
Frank: 
Just what we need - more government.
Stephen: 
All right, find out everything about her.  But, until you know more, I'd just as soon keep every bureaucrat at arm's length.
Frank: 
I know the military hasn't told us everything.  Just like last time.
Stephen: 
You know, you're probably right.  But, conspiracy theories are going to have to wait for another day.  Let's just investigate the medicine, okay?
He leaves the room and Natalie hurries after him.
Natalie:
  Hey, Connor.  I know it's not the first thing on your mind right now, but we have a problem with the Von Recklinghausen trial.
Stephen:  The last thing I read about it...
Natalie: 
They were fine.  I know.  But, now, some of the participants are having a reaction to one or more of the drugs - severe rashes and a high creatinine level.
Stephen: 
It could be an intercurrent illness or a possible response to the immune system attacking the neurofibromas.
Natalie: 
Thanks, I'll look into it.
She walks away as Stephen's cell phone rings.
He
answers it:  Connor.
Lisa Connor: 
Stephen.

Stephen:  Hey, Lis.
Lisa: 
Did you get the separation papers?
Stephen: 
Uh...yeah, I got the papers yesterday.
Lisa: 
We have to talk about them.
Stephen: 
We have to talk to Jack first.
Lisa: 
Stephen...
Stephen:  You're the one who asked for this.  If you're going to tear his life apart, he should hear my side of the story.
Lisa: 
Well, you had your chance last night.
Stephen: 
Well, I had something to do.  Something came up.
Lisa: 
I heard.  Just like old times.
Stephen:
  You heard?...You know what?  I'm going to tell Jack about the separation in my own way and in my own time.  Did you hear that?  (He hangs up the phone.)


Natalie calls Barrett Fidler and gets his answering machine:  This is Barrett.  If I were home, I wouldn't have picked up anyway, so don't blame yourself.  Leave a message.
Natalie:  Barrett.   Hi, it's Dr. Durant, Natalie.  I was expecting to see you this morning.  Actually...um...I need to see you, to make sure you're not having a negative reaction to the treatments.  Anyway, you have my cell, so call me.  Okay?
She hangs up.

Stephen questions one of the soldiers at Walter Reed.
Stephen: 
Hey, Joe?  I'm Dr. Stephen Connor at the NIH.  How are you feeling?
Joe reaches for the oxygen mask he's wearing.

Stephen: 
Here, let me help you with that.  (He removes the mask.)
Joe: 
The guys in my unit?
Stephen: 
They're being taken good care of.  I understand you were out doing a recon report when the ordnance was found?
Joe: 
Yes, sir.
Stephen: 
Was it an isolated shell or was it part of a storage site?
Joe: 
It's hard to say.  The sandstorm was blowing pretty thick, sir.
Stephen: 
Those Shamal winds can get pretty nasty.  Did you get the nosebleeds?
Joe: 
Every day.  It sounds like you were there, sir.
Stephen: 
Different war, but the same damn sand.  Look, Joe, I was wondering if you were exposed to any fallout from blown munitions or chemical dumps, prior to finding the shell.
Joe: 
I'm sure we all were, sir.  We use to say that, that whole war zone was like a big bowl of toxic soup made with some bad-ass ingredients.
Stephen: 
What do you remember about the shell?
Joe: 
I didn't find it, sir.  Henderson and Muldoon did.  It was kinda unusual because it looked brand new compared to the older scrap ordnance we come across.
Stephen: 
Did you try to save the shell?
Joe: 
Excuse the informality, sir, but we were a little more concerned with saving our own asses...I'd really like to see the guys now, sir.
Stephen: 
As soon as you're stronger.
Joe
begins to have more trouble breathing:  I'd really like to make sure that they're okay.
The monitor begins beeping rapidly.
Stephen: 
Powell.  Powell!
Frank
runs up:  Yeah, what have we got?
Stephen: 
He's having a grand mal seizure. 
Stephen
to Nurse:  I need an IV of phenobarbital.
Stephen
to Frank:  All right, roll him over to the right lateral position.  Go!
They roll Joe over.

Stephen: 
Nurse, apply that phenobarbital now!
The nurse administers the medication.
Frank: 
Easy, son.  We got ya.
Stephen: 
Joe, easy.  Easy now.
Frank
to Stephen:  This is a nasty-ass bug.  What the hell are we dealing with?

Stephen is in his office looking at photos on his computer, when Frank walks in.
Frank: 
Natalie's uncovered two additional ARDS cases.  Two middle-aged women at different hospitals across the city.
Stephen: 
Interesting.  Do you know if they had any direct contact with the soldiers?
Frank: 
No, not yet.  (He sees Stephen's computer screen.)  What is that, mustard gas?
Stephen: 
Yeah.
Frank: 
Is it me or is this investigation beginning to smell an awful lot like the inoculation program we went through for the Gulf War?
Stephen: 
I knew I should have turned my computer off as soon as you came in the room.
Frank: 
Listen, all I'm saying is...
Stephen: 
Nothing I haven't heard over and over and over again.
Frank: 
The military has a track record.  They forced us to get inoculations before the war...
Stephen:  Frank.
Frank: 
Then, as soon as soldiers start getting sick...
Stephen: 
Frank!
Frank:
  ....the military blames it on fatigue or pre-existing conditions, instead of admitting the shots we took made us even sicker.  It's the Gulf War Syndrome all over again.
Stephen stares at him without responding.
Frank
smiles slightly:  What do you have to eat around here?
Stephen: 
Licorice.  Bookcase.  Help yourself....So, how do these new ARDS cases affect your Gulf War Syndrome theory?
Frank: 
Complicates it, but doesn't dismiss it.  Anyway, I tried to piece together who the soldiers have
been in contact with since returning.  It'll take weeks.  Apparently, these guys were very popular.
 Eva
knocks on the door, then opens it:  Gladys Halperin is here to see you.
Stephen: 
What did you find out about her?
Eva: 
Still looking.
Stephen: 
Okay.

Stephen is walking down the hall with Gladys Halperin.
Stephen: 
The epidemiology of the disease appears to have echoes of sarin, perhaps smallpox.  It's too early to make a firm diagnosis, but have you found the shell, yet?
Halperin: 
Not yet.  There's several hundred Marines searching every munitions dump in Fallujah as we speak.  Can the soldiers provide a more accurate description?
Stephen: 
Not right now.  They're fighting for their lives.
They enter Stephen's office.

Stephen: 
Please sit.
Halperin: 
I'm sure you understand the critical importance of finding the ordnance.
Stephen: 
With it, finding a cure for the men would be much easier.
Halperin: 
I mean, consequences far beyond these four men.
Stephen: 
My realm is medicine, Ms. Halperin.  I leave politics to the politicians.
Halperin: 
Can you confirm a WMD exposure without the shell?
Stephen: 
I can confirm they were exposed to some type of agent.  But, without the shell, I'd be making an unfounded conclusion.
Stephen computer beeps.

Stephen: 
Excuse me.  (He walks over to the computer and sees a
message from Eva.  It says:  There is no Gladys Halperin registered as an employee at the Pentagon.
Stephen looks over at Halperin.
Halperin: 
Something wrong?
Stephen: 
There's always something wrong, isn't there?
Halperin: 
Well, perhaps, when the soldiers are well, I can come back.
She stands up.

Stephen: 
Who do you work for?
Halperin: 
I don't quite know your meaning.
Stephen: 
You don't work for the Pentagon.  Is it the Administration?  The CIA?
Halperin: 
All I'm asking is, if your conclusion is a wobbler, let it lean towards the truth.
Stephen: 
NSA?  Contractors?  The U.N.?

Halperin: 
There are forces at play much larger than you know, Dr. Connor.
Stephen's
cell phone rings.  He answers it:  Yes?
Natalie
on the phone:  I think we've got something.

Stephen
to Natalie:  I'm on my way.  (He hangs up the phone.)
Stephen
to Halperin:  Get out of my office.
She leaves.


Natalie:  I just got a call.  A local convalescent home, five residents died of pulmonary complications in the the last 48 hours.
Stephen: 
It's likely one or more of the soldiers visited the nursing home.  Miles, see if any of the soldiers are related to the nursing home victims.
Frank: 
It's a long shot, but I'll see if there's a connection between the two hospital deaths and the nursing home.  (He leaves the room.)

Miles: 
There might be a much simpler answer for these nursing home deaths.
Stephen: 
And you're basing your prognosis on what?

Miles: 
Nursing homes are incubators for all kinds of diseases.  You throw in a little neglect and the loneliness that comes with...I watched my grandfather die in one of those places.

Stephen: 
Okay, despite your personal bias, if there's a connection, find it.
Miles: 
Dr. Connor, I'm sorry.  I...
Stephen: 
Miles.  Just do it.
Miles: 
Yes, sir.  (He leaves the room.)
Natalie
reaches out and rubs Stephen's shoulder:  You okay?
Stephen: 
I need you to broaden your testing.
Natalie: 
To include?
Stephen: 
Potential reaction to the Army's ongoing inoculations for smallpox and anthrax.
Natalie: 
Really?  Did that Halperin woman get to you?
Stephen: 
No.  Powell did.


Convalescent Home - Bethesda, Maryland
Miles is being escorted through the home by the Director.

Miles: 
I haven't been in one of these places in years.  This looks more like a social club.
Director: 
We re-designed our facility three years ago and added a variety of programs.  We have a film club, a reading circle, field trips to outlet malls.  We really are an activity camp.
Miles: 
Not bad.
Director: 
Not the snake pit you expected?
Miles: 
Not yet.  But, the day's still young.  One thing never changes.  They all have that same musty smell.

Director: 
Are you always this cheerful?
Miles: 
I guess things have changed somewhat.  The residents seem happy enough.
Director: 
Hm,  why should you think that people who take care of the elderly actually care about them?
She walks away.

Natalie knocks on an apartment door.  When there's no response, she calls out:  Barrett.
Then, knocks again.
Barrett
cracks open the door:  What?
Natalie: 
Can I come in?
Barrett opens the door further and she enters the apartment.

Natalie,
after examining his face:  This cluster of tumors has gotten bigger.  I'd like to run some tests to make sure.
Barrett: 
Not another test.
Natalie: 
Barrett.
Barrett: 
The tumors are getting bigger because I'm not getting the real drug.  In fact, I think I've put on a few pounds taking all those sugar pills.
Natalie: 
You know that in a double-blind trial even the doctors don't know who's receiving the experimental treatment or the placebos.
Barrett: 
My tumors are getting bigger.  The pain...never lets up.  And it's getting worse.  The clinical trial may be double-blind, but I 'm not.
Natalie: 
Come in to NIH this afternoon.  If everything checks out, I'll increase your pain meds.
Barrett: 
Patients getting the real drug have new rashes and skin sores.  You find any new ones on me?  I'm quitting the trial.


Stephen walks over to Joe's bedside.  Joe's breathing has become more labored.
Joe: 
How are my boys, sir?
Stephen: 
They're hanging on, but their lungs are filled with fluid.
Joe: 
Are they dying?
Stephen: 
Not without a fight.
Joe: 
That's 'cause they're good soldiers...I have a favor to ask, sir.
Stephen: 
Anything you want.
Joe: 
The four of us, we made a promise that if something should ever happen, that one of us would make sure that our families weren't told by two faceless reps of the Army.  They'd be told by a friend.
Stephen: 
I understand.
Joe: 
I know it's a lot to ask, sir.
Stephen: 
No.  No, it's not.  But, I'm here to see that no one ever makes good on the promise.  Okay?
Joe: 
But, sir...if something does happen to me, I want you to tell the Army Chaplain not to take it personal, but I would like Father Yost from St. Angela's...
Someone
yells:  Get a crash cart!
Col. Bartek 
runs to the bed of one of the other soldiers:  Dr.  Connor.  Over here!
Stephen
to Joe:  I'll be right back.
Stephen
hurries over to join Dr.  :  What do we have?
Bartek: 
He's in cardiac arrest and non-responsive.  He went into a coma.
Stephen: 
Damn it.

At the Convalescent Home, the Director unlocks the door to a victim's room.
Director: 
Okay, this was Marla's room and her home for the past few years.  She was a good Christian woman, 81, had 14 grandchildren, three sons and a daughter.
Miles: 
Did Marla leave the facilities often?
Director: 
No.  None of them did.  All five were bedridden.
Miles: 
So, they never came into contact with one another?
Director: 
Never.  In fact, they were in different corners of the home.
Miles: 
Did their families or friends ever visit?
Director: 
Well, that's the problem...at their age, you find out exactly how much your friends and family really care about you.  No one's come to call in weeks.
Miles: 
Any military personnel come to visit?  Young men in their 20's?
Director: 
No.  Why would you think...
Miles: 
So, no social contact among the victims.  Or contact with their loved ones.
Director: 
That's right.  What does that tell you?
Miles: 
That whatever killed them might have come from somewhere inside the building.

In a meeting room at NIH.
Stephen: 
What did you find out about the anthrax and small pox inoculations?
Natalie:  Preliminary test results show no apparent connection between the inoculations and the disease.
Miles: 
But, the five deaths at the convalescent home are actually eight.
Stephen: 
Explain.
Miles: 
In the last two months, a total of twelve residents died at the convalescent home.  I believe three, previously attributed to flu-like symptoms, are actually undiagnosed ARDS.
Stephen: 
You believe?
Miles:
  I, also, believe the lung tissue samples I requested will prove it.
Natalie: 
If this were airborne or transmitted by touch and the soldiers were sick before they left Iraq, then someone on the transport plane should have been infected.
Miles: 
It doesn't add up.  We've got two women from different parts of the city sick, with no apparent connection to the five, maybe eight, deaths at the convalescent home.
Stephen:
  And four soldiers who showed no signs of being sick overseas.  It's impossible.  There isn't a biological or chemical weapon that strikes so randomly, unless it's...This isn't a medical Code Yellow.  This has nothing to do with Iraq.  The disease we're fighting is right here, in our backyard.

Stephen, Natalie and Eva are walking down a hallway.
Natalie:  Stephen, making a decision to stop looking overseas for an answer doesn't make medical sense.
Stephen: 
There's no chance this disease was brought on by a biological or chemical weapon.
Natalie: 
Without understanding more about the disease pathology or its incubation period, you don't know that.
Stephen
to Natalie:  We have to make a choice.  Any more time spent in the wrong direction, we risk losing the lives of the men that we have here and I'm not going to let that happen.
Stephen
to Eva:  What do you have on Gladys Halperin?
Eva: 
I can't find her name on any government payroll.  We have no way of knowing who she is.
Stephen: 
As soon as she calls, you call me, then call the police.
Stephen gets on the elevator.

Eva:  So, listen...now the IRB is threatening to shut down the trial because of the ongoing pain issues.
Natalie: 
Tell them we've temporarily halted treatment.
Eva: 
That might not be enough.
Natalie:
  It'll have to be.  Just do your job, Eva.  (She walks away.)

Next...
Screen captures courtesy of Bev at:
Bev's Web
RDAOnline