- Happy holidays, Mrs. Johnson.
Or are you more of a "Merry Christmas" gal?
I need to make sure
you're getting the right blend of tequila.
My name is Dr. Randall Kirby.
I'm here because your doctor
with the warm and fuzzy bedside manner couldn't make it.
Your husband, Tom, tells me that you're a fighter, so...
if it's okay with you, I'm just gonna let her rip.
You came in for a cervical surgery with Dr. Duntsch
a few days ago to remove a disc.
Do you remember that?
Do you remember going home,
telling your husband that you couldn't swallow,
and then you got a fever?
Well, you called Dr. Duntsch,
who told you that everything was normal
and that your fever was from the flu.
Then he stopped taking your calls.
Your fever wasn't from the flu.
It was from an infection moving towards your heart.
Now, we've had that PICC line pumping antibiotics
into your superior vena cava since you got here.
You've turned a corner, but now we need to deal
with the other issues from Dr. Duntsch's surgery.
That crazy straw coming out of your nose
is draining stomach acid
from a hole Duntsch cut in your esophagus.
That's why you couldn't swallow.
As for the surgery Duntsch was supposed to perform,
he failed to remove the disc.
He left it lodged in your spine.
The hardware he was supposed to attach
scattered in there like a bag of leftover screws
from an IKEA bookshelf.
He sliced through a nerve to your vocal cord.
We can't fix that.
This never should have happened.
I apologize to you and to your family.
I promise I will make sure this never happens to anyone else.
Um, om wanted me to discuss a family matter with you.
Your children are in town for the holidays,
and you don't want them to visit.
He's hoping that you would change your mind about that.
I'll fend them off if you provide the stick.
I'm so sorry.
Hey, thanks for coming.
It's, nice to show a united front with these jackasses.
Dr. Kirby. - Dr. Lockett.
He's the CEO here. This is Dr. Robert Henderson.
He's my crime-fighting partner in crime.
Yeah...
would you follow me, please?
Duntsch never operates here again.
- Well, I guess we can call it a night, then.
No harm, no foul.
- How did you come to hire him?
- We needed a neurosurgeon on staff
and performed all due diligence.
- You just missed that teeny-tiny detail
about the two dead bodies at Dallas Medical
and Baylor-Plano, but who's counting?
- We inquired with the Texas Medical Board.
We checked the National Practitioners Data Bank...
- Continue.
- To see if he was ever suspended.
He wasn't, no complaints.
- So neither Baylor-Plano nor Dallas Medical reported him?
- No.
Look, had we known, we never would have hired him,
plain and simple.
He even came with a clean letter from Baylor.
- "All investigations with respect to any areas
"of concern regarding Christopher D. Duntsch, M.D.
"have been closed.
"As of this date, there have been no summary
"or administrative restrictions or suspensions
"of Dr. Duntsch's medical staff membership
"or clinical privileges
"during the time he has practiced
at Baylor Medical Center at Plano."
- Dr. Henderson, tell me...
you're in my position.
What would you have done?
- They warned 'em...
This nurse, Preston's her name, she and some other somebody.
- Who? - I don't know.
A scrub tech. It doesn't matter.
They warned the administration about Duntsch.
They looked him up on the Internet.
They found a ton of crap about him.
I'm not talking good crap.
I'm talking he's a crappy surgeon.
- I get it. - Here's the kicker.
When they went to show them
what was on the Internet, it was all gone.
Everything negative about him, completely wiped way.
- Well, how does somebody do that?
- I don't know... hacking's not really my area of expertise.
The point is they warned them, and they blew it off.
Due diligence.
We're up against a citadel of bullshit here.
Most ass-covering...
In fact, I should use this to wipe my ass.
Definitely...
both: Written by lawyers. - Yeah.
- Are we completing each other's sentences now?
I'm going to see Amy Piel over at Baylor.
You give me a ride? - Jag's right this way.
- So?
- They're gonna grant me privileges to operate.
- They're gonna grant, or they have granted?
They are going to grant me privileges
when they see my roster of patients.
Don't... It's...
It's not a big deal, Wendy.
I have a ton of patients.
All I got to do is make a couple calls.
- Well, that place looks like a Port-a-Potty.
Not like Baylor.
- Fuck Baylor. - Yeah, fuck Baylor.
Fuck Dallas Medical.
Fuck whatever that last one was,
that Legacy Frisco place you were at for, like, two weeks.
It's been quite the fucking year.
- Can you just drive me to my clinic, please?
- Where does it end, Chris? - My God.
Wendy, I'm handling it, okay?
You left me, remember that?
- I don't feel sorry for you.
Why don't you go fuck your nurse again?
Maybe she'll make you feel better.
- I'm driving your sorry ass around,
not because I trust you or because I'm here for you...
but because I can't let you mess things up for him.
- Can I come by this weekend?
- Why don't you make a call to your roster of patients?
Then we'll talk.
- It's from my dad.
- Mrs. Demmings.
How's that Scheuermann's kyphosis coming along?
Is the tingling in your legs pretty consistent?
- I can't stand long enough to hold my grandbabies now.
- And it started in your teens?
- Had no pain until two years ago.
- The problem is these two vertebrae right here...
T7 and T8.
- The ones sticking out. - Exactly right.
It's actually the discs in between them.
Spinal discs are like natural shock absorbers,
and when they're healthy,
they kind of have the consistency of rubber.
But when they get diseased, they harden,
and these two are pushing
those vertebrae right into your spinal cord.
- Every doctor I see said there's nothing they can do.
- Well, you haven't seen me yet.
- What are you saying?
- Well, your preexisting kyphosis is an issue,
but there are new ways... - Surgery.
- It's minimally invasive.
A thoracoscopic anterior spinal fusion.
We make a small incision, about the size of a dime.
We go in there and pull out the bad discs,
and then we fuse the vertebrae together with a plate.
And that's it.
- One surgery?
- In and out in about two hours.
You wake up... no pain, no tingling,
and you're about a good inch taller.
It... it straightens out the curvature of the spine.
So the bad news is, you're gonna have to bend down
a little bit lower to pick up those grandbabies.
- Can I have a word with you?
I get that you're the golden boy around here,
but you're a resident.
These are not your patients, yet.
- I'm just presenting her her options.
- You gave her a fantasy.
With her kyphosis, she's not a candidate.
Raising her hopes is unethical and cruel.
- I spent all night researching this.
- You diagnosed her off of Google?
- Just look at it.
It's a case from NYU... Worse than hers.
I can show you how to do it.
Just look.
Look, all anterior decompressing arthrodesis.
See the end plate?
- See the retractor? You see the angle?
- When the presenting symptoms are pain,
decreased mobility, headaches, and speech dysphasia,
what would your differential diagnosis include?
- Cervical stenosis?
- Are you asking or stating?
Either way, it's incorrect.
Eventually... you'll want to decide
if you're Semmes-Murphey fellows
or Semmes-Murphey dropouts.
- Dr. Skadden? Excuse me. - Christopher, yes.
Um, I was...
- Wondering if I'd read your proposal on obtaining
and culturing disc stem cells?
- Yes.
- Eliminates the need for extraction.
Tons of potential.
I'd love to read more,
once you've fleshed out the research you cited.
- Of course. Yes, sir. Thank you, Dr. Skadden.
Chiari malformation.
Speech dysphasia.
It's likely related to pressure on the cerebellum.
That would be my diagnosis.
I'd really like to be considered
for your fellowship program, sir.
If and when the time is right, Christopher.
- Kayla, Kayla, hey, I got great news.
Skadden read my proposal.
Where are you going? - Don't worry about it.
- Wait, are you leaving?
- Don't play fucking dumb with me, Christopher.
Oxy, Adderall... it's like a C-V-fucking-S in there,
and your name's all over it.
- The scrips? - Scrips.
- They're for friends.
They're all friends in there. It's no big deal.
- Okay, well enjoy your friends.
And whatever's left of your career,
you stupid son of a bitch.
This man's a hero.
Partied us under the table last night,
then did his rounds,
saving lives like Mother-fucking-Theresa.
- What the fuck happened with Kayla?
- Kayla's cool.
Give her the night, she'll calm down.
And if she does dump your dumb face, I'll talk to her,
take care of everything, like always.
You'd lose your big, ugly head
if I didn't tighten the screws every morning, wouldn't you?
- I'm the one with the big, ugly head?
- Yeah.
Duntsch on the offensive.
Trying to reverse Summers with a Granby roll.
But Summers dominates.
He dominates. He dominates so hard.
Uncle! Uncle, uncle!
Shit.
Hey, Skadden said he'd take a look at that.
You just got to come on down, and we'll do some imaging.
Get you fixed up.
I got to work.
Have you seen my LSD blotter?
How many hits did you take?
I must be tripping hard, bro.
The letters are all squiggly and shit.
- No, it's Cyrillic. - It's psychedelic.
Stem cells.
Is this for your PhD, Dr. Doctor?
"Glioblastoma's the most prevalent
malignant brain tumor."
That's harsh.
- The glioblastoma stem is so dominant
that it takes normal cells,
and it changes them into cancer cells.
- It dominates. It dominates hard.
- And everybody's trying to figure out
how to stop glioblastoma.
But what if...
you could just program it to make healthy cells?
- Then it... it wouldn't be cancer anymore.
- Right.
Exactly right.
It can be whatever you want.
A cell that takes over another cell
to make something good.
- A molecular biological Granby roll.
- Yes. Yes. Yes.
Stem cells you inject directly into a diseased disc,
making a brand-new healthy baby spine.
- Preach. - 50% of all spinal surgeries
are to repair diseased discs.
We're talking about a startup. - You're Dock Ellis.
You're pitching a no-hitter. You're crushing it.
I can be your guinea pig.
- What?
- Inject that shit into my neck,
so I can grow a new baby neck with no pain.
Pain's a pain, bro.
That could be your slogan.
Fuck.
Fuck!
Shit.
- Bob. - Hello.
- What a surprise. - Hey, Amy.
- Afternoon, Randy.
So how can I help you?
- Christopher Duntsch. - Boy.
Well, that about sums it up.
- He operated on a patient
at Legacy Frisco a few days ago.
- He left a hole in her esophagus,
sliced through her vocal cord.
- We parted ways with Dr. Duntsch almost a year ago.
- Well, what can you tell us about this reference
that you wrote for Dr. Duntsch?
- I didn't write anything.
- Well, whatever law firm you paid to write...
- And it isn't a reference letter.
It's a letter stating there were no restrictions
or suspensions of his privileges.
- But it implies that there's nothing in this record
to preclude him from working at other hospitals.
He... he maimed people here.
He killed Shelley Brennan
by drilling through her vertebral artery.
- He also did that to another patient at Dallas Medical.
- Shouldn't that have precluded him
from employment at other hospitals?
- I have to be careful about what I say right now.
Whoa.
I feel like I'm in the fucking Twilight Zone here,
like I'm staring at the face of a coverup.
- That's offensive.
Well, I'll make sure to pass on
how offended you are to his other victims.
- Facts were disputed in some of his surgeries here.
- Surgeries?
Yeah, I saw one of his "surgeries" here firsthand.
- And yet somehow, Dr. Kirby,
I didn't receive your complaint.
Our letter for Dr. Duntsch
is our fair and honest appraisal of his standing
at this institution.
- Was Duntsch ever suspended?
Your letter indicates that he was under investigation,
and since it's your policy
to suspend any doctor under investigation,
I assume that you followed through with your policy.
- Yes, you're correct. We did.
As I recall, it was 21 days.
Well, that's convenient.
- Excuse me?
- National Practitioner Data Bank.
- That thing established by Congress...
- I know. - To warn the public
and other hospitals about bad doctors.
- I know. - You only have to report
the ones that are suspended for 30 days or more.
- How come you didn't report Duntsch
to the Texas Medical Board?
- I think we're done here.
- Can I ask you a personal question?
Would you let Duntsch operate on you?
- Lies of omission do not make this institution
any less complicit, Ms. Piel.
- Nobody here is gonna help us.
- I'm not sure what kind of help we're looking for.
- Come on, we can be sitting in Skadden's office
in a few hours.
- We spoke to him already. - I know.
- He says he doesn't know anything.
- I know!
Come on, waste some time with me.
Maybe we'll find out U.T. turned out a fraud.
- Hi, everybody.
So sorry I'm late.
Katya, Dr. Duntsch.
Ilya, Dr. Duntsch.
Welcome to DiscGenics.
Thank you all so much for coming.
That's for you. That's for you.
For you, sir.
And do you mind passing those around?
I just need some vitamin C. Be right back.
Okay.
Sorry about that.
Now, let me tell you why you're all here.
I'm hoping that you will continue to be interested
in what it is that I'm trying to accomplish,
maybe financially interested.
- We already know.
- Our work with osteosarcoma stem cells...
It's a simple deduction.
You wish to research spinal cancer.
Nyet.
Nothing so basic.
I brought you here because of your cancer research.
I practically memorized your paper
on phenotypical heterogeneity of neural cells.
But, look, we can all cure cancer another day.
Right now your research can be exploited
to create stem cells to grow new spinal discs.
Eliminate the need for surgery.
That's what we're doing here at DiscGenics.
- I question if you understand the most basic science.
- Um...
may I see that for one second? Thank you.
Um, if you'll all turn to page...
13.
This is your work in spherical clone generation.
You were able to demonstrate stem cell markers OCT 3/4,
NANOG, and STAT3, unless I misunderstood.
- That is correct. - Right, but unlike with STAT3,
where there was robust expression in both spheres
and adherent cultures, NANOG and OCT 3/4
had more variable patterns of expression.
Ergo, the key determinant in self-renewal and pluripotency
for stem cells in embryonic settings are variable.
Am I right?
I'm right. So all I'm asking is that we take your work
into stem cell self-renewal markers,
and we use it to create a new cell therapy.
We build stem cells
to repair diseased spinal discs.
Will you help me out?
Well, what do you think?
Definitely intrigued.
- Outside the obvious, how can I help?
- Honestly...
My surgical reps are killing me.
You know, there's only so many hours in the day.
- You are an M.D./PhD.
You have to be able to balance both.
You look tired.
Yeah.
I'm burning the candle at both ends and the middle.
- A little friendly word...
if I had a future ahead of me as bright as yours,
I would never want to be a minute late showing up for it.
Okay? - Yes, sir.
- I'm gonna go press some flesh.
- Today I will be performing
an anterior cervical discectomy and fusion.
The vertebral bodies are exposed, and so is the disc.
Chris, I'm thinking DiscGenics is gonna need some more money.
- What do you mean?
- You should meet with some investment bankers.
I am drilling directly into the disc
until I encounter the posterior longitudinal ligament.
Beyond that is the spinal cord.
- Before I get the patent? - The PLL is pierced.
Inside the diseased disc resembles crabmeat.
I use a nerve hook to remove the disc
and decompress the spinal cord.
It's classic chicken-and-the-egg.
Private equity is a lusty courtship.
The spinal cord is the white,
glossy structure with a juicy blood vessel on top,
and that is the dura.
Now, we tease out...
We now tease out the disc.
Dr. Duntsch has successfully removed the disc.
Well done.
Don't worry. You'll get your patent, Chris.
And you and your company will make us obsolete.
- We now drill holes
for the twin screws in the vertebra.
You ready?
The only useful thing you learned at Harvard
was how to name-drop the word Harvard
into any given conversation.
Here are our two esteemed visitors
I was telling you about...
Dr. Robert Henderson and Dr. Randall Kirby.
It's a pleasure to make your acquaintance
in the flesh, gentlemen.
Dr. Kirby went to Rice University
and Baylor College of Medicine.
And Dr. Henderson...
I'm so sorry. I-I'm completely forgetting.
Where did you get your M.D.?
- University of Nebraska. - Yes.
Right, right. Um, go, Corn Huskers.
- Duntsch's friend, if you can believe he actually had one.
- Turned him into a quadriplegic.
As of today, he's closing in
on two dozen botched surgeries...
Holes that drilled through muscle,
nerves severed, arteries.
I mean, the guy can't define basic regional anatomy.
- He approaches spinal surgery
like a child playing with Tinkertoys.
- This is not the Christopher Duntsch I knew.
These things here, I...
I never saw.
I just can't explain it.
- Well, perhaps you could help us unpack
the reference you provided for Duntsch?
- Of course.
- He met all of his training hours?
- Yes, though I-I can't speak to his... his residency.
You'd have to check with them for that.
- I'm sure you wouldn't have included him in your fellowship
if you didn't think he was properly trained, correct?
- Correct.
- You oversaw his surgical reps here?
- Yes.
And if you were one of my fellows
and I was watching
and you did what you've shown me here,
that would be the end of your fellowship.
- Any drugs?
- I never saw anything
that would lead me to that conclusion.
- Psychiatric issues?
- He may have sought counseling.
A lot of students do.
I'm afraid that's really all I can help you with.
- With all due respect, I have to disagree with you there.
- His references are the bedrock to his bullshit.
He can get credentialed anywhere.
- You're in a unique position
to tell them what you know about Dallas.
- I did, on the form for Forest Park.
I mentioned poor outcomes at Baylor.
- But not Dallas Medical? - No, no.
They wanted the form back immediately.
So I checked the boxes as requested,
stated that he was...
satisfactory, which he was.
- If it had been me,
I would have done everything in my power to say,
"No, I cannot recommend him."
- I can read you the form for privileges,
but it only relates to his time here.
You're only allowed to attest to what you directly observe,
that period of time the observation is made,
and your role as observer...
What happened during his training.
- What about the images we've provided you with?
Yeah.
Yeah, I'm sorry.
I-I'm afraid I'd have to throw the ball back to Dallas.
What happened, he did in Texas.
Makes you think the hospitals there
will take any surgeon with a pulse.
I see why you're so upset...
These hospitals not reporting him,
Not vetting him properly.
But this is a Texas problem...
not a Tennessee problem.
Hi, it's Christopher Duntsch.
Dr. Christopher Duntsch calling.
Just following up on that exam you had
a couple of months ago.
I just wanted to see if you're still interested in surgery
to correct all that pain.
I'm still working out of Baylor-Plano,
but I did actually start working at another hospital.
I'm just following up. How's that neck pain?
A tingling foot?
The exam is free.
You are interested.
You moved.
Out of state.
You know, January is Spinal Health Awareness Month.
Hello?
Mrs. Bloom?
He passed.
I will say hi to Jerry for you.
Kim is great.
Yeah.
No, she's great.
Well, Jerry...
moved on.
That's a hairline fracture.
You... you could be paralyzed if you don't correct it.
Kim is great.
Yes.
Yes, yes.
I promise I'll never call back.
- Dr. Duntsch?
The Dr. Duntsch?
- Can I help you? We're kind of closing up.
I'm Stan Novak.
I, found 'em in your door.
It's that damn office manager...
So scatterbrained.
When did you hurt your neck?
- Motorcycle crash six years ago.
I've had five back surgeries.
How'd you know it was my neck?
It's kind of what I do for a living.
Let me guess...
when the spasms happen,
it feels like an electric shock?
Any little thing sets 'em off.
Sometimes hits me when I'm driving.
I almost go off the road.
- Yeah, that's Lhermitte's sign.
We're looking at a cervical fusion.
You got severe compression of the spinal cord,
but if we decompress that, you'll have a full recovery.
I've seen so many doctors, but I wanted you.
Saw your award video.
Best Docs.
- Two reasons why patients normally present
to their doctors for pain related to the spine...
The first is related to the peripheral nervous system.
That's called radiculopathy.
Now, that's normally associated with compression
or degenerative changes
to the spinal structure irritating the nerve, or...
Award for best doctor in Texas?
You caught me in the middle of an expansion.
I'm a little short-staffed right now.
- You can still do it, right?
- I'm all booked up at Baylor,
but I did just start at University General.
I can squeeze you in there.
- We get the process, Duntsch.
- And we do like disruptive tech.
- Then you're gonna love DiscGenics.
It's just that I was forced to take
the "D to a C" program, in high-school biology, so...
- I put the fucking A in AP chem,
and I still don't get what it does.
- Okay, brass tacks...
I'm inventing
an injectable fountain of youth for the spine.
- Work for his wanker? - That's phase two.
- Hey, there's hope.
- Look, simply put, stem cells take over diseased cells
in spinal discs and repair them.
- How far along is it?
- We're looking for partners right now to raise capital
based on lead assets that we've already generated.
I mean, look, I am developing a key process
in the manipulation of stem cells,
but, equally important,
our competitors are going to need to use this step
if they want to play in our space.
We'll own it, and they'll have to pay.
- And how'd you come up with the concept?
- I knew it. - I knew it.
- Whoa, whoa, whoa, hey, Make way for the king.
Yo, what the fuck's a MISI?
- Minimally Invasive Spine Institute...
- Minimally invasive spines are your jam, man.
Too many choices. What are you gonna do?
- What are we gonna do?
I don't think you should sell anymore, you know?
- Come on, man.
It's no big deal. - No, no.
Come with me.
- Where?
- I got job offers in Dallas, California, wherever.
- What am I gonna do? - You already live with me.
You drive me.
We're best friends, right?
- Goddamn right we are.
Wherever you go, I'll work for you.
Hey, how about director of marketing?
Preach the empire of Duntsch.
- Wait a second.
- Evening.
Just wanted to introduce myself.
- Get out of here. - My name's Chris.
What's yours? - I paid for this, Chris.
Back the fuck off.
- Touch my friend again, I'll break your spine,
and you'll have to pay him to fix it.
- So, what's your name? - Crystale.
It's a little early for Halloween.
I like your costume better. - You gonna pay for it?
- No, 'cause you are priceless.
If only I hadn't heard that line seven times tonight.
- I bet you break a heart every time you say that.
- If you're really a doctor, what kind are you.
Aside from being a cheap-ass one?
Well, Crystale, unless you're board certified
in neurosurgery and molecular biology,
I don't think I could explain it to you.
- I'm board certified in knowing you're an asshole.
- Hey!
- My name's not "hey."
- Well, it's not Crystale either.
Look, I've had a crazy day.
A bunch of dreams just came true all at once.
Has that ever happened to you?
- Dancing here is my trifecta of dreams come true.
- Okay, so I'm an asshole,
and I'm sorry for what I said earlier.
- Pardon the interruption.
Listen, bro, I don't need to be marketing director.
Only title I want in your life is friend,
and you can never fire me.
I go where you go,
but you do need a slogan for DiscGenics.
- A slogan? I'll give it a whirl.
- You don't know what it is. - Do you know what it is?
- I don't need to. I'm good.
- Holy shit. Done fucking deal.
Fuck, yeah. Chris, you got to hear it.
She's rock and roll.
- Yes.
Bob!
Hey! Come on!
No, no, no...
I came at a bad time, I'm sorry.
- No, no, no! Come on. It's opera night, come on in.
Come on. - Hey, look at this.
He got another job.
University General Hospital.
You know what? I went to med school
with the owner of this place... Dr. Sasani.
We should go there.
- And do what exactly? - I don't know.
We'll figure it out.
We'll, denounce him publicly.
No more half measures, right?
- Okay. - Come on.
Jacqueline, look who's here!
This is Dr. Bob Henderson.