- Dr. Natalie Manning: We are aware that your son was prescribed a new oral chemo, and that you have been withholding it.
- Adam Moore: I'm not withholding them.
- Dr. Natalie Manning: I understand that you're a single father and that this must be incredibly hard for you...
- Adam Moore: It's not about me.
- Dr. Natalie Manning: But if you are willingly keeping your son off of his meds, then we...
- Adam Moore: It's his decision.
- Dr. Natalie Manning: Excuse me?
- Adam Moore: Gabe's. He's been through four courses of chemo. The nausea, the pain, the the drugs to treat the pain, it was awful.
- Dr. Natalie Manning: That doesn't mean you can just stop trying.
- Adam Moore: He begged me all through the last course. But I wouldn't stop it. And it didn't help at all. None of them helped. So this time, I let him decide.
- Dr. Natalie Manning: Well, he can't decide. He is eight years old, okay? His brain is literally not developed enough to process this. Life and death and forever are concepts that he cannot fully understand yet.
- Adam Moore: Gabe does understand.
- Dr. Natalie Manning: I'm sorry, but we need to start your son on his new chemo.
- Adam Moore: No. I won't authorize that.
- Dr. Will Halstead: Tough case?
- Dr. Natalie Manning: Kids get sick. I understand that. But seeing what their parents do to them... it drives me nuts.
- Dr. Will Halstead: You saw Ms. Holloway?
- Dr. Robin Charles: Yep. Thanks for the heads up.
- Dr. Will Halstead: Mm-hmm.
- Dr. Robin Charles: Diabetes studies keep the lights on upstairs.
- Dr. Will Halstead: Glad I could help.
- [looking at Ms. Holloway's chart]
- Dr. Will Halstead: Huh. That's odd. She was an architect.
- Dr. Robin Charles: Why is that odd?
- Dr. Will Halstead: Well, her hemoglobin A1C and lipid panel indicate she takes extremely poor care of herself. You know, it seems out of character for someone I assume pays great attention to detail.
- Dr. Daniel Charles: Slow day for headshrinkers around here. You want me to have a chat?
- Dr. Will Halstead: Sure. Knock yourself out.
- Adam Moore: He's breathing so hard.
- Dr. Natalie Manning: He's septic. We need to give the antibiotics time.
- Adam Moore: He'd scream out in his sleep when it first started, and get these pains. But he kept on fighting. I quit my job to take care of him.
- Dr. Natalie Manning: Then help him keep fighting. Tell him that there's a chance this new chemo could work.
- Adam Moore: Look at him. He's not fighting anymore. He's done. And I will not flog him against his wishes. My boy deserves better than that.
- Dr. Sarah Reese: Differential's long. Could be dissociative identity disorder, schizophrenia...
- Dr. Daniel Charles: Or it could just be a tulpa. I mean, I'm not ruling out any of that other stuff yet, but until we see signs of impairment, we have to consider the possibility that she really could've created an alter ego that she believes cohabits her body.
- Dr. Sarah Reese: But tulpas aren't in the DSM.
- Dr. Daniel Charles: So what?
- Dr. Sarah Reese: She's clearly disturbed. We need a diagnosis.
- Dr. Daniel Charles: Well, it's challenging. And I look forward to seeing where you land.
- Maggie Lockwood: [approaching] Hey, I just got off the phone with PD. They've got several eyewitness accounts of the accident, saying that your patient accelerated directly into traffic. They think it was a suicide attempt.
- Dr. Daniel Charles: Hmm.
- [to Reese]
- Dr. Daniel Charles: Just got a little more complicated.
- Dr. Will Halstead: What's the verdict?
- Dr. Daniel Charles: Definitely in the red on the old ecccentricity meter, but not really any alarm bells to speak of.
- Dr. Will Halstead: Yeah. So we can't hold her?
- Dr. Daniel Charles: Not if she wants to go. Totally her call.
- Dr. Will Halstead: Figured. Thanks.
- Dr. Will Halstead: You know, it used to be if a doctor told a patient to do something, they just did it.
- Maggie Lockwood: You been binging on "Dr. Quinn, Medicine Woman" again?
- Dr. Will Halstead: No, I'm just saying things were different.
- Dr. Sarah Reese: Put her on a five-day hold?
- Dr. Daniel Charles: Yeah. Poor woman.
- Dr. Sarah Reese: Mm-hmm. At least we can narrow it down to something psychiatric. Maybe put her on a trial of antipsychotics?
- Dr. Daniel Charles: I don't know.
- Dr. Sarah Reese: Becca tried to kill Grace.
- Dr. Daniel Charles: Yeah, but let's not forget Becca *is* Grace. I mean, we might yet find that she's psychotic, but she could also just be... cracking under the pressure of forcibly being cut off from a part of herself.
- Dr. Sarah Reese: Wait. You don't think she is actually within the boundaries of functionality?
- Dr. Daniel Charles: I think we need more information, don't you? Grab me when her husband gets back. I think it might time for us all to, um... to meet Becca.
- Dr. Robin Charles: Ms. Holloway's case has a psych component after all. Toxoplasmosis.
- Dr. Will Halstead: That's a parasite from cat feces.
- Dr. Robin Charles: Which lives in the victim's brain forever, and in women, Toxo creates a compulsion to take care of cats.
- Dr. Daniel Charles: Makes me wonder. Do cat lovers get Toxoplasmosis, or does Toxo make them cat lovers?
- Dr. Will Halstead: Interesting, but not terribly relevant.
- Dr. Sarah Reese: [after "meeting" a patient's alternate personality] Obviously, she is profoundly disturbed, which we should have known when she first said "tulpa". Why are we treating her like she is sane when she isn't?
- Dr. Daniel Charles: Wouldn't that be a little too easy, though? I mean, sure, we could, you knojw, slap a label on her, put her in some diagnostic box, pour some medicine on top; but sometimes it's a little more complicated than that.
- Dr. Sarah Reese: She had an argument with her made-up friend while her subconscious crashed the car. It seems pretty simple to me.
- Dr. Daniel Charles: Grace is definitely a fractured personality. But it's all the more reason that we have a responsibility to dig deeper and figure out why.
- Dr. Sarah Reese: Right. I'm sorry, Dr. Charles, but I like boxes. None of this makes any sense. It is all so subjective. I hate it. I mean, where's the science?
- Dr. Daniel Charles: Dr. Reese, every medical discipline, psychiatry included, is as much art as it is science.
- Dr. Sarah Reese: Well, I don't see the science or the art. You know, everybody was so surprised when I went into this; me, the lab geek. Well, they were right. I don't belong here.
- Dr. Connor Rhodes: Looks like you're having a good time.
- Dr. Isidore Latham: Ah. Very nice young woman. We're going up to my room. She has an irregular mole she'd like me to take a look at.
- Dr. Connor Rhodes: Was that her idea or yours?
- Dr. Will Halstead: [his patient is leaving against medical advice] She's just gonna be back with another coronary event.
- Dr. Daniel Charles: Funny thing about the truth: it rarely sets anyone free.
- Dr. Connor Rhodes: So, here's the deal. I'm gonna need everything that she took from my friend, and I'm gonna give you one hour.
- Bartender: I'm sorry, I don't know what you're talking about.
- Dr. Connor Rhodes: Dr. Latham came all the way out here to save the life of the mayor's daughter, so how do you think the mayor's gonna react when he hears that you ripped that doctor off? The watch and the $300.
- Bartender: It... it was only $200.
- Dr. Connor Rhodes: Call it punitive damages for pain and suffering.
- Bartender: Come on, man.
- Dr. Connor Rhodes: One. Hour.
- April Sexton: Sorry I got so worked up earlier. I...
- Dr. Natalie Manning: You had a point.
- April Sexton: I get these thoughts and urges now. Maybe it's this little tyrant in my uterus.
- Dr. Natalie Manning: You think?
- [they share a laugh]
- April Sexton: I'll be really glad when this part is over.
- Dr. Natalie Manning: The part where every decision you make is because of your child? I hate to break it to you, but that one's forever.
- Dr. Sarah Reese: This was a total disaster.
- Dr. Daniel Charles: I'm not so sure that's true. I mean, from Grace's perspective, this could be as close to a win as we can get.
- Dr. Sarah Reese: She just chose her tulpa over her husband; her tulpa that almost killed her.
- Dr. Daniel Charles: I just saw her tulpa talk her off a ledge.
- Dr. Sarah Reese: I have no idea what to think.
- Dr. Daniel Charles: Like it or not, the line between psychological illness and a coping mechanism is a blurry one. I mean, just 'cause we don't give them names and voices doesn't mean we don't all have different sides. I mean, our personalities change based on... how much sleep we get, how hungry we are. Hell, intestinal bacteria could be the determining factor in our emotions. Look... I know you think of yourself as an analytical thinker and a scientist, and that you're wondering if you have a place in psychiatry right now. But I also see this other Sarah in there, and she's filled with intuition and compassion, humanity. And when you put 'em both together, like during Grace's panic attack today, then I see a sensational psychiatrist.