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'Royal Pains' weird procedure of the week: 'Doubt of Africa'

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Giovanny Rufino/USA Network

Royal Pains

type:
TV Show
Current Status:
In Season
run date:
06/04/09
broadcaster:
USA Network
genre:
Comedy

It’s been way too long since we’ve gotten to witness Dr. Hank tamping the throttle in the emergency room, but when Hamptons Heritage is suddenly short-staffed while HankMed is conveniently running low on retainer-paying patients, Henry (as Evan calls him to bare a little authority muscle) is down to step in as a fill-in for the heck of it.

Which means not only is it one of the busiest doctoring days we’ve seen since HankMed broke proverbial ground — and brotherly workplace tensions are creating all new levels of dissonance between the Lawson men — but there are wacky procedures galore and Hank gets to play MacGyver, M.D. again, big time.

#1: How many doctors does it take to screw in an LVAD wire?

Not since Izzie Stevens took a pair of scissors to Denny Duquette’s cardiac device back in season 2 of Grey’s Anatomy has there been so much sweat broken over a cut LVAD wire situation on the small screen. Hank might get a few softballs to start the day as the ER sub — an ingrown toenail with paronychia and a minor forehead laceration, to be exact — but it doesn’t take long before he’s called upon to work some of his mental magic to beat the clock and save a man whose pulse has stopped and who is not responding to the EMT’s rampant chest compressions.

Well, duh, people, of course he’s not responding to them; he’s got a freaking LVAD system right there in his fanny pack. And what’s worse is those compressions could actually kill this man, so thanks a lot. You’ve done a great job, guys. (How could they actually miss that?! Nope, nope, nope. We’ll have to just suspend all disbelief on that note and just let this happen because otherwise, all faith in the ambulance support system is dunzo.)

After the two seconds it takes Hank to figure out what’s wrong with the guy — his left ventricular assistance device has been disabled thanks to the sliced wire — he alerts the cardio squad to book an operating room immediately and requests the following items for his slapshot savior operation: a scalpel, electrical tape, a bunch of hemostats, and cardboard.

It turns out, Hanks’ minor in college was electrical work (that or he’s a born Hank of all trades) because he’s able to strip the LVAD wires and attach them to a new power source to hold the guy over until he gets upstairs to the specialists, and it’s nothing short of an electromechanical engineering-meets-medicine miracle.

Anyone else suddenly have an impulse to switch to Hank’s usual “extra hot extra shot” coffee order? It’s obviously working wonders for him.

NEXT: Sound the alarms; we’ve got an actual Ebola scare…

[pagebreak]

#2: Dr. Hans, meet Dr. Hank; Dr. Hank, meet Dr. Hans.

Jill is back in the house hospital! But only for a little bit, as she’s in town to support a major foundation fundraiser for her clinic and wanted to check out her old ship — and evaluate its new captain’s steering skills. Things are going swell for her in Sierra Leone; it’s “the best decision” she’s ever made in her life, she tells Hank. (Roughly translated, that means: “Yeah, I think about you sometimes, but not enough to land me back here again.”)

Oh, and her travel partner is a handsome, accented, and good-to-the-core muscle man named Dr. Hans. The jealousy that’s emanating through Hank’s very pores upon witnessing their rapport makes him actually, visibly green for a second there, but even he can’t resist Hans’ charms. He agrees to quickly treat Hans for a possible strep throat onset right there in the hallway with a culture swab and an Rx for penicillin. No big deal, right?

WRONG. Evan thinks it’s a big deal. And the reason he thinks so is because hospital protocol tells him what to think in these situations, and when a patient who’s been in an Ebola outbreak zone like Sierra Leone presents with a low-grade fever, it is, in fact, a pre-ordained crisis. He’s professionally obligated to quarantine the guy on the spot, followed by anyone who’s been in contact with him if the tests come back positive.

From the perspective of a member of the Ebola-free public who’d like to keep it that way indefinitely, Evan’s foot-down diligence on this issue is greatly respected and appreciated. For Hank, though, it’s all just an over-reactive nuisance because he has himself convinced Hans has not contracted Ebola — so much so that he’s willing to throw himself into the quarantine tank right along with him and prove it.

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See, above the sore throat and spiking fever, Hans has also now developed a nastily swollen left eye. While that could qualify as a late symptom of Ebola, sure, it doesn’t make sense that he wouldn’t be showing any other tell-tale signs of the disease at this point (including stomach pain, weakness, vomiting, and all kinds of other hideousness). When Hank finds out he has had a major trauma to that eye before, he hops right on-board his own hubris train and proves that all that CDC and press phone call-juggling Evan’s been doing over this is for naught.

Turns out, Saint Hans fractured the floor of his eye socket rescuing his kid brother from certain death by ice collapse when he was 12, so the metal plate that he had implanted has now been infected by the strep bacteria. Hank finds this out by inserting a needle into Hans’s eye socket — SQUIRM!! — and drawing out some bright yellow fluid. Thanks to Han’s handy dandy microscope app (yes, there is actually an app for that), we quickly discover the sample is filled with white blood cells and bacteria, just as the doctor suspected. National catastrophe narrowly avoided!

NEXT: Doctor, stenographer — what’s the difference?

[pagebreak]

#3: These healing hands have an impressive w.p.m. count.

We’ve been looking at Hank’s end for a long-term romantic prospect to finally emerge — and the brief return of Jill proves they were/are/could always be the real deal, especially since we’ve been told Jill’s not Hans’ type — but it looks like Jeremiah might also be due for a happy ending.

He pitches in to help Divya out with HankMed for their one and only call of the day (while Hank’s up to his elbows with playing automechanic on heart parts and quieting an Ebola crisis and such), and it turns out the patient is actually his literary idol.

Cindy Greene (pen name: C.G. Leviathan) is the author of Jerry’s favorite books: a series that helps him intuit human emotions because the characters spell out everything they feel. She’s fractured her wrist, has elevated blood pressure, and has been dealing with headaches and weakness for a couple of weeks. Jerry suspects some thyroid irregularities or nutritional deficiencies are at play, but he can’t be sure without lab work. Meanwhile, Cindy — er, C.G. — has a major deadline coming up and can’t afford to be held back by her broken wrist.

That’s when Jeremiah’s treatment gets strange; he doesn’t have to offer up anything beyond run-of-the-mill medical work, but he does put his hands to other good use and offer to be her personal typist (with the promise that doctor-patient confidentiality extends to the goings on at Zoad).

He’s not even going to pretend there’s not a personal gain to be had from finding out what happens in the long-awaited book six, and his fandemonium does, ultimately, come into good use. Thanks to his encyclopedic knowledge of her little universe, he’s able to recognize two continuity issues in Greene’s story dictation. And when her blood pressure spikes to hypertensive levels, he’s able to connect her confusion with the rest of the symptoms and diagnose her with Cushing’s Disease, which will require a minimally invasive transsphenoidal adenomectomy surgery that’ll have her back to work in mere days. Hooray!

Jerry, clearly the smitten kitten, decides to spring her from her pre-surgical hospital bed for just long enough to hit up the Zoad book fair that just so happens to be in town, and she’s pleasantly surprised to see just how many people also like to live in her fictional-but-very-real little fantasy world.

As for the rest ….

  • Evan sure got the eye-for-an-eye punishment treatment this episode, didn’t he? Considering his cornea scratch happened to the same exact eye that Hans was gushing fluids from just a few minutes before, and it happened just after he screamed at his big brother for undermining his authority in front of other people over the Ebola “scare,” it smells like a little karma sandwich was just delivered to his doorstep right on time.
  • It can’t be a coincidence that the song Hank hears as Jill’s being whisked away so somberly in the backseat like that ends with the phrase “come away.” As in, move out to Sierra Leone and join the ultra-rewarding clinic with lots of “monsoon stories” to dish out? That kind of come away? Nahh, he wouldn’t … wait, would he? He did start a sentence with “maybe” before he was accidentally interrupted by Hans hurrying Jill’s goodbyes along.
  • Is Evan even considering the possibility that he and Paige might be the perfect people to take Lena, Max, and Ian in? It really doesn’t seem like there’s an actual Aunt Rosanna out there even still, and he even said he relates so well with their parentlessness. Plus, they’ve had so much trouble with the whole baby-making process, and there we have three lovely (albeit a little rambunctious) kiddos looking for some love and guidance.

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