Polite Dissent

Title: In Which Cooper Finds a Port in His Storm

Not as strong as the last couple of episodes, but still an enjoyable hour of television. There was a lot of personal fallout from last weeks failed (and succesful) connections. Addison found a new interest, as did Cooper (and a devilish one at that), while Sam and Naomi are trying to figure out if last week’s rendezvous was a mistake or a starting point.
The medicine this week only fair. Epidemics of tropical diseases are always interesting, but the show managed to screw it up here, though it was still mostly interesting. The rest of the storyline was heavy on drama and light on actual medical care.

Dr. Violet Turner and Dr. Addison Montgomery
One of Violet’s patients is a man named Carl. He runs into Addison at the coffee stand downstairs and they strike up a conversation. A few hours later, he calls up Addison and asks for a date. They meet at a cafe down the block and are having a good time before Addison is paged away.
Carl, however, has a problem — an obsession, really. When he is in stressful situations, he likes to borrow other people’s belongings and…firmly place them where the sun don’t shine. After his date with Addison, he steals one of her shoes and puts it to a use for which it was never intended. As one might imagine, this is not a socially desirable skill set. Sadly and belatedly realizing this, Carl realizes that he should return to therapy and asks Violet to break it off with Addison for him.
Ethics, or lack thereof, is the too-often-repeated theme of this show. Despite lecturing Pete about ethics, Violet tells confidential information to Pete and Cooper, and then tells the whole story to Addison. Nice job, Violet. That whole doctor/patient confidentiality? Just forget about it. Must not be important at all, particularly for a psychiatrist.

Dr. Addison Montgomery and Dr. Peter Finch
Addison and Pete are the doctors on call for the Safe Surrender Program. This is a program where a young mother who feels she is unable to care for her newborn can call the team and they will pick up the baby — no questions asked — and keep it safe and healthy until foster care can be arranged. The mother and baby are given matching hospital bracelets in case she changes her mind later and decides that she wants to keep the baby.
They are called by a young woman named Darcy who has delivered a baby girl at home without her mother even realizing she was pregnant. Addison becomes attached to the baby and is clearly thinking about trying to adopt it herself when Darcy and her mother come to reclaim her.
Later, Pete and Addison are also called to a park where they find a cold newborn who isn’t breathing. They rush the baby to the hospital, but despite trying for an hour, are unable to revive the infant.
Addison called Darcy’s baby “Batgirl” because she made cry like a bat (“eee eee eee”) and liked the dark. As a comic book fan, I think this is a great name and I feel strongly that more children should be named for crime fighting librarians.
I was always taught that you don’t call a code on a hypothermic patient until their body temperature is normal because the heart conducts abnormally at low temperatures. Like many things I learned during residency, this should be taken with a grain of salt.
Otherwise, the code looked appropriate. I was pleased to see there was no attempt made to “shock the flatline.”

Dr. Sam Bennett and Dr. Naomi Bennett
Sam and Naomi are called by their priest to evaluate a sick nun at the convent next door. The nuns have been sequestered for 3 weeks, and 86 year-old Sister Helen has been sick for the past week. She has a high fever, tachycardia (rapid heart rate), tachypnea (rapid breathing), and an impressive macular rash on her trunk. Most of the other nuns also become sick and Sam and Naomi quarantine the convent. An infectious disease specialist identifies the disease as typhoid (probably better known as “typhoid fever”>, and due to the short incubation period of the infection, the doctors realize that someone — a typhoid carrier (like Typhoid Mary) — had been secretly visiting the nuns. Ultimately, they discover that the priest had struck up a friendship with one of the nuns and had been sneaking it at night for cooking lessons (literally, no double entendre here). The priest is the carrier of the disease and infected the nuns. With a course of antibiotics they all should recover.
The big problem here is that the show is confusing two similarly named but very different diseases: typhoid and typhus. The symptoms and course are most consistent with typhoid, but Sam refers to it at least once as “typhus.”
While typhoid can have a rash, the one shown is more consistent with the rash of typhus.
Both diseases can cause high fevers, tachypnea, and cough. Interestingly, both cause a slow heart rate, not the tachycardia seen in the show.
The show is correct in stating that the incubation period for typhoid is 10-14 days. However, they incorrectly state that typhoid is spread by “skin-to-skin” contact. Not quite: typhoid is spread by fecal-oral contact or contaminated food or water. This means that a certain priest wasn’t washing his hands well after going to the bathroom.