Practice English Speaking&Listening with: Medical Investigation (2004) Season one episode 4 (1x04)

And makes me

Whoever thought vacationing with the people you see all week was a good idea should be shot. Oh my god

Having me to see Jerry Landau in a speedo

Um you ladies okay, just another day in paradise

Where's your friend Kim? Is it? Actually she's feeling kind of sick?

We thought it was too many tequila shots, but the resort doctor said there's a bug laying around well. Don't worry

I'm sure it's nothing. I'll check on her for you

What can I do it's getting worse get help now

Lelaina in Miami at 40 from there so our by chopper to the iron rundown what we have dr. McCabe for whose benefit yours

Okay

We have half a dozen guests at the cost to Bimini resort a private island off the coast of Grand Bahama down with a variety

Of symptoms, what's the chief complaint heretic chest pain at night, so I said no

What does that tell you it could be the flu well it could be the onset of

Hemorrhagic fever if anything gets been in Africa lately you're overthinking this forget Africa. We're in the Western Hemisphere

There's possible cavitation in the mid and lower lung fields to break your losses. That's what the local doctor. Thanks then again

He probably went to med school in Grenada

In H and E stain

Oxygen activated charcoal IV poles and saline don't they have any supplies whatever you want someone gets sick never been sick on vacation

miles

No, don't be no high-end resort is gonna set aside space for a clinic when they can book a room for $600 a night

I just have some fun with Bethesda remember that mystery pneumonia and Dade County yeah

The case we passed on first patient died now there are three more cases

It turns out to be TB in the island. We'll treat it in back traffic one of the patients, Raymond Diaz

It's a local director for Health and Human Services here in Miami

I'm a distant man who signs your checks

We can't but you're gonna stay here and monitor the pneumonia case with all due respect dr. Conner

I'm ready for more than palpating and intubating and I never been to the Caribbean

I'll stay dr. McCabe is better suited for the kind of triage

You'll need you, and I can do everything we need by cell phone and computer uplink

Fine Eva you stay here with Natalie helped you with the pneumonia case Powell McCabe come with me

Thank god, you're here. My employees are dropping by the hour my VP lay down this morning

How did it start chest pains buddy was having a heart attack? Did you all come here directly from the mainland?

No, we first spent two days in st. Thomas, but no one got sick until we got here

We have an excellent record when it comes to health and safety doctor nothing like this has ever happened before

When you transport the patient to the nearest hospital we tried the island hospital is nothing more than a glorified

Clinic they just sent one of the doctors there have been some isolated cases of tuberculosis on the island now

They think we've got a situation and we're gonna spread it when three percent of your population is ill it's no longer

Situation is now boring do we please not label dozen? I really don't want to scare the guests. There's no longer about public relations

Responsible public health and you have a little problem on your hands

Make that a big one

We were told you were stabilized at six patients that was yesterday. Yeah, whatever's infecting them is spreading fast

Look if we're gonna treat this when you total this closure from here on it. Okay. I'm sorry

What can I do I need a list of all the guests who's sick? Who's not what rooms?

They're in what they've been eating and drinking

They made a record of every illness documented here in the last two years as well as every suspected case of TB on this island

God, that's gonna. Take time you

Strike me as confident

So we have over a dozen guests with a systemic debilitating illness shouldn't we be taking?

precautions if we think it's TB like masks

What do you think I asked you about your BCG shots? We all receive TB vaccinations back in Washington

I'll start a timeline a database for all the patients document their every move from the moment

They got here until now see if there's been any changes in the weather patterns or recent

Infestations see if the place has been renovated or painted

There are a number of toxins that can cause acute respiratory distress and look like TV ammonia smoke hydrocarbons

There's also a chance someone from the registry was exposed early, and what they'll miss with them

No, I checked with the company's home office in Orlando

No one back there has any of the same symptoms

So let's just assume for now the source is here remember is enough fax machines and cell phones to create a panic

Let's keep this thing quiet. Okay, okay?

Have you traveled outside the country recently mr. Days, this is an ordinary pneumonia is it the doctor said it's a negative for bacteria

I'm gonna have miss Rossi take a detailed history

Places you've been things you've eaten

Animals have been in contact with I gave the doctors everything you more than anyone know what we do mr.

Diaz trust us to take care of you

It's true a way to find out if you people are as good as I've been told

But this young woman has severe multiform, where'd you give her?

I saw tied into his amine, but it didn't have it didn't help because she's not suffering from an allergy. I'm only one person

That's why my hospital called you

Okay

Giving the presenting symptoms, and the histamine was the right call well

It's changing spreading isn't it significantly nosebleeds headaches and enlargement of lymph nodes?

Okay visiting hours are over until we know what this is no one healthy gets in alright

Yes, sir get blood urine man - scratching full history what you wanted, yeah

treat your patient smiles

I'll be right back, sweetie

Excuse me excuse me

My husband is lying in there and nobody is telling me. What's wrong with him. Can you please help him?

As soon as we know we're dealing with we will

All right

I'll start testing the food and water then move on to the victims room from there get a chronology from the doctor see if we

Can figure out who came down with this first?

We confirm the doctor's diagnosis of endocarditis it's the swelling of the valves around the heart yeah, and learned a lot from my dad

So you can treat it the endocarditis is only a complication of the underlying condition, what's that? We don't know you?

We one of the first to get sick

However my friends while they're flying I said they're waiting to have another tequila shot

Sticking your tongue for me

Okay Kim

You're gonna be fine

You're going to have you all back in a Miami hospital in just a few hours

All right, this is East pavilion West pavilion

There's a small cluster in this structure right here, but it stops my third floor that can indicate a source

But there are cases Franklin all over the other buildings

There's no pattern if we're spreading person-to-person would see a more consistent plume so far. There's no link between food drink alcohol nothing

What's this one right here? That's the staff quarters and not one of them is sick

nary a soul

What are the guests doing to the staff isn't your voting Republican playing pools hot tubs spa the gym the game room

Probably have different sheets and abets to whatever distinguishes the guests from the staff tested her

The Diaz's were one of the first families to come here when Castro took power in 59

Wait a long talk were you able to talk to the other pneumonia patients

I had to show the chief of staff my special tattoo, but yes

I was and I can't find anything that links them nothing that makes sense anyway

There's a reason why they have an acute respiratory illness and thousands of others here

Don't go back over everything the kinds of household chemicals. They use sports. They enjoy habits

They have I I'm not a doctor or a toxicologist

I'm the press liaison yeah, but you were an investigative journalist for four years before you became a PR person

You know how to talk to anyone I know miss flex

Okay, fine. Just remember unlike what you usually do this isn't about spinning information to suit our purposes

It's about sifting through and gathering evidence that objectively leads to conclusion

So how are things with that hockey player?

Excuse me okay, Jeremy Joe Jordan, what's up?

Why do you ask you just don't see that many women who are beautiful and brilliant, I would think man would be all over you

Were you able to talk to a mr. Of Gerald Boorman no I've been at the hospital all morning why

Muse's Borman died from endocarditis five days after showing symptoms

Ray Diaz has been sick for four

Wormans wife may have been the first to contract the disease

I'll go see if I can tie her to any any other victims

Now you're thinking like an epidemiologist

25 and Counting and I'm still in the dark, maybe I can be your guide. What do you got?

What I'm seeing that resort is a four-star petri dish

you've got a coli Enterobacter non-pathogenic staff lactobacillus Candida

Which explains where the symptoms are all over the map it's also gonna make a clinical diagnosis difficult a scary thing is the people are

Getting sick then an older immunosuppressed

They're young healthy adults in if you don't find and stuff with a have they gonna bring this back to the stick

Stephen are you there?

Warranty don't you think that's a little drastic this thing is an airport if the point is we know the source is here if the

Patient's dispersed to the mainland infection spreads won't know where to look, but I already told these people they'd be going home

Can you please tell my husband the government's making arrangements for us to leave I got my food

I can't until we know more. No one's allowed off feeling

Well because of the unknown nature of this illness. I've issued warranty or

mystery sorts under lockdown

I

Chartered a boat from Miami to pick up the patients

I pull every string I had to get it tell it to turn around

Why should I the people who work me the people who I care for are getting sicker?

I had two more employees go down this last hour

That's my point exactly as bad as this may seem at least we're in a closed

Controllable environment one sick person were to reach the mainland. There's no stopping runaway infection. Do you have no jurisdiction dr.?

Conor your team is here at the invitation of the local Ministry of Health you can personally place the island under quarantine

You're absolutely right the small I have no jurisdiction

But what I do have is 15 years of experience all over the world seeing firsthand when infectious disease can do how fast it can?

Spread and how viciously you can kill so closing this place down for a few days means saving thousands of lives so be it no

I'm trying to understand doctor, but you yourself said that you didn't what this is, maybe it's nothing suppose. It's not suppose

We don't contain it here

Do you want your company or your company associated with the legal and financial liabilities of exposing hundreds of thousands of people?

Chirico mr. Eisen

Okay, I'll tell the boat to hold for now

Okay have you identified those with symptoms? Yes, sir we need to separate those most vulnerable

No one in the company is older than 40 - I'm talking about the children

Perfumey to isolate them, you know what you need to do

This is herring can I see my husband ma'am?

I need to put your daughter in a clean environment what?

We need to quarantine your daughter

You want to take her away from me only temporarily children can get very ill from the kinds of things

We're looking into no she's not sick. I'm not sick

You could be a carrier what we don't know yet, but if you start to show symptoms. It'll be too late. She'll be infected

Come on sweetie no

I've already been separated from my husband. You can't expect me to give you my little girl. Ma'am. You don't have a choice

It's for her own. Good. I promise she'll be okay

Mrs.. Harrington, please

It's okay, baby

How was your wife's health mr.. Boorman Judy was never sick

Used to joke about our paternity. She had my mom's like that run run long

concerts

Benefits she had a list of all the exotic trips. We did to take did you to go anywhere recently? I couldn't get away

And what about the rest of her routine did it change at all?

Tennis with her girlfriends work at the Museum

She even RIT to the school kids it over town before she realized how sick she was

She sounds like a great lady. Yeah, I

Heard you're her day planner. I thought it would be helpful

Every night we'd have a glass of wine look out at this gorgeous view remind ourselves. Just how lucky we were

It's Harry I'm dr. Connor

The doctor here says you're having some pain in your chest

Feels like a weight pushing down on it. He's got reddening of the eyes could be a virus and rales bilaterally

where my wife and daughter

Their good hands

Trust me

Look I need you to focus your notepad

Now you're hurting, but there's something linking you with your sick coworkers something that you all may have done others didn't

Did you do anything ritualistic as a group swim in a reef go hiking he buries anything as insignificant as it might seem?

no, I just

Been content to sit in the whirlpool all day. Oh, yeah, what is that? Mess? You know Sierra's replenishing?

Legionnaires disease, are you sure this place is loaded whirlpools

and steam rooms all of them whipping up an aerosolized mist a

Bacterial soup night and day well not everyone becomes symptomatic that explains why you have 25 down not 125

Are you sure you're right look we can't wait for confirmation

I'll start treating with what I have but I mean broad-spectrum

Antibiotics cipro erythromycin loads of it and fast well get me what you've sampled so far. I'll turn around as quickly as possible

The 76 outbreak was linked to egg addition wasn't it just never ruled out I need access to the ducts

I

bake

Oh, it's the same art gallery marked with a big she she opening 10 days ago a group show progressive Latin American artist

the Kazarian gallery

Anyone moves or discards anything

Thank importance in my club

I've actually heard it at the artist sadly during one exhibit

He lay naked under Plexiglas bridge and did things to himself while people walked in I prefer landscapes myself

First place that looked pool of standing water under an evaporator

Which tells you what if the what is in fact that we Legionnaires the fan gets easily aerosolizing into a mist

And from there spread the disease I only check the portion of the ducts, but I think we're on the right track

Shut down central air

Dr.. McCabe

Please let me go in and see her. I can't I'm sorry

At least let me give her this blanket, it's the only thing that keeps her calm

Please have a heart, please. Thank you

Dr.. Potter we need you now

I meant what's happening dan haren is crossing. I'm trying to intubate

Okay, that's it BP

60 over 20

Well jumping me five ten milligram now that it switch

Let's go go swish

all right, thanks Beth

Let's go

Miles, where's it dopamine hey guys go

Right now get back. Okay. What's false?

Miles puts girls how much there?

Dr.. Diamond floor Moses panic they're losing

The disease must have progressed too far Legionnaires didn't kill him Stephen the bacterial culture was negative

We're back to square one we know almost nothing not really now you know kills

And into some red tape with Dan herrings body the coroner's just starting the autopsy

I did notice small burns on his fingertips

That could be something what about the samples in the property aside from the bacterium staph I mentioned earlier

There's a pretty high concentration of mold spores inside or out both, but that's unusual given the plant life there

I'll know what kind of fungus

It is in a few hours

make sure the enemy matches anything he finds with your list whatever kill herring isn't something that we see every day I

Never thought that Dan would settle down he wasn't really the marrying type when we met

Bo and Gracie was born he really grew up. He loved being a dad. What was his daily routine

What'd he do the moment that he won't got bore right before bed why you ask you know it's question

Because of the progression of your husband's illness we think that he was the first one to become infected it

Helps us if we can put together a picture of his activities prior

Was he sick at all before you came to the resort no

He was actually in the best mood. I'd seen him in in months. He was working really hard on this IPO. They all were

Bought me this bracelet in Saint Thomas. It was kind of his way of saying. Sorry. Sorry sorry for what?

for being distant you know

I'm not available. You know that kind of thing yes husbands are smoking mrs.. Harry

No

Other than a bracelet that he purchase anything else didn't say to us. No. I don't think so but yourself

Did you bring anything over on the boat?

Smoke alarms taped over yeah, I saw that too

Why would you lie maybe she didn't maybe she thinks acquit makes you wonder what else she doesn't know about it there

Yeah, how much longer will you be ma'am first off?

She's a doctor second of all there's a lot of sick people depending on her for recovery

So she'll take as long as she needs um. Here's the name of the caterer

we used plus the list of the food and drink we ordered for the opening well awesome to know who else was here for the

Week leading up to the event did you have a service clean the place?

Well, I didn't want people sweating all night, so I had someone fine-tune essential air. We'll need to take a look at that

I'm sorry. I'm not trying to be uncooperative

It's just that this has been a very trying two weeks for me first Ellie passes away

And now the NIH thinks I have something in my gallery. That's killing people wait cool passed away at least the guy

I was telling you though spent so many years trying to be shown in a mainstream

Gallery like this and he dies two days after his opening

How did he die was he sick?

Ali had been battling HIV for a number of years, but I didn't know he was that sick I

Put some more painkiller and a muscle relaxant in your IV, it should help your throat Kym

Dr.. McCabe C. Sounds better already

Can you take a message to my friends? Yeah of course? Can you tell them if I die I want Jules to take my cat

She's the responsible one

Hey Kim, you are not gonna die

Dr. Carter is the best I know you don't know him, but he's a brilliant man dr. McCabe. I need you

Either she was already sick or someone compromised the area. I never let anyone in what about the lady who gave you the blanket?

Something you want to say McCabe

My mom was beside herself she couldn't stop crying

It was the only thing that would help I took the blanket from the mom and gave it to her

I never let the mommy and take the child to the nightclub with the others the parents know

You know who that little girl is don't you that's aunt herrings daughter

Where's the blanket

Let's leave this right back to Dan herrings room this it actually helped

I don't act like your mistake was part of some master plan the kid who let emotion cloud your better judgment and you compromised that

Environment the safer bet was to leave you in Miami well. You've been looking at the big picture

I've been treating 25 patients and triaging over a hundred others. I'm sorry if I messed up one time

We can't afford to mess up ever

What the hell

Test it

For what

Miss small where they going home arrangements have already been made. I told you we haven't contain the situation yet

We don't know what's making them sick of where it's coming from preaching to the wrong person dr. Conner

I didn't arrange anything Gary Rises did

Ellis cause of death was officially listed as aids-related pneumonia. Well, that's what you expected isn't it well

That's what everyone around him expected since he had had a number of bouts with pneumonia

I'm not following because Ellie had HIV no one questioned how he died

But maybe he didn't have aids-related pneumonia you think maybe he had when I was making Diaz and the other sick

I think he had it first oh

By the way if anyone comes in we're from century 21

This guy's definitely in your face

Doesn't do it for you. I'd rather sit through a hockey game

My ex was into art

Excuse me

exes an ex-husband

That kind of ex

Oh

Oh

That's what the maggots like paint. That's not just paint in there. That's feces ah

I

Gave you time dr. Connor, but now one of my employees is dead

What do want me to do is sit around watch half my company die I did not get to where I am by passively taking

orders neither

Did I the healthy people are going home the sick people are going to the hospital as you said?

It's my call your arrogance is impressive right back at you doctor

The MEA my aim has been trying to reach you autopsies in on dead herring and acute histoplasmosis

Acute disseminated histoplasmosis

Re told miles. He said it's a fungus right yep from contaminated soil all right, so when are we looking for him?

What issues no stomping through dirt won't do it? You need proximity to the spores in order for it to get into your lungs

There's been any disturbance to the grounds and the heavy winds construction anything no nothing

Well times I poke it here assuming it's going six knots

forty minutes max

If everyone leaves the island before we find a source will lose containment yeah, and more people will get sick

I

Checked with the bimini Ministry of Health there's no documented cases of histoplasmosis on the island

How rare is this thing we haven't in the States yeah?

We call it

Ohio Valley or Mississippi Valley disease the fungus itself is pretty common in the soil was it come from the birds contaminate the soil with

Their droppings we get sick from inhaling the spores

First day here for the patients one on a bird-watching tour. Yeah, but not all

Any other exposure to soil well some of the patients went hiking north of the resort

But a bunch more went to the same place and then get sick dan haren never left the grounds

So we still have absolutely no explanation of how the soil became

Aerosolized no common activity among the guests no history of histo in the island the source hadn't been brought in

So you're still thinking dan haren was patient zero yeah?

But the question is how does a soil based fungus kill a?

37 year old vice president on vacation you know it's ironic that people from the city come here to get close to nature

And nature by stem in the ass

and nature's funny that way take the biggest animal in the planet the blue whale

pitted against the tiniest microscopic bacterium

bacterium kills the whale every time

Contact the Coast Guard off Miami tell them we haven't identified the mode of transmission yet see if they can arrange an escort into a

Quarantine station come on it hotter

Dr. Conner, what do you got kid something curious about the blanket because the source is from spores?

I had a crazy idea put it under a blacklight chlorophyll all over it first

It was soil nice plants there any plants and Dan hearings room

We're gonna have to take down Elias paintings Q fever are you people making this up the scientific name is coxiella brunetti

It's a bacteria found mostly in farm animals. We found an abundance of it in Ellie's paint. I don't understand

What's it doing?

That well you mentioned Ellie was out of the mainstream, but you didn't say that he added cow patties and placenta to his work

I believe it's called shock art radical art outer art Google art feces sometime. You'll be amazed

How many hits you get it started as a movement to ridicule the idea that everything is on movement being a keyword

So you knew his work was smeared with excrement no, but I'm not surprised Ellie was always taking risks

Mr.. Kazarian about the little matter of removing the work

It's not the plants darrell's silk

Then herring that of histoplasmosis sports originating from contaminated soil

His illness was systemic, which means he received a massive spore load

So I didn't want you smoking or

Sorry

His wife didn't wanna smoke

especially around the child

But why would an lie about dance smoking her husband was dying?

Jasmine and rosemary, I knew I smelled something earlier. It's a plant base and a chance to contain live spores doubtful

Unusual place where a freshman is oh you mean?

Why is that in the bathroom hmm well maybe is trying to cover up the cigarette smoke or certain aroma

Durant you get a preliminary tox screen on Dan Harry, I'll have to check the Emmys report

What are you looking for pairing had reddening of the eyes and burns on his fingertips?

Check for THC

Stress

When she said he didn't smoke she was half, right

He didn't smoke cigarettes, but he did smoke marijuana especially when he's under the stress of taking a company public well

He answered me this a lot a whole code of silence thing if everyone who's sick lit up someone would have mentioned it

Well pots illegal, and I don't think everyone who was sick

Did I think herring party with some of his colleagues those on his team perhaps, but that was about it

Yeah, Herring's blood tested positive for THC

He tested positive, I look at this the people in the next four rooms along this corridor all got sick

Then I can't be it the spores are too small the heat adjoint me to burn them up

So how do the spores travel how do they contaminate the others?

The child's blanket could have been contaminated here in the room which explains how the little girl. Got sick. What about the others?

If he stash the marijuana in the luggage or under the bed it still doesn't explain how those and the other rooms got infected Smitty

What James Peter Smith my 30th monk maiden Amy nice a guy, okay sailor?

But a major pothead anyway every time the NCO came around old Smitty well had a stash up an event

Event

If he stashed the marijuana in the vent the flow of the air could have blown the spores along the corridor

At least far enough to reach the other victims

Especially if the bag wasn't sealed

I

Got this pistol plasma capsule item he stuffs loaded with it. It's a nasty little fungus

I can't believe that Histoplasma capsule item could get from the soil under the leaves like this urban cases of pot tank to a salmonella

Hep A and that's through ingestion this had to be inhaled sure almost anything's possible when you're dealing with organisms as small

marijuana

Don't get too freaky McCabe. It's rare

Are you going to tell the guests

Your patients

You're lucky man mr. Diaz

Could have died

The tricky thing about Q fever is it often cultures negative, but it is

Bacteria a Rickettsia bacteria which requires a specific test which we only ran after we found the animal parts in el estudio

And only then could we give you the right antibiotics for that particular infection like we said

Lucky and all from standing close to a painting you're gonna be okay mr.

Diaz the doctors here will monitor your heart and keep you on a steady dose of IV tetracycline

Thank goodness. I worked for the government. Yeah, we would have gotten around here at some point

Thank You dr. McKay

These people have a long road ahead sick ones yeah

Antifungals chemo three months before they're back to normal

If ever

Pallfy season I would have thought dad always said modern art was crap and hello to you, too

I knew it the histo problem

The Bimini Ministry of Health is putting out a warning plus their reexamining all TB cases looking for anything that might actually be histoplasmosis

the marijuana still circulating with the information mrs

Heron gave us the local police were able to find a few dealers and the contaminated field in st. Thomas

It's being destroyed as we speak

Nice work

We live to fight another day. I'm not gonna. Give me one a year. We may have won. The battle but not Wars

We're just sorry you're tired good. I think we did a damn good job. I don't want to hear it