In what might be the most emotionally moving episode of Three Rivers yet, the episode begins with a man coming to the hospital after a car accident. He suffers from ALS, also known as Lou Gehrig’s Disease. (He is played by award-winning actor Mandy Patinkin.)
Also highlighted in this episode is a young man who comes in with breathing trouble.
Kuol is one of the first to connect with Victor, the ALS patient. Kuol asks him what he’s in the hospital for and Victor explains his condition. They talk about baseball and have a laugh when Kuol re-enacts Lou Gehrig’s final speech.
David discovers the man with lung problems wants to leave the hospital instead of getting his lungs treated. David tries to stop him, but legally he cannot. The man promises to come back to the hospital if the lung issue comes back and David gives him his personal cell phone number.
Andy tells Victor that he needs surgery to repair his heart, and Victor agrees after some hesitation. Afterward Victor has to hear that his condition is worse than they thought. Because he has an injured diaphragm, he must be put on life support in order to survive. He may not be able to ever come off life support, doesn’t take the news well, and becomes depressed. Who can blame him?
David tells Ryan to get his lung patient on the transplant list just as the patient calls his cell phone for help. He is immediately rushed back to the hospital where he goes into respiratory failure.
Kuol comes by again to see Victor after his surgery. He tries to lift Victor’s spirits by talking about his condition and telling him how they are alike.
When David’s patient comes to, he tells him that his lungs are failing and he needs a transplant.
When Andy checks on Victor, he asks Andy if he believes in fate. Andy doesn’t understand initially but soon does as Victor tells him he wants to be taken off of life support and donate his organs. Specifically, he wants his heart to go to Kuol. Andy tells Kuol about the situation, and he’s taken aback by the decision. Andy tells him nothing is set yet because it must be cleared by a committee before something like that can take place.
In the committee, Andy says he is totally against it. But the rest of the board insists that it is ultimately up to Victor. He is also an O- blood type, which means he is a universal donor and could give his heart to Kuol. Eventually, and against Andy’s will, the board votes to allow the transplant.
When patients begin to hear that Victor is going to do this, some of them start coming to him to ask about donating to their cause. Miranda is totally against farming Victor’s lungs, but David is considering asking him if he would donate his lungs to David’s patient and later does.
Victor’s daughter comes by and he decides to tell her what he is going to do. In a heart-wrenching scene, he tells her he will take himself off of life support in order to save others. He says he wants to die with dignity and on his own terms. She obviously doesn’t take the news well.
In Jordan’s office, Andy again brings up his objection to Victor’s willingness to die and donate his organs, but she can only recommend he talk to Victor himself.
Later, Jordan brings Victor a final document to sign before they take him off of life support, but just as he is about to sign his daughter comes in and tears the paper from Jordan’s hand. She says she just talked to her lawyer, and in her father’s final will he gave her permission to make his end-of-life decisions. She tells him she won’t let him go through with it and tears up the form.
Andy comes by Victor’s room later to talk with him. Victor is furious that he cannot continue with his wishes and help all the people he wanted to and die on his own terms. More than anything, he wants to beat the ALS and just die with dignity, knowing he helped someone. Andy finally comes to terms with Victor and decides to speak with his daughter. Andy takes her to a reunion for donors and families to talk about letting Victor proceed with his wishes. Eventually she concedes to allow him to go through with it.
As if the episode could not get any sadder, as Andy is prepping Kuol for his transplant, they find that he has a fever, and unfortunately cannot receive Victor’s heart. What should be devastating to Kuol is surprisingly taken in stride and he keeps his head up, showing just how much character the young man has.
In Victor’s room, Andy speaks with him one last time before taking him off of life support. Before the procedure, however, he asks Andy to do the surgery himself. Andy agrees and they wheel Victor to the operating room.
Sharing tears and a hug for the very last time, Victor and his daughter say their last goodbyes. Victor tells her he will be okay and asks for a smile before finally being wheeled away into the operating room. Victor’s generosity will save the lives of seven people as the curtain falls on this tear-jerking episode.
More Three Rivers next week.
