S04.E15: Donors

[jewel21]

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Grace and Carlos work together when they suspect a young woman was a victim of a black market organ trafficking ring; Owen's brother Robert comes to visit and meet T.K., but surprises Owen with news that can affect the Strand family.

Airdate: 05/02/2023

[Kleav]

I wonder if it was strange for Rob to call Chad Robert. 

[shapeshifter]

When Grace first teared up when the dying 9-1-1 caller called her "Mom," it was like my 9-1-1 daughter's reactions to some calls.
But, as usual, Grace's actions after that were not like anything my daughter would ever do. 
IDK. They made a good case for Grace getting involved because who else cares about victimized women of color?

**************

Hah! Firefly reunion! 
Adam Baldwin slightly broke character in his scene with Gina Torres.

[Lady Calypso]

Another very solid episode in a season filled with duds. Maybe the other key to a successful episode is more Grace! Hey, maybe Grace and Marjan finally need to team up! That would apparently make the best episode the series has ever seen.

It wouldn't be Lone Star without TK getting injured once in a season. At least this didn't end him in a coma, so baby steps! 

As much as I always hate seeing Grace be reckless and try to play detective, she always seems to have a believable enough reason for me to be not so upset at her. Her reasoning to Judd about why she was risking her life, though still stupid, was noble and for the right reasons. And I'm glad they DID do a fake-out with the detective (though, dude, maybe get there faster and call for back-up like she asked). And Grace got Mike to roofie himself! 

I did like the touch that they cast a man of colour in the role because it makes sense that a woman of colour would be more trusting.

So, Uncle Robert Lowe comes to town to visit Owen and TK. Oh, and he has Huntington's. I guess that's better than my previous theory that he would need a donor. I suspect Owen will also test positive for the gene and we'll see shaky hands Owen at some point, maybe not this season, but certainly next. 

But no, at least they're going to attempt to do something a little different here, at least with another disease that they don't show often on TV. The last Huntington's character I can remember seeing was Thirteen on House.  

[possibilities]

Damn. Huntingtons Disease is BAD. And if you have the gene, that's it, you get it, and it's uncurable, and it's way worse than a tremor or a little forgetfulness. Owen's brother is in the early stages. It's one of the most horrific diseases, in myopinion. And you have a very high chance of having it if your brother and father had it.-- a 50%  chance, IIRC.

Either Owen tests negative, or this is Rob Lowe's bid to leave the show, which is something he has been known to do after a few years on shows where he starts off as the big name draw.

https://www.hopkinsmedicine.org/health/conditions-and-diseases/huntingtons-disease

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Grace is crazy but I love her and my only complaint is that she didn't ensure she had back up before she went to the bar. Trusting the dude who blew her off before was  too risky!!

 

 

Edited May 6, 2023 by possibilities
Needed to clarify that it'sn ot MY brother who's got Huntington's-- it's Owen's brother!

[Madding crowd]

If Mike was just grabbing random women an off of a dating app , how was he matching their kidneys to people who needed them? I could see if he stole records from a hospital but you can’t just transplant a random kidney in someone.  My niece died waiting for a kidney and no one in our family matched. 
Grace was right to care about Lexi but Grace is very level headed. She would not have gone to that bar without having back up. And it didn’t look like she could have switched the drinks without him noticing.

[Lady Calypso]

18 minutes ago, Madding crowd said:

If Mike was just grabbing random women an off of a dating app , how was he matching their kidneys to people who needed them? I could see if he stole records from a hospital but you can’t just transplant a random kidney in someone.  My niece died waiting for a kidney and no one in our family matched. 

He wasn't. How I took it is that he was just in it for the money, so he didn't care if the organ matched or not. He just did whatever he could go get the money from the poor victim he was telling the lies to. 

I mean, yeah, Lexie woke up in a tub of ice water and had a phone that said to call 911, so I guess there was SOME level of care...but not that much so can't really say he did any good there.

12 minutes ago, LtKelley said:

Agreed its awful and its kind of unlikely that Owen, or lil brother Robert for that matter, would be just starting symptoms. Likewise the dad reaching mid to late seventies but actually dying of it and no one mentioning it at the time. But really it usually presents between 30 to 50 so while lil brother Robert is in the window barely, it seems like Owen's age alone means he dodged the bullet.

Apparently, Huntington's can really be diagnosed at any time. 30 to 50 is an average diagnosis, but someone can show symptoms at any time. I think Robert is supposed to be in his 40s, anyway, since Owen's brother died when he was 10 in 1984 and Robert was born some time after that. Chad Lowe is obviously older but Robert shouldn't be past his mid-40s, according to the timeline they set up. And Owen is early 50s, so he's still technically in the average age to show symptoms. 

[Madding crowd]

People who can afford $60,000 or more for a kidney would want some proof that it would be a match. That’s why the waking up in a tub of ice is a myth. I get it that it’s a TV show but it would make more sense to me if the guy worked at a clinic or hospital and at least matched blood types. 
If the ‘doctor’ just wanted the patient to die why do the surgery at all? He could just take the money, knock the patient out and run. When people ( in other countries mostly) are paid for organs they are matched with someone who needs it. This guy is taking an extra risk by choosing a random person who may or may not die and putting their kidney in someone who will surely die. 

Edited May 3, 2023 by Madding crowd

[DanaK]

1 hour ago, Madding crowd said:

People who can afford $60,000 or more for a kidney would want some proof that it would be a match. That’s why the waking up in a tub of ice is a myth. I get it that it’s a TV show but it would make more sense to me if the guy worked at a clinic or hospital and at least matched blood types. 
If the ‘doctor’ just wanted the patient to die why do the surgery at all? He could just take the money, knock the patient out and run. When people ( in other countries mostly) are paid for organs they are matched with someone who needs it. This guy is taking an extra risk by choosing a random person who may or may not die and putting their kidney in someone who will surely die. 

It would seem “Mike” the kidney procurer was being sloppy and I assume the doctor was assuming the kidneys were being matched

[shapeshifter]

29 minutes ago, DanaK said:

It would seem “Mike” the kidney procurer was being sloppy and I assume the doctor was assuming the kidneys were being matched

But then how would this have been a "big organ trafficking network"?
It seems there would be a lot of bodies piling up.
If they showed that the first victim and Grace both had made use of the type of genetic testing service that includes medical as well as ancestry information, and if there was a hacker involved, we wouldn't be asking these questions or making up excuses for the plot holes. 

 

[Lady Calypso]

7 minutes ago, shapeshifter said:

But then how would this have been a "big organ trafficking network"?
It seems there would be a lot of bodies piling up.
If they showed that the first victim and Grace both had made use of the type of genetic testing service that includes medical as well as ancestry information, and if there was a hacker involved, we wouldn't be asking these questions or making up excuses for the plot holes. 

Well, we know Mike moved from state to state, so that's how he got away with getting caught. He left before it became a noticeable pattern to the police.

Not that I think the plot was that well written, but that's the implication.

[iMonrey]

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If Mike was just grabbing random women an off of a dating app , how was he matching their kidneys to people who needed them? I could see if he stole records from a hospital but you can’t just transplant a random kidney in someone.  My niece died waiting for a kidney and no one in our family matched.
Grace was right to care about Lexi but Grace is very level headed. She would not have gone to that bar without having back up. And it didn’t look like she could have switched the drinks without him noticing.

Yeah, the story had potential and I appreciate that at least we had some 911 calls this week, but the whole kidney operation story was flimsy at best.

It also made Grace look like an idiot. I'd have been furious with her if I were Judd. It would have been one thing if she were wearing a wire and the police were right outside in a van listening, but to run off on her own without any backup into that situation was absurd. She's just not that stupid. At least I didn't think so.

I wonder if Adam Baldwin is going to be recurring. He's kind of a big name to do a one-off like this.

[possibilities]

I was astonished that they didn't even have a donor picked out until the recipient was already prepped and on the table awaiting the surgery. I agree there were details that stretched credulity, but this is a show that has made a regular practice of stretching credulity, so I am not really surprised.

I also assumed that the trafficker planted the $1500 on the nightstand, so the victims would also be suspects, and less likely to report anything if they survived, and also less likely to be taken seriously by law enforcement. They were clearly looking for victims who didn't have local ties, and we didn't see him offer Grace any money. I believed the girl who told Grace she had not been offered any. payment nor informed of what was about to happen.

At first, I thought the cop was part of the trafficking and HE had planted the $1500. 

[eel21788]

16 hours ago, Lady Calypso said:

I suspect Owen will also test positive for the gene and we'll see shaky hands Owen at some point, maybe not this season, but certainly next.  

If Owen doesn't test positive, there is no way for him to pass the gene on to TK. That would totally eliminate a TK In Peril Again storyline. Would the writers let him off that easily?

16 hours ago, Lady Calypso said:

I guess that's better than my previous theory that he would need a donor.   

Having had cancer, Owen can't be an organ or bone marrow donor. That would bring us back to another TK dilemma.

[eel21788]

16 hours ago, Lady Calypso said:

But no, at least they're going to attempt to do something a little different here, at least with another disease that they don't show often on TV. The last Huntington's character I can remember seeing was Thirteen on House.  

Although it was never specifically stated, the assumption on NCIS was that Director Jenny had either Huntington's or ALS.

[eel21788]

15 hours ago, Madding crowd said:

If Mike was just grabbing random women an off of a dating app , how was he matching their kidneys to people who needed them? 

When they were at the recipient's house trying to convince the wife to let him in, Tommy said she thought he had received a mismatched kidney.

HLA typing isn't as important in kidney donation as it is with other organs. It looks as though the "network" was just playing the odds that whoever they chose as a donor would have a compatible blood type. It didn't need to be a perfect match. If the donor turned out to be O-, it would work for any recipient blood type. If it turned out to be the wrong blood type, there was very little recourse for the recipient. The "network" would just chalk the postop decompensation and inevitable death up to acute rejection and say it was beyond their control. There is also a lot else that can go wrong with the donated kidney if the proper precautions aren't taken postop (not monitoring and keeping the central venous pressure high enough would kill the kidney; since he got no ICU care afterwards, that easily could have been another mistake). The recipient or family would be pretty reluctant to seek out further medical care or even have an autopsy to learn the truth. 

[eel21788]

8 hours ago, Madding crowd said:

People who can afford $60,000 or more for a kidney would want some proof that it would be a match. 

He was trusting someone to do something he knew was totally illegal. I doubt he would have gone beyond asking if everything was set to go. If he had asked for some kind of proof, I'm sure the "network" could have easily provided him with something forged that looked like a legitimate crossmatch. 

[Madding crowd]

As I mentioned earlier, my niece died waiting for a kidney transplant and I helped her with her medical stuff. No one in our family was deemed a match , but we were never told that she could get any kidney with a type O blood type. I’m wondering now why it takes so many years to get a transplant if all you need is a person with the right blood type. 

[iMonrey]

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I was astonished that they didn't even have a donor picked out until the recipient was already prepped and on the table awaiting the surgery. I agree there were details that stretched credulity, but this is a show that has made a regular practice of stretching credulity, so I am not really surprised.

None of it was remotely realistic. I also question whether a kidney would be removed from the abdomen - both the recipient and the "donor" had incisions on their abdomens. Kidneys are located in the back. It would seem more efficient to remove them from there.

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At first, I thought the cop was part of the trafficking and HE had planted the $1500. 

Well, never fear. If he turns out to be a crooked cop I'm sure Owen will solve the case!

Edited May 3, 2023 by iMonrey

[possibilities]

There was a Huntington's disease case on Everwood, years ago. I agree it's not often portrayed. 

 

[shapeshifter]

20 hours ago, Madding crowd said:

And it didn’t look like she could have switched the drinks without him noticing.

In the flashback, we saw that Grace "switched" drinks by simply taking his.
It was a very believeable sleight of hand. 
Probably the most believeable thing in the episode.

 

[MaryHedwig]

1 hour ago, shapeshifter said:

n the flashback, we saw that Grace "switched" drinks by simply taking his.
It was a very believeable sleight of hand. 
Probably the most believeable thing in the episode.

She was always clever to say, "I'll have whatever you are having."

[tennisgurl]

I'm glad that at least we got a few more actual calls in this one, even if they mostly existed to get us to the "Grace breaks up an underground organ trafficking ring" story, because these people seriously cant go anywhere without running into domestic terrorists or serial killers or human traffickers or every other thing you can imagine. I did at least like seeing a Grace episode, even if she really should been more wary about going to meet a guy she knows is drugging women and stealing their organs. At least call Judd or someone else for backup. I get why she was so invested in this, but still. 

Its not an episode of Lonestar without TK getting hurt, although at least this time he managed to avoid a coma, so that's progress at least. 

Huntingtons is rough, and with it being genetic this could be a real problem. It really is always something.

[mrsbagnet]

I thought they were going to have a conversation with TK about Huntington's, as it could affect his and Carlos's family planning choices. Maybe we'll get that in a later episode.

[possibilities]

Someone should correct me if I'm wrong, but I think that if Owen doesn't have the gene, then TK is safe. But Owen should definitely get tested ASAP.

[eel21788]

23 hours ago, Madding crowd said:

As I mentioned earlier, my niece died waiting for a kidney transplant and I helped her with her medical stuff. No one in our family was deemed a match , but we were never told that she could get any kidney with a type O blood type. I’m wondering now why it takes so many years to get a transplant if all you need is a person with the right blood type. 

Even though it isn't essential, they do try to get a decent HLA match when doing it the legal way. If the blood type is compatible, it is still possible for a kidney to go to someone below you on the list because of a better HLA match.

As I said before, these guys were playing the odds and hoping that the donors they selected randomly would be a compatible blood type and close enough on the HLA. However, they really didn't care if the roll of the dice came up snake eyes. Once they had they money and did the surgery, they weren't providing anything in the way of medical care to the recipients. There are hundreds of reasons for things to go wrong. If it all went to shite, the "network" would have simply shrugged its shoulders and said, "Oh, well. At least we tried. No refunds."

It would have been an interesting plot point for them to tell us what percentage of the recipients actually survived. If the "network" was recruiting patients by word of mouth, I would think someone would look into that. 

[possibilities]

I wondered what happened in the hospital after-- they must have removed the kidney that he rejected.... does that mean he has zero kidneys? 

[eel21788]

15 hours ago, possibilities said:

I wondered what happened in the hospital after-- they must have removed the kidney that he rejected.... does that mean he has zero kidneys? 

Unless a compatible donor had suddenly become immediately available, then he is back on dialysis again.

[possibilities]

Wouldn't he lose his place on the waiting list because of his attempt to buy a black market organ?

 

[eel21788]

On 5/5/2023 at 7:26 PM, possibilities said:

Wouldn't he lose his place on the waiting list because of his attempt to buy a black market organ?

 

My best guess is that it would either move him higher up the list because now he is a lot sicker than he had been before, or it would eliminate him from the list entirely because now he is considered to be too sick to have a successful transplant. There is also the issue of the possibility that he may be spending 5 or more years in prison for his role in the organ theft and subsequent womanslaughter.

[possibilities]

I thought people on the list for donated organs need to follow very strict rules to prove they are responsible enough and "deserving" of the responsibility. There is such a shortage that they are very strict about things, and people can get bumped down or off for even minor infractions, or at least that's what I've heard.

[eel21788]

16 hours ago, possibilities said:

I thought people on the list for donated organs need to follow very strict rules to prove they are responsible enough and "deserving" of the responsibility. There is such a shortage that they are very strict about things, and people can get bumped down or off for even minor infractions, or at least that's what I've heard.

For the guy who got the pig heart, they didn't take his criminal record into consideration.

There is also a guy who totally abused and didn't follow through on any of his aftercare and lost a transplanted kidney, and he was still allowed to have another kidney along with a pancreas (read Taylor's Gift if you're actually interested in knowing more about him).

I think it probably just comes down to who happens to be making the ethical decisions for the UNOS on a given day. 

[possibilities]

The pig heart was an experimental surgery, though, wasn't it? I think that's an entirely different pipeline with different rules.

But I didn't know about that other story. Hmmn.