- Previously on "Brilliant Minds"...
- Who is that? - This is John Doe.
- His toe-- It's moving.
- I don't think this man is in a coma.
It appears that our John Doe is suffering
from locked-in syndrome.
- Did you see that? - [ Woman speaking Russian ]
- Maybe she's speaking his language.
- [ Speaking Russian ]
- This neurotech could translate his thoughts
into written and spoken word in real time.
- Oliver Wolf is not a team player.
- You won't regret changing your mind
for taking a chance on Wolf. - I'm taking a chance on you.
- Your John Doe is in the InterMind study.
- What? Are you serious? - Yeah.
- Since the beginning of civilization,
we have looked up to the stars for answers.
To guide us in the dark. Give us hope...
We project meaning onto the cosmos.
Myths and narratives
that help us understand our purpose.
To be ourselves,
we must have ourselves.
Possess-- or in some cases, repossess-- our life stories.
A primal need to maintain our identity.
[ Siren wailing ]
♪
Every patient has a story.
This is Roman's.
[ Wailing continues ]
Roman.
Look up if you can still hear me.
- [ Translates in Russian ]
- Great. Okay, so the electrode will read signals
from the parts of the brain that control your face
and your mouth, your tongue and your throat,
so you can communicate in real time.
- [ Translating in Russian ]
- If you understand, look up. - [ Translates in Russian ]
- Because this is brain surgery, there are risks.
Bleeding, stroke, infection.
- [ Translating in Russian ]
- Roman, do you have any questions?
Look up for yes, down for no.
- [ Translating in Russian ]
- Do you want to move forward
implanting the brain-computer interface?
- [ Translating in Russian ]
- Once more... to be certain.
- [ Translating in Russian ]
- Okay.
Let's give Roman a voice.
♪
- The story is worse than we thought.
9 months, 12 hospitals, 5 long-term care facilities.
- When Roman landed at the first hospital,
they thought he was having a seizure.
- It wasn't a seizure at all
but the early stages of a pontine stroke.
- Causing movements that looked like
a generalized tonic-clonic seizure.
- Right and that error meant they put him on propofol.
- Which is why no one noticed he was locked in.
They sedated him into oblivion to treat seizures he never had.
- When he could have woken up, he got caught up
in a cycle of infections, wound up on the vent long term
after his second bout with pneumonia.
- Strong work. Nursing notes, meds, diagnoses.
Some correct, some tragically incorrect.
Nothing on his history.
- Zero on the Internet about Roman Fedorov.
Not to perpetuate the stereotype,
but maybe he's a spy.
- It's definitely on my differential.
- Somebody, somewhere has to be looking for him.
Let's find out who.
- Oliver.
I hear congratulations are in order.
- Oh, tell Dr. Pierce.
She's the one who knew about the trial.
- I hear under 100 patients have had this device placed ever.
Families often decline these types of operations,
so it's actually lucky that he doesn't have one.
- Well, we don't know that. That's why we're doing this.
- [ Sighs ] Just getting this technology here
at Bronx General...
it's gonna change things for our hospital.
- It's gonna change things for our patient.
- I'm just trying to say, as your mother, not your boss,
I'm proud of you.
- [ Scoffs lightly ]
- I know your father would be, too.
- So starting off with a fun one-- a BMI implantation
for the InterMind clinical trial.
- Cookie-cutter craniotomy, I assume.
- Single burr hole by perforator, separate dura fully
and a 5-centimeter by 5-centimeter flap
should be adequate.
Okay, if no one has any concerns...
- I'd like to be in the room.
- Do you know what happens when a neurologist finds
their way into an O.R.?
You get a lot more talking.
- Ha ha.
- This is your idea in my hands.
I assume you know where to find scrubs.
- Um, do you mind if I play some music?
[ Classical music playing ]
- Final dural tack up.
Ready to place the first array.
We're at his motor cortex. Our spot is right--
- The blood vessel sitting across the gyrus--
should we get medial to that or...?
- "We"? - You.
- Actually, I'd go with lateral.
That's the highest yield location.
- That makes sense. - Arm please.
- Ohh.
Smaller than a baby aspirin
with 100 minute electrode sensors
that will detect brain cell electrical activity.
It's so small, but it's so huge.
- You done? - Sorry. Yeah.
- Ready to implant the sensor.
Let me wait for the brain to move toward me
and... arm.
[ Arm whirrs ]
♪
- [ Speaking in Russian ]
- [ Man yells in Russian ]
- Neuro exam is stable. Vitals are good.
Roman is on track for a healthy recovery.
- Nice work, Dr. Nichols.
- Now that the device is in,
are we installing apps into his mind?
- Sometimes when I close my eyes, I see Candy Crush.
- More like calibrating the decoder.
I'm showing Roman words on a screen,
and then he's saying them out loud in his head.
- So his brain signals correspond to different words.
- Like sign language with neurons.
- We're reading his body signals as he tries to speak.
- Which, after the training,
will allow him to generate words of his own and sentences.
- It'll translate from Russian to English and vice versa?
- Yes, I've programmed a tool for just that purpose.
The initial phase of training protocol is complete.
- So now what? Do I just...
- Talk to him,
just like you would any other patient.
- Uh...
Um, hi, Roman.
Uh...
is there something you'd like to say?
♪
- This is worse than the three dots when someone's texting you.
- Is the language model working?
- Maybe check the cable connection?
- He hasn't used words in a really long time.
He might just need a second.
♪
- Wait. Something's coming through.
♪
"Scratch my nose." - [ Woman laughs ]
♪
- Okay. Uh...
♪
- He says thank you.
♪
- Roman, can you hear me?
- I could always hear you.
Now I can understand you.
It's nice to officially meet you, Dr. Wolf.
- You know my name.
- You brought me a fern.
Played me Bach.
Though, I prefer Stravinsky.
Got me the microchip. Of course I remember your name.
- Well, it's nice to officially meet you, too, Roman.
Truth be told, I don't know anything about you.
How did you get here?
- I came here from Chechnya.
I didn't have a choice. I had to leave.
It was exciting, but scary to be all alone.
I knew some English.
- Hey, watch where you're going. Idiot!
- Americans speak so fast. - Open your eyes.
[ Ship horn blows ]
- Sometimes I felt like I was living in a dream.
Seeing things I had only heard about my whole life.
I found comfort in small pleasures.
We have better shashlik in Russia.
But you have better pizza.
Eventually, I found a job that paid cash.
I needed to send money home and save enough to hire a lawyer
and apply for asylum.
It wasn't easy, but... - $10 an hour.
- ...I didn't have options. - The best I can do.
♪
- My boss gave me an old bike.
It was the fastest, cheapest way to get around.
I rode everywhere...
Coney Island, the Brooklyn Bridge,
the East River.
I loved America in those moments.
No one knew I didn't speak the language
or that I wasn't supposed to be here.
On my bike, I belonged. I was connected to the city.
♪
[ Horn blares, metal crashes ]
May I ask you a question now?
- You must have so many. - Just one actually.
Will I ever get better?
- Um...
given the amount of time that's passed since your stroke,
I don't expect that you'll regain any movement.
But that doesn't mean you can't live a rich life.
- And the tube in my throat?
- We tried to help you breathe without a ventilator,
but unfortunately,
your lungs are too damaged from multiple infections.
Roman, is there anyone I can call?
Family? A friend maybe?
Anyone?
♪
- I can't believe we did it.
- [ Laughs ] Oh, so you doubted me?
- You? Never. Dr. Wolf however...
- Alright. That's enough. He came through.
- Excuse me. - You're excused.
- I was thinking I would love to bring some investors
to meet with Roman.
It's important that we show success outside
of our research program and clinical circle.
Show that we're no longer in the realm of science fiction.
- Absolutely. This technology is incredible.
It'll open up an entire population of patients
we're unable to communicate with verbally.
Patients whose mental health is an afterthought
or completely disregarded.
- I never even considered the psych perspective.
An oversight that could perhaps be avoided
if we had a psychiatrist on our board.
- [ Chuckles ]
♪
- Good evening, Roman. You're looking good, man.
Fresh.
- My mother would tease
I look like Rasputin when I forget to shave.
- Damn, man, not Rasputin. [ Chuckles ]
- It's funny the things that make you feel human.
Feeling clean skin, physical touch.
That day you gave me a shave, I needed it.
I needed to remember that I was still alive.
- I'm not supposed to say stuff like this,
but I wish we could do more.
I'm so sorry, man.
- Please don't be.
I could never repay you for what you've already done.
- Don't even sweat it.
- I have one request, if I may.
I've been thinking about it for a while,
and I didn't have a way to say it before.
But now I can.
And I'm certain.
I don't want to live like this anymore.
♪
- Are we sure that's what he meant?
John Doe wants to die? - His name is Roman.
And yes. However, I have assured him
there is much more we can do,
and we will exhaust every option.
- We've projected onto him for weeks.
Thoughts, desires, a name.
Now he's telling us who he is,
and for better or worse, what he wants.
- I thought assisted suicide was illegal in New York.
- It's not assisted suicide.
It would be palliative withdrawal
of mechanical ventilation.
We're not actively ending Roman's life.
We're just removing the machines that have been prolonging it.
- It is an ethical gray zone for some,
but it is definitely legal.
- Would Roman's death impact Dr. Gadson's clinical trial?
- The implant's meant to enable communication.
On that metric, Roman's already a success.
Mortality also matters,
but it's not mortality related to a device malfunction.
Either way, that's not a good-enough reason
to keep Roman alive against his will.
- Okay, but what was the purpose of the surgery
if Roman wanted to die all along?
- To restore his autonomy.
Sometimes that means giving a patient the ability
to make a decision you might not agree with.
- So y'all are cool with this?
We can't just give up.
- Roman just learned of his full prognosis for the first time.
We have to give him a chance to come to terms with it
and imagine a new life, one he actually wants.
Leave no stone unturned.
Find a reason for Roman to want to live.
[ Monitor beeping ]
♪
- Careful.
I was the captain of my high school chess team.
- Check. You're out of practice.
♪
You sure you want to do that?
Try again. I like second chances.
♪
- You said you came to America seeking asylum.
Why?
[ Siren wailing in distance ]
Roman...
- Embrace the quiet, Doctor.
It is the key to chess...
and other things.
Checkmate.
You're on your phone a lot.
- I'm anxious-avoidant.
And so are you, it seems.
You didn't answer my question.
Why did you leave Chechnya?
- Oh, man. - What happened?
- Someone call 911. - Call 911.
He don't look so good.
- Is anything broken? Do you need an ambulance?
- I'm okay.
- I'm calling 911.
- No! No police.
[ Siren wailing in distance ]
- Is that guy okay?
- I had $500. No papers.
They told me I was safe until my asylum appointment.
But I didn't know.
What I did know...
I could never go back to Chechnya.
♪
Those were my last thoughts before everything went black.
♪
[ Sighs ]
- You didn't answer my question.
Why did you leave Chechnya?
♪
- For love.
♪
- Big news. Roman isn't alone.
Jacob, go to the warehouse by the pier where he works.
See if anybody has stopped by to look for him.
Ericka, check out his old apartment.
I've texted you the address.
Van, call immigration, social services.
I've already started a deep dive online.
♪
Ready, Alex?
[ Telephone ringing ]
- Roman.
Can he hear me?
- Yes.
- Alex.
- Rome.
Rome...
♪
- That's why he came to America.
- It's illegal to be gay in Chechnya.
Friends and family turn their loved ones in.
And those suspected are persecuted,
abducted, even killed.
- Let's give them some privacy
so they can catch up without an audience.
♪
How did you two meet? - In school.
We both loved astronomy and dessert.
This one is not bad.
When I got here,
I checked every hospital, police station, shelters.
I searched for Roman every day.
I thought that I might never see him again.
No one knew where he was or what happened.
But you do.
- We pieced it together.
Uh, Roman was thrown from his bike.
His head must have gone forward and back very quickly.
We call it whiplash.
At first he thought he was okay,
but then his neck started to hurt.
He didn't go to the hospital because he was afraid.
He thought he'd be fine.
But the injury caused a clot in an artery
that supplies blood and oxygen to the brainstem.
Roman had a massive stroke.
Now, the parts of the brain
responsible for thought were unharmed.
But because he was almost entirely paralyzed,
no one knew he was still awake, still himself.
- So if he had gone to the doctor after the accident...
- I know you've heard his decision.
- Roman can be quite stubborn when his mind is made up.
- Well, if we are able to convince him otherwise,
he would be able to leave the hospital.
Then the question would become does he return to long-term care
or does he go home with you?
- I would love him home.
♪
- I want to make sure you understand what this means.
There will be nursing help,
but a tremendous responsibility will fall to you
between his tracheostomy tube, the ventilator...
- I will do it.
I will do it.
It was my idea for us to come here.
I'm the one who speaks English.
I was always planning to care for Roman.
It just looks different now.
- [ Chuckles ]
Um, as we say in our country,
Alex is a prince among men.
You're very lucky. - Very.
Not a lot of options where we come from.
- If only I had the same excuse.
Dr. Nichols is taking Alex through the post-op
dressing changes and troubleshooting device.
My interns are working with the respiratory therapists
to train him on suctioning your tracheotomy tube
and responding to ventilator alarms.
And Dr. Dang is searching for first-floor apartments
to move you home.
- No, I told you, Dr. Wolf. I don't want that.
- But Alex wants to-- to care for you.
He understands what is required.
You came here to be together.
He still wants that.
Don't you?
- [ Sighs ]
Before you,
all I wanted was to be released from the misery
of being an able mind trapped in a useless body.
I made my decision then.
But then, uh, in between,
you afforded me so much.
You gave me my voice back.
You gave me my love back.
[ Chuckles ]
And now...
I need you to give me one more thing.
- I'm reading about these experimental technologies
that I think could make--
- As much as I appreciate your efforts,
I don't want this version of life.
Not for me or for Alex.
- Why did you ask me not to leave you
if you knew you wanted to go?
- I had been passed from hospital to hospital, doctor to doctor.
I needed someone to stop, look at me and listen.
- Who is that?
- Yes, this is John Doe.
No I.D., no medical history,
no family.
Transferred from hospital to hospital
every time he gets a new infection.
Now he's ours.
- You saw me when no one else did.
Which is ironic, because they tell me you can't see faces.
And because it seems like you don't see me at all anymore.
- Wolf, put yourself in Roman's shoes.
You'll never walk, talk, swim,
or obsessively care for a fern again.
- That's not a fern. - What would you do?
- Adapt and Roman can, too.
Many locked-in patients report being relatively happy
across multiple studies.
- But Roman is not just dealing with locked-in.
He's vent-dependent, which is an acceptable quality of life
for some, but not for him.
- He must be depressed. Can you talk to him?
Assure him that there are other paths that we can explore?
- I know you want to save his life, Wolf.
You're attached. - That's not a bad thing.
- It's a beautiful thing.
That's what makes you the doctor you are.
Roman came here seeking the ultimate freedom
and ended up in the ultimate prison.
You've done so much, more than any other doctor would.
But not every patient can be saved, Wolf.
Not every patient wants to be saved.
- Can you talk to him and try, please?
For me?
- Yes, but if he has capacity, it's not up to us to stop it.
Why would we give Roman a voice just to ignore it?
- Alex was supposed to come first.
He planned it out, but things changed.
At the time, it scared me.
- And how do you feel about it now?
- In a strange way, I feel... content.
I have everything I wanted.
- Hmm.
Many people with locked-in syndrome report happiness,
and they go on to live for decades,
particularly those with dedicated caretakers.
- [ Chuckles ]
Good for them.
I'm at peace with my decision.
- [ Chuckles ]
Your ability to reframe the narrative,
it's... it's quite impressive.
- I've had a lot of practice and time to think.
Coming to America,
taking a leap of faith to create a life with Alex,
having him with me in the end, that's my story.
- And what about Alex?
- Alex will be okay.
He'll fall in love again.
Write a new story for both of us.
♪
[ Horns honking ]
- Are there any innovations we could try?
Robotic limbs? Exoskeleton? Clinical trials?
I read about a study with a guy--
- I don't think another clinical trial
is what Roman's asking for, Wolf.
- I want to be a good doctor.
I want to see his perspective.
But we've come so far just to let him go.
I can't, not with him.
[ Siren wailing in distance ]
- What you do best is allow your patients to see
the world the way they want to.
You honor who they are, what they choose.
Even if you disagree.
I admire that about you.
Yes. Do you know how many lives I've saved
only to have patients relegated to states
they find unacceptable--
states I would find unacceptable?
The decision he made is hard.
If we're good doctors, we honor it.
♪
- We'll administer morphine to make sure you're comfortable
when we decrease the ventilator settings.
And then when we take you off the vent,
we'll give you more meds to ensure you're not anxious
or struggling to breathe.
Then... you'll... pass away.
Okay.
Would you like to speak with a chaplain or a spiritual advisor?
- No.
- Alright.
[ Voice breaking ] Just one more.
- You're disappointed in me.
- N-N-Not at all.
I guess I used to imagine who you were.
What you wanted.
What your life would look like after everything.
And it... wasn't this.
Is there anything we can do [sniffles]
to support you in your final moments?
- Remember that day you and Dr. Nash took me outside?
- If there's any psilocybin in his system,
then he won't be able to participate
in the sleep study, but thank you. Yeah.
- We need to take Roman home. - To Chechnya?
I suppose a medflight's not out of the question,
but-- - Not home home. A home.
He needs to get out of the hospital before tomorrow for...
- For when he leaves us.
- He doesn't want to die in the hospital.
♪
- Oh. - Okay.
Ostrich ferns don't particularly like to be trampled, Dr. Markus.
- Copy that.
- [ Chuckles ] This--
- Uh, no.
- Dr. Wolf. Do you ever let anyone in?
- You're here. I let you all in.
I'm regretting it with each passing moment.
- He meant in your heart.
♪
- Thank you for bringing me here.
It's much better than the hospital.
Very homey.
- That's what I thought when I first saw it.
It was on my swimming route. It reminded me of my childhood.
- I used to love to swim. When I was young,
my father and I would go to this crystal-blue alpine lake
in the summers called Kezenoy-am.
- Hmm. Sounds much nicer than the Hudson.
That's where my father taught me.
- Do you see your father often?
Me neither.
Even before I left, we agreed on nothing
but our love for each other and swimming.
- I find opposite perspectives and mutual respect
make a good team.
- You know who makes a great team?
You and the tall doctor.
- Carol's actually not that tall.
She's just obsessed with high heels.
- No, the surgeon. He likes you.
- [ Laughing ]
Dr. Nichols? Yeah.
No. Okay.
I mean, I think you just caught us on a good day.
♪
- Take it from a locked-in patient.
There is no time like the present.
♪
- You're doing the right thing.
I hope you know that.
- 200 billion trillion.
That's how many stars there are in the universe.
Whether you're in Grozny or New York,
we all see the same incandescence.
To ancient cultures, these stars were alive
and animate.
Their celestial bodies of light
every bit as real as our earthly ones of flesh.
That's why they named them.
Capella.
Pollux. Mirfak.
And my favorite, Vega and Altair.
♪
In Chinese folklore, they represent forbidden lovers
who were separated by the galaxies.
But in spite of their great distance,
they always, always stay connected by their hearts.
♪
- ♪ Think about it ♪
♪ There must be a higher love ♪
- [ Speaking Russian ]
- ♪ Life is wasted time ♪
♪ Look inside your heart, and I'll look inside mine ♪
♪ Things look so bad everywhere ♪
- [ Speaking Russian ]
- ♪ We walk the line, we try to see ♪
♪ Fallin' behind in what could be ♪
♪ Bring me a higher love ♪
♪ Where's that higher love I been thinking of? ♪
♪ Worlds are turnin', we're just hanging on ♪
- Roman.
- ♪ Facing our fear and standin' out there alone ♪
♪ A yearning ♪ - It's time.
- ♪ And it's real for me ♪
♪ There must be someone who's feeling for me ♪
♪ Things look so bad everywhere ♪
[ Monitor beeping rapidly ]
♪ In this whole world, what's fair? ♪
♪ We walk the line, we try to see ♪
♪ Fallin' behind in what could be ♪
♪ Bring me a higher love ♪
♪ Where's this higher love I been thinking of ♪
- Remember those investors I scheduled to meet Roman,
all eager to see the successful implantation of the device
that they funded? - Look, Simon--
- Imagine their surprise
when I had to cancel the visit last minute
because your nurse just informed me that Roman is dead.
This is exactly why I didn't want to work with Wolf.
And now I can see that you're just as reckless.
That device was created to save lives, not end them.
- It was what was best for the patient.
Surely you wouldn't want him to exist purely for research.
- His death is on the record as a mortality
within the first 30 days of the device's implantation.
Do you know how bad that looks?
Our goal is to revolutionize many lives, not just one.
- You gave Roman a voice. As his doctors, we respected it.
Isn't that a revolution in itself?
- I had thought that this was the start
of a prolific partnership with Bronx General.
Clearly, I was wrong.
♪
- If you are here because I took Roman out of the hospital,
please do me a favor and just file an official grievance,
because I really don't feel like talking about it.
- I'm checking in to make sure you're okay.
- What? I'm-- I'm fine.
I need to start my rounds.
- Well, before you leave, I just have to say that I'm surprised.
After all you did for Roman,
that... you just seemed to give up so easily.
- There was nothing easy about what we did.
It was the single hardest decision I've ever made.
- Well, it's just not like you, Oliver.
I thought that you would have tried harder
to convince him to stay alive, to give it a chance.
- You think I gave up?
You think I didn't try hard enough?
Let's talk about giving up. - Oliver...
- Whenever Dad was in a bad place,
you just spent more time at work.
When you knew he couldn't be fixed,
you just stopped trying.
You let him become a shell of a man, and then you left him.
But you think I should try harder?
- After all these years, you're still trying to fix him.
And it doesn't matter how many patients you treat, honey.
It's not going to bring him back.
And the sooner that you deal with this,
the sooner you will stop making decisions
that primarily serve you.
- What I did was for Roman.
His choice, not mine.
- A choice that hurt this technology,
other patients out there who could benefit from this.
- I will always focus on the patient right in front of me.
- Huh.
I'm glad you have that privilege.
- You and I are never gonna see eye to eye, Mom.
If you want to terminate me because of that, then do it.
That's on you.
♪
- Hey, Ericka.
You holding up?
- If stuff like that comes with the job,
I'm glad we have each other.
- I've been wanting to ask you something,
and I could be totally off base here,
but, um, the past couple of days,
I've been getting a sense that you have, uh, feelings.
Good ones, big ones.
- You felt that? - [ Sighs ]
- Of course you did.
You're right.
I am.
I do.
[ Whispers ] Please don't tell Jacob.
- ♪ I was distracted and in traffic ♪
♪ I didn't feel it when the earthquake happened ♪
♪ But it really got me thinking ♪
♪ Were you out drinking? ♪
♪ Were you were in the living room? ♪
♪ Chilling, watching television? ♪
♪ It's been a year now ♪
♪ Think I've figured out how ♪
♪ How to let you go and let communication die out ♪
♪ I know, you know, we know ♪
♪ You weren't down for forever and it's fine ♪
♪ I know, you know, we know ♪
♪ We weren't meant for each other and it's fine ♪
♪ But if the world was ending, you'd come over, right? ♪
- I always had this wish that after I moved to New York,
I would see Alex on the street.
He smiles at me.
I run toward him,
and we kiss right there in the middle of everything,
and no one would look at us or care because we were free.
- ♪ If the world was ending, you'd come over, right? ♪
- What's wrong? - Nothing.
I just wish I could have given that to you
and Alex.
- You did.
My question to you is...
- ♪ If the world was ending ♪
- ...what are you waiting for?
- ♪ The sky'd be falling and I'd hold you tight ♪
♪ No, there wouldn't be a reason why ♪
♪ We would even have to say goodbye ♪
♪ If the world was ending ♪
♪ You'd come over, right? ♪
♪ You'd come over, you'd come over, you'd come over, right? ♪
♪ Yeah ♪
♪ If the world was ending, you'd come over, right? ♪
♪
- Greg, move your head.