John Q Page #4

John Q. and Denise stare nervously at the fleshy fist-sized organs on the translucent glass.

DR. TURNER (CONT'D)

There are septal defects here, here, and here, which have induced a myopathy resulting pulmonary edema, and malignant ventricular ectopy. As you can see, Mike's heart is approximately three times normal size.

He points to Mike's heart, huge in comparison.

J.Q.

I'm sorry. I don't understand. Could you pout that in layman's terms?

DR. TURNER

Of course. Basically, there's not enough blood being pumped by the heart, so it backs up in the lungs. Sort of like a sponge getting wet. Mike's heart is trying, but I'm afraid it's working too hard.

J.Q.

So what's he need? An operation?

Turner gathers himself, takes off his glasses.

DR. TURNER

I'm afraid we're considerably beyond the point of corrective surgery, Mr. and Mrs. Archibald. Your son's heart is useless. He is going to need a transplant.

The room goes silent.

DENISE:

He's nine.

PAYNE:

Wait a second. There are other options.

J.Q.

What options?

PAYNE:

To do nothing. Medicate him. Keep him as comfortable as possible. You need to start thinking about quality of life now.

DENISE:

I don't understand. We were just with him. He seemed fine.

DR. TURNER

He's going to seem fine. But as his heart gets worse, he will become increasingly fatigued, need more and more sleep, until one day, he'll go to sleep and he won't wake up.

PAYNE:

I know it's difficult, but you must face the fact that your son may not have much time left. You might want to make it a happy time. Say goodbye.

DENISE:

Oh my God.

PAYNE:

And transplantation is a high risk operation. You could lose your son on the table. You may not want to take that chance.

J.Q.

What do you think, Dr. Turner?

DR. TURNER

This isn't my decision.

J.Q.

I know that. I'm asking for your opinion. Without surgery, how long does he have?

DR. TURNER

Not long. Months. Weeks. Days.

This is too much for Denise. She breaks into tears. John puts his arms around her, steadies her, gathers his thoughts.

J.Q.

What would you do if it was your son?

PAYNE:

Mr. Archibald...

J.Q.

Not you. Him.

DR. TURNER

I'd do the transplant. Absolutely.

J.Q. looks at Denise, who nods.

J.Q.

Okay. Let's do it.

DR. TURNER

The first step is to get Mike's name on an organ recipient list. Once he does, his chances are very good. Your son's an extremely rare type so there's less demand. With B-positive blood, Mike could go to the top of the list right away.

PAYNE:

It's not that simple. There are other considerations before a prospective recipient is placed on the donor list, Mr. Archibald. The cost of transplant surgery is expensive. In most cases, prohibitively so.

J.Q.

I've got major medical. Don't worry, I'm covered.

PAYNE:

Actually, we've already checked with your carrier. There's no provision in your policy for a procedure of this magnitude.

J.Q.

There must be some kind of mistake. My son is covered. I've got full medical. He's covered.

PAYNE:

What about you, Mrs. Archibald? Do you have coverage?

DENISE:

No. I've only been working at the market a short time. You need to be there two years before you get benefits.

Payne flips through the Archibald family file.

PAYNE:

I see that you don't own your own home. No investments, stocks, bonds. And you have a little over one thousand in savings.

J.Q.

Did you hear what I said? I'm telling you, I'm insured.

PAYNE:

That may very well be, but you'll have to check with your carrier on that. In the meantime, I'm afraid we're going to have to treat you as a cash account.

DENISE:

How much does a transplant cost?

PAYNE:

Transplant surgery, doctor fees, post operative treatment and immunosuppressant drugs, you're looking at two-hundred and fifty-thousand dollars minimum.

J.Q.

What are you saying? If I don't come up with a quarter million dollars you're not going to treat my son?

PAYNE:

We have treated him. We continue to treat him. Now I understand how upset you are, sir. But with other options available, we are not obligated to cover a procedure this costly. If you opt for replacement surgery, that's your choice. But the hospital maintains a very strict policy with respect to cash patients. We require a down payment before the patient's name can be placed on the receiver list.

DENISE:

What kind of down payment?

PAYNE:

Thirty percent. Seventy-five thousand.

J.Q. Seventy-five thousand dollars to put my kid's name on a list?

DENISE:

Our son is upstairs dying and all you can talk about is money?

PAYNE:

Yes, it takes money to provide health service. It's expensive for you and for us. My job is to keep this program alive. For everyone. Now, I'm sorry, but we need you to guarantee payment before we can place your son's name on the list.

INT. HALLWAY - CARDIO-THORACIC DEPT. - DAY

J.Q. and Denise move down the hallway towards the elevators.

DR. KLEIN (O.S.)

Mr. and Mrs. Archibald?

They turn.

J.Q.

You don't want to treat my kid? Fine. I'll take him over to County Memorial.

DR. KLEIN

Trust me. You don't want to do that.

J.Q.

I don't, huh? Watch me. It's a county hospital. They have to treat him.

DR. KLEIN

No they don't. Transplantation is always considered an elective procedure. This hospital's politics are particularly infuriating, but you're in the right place. Believe me. You want Dr. Turner. His bedside manner is terrible, but he's one of the foremost surgeons in the country.

J.Q.

What do you want us to do? You heard Payne. We're a cash account.

DR. KLEIN

I know it's outrageous, but don't give up. Talk to your insurance company. Check with our Human Resources Department for medical assistance, State Children's Services, Medicaid. Just don't take no for an answer.

INT. NEIMAN MACHINERY PLANT - EMPLOYEE SERVICE OFFICE - DAY

John sits in a cubicle across from his employer's insurance representative.

INSURANCE REP.

You coverage has changed, Mr. Archibald.

J.Q.

Changed?

INSURANCE REP.

We've recently switched carriers from a PPO to an HMO. It's a less expensive policy, but unfortunately it has some restrictions.

J.Q.

What kind of restrictions?

INSURANCE REP.

This is how it works. Non-management, part-time employees such as yourself only qualify for second tier catastrophic coverage.

J.Q.

But I'm not part-time. I'm a full-time employee. It's just slow right now.

INSURANCE REP.

Sure. But your coverage is based on house worked. Like I said, you only qualify for second tier, and that has a maximum payout limit of twenty-thousand dollars.

J.Q.

Wait a minute. I've been paying for my coverage for years. You take it out of my paycheck every week.

INSURANCE REP.

And that's why we're going to cover you for the full twenty.

J.Q.

Let me get this straight. You drop me from full-time to part-time, switch carriers, and now you're telling me I'm not fully covered even though I have a policy that says I am.

INSURANCE REP.

Doesn't seem right, does it?

J.Q.

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