Season 2, Episode 10:
In a Boston mental institution, Thomas Jerome Newton performs brain surgery on a patient, Mr Slater, who keeps repeating "Heather" "flowers in her hair", and a "girl in a red dress". Newton successfully removes part of his brain, but he and his team are forced to leave before they can seal the man's head back up. The Fringe team of Olivia, Peter, and Walter arrive at the institution and learn that Slater's paranoid schizophrenia was apparently cured by the operation, and that his brain is still structurally intact.
While viewing security footage, Olivia recognizes Newton, the leader of the shapeshifters who was re-animated from a cryogenically frozen head in "Momentum Deferred." Astrid and Walter research the patient's physician, Dr. Paris, and learn he set up an indefinite prescription fourteen years ago for Slater as well as two other patients in the same week. Peter and Olivia interview one of these other patients, who constantly thought about the number 28, but was recently cured of her obsessive compulsive disorder by Newton. She tells them she was originally sent to the hospital by Dr Paris for mild postpartum depression, and that her obsessive compulsive disorder started soon after. Peter and Olivia also hear of a third patient who was mysteriously cured two days ago. Walter realizes that all the patients were given constant doses of organ transplant medication, and that foreign brain tissue was stored in each of their brains.
Walter undergoes a CT scan, and the team learn Walter had three pieces of his brain tissue removed from his hippocampus, the primary repository for long-term memory. The pieces were then apparently stored inside the brains of the three patients fourteen years ago. Knowing only Walter could comprehend the memories concerning how to open a portal to another reality, the shapeshifters kidnap him. By the time the others find Walter, Newton has already learned what he needs to know and escapes. Olivia manages to stop them, but is forced to choose between seizing Newton and saving Walter, as he has been given a neurotoxin that will kill him unless Newton gives them the correct directions. Olivia chooses to save Walter's life, and Newton replies "Now I know how weak you are".
Broyles eases Olivia's concerns that she made an emotional choice by assuring her that her decision to save Walter was a logical one as Walter is highly valuable to the team.
As Walter undergoes a follow-up MRI, he flashes back to a past surgery, where he is being operated on by William Bell (AKA Dr Paris), who removed Walter's brain fragments and hid them in the patients' brains to prevent anyone else from gaining the information.
Tropes found in this episode:
- Actor Allusion: Dr. Paris as an allusion to Leonard Nimoy's character on Mission: Impossible.
- Artistic License Medicine
- Many physicians do not belong to the AMA, which is a professional society. Searching state medical licenses would make more sense.
- If you assume the "RX number" referred to by Walter is the DEA number, it does not have enough digits. The number Astrid types in is 39345-48. DEA numbers typically consist of 2 letters and 7 numbers.
- You would not be able to access prescription records or any patient information from the AMA website.
- Prescriptions can not be unlimited. The longest period refills can be ordered for is 1 year, and for some medications the period is shorter.
- Dr. Paris prescribed these drugs in 1995, but Sirolimus was not FDA approved until 1999, and Basiliximab was not FDA approved until 1998.
- All of the drugs prescribed require very careful monitoring as they can cause low white blood cell counts putting an individual at risk for infection. They also have other life threatening side effects such as liver failure. It is difficult to conceive how someone would remain on these medications if they were not known to have a transplanted organ.
- Also, Muromonab-CD3 is an injection which is only given for steroid resistant acute rejection of a transplant, and is not used to prevent organ rejection.
- The abnormality pointed out by Walter on the MRI looks nothing like an artifact or "machine error", although there is another prominent artifact on the MRI image in the lower left corner.
- The MRI abnormality has a signal of the same intensity as the CSF fluid and appears to be a cyst (fluid filled hole) in the brain, not abnormal/transplanted brain tissue. There may have been a thin outline of abnormal signal around the cyst on the images, so maybe we were supposed to assume most of the transplanted tissue died leaving a hole, but a thin rim of the transplanted tissue did survive around the cyst.
- The MRI image on the lower right side shows T2 signal change in both temporal poles. Without more images it is difficult to say, but this may very well be the MRI of an individual with CADASIL and the abnormality pointed out by Walter is an old lacunar infarct.
- The craniotomy exposed the left and right occipital lobes, but the abnormal tissue was shown to be in the lateral left temporal lobe.
- 50 mg of Valium is 10 times the standard dose and out of line, even if someone has tolerance.
- Diaphoresis and nausea would not occur from a one time higher then normal dose of Valium, but from withdrawal from long term use of benzodiazepines. It is not clear why Walter tries to explain his symptoms as being from miscalculating the Valium dose.
- The abnormalities noted in Walter's brain are not in the hippocampus, but in the lateral temporal lobe.
- There may be cells in the hippocampus that respond to very specific stimuli, but removing the hippocampus would not remove these memories as this cell in part of a large population responding to the specific stimuli. The hippocampus is important for consolidating short term memories into long term memories, but the memories are stored elsewhere.
- When Walter becomes more coherent and confident after the brain tissue is integrated back into his brain, it implies that the resection of his hippocampus resulted in his current mental disorder. This is doing a disservice to individuals with medically refractory epilepsy, who may be offered surgical resection of the hippocampus as a cure for their seizures. This procedure actually has a low rate of complications.
- Brain in a Jar: Reconstruction where the tissue samples are briefly seen in a suspension, but Walter says that brain tissue can not survive longer periods in a nutrient suspension as they die without electrical stimulation. This need for electrical stimulation is not explained, but may keep the brain from dying because of lack of sensory impulses or loneliness.
- Continuity Nod: Walter and Astrid are listening to Thelonious Monk in the lab. A picture of Monk was prominently diplayed on the wall of William Bell's WTC office in 'Momentum Deferred'.
- Drugs Are Bad: Inverted Trope, Walter's drug use is consistently treated as a laughing matter. Inhaling benzene is presented as a fond memory.
- Laser-Guided Amnesia
- Losing Your Head: While brains can not survive without electrical stimulation, there does not seem to be any problem with the brain if you take the whole head and freeze it, as evidenced by Thomas Newton.
- Napoleon Delusion:Peter: Apparently Mister Gordon thought he was the actor Sydney Greenstreet — and walked around quoting Casablanca.
- Perfect Poison
- Super OCD: Arithmomania is an obsession with counting things, not an obsession with a specific number.
- Technicolor Science: Blue, yellow, red antidote.