Passage

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An old nursing friend of Jackie's checks into All Saints with late stage lung cancer and one small request: for Jackie to help her check out before it's time to go to the hospice. Dr. O'Hara offers to help, but it's all nurses around her bedside at the final toast. Zoey spends the whole time trying to reconcile her ethical issues with her very real need to get as close to Jackie as possible, but pulls it together after a hardcore and very admirable speech from Big Pharma Eddie about how none of this is actually about her: It's about Paula, or as we like to call her, "BJ Poteet."

Meanwhile, Fitch Cooper's Two Mommies arrive, one with a gall bladder problem, and before you know it he's grabbing Eleanor's boob mid-surgery and discussing his Tourette's and OCD, which are apparently real, with his other mom, Swoozie Kurtz. The fact that Swoozie Kurtz is once again playing Swoozie Kurtz shouldn't surprise anybody, but it's the birth mother that's the real surprise: Swoozie's real-life BFF Blythe Danner, whose real-life daughter is the only person with more airquotes around her life than Coop himself. All in all, especially given the subject matter, it's a pretty light episode. But given that we're halfway through the season, and the last couple have been pretty intense, that's probably for the best.

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The girls are sitting at the bar, drinking virgin cocktails, while Jackie works on Fiona's sunflower costume with a sewing machine right up on the bar and discusses private school opportunities with Grace. Immaculate Virgin is out, Grace says, because the nuns whack you with a ruler. Fiona offers to whack them back, and her father cautions her against whacking nuns, ever, but Jackie tells them that corporal punishment has been illegal since some date neither she nor Kevin knows. Fiona asks what purple punishment is, and Grace corrects her: it's corpal punishment, and they only do it for your own good. Sort of Jackie's whole approach. Also God's.

Kevin says they whacked him plenty, and Jackie of course curtly suggests that in his case it was necessary, and also could the girls please finish their dinner. Fiona asks to go to private school with her sister, and Jackie points out that then, there would be nobody to play the sunflower in the "What's So Great About Mother Earth" pageant. Fiona grabs her cocktail off the bar and allows as how she forgot that part. It's easy to forget how essential sunflowers are, until you leave them out.

Seems like a crazy homeless lady hanging out, smoking under a giant statue of Jesus, but by the way Jackie greets her, she's either a very special homeless lady or not a homeless lady enough. I'm no doctor, but headscarf + generally hellish looking + rampant, bloody-sounding coughs generally = lung cancer. Unless you cough blood into a napkin and it's a hundred years ago, because that's automatically TB. In this case, it's the former; Jackie cautions her friend against smoking, and she laughs. "I know! It'll kill me!" And the time it takes to finish the job, Paula says, is directly proportional to how shitty her luck is. She blows the smoke in Jackie's face, and Jackie loves it, breathing it in with a satisfied hum.

"Paula. I'm so sorry." Paula laughs at Jackie, at how she's remained so civil after all their years working together in "this crappy so-called place of healing." Jackie returns the compliment, which cracks them both up, because as Paula says, they both know she's always been a bitch on wheels. Jackie's brows knit together. "How are you doing," she asks, and Paula grunts. "That prick Singer, in Oncology?" Jackie nods. "He says I'm out of options today." It's time to move into the hospice, for palliative care. "Palliative care my ass." She turns to Jackie with almost a hint of something dark, a request outside the limits. Not because of what it is -- they're both attuned to what it is -- but because they both find asking for favors completely gross.

"Thing is, I want to go out a little sooner rather than later. With a shred of dignity." When they put her in hospice, she'll lie there until she's dead. "I'm up to my tits in tragedy! You know how the story ends." Jackie does, but you have to say the words. To cross the line, you have to say it out loud. She coughs. "So I want to go out with a little help from my friends." Line crossed. Jackie breathes.

When Jackie wheels Paula into the nurses' station, she's not even come to a full and complete stop before Paula and Mo-Mo are yelling at each other; even if she looks like shit, she says, at least she has an excuse. He tells her he's an RN now, and demands respect, and she says he'll always be an LPN to her. He's got both, actually, and what does she have? "Cancer," she says, and wins. "You big queen." He snaps gaily at her, but with a look at Zoey, who is working some things out about this situation, Jackie tells them both to chill.

"Some people are just too mean to live," he says to Zoey, to comfort her; to teach her how we do this, how we deal with this. How we smile when death comes, and how many directions that means we have to smile every day. She smiles, nervously; she is learning the rules of death, and where to stand. Paula asks her if Bed Five is still doing it's magic, and Mo-Mo clarifies: "They check in, but they don't check out." Zoey nods as Paula grins, "Sounds good to me."

Gloria enters, and life floods back into Paula for a moment; she does a little routine about how her name sounds like a disease -- "I got Akalitus," she says, shivering and palsied -- and Gloria asks WTF she's doing there. "Just passing through," Paula says, with a wink at Jackie, but Jackie keeps her head down. She tells Gloria they're waiting for a bed in hospice, and for a moment Gloria is sincere. "I'm sorry to hear that."

But Gloria doesn't have that right, and she certainly doesn't have the right to break the rules of death, so Paula rears up again, promising Gloria forgiveness for "all those years of shitty treatment." "I'm speaking personally, of course," she says, but of course she is not: she's speaking professionally. That's where Gloria belongs. And she knows it, finally returning the serve by telling Jackie to let her know if there's anything she can do to expedite matters, even insofar as pulling somebody else's plug to make room in hospice. Jackie stares, and as Gloria leaves, Paula hoots. "What a cunt!"

Jackie stands before an x-ray of Paula's lungs, exhaling in horror. It's all through there; it looks like what you find under an old tree's bark. "Friend of yours?" asks Elenor, and Jackie nods. They worked together for about fifteen years, here at All Saints, until she left about a year ago. And now Paula's at the nurses' station, giving Akalitus shit. "Nice," Elenor says approvingly, and watches Jackie's face. "Hard for you." It's a question, but she already knows the answer, she thinks. "You don't know the half of it," Jackie says meaningfully, and the temperature changes as Elenor absorbs this. "Oh," she says. "Are you going to do it?" she asks, and Jackie says she'd reciprocate. "...Do you want my help?" Elenor asks, and Jackie shakes her head, and cuts her off with thanks before she can offer anything else.

Nobody knows the rules of death. Nobody knows where to stand, who to be, what to say, how to make sure it's all about you, how to make sure it's not all about you, how to make sure everybody knows you know it's not all about you, which makes it all about you. The large things that happen, they're too big to fit into your head. It's like that dance in the doorway, when you and the person try to do the math and figure out who should stand aside. We make it up new every single time.

Elenor leaves, and Zoey arrives, dancing with her in the doorway for a moment before coming around behind Jackie and staring up at the film, mirroring her posture, desperate to help but more desperate to get closer to Jackie, to use this in some way she can't really consciously admit to herself to prove something to Jackie, that she can be of aid, that Jackie should love her specifically, because she understands Jackie, because she is the protégé.

And if you said this to her you'd wound her terribly, but you wouldn't be wrong. She's just dancing in the doorway because she doesn't know what else to do, and because her job now is to be surrounded by death, always with different meanings and different stories and different degrees of pain and accountability attaining to it, and if she can't stand like Jackie -- back arched, arms crossed, reading the x-ray like tea leaves -- she won't know how to stand at all. But this death is special, because this death, in some way, is happening to Jackie. Which means all the rules go out the window.

"Zoey," Jackie says, warningly and tenderly and exhaustedly. She scatters.

Fiona calls, tented in her bedsheets, wearing her sunflower costume, asking Jackie for permission to wear it as pajamas, to bring the sunflower with her all through the night, and to please not tell Daddy that she's still awake. Jackie laughs. In this moment she would promise her daughter anything.

"Okay bye," says Fiona, and hangs up. She never hears her mother's panicked begging, in the bright shadow of that x-ray film, to stay on the line for just a second longer.

Then it's later, and they're wheeling in B

lythe Danner, who is suffering abdominal pain, and who is Fitch Cooper's mother, and who was forced to go to the hospital by Leslie, and who believes she just needs a Tums before she can go on her way. She asks him to have a look, and he protests that it's against the rules to treat family. "I gave birth to you, put you through med school. At least have a look. Don't be such a baby, Fitch." He complains, noting that among the other illegalities and indignities, he hasn't seen her stomach since he was a child.

Coop hurries Elenor over, but squeals as she's palpating her: "You're hurting my mother!" Eleanor tells him to calm down and calls him a ninny, and of course Mrs. Cooper reacts to that, and then beckons him to her bed with a crooked finger as they wheel her away. Leslie Scheinhorn -- Swoozie Kurtz -- arrives in the ER, complaining that it was Mrs. Cooper who insisted on coming to All Saints in particular, and he comforts his mother. She follows after the gurney, and Elenor stares at him. "I have two moms, yeah," he says offhandedly, and she looks him up and down. "Bravo, Dr. Cooper."

Paula's arms are shot through and Jackie can't find a vein. She requests crushed ice, "with a hemlock chaser," and Zoey suggests calling the hospice so they know she's coming. "I'm not going to hospice, Pippi Longstocking," Paula hisses, "Like I need more sad shit in my life? Put me in a room full of death." She tells Zoey she's sweet for asking, and turns to Jackie: "Christ?" Jackie sends poor Zoey off to get ice, and poor Zoey wongles off into the ER as weirdly as ever.

Into the bed door the EMTs wheel Cat Ball Guy from a couple weeks ago. This time it's his hands: the cat switched on the garbage disposal while he was fishing out a fork. "I'm waiting for a vascular surgeon, and 'someone from Plastics,' whatever the fuck that means," he groans angrily. Paula, from the bed over, offers her theory that he's "Cat Ball Guy" because he was naked and the cat pounced on his junk. Jackie swears she didn't tell her, and Paula laughs. "Cats are cats!" She tells a story about how one time a guy came in with his nuts in a baggie -- "Cat went apeshit on him!" -- prompting CBG to wheeze, "Who is she?"

Jackie closes the curtains, and nods when Paula suggests he should just kill the cat. No, that's not what she says. What Paula says is, "He needs to kill that cat." What Paula says is that something only has to hurt you so many times before you're ready to say goodbye.

Then it's later, and as Jackie pulls morphine into a needle, Elenor stands against a bathroom stall door, breezily: "You better not care more about that old nurse than you do about me, by the way." Inside the stall, Jackie worries over it; she'll need five times that much to get it done. Zoey comes looking for Jackie, but spotting Elenor, immediately disappears again. Jackie's voice is a little shaky as she tells Elenor it's better for her to leave for this part. "Nonsense. Nothing's better if I leave."

(I'm fairly certain I would adore Elenor in real life, and I love Jackie in all universes, and Coop is a foregone conclusion, but the proof that this show has accomplished creating its own tone and universe is the fact that I find Zoey hilarious and adorable on TV, but would hate her blackly in real life. If ever you think Elenor and/or Jackie are ever being bitches to her, remember that I would do worse. Gleefully. With malice of forethought. Nothing brings out my inner bully like this type of creeping, flesh-crawling awkwardness and aggressively tone-deaf inability to relate to human beings. On TV, my God she's awesome, but as an object lesson in what not to actually do, ever, she's like a red flag waving in front of a bull.)

Coop explains every single detail of her gall bladder surgery to his mother, finally prodding Elenor to ask if the textbook point-by-point was really necessary, and both moms assure her that it is. Mrs. Cooper likes to know everything before it happens, she says, and Mrs. Scheinhorn rolls her eyes: "She's impossible to watch movies with." Mrs. Cooper asks Elenor to let her son "assist in the opening of [her] abdominal wall," and Elenor finally relents, "as long as he doesn't touch anything." Which is a funny line, but we don't know that yet. So Elenor removes it, and he asks to see it, and he asks for a jar to put it in, and then his mother's BP drops suddenly, and he responds by grabbing Elenor's breast. She stares him down, he notices (or "notices") and lets go: "There's a good boy."

(It is vertiginous, though, because he's such a fraud and because I think he honestly doesn't know when he's defrauding, but we know from this episode that he did grow up with OCD and Tourette's, in some form, and although it's doubtful that he would act out like this consciously during his mother's life-threatening moment on the table, he's still such a giant asterisk that I don't feel we can definitively say what's going on. I'm sticking with "And neither can he.")

Then it's later and Zoey approaches Elenor with that weird professional voice she puts on whenever she's about to do something truly dreadful: "Doctor, can I have a minute of your time please?" Elenor, without looking up, replies in the affirmative. "Walk with me," Zoey says, and wanders off by herself. Eventually she comes back, permitting Elenor to stay where she's at. "Um. I sense that Jackie is going through something. And as her protégé, I think it's my duty to be there to support her." Elenor's eyes flash with delight: "Darling, your instincts are spot on." Jackie arrives behind Zoey, listening quietly, and Elenor doesn't give the slightest indication.

"And not to take anything away from your friendship with Jackie," Zoey says, causing Elenor to sputter with laughter, quickly hidden: "Of course not?" Zoey levels. "You're a doctor. She and I are both nurses. In the trenches together. You know? I want her to know that I'm here for her."

And I know I just said she gave me the creeps but I feel really sympathetic to this, which is really if you think about it the most brazenly offensive thing she's ever said. But death is... The rules are for before death. After death, other rules would apply, if there were any.

And that's just normal death. Euthanasia-in-a-hospital death, obliquely black-widow/mercy-killer nurse-stereotype death, opposite-of-palliative-care death, that's just a question mark with a question mark appended. That's confusion to the power of confusion, especially for somebody like Zoey, who honestly understands that her job performance is about dealing with real-life, awful physical issues in a professional way. Who understands that every other job is about carrying on in spite of medical issues, but her job, nursing, is about carrying on in the face of those things. And she's completely without a role model here, because in this instance Jackie has nothing to offer, or at least nothing that makes sense.

The wary, respectful relationship healers have with death, that snake around the caduceus, is reflexive and relative, and that's not something Zoey is prepared to handle yet. There should be activity in the face of death. Swords drawn, fists flying, guns blazing, bare knuckles. That's the job. But in the face of this particular death, the action is inaction. You stand there at the door and instead of sending him away, you invite him in. Into your bed, like a lover. Zoey's not prepared for that yet. But the more death she sees, the more kinds of negotiations she brokers, the more fights she wins and loses, the more rules she'll learn, for every kind of death. There's not a rite for this, just ritual.

But she's not there yet, so all she's got is Jackie Peyton, who she knows -- can tell -- isn't working right, because if she were working right she'd do what she always does: stare death down until he limps away. So all she's got is her need to crawl inside Jackie, and her own natural need to help, to heal, and if those aren't the tools required this time -

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- and, precisely, they are not -- they're still the only ones she's got: "And I think she's afraid to cry," Zoey says to Elenor, who is amazed enough that it takes her a moment to catch up.

"...Darling, you are absolutely right. You know what Jackie needs right now is... Mountains of hugs. Especially from you." She offers a little tip: "She's going to want to run. But don't you let her. She needs you now more than ever." Zoey nods sagely, putting praying hands to her lips, in thanks. And turns, bumping right into Jackie, who shouts, scaring her, and both women collapse in laughter while she stares back and forth, optimistic "ya got me" grin plastered on, smacking them both and wobbling away.

Mo-Mo massages Paula's feet, talking about her ex-husband and going through her purse. She tries to give him subway tokens, which are useless now and have been for seven years or so -- "How old is that purse?" -- but she pushes them on him, desperate to clean up after herself, to give him something. He takes them, without thanks, and when she calls him on it he points out that a foot massage is more than good enough. She relaxes into it, marveling at how it can feel so good when other parts of the same body, her lungs, feel full of razor blades.

Paula wonders at how she can still crave a cigarette, she says, waving a pack of American Spirits between them, to guilty smiles from both. The secret life of nurses, who smoke knowing what it can do, and then there's Paula, who doesn't have to feel any guilt at all. She blows the smoke in Jackie's face, and Jackie only smiles. Paula produces her housekeys, wondering who to give them to. The last responsibility, and to whom it should fall. She admits to Mo-Mo that all her stuff is "shit," just as Akalitus walks up asking how she's feeling. "Like I'm dying. And every time I see you, I am reminded what a slow and agonizing process it is." Which is not an answer, but then that's not really what she was asking. She repeats the question, in new words: "What are you still doing here?" Paula produces a middle finger from her purse as a final gift to Gloria, buying them more time.

Fitch sits in a room chair, curled sideways like a boy, reminiscing with Mrs. Scheinhorn about his childhood. He tried to change his name in fifth grade, he says, because the A-K kids in homeroom were so mean about his Tourette's and OCD and lesbian moms. She grins at him, shaking her head. "Well really, Fitch. Do you honestly think the L-Z kids would have been any nicer?" He shakes his head. But that wasn't the only reason he wanted to change it. "Paging Dr. Scheinhorn, Dr. Scheinhorn to the OR..." he says, and they laugh. It's what Mrs. Cooper says, what she's always said, making fun of Leslie; he wanted to be the doctor she was paging, to make her joke real.

"Cooper is a much better name," Mrs. Scheinhorn says, and he looks down, suddenly a boy. "Yeah, but I liked you better." She tells him to stop. "I taught you to drive stick, I let you stay up late? So what?" So she was a better cook too, he says, and sewed his buttons back on. And took him to Duran Duran. "I love you more, embrace it!" He's only kidding; he's not kidding at all. It's tremendous pressure on them both, but Mrs. Cooper -- sleeping just over there in the bed, a few feet away -- knows it's for their own good.

Mrs. Scheinhorn explains that she was more fun because Mrs. Cooper wanted them to bond, and gave her all the fun stuff. "She gets the credit, not me." And besides, she says taking his hand, "It worked. Here we are." From the bed comes the quavering, quiet voice of Mrs. Cooper as she wakes. "Paging Dr. Scheinhorn, Dr. Scheinhorn to the ER..." They both respond.

All gone, they tell her. All news is good. "And where is the little fucker?" she asks, getting stronger and more wakeful. They point to the jar. "Oh. For all the pain it sure as hell doesn't look like much. Exact same thing I said when they cut the cord, and put you in my arms." It's for his own good, still. It's so they'll bond. He smiles, because this is how Mrs. Cooper speaks to him, and it means she's feeling better; Mrs. Scheinhorn's heard it before.

Jackie stands at the nurses' station, reading charts and looking up facts, entering data, receiving faxes. All through the night, she stands in the nurses' station, as one by one the nurses come. Mo-Mo drops a vial into her hand, and then more hands move silently past, Thor, other nurses we've seen, dropping the bottles one by one into her waiting palm. They are a sisterhood as old as healing. It's a ritual for one of their own. Zoey watches it all go down, suspicious and innocent, unable to see the meaning in the dance, or the age of their sorority. This is love. With every bottle dropped, leading to death, into Jackie's palm, they are saying "I love you." Eddie's been doing this for a year now: Eddie brings up the rear.

Paula thanks Jackie and Elenor for taking time to sit with her, and Elenor continues her story. "So right before we stabilize Vagina Mom, he grabs my tit." Jackie wonders if she should ask, but Elenor goes ahead and explains. "Apparently Coop has two mothers. Vagina Mom's the one that actually gave birth to him -- as opposed to putting him in a sack and tossing him in the sea -- and the Other One is... The other one." They laugh, amazed as Elenor was that Cooper's capable of being so interesting.

Eddie arrives at Paula's bedside with a warm, tight smile, paying his respects while she's "passing through, so to speak." They banter for a bit, with a complete lack of that acidic sarcasm she's brought with the nurses, and he kisses her lips goodbye, as Zoey watches, with her hand tightly in his. It's hard to let go.

"Eddie's a nice guy," Paula says when she's gone, and Jackie's panicked eyes top a casual nod and a firm smile. "You know, he was my pipeline to Percocet after my surgery? Always thought he was so cute..." Jackie, not to put too fine a point on it, spazzes out. "Seriouslyhegaveyouextrapillsreally?" Elenor cocks her head at this whole new Jackie, and Paula nods. "Anything I wanted. One time I ran out of Vicodin..." Jackie's whole body starts flailing to a Catskills beat: "WellhuhhehuhImeanum hehwhoyagonnagoto hehImeanhe'sthe pharmacist, right? I'm gonnagetyoumoreiceokay?" Elenor has definitely noticed, now; all she's missing are the cartoon drops of sweat flying out of her head in all directions. When she stands, Paula smiles. "Jackie? Screw the ice. I think it's time for a toast." Jackie looks down at her, asking with her eyes, and after a moment she nods: "It's time."

The show is about, in broad terms, the razor line of public and private, and how we must straddle it every day if we're going to stay human. Eddie and Kevin, addiction and real life, Vagina Mom and The Other One, healers and patients: there's what's inside the door and what's outside it. Public school and private school, family-plan cell phones and the disposable kind. It's set in a hospital, and it's about nurses, who crisscross that line all the time if they're doing their job. And what this episode does is focus on the line itself, which is why Zoey's so important: Coop's Vagina Mom comes in and he's not allowed to touch her; Jackie's Other Mom comes in and doesn't want any treatment at all. And they deal with them in exactly the ways delineated by the show all along: the doctors diagnose and remove the offending organ, while the nurses draw together in a family, and serve the patient's soul.

Jackie fills up the needle from her donations, and caps it, and snorts a line of Percocet. "You okay?" asks Elenor outside, hearing her sniffling. "What do you think?" Jackie asks.

Zoey approaches Eddie awkwardly through the glass, and he calls her Angela. She asks to come in, with hand gestures, and once she's inside the Harmacy she sighs. He smiles, waiting for the point. "Okay. You and Jackie?" His smile falls. "Your friend. The nurse, who's dying." He clears his throat, taking her in again, protective: "Paula." She nods, not hearing him. "I think the nurses... uh ... Are planning something. For her. Ya know?" He doesn't move; he stares her down. "But I'm not sure I can participate in this thing that they're planning." He tells her to forget about it then, and that for the record he doesn't know what she's talking about. She nods. "Gotcha."

"...But if I don't, the other nurses won't respect me. I'm sure this is some sort of rite of passage or something." He is astounded. "So you think this kind of thing happens all the time? Because I've never seen it happen once." He's amazed by her. "Rite of passage? Jesus Christ, do you even think before you talk?" She nods, eyes wide: "Constantly!"

"Listen, I've been here since before you can read." She doesn't think so, because she could read since she was four. "Right, shut up. This is a shitty day for a lot of really good people. So get on board, stand on the sidelines, look the other way. Nobody's gonna judge you one way or the other." He shakes his head as she's leaving, and at the window she nods weirdly at him: "I thank you." I like Eddie more right now than ever. I didn't know he could be a man.

Jackie squirts the needle into a glass of champagne; Thor fills up their glasses one by one. Zoey stands in the back, near Jackie: done begging, done trying t

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o do anything but inaction. "I just. You know. Want to be here. Okay?" Jackie's lack of an answer is her answer, but it's the right one: there aren't any rules because it's new every time. She looks at the floor.

"Okay, a toast. Here's to you, and here's to me, and if we ever disagree, fuck you. And here's to me!"

She downs it in one, wisely. Thor and Mo-Mo and the nurses drink; Mo-Mo chokes it down, Zoey doesn't drink. "...What are you all looking at me for? That's all I got!" She smiles a moment as it burns, going down. And then her face changes, and the immensity hits her, and she feels him walking in the door. "Jackie. I need a priest..."

Grateful for the errand and anxious to do this right, Jackie goes sprinting to the hospice. She puts her fingers on a man's throat, grabbing at the priest at his bedside. "Okay, you got ten minutes, honey, and I need him for five. Come on." The priest goes -- wouldn't you? -- and administers her Last Rites as they watch. And they watch the lights go out of her, and he leaves.

In the silence, now that it's happened, Thor weeps. "Fuck you," Jackie says suddenly, "And here's to me." Mo-Mo's the first to laugh, and then Thor, and Zoey smiles, and they are all laughing. That's the ritual. Gloria throws open the curtains and stares at them all; Jackie's smile is defiant, but dropping. "If there's anything funny with that bag," Jackie points at her IV, "I'll have your asses. Every single one of them." They roll their eyes, as she's leaving.

Jackie opens the door of an apartment building and steps inside. The mailboxes line a wall. Upstairs, she heads into an apartment, and stares around herself. Ready to cry now, looking around at what's left of a life, at the hours in pain and fitful breathing it must have taken to clean up after herself, without the benefit of oxygen. The room is full of moving boxes, paintings lean against the wall. Everything is packed up. Everything is ready to go.

Discuss this episode in our Nurse Jackie forums, then see how Jackie's bedside manner compares to Meredith Grey's in TV is the Answer!

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