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Dr. Preijers: In these situations time is always of the essence. There is a woman in Minnesota who can be saved by your friend's heart. In a real sense, she will live on.
Doggett looks like he's been punched in the solar plexus, like he cannot remember how to breathe. How many times has Scully worn that same expression on her own face? She watches him sway slightly, nearly reaches out a hand to steady him, but he blinks, coming back to himself.
"No," he finally says, taking a step backward and shaking his head. "I'm not signing off on any of that. Not when you've barely even tried to figure out why she's in this condition or whether it's temporary or…"
"Brain death isn't something one can come back from, I'm afraid," Dr. Preijers says gently. "With something like a coma or a persistent vegetative state, we would still see some measurable activity in the brain, and while that alone is no guarantee that the condition might be reversible, it would at least remain a possibility. However, this is not the case with your partner.”
“Well what if there’s something wrong with your equipment?” Doggett presses. “Maybe there’s activity there that it’s just not picking up. Wouldn’t that change the diagnosis?”
“Agent Doggett, I assure you that these monitors are all calibrated on a regular basis and are in perfect working order.”
“And in any case,” Scully interjects, in an attempt to both lend support to Dr. Preijers and also ease Doggett’s mind that nothing was missed, “a diagnosis of this type is usually confirmed by additional imaging scans and consultation with a neurologist.”
“In a less clear-cut case, perhaps,” the doctor counters, bristling slightly, “but that isn’t necessary in this instance. I am more than capable of determining whether there is or is not anything visible on an EEG.”
Scully frowns. “I wasn’t suggesting otherwise. It’s just usually a matter of hospital policy, at least in my experience.”
“Yes, well… at this hospital, that sort of thing is left to the discretion of the attending physician." There is a bitterness to his voice as he adds, "We don't have the luxury of funding for unnecessary procedures here."
"But, surely, when making a decision to discontinue life support, it would be prudent to base that decision on more than just one diagnostic measure." Scully keeps her tone carefully neutral, lest she offend him further.
To be fair, she doesn't disagree with his assessment, and she is not unsympathetic to his concern over the time-sensitive nature of a potential transplant situation. But she also cannot imagine making a call of this magnitude without corroboration, and it strikes her as more than a little odd that any hospital administration would be more worried about procedure cost than about shielding themselves from any sort of malpractice claim.
Doctor Preijers visibly schools his features into the expression Scully recognizes as "humoring the patient's family so they will quit causing a scene."
"If it will make you feel better, I can order a head CT for Ms. Reyes," he says with artificial blandness. "But just so we are completely clear, the results of the scan have no potential to contradict the diagnosis. The only thing they might be able to do is illustrate whatever internal trauma could be the cause."
"Do it," Doggett says, and Doctor Preijers nods.
"I'll go and make the arrangements."
As soon as the doctor is out of the room, Doggett pulls a chair to Monica's bedside and sits, picking up her hand. Scully looks away, feeling like an intruder. She flips through Monica's chart again, though she's read it all a dozen times already. But it gives her somewhere else to look than at the intensely private, yet intensely familiar scene playing out on the other side of the room.
After a few quiet minutes, Doggett clears his throat. Scully glances up to see him wiping his eyes.
"So, a head CT. That's a CAT scan, right?"
"Yes. It uses x-rays to build a series of images of the brain.”
"And that'll show us why she's like this?"
"It might. If there's been a stroke or internal swelling, that could be visible on the scan." She pauses, closing the chart and meeting her former partner's eyes. "But you heard Dr. Preijers. Even if it does give us some answers as to the why, it still won't change anything. Brain death is not reversible, no matter the cause."
“How can you stand there and tell me there’s no hope when you yourself have been right where she is now? Lying in a hospital bed, the doctors telling your family, telling Mulder, that all the medical evidence pointed to you being a goner, but they were wrong. And Jesus, Mulder, Mulder. Everyone was so sure he was dead we buried him, for God’s sake! And you know how that turned out.”
Scully recognizes the look in Doggett’s eyes – the all-too-familiar look of a person desperate to believe they can avoid the loss inexorably bearing down on them – and her heart breaks even more for him.
“John…”
“And don’t tell me this is different! Just because the circumstances aren’t perfectly identical, that doesn’t mean she hasn’t got a chance. It doesn’t mean there’s not something here we’re missing.”
But it is different. Monica wasn't taken. She didn't just appear in the hospital like Scully had, and she wasn't dropped off in a field by a UFO. She was in a car accident. A tragedy for certain, but a perfectly ordinary, utterly non-paranormal one. And there is nothing that any of them can do to escape that fact.
"John," she tries again, "I'm sorry. I truly am. I wish there were something that her doctors and I are missing, but--"
"How can you know for certain that there's not? How can you possibly know that?"
She sighs. There isn't a single thing she could say right now that would convince him.
"Until someone can explain to me, in detail, how she can be brain dead without any physical signs of trauma to the head, no indications on any of her scans that there is an identifiable reason for her condition, I'm not letting anyone pull any plugs or cut her up."
