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(p. 2 of 5)

INT--NEUROLOGICAL DISEASE (PSYCHIATRIC) UNIT, BROOKINGS HOSPITAL, BALTIMORE, MD--NIGHT

DAY, who has just arrived at work, walks with her gear to a nurses' station where BONNIE PHILIPS, an older psychiatric nurse, sits doing paperwork. PHILIPS notices DAY.

PHILIPS

Hey kid. Ready for the Dysfunction Daily?

DAY

You shouldn't say that. These people are no more responsible--

PHILIPS

Uh-huh. But talk to me in 20 years.
(With affection.)
You really are the daughter I never wanted.

INT--PSYCHIATRIC UNIT, BROOKINGS HOSPITAL, BALTIMORE, MD--NIGHT

DAY and PHILIPS are walking down the hall of the unit.

PHILIPS

...but the big story is, Bill's back.

DAY

Bill.

PHILIPS

(Handing DAY a chart.)
William Clinton, 21-year-old white male, paranoid schizophrenic. Crashed out of Yale after months of increasing psychotic symptoms. Especially the delusion that he was...our beloved 42nd president, Bill Clinton.

DAY

No way. And he just happens to have the same name?

PHILIPS

Uh-huh.

DAY

Maybe he should change it.

PHILIPS

Well, obviously we've considered what role the name may have played in the pathology. But I'm not sure changing it now--

DAY

He'd just be Bill Clinton who changed his name.

PHILIPS

Right.

DAY

What's his middle name?

PHILIPS

Hamilton.

DAY

Well, that's a start.

PHILIPS

Yeah. Anyway, he left school early last year. But no diagnosis till early this year.

DAY

Why not, if the symptoms were that bad?

PHILIPS

Schizophrenics average 10 months of serious symptoms before they get treatment. And Bill's family--his socially prominent family--really struggled with it.

DAY

Least they can afford it.

PHILIPS

Problem is they can't deal with it. Really tough for anybody, sure.
(Adopting a refined accent.)
But how could it happen to us? William's brilliant--why can't he brush his teeth?

DAY

(Looking at the chart.)
Olanzapine.

PHILIPS

Yeah, got him up to 15 mg. a day. But we haven't been able to keep him on it long enough to really assess it. Gets behavioral therapy too, but it's hard to keep him focused. And he can be oppositional, when he's not satisfied with our responses to his programs.

DAY

His programs?

PHILIPS

Yeah, his ideas for new programs, new funding, new treatment...

DAY

For his treatment.

PHILIPS

For everyone's treatment.

INT--PSYCHIATRIC UNIT, BROOKINGS HOSPITAL, BALTIMORE, MD--NIGHT

DAY and PHILIPS approach a large open space in which perhaps 15 INPATIENTS sit or stand. Some interact. Many are withdrawn. In one corner, three INPATIENTS listen to the attractive but somewhat disheveled WILLIAM CLINTON, as he speaks and gestures with his driver's license in his hand.

CLINTON

--so I challenge you to enact a comprehensive health plan founded on these principles: security, equality, and cost efficiency. That's what this card--the Health Security Card--is all about. Americans who work hard and play by the rules shouldn't have to worry about whether they can get the care they need. Nearly 40 million Americans are now uninsured, and--

CLINTON's eyes sweep his small crowd as he speaks, but when he spots PHILIPS and DAY, he stops immediately.

CLINTON

(To DAY, in a frantic whisper.)
What're you doing here?

The INPATIENTS turn and stare at DAY.

PHILIPS

Hello everyone. You know Anastasia Day. Bill, Anastasia's been with us for a few months, and she'll be your nurse tonight.

DAY

(Nodding to CLINTON's audience.)
Johnny, Mike, Donna. Mr. Clinton, I hope--

CLINTON

(To DAY.)
Do they know you're here? You know what they'll do if they find out.

DAY

Do they--who?

PHILIPS

(Leaning toward CLINTON.)
Bill, can we speak privately?

CLINTON

Well, as you can see I'm a little...
(Glancing at the INPATIENTS, then back at DAY.)
All right.
(Shaking INPATIENT hands as he leaves.)
Thanks for coming. Great to see you.

CLINTON, DAY and PHILIPS walk toward a vacant corner of the open area.

CLINTON

(To DAY, putting his arm around her.)
Hillary, don't you see how risky this is? Do Tom and Terry know?

DAY

(Easing away from CLINTON's arm.)
Mr. Clinton, I'm a registered--

CLINTON

I know your party affiliation, I'm talking about the R.N.C., Klayman, Limbaugh, Drudge, the Post, the Times, are you with me?

DAY

Well, I--

CLINTON

(To PHILIPS.)
If they find out, it's not going to look great for the hospital or the university either. You depend on a hundred kinds of federal support.

PHILIPS

Bill, let's back up, OK? Can we just sit and talk for a minute?

CLINTON

You know how important security is. Hillary's taking a big risk, and I want to know who the hell let her--

DAY

Mr. Clinton.

CLINTON

Oh come on, use Bill, Bonnie knows who you are.

DAY

Bill. I am a registered nurse--

CLINTON

Ich bin ein Berliner, eh, honey? Well, I'm a nurse too. I feel their pain. I remember what my mother used to say...
(Turning to PHILIPS.)
I'm sure we don't need to tell you what a threat the nursing shortage poses to the future health of all Americans. Nurses are overworked and underpaid in a shortsighted cost-cutting environment, struggling with a public image that they're unskilled handmaidens--an image that takes no account of the job's real demands, or its place on the front lines of 21st century health care. Nurses are leaving for easier, better paying jobs, and new ones aren't being trained. The average age of a nurse today is 47...seven...severe...
(CLINTON seems lost, then recovers.)
...projected 20% national shortfall. Who'll care for the aging boomer population, with the growth of life-extending technology driving demand even harder? What if there's a serious bioterror event? That's why Hillary's co-sponsored legislation that offers tax and educational incentives to--

DAY

Bill, I appreciate all that. But my job--despite being overworked and underpaid in a shortsighted cost-cutting environment--is to help you. With your thoughts.

CLINTON

My...thoughts.

DAY

Do you know where you are?

CLINTON

Well, a hospital, of course.

DAY

Right. And we're nurses. We're trying to help you with your thinking--

CLINTON

All this talk about thinking, Hillary, I know some of your grades were better, but I'm not sure--

DAY

That's not what I'm talking about, Bill--you've clearly got some serious game. I mean helping you think better about basic things, so you can get back to where you were, making a contribution outside of the hospital. Is that something you'd like?

CLINTON

But I'm here...you know why I'm here.

DAY

Why are you here?

CLINTON looks down.

PHILIPS

(Leaving.)
I have to go. See you tomorrow.

DAY

Thanks, Bonnie.
(Pausing.)
Bill, are you familiar with schizophrenia?

CLINTON

Of course. As one of the most common psychiatric conditions, it affects about 2.8 million Americans. It's been estimated to cost us $65 billion annually--and that figure's over 10 years old. You know, despite de-institutionalization, schizophrenia still accounts for roughly 40% of all long-term hospitalization days. Most schizophrenics have a history of substance abuse, and the suicide rate's been estimated at 15%.

DAY

It is very serious, and that's why we're working to find--

CLINTON

Clearly it's a brain disease associated with genetic and environmental factors. I understand they're looking at abnormalities in brain structure and activity in the prefrontal cortex and other areas, especially the amygdala, the emotional center that's often much smaller in schizophrenics...
(Camera shows image of a BRAIN with shrinking AMYGDALA highlighted.)
...brain circuitry problems that can cause an overload of unfiltered information, leading to positive symptoms like hallucinations, then negative symptoms like flat affect as the mind withdraws from the barrage...
(Camera shows brain circuits getting OVERLOADED.)
...and brain chemicals, especially imbalances in neurotransmitters like dopamine.
(Camera shows DOPAMINE activity.)

DAY

I'm familiar with that research.

CLINTON

The real question is, what can be done about it?

DAY

I was just wondering that.

CLINTON

Are you aware of the newer "atypical" medications that can work on even the negative symptoms, like Olanzapine?

DAY

I believe I've heard of Olanzapine.

CLINTON

And the re-emergence of electroconvulsive therapy? And the growing focus on cognitive-behavioral therapy, to help build capacity for normal thinking and living skills?

DAY

Let's talk about that.

CLINTON

But despite the advances, medication side effects remain a serious issue. The condition still carries a major stigma, and most sufferers don't get adequate care, especially African-Americans. That's why I worked with Tipper on mental health initiatives--
(CLINTON pauses.)
--and that's all we did, nothing else--to ensure parity for mental health insurance coverage, provide a better continuum of services for homeless sufferers, organize the first White House conference...continence...

DAY

Bill. Bill?

CLINTON

Yes?

DAY

I'm glad you know so much about this. And I really appreciate your ideas. I think we can build on them. Okay?

CLINTON is silent.

DAY

I noticed you didn't say much about the symptoms of schizophrenia. Are you familiar with those?

CLINTON remains silent.

DAY

Like delusions, hallucinations, disorganized speech and behavior?

CLINTON

Well...yes.

DAY

And I understand you've had some trouble with your thoughts. Organizing them, distinguishing what's real, helping others understand you.

CLINTON

It all depends on what the meaning of the word "trouble" is.

DAY

I mean whether you can function and relate to people the way you'd like.

CLINTON

I...but...you're so busy, I don't want to drag you into this. On top of everything else I've done...

DAY

Bill, that's what I'm about. I'm here to help you. We're gonna work hard and play by the rules, all right?

INT--THE BURNING EMBER, BALTIMORE, MD--DAY

The NURSES are sipping their drinks.

SMITH

What about--

A glass BREAKS at the bar, and drunken LAUGHTER drowns out the rest of SMITH's words.

MENDEZ

Maybe I should just report here for my ED shifts.

SMITH

What about you, Trent?


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