- The famous writer Gideon Graham was struck by a lightning, and since then he is catatonic. Gallagher tries new methods to bring the patient to reality again. Meanwhile, Suarez have to pay for past decisions.
- We begin with Carl schmoozing with pharmaceutical executive Thom Hygard. Hygard runs into Jack and tells him of his company's new sleep disorder drug, Somnilex. Jack eventually shoves Hygard into a stairwell.
Livid as to Hygard's treatment, Carl demands Nora fire or reprimand Jack. Nora promises only that Jack will apologize. Car pulls out a new policy from Jack barring pharmaceutical reps from the ward without his permission.
At the staff meeting they first discuss Darren Knuth, who beat up several high school football players before driving his car repeatedly into a wall. Arturo believes Knuth has severe issues with his father and may have been abused. Up next is Gideon Graham (David Carradine), who is at Wharton with his daughter for transcranial magnetic stimulation (TMS). Nora says the TMS will be their last shot at helping the catatonic Gideon, who Jack refers to as "a national treasure."
Nora and Gideon's daughter, Niobe, watch the TMS treatment. During the TMS we see shots of Gideon on top of a cliff in what appears to be a lightning storm. Gideon begins flailing his arms around and Jack tells Niobe they have made progess.
Niobe comes to Jack's office. Jack tells her he is a fan of her father, an author, and that he is researching keraunopothy, the pathology of lightning strikes like the one suffered by Gideon. The lightning put Gideon into a coma. Gideon then moved into catatonia, which unlike a coma is a neuropsychiatric condition. Jack guesses it is due to overwhelming grief after the death of his wife. An intellect like Gideon's, he says, is able to build a wall from reality.
Jack takes over for Malcolm during Gideon's pool therapy and Gideon seizes up. Afterwards Malcolm shows Jack that Gideon has been kicking off his shoes.
Jack tells Veronica he doesn't understand why TMS, the least invasive of several treatments they've used with Gideon, had an effect. Jack suggests that the TMS forced Gideon to relive the lightning strike.
During a session with Arturo, Knuth (Intermittent Explosive Disorder) looks ready to beat the resident silly. Once Arturo mentions Knuth's father he immediately becomes docile.
Nora lectures Jack that he doesn't make department policy and that pharmaceutical companies are important for the hospital.
Niobe fills Jack in as to the details of Gideon's injury. Gideon and his wife were hiking in the Sierrras and he intentionally took her to the edge of a cliff to watch a storm. Gideon was aware his wife was afraid of lightning. Niobe says Gideon was working on a new book and will get him the manuscript.
After complimenting him on his work with Knuth, Carl reminds Arturo that he was the one who approved his residency application despite a fabrication on his resume. Carl asks him to be a spy for him with Jack.
Working under the suspicion Gideon might be faking it, Jack and Veronica steal some of the Somnilex and monitor Gideon while he sleeps. Jack turns out to be correct: "The lights are on and Gideon's home."
Arturo overhears Jack having another one-sided phone conversation with Becky, who we find out is his younger sister.
Looking for a next step with Gideon, Jack reads the manuscript Niobe gave him. Gideon's editor tells Jack that the 'V' to which Gideon dedicated the new book was a woman named Vivian. Gideon's wife always knew he had affairs but this dedication was going to make it public
Vivian tells Jack that their relationship brought guilt into Gideon's life. After hearing of the dedication Gideon's wife threatened to leave him and he broke it off with Vivian immediately.
Jack reveals to Nora he believes Gideon is cognitive. He wants to try another round of TMS, as well as to remove every personal effect from Gideon's room.
Jack convinces Niobe to sign a release for additional TMS treatment.
Without ever actually turning on the TMS machine on, Jack begins verbally berating Gideon about his treatment of his wife and daughter. Gideon eventually wakes up, grabbing Jack around his neck.
Arturo tells Carl that Becky is Jack's fraternal twin and suffers from paranoid schizophrenia.
Niobe takes Gideon from the hospital. Later she shows up at Jack's place and rings the door. He answers and the two begin making out.
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