We are back with a brand new episode of Watson! This episode has a lot going on. Below is a recap full of spoilers!
Watson was teaching a class to his select students on a "Signal to Noise" exercise in the lab, presenting three intriguing case studies.
The first case was Ellen Sanderson, who had no fingerprints. She fainted while visiting her new grandson in the hospital, and after closer inspection, they discovered that her grandson shared the same condition. Next, they discussed Vaughn Timms, a patient with frequent bone fractures, the most recent being a wrist injury from opening a pickle jar. Finally, there was William Betancourt, who impaled his tongue while using a floss threader. The question was: what’s signal and what’s noise?
After reviewing the cases, Watson concluded that Ellen Sanderson’s condition was noise, Vaughn Timms was noise with extenuating circumstances, and the only potential signal was William Betancourt.
Dr. Sasha Lubbock seemed to recognize something about Betancourt’s condition, so Watson asked her to explain. Upon closer examination, Sasha determined that the texture of his impaled tongue showed Cowden lesions, which are a genetic precursor to cancer, as the Croft twins had mentioned in sync. Patients with these lesions are at higher risk for multiple cancers at a younger age, making early screening crucial. Watson called for volunteers to take on this case, and both Sasha and Stephens Croft stepped forward. Watson selected Adams and Ingrid to track down Betancourt and schedule the necessary screening.
Meanwhile, Watson hurried out to speak with Shinwell about the green whiteboard markers in the office, which he found offensive to the senses. He informed Shinwell that the office supply budget came from the hospital’s funds, not the Holmes clinic budget, and thanked him for his help in addressing the issue.
Ingrid and Adams were on the phone trying to reach Mr. Betancourt. Adam connected with a live person, while Ingrid reached Betancourt, who preferred to be called Bill, and set up an appointment to discuss his tongue injury. When they met, they informed him that he was genetically predisposed to cancer, but Bill dismissed their concerns, feeling too busy to take them seriously. Adams complimented Sasha on how she handled Watson earlier, to which she responded that she was simply protecting her time. Eventually, Bill agreed to proceed with the screening, starting with a colonoscopy, during which multiple polyps were discovered. Watson confirmed that Betancourt was indeed the signal, and surgery was scheduled. During the procedure, tumors were found in other areas of his body, and he went into cardiac arrest. Sasha, watching the situation unfold, had a flashback to med school when she had dissected a cadaver. Sadly, Betancourt passed away.
Watson contacted Betancourt’s family, and then asked Sasha if she had ever seen similar tongue lesions before. She shared a memory of the cadaver from med school and began to cry, wondering if anyone had warned the cadaver or his family about the risks. Watson suggested she reach out to Betancourt’s family and encourage them to come in for early screenings. It was a mystery waiting to be solved, and that’s what they did.
Sasha presented her findings to the group, and Ingrid was quick to pick apart her case, questioning details about the cadaver.
Sasha began to doubt herself. Watson intervened, suggesting that the research could have long-term implications for future generations. Adams and Stephens pointed out that the issue might have already been solved. Watson introduced a formula and asked the group what variables were needed to solve the problem. Ingrid argued against attempting to solve the issue, but Watson instructed Sasha to let Adams and Stephens review her notes for any overlooked clues. He, along with Sasha and Ingrid, would head to the anatomy lab to search for answers. Before leaving, Watson stopped by his estranged wife, Dr. Mary Morstan’s office. She reminded him that she’d been trying to get him to meet with her and her lawyer, but he’d been unavailable. He asked her to send him a time and place, and he would meet with her lawyer. She hinted that the flood of green markers in his clinic was her way of getting his attention.
In the anatomy lab, Ingrid had a flashback of her cadaver. Brenda, the anatomy lab doctor, recognized the group and Watson asked if they could look through the lab’s confidential ledger to find the specific cadaver. She refused at first, but Watson bribed her with Pittsburgh Steelers tickets.
Adams reviewed Sasha’s detailed notes and noticed that two pages were missing from one of the notebooks. Watson, Ingrid, and Sasha quickly devised a plan to review the ledger and track down the cadaver’s donor. Watson encouraged Sasha to recall any small details about her time with the cadaver, which led to the identification of the specific donor. However, the donor's name was obscured by a coffee stain. Adams then informed Sasha about the missing notebook pages, which she recalled were taken by an art student, Micah, who had asked her to let him into the lab to do sketches. The group tracked Micah down at a museum, and he still had the drawings of the cadaver, revealing a distinct tattoo that Watson recognized. He explained that the tattoo design, an Amish Star of Bethlehem, reminded him of the best summer he’d ever had, where the community had made him a quilt with the same design. The cadaver might have been Amish or connected to the community. It was time for a road trip.
Watson began questioning local residents as Stephens and Sasha discussed wedding plans. He interrupted to share details about the cadaver, identifying him as Jacob Hochstetler, and recommended screening the entire community for Cowden syndrome. They couldn’t find Jacob’s immediate family, as they had left the community due to embezzlement accusations, but Benjamin, a young boy Watson had helped, provided a phone number for a family member. Watson asked Adams to find an address while Sasha and Stephens began screening Lancaster residents. Watson would head to Harrisburg to find Jacob’s family.
Adams found Rachel Smith’s address, and he commented to Ingrid that Watson treated her differently, in a special way—similar to how Sherlock Holmes had treated him. Ingrid agreed, adding that James Moriarty was also in Watson’s inner circle. Adams found Rachel’s address.
Shinwell was in the lab, talking with the robot, Clyde, while taking samples from the fridge. He handed them to Moriarty’s agent, who reprogrammed the robot to upload the clinic's patient genome data. Shinwell stealthily followed the vehicle and retrieved a tracking device.
Watson visited Rachel Smith to discuss Cowden syndrome and urged her family to get tested. Her son, Amos, had lesions on his tongue and feared he might have cancer. Watson organized the team to research Amos’s condition, with Ingrid and Stephens gathering his medical records.
Sasha spoke with an Amish woman, Traya Coblin, who thanked her for helping the community. Later, Adams remarked to Sasha how impressive it was that she could recall so many details about the cadaver. He told her she was remarkable for caring about the cadaver’s community.
Rachel and Watson took Amos to the hospital when his breathing became difficult. A growth on his neck was pressing on his airway. In the hospital, Adams informed Watson that Amos’s tests came back negative for cancer, but Watson suspected that unpasteurized camel’s milk might be the cause of the swelling. Ingrid drained the abscess to help Amos breathe, and an operation followed to resolve the issue. Later, Traya visited Rachel and Amos in the hospital, bringing a quilt made by the community.
The team discovered twelve cases of Cowden syndrome in the Amish community, and some individuals were already showing signs of cancer. Their efforts saved many lives. Ingrid met with Sasha at Micah’s art show and saw through her deception about being engaged. She urged Sasha to stop pretending, revealing that her current boyfriend was using her.
Watson visited Mary and informed her that he wasn’t contesting their divorce. He would attend the next mediation, assuring her that she would always have a place in his heart. A flashback showed how they had met over a cadaver in med school.
This episode wove together a scientific mystery with flashbacks to the team’s early med school experiences. It was an amazing journey that ultimately saved lives and strengthened community ties—a truly remarkable episode.
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