“In Case of Heart Failure,” originally aired on March 2, 2012, potentially marked the end of the A Gifted Man series, given its struggle with ratings on CBS. For viewers seeking a supernatural drama akin to Medium, the show initially held promise, particularly with Jonathan Demme’s directing in the pilot. However, subsequent episodes, including this season finale, left many desiring more depth and engagement. While procedural elements and weekly cases are expected, the series often lacked compelling drama and momentum, feeling somewhat lifeless despite glimmers of potential. While A Gifted Man has its dedicated fans, this review delves into the season finale, exploring its narrative threads and overall impact.
The episode unfolds at Clinica Sanando, where Dr. Michael Holt is preparing for an award ceremony recognizing his achievements in Neurological Research. Zeke’s suggestion for Kate to accompany Michael as his date creates an awkwardness between them. Kate has been attempting to discuss their recent kiss, but Michael has been actively avoiding the conversation. At the Roosevelt Hotel, Michael encounters Gene, a photographer being honored alongside him. Gene, who recently met the love of his life, Trish, in India, exhibits visible nervousness and sweating during his acceptance speech, culminating in him fainting and hitting his head.
Initially dismissed as nerves and jetlag, Gene’s elevated temperature of 101 degrees Fahrenheit suggests otherwise. Michael’s subsequent examination reveals a rising temperature of 102. Michael finds Gene in an operating room, preoccupied with taking photos despite feeling weak and experiencing headaches. Gene mentions Trish’s presence by his side as a distraction from his discomfort. Michael proposes an HIV test, but Gene assures him he and Trish haven’t been intimate. Gene’s condition worsens rapidly as he struggles to breathe, necessitating oxygen support. Rita later informs Michael of another temperature spike, reaching 103. Shortly after his mother arrives, Gene’s breathing ceases, requiring emergency intubation.
During the emergency procedure, Michael discovers Gene is hemorrhaging in his throat, exhibiting diffused rhonchi. Further complicating matters, Gene is experiencing both liver and kidney failure. Rita emerges from the OR to inform Trish and Gene’s mother of his stabilized condition. Later, Trish visits Gene, mentioning her bleeding gums. Upon examination, Michael finds a lesion on Trish’s lip, identifying it as the source of a virus that triggered a severe super-infection in Gene. He assures them the infection is treatable for both. Overwhelmed with guilt, Trish apologizes to Gene for causing him pain. In a subsequent call, Gene urges Trish to return, and she pledges never to leave his side again.
In a parallel storyline, Kate attends to Louise, who recounts injuring her foot ice skating. An X-ray confirms a fractured big toe, for which Kate prescribes a special shoe, assuring Louise of natural healing. However, Louise mentions fatigue following a heart transplant six months prior. Kate orders a blood panel and receives a call from an organ donation administrator, revealing Louise’s transplanted heart belonged to Anna, Michael’s deceased wife. Kate decides to inform Michael of this connection. Anna appears, overhearing their conversation. Michael attributes Louise’s fatigue to medication side effects and refrains from disclosing Anna’s connection to Louise. When Anna questions his silence, Michael justifies it as unnecessary information for Louise.
The unresolved kiss between Kate and Michael becomes a point of discussion. Michael dismisses it as a lapse in judgment, asserting they crossed a professional boundary. Kate agrees to maintain a professional relationship. Anna, present during this conversation, expresses excitement about their kiss, adding an unexpected layer to the interaction. Kate informs Louise of her anemia, recommending iron pills and prunes. Michael later enters and listens to Louise’s heart, seemingly sensing Anna’s presence. Louise returns to Clinica Sanando with a rash, leading Michael to suspect Fat Embolism Syndrome (FES) due to fatty acids released after her toe fracture. Fearing a delay, Michael attempts to transport Louise to the hospital in his car, but heavy traffic forces them to take a cab. Inside the cab, Michael reveals Anna’s connection to her heart. Suddenly, a boy with a red ball walks into the street (a callback to the series pilot), causing the cab to swerve and collide with a truck.
While Michael and the driver escape unharmed, Louise is trapped and losing sensation in her legs. Michael frantically uses a tire iron to extract Louise from the rapidly leaking cab as gasoline spills. He manages to free Louise moments before the cab explodes. Examining her, Michael discovers her collarbone is pressing inward, obstructing blood flow to her heart. Using pliers, he attempts to lift her clavicle, but finds no heartbeat. Despite persistent CPR, Louise cannot be revived. Anna appears, pleading with Michael, “please don’t let her die,” before vanishing. This raises questions about Anna’s appearances being tied to her living heart within Louise and whether her disappearance is permanent. The narrative hints at a potential connection, though a hypothetical season 2 might offer alternative explanations for Anna’s spectral presence.
Kate’s personal life remains a central thread. Her kiss with Michael is addressed, and her strained marriage with Harrison is further explored. Harrison expresses a desire to start a family, met with Kate’s hesitation. He reveals a job offer as CEO of a Houston medical startup and proposes Kate run a new free clinic there, suggesting a fresh start. The episode leaves Kate’s decision ambiguous – whether she will relocate to Houston with Harrison or remain in New York, potentially pursuing a relationship with Michael. Ultimately, Kate informs Michael of her decision to stay in New York and focus on her marriage. Michael questions her true desires, but a new patient interrupts before she can respond. The episode concludes with Kate requesting Michael’s assistance, leaving their relationship’s future unresolved.
One significant critique of the season, and this episode, is the underutilization of Anna’s character. She often felt superfluous, hindering the narrative flow without significant development. The series might have benefited from her absence or a more purposeful integration into the storylines.
Despite shortcomings in writing and plot development, A Gifted Man consistently showcased strong performances. Patrick Wilson’s portrayal of Michael Holt was a highlight, elevating the material. Margot Martindale as Rita also delivered exceptional performances, demonstrating her talent honed from roles like her acclaimed work on Justified. Her presence was consistently a high point, though perhaps underutilized in B-storylines. Martindale’s casting in multiple pilots for the following season suggests a likely departure should A Gifted Man face cancellation.
In conclusion, “In Case of Heart Failure” delivers a mix of medical drama and relationship tension, typical of A Gifted Man. While the episode attempts to tie up loose ends and offer emotional closure, it also underscores some of the series’ recurring weaknesses, particularly in character development and narrative pacing. The strength of the cast, however, remains a consistent positive aspect. The episode leaves viewers pondering the fate of both the characters and the series itself.
