Pilot (Royal Pains)
Encyclopedia
"Pilot" is the first episode of Royal Pains
Royal Pains
Royal Pains is a USA Network television series that premiered on June 4, 2009, starring Mark Feuerstein, Paulo Costanzo, Jill Flint and Reshma Shetty. The series is based in part on actual concierge medicine practices of independent doctors and companies...

, an American
United States
The United States of America is a federal constitutional republic comprising fifty states and a federal district...

 television
Television
Television is a telecommunication medium for transmitting and receiving moving images that can be monochrome or colored, with accompanying sound...

 drama
Drama
Drama is the specific mode of fiction represented in performance. The term comes from a Greek word meaning "action" , which is derived from "to do","to act" . The enactment of drama in theatre, performed by actors on a stage before an audience, presupposes collaborative modes of production and a...

 series created for the USA Network
USA Network
USA Network is an American cable television channel launched in 1971. Once a minor player in basic cable, the network has steadily gained popularity because of breakout hits like Monk, Psych, Burn Notice, Royal Pains, Covert Affairs, White Collar, Monday Night RAW, Suits, and reruns of the various...

.

A doctor
Physician
A physician is a health care provider who practices the profession of medicine, which is concerned with promoting, maintaining or restoring human health through the study, diagnosis, and treatment of disease, injury and other physical and mental impairments...

 is fired after he lets a rich hospital trustee die. Afterwards, his brother brings him to the Hamptons where he becomes a concierge doctor.

Plot

A game of basketball is interrupted when a player, named Darrel, loses consciousness on the court. Another player, on his day off from working as an emergency room doctor, rushes to the victim's aid and uses everyday items scattered around the park to stabilize the victim and transport him to the nearest hospital, where another patient of the doctor's has been called in for another medical emergency. After dealing with the second patient, an elderly gentleman, the doctor, Dr. Hank Lawson (Mark Feuerstein
Mark Feuerstein
-Career:Feuerstein got his break-through on television as a recurring character on the daytime soap opera Loving. When director Nancy Meyers was casting What Women Want, her daughter recognized Feuerstein from Practical Magic and insisted that her mother cast him...

), a well-respected emergency room physician, returns to the injured basketball player and saves his life. Unfortunately, the elderly patient (a wealthy contributor to the hospital) dies from unforeseen complications, causing Hank to get fired from his job at the New York Hospital by the hospital administrator.

Buried by multiple medical malpractice
Malpractice
In law, malpractice is a type of negligence in, which the professional under a duty to act, fails to follow generally accepted professional standards, and that breach of duty is the proximate cause of injury to a plaintiff who suffers harm...

 lawsuits and unable to find employment, Hank then spends his days moping around an apartment he shares with his fiance' (Pascale Hutton
Pascale Hutton
Pascale Hutton is a Canadian actress. She was born in Creston, British Columbia. Hutton attended the conservatory acting program at the University of Alberta in Edmonton.- Filmography :- Television :...

) until she gives up on him and moves out, taking most of the furniture and all the money with her. Hank is convinced by his CPA
Certified Public Accountant
Certified Public Accountant is the statutory title of qualified accountants in the United States who have passed the Uniform Certified Public Accountant Examination and have met additional state education and experience requirements for certification as a CPA...

 brother Evan (Paulo Costanzo
Paulo Costanzo
Paulo Costanzo is a Canadian actor, who is best known for his roles in the 2000 comedy Road Trip, the sitcom Joey, which ran from 2004 to 2006, and as Evan R. Lawson in the current USA Network series Royal Pains....

) to spend a weekend in the Hamptons to forget his troubles, and, after being stuck in traffic and getting embarrassingly rejected by a convertible full of beautiful women, they check into an "economy motel" in the "Worst Hamptons".

After Evan bluffs their way into a party at a German nobleman's posh residence, Hank saves a supermodel's life (she was rendered unconscious due to a reaction to insecticide in the botanical gardens) by interjecting himself between the victim and the host's private doctor who was giving a misdiagnoses that would have killed her. The host, Boris, (Campbell Scott
Campbell Scott
Campbell Scott is an American actor, director, producer, and voice artist.-Life and career:Scott was born in New York City, the son of George C. Scott, an actor, director, and producer, and Colleen Dewhurst, a Canadian-born actress. He graduated from Lawrence University in 1983. His brother is...

) offers to pay him as a concierge
Concierge
A concierge is an employee who either works in shifts within, or lives on the premises of an apartment building or a hotel and serves guests with duties similar to those of a butler. The position can also be maintained by a security officer over the 'graveyard' shift. A similar position, known as...

 doctor, but Hank refuses.

When he tries to leave the host's residence, the valet
Valet
Valet and varlet are terms for male servants who serve as personal attendants to their employer.- Word origins :In the Middle Ages, the valet de chambre to a ruler was a prestigious appointment for young men...

 brings around his older model Saab
Saab
Saab AB is a Swedish aerospace and defence company, founded in 1937. From 1947 to 1990 it was the parent company of automobile manufacturer Saab Automobile, and between 1968 and 1995 the company was in a merger with commercial vehicle manufacturer Scania, known as Saab-Scania.-History:"Svenska...

. As he stands with one foot in the car, another guest of the party, Jill Casey, a beautiful brunette (Jill Flint
Jill Flint
Jill Flint is an American actress, best known for her role of Jill Casey in USA Network's series Royal Pains.-Career:Flint has appeared in several feature films, most recently in Cadillac Records with Adrien Brody, Jeffrey Wright and Beyonce Knowles, and The Women, alongside stars Meg Ryan, Annette...

) with whom Hank had exchanged glances earlier, comes up to him and gently says that he is in the wrong car. Thinking that she is delivering a flirtatious pick-up line, he responds that perhaps he should be getting into her car instead. She clarifies that he is already in her car; his car is next in line. Smiling away the embarrassment, Hank and his brother leave the residence. When Hank's brother turns for one last look at the opulent mansion
Mansion
A mansion is a very large dwelling house. U.S. real estate brokers define a mansion as a dwelling of over . A traditional European mansion was defined as a house which contained a ballroom and tens of bedrooms...

, he realizes that there is a briefcase
Briefcase
A briefcase is a narrow box-shaped bag or case used mainly for carrying papers and other documents and equipped with a handle. Lawyers commonly use briefcases to carry briefs to present to a court, hence the name...

 in the back seat addressed to Hank containing a bar of gold with the host's mark.

The next day, there is a knock at the motel room's door, waking Evan. The beautiful woman whose life Hank had saved the night before (played by Tamara Feldman
Tamara Feldman
Tamara Feldman is an American actress. She is best known for her roles as Mary Beth in Hatchet and in The CW television series Smallville, Supernatural and Gossip Girl.- Personal life :...

) has come to the Hampt Inn to show her gratitude to Hank personally, but Hank is away because of an emergency call and only his brother is in the hotel room. The woman decides to wait for Hank's return. As Evan fumbles around the small room trying to get dressed, there is another knock on the door. He opens it and it is Divya (Reshma Shetty
Reshma Shetty
-Education:Shetty was born to Indian parents and was raised in England and Richmond, Virginia. She originally studied pre-med at James Madison University, but success in vocal competitions prompted her to switch majors and graduate with a B.A. in opera performance...

), a beautiful East Indian woman who has come looking for Hank for a different reason. She wants to be his Physician Assistant
Physician assistant
A physician assistant/associate ' is a healthcare professional trained and licensed to practice medicine with limited supervision by a physician.-General description:...

.

As word of Hank's medical skills travel the social circles, he reluctantly finds himself in demand as a concierge doctor because the wealthy elite
Elite
Elite refers to an exceptional or privileged group that wields considerable power within its sphere of influence...

 do not trust the services of the local Hamptons hospital. One unsolicited patient is Tucker Bryant (Ezra Miller
Ezra Miller
- Early life :Miller was born in New Jersey. His mother, Marta, is a modern dancer. His father, Robert S. Miller, was senior vice president and managing director of Walt Disney Company's adult book publishing division, Hyperion Books. He has two older sisters, Saiya and Caitlin.Miller was trained...

), a teenage heir to the blender fortune, who is left home alone and ends up suffering from complications from a car accident while driving his father's ultra-rare Ferrari
Ferrari
Ferrari S.p.A. is an Italian sports car manufacturer based in Maranello, Italy. Founded by Enzo Ferrari in 1929, as Scuderia Ferrari, the company sponsored drivers and manufactured race cars before moving into production of street-legal vehicles as Ferrari S.p.A. in 1947...

. Learning from Tucker's cyberchondria
Cyberchondria
Cyberchondria refers to the unfounded escalation of concerns about common symptomology based on review of search results and literature online. Articles in popular media position cyberchondria anywhere from temporary neurotic excess to adjunct hypochondria...

c girlfriend Libby (Meredith Hagner
Meredith Hagner
Meredith Hagner is an American actress. She is perhaps best known for originating the role of Liberty Ciccone in the CBS daytime drama As the World Turns from 2008–2010.-Early life:...

) that he is a hemophiliac, Hank saves Tucker's life using duct tape
Duct tape
Duct tape, or duck tape, is cloth- or scrim-backed pressure sensitive tape often sealed with polyethylene. It is very similar to gaffer tape but differs in that gaffer tape was designed to be cleanly removed, while duct tape was not. It has a standard width of and is generally silver or black...

, a Bic pen, a bottle of vodka
Vodka
Vodka , is a distilled beverage. It is composed primarily of water and ethanol with traces of impurities and flavorings. Vodka is made by the distillation of fermented substances such as grains, potatoes, or sometimes fruits....

, an X-Acto knife, a sandwich bag, and the boy's blood-clotting medication
Factor VIII
Factor VIII is an essential blood clotting factor also known as anti-hemophilic factor . In humans, Factor VIII is encoded by the F8 gene...

.

Hank returns to his hotel room to find the beautiful women, both of whom he brushes off. He then receives a phone call from another patient, whom Evan and Divya force him to take. En route, Evan hits on Divya. The locale turns out to be Hamptons Heritage Hospital, called a "taco stand" by the elites, and the patient is "New Parts" Newberg (Christine Ebersole
Christine Ebersole
Christine Ebersole is an American actress and singer.-Early life:Ebersole was born in Winnetka, Illinois, where she attended New Trier High School...

), a middle-aged woman whose cosmetic surgeries always turn out bad—this time a "flat tire", or deflated breast augmentation
Breast augmentation
Breast augmentation denotes the breast implant and fat-graft mammoplasty procedures for correcting the defects, and for enhancing the size, form, and feel of a woman’s breasts...

. Hank is reluctant to take the job, but an overburdened Jill convinces him of the need of concierge doctoring. Hank fixes her by deflating her other breast.

Later, Evan convinces Hank that they should stay for awhile in the Hamptons, with Evan as the CFO of "HankMed". Hank dismisses the idea of "HankMed" but agrees to stay for a bit longer. The two brothers return to the Boris' residence and Hank accepts the man's offer to let them stay in his guest quarters, a large free-standing residence on the property. Hank and Evan quickly move out of the Hampt Inn motel room and into the much more spacious house.

Medical complaints encountered: Complete heart block, ST segment elevation myocardial infarction
Myocardial infarction
Myocardial infarction or acute myocardial infarction , commonly known as a heart attack, results from the interruption of blood supply to a part of the heart, causing heart cells to die...

, Organophosphate
Organophosphate
An organophosphate is the general name for esters of phosphoric acid. Phosphates are probably the most pervasive organophosphorus compounds. Many of the most important biochemicals are organophosphates, including DNA and RNA as well as many cofactors that are essential for life...

 poisoning, Hemophilia complicated by hemopericardium
Hemopericardium
Hemopericardium refers to blood in the pericardial sac of the heart. It is clinically similar to a pericardial effusion, and, depending on the volume and rapidity with which it develops, may cause cardiac tamponade....

, Breast implant rupture

Production

Many scenes from the pilot episode were filmed on location in the Hamptons in September 2008.
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