Chicago Med (2015) s01e02 Episode Script
iNO
- Here, let me help you.
- No, I got it.
- No, I got it.
- No, really, I got it.
I got it.
I'm not sure about that bag on you.
Well, perhaps with a different shoe? Nah.
- You jealous? - Jealous? Of how bad it looks on you? I don't think so.
Dr.
Halstead, got a possible MI coming in.
And good morning to you, Maggie.
Good morning.
Dr.
Manning, it was a pleasure being your caddy today.
Don't expect a tip.
Hey, we still on for tonight? - Tonight? - Ladies' night at Molly's, Me, you, and April.
April hasn't had a date in a while.
She can use some wingwomen.
Me, a wing woman? Your hormones they will lure the dudes in.
Right.
Hey.
Thank you.
You're going the wrong way.
Left my badge in the car.
I'll think about it.
Help! Help, anyone! I need help here.
I got her, I got her, I got her, I got her.
Come on! She's bleeding from somewhere.
Trauma two.
Get your asses over here! Who is she? What happened? I don't know.
I found her a couple blocks away collapsed on the sidewalk.
Let's get her on the monitors.
April, you got this? Got it.
- Where's she bleeding from? - Working on it.
HR 130.
BP's at least 90.
I've got a radial pulse.
- All right, get two lines.
- On it.
Get an I-STAT ABG and send labs.
Make sure we type and cross.
Can you hear me? Can you tell me what happened? The blood did you get shot? Let's get these wet clothes off her now.
Don't worry.
We're gonna put you in a gown and see what's going on, okay? Get blood, O negative, make sure it's warm.
Put it on level one.
Give her two.
Hey, stay with me.
You find the source? No head, neck, or torso trauma.
Belly distended but soft.
That's not an intestine.
It's an umbilical cord.
This kid just delivered a baby.
- What do you mean "just"? - Maybe five minutes ago.
She's still bleeding.
Clamp.
Where did you deliver this baby? Hey, what happened to your baby? Hey, sir? Sir, you're the one who brought the girl, yeah? - She gonna be okay? - Yeah, she's fine.
Where'd you find her? About two blocks that way.
Okay, can you show me? - Yeah.
- Okay.
Hey, grab an OB kit and follow us.
You got it.
She was right there.
What are we looking for? Sexton! Did she just abandon the thing? April! Bulb syringe.
Come on.
Come on, come on, come on, come on.
Come on Oh, okay.
Blanket, blanket.
Oxygen.
Okay okay.
There you go.
All right.
- I'll take him to the NICU.
- I'll take him.
She hasn't delivered the placenta yet.
It has to come out.
Where the hell is OB? Stuck in a delivery.
I can do it.
I've done it before.
I'm on the baby.
You sure? Yes.
April, where'd you find the baby? In a backpack behind that building on Huron.
We got there just in time.
Hey, hotshot.
Yeah, you.
An old lady had a fall, sprained her wrists.
Last name Francis.
Miss Francis? Ms.
Connie Francis? That's me.
You look awfully young to be a doctor.
Oh, I'm a medical student.
Sarah Reese.
Why don't you come with us? Come with you? To the beach.
Hey, did you bring the Coppertone? The He says he's having a heart attack.
He's always having a heart attack.
I'm not always having a heart attack.
Nope, just when the lawn needs mowing or the gutters need clearing or the garbage needs taking out.
Can you describe the pain you're feeling? It feels like someone sitting on my chest, slowly squeezing the life out of me.
How about we take a look? Keep your hands off of me.
I want to go to the beach.
I want to go to the beach.
Oh, Dr.
Charles, good.
Could I get a consult? I need to get this splint on her, but she won't sit still.
I'm late, and we're still 30 minutes away from Fort Lauderdale.
Ms.
Francis, I am so sorry to hold you up, but do you mind if I ask you a couple of questions? I'm Dr.
Charles.
Well, I hope you're not one of those stuck-up Princeton boys.
Oh, heaven forbid.
University of Pennsylvania, thank you very much.
Please forgive Ms.
Reese.
Smart and caring as she is, she's still learning.
Do you mind terribly if we were to borrow this so that we could contact your loved ones? Well, if it won't take you too long.
We will make it snappy.
Be right back.
Thank you.
So it didn't occur to you she might have dementia? That name didn't mean anything to you, "Connie Francis"? Should it have? Oh, I'm so damn old.
Just call her contact.
Uh If you could just fill each of these with nuts, and I brought the nuts.
I'll take care of everything else.
Helen, I thought this was gonna be a little bit more casual.
But I just I want it to be just right, you know? I want I want it to be something she'll remember always.
Helen? Hey, what were you doing with my mother-in-law? Who, Helen? Was she just here? Wish I would've known.
I would've said hi.
She handed you that pink box.
Huh? What's in the box, Maggie? Maggie! Napkin diaper nut cups.
What? Napkin diaper nut cups.
You fold the colored napkin up, you see, and then you hold it together with safety pins, - and then you stuff it - You're throwing me a shower? Surprise! Tonight at Molly's.
So the whole ladies' night ruse Just roll with it, okay? Fine.
Oh, how's baby Doe? Poor thing.
He's stable for now.
And the mother? Just came to.
Do we have any information on her yet? All we know is that her name is Erika.
- Okay.
Thank you.
- Yeah.
Hello, Erika.
I'm Dr.
Manning.
When can I leave? Based on how much blood you lost and what your body's gone through, I'd say you're at least here overnight.
Is there anyone I can call, your mother or father? No.
Maybe a friend? Did they find the backpack? Yes.
How did you end up in that alley, Erika? Why did you leave your baby there? I don't know.
I mean, I knew something was going on inside me, but I figured if I could just not think about it, then maybe I'm so stupid.
I'm just so happy that somebody found him.
Erika, honey, how old are you? There is someone you can call.
She's 14 years old, a kid.
She's scared, alone.
What about the family? Her mother's in prison.
Father's long gone.
She does have an older sister living in Champaign, though.
I left a message.
Here's the thing she was two blocks away.
Two blocks maybe she was trying the make it here.
Is that what she said? She clamped the umbilical cord.
She did not mean to harm that baby.
Right.
Put him in a backpack.
Leave him in an alley.
That'll keep him safe.
It's not that cut and dried.
She was delirious.
She left her baby to die.
It's exactly that cut and dried.
She's a child.
She wasn't ready for any of this, right? People come here for help.
I try to leave my feelings out of it.
Well, that's convenient.
Look, you don't understand because you're not a woman.
Don't give me that.
People need to be held accountable, regardless of sex.
This is a safe haven.
She could've dropped the baby off, no questions asked.
So now you do have feelings? She's got to live with this for the rest of her life.
Do we really want to punish her as well? You're talking as if there's a happy ending where that baby survives.
That baby is going to survive.
And if he doesn't, then what that girl did is murder.
How you gonna feel then? Who's the pediatric surgery attending today? Dr.
Grant.
I've got to get back down to the ED.
Page me if anything changes with this one's condition, okay? - Dr.
Rhodes.
- Yeah? Your father called.
Wants you to call him back.
- Thanks.
- Mm-hmm.
Excuse me, Dr.
Czerny.
You said yesterday that you may have some time today to discuss our new tranexamic acid drug? Talk to me tomorrow.
And are you even supposed to be in here? Have a great day.
Good morning.
Good morning.
Dr Halstead.
I'm Zoe Roth with Stewart and Breck Pharmaceutical.
Will.
Okay, so how big of a problem is blood loss during surgery, Will? I'm an ER doc, Zoe.
Don't do a lot of surgery.
But keep going.
I might learn something.
Well, you should know that S&B is conducting a major multi-institutional trial to establish our product's efficacy in so many different uses and procedures.
I'm sorry, I have a patient.
Can we do this tomorrow? W-what about later? Maybe over dinner? Dinner? Sure, I'm free for dinner.
Good.
Say about 8:00? Yeah, I'll meet you out front.
Call me if there are any conflicts.
All right, will do.
Yeah, okay.
She's very friendly.
Just doing her job.
You got a high fever in treatment 5, dog bite in 4.
These just came back from cardiology.
Uh, thank you, April.
Doug, Jenna, good news.
Second set of enzymes came back fine.
Both EKGs are normal, CK and troponin as well.
These chest X-rays look solid.
So you're telling me I'm fine? That's what the tests say.
Looks like you are good to go, my friend.
I knew it, huh? We wasted six hours here, and it's all on your head.
Well, it's not that simple.
There are plenty of other factors that can contribute to chest pain.
It could be reflux or stress, anxiety Yeah, like I said, all in his head.
Speaking of which, just in time to pick up Liam from daycare.
Bye.
I'm gonna refer you to a cardiologist.
She'll get you on a treadmill and put you through a stress test, okay? Like Jenna's not enough of a test.
I started calling her "Jenna-cide," as a dig, but it turns out she likes the nickname.
All right.
I'll see if they can get you in this week, okay? In the meantime, you tell Jenna the doctor recommends no lawn mowing.
Just in time to start shoveling snow.
- All right, you take care.
- Thank you so much.
Absolutely.
Heard you had a bit of a morning.
Yeah.
So listen, my mother-in-law's throwing me a surprise baby shower tonight that I totally don't want to go to, so you have to come with me.
Can't.
I'm having dinner with Zoe.
Zoe? The new S&B Pharma rep.
Blonde hair.
Yeah, I think I know the one.
So you're deserting me in my hour of need to go get laid? What are you talking about? It's strictly business.
She wants to pitch me on their new TXA product.
Whatever.
I was frantic trying to figure out where she'd gotten off to.
Mr.
Donovan, how long have we been in the Connie Francis era? We met in Fort Lauderdale, Spring Break, 1960 same year "Where the Boys Are" came out.
Carol loved that movie.
She mixes it up in our life.
This past year, it's been getting worse and worse.
Mr.
Donovan, caring for someone with dementia is one of the most demanding tasks in the world.
Remind yourself from time to time it's okay not to be perfect.
Thank you, dear.
I'll give that a try.
Mr.
Donovan, I just need your signature for these discharge papers.
What did I do? You get that from a greeting card or a fortune cookie? So where's my wife? Thank God.
Carol? Who is this? Your husband.
- My husband? - Yes.
I'd rather go with you.
I wouldn't know where to go.
Tom does.
Tom knows the way home.
She'll need to keep the splint on for about six weeks.
I feel so stupid.
Get up to go to the bathroom and trip over the rug.
Wait, wait, wait, wait.
Are you hearing what I'm hearing? Are you okay to walk? Would you mind just getting up and taking a few steps for me? - Sure.
- Here we go.
What do you think? Magnetic gait and complete recall of her injuries not consistent with a diagnosis for Alzheimer's.
- Very good.
- What's going on? I'd like to run a few tests on your wife.
I promise it won't take long, and it could very well be worth our while.
Sure.
Juvie's hemorrhaging! Trauma 2! How many pads did she soak? - Dozen or more.
- She must still have retained products.
Which attending did this? They were busy.
I did it.
You? You did it? All right, page OB.
Let's get her up to the OR now.
Got it.
Yep, your newbie.
How many units has she gotten? - Her most recent hemoglobin? - 5.
9.
She still looks like a ghost.
She needs more blood.
Restart the MTP.
Give me methergine and 1,000 mics of Cytotec.
Little room Erika Dougherty's been in the system for years.
In and out of foster care since her mom was sent to Logan.
Runs away when the families don't kick her out.
Suspected substance abuse, at least alcohol, maybe worse.
Would you ask Dr.
Manning - to step in here, please? - Yes, ma'am.
What about the baby's father? Who knows? Erika's been arrested more than once for solicitation.
- Ms.
Goodwin? - Yes, Dr.
Manning, this Madeline Gastern from the Department of Child and Family Services.
What's the baby's condition? - He's stable.
- And Ms.
Dougherty? Dr.
Pachefsky's treating her.
She may need a hysterectomy.
I reached her older sister, Kara Dougherty.
She's on her way up from Champaign.
Kara's an adult.
Could she potentially take custody of Erika and the baby? Potentially.
I know you always try to keep families intact.
Thank you, Dr.
Manning.
This girl is in big trouble.
She could be going to prison.
Come on.
She's 14 years old.
Solicitation or not, that's rape.
Doesn't absolve her.
She's facing several potential felonies.
Abandonment, attempted murder.
It's up to the State's Attorney and the judge, but Cook County? Anything could happen.
I thought I got it all.
Forcing the delivery of the placenta is an OB procedure, so what the hell were you thinking? It was an emergency situation.
I made a decision.
A bad one.
You overstepped your bounds, and you botched it.
That girl almost needed a hysterectomy.
A 14-year-old! Now, let me ask you something, Dr.
Choi.
You didn't like this patient.
You disapproved of her.
You think that affected my judgment and my performance? You tell me.
Dr.
Halstead to the E.
D.
Dr.
Halstead to the E.
D.
Code Blue.
Dr.
Halstead, cardiac arrest, treatment 5.
- Your patient.
- Code Blue.
I thought you said he was gonna be okay.
Get the pads on him.
He was in earlier.
Is there anything we need to know from his charts? No.
We did a full workup, and everything checked out.
I was driving home, and he I looked over and he was just white as a sheet.
And then I turned around and drove back as fast as I could.
I don't think he was breathing.
Ma'am, I'm sorry.
You need to wait outside.
Okay.
Hold compressions.
V-fib, charge to 200 joules.
- Everyone clear.
- Clear.
I got a pulse.
He's in sinus rhythm, brady at 50.
BP? 90 over 45.
Wait, wait, wait.
72 over 35.
Start dopamine at 10 and titrate to a systolic of 90.
- Yes, sir.
- Get a 12 lead EKG.
Right away, Dr.
Halstead.
We gotta get his BP up.
You paged me? Dr.
Grant.
Pneumothorax.
Right lung collapsed.
Tubing him now.
O2 sats at 78.
We get below 75 and We're not getting below 75.
Campbell.
What do you need? Inhaled nitric oxide.
We need to improve oxygenation.
I'll get a tank.
He's really bradycardic.
Turn up the dopamine.
It should help the pressure and heart rate.
Dr.
Halstead, it's been 15 minutes make a decision.
I'm not giving up yet.
RV's not moving.
You have a blown-out RV and severe akinesis.
I think you might want to consider giving more fluids instead of escalating the pressers.
Call RT for a tank of nitric oxide.
Nitric oxide? It'll reduce the afterload so that the heart works less and buy some time till the cath lab is ready.
I've never seen it used for this.
It's unorthodox, I know, but I don't have a balloon pump, and we're out of options.
RT says Dr.
Manning is signing out the last tank.
They'll have another ready in ten minutes.
He'll be dead by then.
Nat, where are you going? NICU.
Baby Doe's sats are in the 70s.
- Put him on ECMO.
- That's a last resort.
I'm sorry, but I need this tank.
What the hell are you doing? I have no other option.
You do.
- Give me that tank! - Nat, my patient will die without it.
You're putting the baby at risk.
I'm not gonna lose this guy.
- Will - He's got three kids.
Try thinking like a doctor and not a pregnant woman.
He's in v-fib.
Lost his pulse again.
Charge to 200.
Everyone clear.
Clear.
One more round of epi.
Let's go.
Restart compressions.
Nothing.
Come on! Doug? Doug, please? Please listen to me, okay? We need you, all right? - I need you, okay? - Nurse.
- Please? - Please stop.
Hold compressions.
I got a pulse.
Sinus brady again.
Start amnio drip.
Let's get him to the cath lab.
Let's unclamp.
Turn on the circuit.
ECMO acts as a heart-lung bypass, oxygenating the infant's blood outside its body.
- Sats are rising.
- Thank God.
Dr.
Manning? There's a Kara Dougherty downstairs to see you.
Okay.
The usual, Dino.
Dr.
Charles.
Dr.
Choi.
You were in the what, the Navy, right? Still am.
Naval Reserves.
Doc I did my residency with was on away leave from the Navy.
It was tough as hell practicing psychiatry with you guys.
Couldn't get anybody to open up.
Could be a sign of weakness.
Pork rind? No, thanks.
No? I shouldn't eat this stuff so much.
Guess that military culture's tough, right? Loose lips and all? Last chance, man.
Pretty sure they're organic.
- I'm good.
- No? Kara, I'm Natalie.
We spoke on the phone.
I brought Erika some clothes.
Thank you.
- Where's my sister? - Follow me.
There were some complications with the birth, but we think the baby's gonna be fine.
You think? It's still very early, but we have the best neonatal ICU in the Midwest.
I could take you up to see him if you want.
Maybe later.
I spoke to a social worker.
It might be possible for Erika and the baby to come live with you.
Let me talk to her.
- Hey.
- Hey.
You really stabilized him using nitric? Interesting.
What about the patient? The RCA was completely occluded, and there was a 60% occlusion of the circumflex.
I stented both and placed an impella for a couple days to rest the heart.
What was his code time? Maybe 20 minutes total.
20 minutes? I would've let him go.
What's the difference between God and a doctor? God knows he's not a doctor.
I just got a page.
Dr.
Rhodes? Yeah? Please, my boss wants to talk to you.
Okay.
You wear the scrubs well.
I'm glad you approve.
Long time.
Got a couple of minutes? We can go grab a coffee, maybe catch up.
I'm working.
Ah.
You know, I took it as a good sign that you'd come home, that maybe you'd worked through your issues? My issues? Come on.
Let it go.
Let's move on.
You're still the same, aren't you? Just untouchable.
Let me tell you something.
When you left this town, Connor, I was deeply hurt.
Yeah.
You ask Claire.
But right now, I'm willing to put all that behind me, for the two of us to start over.
It's a good pitch, Dad.
Really.
You hit all the right notes.
I'm not buying it.
We can go.
You ready to see your nephew? I wish I could help them.
Kara.
I just got a promotion customer service rep and my boyfriend and I are talking about us moving in together.
I've come too far to get sucked back into this crap again.
They're your family.
You make that sound like a good thing.
Hold that position.
What did you say this might be again, hydro what? Hydrocephalus.
Literally means "water on the brain.
" The lumbar puncture should relieve some pressure.
Well, hopefully, we'll see some cognitive improvement, and if that's the case, we'll implant a surgical shunt for long-term treatment.
I, uh the summer we met, - dancing to "Where the Boys Are.
" - Wow.
I'd give anything to see that look in her eyes even one more time.
How did they miss this? How did I miss it? How would you know? I mean, give yourself a break.
It goes undiagnosed 80% of the time.
I feel like I betrayed her.
Sometimes, when somebody that we love gets sick, very easy to lose sight of the person and see only the disease.
Remembering that our loved one is still there not always easy.
Why don't you go get yourself a cup of coffee, okay? This can take a while.
I'm here.
I know where to find you.
Nat.
Dr.
Manning, the police are on their way to talk to Erika Dougherty.
- Police? - That's the way it works.
What are they gonna do to her? I don't know.
It's not my call.
Can't you change this? No, and neither can you.
Well, this should make you happy.
Listen the hospital's only two blocks away.
What? The police will be here soon.
Tell them you knew the hospital was only two blocks away.
The cops are coming? And tell them you clamped the umbilical cord.
You wanted your baby to live.
The neurologist will talk more about this, but there are going to be deficits increased irritability, forgetfulness, impaired mobility.
He won't be getting out of bed anytime soon.
I'm sorry.
I don't understand, um deficits? We'll see how he does in rehab.
I'm sorry, but your husband's going to need a lot of care.
Oh, my God.
What have you done? Have you turned my husband into a vegetable? We don't know the extent of the damage.
This is not what Doug would've wanted.
He would never want this.
Why didn't you tell me something like this would happen? We We have three kids.
We live we live paycheck to paycheck.
What am I supposed to do now? You son of a bitch! She's still weak from the delivery.
We just need to ask her a couple questions.
She's not facing any charges yet.
Would you mind just giving me a moment with her? Yeah, sure.
She's gone.
Shocker.
Leave a 14-year-old runaway unattended That poor baby.
I had this fantasy I could give him a family.
Where was my head at? You weren't thinking with your head.
And good for you.
You want out of the shower, everyone'll understand.
Ugh, maybe not Helen.
Oh, Helen.
Yeah.
Yeah.
Dr.
Charles do you know? Did they find that girl? Oh, not yet.
I think it's my fault she took off.
I told her the police were coming.
Huh.
So, um how's that sitting with you? Thought I'd feel worse.
Huh.
Interesting.
What are you doing? Trying to figure out where I went wrong.
Guy showed up this morning.
I ran these, discharged him.
Two hours later, he's wheeled in with a massive MI.
How did I miss it? Where was the lesion? Right coronary.
I know what I'm looking for, and I don't see any abnormalities.
I got the guy back, but it's not good.
It's not good.
Sorry, man.
It's late.
Yeah.
Hello there.
Do you know where you are? In a hospital.
And can you tell me your name, please? Carol.
Carol Donovan.
Good.
- Why am I here? - You had some buildup in the frontal subcortical region of your brain.
We drained about 50 ccs of spinal fluid.
What my colleague is trying to say is that you weren't quite yourself.
The pressure on your brain was causing you to see things in a different way, and now that pressure has been relieved.
Can I ask you, do you feel strong enough to stand, - take a few steps? - Oh, yeah, sure.
Tom, honey.
Carol.
You're back.
I was here and I was not here at the same time.
Like I was fading away.
It all seemed so real.
Your memories are gonna feel very real.
That's perfectly normal and to be expected, but this was just a temporary fix.
We're gonna have to do another procedure.
Ms.
Donovan, I have something for you and Mr.
Donovan.
I went online and did a little research.
Not bad.
- Hello? - Zoe, it's Will.
Dr.
Halstead, how are you? I am so sorry.
I got bogged down with a case, and I totally lost track of time.
My bad, completely.
Can I can I get a rain check? No problem.
I just got pulled into a sales meeting that's going long, so this works out for me as well.
Thank you.
- No, I got it.
- No, I got it.
- No, really, I got it.
I got it.
I'm not sure about that bag on you.
Well, perhaps with a different shoe? Nah.
- You jealous? - Jealous? Of how bad it looks on you? I don't think so.
Dr.
Halstead, got a possible MI coming in.
And good morning to you, Maggie.
Good morning.
Dr.
Manning, it was a pleasure being your caddy today.
Don't expect a tip.
Hey, we still on for tonight? - Tonight? - Ladies' night at Molly's, Me, you, and April.
April hasn't had a date in a while.
She can use some wingwomen.
Me, a wing woman? Your hormones they will lure the dudes in.
Right.
Hey.
Thank you.
You're going the wrong way.
Left my badge in the car.
I'll think about it.
Help! Help, anyone! I need help here.
I got her, I got her, I got her, I got her.
Come on! She's bleeding from somewhere.
Trauma two.
Get your asses over here! Who is she? What happened? I don't know.
I found her a couple blocks away collapsed on the sidewalk.
Let's get her on the monitors.
April, you got this? Got it.
- Where's she bleeding from? - Working on it.
HR 130.
BP's at least 90.
I've got a radial pulse.
- All right, get two lines.
- On it.
Get an I-STAT ABG and send labs.
Make sure we type and cross.
Can you hear me? Can you tell me what happened? The blood did you get shot? Let's get these wet clothes off her now.
Don't worry.
We're gonna put you in a gown and see what's going on, okay? Get blood, O negative, make sure it's warm.
Put it on level one.
Give her two.
Hey, stay with me.
You find the source? No head, neck, or torso trauma.
Belly distended but soft.
That's not an intestine.
It's an umbilical cord.
This kid just delivered a baby.
- What do you mean "just"? - Maybe five minutes ago.
She's still bleeding.
Clamp.
Where did you deliver this baby? Hey, what happened to your baby? Hey, sir? Sir, you're the one who brought the girl, yeah? - She gonna be okay? - Yeah, she's fine.
Where'd you find her? About two blocks that way.
Okay, can you show me? - Yeah.
- Okay.
Hey, grab an OB kit and follow us.
You got it.
She was right there.
What are we looking for? Sexton! Did she just abandon the thing? April! Bulb syringe.
Come on.
Come on, come on, come on, come on.
Come on Oh, okay.
Blanket, blanket.
Oxygen.
Okay okay.
There you go.
All right.
- I'll take him to the NICU.
- I'll take him.
She hasn't delivered the placenta yet.
It has to come out.
Where the hell is OB? Stuck in a delivery.
I can do it.
I've done it before.
I'm on the baby.
You sure? Yes.
April, where'd you find the baby? In a backpack behind that building on Huron.
We got there just in time.
Hey, hotshot.
Yeah, you.
An old lady had a fall, sprained her wrists.
Last name Francis.
Miss Francis? Ms.
Connie Francis? That's me.
You look awfully young to be a doctor.
Oh, I'm a medical student.
Sarah Reese.
Why don't you come with us? Come with you? To the beach.
Hey, did you bring the Coppertone? The He says he's having a heart attack.
He's always having a heart attack.
I'm not always having a heart attack.
Nope, just when the lawn needs mowing or the gutters need clearing or the garbage needs taking out.
Can you describe the pain you're feeling? It feels like someone sitting on my chest, slowly squeezing the life out of me.
How about we take a look? Keep your hands off of me.
I want to go to the beach.
I want to go to the beach.
Oh, Dr.
Charles, good.
Could I get a consult? I need to get this splint on her, but she won't sit still.
I'm late, and we're still 30 minutes away from Fort Lauderdale.
Ms.
Francis, I am so sorry to hold you up, but do you mind if I ask you a couple of questions? I'm Dr.
Charles.
Well, I hope you're not one of those stuck-up Princeton boys.
Oh, heaven forbid.
University of Pennsylvania, thank you very much.
Please forgive Ms.
Reese.
Smart and caring as she is, she's still learning.
Do you mind terribly if we were to borrow this so that we could contact your loved ones? Well, if it won't take you too long.
We will make it snappy.
Be right back.
Thank you.
So it didn't occur to you she might have dementia? That name didn't mean anything to you, "Connie Francis"? Should it have? Oh, I'm so damn old.
Just call her contact.
Uh If you could just fill each of these with nuts, and I brought the nuts.
I'll take care of everything else.
Helen, I thought this was gonna be a little bit more casual.
But I just I want it to be just right, you know? I want I want it to be something she'll remember always.
Helen? Hey, what were you doing with my mother-in-law? Who, Helen? Was she just here? Wish I would've known.
I would've said hi.
She handed you that pink box.
Huh? What's in the box, Maggie? Maggie! Napkin diaper nut cups.
What? Napkin diaper nut cups.
You fold the colored napkin up, you see, and then you hold it together with safety pins, - and then you stuff it - You're throwing me a shower? Surprise! Tonight at Molly's.
So the whole ladies' night ruse Just roll with it, okay? Fine.
Oh, how's baby Doe? Poor thing.
He's stable for now.
And the mother? Just came to.
Do we have any information on her yet? All we know is that her name is Erika.
- Okay.
Thank you.
- Yeah.
Hello, Erika.
I'm Dr.
Manning.
When can I leave? Based on how much blood you lost and what your body's gone through, I'd say you're at least here overnight.
Is there anyone I can call, your mother or father? No.
Maybe a friend? Did they find the backpack? Yes.
How did you end up in that alley, Erika? Why did you leave your baby there? I don't know.
I mean, I knew something was going on inside me, but I figured if I could just not think about it, then maybe I'm so stupid.
I'm just so happy that somebody found him.
Erika, honey, how old are you? There is someone you can call.
She's 14 years old, a kid.
She's scared, alone.
What about the family? Her mother's in prison.
Father's long gone.
She does have an older sister living in Champaign, though.
I left a message.
Here's the thing she was two blocks away.
Two blocks maybe she was trying the make it here.
Is that what she said? She clamped the umbilical cord.
She did not mean to harm that baby.
Right.
Put him in a backpack.
Leave him in an alley.
That'll keep him safe.
It's not that cut and dried.
She was delirious.
She left her baby to die.
It's exactly that cut and dried.
She's a child.
She wasn't ready for any of this, right? People come here for help.
I try to leave my feelings out of it.
Well, that's convenient.
Look, you don't understand because you're not a woman.
Don't give me that.
People need to be held accountable, regardless of sex.
This is a safe haven.
She could've dropped the baby off, no questions asked.
So now you do have feelings? She's got to live with this for the rest of her life.
Do we really want to punish her as well? You're talking as if there's a happy ending where that baby survives.
That baby is going to survive.
And if he doesn't, then what that girl did is murder.
How you gonna feel then? Who's the pediatric surgery attending today? Dr.
Grant.
I've got to get back down to the ED.
Page me if anything changes with this one's condition, okay? - Dr.
Rhodes.
- Yeah? Your father called.
Wants you to call him back.
- Thanks.
- Mm-hmm.
Excuse me, Dr.
Czerny.
You said yesterday that you may have some time today to discuss our new tranexamic acid drug? Talk to me tomorrow.
And are you even supposed to be in here? Have a great day.
Good morning.
Good morning.
Dr Halstead.
I'm Zoe Roth with Stewart and Breck Pharmaceutical.
Will.
Okay, so how big of a problem is blood loss during surgery, Will? I'm an ER doc, Zoe.
Don't do a lot of surgery.
But keep going.
I might learn something.
Well, you should know that S&B is conducting a major multi-institutional trial to establish our product's efficacy in so many different uses and procedures.
I'm sorry, I have a patient.
Can we do this tomorrow? W-what about later? Maybe over dinner? Dinner? Sure, I'm free for dinner.
Good.
Say about 8:00? Yeah, I'll meet you out front.
Call me if there are any conflicts.
All right, will do.
Yeah, okay.
She's very friendly.
Just doing her job.
You got a high fever in treatment 5, dog bite in 4.
These just came back from cardiology.
Uh, thank you, April.
Doug, Jenna, good news.
Second set of enzymes came back fine.
Both EKGs are normal, CK and troponin as well.
These chest X-rays look solid.
So you're telling me I'm fine? That's what the tests say.
Looks like you are good to go, my friend.
I knew it, huh? We wasted six hours here, and it's all on your head.
Well, it's not that simple.
There are plenty of other factors that can contribute to chest pain.
It could be reflux or stress, anxiety Yeah, like I said, all in his head.
Speaking of which, just in time to pick up Liam from daycare.
Bye.
I'm gonna refer you to a cardiologist.
She'll get you on a treadmill and put you through a stress test, okay? Like Jenna's not enough of a test.
I started calling her "Jenna-cide," as a dig, but it turns out she likes the nickname.
All right.
I'll see if they can get you in this week, okay? In the meantime, you tell Jenna the doctor recommends no lawn mowing.
Just in time to start shoveling snow.
- All right, you take care.
- Thank you so much.
Absolutely.
Heard you had a bit of a morning.
Yeah.
So listen, my mother-in-law's throwing me a surprise baby shower tonight that I totally don't want to go to, so you have to come with me.
Can't.
I'm having dinner with Zoe.
Zoe? The new S&B Pharma rep.
Blonde hair.
Yeah, I think I know the one.
So you're deserting me in my hour of need to go get laid? What are you talking about? It's strictly business.
She wants to pitch me on their new TXA product.
Whatever.
I was frantic trying to figure out where she'd gotten off to.
Mr.
Donovan, how long have we been in the Connie Francis era? We met in Fort Lauderdale, Spring Break, 1960 same year "Where the Boys Are" came out.
Carol loved that movie.
She mixes it up in our life.
This past year, it's been getting worse and worse.
Mr.
Donovan, caring for someone with dementia is one of the most demanding tasks in the world.
Remind yourself from time to time it's okay not to be perfect.
Thank you, dear.
I'll give that a try.
Mr.
Donovan, I just need your signature for these discharge papers.
What did I do? You get that from a greeting card or a fortune cookie? So where's my wife? Thank God.
Carol? Who is this? Your husband.
- My husband? - Yes.
I'd rather go with you.
I wouldn't know where to go.
Tom does.
Tom knows the way home.
She'll need to keep the splint on for about six weeks.
I feel so stupid.
Get up to go to the bathroom and trip over the rug.
Wait, wait, wait, wait.
Are you hearing what I'm hearing? Are you okay to walk? Would you mind just getting up and taking a few steps for me? - Sure.
- Here we go.
What do you think? Magnetic gait and complete recall of her injuries not consistent with a diagnosis for Alzheimer's.
- Very good.
- What's going on? I'd like to run a few tests on your wife.
I promise it won't take long, and it could very well be worth our while.
Sure.
Juvie's hemorrhaging! Trauma 2! How many pads did she soak? - Dozen or more.
- She must still have retained products.
Which attending did this? They were busy.
I did it.
You? You did it? All right, page OB.
Let's get her up to the OR now.
Got it.
Yep, your newbie.
How many units has she gotten? - Her most recent hemoglobin? - 5.
9.
She still looks like a ghost.
She needs more blood.
Restart the MTP.
Give me methergine and 1,000 mics of Cytotec.
Little room Erika Dougherty's been in the system for years.
In and out of foster care since her mom was sent to Logan.
Runs away when the families don't kick her out.
Suspected substance abuse, at least alcohol, maybe worse.
Would you ask Dr.
Manning - to step in here, please? - Yes, ma'am.
What about the baby's father? Who knows? Erika's been arrested more than once for solicitation.
- Ms.
Goodwin? - Yes, Dr.
Manning, this Madeline Gastern from the Department of Child and Family Services.
What's the baby's condition? - He's stable.
- And Ms.
Dougherty? Dr.
Pachefsky's treating her.
She may need a hysterectomy.
I reached her older sister, Kara Dougherty.
She's on her way up from Champaign.
Kara's an adult.
Could she potentially take custody of Erika and the baby? Potentially.
I know you always try to keep families intact.
Thank you, Dr.
Manning.
This girl is in big trouble.
She could be going to prison.
Come on.
She's 14 years old.
Solicitation or not, that's rape.
Doesn't absolve her.
She's facing several potential felonies.
Abandonment, attempted murder.
It's up to the State's Attorney and the judge, but Cook County? Anything could happen.
I thought I got it all.
Forcing the delivery of the placenta is an OB procedure, so what the hell were you thinking? It was an emergency situation.
I made a decision.
A bad one.
You overstepped your bounds, and you botched it.
That girl almost needed a hysterectomy.
A 14-year-old! Now, let me ask you something, Dr.
Choi.
You didn't like this patient.
You disapproved of her.
You think that affected my judgment and my performance? You tell me.
Dr.
Halstead to the E.
D.
Dr.
Halstead to the E.
D.
Code Blue.
Dr.
Halstead, cardiac arrest, treatment 5.
- Your patient.
- Code Blue.
I thought you said he was gonna be okay.
Get the pads on him.
He was in earlier.
Is there anything we need to know from his charts? No.
We did a full workup, and everything checked out.
I was driving home, and he I looked over and he was just white as a sheet.
And then I turned around and drove back as fast as I could.
I don't think he was breathing.
Ma'am, I'm sorry.
You need to wait outside.
Okay.
Hold compressions.
V-fib, charge to 200 joules.
- Everyone clear.
- Clear.
I got a pulse.
He's in sinus rhythm, brady at 50.
BP? 90 over 45.
Wait, wait, wait.
72 over 35.
Start dopamine at 10 and titrate to a systolic of 90.
- Yes, sir.
- Get a 12 lead EKG.
Right away, Dr.
Halstead.
We gotta get his BP up.
You paged me? Dr.
Grant.
Pneumothorax.
Right lung collapsed.
Tubing him now.
O2 sats at 78.
We get below 75 and We're not getting below 75.
Campbell.
What do you need? Inhaled nitric oxide.
We need to improve oxygenation.
I'll get a tank.
He's really bradycardic.
Turn up the dopamine.
It should help the pressure and heart rate.
Dr.
Halstead, it's been 15 minutes make a decision.
I'm not giving up yet.
RV's not moving.
You have a blown-out RV and severe akinesis.
I think you might want to consider giving more fluids instead of escalating the pressers.
Call RT for a tank of nitric oxide.
Nitric oxide? It'll reduce the afterload so that the heart works less and buy some time till the cath lab is ready.
I've never seen it used for this.
It's unorthodox, I know, but I don't have a balloon pump, and we're out of options.
RT says Dr.
Manning is signing out the last tank.
They'll have another ready in ten minutes.
He'll be dead by then.
Nat, where are you going? NICU.
Baby Doe's sats are in the 70s.
- Put him on ECMO.
- That's a last resort.
I'm sorry, but I need this tank.
What the hell are you doing? I have no other option.
You do.
- Give me that tank! - Nat, my patient will die without it.
You're putting the baby at risk.
I'm not gonna lose this guy.
- Will - He's got three kids.
Try thinking like a doctor and not a pregnant woman.
He's in v-fib.
Lost his pulse again.
Charge to 200.
Everyone clear.
Clear.
One more round of epi.
Let's go.
Restart compressions.
Nothing.
Come on! Doug? Doug, please? Please listen to me, okay? We need you, all right? - I need you, okay? - Nurse.
- Please? - Please stop.
Hold compressions.
I got a pulse.
Sinus brady again.
Start amnio drip.
Let's get him to the cath lab.
Let's unclamp.
Turn on the circuit.
ECMO acts as a heart-lung bypass, oxygenating the infant's blood outside its body.
- Sats are rising.
- Thank God.
Dr.
Manning? There's a Kara Dougherty downstairs to see you.
Okay.
The usual, Dino.
Dr.
Charles.
Dr.
Choi.
You were in the what, the Navy, right? Still am.
Naval Reserves.
Doc I did my residency with was on away leave from the Navy.
It was tough as hell practicing psychiatry with you guys.
Couldn't get anybody to open up.
Could be a sign of weakness.
Pork rind? No, thanks.
No? I shouldn't eat this stuff so much.
Guess that military culture's tough, right? Loose lips and all? Last chance, man.
Pretty sure they're organic.
- I'm good.
- No? Kara, I'm Natalie.
We spoke on the phone.
I brought Erika some clothes.
Thank you.
- Where's my sister? - Follow me.
There were some complications with the birth, but we think the baby's gonna be fine.
You think? It's still very early, but we have the best neonatal ICU in the Midwest.
I could take you up to see him if you want.
Maybe later.
I spoke to a social worker.
It might be possible for Erika and the baby to come live with you.
Let me talk to her.
- Hey.
- Hey.
You really stabilized him using nitric? Interesting.
What about the patient? The RCA was completely occluded, and there was a 60% occlusion of the circumflex.
I stented both and placed an impella for a couple days to rest the heart.
What was his code time? Maybe 20 minutes total.
20 minutes? I would've let him go.
What's the difference between God and a doctor? God knows he's not a doctor.
I just got a page.
Dr.
Rhodes? Yeah? Please, my boss wants to talk to you.
Okay.
You wear the scrubs well.
I'm glad you approve.
Long time.
Got a couple of minutes? We can go grab a coffee, maybe catch up.
I'm working.
Ah.
You know, I took it as a good sign that you'd come home, that maybe you'd worked through your issues? My issues? Come on.
Let it go.
Let's move on.
You're still the same, aren't you? Just untouchable.
Let me tell you something.
When you left this town, Connor, I was deeply hurt.
Yeah.
You ask Claire.
But right now, I'm willing to put all that behind me, for the two of us to start over.
It's a good pitch, Dad.
Really.
You hit all the right notes.
I'm not buying it.
We can go.
You ready to see your nephew? I wish I could help them.
Kara.
I just got a promotion customer service rep and my boyfriend and I are talking about us moving in together.
I've come too far to get sucked back into this crap again.
They're your family.
You make that sound like a good thing.
Hold that position.
What did you say this might be again, hydro what? Hydrocephalus.
Literally means "water on the brain.
" The lumbar puncture should relieve some pressure.
Well, hopefully, we'll see some cognitive improvement, and if that's the case, we'll implant a surgical shunt for long-term treatment.
I, uh the summer we met, - dancing to "Where the Boys Are.
" - Wow.
I'd give anything to see that look in her eyes even one more time.
How did they miss this? How did I miss it? How would you know? I mean, give yourself a break.
It goes undiagnosed 80% of the time.
I feel like I betrayed her.
Sometimes, when somebody that we love gets sick, very easy to lose sight of the person and see only the disease.
Remembering that our loved one is still there not always easy.
Why don't you go get yourself a cup of coffee, okay? This can take a while.
I'm here.
I know where to find you.
Nat.
Dr.
Manning, the police are on their way to talk to Erika Dougherty.
- Police? - That's the way it works.
What are they gonna do to her? I don't know.
It's not my call.
Can't you change this? No, and neither can you.
Well, this should make you happy.
Listen the hospital's only two blocks away.
What? The police will be here soon.
Tell them you knew the hospital was only two blocks away.
The cops are coming? And tell them you clamped the umbilical cord.
You wanted your baby to live.
The neurologist will talk more about this, but there are going to be deficits increased irritability, forgetfulness, impaired mobility.
He won't be getting out of bed anytime soon.
I'm sorry.
I don't understand, um deficits? We'll see how he does in rehab.
I'm sorry, but your husband's going to need a lot of care.
Oh, my God.
What have you done? Have you turned my husband into a vegetable? We don't know the extent of the damage.
This is not what Doug would've wanted.
He would never want this.
Why didn't you tell me something like this would happen? We We have three kids.
We live we live paycheck to paycheck.
What am I supposed to do now? You son of a bitch! She's still weak from the delivery.
We just need to ask her a couple questions.
She's not facing any charges yet.
Would you mind just giving me a moment with her? Yeah, sure.
She's gone.
Shocker.
Leave a 14-year-old runaway unattended That poor baby.
I had this fantasy I could give him a family.
Where was my head at? You weren't thinking with your head.
And good for you.
You want out of the shower, everyone'll understand.
Ugh, maybe not Helen.
Oh, Helen.
Yeah.
Yeah.
Dr.
Charles do you know? Did they find that girl? Oh, not yet.
I think it's my fault she took off.
I told her the police were coming.
Huh.
So, um how's that sitting with you? Thought I'd feel worse.
Huh.
Interesting.
What are you doing? Trying to figure out where I went wrong.
Guy showed up this morning.
I ran these, discharged him.
Two hours later, he's wheeled in with a massive MI.
How did I miss it? Where was the lesion? Right coronary.
I know what I'm looking for, and I don't see any abnormalities.
I got the guy back, but it's not good.
It's not good.
Sorry, man.
It's late.
Yeah.
Hello there.
Do you know where you are? In a hospital.
And can you tell me your name, please? Carol.
Carol Donovan.
Good.
- Why am I here? - You had some buildup in the frontal subcortical region of your brain.
We drained about 50 ccs of spinal fluid.
What my colleague is trying to say is that you weren't quite yourself.
The pressure on your brain was causing you to see things in a different way, and now that pressure has been relieved.
Can I ask you, do you feel strong enough to stand, - take a few steps? - Oh, yeah, sure.
Tom, honey.
Carol.
You're back.
I was here and I was not here at the same time.
Like I was fading away.
It all seemed so real.
Your memories are gonna feel very real.
That's perfectly normal and to be expected, but this was just a temporary fix.
We're gonna have to do another procedure.
Ms.
Donovan, I have something for you and Mr.
Donovan.
I went online and did a little research.
Not bad.
- Hello? - Zoe, it's Will.
Dr.
Halstead, how are you? I am so sorry.
I got bogged down with a case, and I totally lost track of time.
My bad, completely.
Can I can I get a rain check? No problem.
I just got pulled into a sales meeting that's going long, so this works out for me as well.
Thank you.