ER s01e05 Episode Script

Carter? Man, somebody get a drool bucket.
Carter, get up! Where's your pager? I've been beeping you for five minutes.
It's right here.
Keep it on your pillow so you don't sleep through a page.
Come on, let's go.
You've got patients to see.
Carter, let's go! Come on! We've got an undomiciled male with a laceration to the forehead in 2.
Clean and stitch the wound.
Please don't take off his shoes or socks.
God knows what you'll find.
This way.
This way.
Come on.
When you're done, see an old lady with leg pain in 6.
- You ever get used to this? - Used to what? Three hours of sleep.
Anything more and I'm sluggish all day.
The chart's there.
Mark, how was the big day off? First two hours was great.
Then Rachel and Jen left for Detroit.
- What's that all about? - Job interview.
Oh, really? Don't even start.
- Morning, guys.
- Susan, can you work Thursday night? I am on Thursday night.
Tough.
Wife's so far away other immediate temptations so close.
- You haven't the faintest idea - I know exactly what I'm talking about.
Doug, I need you in 3.
And good morning to you, Nurse Hathaway.
Good morning.
The price breaks on the photocopiers start with five unit orders.
Be off in a jiff.
Sam, if you're free this afternoon, say around 3 l'd like to offer a package for your phone, fax, e-mail needs.
Tomorrow then.
Have I told you about our five-year service plan? We guarantee every pinion, spindle, sprocket for the life of the machine.
With unlimited service for the first five years.
It started last week.
People would speak to Ozzie, but he wouldn't respond.
I thought something was wrong with his hearing.
Ozzie, can you hear me? You wouldn't stick things in your ears, would you? My mom told me never to put anything in your ear smaller than your elbow.
Can you hear me whispering? - Yes.
- Okay.
I'll tell you, Mrs.
Chap, there's no sign of infection, no injury.
His hearing seems to be fine.
That's what's so frustrating.
He hears some things, but not others.
What are the things he doesn't hear? Like my mother's voice, for one.
She says really terrible, terrible things.
She thinks that I'm a bad mother.
And your mother lives with you? No, she's dead.
But you still hear her? What are some of the other voices that Ozzie can't hear? My ex-husband's.
The ice cream man's.
Diana.
Diana? The Princess of Wales! Does that ring a bell? Can you excuse us a second? Call Psych Services.
Tell them we need a consult.
Get Social Services for the boy.
Leave the door open until he gets here.
What's up, kiddo? Me and my mom we can stay together, right? - You bet you can.
Did you leave the money there? That's what you sound like! ''Patient is experiencing pain in the right lower extremity.
Recent history shows colon cancer and a 4-hour plane flight.
Patient's calf was found to be tender and 4 centimeters larger than the unaffected side.
Differential diagnosis includes cellulitis, hematoma and deep vein thrombosis.
'' Okay.
So, what would you do? I suggest a CBC, Chem-7, coag study and a duplex scan of the leg.
All right.
Bye now.
Given that two elements of Virchow's Triad are present I feel a venogram is indicated if the scan is inconclusive.
- Proceed.
- You concur with my advice? I said proceed.
Mr.
Madsen gets a GI cocktail, and check with urology.
Can I get some help? - We need a doctor! - Get a wheelchair.
She has chest pains.
I'm Dr.
Greene.
Show me where it hurts.
- My heart.
- Have you had heart problems? Two heart attacks till they put the machine in her chest.
- A pacemaker? - No, a defibrillator.
Just relax.
Take deep breaths.
I want a 12-lead, CBC, Chem-7, cardiac enzymes and a coag profile.
- What's your name? - Vilma.
Vilma, you just relax and we're gonna take care of you.
Sir, I need you to go with the nurse to the waiting room.
I'll come talk to you as soon as I can.
What is ''Virchow's Triad'' anyway? That sounds like a board exam question.
One that I'd skip.
Jerry, do me a favor.
Bring the fan.
I'm burning up.
Word on the vine is, you and Langworthy both put in for the Starzl Fellowship.
That's no big surprise.
No? She's a year ahead of you.
- So what? - So heads up.
Here comes the competition.
- You get the results on bed 4? - Not yet.
Sarah, what's Virchow's Triad? Stasis, trauma and hypercoagulability.
Jerry, get this fan out of here.
It's blowing in my face.
Dr.
B.
wanted it there.
Code 3, auto versus pedestrian.
Just pulled up.
I'll take it.
Peter, you can assist.
Come on.
Step on it.
Step on it.
Hit-and-run victim, approximately 17.
Found in a crosswalk in full arrest.
- Vitals? - Negative.
Pupils are blown.
- How long was he there? - Who knows? No one saw it.
Come on.
Get five units of O-neg to Trauma One.
Tell X-ray we need a cross-lateral C-spine.
Grab that IV, Peter.
Step on it, folks.
Coming through! We need more blood.
Give it half of epi.
- Heart sounds? - Negative.
- Time? - Eighteen minutes.
- X-ray! - Wait! Aprons.
Move it.
Protect your gonads, Peter.
I always do when you're around.
Let's move, people.
Come on.
Move it! Move it! Fire in the hole! Come on! - What's going on? - Kid was DOA.
They're trying to bring him back.
His tube is loose.
Carter, hold his ET tube.
His left side is full of blood.
Autotransfuser! Let me in there.
Give me some help here.
Come on, kid.
Give me some help.
Come on! You can do it.
Come on.
- BP? - 150 over 105.
- How you feeling? - I can't breathe! Respiration is 28.
Pulse 120.
Let's give her.
4 nitro sublingually.
Please, doctor.
- Feel like I'm dying.
- Respiration's 32.
She's hyperventilating.
Try and control your breath, Vilma.
- I can't.
- Slowly.
- It hurts.
- Let's get her some morphine.
Oh, my God! Blood pressure's coming down.
Feeling better? Better.
Much better.
You guys can take it from here.
She said she's been taking both Prolixin and Ativan.
- Schizophrenic? - Floridly.
Yes.
Went off her meds, now she's delusional.
Hearing voices.
I'm going to have to admit her.
What about the boy? The social worker's calling the Presbyterian Home.
Skull fracture, C5 neck fracture hemopneumothorax, ruptured diaphragm.
Any heart activity? Time? Time of death: We lose them all the time, Carter.
Does the pain move around? It just sits there like a bayonet to the gut.
- How long have you had this? - A year, off and on.
Never this bad.
Also, I get constipated and sometimes there's blood in the bowl.
You haven't seen a doctor? If he was open nights and Sundays, but who's got the time? That's me.
Harry Stopak.
Bob Wellman! How are you? You got the brochure I sent over? Sorry, I gotta take this.
So you like the EM-250? It's a good copier, Bob.
But frankly, I saw you more in EM-250 R.
- You get any breakfast yet? - No.
Get some and be back in 15.
Carter, come here a minute.
He was on his way to shoot buckets.
No ID, no name on the ball.
His shorts say ''Von Stuben High.
'' Call them.
Maybe someone can come and ID him.
Who said you could assign duties to my student? I didn't know you owned him.
I thought he was assigned to surgery.
Well, he isn't.
- Are you saying he's unavailable to me? - I'm saying next time you ask.
Identify the dead boy for Dr.
Langworthy, then you report back to me.
Doug Ross.
We've got a little girl here who may have a broken hand - You son of a bitch! - Can you hold on a second? Get your hands off of me now! Let go! You son of a bitch, get your hands off me now! You son of a bitch! Get them off me now! Get your hands off me now! Calm down.
Thank you.
Damn it! Damn it! Give her Haldol I.
M.
and get her upstairs! I'll get you! Why are you doing this? - Get her out of here! - No! Please! Stop this! The kid's gone.
- Damn it! - Get someone to look at this.
Thank you, doctor.
Your lab tests look fine, and your heart rhythm's normal.
I'm gonna give you the name of an anti-gas tablet.
And I'd lay off the kielbasas for breakfast.
Thank you, doctor.
You saved her.
- It's another attack! - Is she seizing? Hold on.
Hold on.
Hold on.
Just relax.
Just relax.
Her heart's fine.
Has this happened before? Never.
What was it? I definitely felt that.
What's happening, doc? The defibrillator in her chest is going off.
Why is it shocking me? It's supposed to, but only when you're having arrhythmia, which you are not.
Must be malfunctioning.
- Can't you shut it off? - We're going to try.
Call Cardiology.
She really sank her teeth into you.
Any patient who's even potentially psychotic should be placed in four-point restraints and muzzled.
Spoken like a true healer.
After 15 years not one week has gone by without being bitten, spat, puked or peed on.
You're a misanthropic old fart.
I'm not old.
Is this necessary? Human mouth literally swims with bacteria.
Staph aureus, Eikenella.
The woman deserves a lobotomy or a hammer to the head.
Sorry.
Did that hurt? - Dr.
Langworthy? - Yes? The janitor at the high school left a message for the principal.
He's giving me a copy of the yearbook to try to find the boy's picture.
- I wish I could do something more.
- Such as? I don't know.
Should I go back to Dr.
Benton, or? - Go.
- Okay.
If Billy Fleishell hadn't piled on, it never would've happened.
He left some cleat marks on your knuckles.
From his teeth.
He speared me, so I popped him one.
The game's gotten rougher than when I used to play.
Nothing is broken.
Carol will take Blair to X-ray and give her something for the pain.
I don't need anything.
Right this way.
John, thanks for coming down.
No problem.
Hey, listen.
I hear you've been quite attentive to Carol since she got back.
I didn't mean to be.
No, it's okay.
I'm glad you guys are still friends.
Really.
Call me anytime, okay? Mr.
Stopak, you need to see a specialist for further tests to rule out ulcerative colitis.
Which is serious.
You think that's what I've got? Based on your history and what I've seen, no.
I think you have irritable bowel syndrome, which can become serious.
If that's what I have, how do I get rid of it? Increase the bran in your diet, and more important decrease the stress in your life.
I don't exactly control the stress in my life.
Cut back your work hours.
Cut back? In my office there are two kinds of guys.
Those who sell 10 million and win a trip to Palm Springs and those who don't.
Know how long it's been since I missed the trip? I have never missed the trip.
- I'm back.
- Good.
Fill out these slips and take those urine samples to the lab.
It's good to be back.
Walt! What's up? I parked in the first row near the dumpsters.
- So it was the transmission? - That sucker was shot.
How you getting back? - Peanut followed me in the truck.
- Is Jackie excited about tonight? I'm taking her to this real fancy place she's been dying to try ever since she heard that Oprah owned it.
It's steep, but it's our What the hell? Your sister's worth it.
And I appreciate you coming to sit with your mom.
How's she doing, man? Well, no incidents this week.
But you can't leave her alone for five minutes.
She'll be in the back yard yelling at the neighbors.
But she had Jackie take her to the beauty parlor so she can look pretty for you.
Look, man, I gotta split.
I'll be there.
My name's Carol.
I like your sneakers.
They're not the good kind.
My mom got them from the cheapo store.
Where is she? The doctors took her upstairs.
She's very sick.
They're gonna try and make her better.
But that doctor said we can stay together.
It looks like your mom may have to stay here for a while.
Can I see her? I don't know if she can have visitors, but I'll check.
You wanna hang out with me? I'll take you to Cardiology.
They're familiar with this.
You don't have to worry.
You'll be okay.
- Let me grab your records.
- Dr.
Lewis.
I appreciate your advice.
My wife's been saying that for 18 years.
You have the number for the gastroenterologist? Do you know who's in charge of business machine procurement here? Hello? I can't hear you.
Who? Louise! Did you get the rate card I faxed? I can't hear you.
It's kind of noisy here.
Hang up that phone.
Hang up that phone, now! - You okay? - What kind of phone is that? The most powerful hand-held around.
Turbo dial, alphanumeric memory.
- Get you half price.
- I don't want one.
I want you to take that phone out of this hospital, now! Now! You're supposed to screw the caps on.
Von Stuben High yearbook.
A guy dropped it off for you.
Yeah, sure.
I'll take care of it.
Find him? Yeah.
Steven Tierny.
A junior.
A member of the marching band and on the debate club.
He was kind of a nerd.
Kind of like me.
I gotta get up to the O.
R.
and do a hernia.
You call his folks? Should I? Get them down here.
Let Langworthy break the news.
Change your clothes.
You're telling me you haven't even thought about it, with Susan? So what? I'm a married man.
Doesn't mean I'm not allowed to even speculate.
You're saying that you would never act on it? Ever? You're asking if there are circumstances where I might possibly, conceivably Commit adultery? Yes.
Let's say Jen takes a job out of town in, I don't know, Detroit, and she leaves you here.
No.
There would have to be more.
An affair, perhaps? She goes out on you and then you could justifiably - Even the score? - So to speak, yes.
- That's not gonna happen.
- You just never know.
Maybe I could be of service.
Mark, that chest pain rule-out MI just got here.
- 55-year-old with substernal chest pains.
- Thank you.
- What about her? - They lost the key.
We'll need bolt cutters for these cuffs.
And cut off these chaps.
This is so embarrassing.
- Exam Room 2, Jer? - Curtain 3.
What's the patient's name? Neil Shearer.
Thank you.
We're gonna hang out with all the big people.
Hey, Jerry.
This is Ozzie.
How you doing? He's gonna be with us for a while.
His mom's on the 5th floor.
Okay.
Okay.
- Can you watch him for a while? - Sure, no problem.
I'll be right back.
So.
You ever seen a picture of a diseased gall bladder? Check it out.
Excuse me.
My husband was brought here in an ambulance.
- What's his name? - Neil Shearer.
Wait here one second.
His rhythm's off.
He has multipulpal PVCs.
Give him 100 of lidocaine IV push and start a drip.
Here you go.
Sit down right here.
Thank you.
Thank you.
- Excuse me.
- What is it? Mr.
Shearer's wife is at the desk.
- Oh, God! - Are you and Mrs.
Shearer acquainted? I'm her secretary.
Jerry, show Mrs.
Shearer to the waiting room.
Behind you.
Look out.
Malik, you look like a surgeon.
- Excuse me.
- Oh, here.
Come on.
Does it hurt anywhere in here? Not really.
Just tell me when it does, okay? - You did an abdominal series? - It was negative.
CBC, UA, Chem-7, amylase? All negative, but her sed rate's 50.
- Right there.
- Okay, just sit tight.
You pulled me off my first hernia for a lady with arthritis? - But her sed rate - Is high due to inflammation.
She's got no GI symptoms and guaiac negative stool.
What surgical problem does she have? - Gall bladder, appendix - Based on what? Based on what the patient's telling me.
I'll leave you two to chat.
I'll be in the O.
R.
if you get a real surgical candidate.
Mrs.
Shearer? Mrs.
Shearer? Ozzie.
Ozzie? I'll find him.
Hello, Mr.
Tierny? This is I'm John Carter at the Emergency Room at Cook County General Hospital.
Your son, Steven, has been involved in an accident.
His condition is serious.
I think you should come down here right away.
It's serious.
Very, very serious.
Thank you.
Carol, does the name Joey Skarneckia ring a bell? It's a Pedes case.
A car accident about three months ago.
Not a clue.
His insurance company wants information.
Will you call Medical Records for me? Are your hands painted on? What? Pick up the phone and dial.
Out of curiosity, is this free-flowing hostility aimed at the world in general, or just me? - You don't wanna know.
- What? What? You told Ozzie he'd be with his mom when you knew she'd be put away, probably for a long time.
Just who did you help by lying? I didn't lie.
Sure you did.
You didn't want a big emotional scene which is something you can't handle and avoid at all costs.
Oh, boy.
White count's 20,000! Oh, God! Call the O.
R.
Get Morgenstern down here now.
Hang in there.
- Come on, come on! - I'm trying.
Okay - Faster! You gotta Please! - Relax.
Go to the left.
Go a little bit to the left, please! There's a Mrs.
Shearer outside.
Hurry, I gotta go! Patient's conscious.
God! Neil, what happened? Patient's unconscious.
He had a small heart attack.
We gave him medication and he's stabilized.
I'm gonna have to ask you to wait outside.
Why do I have to wait outside if he's stabilized? It's hospital policy.
I'm sorry.
I'm sorry.
This is my husband and I want to be wherever he is.
What's this? Do you have a pen? Where are his clothes? Excuse me? The clothes he was wearing when he was brought in here.
Where are they? I'm not sure.
They have to be here somewhere, don't they? Priscilla? I suppose you all think this is very, very funny.
Don't you? Excuse me.
Call the O.
R.
! We got a retrocecal appendix.
We need a room.
- She perfed? - Yes, she did.
Thanks to Dr.
Lewis.
A patient has stabbing lower back pain and you don't get surgical consult? A medical student would know better.
She consulted me.
I assessed the patient wasn't a surgical candidate.
Do you need an assist? Yes, I do.
Come on, Sarah.
Watch it! - You seen Dr.
Lang - Why do you want her? The parents of the high-school kid are here.
- What's his name? - Steven Tierny.
All right, come on.
You gotta learn this anyway.
Mr.
and Mrs.
Tierny? Hi.
I'm Dr.
Benton.
At 9:30 this morning, your son was brought in in full cardiac and respiratory arrest.
We tried to revive him, but with no success.
I'm sorry, your son died.
No! No.
Can we see him? Sure.
Oh, no! Dear God! Doctor this isn't our son.
Oh, God! Dr.
Greene! Dr.
Greene! Damn! It's good to see you, man.
Bob Brickley.
One year ago today, you saved my life.
- Of course.
- A small token of my gratitude.
Frozen T-bone steaks.
The real deal.
All the way from Texas.
From now on, August 25th is gonna be Dr.
Greene Day in my book.
I'm gonna honor it every year for the rest of my life.
Well I don't know what to say.
Thank you.
Hey, man, a handshake won't do it! Happy Dr.
Greene Day! I was embraced by two men today.
I find that highly unusual.
- Some guys have all the luck.
- One gave me a dozen steaks.
How about a cookout on the roof? That sounds nice, but I've got a date.
Oh, yeah? Anyone I know? Yeah.
Div Cvetic.
We've kind of been together for a month or so.
Really? Great.
Div's a great guy.
- What's with this patient? - Addict having withdrawal.
He sounds like a car alarm that you can't shut off.
Mr.
and Mrs.
Fisher? I'm John Carter.
Your son, David, was hit by a car this morning.
And he was brought here by ambulance in full arrest.
And we tried to resuscitate him for 31 minutes.
We used all of our capabilities but his injuries were too severe, and he died.
And I'm sorry.
How is she? Fine.
In and out, 20 minutes.
Peter, listen.
That was a difficult diagnosis.
Lots of surgeons would've missed it.
Because a lot of them don't take the time to listen to their patients.
The good ones do.
I'm doing a Whipple procedure.
Care to assist? A Whipple? Are you kidding? Patient's a 62-year-old man with a history of pancreatic cancer.
Came in four weeks ago with mid-upper gastric ER.
Dr.
Taglieri wants to see you outside supplies, about that missing kid.
And these squiggly tubes here, these are the intestines, see? And this blob, that's the heart.
Where's the gall bladder? What do you know? Someone took it out.
Must've been diseased.
You still got yours though, don't you? It's down there somewhere.
Where are you taking me this time? A social worker is going to take you to the Presbyterian Home.
I can't stay with my mom? The truth is that your mother's very sick.
It's not her fault.
She hasn't done anything wrong.
But to help her get better, she's being sent to the psychiatric hospital.
I hate her.
I don't think that's true.
Listen, your mama loves you very much.
Then why is this happening? I wish I could tell you.
Come here.
I wish I knew.
How was the Whipple? - No problem.
In and out.
- Who performed it? I did.
- Walt, I'm sorry - Our 10th anniversary.
I know, I got held up in O.
R.
No, no, no! Don't hand me that ''O.
R.
'' crap.
I know how important your work is compared to the small events of my life.
Walt, I'm sorry.
We don't ask much.
Practically nothing.
Just that once in a while you come and sit with your mother so your sister and I can be together.
And you act like you're doing us a favor! Okay.
All right, Walt My next three nights off I'll come and sit with her.
I promise.
I forgot, man.
I swear I'm sorry.
Funny how that happens when it comes to your family.
You off? - Yeah.
- Me too.
Twelve whole hours.
When you back on? Tomorrow.
If I come back.
You serious? I can't remember even why I'm doing this.
You wanna be a doctor, right? Benton told my adviser I was doing a generally adequate job.
And that was before today.
I don't belong here.
What kind of drugs is that guy on? Help! Help! My wife is having a baby! It's coming.
I can feel it! - That's the head.
- What do I do? You take it.
I'll get help.
You're gonna be fine.
Your baby's coming.
All you have to do is lie back and push.
Okay? Whenever you're ready.
That's it, just push.
Push! Push.
That's it, push.
Okay.
One final push now.
Come on.
Come on.
That's it.
You're doing great.
Now move the cord back over the head.
You got it.
That's it.
You're doing great! You're doing great.
Okay, one final push.
Come on, just push.
That's it, okay.
Push! - Move the cord out of the way.
- That's it.
That's it.
That's it.
It's a girl! You all right? You got her? Over there.
Get the lock.
Yes! Yes! - Hey, Doug.
- Hey, John.
- This is a bad idea.
- Who is it? Doug Ross.
What are you doing? Nothing.
My car broke down and the tow truck was taking so long I thought I would use your phone.
I'm late for my date.
You know, I see the tow truck right there.
I'm really sorry.
What were you thinking? What could you possibly have thought would happen tonight? That you would come to my doorstep at midnight, drunk and I would find that as some sort of grand gesture of love? Is that what you were thinking? That you can just show up? I'll invite you back in my life? In my bed? Is that what you imagined? - I don't know.
- You have no right to do this! I'm sorry.
Do you think that you love me? For how long, Doug? How long till you start wondering if there isn't someone better in the next room? How long till you're reminded of all the 22-year-olds you could be screwing tomorrow or the next day? I will not let you do this to me again.
I'm sorry.