Chicago Med (2015) s01e14 Episode Script
Hearts
How long have you been awake? Ethan? Since 1:00.
Well, I didn't leave a toothbrush and eyeliner in your medicine cabinet so I could sleep in your bed without you.
I've been in therapy.
Not just Dr.
Charles, but the group he sent me to at the V.
A.
Thought I'd be further along.
Thought I'd at least be sleeping.
Beginning to think it's a waste of time.
Ethan, you know PTSD there's no quick fix.
It's a process.
Come back to bed.
Gotta go for a run.
[sighs.]
This is not my first rodeo.
I-I've been through this before.
You sit there deciding who gets to see the doctor next.
And the answer is me.
I'm next.
Mr.
Coleman, there are people in front of you.
My heart is beating inside my head.
Find a magazine and please wait your turn.
We've been through this.
Tell me something.
Leah, where's your heart? In your chest, right there, behind your bra? - You step back now.
- Not mine.
No, mine's floated up my neck and it's beating inside my skull.
It's just it's beating inside my skull and it's driving me crazy.
Please, man! - Hey! - I need to see a doctor! - Hey, sir! - Excuse me! - Security! - Sir April, get security.
Sir I need a doctor! [panting.]
Can someone please help me? [grunts.]
- Dr.
Choi! - Whoa, whoa.
Sir, look at me.
Wait, wait, wait.
We need to get you back into the waiting room.
I could have lied; I could have said that I had chest pains.
You would have had to see me then, but I'm not a liar.
Okay, okay.
Sir, why don't you just come with me? Come with me.
- It's okay.
- Someone's gotta make it stop.
- Okay.
- It's gotta stop.
We will get to you as soon as we can.
No! [shouting.]
[screaming.]
Will somebody see me now? [sobbing.]
Page Dr.
Charles.
Got you.
I'm not crazy! I'm not! Mr.
Colman, I'm Dr.
Choi.
We need you to stay calm.
Didn't help It's it's still pounding! He says his heart is pounding inside of his head.
Mr.
Coleman, I need to examine your ear.
I don't care about the ear! [screaming.]
Let's get him something for the pain.
- 5 of morphine IV, please.
- Got it.
Mr.
Coleman, I'm Dr.
Charles, psychiatrist.
Just because I'm a vet does not mean that I am a mental case.
You did walk in here and stab yourself in the head.
Because no one No one would help me.
Well, look, I-I just need to do a little evaluation, ask you a couple questions; that be all right? I'm not crazy.
I'm not a drug addict.
You're wearing six shirts? Yeah, but just one pair of pants.
Why's that? Isn't it obvious? To to muffle the sound of my heart.
Does it help? Nothing nothing helps! [panting.]
Please somebody [panting.]
Good morning.
I'm Dr.
Manning.
- I bet you're Bo.
- And I'm Griffin.
Well, hello, Griffin.
Nice to meet you.
Did you see that man? He stuck a pencil in his ear.
Yes, it was very bad, wasn't it? - Yeah.
- Sorry you had to see that.
The boys were playing in the driveway waiting for the school bus.
I see you fell off your hoverboard.
I see a lot of hoverboarders in here, if that's even a word.
Yeah, he hit a patch of gravel.
I tried to keep it cold.
Let me know if this hurts.
[groaning.]
I see there's no abrasions on the palm.
It it feels like it's sleeping.
Hmm.
You know what I think? I think this is a very broken wrist.
I do too.
It made a bad noise.
Griffin, honey, please.
Did you hurt your hand as well, Mrs.
Taylor? No, no, no.
Kitchen accident.
Burnt myself.
It's fine.
Well, I'd like to get an X-Ray of Bo's wrist.
You know what, I'd prefer you didn't.
I don't want to expose him to unnecessary radiation.
It's just a minute radiation exposure and it is necessary.
A surgeon needs to go in there and reposition the bones.
But if they're already operating, why do you need a X-Ray? An X-Ray will tell the surgeon exactly what needs to be done.
But I do need your permission.
[sighs.]
Okay, it's fine.
All right, well, someone will be in to take you up to X-Ray.
Thanks.
[groaning and stammering.]
- Fresh balloons every day.
- Yeah, I know.
His room is starting to look like a party store.
[chuckles.]
I appreciate you checking in on him the way you do.
Oh, please.
Eric's my guy.
Tell him I'll be up during my break.
All right.
Your ride's here.
Hold that, hold it please.
Thank you.
[laughs.]
Honey, the only thing that's worse than dating a patient is dating an athlete.
Well, his son is the patient, and he's retired.
Don't get me wrong.
I love athletes.
But in my experience, they're little kids in men's bodies.
Bad long-term bets.
Ventricular septal defect repair.
Lots of people born with holes in their hearts.
Procedure's a mainstay in the CT repertoire.
Good one to get under your belt.
You mind my talking? No.
Straightforward, high success rate.
Mostly kids, sometimes a newborn, in which case, stay focused on the simplicity of the procedure.
Try not to be distracted by the fact that an infant's heart is smaller than a strawberry.
Can take you out of the moment.
Right.
So far so good.
You punctured the tympanic membrane and went into the middle ear.
We can do the repair.
It's called a tympanoplasty.
Just listen to my heart.
It's loud, right? Sounds normal to me.
[scoffs.]
That can't be! You know, Mr.
Coleman, I'm a vet too.
I know something about PTSD.
It's not that.
I-I saw combat, but I-I was okay.
What happened? My convoy hit an IED.
I took a back full of shrapnel.
That was it.
Mind if I take a look? Looks like it was serious.
I'm sorry.
I was out of the hospital in a couple weeks.
That was three years ago.
I was doing fine.
This thing with my head and my heart, that started just six months ago.
I wish I could tell you there's a physical reason for the problem.
[groaning.]
I can't see one.
Morning.
Hey.
I heard Mr.
Baker dropped the lawsuit.
Yeah.
That must be a relief.
Not exactly the happy ending, but yeah.
Reese, are you chewing gum? Oh, it's sugarless.
Well, that's not the point.
It's unprofessional.
Spit it out before you go see another patient.
Dr.
Reese.
Not quite.
Hey, Joey.
To congratulate you for getting your Pathology Match.
Oh, it's beautiful.
Can you read it? Bubonic plague bacillus.
That's amazing.
It's from the Royal London Hospital; it's 1893.
Wow.
Do you like it? I love it.
Joey, I am so sorry.
I have to steal her.
Dr.
Halstead in 4.
Thank you.
Reese.
Spit out your gum.
- Any pain? - Nope.
Dr.
Halstead? Mr.
Kellogg, this is Ms.
Reese, fourth year med student, soon to be doctor.
Congratulations.
Grab a hammer, will you? Mr.
Kellogg is a gymnastics teacher.
I fell.
Honestly, I'm I'm not hurt actually.
It just it happened on school property, so I gotta get a doctor's note.
Pupils look good.
Ms.
Reese is gonna check your reflexes, then we'll get you out of here, okay? [exhales.]
- You okay? - Yeah, fine.
[distorted.]
You okay? - Oh - Reese! Oh, whoa! So it's pretty clear what bones in the wrist are affected.
But what I'm actually curious about is this.
This is a previous fracture One that's already healed.
- Really? - Yeah.
I don't remember seeing it in Bo's history.
Hey, sorry.
Got here as soon as I could.
How's Bo? His wrist got broken, Daddy.
I'm afraid your son's gonna need surgery.
Oh, God, you hurt yourself pretty good, huh, big guy? Dr.
Manning was just showing me Bo's X-Ray.
Appears that he's broken his arm before and we didn't realize it.
Oh.
Well, that must have been from last year when he fell down the stairs.
He hardly complained; we just thought it was a sprain.
Remember that? Mm-hmm.
Poor Bo.
Bo's hand is cold.
Griffin, don't touch your brother's hand.
- Aaron - Sorry, I just I don't want him making it worse.
It is cold.
The capillary refill's delayed.
Wait, what does that mean? He's losing circulation.
Not enough blood flow.
April, call the OR.
Tell them we're on our way up right now.
- Got it.
Christy.
- Excuse me.
- I'm so embarrassed.
- Don't be.
You fainted.
Yeah, right on top of that poor gymnastics teacher.
Did he say anything? Only that he was very impressed with your dismount.
Reese, your EKG and BP are normal, so I think what we're looking at Is a vasovagal syncope, right? Probably.
Just gotta figure out what the trigger is.
- Okay.
- You know, maybe blood sugar.
- Let's get you some orange juice.
- Yeah.
Thanks, Mel.
Well, I'm no Dr.
Charles, but is everything okay with you? Everything's great.
The oh, the tuba player living above me? He finally moved out.
And of course, I just got my Pathology match.
And, oh Look.
Joey gave me the bubonic plague.
Wow.
He must really like you.
He does.
[sighs.]
And he's very excited about me going into pathology.
We're both excited.
You know, Dr.
Halstead, I'm sure this was nothing.
Probably.
But just to be safe, let's order a CBC and we'll take it from there, all right? Okay.
All right.
The patch is done.
And the heart's closed up.
Okay, then.
Moment of truth.
Give warm blood cardioplegia to restart the heart.
- Yes Doctor.
- I'll need sutures for the chest.
She's in third degree complete heart block.
I can see that, Marty.
What do you want me to do? - Dr.
Rhodes? - Relax.
Hold on the pump.
One of the patch sutures must've bagged the conducting system.
- Mm-hmm.
- Suture cutters.
That one.
Here.
Normal sinus rhythm.
Good call.
Because of the edema in the boy's hand, I'd say he broke his wrist at least 24 hours ago, if not longer.
Also, she said he hit a patch of gravel.
You'd expect there to be abrasions on his hand, but there are none.
Combine that with the previous fracture You suspect abuse? I don't know.
Maybe.
- Where's the boy now? - In surgery.
Dr.
Reyes feels confident he'll be able to save his hand.
- Thank goodness for that.
- Yeah.
And you said there's an older brother as well? Griffin.
He's ten.
Well, if there's a possibility of abuse, we have to protect those children.
I just I don't want to rush to judgment.
I feel like my radar has been off lately.
You're referring to the shaken baby case? We put that woman through hell, and she was blameless.
Well, before we call DCFS, let's get a second opinion.
I know we're supposed to keep our emotions out of the OR but every time we get one of those newborns, I'm just a wreck, even when it turns out all right.
Amazing how you keep your cool.
He's an ace, Dr.
Downey.
Yes, he is.
- Nice work in there.
- Thank you.
Where you going? I gotta get back down to the ED.
And miss the best part? Telling the family their baby's gonna be just fine.
The honor is yours, Dr.
Rhodes.
Mr.
Coleman'll be ready to transfer in the morning.
Good, I've got him set up with psychiatry first thing.
Hopefully the right meds and therapy will help get this under control.
Good luck with that.
Mr.
Coleman, this is Dr.
Glass.
She'll be supervising your care at the V.
A.
Oh, fantastic.
Nice to meet you.
I heard the surgery was a success.
No, it wasn't.
I still hear the beating.
Auditory hallucinations are complicated.
It's not an hallucination.
Whatever it is, we want to help figure that out.
Now Dr.
Charles has contacted a psychiatrist at the V.
A.
Should follow up this afternoon.
It's useless talking to you people.
Dr.
Choi, would you like to weight in? It's possible Mr.
Coleman is right.
I think we should get a chest CT.
What's the brother's name again? Griffin.
Wait wait a second.
I already challenged them on the injury.
Now I walk in with a psychiatrist? So who're you gonna be? Still me.
Just, uh not advertising.
Okay.
- Hi.
- Dr.
Manning, how's Bo? Are they still operating on him? Last we heard, he's doing very well.
- You must be Griffin.
- Yes, sir.
I'm Dr.
Charles.
Nice to meet you.
Nice to meet you too.
As soon as Bo moves up to the ICU, I'll let you know.
When he comes home, I'm gonna take care of him.
Griffin.
Ms.
Taylor, Dr.
Manning told me that you burned your hand.
Would you like us to redress that while you're here? No, no, no, it's it's fine.
It's practically healed.
[giggles.]
Mommy's clumsy.
Is there a reason you're here, Doctor? Well, waiting for a child to come out of surgery, that's a stressful time for for any family, and we like to make ourselves available for questions, concerns.
I thought you just said the surgery was going well.
It is.
So why would we need to talk to anyone? Aaron, please.
Look, can't you see what this is? This phony concern for your hand? Is Daddy in trouble again, Mommy? - No no, honey.
- Doctor, let's step outside.
- Can I come with you? - You stay here, Griffin.
I'm not stupid.
I've been waiting for this.
You think I abuse my family? We do have a-a couple of questions.
I didn't touch my boy or my wife, and if you think I did, that's fine.
You call family services, call the police, have 'em give me a lie detector test.
I don't care.
Now if you'll excuse me.
What do you think? I don't know.
I mean, something's off, right? I think so.
Let's call his bluff.
Hey, Reese.
How you feelin'? Fine.
Haven't seen a swoon like that since I took my niece to see Justin Bieber.
And she just Oh! I'm fine.
It was nothing.
[chuckles.]
Glad to hear it.
Hey, is everything okay? Why do people keep asking me that? Yes.
Dr.
Halstead ordered a full panel on you.
Did something happen? How is that any of your business, Joey? I thought you were supposed to be running the labs, not interrogating patients.
Sorry.
I was just concerned about you.
It's just unprofessional, Joey.
There is a protocol in the ED.
It's not like pathology.
Okay.
Well, here.
Um Everything came back normal.
See? Well, don't give it me.
Give it to Dr.
Halstead.
Okay.
Mr.
Coleman, the CT scan we took of your chest showed a lot of scar tissue from your shrapnel wounds.
So? It's not affecting your health or your heart functions.
But this scar tissue has created a malformation which acts like an echo chamber.
It amplifies the sound waves of your heart.
I could see it affecting a dish of Jell-O on your tray.
So I was right.
It is physical.
Yes, the vibration carries up to your inner ear.
You really are hearing your heart pounding in your head.
God.
Finally.
So what are you gonna do to make it stop? I'm afraid there's nothing we can do.
Come on, an an operation maybe? There's too much scar tissue, and it's too close to the heart.
An operation just isn't feasible.
It's okay, it's okay, it's okay, it's okay.
You gotta do something.
This is driving me crazy.
Listen to me.
We'll talk to Ear, Nose, and Throat.
See if there are any options.
Please, please, do that.
[sobbing.]
Please.
[grunting.]
[panting.]
I've spoken to the Department of Child and Family Services.
They'll be here in an hour.
Thank you.
Dr.
Rhodes, trauma one incoming.
Talk to me.
18-year-old female hit a guard rail, flipped her car.
Open left tib/fib, BP 90/75.
- Rotate.
- Heart rate 130, GCS 10.
All right, she's gonna need ortho.
Call X-Ray.
Alert the OR.
Got it.
- One, two, three.
- Transfer.
It's okay, sweetie.
- Let go of the purse; it's okay.
- Give her the purse.
- Let go.
- It's okay.
You can give her the purse, okay? You can give her the purse, okay.
Hey, I'm Dr.
Rhodes, okay? Maggie, see if you can find me a name.
Looking for it now.
Dr.
Rhodes.
Skyler.
Hey, Skyler, listen to me.
You were in a car accident, and you broke your leg, but we're gonna take care of you, okay? Hey, see if you can find her family.
Got you.
Sweetie, I have your purse.
Thank you.
[crying.]
Thank you.
BP's crashing.
- Pulse ox is 78.
- She's lost consciousness.
Give me 100 of Sux, 20 of Etomidate.
- Need a hand? - Yep, throw in a tube.
- On it.
- Tube and scope ready, Doc.
- Hang a Mag and KRider.
- Got it.
She's bleeding from somewhere.
Get the level one transfuser, trigger the MTP.
I need the FAST scan and a chest X-Ray.
- On it.
- Move it here.
Blood is on its way.
I'm in.
All right, there's no free fluid in her belly.
Get the X-Ray in here.
Dr.
Rhodes, take over.
- Got it.
- Increase O2 to max.
- Thank you.
- Mm-hmm.
- Get her on the board.
- Coming in.
- X-Ray, clear.
- Clear! Her left side is whited-out, and her mediastinum's shifted to the right.
Tension haemothorax.
Chest tube tray now.
36 French.
Got it.
- Gown.
- Here you go.
- Hand me the trauma shears.
- Here you go.
Airway clear.
- Dr.
Halstead.
- Thank you.
Get the pleur vac.
- Set up for suction.
- All right.
Coming through.
I've got it now.
Suction's prepped.
- Stand by.
- We need more sponges.
- Yes, doctor.
- More four by fours.
She tore something major in there.
Transfuser's here.
Hook it up start with the blood and the plasma.
- Got it.
- Starting now.
All right, we need some more lab sponge in here.
- We're going up to the OR now.
- Yep.
Hi, Dr.
Charles.
Hey, Griffin.
Where're your your parents? Dad went to get some pop.
Mom had to go to the bathroom.
Oh.
What'd you find? Nothing.
I thought I saw you pick something up.
Oh.
A button.
It's that lady's.
Oh, the one who got hurt.
Uh-huh.
Yeah.
What you gonna do with it? Give it to the nurse, so the lady can get it back.
I'm not in trouble, am I? No.
But you know what, let's Let's find Mom and Dad.
It's kind of a scary place.
I'm not scared.
No? I want to be a doctor.
Really? Why's that? The knives.
What? To help people.
There you are, honey.
I told you to stay put.
- I got bored.
- Okay, come on, let's go.
- Rib spreader.
- Yes, Doctor.
Dr.
Rhodes.
Blunt force trauma, massive left-sided bleeding.
4 PRBC's and 4 plasma given.
Had a hard time getting her under, but there's no time left.
So here we go.
Long metz and Debakeys to me.
I'll get the lung out of the way.
She's moving.
Marty? I've given her plenty of Roc, but it's not circulating.
I can't relax her.
I'm opening the pericardium.
Damn it.
Right atrium's torn clear off the cava.
Give me a Satinsky.
Gotta try to clamp it.
[gasping.]
[monitor flatlining.]
She's gone.
Dr.
Rhodes? Time of death: 14:21.
Just spoke to my guys at the V.
A.
There's nothing they can do for Mr.
Coleman.
How 'bout you? Our ENTs said the same thing.
So how do we keep this guy from shooting himself in the head? The thing is, his condition has a physical cause.
It's not some complex psychological issue.
It's a matter of Mr.
Coleman learning how to cope with it.
That's a tall order.
I know.
But it's a problem he can see, you know what I mean? In a way, isn't it easier to deal with things you can see? Yeah.
Yeah.
So, it's not the father? In my opinion, no.
I think the father Very possibly both parents are protecting Griffin.
A sociopath, really? He's just a little boy; he's only ten.
Sociopathic traits are identifiable in very young children, infants even.
Couldn't the picking up of the button just be a normal curiosity? Most children when confronted with such a horrific event would be repelled.
They'd be frightened, upset.
He was drawn to it.
And then to to focus on an object instead of the person who had been so terribly injured I think that Griffin's a danger to that boy The whole family.
I mean, the burn on the mother's arm? What what's that about? Okay, so what can we do? Very little.
We inform DCFS of Dr.
Charles's opinion.
If they deem Griffin a threat to his brother and his parents, they'll recommend removing him from the house.
But it's only a recommendation.
They can't force the issue.
The parents have to take that step.
Her pericardium was filled with blood.
She was bleeding to death inside of her chest.
That's why the anesthesia wasn't working.
It wasn't circulating.
I better go notify the family.
I'll do that.
You should get back to the ED.
Okay.
Reese, you okay? Uh-uh.
It happen again? Vertigo.
Maybe something is going on.
We should run some more tests.
[sighs.]
No.
I know what it is.
Pathology.
What what is What are we doing? What is all this? There's something we'd like to show you.
There.
We wanted you to meet your brother-in-arms.
- Brother-in-arms? - Yes.
Your heart.
Do you see how hard your heart is fighting for you? Fighting to keep you alive.
Mr.
Coleman, we can't make you the person you were before.
And dealing with this is going to be a long process.
But it would help if you could begin to think about that pounding in your head in a different way.
More like a reminder.
A reassuring, comforting sound That your heart is there for you.
[crying.]
Wow! You don't have to do this.
I'm happy to.
What are you gonna make me? A rocket ship.
Ooh, I can't wait.
Thanks.
I'll see you tonight.
Mr.
and Mrs.
Taylor? I understand Bo's surgery went well.
Have you been up to see him? Yes.
He was still asleep, though.
Listen, we owe you both something of an apology.
We were wrong about your situation.
Could we step into the consultation room so that I can explain? What about Griffin? You can watch him from in there.
All right.
Griffin, honey, you stay here.
We'll be right back.
Okay.
Mr.
Taylor, I don't believe that you are an abuser.
But I do think that you are covering up for one.
Your son, Griffin.
[scoffs.]
That's ridiculous.
We're concerned for Bo's safety.
And yours, frankly.
We're talking about a little boy here.
Who has been exhibiting some very serious anti-social behavior.
Look, you just met our son.
You can judge him like that? I would love to be wrong about this.
And you should have Griffin thoroughly evaluated.
But if indeed we're talking about psychopathy here Psych Psychopathy.
He's still young.
His brain is still developing.
There are very real things we can do to intervene and help him.
Behavioral therapy has shown No, no, we're not listening to any more of this.
- Nedra.
- I recommend you do.
Because if you don't, ultimately, Griffin may have to be removed from your home.
- No.
- Let's go.
Wait Where's Griffin? [electronic alarm beeping.]
[whimpering.]
- Griffin! - Griffin! Griffin? - What did you do? - Nothing! Blood pressure spiking.
Heart's racing.
- Get away from your brother.
- I didn't do anything! [sobbing.]
Oh, my God, sweetie, it's okay.
Mommy's here.
Mommy's here.
Mommy's here.
Heart rate, BP's coming down.
What's happening to Bo? He's terrified.
Fear response is an involuntary reflex.
Even though he's heavily medicated, he's aware he's in danger.
[sobbing.]
Sweet boy.
My poor boy.
Mrs.
Taylor [crying.]
Mrs.
Taylor, you know you have a problem.
Please let us help your family.
I've been looking for you.
Why, so you can yell at me some more? No.
I wanted to say I'm sorry.
And to ask you something.
Okay.
First, I really do love the plague slide.
It was very thoughtful.
But [exhales forcefully.]
Will you still like me if I don't go into pathology? You're not going into pathology? I want to be in the ED.
I actually like treating patients.
Okay.
Really? Okay? Reese, you gotta get over yourself.
I know I do.
You're so sweet.
Thanks.
DCFS recommended that Griffin be separated from the family.
- Good.
- No.
The Taylors aren't going to do it.
What? I don't understand.
They saw.
"Heart will not accept what the eye can see.
" Willful blindness, right? I'm afraid this is not gonna end well.
I wish we could have done more, Dr.
Manning.
Yeah.
Hey! Bet it felt good to get out of that room.
Uh-huh.
Is that the amazing rocket ship you made? Gotta get you to bed.
Will you come say good night? You know I will.
April, I've been thinking about what you said, the transference stuff.
I see you're a great nurse, but that's not why I want to go out with you.
Okay? Okay.
You're wrong about him.
He's a good guy Let's hope.
Good night, Christy.
- Ms.
Goodwin.
- Ms.
Reese? I was wondering, is there any way that I can undo my match? Come again? Undo my match in pathology.
Matches are binding.
I understand, but I thought if you were to say something Ms.
Reese, it's a legal contract.
Good night.
Good night.
[exhales.]
Good night, Dr.
Manning.
Good night.
Mrs.
Taylor.
Sorry.
I'm going up to see Bo.
I heard about your decision.
It's a phase.
He'll grow out of it.
You have to protect Bo.
Do you have children? A son.
And what would you do? Would you send him away? Hey.
Tough loss today.
Yeah.
Sorry.
Thanks.
Buy you a drink? Uh Yeah, sure.
Great.
Meet you at Molly's? See you there.
You got group at V.
A.
tomorrow? Yeah.
You gonna go? Remember Mr.
Coleman.
You, Dr.
Choi, have to fight as hard for yourself as your heart does.
I'll go.
Good.
[sobbing.]
She's gone.
My baby's gone.
I want her back.
[wailing.]
[exhales shakily.]
[crying.]
Okay, if you say so.
What? - Thank you.
- Appreciate it.
I better go.
Afraid he'll wake up and I won't be there.
Sure.
God.
Sorry.
Not much of a first date.
Mm.
It was perfect.
Hey, two beautiful, unescorted ladies.
You're not stepping out on Bert, are you? No, he's taking a night course.
Hindi.
Three times a week.
- Ooh, okay.
- Yeah.
Bert's not still on that travel kick, is he? More than ever.
Huh.
- Hey, Will.
- Hey, Herrmann.
- You seen Connor? - Nah, not tonight.
Hey.
Well, I didn't leave a toothbrush and eyeliner in your medicine cabinet so I could sleep in your bed without you.
I've been in therapy.
Not just Dr.
Charles, but the group he sent me to at the V.
A.
Thought I'd be further along.
Thought I'd at least be sleeping.
Beginning to think it's a waste of time.
Ethan, you know PTSD there's no quick fix.
It's a process.
Come back to bed.
Gotta go for a run.
[sighs.]
This is not my first rodeo.
I-I've been through this before.
You sit there deciding who gets to see the doctor next.
And the answer is me.
I'm next.
Mr.
Coleman, there are people in front of you.
My heart is beating inside my head.
Find a magazine and please wait your turn.
We've been through this.
Tell me something.
Leah, where's your heart? In your chest, right there, behind your bra? - You step back now.
- Not mine.
No, mine's floated up my neck and it's beating inside my skull.
It's just it's beating inside my skull and it's driving me crazy.
Please, man! - Hey! - I need to see a doctor! - Hey, sir! - Excuse me! - Security! - Sir April, get security.
Sir I need a doctor! [panting.]
Can someone please help me? [grunts.]
- Dr.
Choi! - Whoa, whoa.
Sir, look at me.
Wait, wait, wait.
We need to get you back into the waiting room.
I could have lied; I could have said that I had chest pains.
You would have had to see me then, but I'm not a liar.
Okay, okay.
Sir, why don't you just come with me? Come with me.
- It's okay.
- Someone's gotta make it stop.
- Okay.
- It's gotta stop.
We will get to you as soon as we can.
No! [shouting.]
[screaming.]
Will somebody see me now? [sobbing.]
Page Dr.
Charles.
Got you.
I'm not crazy! I'm not! Mr.
Colman, I'm Dr.
Choi.
We need you to stay calm.
Didn't help It's it's still pounding! He says his heart is pounding inside of his head.
Mr.
Coleman, I need to examine your ear.
I don't care about the ear! [screaming.]
Let's get him something for the pain.
- 5 of morphine IV, please.
- Got it.
Mr.
Coleman, I'm Dr.
Charles, psychiatrist.
Just because I'm a vet does not mean that I am a mental case.
You did walk in here and stab yourself in the head.
Because no one No one would help me.
Well, look, I-I just need to do a little evaluation, ask you a couple questions; that be all right? I'm not crazy.
I'm not a drug addict.
You're wearing six shirts? Yeah, but just one pair of pants.
Why's that? Isn't it obvious? To to muffle the sound of my heart.
Does it help? Nothing nothing helps! [panting.]
Please somebody [panting.]
Good morning.
I'm Dr.
Manning.
- I bet you're Bo.
- And I'm Griffin.
Well, hello, Griffin.
Nice to meet you.
Did you see that man? He stuck a pencil in his ear.
Yes, it was very bad, wasn't it? - Yeah.
- Sorry you had to see that.
The boys were playing in the driveway waiting for the school bus.
I see you fell off your hoverboard.
I see a lot of hoverboarders in here, if that's even a word.
Yeah, he hit a patch of gravel.
I tried to keep it cold.
Let me know if this hurts.
[groaning.]
I see there's no abrasions on the palm.
It it feels like it's sleeping.
Hmm.
You know what I think? I think this is a very broken wrist.
I do too.
It made a bad noise.
Griffin, honey, please.
Did you hurt your hand as well, Mrs.
Taylor? No, no, no.
Kitchen accident.
Burnt myself.
It's fine.
Well, I'd like to get an X-Ray of Bo's wrist.
You know what, I'd prefer you didn't.
I don't want to expose him to unnecessary radiation.
It's just a minute radiation exposure and it is necessary.
A surgeon needs to go in there and reposition the bones.
But if they're already operating, why do you need a X-Ray? An X-Ray will tell the surgeon exactly what needs to be done.
But I do need your permission.
[sighs.]
Okay, it's fine.
All right, well, someone will be in to take you up to X-Ray.
Thanks.
[groaning and stammering.]
- Fresh balloons every day.
- Yeah, I know.
His room is starting to look like a party store.
[chuckles.]
I appreciate you checking in on him the way you do.
Oh, please.
Eric's my guy.
Tell him I'll be up during my break.
All right.
Your ride's here.
Hold that, hold it please.
Thank you.
[laughs.]
Honey, the only thing that's worse than dating a patient is dating an athlete.
Well, his son is the patient, and he's retired.
Don't get me wrong.
I love athletes.
But in my experience, they're little kids in men's bodies.
Bad long-term bets.
Ventricular septal defect repair.
Lots of people born with holes in their hearts.
Procedure's a mainstay in the CT repertoire.
Good one to get under your belt.
You mind my talking? No.
Straightforward, high success rate.
Mostly kids, sometimes a newborn, in which case, stay focused on the simplicity of the procedure.
Try not to be distracted by the fact that an infant's heart is smaller than a strawberry.
Can take you out of the moment.
Right.
So far so good.
You punctured the tympanic membrane and went into the middle ear.
We can do the repair.
It's called a tympanoplasty.
Just listen to my heart.
It's loud, right? Sounds normal to me.
[scoffs.]
That can't be! You know, Mr.
Coleman, I'm a vet too.
I know something about PTSD.
It's not that.
I-I saw combat, but I-I was okay.
What happened? My convoy hit an IED.
I took a back full of shrapnel.
That was it.
Mind if I take a look? Looks like it was serious.
I'm sorry.
I was out of the hospital in a couple weeks.
That was three years ago.
I was doing fine.
This thing with my head and my heart, that started just six months ago.
I wish I could tell you there's a physical reason for the problem.
[groaning.]
I can't see one.
Morning.
Hey.
I heard Mr.
Baker dropped the lawsuit.
Yeah.
That must be a relief.
Not exactly the happy ending, but yeah.
Reese, are you chewing gum? Oh, it's sugarless.
Well, that's not the point.
It's unprofessional.
Spit it out before you go see another patient.
Dr.
Reese.
Not quite.
Hey, Joey.
To congratulate you for getting your Pathology Match.
Oh, it's beautiful.
Can you read it? Bubonic plague bacillus.
That's amazing.
It's from the Royal London Hospital; it's 1893.
Wow.
Do you like it? I love it.
Joey, I am so sorry.
I have to steal her.
Dr.
Halstead in 4.
Thank you.
Reese.
Spit out your gum.
- Any pain? - Nope.
Dr.
Halstead? Mr.
Kellogg, this is Ms.
Reese, fourth year med student, soon to be doctor.
Congratulations.
Grab a hammer, will you? Mr.
Kellogg is a gymnastics teacher.
I fell.
Honestly, I'm I'm not hurt actually.
It just it happened on school property, so I gotta get a doctor's note.
Pupils look good.
Ms.
Reese is gonna check your reflexes, then we'll get you out of here, okay? [exhales.]
- You okay? - Yeah, fine.
[distorted.]
You okay? - Oh - Reese! Oh, whoa! So it's pretty clear what bones in the wrist are affected.
But what I'm actually curious about is this.
This is a previous fracture One that's already healed.
- Really? - Yeah.
I don't remember seeing it in Bo's history.
Hey, sorry.
Got here as soon as I could.
How's Bo? His wrist got broken, Daddy.
I'm afraid your son's gonna need surgery.
Oh, God, you hurt yourself pretty good, huh, big guy? Dr.
Manning was just showing me Bo's X-Ray.
Appears that he's broken his arm before and we didn't realize it.
Oh.
Well, that must have been from last year when he fell down the stairs.
He hardly complained; we just thought it was a sprain.
Remember that? Mm-hmm.
Poor Bo.
Bo's hand is cold.
Griffin, don't touch your brother's hand.
- Aaron - Sorry, I just I don't want him making it worse.
It is cold.
The capillary refill's delayed.
Wait, what does that mean? He's losing circulation.
Not enough blood flow.
April, call the OR.
Tell them we're on our way up right now.
- Got it.
Christy.
- Excuse me.
- I'm so embarrassed.
- Don't be.
You fainted.
Yeah, right on top of that poor gymnastics teacher.
Did he say anything? Only that he was very impressed with your dismount.
Reese, your EKG and BP are normal, so I think what we're looking at Is a vasovagal syncope, right? Probably.
Just gotta figure out what the trigger is.
- Okay.
- You know, maybe blood sugar.
- Let's get you some orange juice.
- Yeah.
Thanks, Mel.
Well, I'm no Dr.
Charles, but is everything okay with you? Everything's great.
The oh, the tuba player living above me? He finally moved out.
And of course, I just got my Pathology match.
And, oh Look.
Joey gave me the bubonic plague.
Wow.
He must really like you.
He does.
[sighs.]
And he's very excited about me going into pathology.
We're both excited.
You know, Dr.
Halstead, I'm sure this was nothing.
Probably.
But just to be safe, let's order a CBC and we'll take it from there, all right? Okay.
All right.
The patch is done.
And the heart's closed up.
Okay, then.
Moment of truth.
Give warm blood cardioplegia to restart the heart.
- Yes Doctor.
- I'll need sutures for the chest.
She's in third degree complete heart block.
I can see that, Marty.
What do you want me to do? - Dr.
Rhodes? - Relax.
Hold on the pump.
One of the patch sutures must've bagged the conducting system.
- Mm-hmm.
- Suture cutters.
That one.
Here.
Normal sinus rhythm.
Good call.
Because of the edema in the boy's hand, I'd say he broke his wrist at least 24 hours ago, if not longer.
Also, she said he hit a patch of gravel.
You'd expect there to be abrasions on his hand, but there are none.
Combine that with the previous fracture You suspect abuse? I don't know.
Maybe.
- Where's the boy now? - In surgery.
Dr.
Reyes feels confident he'll be able to save his hand.
- Thank goodness for that.
- Yeah.
And you said there's an older brother as well? Griffin.
He's ten.
Well, if there's a possibility of abuse, we have to protect those children.
I just I don't want to rush to judgment.
I feel like my radar has been off lately.
You're referring to the shaken baby case? We put that woman through hell, and she was blameless.
Well, before we call DCFS, let's get a second opinion.
I know we're supposed to keep our emotions out of the OR but every time we get one of those newborns, I'm just a wreck, even when it turns out all right.
Amazing how you keep your cool.
He's an ace, Dr.
Downey.
Yes, he is.
- Nice work in there.
- Thank you.
Where you going? I gotta get back down to the ED.
And miss the best part? Telling the family their baby's gonna be just fine.
The honor is yours, Dr.
Rhodes.
Mr.
Coleman'll be ready to transfer in the morning.
Good, I've got him set up with psychiatry first thing.
Hopefully the right meds and therapy will help get this under control.
Good luck with that.
Mr.
Coleman, this is Dr.
Glass.
She'll be supervising your care at the V.
A.
Oh, fantastic.
Nice to meet you.
I heard the surgery was a success.
No, it wasn't.
I still hear the beating.
Auditory hallucinations are complicated.
It's not an hallucination.
Whatever it is, we want to help figure that out.
Now Dr.
Charles has contacted a psychiatrist at the V.
A.
Should follow up this afternoon.
It's useless talking to you people.
Dr.
Choi, would you like to weight in? It's possible Mr.
Coleman is right.
I think we should get a chest CT.
What's the brother's name again? Griffin.
Wait wait a second.
I already challenged them on the injury.
Now I walk in with a psychiatrist? So who're you gonna be? Still me.
Just, uh not advertising.
Okay.
- Hi.
- Dr.
Manning, how's Bo? Are they still operating on him? Last we heard, he's doing very well.
- You must be Griffin.
- Yes, sir.
I'm Dr.
Charles.
Nice to meet you.
Nice to meet you too.
As soon as Bo moves up to the ICU, I'll let you know.
When he comes home, I'm gonna take care of him.
Griffin.
Ms.
Taylor, Dr.
Manning told me that you burned your hand.
Would you like us to redress that while you're here? No, no, no, it's it's fine.
It's practically healed.
[giggles.]
Mommy's clumsy.
Is there a reason you're here, Doctor? Well, waiting for a child to come out of surgery, that's a stressful time for for any family, and we like to make ourselves available for questions, concerns.
I thought you just said the surgery was going well.
It is.
So why would we need to talk to anyone? Aaron, please.
Look, can't you see what this is? This phony concern for your hand? Is Daddy in trouble again, Mommy? - No no, honey.
- Doctor, let's step outside.
- Can I come with you? - You stay here, Griffin.
I'm not stupid.
I've been waiting for this.
You think I abuse my family? We do have a-a couple of questions.
I didn't touch my boy or my wife, and if you think I did, that's fine.
You call family services, call the police, have 'em give me a lie detector test.
I don't care.
Now if you'll excuse me.
What do you think? I don't know.
I mean, something's off, right? I think so.
Let's call his bluff.
Hey, Reese.
How you feelin'? Fine.
Haven't seen a swoon like that since I took my niece to see Justin Bieber.
And she just Oh! I'm fine.
It was nothing.
[chuckles.]
Glad to hear it.
Hey, is everything okay? Why do people keep asking me that? Yes.
Dr.
Halstead ordered a full panel on you.
Did something happen? How is that any of your business, Joey? I thought you were supposed to be running the labs, not interrogating patients.
Sorry.
I was just concerned about you.
It's just unprofessional, Joey.
There is a protocol in the ED.
It's not like pathology.
Okay.
Well, here.
Um Everything came back normal.
See? Well, don't give it me.
Give it to Dr.
Halstead.
Okay.
Mr.
Coleman, the CT scan we took of your chest showed a lot of scar tissue from your shrapnel wounds.
So? It's not affecting your health or your heart functions.
But this scar tissue has created a malformation which acts like an echo chamber.
It amplifies the sound waves of your heart.
I could see it affecting a dish of Jell-O on your tray.
So I was right.
It is physical.
Yes, the vibration carries up to your inner ear.
You really are hearing your heart pounding in your head.
God.
Finally.
So what are you gonna do to make it stop? I'm afraid there's nothing we can do.
Come on, an an operation maybe? There's too much scar tissue, and it's too close to the heart.
An operation just isn't feasible.
It's okay, it's okay, it's okay, it's okay.
You gotta do something.
This is driving me crazy.
Listen to me.
We'll talk to Ear, Nose, and Throat.
See if there are any options.
Please, please, do that.
[sobbing.]
Please.
[grunting.]
[panting.]
I've spoken to the Department of Child and Family Services.
They'll be here in an hour.
Thank you.
Dr.
Rhodes, trauma one incoming.
Talk to me.
18-year-old female hit a guard rail, flipped her car.
Open left tib/fib, BP 90/75.
- Rotate.
- Heart rate 130, GCS 10.
All right, she's gonna need ortho.
Call X-Ray.
Alert the OR.
Got it.
- One, two, three.
- Transfer.
It's okay, sweetie.
- Let go of the purse; it's okay.
- Give her the purse.
- Let go.
- It's okay.
You can give her the purse, okay? You can give her the purse, okay.
Hey, I'm Dr.
Rhodes, okay? Maggie, see if you can find me a name.
Looking for it now.
Dr.
Rhodes.
Skyler.
Hey, Skyler, listen to me.
You were in a car accident, and you broke your leg, but we're gonna take care of you, okay? Hey, see if you can find her family.
Got you.
Sweetie, I have your purse.
Thank you.
[crying.]
Thank you.
BP's crashing.
- Pulse ox is 78.
- She's lost consciousness.
Give me 100 of Sux, 20 of Etomidate.
- Need a hand? - Yep, throw in a tube.
- On it.
- Tube and scope ready, Doc.
- Hang a Mag and KRider.
- Got it.
She's bleeding from somewhere.
Get the level one transfuser, trigger the MTP.
I need the FAST scan and a chest X-Ray.
- On it.
- Move it here.
Blood is on its way.
I'm in.
All right, there's no free fluid in her belly.
Get the X-Ray in here.
Dr.
Rhodes, take over.
- Got it.
- Increase O2 to max.
- Thank you.
- Mm-hmm.
- Get her on the board.
- Coming in.
- X-Ray, clear.
- Clear! Her left side is whited-out, and her mediastinum's shifted to the right.
Tension haemothorax.
Chest tube tray now.
36 French.
Got it.
- Gown.
- Here you go.
- Hand me the trauma shears.
- Here you go.
Airway clear.
- Dr.
Halstead.
- Thank you.
Get the pleur vac.
- Set up for suction.
- All right.
Coming through.
I've got it now.
Suction's prepped.
- Stand by.
- We need more sponges.
- Yes, doctor.
- More four by fours.
She tore something major in there.
Transfuser's here.
Hook it up start with the blood and the plasma.
- Got it.
- Starting now.
All right, we need some more lab sponge in here.
- We're going up to the OR now.
- Yep.
Hi, Dr.
Charles.
Hey, Griffin.
Where're your your parents? Dad went to get some pop.
Mom had to go to the bathroom.
Oh.
What'd you find? Nothing.
I thought I saw you pick something up.
Oh.
A button.
It's that lady's.
Oh, the one who got hurt.
Uh-huh.
Yeah.
What you gonna do with it? Give it to the nurse, so the lady can get it back.
I'm not in trouble, am I? No.
But you know what, let's Let's find Mom and Dad.
It's kind of a scary place.
I'm not scared.
No? I want to be a doctor.
Really? Why's that? The knives.
What? To help people.
There you are, honey.
I told you to stay put.
- I got bored.
- Okay, come on, let's go.
- Rib spreader.
- Yes, Doctor.
Dr.
Rhodes.
Blunt force trauma, massive left-sided bleeding.
4 PRBC's and 4 plasma given.
Had a hard time getting her under, but there's no time left.
So here we go.
Long metz and Debakeys to me.
I'll get the lung out of the way.
She's moving.
Marty? I've given her plenty of Roc, but it's not circulating.
I can't relax her.
I'm opening the pericardium.
Damn it.
Right atrium's torn clear off the cava.
Give me a Satinsky.
Gotta try to clamp it.
[gasping.]
[monitor flatlining.]
She's gone.
Dr.
Rhodes? Time of death: 14:21.
Just spoke to my guys at the V.
A.
There's nothing they can do for Mr.
Coleman.
How 'bout you? Our ENTs said the same thing.
So how do we keep this guy from shooting himself in the head? The thing is, his condition has a physical cause.
It's not some complex psychological issue.
It's a matter of Mr.
Coleman learning how to cope with it.
That's a tall order.
I know.
But it's a problem he can see, you know what I mean? In a way, isn't it easier to deal with things you can see? Yeah.
Yeah.
So, it's not the father? In my opinion, no.
I think the father Very possibly both parents are protecting Griffin.
A sociopath, really? He's just a little boy; he's only ten.
Sociopathic traits are identifiable in very young children, infants even.
Couldn't the picking up of the button just be a normal curiosity? Most children when confronted with such a horrific event would be repelled.
They'd be frightened, upset.
He was drawn to it.
And then to to focus on an object instead of the person who had been so terribly injured I think that Griffin's a danger to that boy The whole family.
I mean, the burn on the mother's arm? What what's that about? Okay, so what can we do? Very little.
We inform DCFS of Dr.
Charles's opinion.
If they deem Griffin a threat to his brother and his parents, they'll recommend removing him from the house.
But it's only a recommendation.
They can't force the issue.
The parents have to take that step.
Her pericardium was filled with blood.
She was bleeding to death inside of her chest.
That's why the anesthesia wasn't working.
It wasn't circulating.
I better go notify the family.
I'll do that.
You should get back to the ED.
Okay.
Reese, you okay? Uh-uh.
It happen again? Vertigo.
Maybe something is going on.
We should run some more tests.
[sighs.]
No.
I know what it is.
Pathology.
What what is What are we doing? What is all this? There's something we'd like to show you.
There.
We wanted you to meet your brother-in-arms.
- Brother-in-arms? - Yes.
Your heart.
Do you see how hard your heart is fighting for you? Fighting to keep you alive.
Mr.
Coleman, we can't make you the person you were before.
And dealing with this is going to be a long process.
But it would help if you could begin to think about that pounding in your head in a different way.
More like a reminder.
A reassuring, comforting sound That your heart is there for you.
[crying.]
Wow! You don't have to do this.
I'm happy to.
What are you gonna make me? A rocket ship.
Ooh, I can't wait.
Thanks.
I'll see you tonight.
Mr.
and Mrs.
Taylor? I understand Bo's surgery went well.
Have you been up to see him? Yes.
He was still asleep, though.
Listen, we owe you both something of an apology.
We were wrong about your situation.
Could we step into the consultation room so that I can explain? What about Griffin? You can watch him from in there.
All right.
Griffin, honey, you stay here.
We'll be right back.
Okay.
Mr.
Taylor, I don't believe that you are an abuser.
But I do think that you are covering up for one.
Your son, Griffin.
[scoffs.]
That's ridiculous.
We're concerned for Bo's safety.
And yours, frankly.
We're talking about a little boy here.
Who has been exhibiting some very serious anti-social behavior.
Look, you just met our son.
You can judge him like that? I would love to be wrong about this.
And you should have Griffin thoroughly evaluated.
But if indeed we're talking about psychopathy here Psych Psychopathy.
He's still young.
His brain is still developing.
There are very real things we can do to intervene and help him.
Behavioral therapy has shown No, no, we're not listening to any more of this.
- Nedra.
- I recommend you do.
Because if you don't, ultimately, Griffin may have to be removed from your home.
- No.
- Let's go.
Wait Where's Griffin? [electronic alarm beeping.]
[whimpering.]
- Griffin! - Griffin! Griffin? - What did you do? - Nothing! Blood pressure spiking.
Heart's racing.
- Get away from your brother.
- I didn't do anything! [sobbing.]
Oh, my God, sweetie, it's okay.
Mommy's here.
Mommy's here.
Mommy's here.
Heart rate, BP's coming down.
What's happening to Bo? He's terrified.
Fear response is an involuntary reflex.
Even though he's heavily medicated, he's aware he's in danger.
[sobbing.]
Sweet boy.
My poor boy.
Mrs.
Taylor [crying.]
Mrs.
Taylor, you know you have a problem.
Please let us help your family.
I've been looking for you.
Why, so you can yell at me some more? No.
I wanted to say I'm sorry.
And to ask you something.
Okay.
First, I really do love the plague slide.
It was very thoughtful.
But [exhales forcefully.]
Will you still like me if I don't go into pathology? You're not going into pathology? I want to be in the ED.
I actually like treating patients.
Okay.
Really? Okay? Reese, you gotta get over yourself.
I know I do.
You're so sweet.
Thanks.
DCFS recommended that Griffin be separated from the family.
- Good.
- No.
The Taylors aren't going to do it.
What? I don't understand.
They saw.
"Heart will not accept what the eye can see.
" Willful blindness, right? I'm afraid this is not gonna end well.
I wish we could have done more, Dr.
Manning.
Yeah.
Hey! Bet it felt good to get out of that room.
Uh-huh.
Is that the amazing rocket ship you made? Gotta get you to bed.
Will you come say good night? You know I will.
April, I've been thinking about what you said, the transference stuff.
I see you're a great nurse, but that's not why I want to go out with you.
Okay? Okay.
You're wrong about him.
He's a good guy Let's hope.
Good night, Christy.
- Ms.
Goodwin.
- Ms.
Reese? I was wondering, is there any way that I can undo my match? Come again? Undo my match in pathology.
Matches are binding.
I understand, but I thought if you were to say something Ms.
Reese, it's a legal contract.
Good night.
Good night.
[exhales.]
Good night, Dr.
Manning.
Good night.
Mrs.
Taylor.
Sorry.
I'm going up to see Bo.
I heard about your decision.
It's a phase.
He'll grow out of it.
You have to protect Bo.
Do you have children? A son.
And what would you do? Would you send him away? Hey.
Tough loss today.
Yeah.
Sorry.
Thanks.
Buy you a drink? Uh Yeah, sure.
Great.
Meet you at Molly's? See you there.
You got group at V.
A.
tomorrow? Yeah.
You gonna go? Remember Mr.
Coleman.
You, Dr.
Choi, have to fight as hard for yourself as your heart does.
I'll go.
Good.
[sobbing.]
She's gone.
My baby's gone.
I want her back.
[wailing.]
[exhales shakily.]
[crying.]
Okay, if you say so.
What? - Thank you.
- Appreciate it.
I better go.
Afraid he'll wake up and I won't be there.
Sure.
God.
Sorry.
Not much of a first date.
Mm.
It was perfect.
Hey, two beautiful, unescorted ladies.
You're not stepping out on Bert, are you? No, he's taking a night course.
Hindi.
Three times a week.
- Ooh, okay.
- Yeah.
Bert's not still on that travel kick, is he? More than ever.
Huh.
- Hey, Will.
- Hey, Herrmann.
- You seen Connor? - Nah, not tonight.
Hey.