ER s02e02 Episode Script

E.
R.
Previously on E.
R.
You're an Attending now.
Got a problem with another department, you solve it.
I'm Kerry Weaver.
I heard you hired Kerry Weaver as chief.
That's definitely a move in the right direction.
How was school today? They're teaching us how to use Word and the spreadsheets.
- Whoa! I got a pumper! - He's gonna need an airway.
- Stop moving around.
Now! - Scissors! - It's Hathaway, right? - Yeah.
This is Shep.
Raul.
Why don't you stay? You know I can't.
"Summer Run" How you doing, Nurse Hathaway? If I were driving, we would've been there by now, Paramedic Shepard.
- You gotta love these late summer runs.
- Especially up to Humboldt Park.
You ever been to California and Division? Yeah, that little outdoor café? Cappuccinos every morning.
Yeah, well, slip that vest on before you order.
We always promise these rides will be exciting.
Might have to wait on those cappuccinos.
Yeah, right.
Excuse me! Pardon me! Come on.
We got this one.
Hathaway, come here.
He's cyanotic.
Man, looks like he lost about 4 liters.
Doesn't look good.
Pupils are fixed and dilated.
Multiple gunshot wounds.
Chest, abdomen.
He's lost a lot of blood.
- Hey, Raul? - Yeah? - We got Payaso over here.
- No breathing, no pulse.
- We're in full arrest.
How about you? - Brains all over the asphalt, bro.
Well, come over here.
We need you.
You can help me tube him.
- Here.
- Check his rhythm.
- Where's the ambu-bag? - Behind you.
A little cricoid pressure.
Got it! You bag him.
I'm gonna stick him.
Goddamn it! - His name is Payaso? - It's a nickname.
Means "little clown.
" - Worked on him three times before.
- You're really pissing me off, Payasito! - Crackhead at 14.
- We need a line.
I can't get a vein anywhere here.
- Pedro! - Can we get a little crowd control here? - Please, everybody, move back! - Back up, please.
Coming through! Excuse me.
One, two, three.
Give them room, give them room.
Back it up.
Move it back! Everybody, back up! Back, back! Everybody, back! I need you all to move back, please.
Back up! Out of the way! County General.
ETA, seven minutes.
Give him another amp of epi in two minutes.
Got it.
Welcome to hell.
- Lydia, you seen Carter? - Not lately.
- Hey, Kerry.
- Hey, Peter.
These your sprouts? One ER rotation together, and that's what you remember? They're dead.
I need the space.
So how is it going? My first day here, and I've only upset Doug Ross.
That's not too bad, huh? You must be losing your touch.
- Good to see you again, Kerry.
- Thanks, Peter.
- No can do.
- That's not the attitude that we encourage around here, Bob.
- No can do, Dr.
Ross.
- You love saying that, don't you? - Anybody seen Carter? Anybody seen the chocolate doughnut that Bob refuses to bring me? He's in Exam 4.
Dr.
Weaver said no more food errands.
- Inappropriate use of personnel.
- You just love Dr.
Weaver, don't you? Appeals to that whole Germanic thing in you.
I am Polish.
- Screaming twins.
Curtain 2.
- All right.
- Morning, Susan.
- What've you got? Fourteen-year-old, multiple gunshot wounds.
Asystole, 2 amps epi, - How long has he been down? - Thirty-five minutes.
- Looking for miracles? - Two liters of saline already in.
- On my count.
One, two, three.
- Here we go.
Slumming with the paramedics? Yeah, recertifying for my MICN, so pretty much.
Come on, Payaso, you've survived worse than this before.
- He's in fib.
- Let's shock him.
Two hundred.
- Four units O-neg.
- Got the loop.
Clear.
- Three hundred.
Clear? - Clear.
- 360? - Yeah.
Clear? - Amp of epi here.
- No breath sounds on the left side.
- Hemothorax.
Chest-tube tray.
- Got your O-neg.
Another amp of epi? Yeah, let's high-dose him.
Five milligrams.
Scalpel.
Tube.
Oh, man, the blood's pouring out.
He's still asleep.
God, we had such a night last night.
You wouldn't believe it.
Triple MVA.
Car versus horse trailer in the middle of Chicago.
What a mess.
I had such a blast.
But we didn't get to bed till 5, and now I am late for rounds.
So if you're still here when he wakes up, would you tell him I said thanks? Thanks.
Carter.
Carter! There's already 1500cc's in the Pleuravac.
Thoracotomy tray? - Time down? - Forty-four minutes.
- There's a bucketful.
Get some lap pads.
- Somebody get a light in here.
Double MVA at the back door.
What've you got? - Multiple gunshot wounds, in full arrest.
- Susan.
High dose epi, atropine, - He's exsanguinated into the left chest.
- You might want to help your pals.
- I work here.
Nurse manager.
- Kerry Weaver.
Chief Resident.
- How long has he been in arrest? - Forty-five minutes.
- Let's call it.
We need the room.
- It's my case, Kerry.
We got a 7-year-old kid and his mom coming in, who we can save.
- We've got a 14-year-old on the table.
- Who we can't.
Call it.
- What was that time? - Forty-five down.
Susan.
Susan! All right, I'm calling it.
Time of death, 7: 19.
Someone call Housekeeping.
- Poor tidal volume.
No response.
- Another gurney, please! - Let's tube him and use number six.
- Mannitol.
We need X-ray in here! - Welcome to hell.
- Who's on for neurosurgery? - Carrera.
- Page him.
Stat.
Tube's in.
Hyperventilate.
Absolutely nothing happened, I can assure you.
She must've made the other bed.
That's where she was sleeping.
We didn't do anything.
- Carter, do I look like your father? - No, actually, not at all.
I don't care what you did or didn't do, except for oversleep, which you did.
Despite your nap, I assume you're fully prepared for this morning's surgery.
- Absolutely.
- Good.
- Because I'm gonna work your ass off.
- Great.
- Because we're doing the - Thoracic outlet syndrome.
Right.
I'll just be over there.
Carol.
- You scared me.
- I know.
I do that to a lot of people.
I'm sorry.
And I'm sorry I didn't realize who you were earlier.
- Oh, that's all right.
- You enjoying paramedic ride-along? It's fun being out for a change.
Good.
I've been reorganizing a little bit.
- Can I run some things by you? - Okay.
The doctors need to write down their orders when they give them.
No more of this three-hours-later crap, then blaming the nurses.
That'd be great.
And I think that Residents are capable of cleaning up after procedures, don't you? - Are you gonna tell them that? - Sure.
Why not? They'll stop peeking through the charts, picking the most interesting cases.
I mean, you don't get a choice.
Why should they, right? - It's gonna be a bumpy ride.
- Already is.
So thoracic outlet syndrome I really haven't had a chance to - It's the lung, right? - Don't get me started on the Brigham.
- What? - They bring me in to set up their Emergency Medicine training program.
Keep me on the line for six months.
Damn thing never got out of committee.
- Bunch of mud-phuds.
- Mud-phuds? MD-Ph.
D.
Bench scientists doing research.
Running gels, chopping up DNA.
Northern blots, Western blots, Southern blots.
- Blots? - Don't get me wrong.
They're good people.
They're smart people.
But they couldn't diagnose a cold if it stood up and sneezed on them.
So you must be pretty glad to be back, then? You bet you.
Give me a good sick body, needs a little slicing, and I'm a happy man.
Go find Benton, will you? I believe we're ready.
Maybe it's just too complicated for tonight.
No, no, I want to see you.
- I promised Jackie I'd - Dr.
Benton, I think all he needs is active resistance therapy for that left leg.
Yeah, that's good.
I promised Jackie that I'd pick up Steven after football practice.
Walt's down with the flu.
My class is over at 7.
I can make it by 7:30.
- How about 8? - Al's off at 10.
Oh, man.
Yeah, it's yummy, yummy.
- Hey, Bob, you seen Big Susie? - At the desk.
You look very sharp.
Thank you.
Did you hear that, bumpkin? She says I look sharp.
- Hey, Susie.
- Chloe, what are you doing here? I'm running so late.
Will you take the baby to daycare, please? We're learning Windows.
I can't miss class this morning.
It's complicated.
How are things at Midwest Biz? - You know the academy? - Night school two years ago.
If you need help, I'm pretty good at all that computer stuff.
Oh, thanks, Jerry.
- She should've been here an hour ago.
- I know, but don't I look sharp? - Yeah, you do.
- I know.
Okay.
Thank you, Susie.
So you're gonna pick her up after work, okay? Because I got that job fair.
- That's tonight? - I put it on our weekly schedule.
Oh, yeah, that's right, that's right.
I forgot.
Okay.
Bye, Susie.
Bye, sweetie.
- You need any help? - No.
Oh, sorry about that.
Okay, yeah.
- So just hold up his arm.
- He's a pretty big guy.
- Oh, yeah, 380, easy.
- Big arm.
You'd think we'd have some kind of pulley thing for this.
Watch the pleura.
Don't want to puncture it.
We do.
- We do? - Hold it up higher, Carter.
Keep the neurovascular bundle out of the way.
Let's Bovie this little fella, please.
- So the pulley thing, it's not working? - Periosteal elevator.
- What did he do? - Overslept.
- Well, this will teach him a lesson.
- Yeah, well, that's what we're here for.
To teach him.
Right, Carter? Don't move that arm.
Just out of curiosity, how long is this surgery? I need the rib cutter.
And Bovie, please.
So Rachel had her pancakes, then threw up at 6:30.
Jen had a breakfast meeting.
I missed the first train out.
While I'm waiting for two hours at the station I start talking to this guy named Gozukizil.
So he's heard I'm a doc, right? Next thing you know, he's pulling down his pants.
He wants to show me some mole on his butt.
I don't think I'm cut out for commuting.
Mark, that's really interesting, but it's been a lousy morning.
I've got a crying baby in my arms.
Here's the diaper bag.
So maybe we can talk when I get back from daycare.
Sure.
Oh, I see Kerry Weaver made it in.
Have you had a chance to meet her yet? Oh, yeah.
She's in, all right.
And I've definitely met her.
Great call on the new Chief Resident, Mark.
Really special.
Hi, Al.
It's me.
Hi.
Listen, I'm sorry, honey.
I hate to do this again but they changed the study-group schedule.
Yeah, for tonight.
- I know, but what can I do? - Well, how about a late dinner? No, I probably won't get out till midnight.
No problem.
It was running fine this morning.
Started right up.
Yeah, I'll be careful.
Okay, thanks.
And, Al, I'm sorry.
Okay.
I'll see you tonight.
Okay.
Bye.
Sticky bag lady for you.
- Maple syrup would be my guess.
- Yeah, it was a real mystery.
She fell trying out her new Rollerblades down Michigan Avenue.
- Wanna take her, Susan? - I really would.
But I've already taken the next patient in line.
Rhinorrhea with otitis.
Exam 5.
Okay.
Conni, let's get a room.
Oh, man, I hate the sticky ones.
- Oh, you got another one? - Yeah.
Hitchhiker.
Flagged us down on the way in.
- She asked for you personally.
- Loretta, right? - Same room? - Sure.
Why not? - Looks like the old PID shuffle.
- Pelvic inflammatory disease.
Occupational hazard.
I just bring them in.
I don't need to know what they have.
Five hundred milligrams tetracycline and a dose of mebendazole for the baby with the pinworm.
There you go.
I've written them all down.
Are you happy? - And those would be generic, Dr.
Ross? - Yes, Haleh, those would be generic.
Mrs.
Beals, I'm Dr.
Ross.
This is Haleh Adams.
- And you must be Byron.
- Yeah.
He burned himself.
Let me see.
Let's take a look.
Yeah, boy.
It looks kind of cool and gory-looking, though, huh? Do you feel that? Yeah? - It happened while you were at work? - The manager called me.
He had the cops and the fire department there.
They were all yelling, so I brought him here.
- The manager? - Yeah, we live in a motel.
The Harbor View.
Although there's no harbor, and there's no view.
Byron set the room on fire.
I guess we probably don't live there anymore.
What is the differential diagnosis for pelvic pain? - Ectopic pregnancy.
- Appendicitis.
- And - Stress in the workplace.
What else? Mittelschmerz, PID, endometriosis ruptured ovarian cyst, to name a few more.
- My money's on PID.
- You had it before? Yeast infection, urinary tract infection - Not much I haven't had.
- Tests? CBC, lytes, pregnancy, cultures for GC and chlamydia.
Barinski? - Pelvic ultrasound? - Not quite yet.
Let's assume for the moment that it is PID.
How do you want to treat her? Ceftriaxone and Zithromax.
She is way ahead of you here.
- Joanie, how is she? - Susan, thanks for coming up so quickly.
Oh, what's wrong, little one? Are you okay? She's burning up.
It's just a slight fever, but you know the rules, no fevers or infections.
Thank you for calling me.
I'm wanna get her checked out.
I'm sure it's nothing serious, Susan.
- Did you call Chloe? - No, this is one of her class days.
- You're the contact.
- Oh, right.
You may want to take her downstairs first.
Yes, yes.
Thank you.
I don't know who's in worse shape, mom or kid? Let's worry about the kid first.
Get ahold of Jack Chandler, Child Psychiatry.
I don't know if he's on, but track him down.
He owes me a favor.
Okay? - Okay.
- Thank you, Haleh.
Doug, I need you for Little Susie.
Fever from daycare.
- Maybe she should go to Pedes.
- Let me look.
- What's the story with this little one? - She's burning up! Well, not really.
I'll check her out.
It might be roseola.
She looks like she might be getting a rash.
- I don't actually see that.
- Maybe she's bacteremic.
- Is there anything going around? - Always, always.
Now, listen, why don't you go on your break and let your friendly pediatrician take a look.
- Yeah, okay.
- Come here.
- Thanks.
- Dr.
Lewis? Dr.
Weaver asked if you could take the bounce-back back pain in Exam 6.
Bounce-back back pain, right, sure.
And, Bob, could you do me a favor and call my sister for me? Chloe Lewis, Midwest Business Academy.
The number's on a card in my wallet in my bag, in a drawer, in a desk, in the lounge.
Tell her Susie's sick, and she needs to come pick her up.
- Bag, drawer, desk, lounge.
Got it.
- Thank you.
So, what do you wanna do? How about some Jim Beam and call it day? - We should get CBC and Chem-7.
- Lytes? Lytes are in the Chem-7.
But before we order any tests why don't we observe the patient.
What's wrong with him? Okay, does the fact that he's bright yellow suggest anything? He's jaundiced.
Probable alcoholic hepatitis.
I'd start him on a banana bag and check his LFTs.
Carter, take this whiny guy.
Frequent flyer complaining of stomach pain, Exam 4.
Betadine, Kerlix, adult no-necks God, I love County.
Private hospitals get all bent out of shape if you steal their supplies.
Stealing supplies? We were just saying how it's not really considered theft here at County.
I know.
I was joking.
There's a Mrs.
Rodriguez here.
You brought in her son this morning, that 14-year-old.
Anyway, someone said you knew the family.
I think it's probably best if they hear it from someone they know.
Sorry.
I don't know the family.
I've never seen them before.
This is not what I do.
Why don't we put this stuff down.
- What was his name again? - Payaso.
No, that's a nickname.
It's Carlos, I think.
Mrs.
Rodriguez, I'm Carol Hathaway.
I'm a nurse here at the hospital.
Go ahead.
Your son, Carlos, was brought in this morning.
He had multiple gunshot wounds to his chest.
We tried to save him for 45 minutes.
We used all our capabilities, but his heart stopped and he died.
I'm very sorry.
His name is Rawlings, 51 years old.
Acute onset of right groin pain last evening with nausea and vomiting times three.
No bowel movement in the last 24 hours.
And a previously reducible mass that suddenly became tender and nonreducible after sneezing.
He's currently on no medications and has no allergies.
Upon physical exam, a small, tender, nonreducible mass in the right groin.
Consistent with a strangulated hernia.
Let's get him up to the O.
R.
Let's move.
IV and Foley are in.
CBC and lytes are back.
O.
R.
's been notified.
- Carter, you ordered all that? - Yeah.
Good pickup.
- Thanks.
I was examining him - Let's just get him up.
Come on, move! Clear! Clear! I think you're the only Resident whose handwriting the nurses can read.
Well, that's something.
So let them read it.
Write down the meds when you're ordering them, okay? I don't want a screwup because some nurse forgot the heparin.
- The nurses here are pretty good.
- The nurses here are downright great.
And I think they deserve that from the rest of us.
Oh, good, Doug.
How is she? She's fine, except for the noise factor and a slight cold.
- She'll be fine in a day or so.
- Thanks, Doug.
Oh, it's okay.
It's okay.
You just have a little cold, is all.
That's all.
It's okay.
- Dr.
Lewis.
Dr.
Lewis.
- Yes.
It's okay.
- Your sister isn't there.
- Did they say where she went? No, they said she hasn't been there in three weeks.
What do they call it, "drop off"? - Dropped out? - Yes.
You're kidding, Bob, right? Why don't you give me a hand.
Susan? Susan? Bob tells me you've been sitting here for 20 minutes.
Are you in some kind of a fugue state? We've got a trauma coming in.
A bank robber.
Some little old lady mowed him down while he was fleeing the scene.
Hit him with her car.
It's all very exciting.
Malik will watch the baby.
I slid the peanut under the spermatic cord.
- What's a peanut? - Oh, sorry.
I keep forgetting you haven't done surgery.
It's a small clamp with some gauze on the end of it.
I'm sorry.
Are you sure you don't mind this? I could probably practice on some patient.
No, no.
You're actually pretty good at it.
Yeah, but I missed one earlier this morning and In that case, I think the veins are a little over there.
Yeah.
It's a pretty complicated surgery, actually.
I was surprised that Dr.
Benton let me Bovie those bleeders.
You're kidding.
I didn't think med students got to Bovie anything.
It's very rare.
Did you do it in that surgery this morning? The thoracic outlet syndrome? No, that's standard stuff.
They didn't really need me too much on that.
Hey, that looks pretty good.
Maybe I could draw some blood later? Sure.
Carter.
BP's 100/50, pulse 120.
Blunt trauma to the abdomen, both legs and head.
Car threw him about 15 feet.
Knocked him out of his sneakers.
Cops kept questioning him, as if he wasn't gorked out or something.
They were following us all the way in.
- On my count - One, two, three, now.
- Love your work.
- Always.
- Let's go.
Hurry up, Conni.
- Look, we got a child bank robber.
Get a CBC, type and cross-match Get a Foley, and we need x-rays cross-table C-spine, chest, pelvis and both lower extremities.
Conni, could you please call for the portable now? Conni, get some O-neg down here while you're at it.
- How are you doing? - Really well.
- Has your day gotten better? - Goodbye lateral breath sounds.
Actually, no.
Seems to be tension in the workplace.
Holy moly, check this out.
Lottery time.
- You think anyone will notice? - I know I won't.
Can we get the peritoneal lavage prepped? And where the hell's the Foley? All right, let's get that lavage going.
Hey, you boys want one of these? - What? - It's kind of a policy thing with us.
Wet-Naps are for wimps.
Oh, yeah? Well, it might help clean off some of that primordial ooze.
What? - Hey, why's 23 here? - Maybe there are multiple victims.
Hey, Larkey, the boys at Dispatch screw up again? No, we were out cruising for snow cones.
Heard the call.
- Is this the seizure? - Heat prostration.
Fell down, started mumbling in Lithuanian which our junior ticket taker there diagnosed as a seizure.
Okay.
Well, it looks like you have everything under control here.
- Your rig's a little sloppy, though.
- Some of us are trying to work here.
Hey, Larkey.
So where are those snow cones? You did excellent work today, Carter.
A lot of students freeze up on their first Bovie, but you were calm, steady.
- Morgenstern was impressed.
- Really? So was I.
Vaguely.
Choledocholithotomy, first thing in the morning.
- And then I could scrub in? - 7 a.
m.
- About the IV thing that happened - Carter! Just don't oversleep.
I'd always heard banks put dye in with stolen money.
Well, guess it's better than being puked on but harder to get out, I hear.
- Yeah.
Don't suppose we get to keep the money.
- God knows County could use it.
- No, I don't suppose.
I understand your niece has a cold.
Fluids and fever-control measures.
Yeah, Malik's looking after her in Room 5.
I saw her.
She is quite adorable.
Thank you.
Susan You got a little spot right there.
Under your chin.
- Can I come in? - What is this, Grand Central? - Are you all right? - It's just dye, Mark.
- That's not what I meant.
- It hasn't been a very good day.
I know you're worried about the baby, but it's just a cold.
Rachel got them all the time.
She still gets them.
You don't need to tell me that children get colds.
Doug Ross and Kerry Weaver told me that.
I get it.
I didn't know you and Kerry were close enough to be talking about Little Susie.
- She told me about calling that code.
- She's irritating as hell, and you know it.
- I'll admit that she has a style - Problem? Challenge.
You'd think, on her first day, she'd at least try and be nice.
Well, maybe she thinks that way about you.
Sorry.
You think you're gonna be able to handle this okay? Do I have a choice? - Take a look.
- No, thank you.
- It's great.
- It's high, which means it's scary.
- Compared to what you do for a living? - I'm very careful down there.
I'm being careful.
- And I'm a wimp for using a Wet-Nap? - Now, that's different.
- Oh, it's a policy kind of thing? - Yeah.
It's like whoever is driving gets to pick the music.
Except for country, which is unacceptable.
And whoever drives gets to pick where we stop for lunch.
They decide who stays in the ambo and who goes up on the Ferris wheel.
- Raul never gets to drive, does he? - No.
So if you're so afraid of heights, what are we doing up here? I figured we should have a little quality time.
- So this is a sacrifice on your part? - Yes, you could say that.
Not to mention the sacrifice Raul is making in staying on the ground.
Who? Okay, one more time.
Excuse me, Dr.
Ross? Mrs.
Beals? Could you excuse me just for a second? It's not really Mrs.
, but that's okay.
I need to make the afternoon shift, or I'll lose my job.
Byron will be okay with you, right? - You can't leave yet.
- I have to, or they'll fire me.
- I'll take Byron with me.
- He has to see the child psychiatrist.
He's in there with him now.
Dr.
Ross, please.
I really need this gig.
All right, we'll watch out for Byron.
- You get back as soon as you can.
- Thanks.
Okay.
Oh, thank you, Haleh.
- When did you reach Jack Chandler? - I haven't.
- Where's my mom? - She'll be back.
Gym class, right? I don't even go to school.
I don't have to anymore.
Where's my mom? Dr.
Myers, can I see you down the hall? Just for a second.
Byron, we'll be right back.
Okay, buddy? So this kid is a real mess.
Who are you, and what are you doing in there? Psych Resident.
I'm trying to help him.
You can't poach this case out of the ER.
Hey, I was called down here.
- By who? - By whom.
By Dr.
Weaver.
Chief Resident? Code red! Somebody call the damn fire department! Rip it out! Rip it out! I got it.
Byron? Byron? - Where's the kid? - What kid? - What kid? - Call Security.
Byron? Hey, are you okay? Come here.
Let me see.
- Everything's gonna be all right.
- Where's my mom? You kind of had me scared there for a minute.
- Where's my mom? - We'll get your mom.
- Where's my mom? - It's okay.
- Where's my mom? - It's all right.
This thing break down on you again? Should've called me.
I'd have helped.
Al.
You know Peter Benton, don't you? I did physical therapy for his mother last year.
My husband, Al.
Yeah, you came by the house once, right? Yeah, right.
Right, yeah.
- Surgeon, right? - Resident.
Well, yeah, you know Surgical Resident.
- You know anything about distributors? - Peter's brother-in-law's a mechanic.
His mother talked about her family a lot.
All the time.
Sounds like my mom, doesn't it? Is there anybody you want me to call? No, no, I think we got it.
Why don't you give it a try.
Yeah, okay.
There you go.
We got it.
I gotta get her some new wheels, man.
This thing's shot.
- Hey, it's good to see you again.
- Yeah.
Take care.
- Mrs.
Beals - I told you, there is no Mrs.
Cindy, okay? Please don't leave yet.
Byron's a very sick little boy.
He needs psychiatric help.
He could've burned himself up in there.
I'll take him to work.
He likes that.
He'll be okay.
Listen, taking him to work is not gonna solve any of his problems.
Well, neither are you.
Look, I really appreciate your help and I'll do all the follow-up for his hand.
My cousin is gonna put us up.
She's waiting in the car.
She's got a bunch of kids home, so we really do have to go.
Someone gonna answer the phone? - Hey, Bob, what's going on? - What happened to you? What do you mean? We were goofing around on that last run.
You know, sticking our heads out the window, the way dogs like to do.
It's a good look, Carol.
- Bob, have you seen Dr.
Weaver? - Suture Room.
- The bounce-back migraine is here again.
- Not now, Jerry.
I'm only trying to get you out in time for your train.
- Curtain 2.
- Thank you.
We run out of Vicryl before nylon, and lidocaine with epi is always low.
And 25 days and Kerry, would this be a good time? Thank you, Dr.
Carter.
- I appreciate your staying late.
- Sure.
Who gave you the right to call a Psych Resident on one of my patients? The 9-year-old pyromaniac? Seemed appropriate.
We were waiting for Jack Chandler, who, as you know specializes in children.
- Chandler is not on call today.
- He was giving me a curbside consult.
- He's out playing golf.
- He was gonna stop by.
He owes me a favor.
You're asking an extremely distraught to hang around, delay treatment, for a chat with your buddy? Instead you send in some prepubescent Resident who upsets the kid, so he sets the curtains on fire.
He set the curtains on fire because you left him alone.
Chandler comes in on a curbside he won't write anything in the chart or follow-up.
Where does that leave the kid? Where's he left now? His mother took him out of here AMA.
And whose fault is that? The Psych Resident wasn't managing this case.
You were.
- I'm out of here.
- Doug.
I said that I'm off! - Doug, come on.
Wait a minute.
- Did I miss something here today? Let's just say that the last train to Milwaukee is in 48 minutes and I plan to be on it.
- So now is not a good time to tell you about a blunt trauma to the chest pulling up? See you tomorrow.
You okay? I'm afraid to move.
Every time I do, she starts to cry.
- It's an amazing sound, really.
- Tell me about it.
I got two at home.
- And a new one on the way.
- Congratulations.
I didn't even know.
No one does.
I guess I just announced it.
But when you gotta move them, you gotta move them.
Take your chances.
Oh, Conni, I'm sorry about my attitude today in that trauma.
You were pretty pissy, all right.
But it was worth it just to see you take that green splash.
- Here.
Wanna try a handoff? - Yeah.
Shooting! We need a 12-lead EKG on him.
Let this be a lesson, Daniel.
Never try to catch a running back with your chest.
- I can't breathe too well here.
- Take it easy.
You're gonna be okay.
- It's just a bruise? - He's hyperventilating.
You would be too if you took a helmet to your solar plexus.
Get a pulse ox.
- BP's falling, 70/40.
- Pulse ox is 92.
Oh, great.
Put him on a mask.
Six liters.
- Is something wrong? - Yeah, Dan, you should've tackled lower.
Blood gas is back.
PO-2, 65.
PCO-2, 28.
pH, 7.
48.
He's hyperventilating, but his PO-2 is way too low.
Shortness of breath, acute hypoxia in an otherwise healthy 15-year-old.
JVD, muffled heart sounds, crashing BP.
- Pericardial tamponade? Blunt trauma? - It happens.
What's a pericardial tamponade? Is that something bad? I can't breathe too well.
I can't breathe.
- Twelve-lead? - No time.
Pericardiocentesis tray.
It's a bizarre thing, Daniel, which makes you a bizarre guy.
But we like that about you.
There's bleeding in the sac around your heart, so it's not beating right.
We're gonna numb the area and then we're gonna insert a needle and drain the blood.
You're gonna stick a needle in my heart? Don't worry, I've done it a thousand times.
- John, move in for a better look.
- Sure.
I'm using a subxiphoid approach.
Forty-five degree angle.
We're aiming at the left shoulder drawing back as you advance the needle.
- Cool.
- See, Dan, there's nothing to it.
BP's coming up, 100/60.
Mark, didn't you say something about catching a train? - Oh, no.
Oh, God.
Thanks.
Good night.
- Good night.
When were you gonna tell me? I tried, Susie.
I really did.
Hey, I got another job for a couple days, waitressing.
Made 110 bucks.
School was too hard.
They had all these different programs.
You had to move this file into this file.
It made me feel so stupid.
All the other girls in the class already knew how to type and how to write business letters.
I thought a letter was, like, a letter.
They had all the right clothes.
I didn't have any of that stuff, except for what I borrowed from you.
Even then, it doesn't look right on me.
I really wanted this.
For Susie.
And to show you that I could do it.
I didn't tell you because I knew that I would disappoint you.
And because I thought that just maybe this time I wasn't gonna screw up.
But What happened to the waitressing job? Good night, Chloe.
Hold on! Hey, wait! Damn! Enjoying the view? I'm glad you came by.
I wasn't sure you would.
- I wasn't sure you'd want me to.
- No, no, no, I'm glad.
Look, you know, Jeanie, I thought I could do this, but We can't.
I know.
We talked about all this before.
It's just, it's hard.
Yeah, well, so is this.
You gotta tell him.
You gotta tell him.