ER s02e19 Episode Script
Fire in the Belly
E.
R.
Previously on E.
R.
But you can't change the fact that he misdiagnosed the kid.
I'll talk to Doug.
So you're a cameraman-? Woman? Director and producer of infomercials.
The whole study is a sham.
Are you prepared to back that up? - I'm adopting her.
- She's my baby, Susan.
They have a right to know.
It's none of your business.
We made a decision.
That's final.
Good news.
The oncologist can take care of Brett.
You missed it and didn't have the decency to tell us.
This is about your guilty conscience.
You didn't have the guts to speak up about Vucelich so you blow the whistle on Doug.
"Fire In The Belly" Hey, Carol.
- Carol, I got an idea.
- Two more minutes.
It's beautiful out.
Let's call in sick.
Take a day trip somewhere.
- Trip? - Yeah, we'll play hooky.
We'll just jump in the car and head north and find a lake and just sit there.
- I can't skip work.
I need the hours.
- Please? The thought of having to cart around the wretched of the Earth all day long with Reilly yapping in my ear about his stupid beer can collection I can't.
Not today.
- You go.
You go.
- I don't wanna go without you.
That's the whole idea.
I want us to get away together.
We'll just go someplace where there aren't any sick people.
Just cows.
Healthy cows.
Good cows.
Some place where we can make love in the grass.
- In front of the cows? - Sexy cows.
We could take a trip this weekend.
- Yeah.
- Sure.
I might be persuaded to be a little late for work.
- Next? - I repacked Mr.
Otto's abscess.
- Is it granulating? - Quite nicely, thank you.
- Give Mr.
Otto my best.
What else? - Mrs.
Mendoza in 2.
She's had two days of vomiting, diarrhea and periumbilical pain.
- Vitals? - Normal.
It began after dinner in Mexico City.
Came straight here from the airport.
- White count? -12,000.
No rebound or guarding.
Sounds like Montezuma's revenge.
Loperamide and clear liquid diet.
- Do you wanna see her? - No, you can send her home.
Peter.
You won't be scrubbing in on Dr.
Heizenbach's jejunostomy this morning.
- Why not? - He won't work with you.
The word's out about your difficulty with Doug Ross.
It spread to the surgical crew.
The prevailing view is that you betrayed a colleague.
Is that what you think? I think maybe you're in for a chilly summer.
- We still on for tonight? - If you tell me where we're going.
- It's a surprise.
- How do I know what to wear? - Dress nice.
- Carter.
You got a call confirming your reservations for the Moonlight Dinner Cruise on the lake.
Thanks, Jerry.
Sounds romantic.
Remind me to bring my seasickness pills.
- Harper.
- Dale! - I've been looking for you.
- What are you doing here? Trauma sub-I until June, then I start my Residency.
- You matched here? - I did.
- In medicine? - Surgery.
John Carter, he matched in surgery here too.
Dale and I went to college together.
- And you're coming from? - Boston.
- Meaning Harvard? - Go Crimson.
The last time you e-mailed me, you were taking out your first appendix.
- That's right.
- You took out an appendix? They let us do appys lipomas, pilonidal cysts, all that small stuff.
- God, it's great to see you.
- You too.
- I don't know, Doug.
- You, me, Inga, Hulda - and a Chinese restaurant.
- Inga's not really my type.
- You said that about Kathy Snyder.
- I'll get out there in my own pace.
Prostates don't last forever.
Dr.
Greene, is this loan application yours? - It's mine.
- Buying a car? No, I'm helping the kid I misdiagnosed with his cancer treatment.
- I have to bail on M&Ms today.
- Can you change the meeting? - No, and I don't have a lawyer yet.
- Do what you have to do.
- Thanks.
I'm on till 2.
- What's that? She's meeting with a judge.
Chloe wants visitation rights.
- God bless the child.
- Morning, guys.
Sorry I'm late.
Traffic was a bitch.
- Hey.
- Peter.
Let me just clear this off for you Mrs.
Garvey, you're having chest pains? - Where have you been? - And irritability.
- I've waited so long, the pain's gone.
- Just got here.
- I'm burning with fever.
- Temp's normal.
- After sitting in your drafty waiting room.
- Your pain's gone? It's coming back.
- Okay, let's get that EKG.
- What's that? It monitors the heart's electrical activity.
How? The leads carry impulses from your heart to the monitor.
- I don't understand.
Explain it again.
- We wanna make sure you're okay.
Don't patronize me.
You doctors are all the same.
I came in here for stitches, I had to come back five times and my leg's never been the same.
This place is filthy.
Your EKG is abnormal.
We're gonna have to draw some blood.
- Why? - To check your cardiac enzymes.
What are those? Elements that tell us if you've had a heart attack.
I don't understand.
Explain it again! I'm the only fourth-year in the country who hasn't done an appendectomy yet.
I'm about to start my Residency and I'm three steps behind the curve.
GSW to the chest coming in.
ETA two minutes.
Let me run the code.
I'm ready.
And I need the experience.
Listen, everybody.
Carter's gonna run the code.
- All right, everybody, gown up! - What do you want us to do, Carter? - Malik, you start the IVs.
- We have IVs from the field.
- Scratch that.
Malik, you scribe.
- Man, I don't wanna scribe.
Do it.
A: Airway.
Dr.
Greene will intubate.
Breathing.
Haleh, call Respiratory and tell them to get here.
Chuny, you set up the Dynamap.
Circulation.
You on the rapid infuser.
Disability.
Benton! Dr.
Benton.
Check the DTRs and the Babinski, if that's okay.
- All right, what's left? - Foley.
- Who wants to hook up the Foley cath? - You're the only one left.
- What's coming in? - Gunshot wound.
Dale, hook up the Foley cath, and Harper, just jump in as needed.
- They're here.
- All right, man your stations.
Female, found down.
GSW to the chest, traumatic full arrest.
- Heart sounds? - Asystole.
Atropine and epi in the field.
- Got it in the heart.
- Let's get the rapid infuser going.
Get some O-neg down and get a gas cooking.
- Let's move it.
- Monitor's going.
- Flatline.
- Let's go with the epi.
5 mg, IV push.
- Pulse ox? - Forty.
- That's the lowest I've heard.
- Where is Respiratory? - She looks stiff.
Her jaw won't move.
- She looks really cyanotic.
- Boxcars in the eyes.
- Let's get the O-neg going! Let's go! - Should we even be doing this? - How long was she down? It could have been a long time.
From the degree of lividity, she's been dead three hours.
- Let's move with the O-neg! - I agree with Dale.
- Let's call it.
- No, I wanna crack her.
- Time of death- - No, I'll do it.
Time of death: 10:32.
What a gyp.
- She's got an engagement ring.
- She had a little boy too.
Forty-seven brought him in.
- The boy wasn't hurt? - There's nothing physical.
- But he hasn't spoken since he came in.
- It could be posttraumatic shock.
- His mother make it? - Anybody know what happened? Neighbor said she heard the mother and her boyfriend fight this morning.
- Poor kid must have seen the whole thing.
- What's his name? - Where is the boyfriend? - In the wind.
Hey, buddy.
I'm Doug.
And that's Carol right there.
What's your name? I'm gonna listen to your heart, okay? - Doug, his name's Jeremy.
- Jeremy? Can you hear me? Good reflexes.
I'll call Psych.
Why don't you see if you can track down a relative.
He witnessed a murder.
Boyfriend could come back.
We'll get the cops to post a guard.
Hey.
- Peter, come quick.
Mrs.
Mendoza.
- Who? The woman I sent home with Montezuma's revenge.
The pain's moved from mid-abdomen to the right lower quadrant.
- Are you a doctor? - I'm a surgeon.
- She's in so much pain.
- It's her appendix.
- You sure? - Don't worry, we're going to take it out.
We were here earlier, but that nurse sent us home.
We never saw a doctor.
Don't worry, Mr.
Mendoza, we'll take care of her.
Clear! - Did Psych come down for that boy? - Yeah.
She's in there with him now.
- Jerry, will you fax this for me? - Loan application? Sorry.
No more personal use of the fax.
Per the Weaver.
Jerry.
Just do it.
Call Pathology to take that lady's body, these video people need to get in there.
- What video people? - You didn't read the memo? No.
I wanna start videotaping the traumas so we can critique our work.
I don't think this sounds like a good idea.
David Morgenstern thought it was.
- He wrote the memo.
- On a trial basis.
Path's backed up.
They asked for you to keep that DB here.
Put her in Exam 3.
These guys need to get to work.
Come on.
- Gown me, quick! Is that the appy? - Knife.
- What, I can't do it? - No.
- I've seen dozens.
- I said, no.
Carter, go cover the ER.
All right, here we go.
Retract the fascia.
Can you see? - Suction.
- Pulse is up to 120.
Here we go.
- Damn it! Belly's full of puss.
- She done perfed good.
Let's load her up with amp, gent and Flagyl.
Liter of warm saline.
We gotta irrigate before she goes septic.
- What a mess.
- Yeah, too bad she didn't come in sooner.
Damn.
- Mrs.
Garvey.
- You've got some nerve.
- Mrs.
Garvey.
- "Patient is uncooperative demanding, prone to exaggerate symptoms"? - Can I have my chart back? - Give me a pen.
I want this changed.
Doctor is unprofessional, openly hostile.
Your enzymes suggest a heart attack.
- We need to do an echocardiogram.
- What's that? - It's like an ultrasound of your heart.
- Why do I need one of those? We need to make sure that your artery is not blocked.
I don't understand.
Explain it again.
This is your heart.
This is an artery going into your heart.
If it is blocked, it can explode causing a massive heart attack which would kill you within minutes.
You are a sick woman.
- said they heard fighting.
Did your mom and her boyfriend have a fight this morning? Is that what happened? Detective? Can I talk to you outside, please? - What are you doing? - Trying to talk to him.
- What did you say? - I asked what happened.
This boy's had a psychological trauma.
You could have set him back weeks.
- Didn't know that.
- Well, now you do.
Okay? - Hey.
Where's your e-mail pal? - He took a hernia up to the O.
R.
- You're kidding.
- About an hour ago.
Should be back soon.
- Seems like a great guy.
- He is.
- So you guys went out? - We never exactly went out.
- But you - Once.
One night, anyway.
Harper.
Guy in 6 needs a rectal.
I have to take these to the lab.
See you.
- Carter? - Pass.
Abdominal pain, could be surgical.
Haleh, have you seen that cute guy from Harvard? - He just came down, try the desk.
- I'll take it.
I'll take that.
I got it.
Thanks.
Try the 15 mm for me, tilt down, get the whole bed in the frame.
- How's that? - Good.
Pan left- - Iris.
- Oh, Dr.
Greene.
Would have thought we were small potatoes for an infomercial director.
I do educational tapes, equipment rentals.
I'll take your money any way I can.
Would you zoom in to a medium shot for me, Max? - How's your eye? - Oh, fine.
Nice profile.
You sure you won't go on the air? I wouldn't feel right plugging your hair-growth products.
I don't believe in them.
Well, you're more secure than most men.
And you look like you're in pretty good shape.
You exercise? - Run, pushups a little.
Why? - I'm just about to go national with a new exercycle and I haven't found a pitchman yet.
You interested? He's had periumbilical pain that localized to the right lower quadrant - nausea and vomiting.
- What's his white count? Nine thousand.
I'm thinking appendix.
Appys usually present a bit lower, but they can fool you.
- Let's take him up.
- Can I do the procedure? - Does Benton let you do appys? - He talked about it.
Well, there's a first time for everything.
All right.
Mr.
Kennerly, you're going to the O.
R.
, but there's no reason to worry.
Everything is going to be fine.
Thanks.
- Clean her out yet? - Still gotta drain the abscess.
- She's tachy, 180.
- Temp's 104.
- I'll get a cooling blanket.
- This is making me nervous, Peter.
Just hold on.
- Isn't that your med student next door? - What? - What's going on over there? - Another appendix.
- When it rains, it pours.
- Somebody close those blinds.
- Run of five.
Your time's about up.
- Just give me two minutes.
- Too late! - She's fibrillating.
- Damn it! - Crash cart.
Charging at 200.
- Come on, don't do this to me! - Clear! - three enzymes that are released by the heart after a heart attack: CKMB, AST and LDH.
By graphing the levels of each enzyme, we can determine that you had your heart attack at approximately 4 this morning.
Oh, thank you, doctor.
She's the one! - Susan! - Yes, Kerry.
One of the nurses alerted me that Ethel was about to sign out AMA which in her condition might have killed her.
I thought it best to indulge her in order to save her life.
Good thinking.
I know it's frustrating dealing with difficult patients but you have a tendency to become anger-locked and inflexible.
- Thank you for pointing that out.
- If you feel yourself getting dug in just call me.
I'm here to help.
- Retractor.
- Expose the internal oblique.
- Can I have some suction? - Good.
Now cut it open.
- I'm in.
- Okay, now put your hand in the peritoneum and feel around until you find the appendix.
- I got it.
- Okay, let's see.
Well, that is the pinkest, most healthy appendix I've ever seen.
- But he had all the symptoms.
- They can fool you.
- Well, as long as we're here - Better not.
Besides, I think I see the cause of Mr.
Kennerly's bellyache.
What? Toothpick in the terminal ileum.
I think if you pull on the gold tassel it'll slide right out.
Congratulations, Mr.
Carter, on your first toothpick-echtomy.
Now, let's start irrigating.
- Mr.
Mendoza.
- Yes.
Your wife is out of surgery, but she's very sick.
Her appendix burst before I could remove it and the bacteria invaded her bloodstream.
We're giving her antibiotics.
I expect her to pull through it.
Are you saying she could die? - It's a possibility.
- When we first came in was there no way to tell that it was the appendix? The symptoms and the story suggested food poisoning.
That woman sent us home without ever seeing a doctor.
She consulted a doctor, who ordered your wife discharged.
How could this happen? - How's the kid doing? - The same.
Think I could take a peek in there, give him this? - Did you draw that yourself? - I did.
- Hey.
Where is he? - I don't know.
Jeremy? - Oh, man.
- Jeremy! - Jeremy! Have you seen the kid? - What kid? - The one who won't talk.
- No.
Jeremy! Oh, God.
Jeremy! Hey, sweetie.
Hey, come on.
Let's go back to your room.
Come on.
Okay? The Pedes Attending's name is Keller, and there's a med student named Amber who will sit with him till his aunt comes.
- Okay, you got it.
- Thanks.
Who does this belong to? - I told you to hold on to him.
- I just turned around for a second.
We picked him up on Michigan Avenue.
He's zonked out of his gourd.
- He's tachy, diaphoretic.
- Could be coke, PCP.
All right, well, let's get him a room.
- Hey, Dr.
Ross.
- What's this? Some guy dropped it off for you.
Wanna order something from Psycha-Deli? I'm starving.
Could someone release the guy in 4? I gotta go.
- Sure.
You okay? - I'm having a walking anxiety attack.
Call me.
- Hi.
You're all wired up.
- Oh, great.
I'm gonna show you how everything works but I wanna eat something.
How about you? I'm not really hungry.
So, what's wrong with her? - What is this? - Check it out.
Yowza! Twenty-five thousand in- Oh, it's a gift from the old man.
10 to 1 it's dirty.
Looks like your treatment fund just got richer.
It's going back.
Penance doesn't mean anything if it's that easy.
- What do you know about penance? - I used to date a lot of Catholic girls.
You want their numbers? - Her lungs are filling up with fluid.
- How is she? She might not make it.
How could you miss the signs of appendicitis? - Pain localizing to the right.
- She told me it was diffuse.
- Check rebound and guarding? - I told you I did.
I'm asking you if you actually did.
Yes.
And if you had any doubts, you should have examined her yourself.
I trusted you to do that.
You know how difficult appendicitis is to diagnose.
I asked if you wanted to see her- - The appendix that wasn't.
- There'll be plenty more ahead of you.
- I wish I had at least one behind me.
- It is cause for concern - what with the pyramid system.
- Pyramid system? From now on, all surgical interns will be ranked.
Those who fall in the lower third won't be asked back a second year.
- Come on, you gotta help me out here.
- Hey, come on, bud.
Cooperate.
This Rolling Stones, that's a cool one.
"Ban the bra.
" "All the way with LBJ.
" What's that about? I won't hurt your buttons, I promise.
I'll give your buttons right back, you just gotta take this off.
Let go of her! Shep! I don't think he's breathing.
Shep! - There's no pulse! - Get the crash cart.
Get CPR! - What are you doing to my crash cart? - Where's the ET tube? - Wait! He's got a pulse.
- He's back.
I got it! Security! Security! - Hey! Did they call us in? - Relax, we still have a few minutes.
- Where's Mom? - She went to Northfield to see Sally.
- Called that one right.
- Well, this is very upsetting for her.
And for me.
To have to choose between your own daughters.
It's not right.
What do you mean? - I'm not going in.
- Dad.
I don't wanna take sides.
For three weeks you've been promising to back me up and you change your mind now? You haven't spent five minutes with Chloe.
You haven't met Joe.
- Unbelievable.
- Your sister is like a new person.
She got a job the first morning.
She insists on paying for the food.
- Joe is a good guy.
- Did you check his rap sheet? - He's a cop.
- What? - I'm not going.
- It's all set.
Inga's counting on you.
- I'm not going! - What is the problem here? I was married for 11 years.
To be faced suddenly with dating - You're over-thinking.
Follow your id.
- It's more complicated than that.
No, it's not.
What is about to pass between us must remain in the strictest of confidence.
When I first met Jen- - When you first met Jen? - I had never had sex before.
- You were 17, right? - Sixteen.
And through all those years, I've always been faithful.
Wait, are you telling me that you've only had sex with Jen? - That so unusual? - In the 20th century? - Yeah, you're right.
I'm a freak.
- That's a little strong.
No, it's true.
I've only had sex with my wife.
The thought of being intimate with a stranger What if she can't arouse me or I can't please her? - The thought alone scares me to death.
- Well you're right, Inga's not for you.
County, this is Unit 52.
We have a 16-year-old male, beating victim.
Multiple injuries to the face and torso.
Broken tib-fib, difficulty breathing.
Dr.
Ross, 16-year-old trauma.
BP is 80/50, resps are shallow at 53.
Do you copy? - We copy, 52.
What's your ETA? - I'd say 15 minutes.
Dr.
Ross, I'd like to run this trauma- I promised Dale he could run the next one.
Jerry, page me in 10 minutes.
These Kerley B lines.
- What are you looking at? - Pulmonary edema.
- I'm hungry.
You guys had lunch yet? - We're going soon.
Care to join? I really should go up now.
I've got some labs coming.
- Well, Doc Magoo's? - Why don't we do the lunch room? On October 10, 1994, Chloe was arrested for drunk and disorderly conduct.
At this time, she swore she would seek treatment.
Six months later she was arrested for driving under the influence.
Dr.
Lewis, we are here to explore the possibility of you and your sister settling this without the court's help.
- I take it you're not interested.
- No, Your Honor.
- And on the issue of visitation rights? - I don't trust her.
- Based on? - Based on her history of drunkenness addiction and false claims of rehabilitation as outlined here.
I have a copy.
Chloe, is there anything you'd like to say? Everything Susan said about me is true.
But I've never stayed in rehab more than a week before now.
And you've been free of alcohol and drugs for? Five months.
Here are the urine test results.
You've barely started taking responsibility for yourself.
How do you expect to take responsibility for a child? I ask myself that a lot.
But I am on the right track now.
And I never, ever wanna go back to who I was.
And I feel that with the help of God and my friends and my family that I can be a good mother to my baby.
And you've been employed as a claims adjuster in Phoenix for four months.
Yes, here are the affidavits.
They're holding a job for me and I got a job here.
Could you step outside, please? I want to speak to Dr.
Lewis alone.
I am going to allow your sister three overnight visits a week, starting tonight pending resolution of the adoption issue.
And I'm telling you now that if you proceed with a custody fight you will lose.
Chloe is the mother and, as far as I can see, she presents no danger to her child.
Given that, I want you to consider the cost of proceeding.
Not just financially, but in terms of the disruption to your life to Chloe's life and to the baby.
We should've gone fishing.
We could be sitting on a pier with our toes in the water, drowning a couple of worms.
Instead, here we are, two urban casualties of the Button Man.
My throat's fine, by the way.
We're not raising our kids here.
- We're not? - No.
Definitely not.
Okay.
- What happened here? - Appendix ruptured.
She's septic.
I took a look at her chart.
And lo and behold, you sent her home without examining her.
Nothing in the P.
A.
's exam suggested appendicitis.
I disagree.
Abdominal pain.
Cramping.
Fever.
You should have laid hands on her, that's what a surgeon does.
You were quick to assign blame when Doug made a mistake.
But when your ass is on the line, you hide behind excuses.
If this hits the fan, don't expect your colleagues to line up with support.
Reap as you sow.
-7.
43.
- I got it.
You get it next time.
Why don't you go ahead.
Oh, damn it.
Labs are up.
- They can wait 10 minutes.
- Better not.
You go ahead, I'll catch up.
Your soup's gonna get cold.
bruises to face, chest and abdomen.
Possible fractured left tib-fib and facial fracture.
Anybody seen Dale? This guy sure pissed somebody off.
- He got jumped out of a gang.
- Can I do something? - You wanna run it, run it.
- Airway? Patent.
No tracheal deviation.
Bruises on chest and abdomen.
No blood in the canal.
Let's get a C-spine, chest and head CT.
Pupils? Round, equal and reactive.
- What's your name? - Virgil.
- BP is down to 60.
- Carter? He's bleeding from somewhere.
- Where? - Good breath sounds.
That clears the chest.
There are no marks on his back.
- Must be the belly.
Lavage kit! - Lavage kit, please.
Number 11 blade.
- Ever done this? - Not until today.
Well, Mr.
Carter, I see you're finally getting a procedure.
Okay, go.
- Make sure you're into the peritoneum.
- I'm in.
Hook up the saline.
And extension tubing.
Almost looks like he knows what he's doing.
- How is she? - A little better.
I put a catheter in her artery to make it easier to draw blood.
I don't see any other doctors sitting by her bed all day.
Thank you for taking care of my wife.
Mr.
Mendoza.
When you asked earlier if the appendicitis could have been caught I didn't give you a full answer.
I'm the doctor who discharged your wife.
If I'd examined her, I probably would have caught it but I didn't.
I made a mistake.
I'm sorry.
- Nothing.
No blood in the belly.
- BP's down to 40.
- Where is the bleed? - You check his back? Take a look.
- It doesn't make any sense.
- Maybe a faulty pressure cuff? Colon's clear.
- Spoke too soon.
- Must have blown a clot.
- Where is that damn wound? - What's that? That is a very small puncture wound.
Probably an ice pick.
- Went right by me.
- Me too.
Let's get this kid upstairs.
Do you think he took it in the kidney or renal artery? - Renal.
- Wanna come up and find out? Sure.
- Nice catch.
- Thank you.
- What's going on? - Stumbled right into a trauma.
Ice pick to the kidney.
We're taking him up now.
Hi.
- This is weird, isn't it? - Yeah.
- You haven't really met Joe yet.
- Hi, Susan.
Hi, Joe.
I brought extra diapers and some baby Tylenol in case she gets a fever.
And Mr.
B.
She can't go to sleep without him.
- What's her bedtime routine? - Well, a bath.
And then we read two picture books.
And a bottle while she's getting rocked.
And usually I sing to her.
All right, I better go.
- We were hoping you'd stay for dinner.
- No, I don't think so.
Oh, please? I know little Susie would want you to.
She doesn't know who I am.
Come on.
First, let's review a relatively simple trauma led by our own Mr.
Carter.
Note the uneven distribution of personnel screen right.
Everyone clumped together like a herd of wildebeest while the left side is underutilized.
- How's it going? - Very enlightening.
Next, we'll see an example of poor trauma hygiene.
Observe Mr.
Carter wiping his nose with his gloved hand just prior to grabbing the scalpel.
Let's look one more time.
The wipe and now the grab.
One more time.
Wipe and grab.
Good.
Now let's take a look at a more organized trauma led by Dale earlier in the day.
- You wanna have dinner tonight? - Love to.
Are you saying that you've never had sex with anyone but Jen? - That so unusual? - In the 20th century? I may have gone too far back.
What if she can't arouse me or I can't please her? - The thought alone scares me to death.
- Well, you 're right.
Inga's not for you.
Oh, my God! - Mrs.
Mendoza's doing better.
- Yeah, I know.
I spoke to her husband.
He said that you told him it was your fault.
It was my fault.
- Peter, do you hate me? - No.
You don't even look at me when we talk.
It's been like this all year.
Look, I'm sorry that I hurt you, but I thought by now we'd be past it.
I am past it.
Way past it.
You have to admit it was funny.
It was the most humiliating moment of my life.
- Dr.
Ross, this came for you.
- Bad news? I've been denied a loan from a company whose motto is: - "We lend money to anyone.
" - There's always your dad's dough.
- Yeah, then I'd have to thank him.
- Penance has its price.
- Ready? - As I'll ever be.
- How's your appetite? - Good.
- Oh, thanks.
- It's strong.
It's all right.
I hate to bring up the elephant in the room but I think you did a wonderful thing.
You mean taking care of Susie? I didn't have a choice.
Even so, you gave Chloe a chance.
When she first came to AA, she had as low opinion of herself as anyone could.
- But she wanted to get well.
- I thought you were a cop.
I'm also a recovering alcoholic.
Nine years.
The program frowns on old-timers like me getting involved with newcomers.
But we fell in love.
Won't get married for a while, though.
- Not till Chloe gets her year cake.
- If she makes a year.
- Weren't you going home to change? - I did, but I changed my mind.
- You don't wanna go.
- No.
- I bought the tickets.
- Normally that would bother me.
- Considering the occasion, I don't care.
- What occasion? - My dumping you.
- You're dumping me? - And I feel good about it.
- What's going on? - You know.
- No, I don't know.
Get out of here.
You lured Dale and me upstairs so that you could do a procedure.
- That's not true.
- Yeah, it is! You're a weasel! All that matters to you is making suck-points with surgical Residents.
- Let's go someplace and talk.
- No.
- Harper, please.
- No, it's too late.
I don't even know who you are anymore.
- Hey.
- Are you ready? Almost.
Where's Reilly? At Magoo's with that cute tech he's after.
- Boy doesn't waste much time.
- Yeah.
Good luck.
- Hey, doc, did you hear? - No, what? That kid that saw his mom get shot finally started talking.
Turns out that the boyfriend was slapping mom around, so the kid runs gets a gun from the drawer.
He's gonna protect his mom, right? - Only he's not such a good aim.
- No.
Yeah.
Killed his own mother.
Nice world, huh? I feel like I just plucked the virtue of a virgin.
I'm so glad you did.
- Wanna do that again? - I need a minute to recuperate.
Okay.
You let me know.
Meantime, we can play back the tape critique your technique.
Relax, sweetie.
I'm kidding.
- You're awful quiet.
- I was just thinking about that kid.
He will never get over what happened.
He will be, for the rest of his life, damaged goods.
- Probably end up like the Button Man.
- No, he won't.
Yes, he will.
He is a Button Man in the making.
- What's going on here? - Idiots.
Unit 47 requesting police backup at 46 and Hutchins.
Couple of guys bonking each other over the head- Hey! Jeez! What are you doing? What's wrong with you? - Son of a bitch! - Hey, Shep! Shep, get back here! Shep, what are you doing?! Shep! Stop! For God's sake, Shep! Stop it! Get off of me! - Hi.
- Hi, I'm looking for Ray.
- He's not here.
- Okay.
Oh, come on in.
Okay.
- I'm Karen.
- I'm Doug.
- Can I get you something to drink, Doug? - No, thank you.
Do you have any idea when Ray's gonna be back? - Not tonight.
- I'm his son.
Oh, I know.
I saw you the night you came into the bar.
That's right.
He said that you were his boss.
Yeah.
I try to remind him of that every chance I get.
- So are you his boss? - Why don't you just ask me.
- Ask you what? - Do I sleep with your father? - Do you? - I'm not going to answer that.
I only say that because it's unusual that your boss would be living in your apartment.
- What's this? - Scotch.
Who said I lived here? What are you doing here? I'm staying here tonight.
What are you doing here? I have no idea.
What's this? Names, dates, case numbers that Dr.
Vucelich dropped from his study.
I'm going on record to show that he's a fraud.
- Why are you doing this, Peter? - Like you said it's easy to make excuses for not doing the right thing.
No more excuses.
She takes four ounces of milk at night heated for 40 seconds at 50 percent.
Okay.
I'm so glad you stayed.
I know everybody thinks you've changed, and I hope to God that you have but forgive me for not rejoicing just yet.
Maybe I can't be objective because I've been so angry at you for so long.
Do you really think you can be a good mother to this little girl? Yes.
More than anything, that's what I wanna be.
Well, I can finish up in here.
Thanks.
I'm so glad Susie's got an aunt that'll always be there who's smart and a doctor.
She's gonna give you good advice.
Yeah.
Hey, you wanna say good night? Yeah.
Good night, sweetie.
for Paul Leder
R.
Previously on E.
R.
But you can't change the fact that he misdiagnosed the kid.
I'll talk to Doug.
So you're a cameraman-? Woman? Director and producer of infomercials.
The whole study is a sham.
Are you prepared to back that up? - I'm adopting her.
- She's my baby, Susan.
They have a right to know.
It's none of your business.
We made a decision.
That's final.
Good news.
The oncologist can take care of Brett.
You missed it and didn't have the decency to tell us.
This is about your guilty conscience.
You didn't have the guts to speak up about Vucelich so you blow the whistle on Doug.
"Fire In The Belly" Hey, Carol.
- Carol, I got an idea.
- Two more minutes.
It's beautiful out.
Let's call in sick.
Take a day trip somewhere.
- Trip? - Yeah, we'll play hooky.
We'll just jump in the car and head north and find a lake and just sit there.
- I can't skip work.
I need the hours.
- Please? The thought of having to cart around the wretched of the Earth all day long with Reilly yapping in my ear about his stupid beer can collection I can't.
Not today.
- You go.
You go.
- I don't wanna go without you.
That's the whole idea.
I want us to get away together.
We'll just go someplace where there aren't any sick people.
Just cows.
Healthy cows.
Good cows.
Some place where we can make love in the grass.
- In front of the cows? - Sexy cows.
We could take a trip this weekend.
- Yeah.
- Sure.
I might be persuaded to be a little late for work.
- Next? - I repacked Mr.
Otto's abscess.
- Is it granulating? - Quite nicely, thank you.
- Give Mr.
Otto my best.
What else? - Mrs.
Mendoza in 2.
She's had two days of vomiting, diarrhea and periumbilical pain.
- Vitals? - Normal.
It began after dinner in Mexico City.
Came straight here from the airport.
- White count? -12,000.
No rebound or guarding.
Sounds like Montezuma's revenge.
Loperamide and clear liquid diet.
- Do you wanna see her? - No, you can send her home.
Peter.
You won't be scrubbing in on Dr.
Heizenbach's jejunostomy this morning.
- Why not? - He won't work with you.
The word's out about your difficulty with Doug Ross.
It spread to the surgical crew.
The prevailing view is that you betrayed a colleague.
Is that what you think? I think maybe you're in for a chilly summer.
- We still on for tonight? - If you tell me where we're going.
- It's a surprise.
- How do I know what to wear? - Dress nice.
- Carter.
You got a call confirming your reservations for the Moonlight Dinner Cruise on the lake.
Thanks, Jerry.
Sounds romantic.
Remind me to bring my seasickness pills.
- Harper.
- Dale! - I've been looking for you.
- What are you doing here? Trauma sub-I until June, then I start my Residency.
- You matched here? - I did.
- In medicine? - Surgery.
John Carter, he matched in surgery here too.
Dale and I went to college together.
- And you're coming from? - Boston.
- Meaning Harvard? - Go Crimson.
The last time you e-mailed me, you were taking out your first appendix.
- That's right.
- You took out an appendix? They let us do appys lipomas, pilonidal cysts, all that small stuff.
- God, it's great to see you.
- You too.
- I don't know, Doug.
- You, me, Inga, Hulda - and a Chinese restaurant.
- Inga's not really my type.
- You said that about Kathy Snyder.
- I'll get out there in my own pace.
Prostates don't last forever.
Dr.
Greene, is this loan application yours? - It's mine.
- Buying a car? No, I'm helping the kid I misdiagnosed with his cancer treatment.
- I have to bail on M&Ms today.
- Can you change the meeting? - No, and I don't have a lawyer yet.
- Do what you have to do.
- Thanks.
I'm on till 2.
- What's that? She's meeting with a judge.
Chloe wants visitation rights.
- God bless the child.
- Morning, guys.
Sorry I'm late.
Traffic was a bitch.
- Hey.
- Peter.
Let me just clear this off for you Mrs.
Garvey, you're having chest pains? - Where have you been? - And irritability.
- I've waited so long, the pain's gone.
- Just got here.
- I'm burning with fever.
- Temp's normal.
- After sitting in your drafty waiting room.
- Your pain's gone? It's coming back.
- Okay, let's get that EKG.
- What's that? It monitors the heart's electrical activity.
How? The leads carry impulses from your heart to the monitor.
- I don't understand.
Explain it again.
- We wanna make sure you're okay.
Don't patronize me.
You doctors are all the same.
I came in here for stitches, I had to come back five times and my leg's never been the same.
This place is filthy.
Your EKG is abnormal.
We're gonna have to draw some blood.
- Why? - To check your cardiac enzymes.
What are those? Elements that tell us if you've had a heart attack.
I don't understand.
Explain it again! I'm the only fourth-year in the country who hasn't done an appendectomy yet.
I'm about to start my Residency and I'm three steps behind the curve.
GSW to the chest coming in.
ETA two minutes.
Let me run the code.
I'm ready.
And I need the experience.
Listen, everybody.
Carter's gonna run the code.
- All right, everybody, gown up! - What do you want us to do, Carter? - Malik, you start the IVs.
- We have IVs from the field.
- Scratch that.
Malik, you scribe.
- Man, I don't wanna scribe.
Do it.
A: Airway.
Dr.
Greene will intubate.
Breathing.
Haleh, call Respiratory and tell them to get here.
Chuny, you set up the Dynamap.
Circulation.
You on the rapid infuser.
Disability.
Benton! Dr.
Benton.
Check the DTRs and the Babinski, if that's okay.
- All right, what's left? - Foley.
- Who wants to hook up the Foley cath? - You're the only one left.
- What's coming in? - Gunshot wound.
Dale, hook up the Foley cath, and Harper, just jump in as needed.
- They're here.
- All right, man your stations.
Female, found down.
GSW to the chest, traumatic full arrest.
- Heart sounds? - Asystole.
Atropine and epi in the field.
- Got it in the heart.
- Let's get the rapid infuser going.
Get some O-neg down and get a gas cooking.
- Let's move it.
- Monitor's going.
- Flatline.
- Let's go with the epi.
5 mg, IV push.
- Pulse ox? - Forty.
- That's the lowest I've heard.
- Where is Respiratory? - She looks stiff.
Her jaw won't move.
- She looks really cyanotic.
- Boxcars in the eyes.
- Let's get the O-neg going! Let's go! - Should we even be doing this? - How long was she down? It could have been a long time.
From the degree of lividity, she's been dead three hours.
- Let's move with the O-neg! - I agree with Dale.
- Let's call it.
- No, I wanna crack her.
- Time of death- - No, I'll do it.
Time of death: 10:32.
What a gyp.
- She's got an engagement ring.
- She had a little boy too.
Forty-seven brought him in.
- The boy wasn't hurt? - There's nothing physical.
- But he hasn't spoken since he came in.
- It could be posttraumatic shock.
- His mother make it? - Anybody know what happened? Neighbor said she heard the mother and her boyfriend fight this morning.
- Poor kid must have seen the whole thing.
- What's his name? - Where is the boyfriend? - In the wind.
Hey, buddy.
I'm Doug.
And that's Carol right there.
What's your name? I'm gonna listen to your heart, okay? - Doug, his name's Jeremy.
- Jeremy? Can you hear me? Good reflexes.
I'll call Psych.
Why don't you see if you can track down a relative.
He witnessed a murder.
Boyfriend could come back.
We'll get the cops to post a guard.
Hey.
- Peter, come quick.
Mrs.
Mendoza.
- Who? The woman I sent home with Montezuma's revenge.
The pain's moved from mid-abdomen to the right lower quadrant.
- Are you a doctor? - I'm a surgeon.
- She's in so much pain.
- It's her appendix.
- You sure? - Don't worry, we're going to take it out.
We were here earlier, but that nurse sent us home.
We never saw a doctor.
Don't worry, Mr.
Mendoza, we'll take care of her.
Clear! - Did Psych come down for that boy? - Yeah.
She's in there with him now.
- Jerry, will you fax this for me? - Loan application? Sorry.
No more personal use of the fax.
Per the Weaver.
Jerry.
Just do it.
Call Pathology to take that lady's body, these video people need to get in there.
- What video people? - You didn't read the memo? No.
I wanna start videotaping the traumas so we can critique our work.
I don't think this sounds like a good idea.
David Morgenstern thought it was.
- He wrote the memo.
- On a trial basis.
Path's backed up.
They asked for you to keep that DB here.
Put her in Exam 3.
These guys need to get to work.
Come on.
- Gown me, quick! Is that the appy? - Knife.
- What, I can't do it? - No.
- I've seen dozens.
- I said, no.
Carter, go cover the ER.
All right, here we go.
Retract the fascia.
Can you see? - Suction.
- Pulse is up to 120.
Here we go.
- Damn it! Belly's full of puss.
- She done perfed good.
Let's load her up with amp, gent and Flagyl.
Liter of warm saline.
We gotta irrigate before she goes septic.
- What a mess.
- Yeah, too bad she didn't come in sooner.
Damn.
- Mrs.
Garvey.
- You've got some nerve.
- Mrs.
Garvey.
- "Patient is uncooperative demanding, prone to exaggerate symptoms"? - Can I have my chart back? - Give me a pen.
I want this changed.
Doctor is unprofessional, openly hostile.
Your enzymes suggest a heart attack.
- We need to do an echocardiogram.
- What's that? - It's like an ultrasound of your heart.
- Why do I need one of those? We need to make sure that your artery is not blocked.
I don't understand.
Explain it again.
This is your heart.
This is an artery going into your heart.
If it is blocked, it can explode causing a massive heart attack which would kill you within minutes.
You are a sick woman.
- said they heard fighting.
Did your mom and her boyfriend have a fight this morning? Is that what happened? Detective? Can I talk to you outside, please? - What are you doing? - Trying to talk to him.
- What did you say? - I asked what happened.
This boy's had a psychological trauma.
You could have set him back weeks.
- Didn't know that.
- Well, now you do.
Okay? - Hey.
Where's your e-mail pal? - He took a hernia up to the O.
R.
- You're kidding.
- About an hour ago.
Should be back soon.
- Seems like a great guy.
- He is.
- So you guys went out? - We never exactly went out.
- But you - Once.
One night, anyway.
Harper.
Guy in 6 needs a rectal.
I have to take these to the lab.
See you.
- Carter? - Pass.
Abdominal pain, could be surgical.
Haleh, have you seen that cute guy from Harvard? - He just came down, try the desk.
- I'll take it.
I'll take that.
I got it.
Thanks.
Try the 15 mm for me, tilt down, get the whole bed in the frame.
- How's that? - Good.
Pan left- - Iris.
- Oh, Dr.
Greene.
Would have thought we were small potatoes for an infomercial director.
I do educational tapes, equipment rentals.
I'll take your money any way I can.
Would you zoom in to a medium shot for me, Max? - How's your eye? - Oh, fine.
Nice profile.
You sure you won't go on the air? I wouldn't feel right plugging your hair-growth products.
I don't believe in them.
Well, you're more secure than most men.
And you look like you're in pretty good shape.
You exercise? - Run, pushups a little.
Why? - I'm just about to go national with a new exercycle and I haven't found a pitchman yet.
You interested? He's had periumbilical pain that localized to the right lower quadrant - nausea and vomiting.
- What's his white count? Nine thousand.
I'm thinking appendix.
Appys usually present a bit lower, but they can fool you.
- Let's take him up.
- Can I do the procedure? - Does Benton let you do appys? - He talked about it.
Well, there's a first time for everything.
All right.
Mr.
Kennerly, you're going to the O.
R.
, but there's no reason to worry.
Everything is going to be fine.
Thanks.
- Clean her out yet? - Still gotta drain the abscess.
- She's tachy, 180.
- Temp's 104.
- I'll get a cooling blanket.
- This is making me nervous, Peter.
Just hold on.
- Isn't that your med student next door? - What? - What's going on over there? - Another appendix.
- When it rains, it pours.
- Somebody close those blinds.
- Run of five.
Your time's about up.
- Just give me two minutes.
- Too late! - She's fibrillating.
- Damn it! - Crash cart.
Charging at 200.
- Come on, don't do this to me! - Clear! - three enzymes that are released by the heart after a heart attack: CKMB, AST and LDH.
By graphing the levels of each enzyme, we can determine that you had your heart attack at approximately 4 this morning.
Oh, thank you, doctor.
She's the one! - Susan! - Yes, Kerry.
One of the nurses alerted me that Ethel was about to sign out AMA which in her condition might have killed her.
I thought it best to indulge her in order to save her life.
Good thinking.
I know it's frustrating dealing with difficult patients but you have a tendency to become anger-locked and inflexible.
- Thank you for pointing that out.
- If you feel yourself getting dug in just call me.
I'm here to help.
- Retractor.
- Expose the internal oblique.
- Can I have some suction? - Good.
Now cut it open.
- I'm in.
- Okay, now put your hand in the peritoneum and feel around until you find the appendix.
- I got it.
- Okay, let's see.
Well, that is the pinkest, most healthy appendix I've ever seen.
- But he had all the symptoms.
- They can fool you.
- Well, as long as we're here - Better not.
Besides, I think I see the cause of Mr.
Kennerly's bellyache.
What? Toothpick in the terminal ileum.
I think if you pull on the gold tassel it'll slide right out.
Congratulations, Mr.
Carter, on your first toothpick-echtomy.
Now, let's start irrigating.
- Mr.
Mendoza.
- Yes.
Your wife is out of surgery, but she's very sick.
Her appendix burst before I could remove it and the bacteria invaded her bloodstream.
We're giving her antibiotics.
I expect her to pull through it.
Are you saying she could die? - It's a possibility.
- When we first came in was there no way to tell that it was the appendix? The symptoms and the story suggested food poisoning.
That woman sent us home without ever seeing a doctor.
She consulted a doctor, who ordered your wife discharged.
How could this happen? - How's the kid doing? - The same.
Think I could take a peek in there, give him this? - Did you draw that yourself? - I did.
- Hey.
Where is he? - I don't know.
Jeremy? - Oh, man.
- Jeremy! - Jeremy! Have you seen the kid? - What kid? - The one who won't talk.
- No.
Jeremy! Oh, God.
Jeremy! Hey, sweetie.
Hey, come on.
Let's go back to your room.
Come on.
Okay? The Pedes Attending's name is Keller, and there's a med student named Amber who will sit with him till his aunt comes.
- Okay, you got it.
- Thanks.
Who does this belong to? - I told you to hold on to him.
- I just turned around for a second.
We picked him up on Michigan Avenue.
He's zonked out of his gourd.
- He's tachy, diaphoretic.
- Could be coke, PCP.
All right, well, let's get him a room.
- Hey, Dr.
Ross.
- What's this? Some guy dropped it off for you.
Wanna order something from Psycha-Deli? I'm starving.
Could someone release the guy in 4? I gotta go.
- Sure.
You okay? - I'm having a walking anxiety attack.
Call me.
- Hi.
You're all wired up.
- Oh, great.
I'm gonna show you how everything works but I wanna eat something.
How about you? I'm not really hungry.
So, what's wrong with her? - What is this? - Check it out.
Yowza! Twenty-five thousand in- Oh, it's a gift from the old man.
10 to 1 it's dirty.
Looks like your treatment fund just got richer.
It's going back.
Penance doesn't mean anything if it's that easy.
- What do you know about penance? - I used to date a lot of Catholic girls.
You want their numbers? - Her lungs are filling up with fluid.
- How is she? She might not make it.
How could you miss the signs of appendicitis? - Pain localizing to the right.
- She told me it was diffuse.
- Check rebound and guarding? - I told you I did.
I'm asking you if you actually did.
Yes.
And if you had any doubts, you should have examined her yourself.
I trusted you to do that.
You know how difficult appendicitis is to diagnose.
I asked if you wanted to see her- - The appendix that wasn't.
- There'll be plenty more ahead of you.
- I wish I had at least one behind me.
- It is cause for concern - what with the pyramid system.
- Pyramid system? From now on, all surgical interns will be ranked.
Those who fall in the lower third won't be asked back a second year.
- Come on, you gotta help me out here.
- Hey, come on, bud.
Cooperate.
This Rolling Stones, that's a cool one.
"Ban the bra.
" "All the way with LBJ.
" What's that about? I won't hurt your buttons, I promise.
I'll give your buttons right back, you just gotta take this off.
Let go of her! Shep! I don't think he's breathing.
Shep! - There's no pulse! - Get the crash cart.
Get CPR! - What are you doing to my crash cart? - Where's the ET tube? - Wait! He's got a pulse.
- He's back.
I got it! Security! Security! - Hey! Did they call us in? - Relax, we still have a few minutes.
- Where's Mom? - She went to Northfield to see Sally.
- Called that one right.
- Well, this is very upsetting for her.
And for me.
To have to choose between your own daughters.
It's not right.
What do you mean? - I'm not going in.
- Dad.
I don't wanna take sides.
For three weeks you've been promising to back me up and you change your mind now? You haven't spent five minutes with Chloe.
You haven't met Joe.
- Unbelievable.
- Your sister is like a new person.
She got a job the first morning.
She insists on paying for the food.
- Joe is a good guy.
- Did you check his rap sheet? - He's a cop.
- What? - I'm not going.
- It's all set.
Inga's counting on you.
- I'm not going! - What is the problem here? I was married for 11 years.
To be faced suddenly with dating - You're over-thinking.
Follow your id.
- It's more complicated than that.
No, it's not.
What is about to pass between us must remain in the strictest of confidence.
When I first met Jen- - When you first met Jen? - I had never had sex before.
- You were 17, right? - Sixteen.
And through all those years, I've always been faithful.
Wait, are you telling me that you've only had sex with Jen? - That so unusual? - In the 20th century? - Yeah, you're right.
I'm a freak.
- That's a little strong.
No, it's true.
I've only had sex with my wife.
The thought of being intimate with a stranger What if she can't arouse me or I can't please her? - The thought alone scares me to death.
- Well you're right, Inga's not for you.
County, this is Unit 52.
We have a 16-year-old male, beating victim.
Multiple injuries to the face and torso.
Broken tib-fib, difficulty breathing.
Dr.
Ross, 16-year-old trauma.
BP is 80/50, resps are shallow at 53.
Do you copy? - We copy, 52.
What's your ETA? - I'd say 15 minutes.
Dr.
Ross, I'd like to run this trauma- I promised Dale he could run the next one.
Jerry, page me in 10 minutes.
These Kerley B lines.
- What are you looking at? - Pulmonary edema.
- I'm hungry.
You guys had lunch yet? - We're going soon.
Care to join? I really should go up now.
I've got some labs coming.
- Well, Doc Magoo's? - Why don't we do the lunch room? On October 10, 1994, Chloe was arrested for drunk and disorderly conduct.
At this time, she swore she would seek treatment.
Six months later she was arrested for driving under the influence.
Dr.
Lewis, we are here to explore the possibility of you and your sister settling this without the court's help.
- I take it you're not interested.
- No, Your Honor.
- And on the issue of visitation rights? - I don't trust her.
- Based on? - Based on her history of drunkenness addiction and false claims of rehabilitation as outlined here.
I have a copy.
Chloe, is there anything you'd like to say? Everything Susan said about me is true.
But I've never stayed in rehab more than a week before now.
And you've been free of alcohol and drugs for? Five months.
Here are the urine test results.
You've barely started taking responsibility for yourself.
How do you expect to take responsibility for a child? I ask myself that a lot.
But I am on the right track now.
And I never, ever wanna go back to who I was.
And I feel that with the help of God and my friends and my family that I can be a good mother to my baby.
And you've been employed as a claims adjuster in Phoenix for four months.
Yes, here are the affidavits.
They're holding a job for me and I got a job here.
Could you step outside, please? I want to speak to Dr.
Lewis alone.
I am going to allow your sister three overnight visits a week, starting tonight pending resolution of the adoption issue.
And I'm telling you now that if you proceed with a custody fight you will lose.
Chloe is the mother and, as far as I can see, she presents no danger to her child.
Given that, I want you to consider the cost of proceeding.
Not just financially, but in terms of the disruption to your life to Chloe's life and to the baby.
We should've gone fishing.
We could be sitting on a pier with our toes in the water, drowning a couple of worms.
Instead, here we are, two urban casualties of the Button Man.
My throat's fine, by the way.
We're not raising our kids here.
- We're not? - No.
Definitely not.
Okay.
- What happened here? - Appendix ruptured.
She's septic.
I took a look at her chart.
And lo and behold, you sent her home without examining her.
Nothing in the P.
A.
's exam suggested appendicitis.
I disagree.
Abdominal pain.
Cramping.
Fever.
You should have laid hands on her, that's what a surgeon does.
You were quick to assign blame when Doug made a mistake.
But when your ass is on the line, you hide behind excuses.
If this hits the fan, don't expect your colleagues to line up with support.
Reap as you sow.
-7.
43.
- I got it.
You get it next time.
Why don't you go ahead.
Oh, damn it.
Labs are up.
- They can wait 10 minutes.
- Better not.
You go ahead, I'll catch up.
Your soup's gonna get cold.
bruises to face, chest and abdomen.
Possible fractured left tib-fib and facial fracture.
Anybody seen Dale? This guy sure pissed somebody off.
- He got jumped out of a gang.
- Can I do something? - You wanna run it, run it.
- Airway? Patent.
No tracheal deviation.
Bruises on chest and abdomen.
No blood in the canal.
Let's get a C-spine, chest and head CT.
Pupils? Round, equal and reactive.
- What's your name? - Virgil.
- BP is down to 60.
- Carter? He's bleeding from somewhere.
- Where? - Good breath sounds.
That clears the chest.
There are no marks on his back.
- Must be the belly.
Lavage kit! - Lavage kit, please.
Number 11 blade.
- Ever done this? - Not until today.
Well, Mr.
Carter, I see you're finally getting a procedure.
Okay, go.
- Make sure you're into the peritoneum.
- I'm in.
Hook up the saline.
And extension tubing.
Almost looks like he knows what he's doing.
- How is she? - A little better.
I put a catheter in her artery to make it easier to draw blood.
I don't see any other doctors sitting by her bed all day.
Thank you for taking care of my wife.
Mr.
Mendoza.
When you asked earlier if the appendicitis could have been caught I didn't give you a full answer.
I'm the doctor who discharged your wife.
If I'd examined her, I probably would have caught it but I didn't.
I made a mistake.
I'm sorry.
- Nothing.
No blood in the belly.
- BP's down to 40.
- Where is the bleed? - You check his back? Take a look.
- It doesn't make any sense.
- Maybe a faulty pressure cuff? Colon's clear.
- Spoke too soon.
- Must have blown a clot.
- Where is that damn wound? - What's that? That is a very small puncture wound.
Probably an ice pick.
- Went right by me.
- Me too.
Let's get this kid upstairs.
Do you think he took it in the kidney or renal artery? - Renal.
- Wanna come up and find out? Sure.
- Nice catch.
- Thank you.
- What's going on? - Stumbled right into a trauma.
Ice pick to the kidney.
We're taking him up now.
Hi.
- This is weird, isn't it? - Yeah.
- You haven't really met Joe yet.
- Hi, Susan.
Hi, Joe.
I brought extra diapers and some baby Tylenol in case she gets a fever.
And Mr.
B.
She can't go to sleep without him.
- What's her bedtime routine? - Well, a bath.
And then we read two picture books.
And a bottle while she's getting rocked.
And usually I sing to her.
All right, I better go.
- We were hoping you'd stay for dinner.
- No, I don't think so.
Oh, please? I know little Susie would want you to.
She doesn't know who I am.
Come on.
First, let's review a relatively simple trauma led by our own Mr.
Carter.
Note the uneven distribution of personnel screen right.
Everyone clumped together like a herd of wildebeest while the left side is underutilized.
- How's it going? - Very enlightening.
Next, we'll see an example of poor trauma hygiene.
Observe Mr.
Carter wiping his nose with his gloved hand just prior to grabbing the scalpel.
Let's look one more time.
The wipe and now the grab.
One more time.
Wipe and grab.
Good.
Now let's take a look at a more organized trauma led by Dale earlier in the day.
- You wanna have dinner tonight? - Love to.
Are you saying that you've never had sex with anyone but Jen? - That so unusual? - In the 20th century? I may have gone too far back.
What if she can't arouse me or I can't please her? - The thought alone scares me to death.
- Well, you 're right.
Inga's not for you.
Oh, my God! - Mrs.
Mendoza's doing better.
- Yeah, I know.
I spoke to her husband.
He said that you told him it was your fault.
It was my fault.
- Peter, do you hate me? - No.
You don't even look at me when we talk.
It's been like this all year.
Look, I'm sorry that I hurt you, but I thought by now we'd be past it.
I am past it.
Way past it.
You have to admit it was funny.
It was the most humiliating moment of my life.
- Dr.
Ross, this came for you.
- Bad news? I've been denied a loan from a company whose motto is: - "We lend money to anyone.
" - There's always your dad's dough.
- Yeah, then I'd have to thank him.
- Penance has its price.
- Ready? - As I'll ever be.
- How's your appetite? - Good.
- Oh, thanks.
- It's strong.
It's all right.
I hate to bring up the elephant in the room but I think you did a wonderful thing.
You mean taking care of Susie? I didn't have a choice.
Even so, you gave Chloe a chance.
When she first came to AA, she had as low opinion of herself as anyone could.
- But she wanted to get well.
- I thought you were a cop.
I'm also a recovering alcoholic.
Nine years.
The program frowns on old-timers like me getting involved with newcomers.
But we fell in love.
Won't get married for a while, though.
- Not till Chloe gets her year cake.
- If she makes a year.
- Weren't you going home to change? - I did, but I changed my mind.
- You don't wanna go.
- No.
- I bought the tickets.
- Normally that would bother me.
- Considering the occasion, I don't care.
- What occasion? - My dumping you.
- You're dumping me? - And I feel good about it.
- What's going on? - You know.
- No, I don't know.
Get out of here.
You lured Dale and me upstairs so that you could do a procedure.
- That's not true.
- Yeah, it is! You're a weasel! All that matters to you is making suck-points with surgical Residents.
- Let's go someplace and talk.
- No.
- Harper, please.
- No, it's too late.
I don't even know who you are anymore.
- Hey.
- Are you ready? Almost.
Where's Reilly? At Magoo's with that cute tech he's after.
- Boy doesn't waste much time.
- Yeah.
Good luck.
- Hey, doc, did you hear? - No, what? That kid that saw his mom get shot finally started talking.
Turns out that the boyfriend was slapping mom around, so the kid runs gets a gun from the drawer.
He's gonna protect his mom, right? - Only he's not such a good aim.
- No.
Yeah.
Killed his own mother.
Nice world, huh? I feel like I just plucked the virtue of a virgin.
I'm so glad you did.
- Wanna do that again? - I need a minute to recuperate.
Okay.
You let me know.
Meantime, we can play back the tape critique your technique.
Relax, sweetie.
I'm kidding.
- You're awful quiet.
- I was just thinking about that kid.
He will never get over what happened.
He will be, for the rest of his life, damaged goods.
- Probably end up like the Button Man.
- No, he won't.
Yes, he will.
He is a Button Man in the making.
- What's going on here? - Idiots.
Unit 47 requesting police backup at 46 and Hutchins.
Couple of guys bonking each other over the head- Hey! Jeez! What are you doing? What's wrong with you? - Son of a bitch! - Hey, Shep! Shep, get back here! Shep, what are you doing?! Shep! Stop! For God's sake, Shep! Stop it! Get off of me! - Hi.
- Hi, I'm looking for Ray.
- He's not here.
- Okay.
Oh, come on in.
Okay.
- I'm Karen.
- I'm Doug.
- Can I get you something to drink, Doug? - No, thank you.
Do you have any idea when Ray's gonna be back? - Not tonight.
- I'm his son.
Oh, I know.
I saw you the night you came into the bar.
That's right.
He said that you were his boss.
Yeah.
I try to remind him of that every chance I get.
- So are you his boss? - Why don't you just ask me.
- Ask you what? - Do I sleep with your father? - Do you? - I'm not going to answer that.
I only say that because it's unusual that your boss would be living in your apartment.
- What's this? - Scotch.
Who said I lived here? What are you doing here? I'm staying here tonight.
What are you doing here? I have no idea.
What's this? Names, dates, case numbers that Dr.
Vucelich dropped from his study.
I'm going on record to show that he's a fraud.
- Why are you doing this, Peter? - Like you said it's easy to make excuses for not doing the right thing.
No more excuses.
She takes four ounces of milk at night heated for 40 seconds at 50 percent.
Okay.
I'm so glad you stayed.
I know everybody thinks you've changed, and I hope to God that you have but forgive me for not rejoicing just yet.
Maybe I can't be objective because I've been so angry at you for so long.
Do you really think you can be a good mother to this little girl? Yes.
More than anything, that's what I wanna be.
Well, I can finish up in here.
Thanks.
I'm so glad Susie's got an aunt that'll always be there who's smart and a doctor.
She's gonna give you good advice.
Yeah.
Hey, you wanna say good night? Yeah.
Good night, sweetie.
for Paul Leder