ER s03e08 Episode Script
Union Station
- Previously on ER - Can I get a couple of condoms? - How old are you? - 18.
The hospital is floating me to Neuro three times a week.
It's a miracle.
Abby.
Do us all a favor.
Ask her out.
- You wanna go out tonight? - I can't.
I've got plans.
I waited too long.
Missed my chance.
Blew it.
I'm leaving my Residency.
- Quitting? - Transferring.
- Where? - Phoenix.
If you don't have your child's card with you, let me know.
Chuny, can I get a hand in here, please? Okay, I'll be with you in a second.
Did everybody get a cookie? Excuse me, pal.
I need you to explain to her about the lead.
That ain't Spanish.
We need to take some blood to see if the baby's been exposed to lead.
- Lead is very bad for children.
- Okay.
- Lf there's a problem, we'll call you.
- Okay.
You sign this, and the nurse will take some blood.
- Okay.
- Next, please! - I think that was informed consent.
- Close enough.
- Hey, old man.
- You again? Yeah, I know Halloween.
Charlie, right? You gave me some condoms.
You were a couple of years late.
- You're telling me that's yours? - Why not? - His dad's a Pakistani dude.
- And his name is Lopez because Okay.
His mom, Gloria, is a friend of mine.
She got a job today, so I'm babysitting.
She heard they were giving out free shots.
Ahmed hasn't been seen since he was 4 months old? - I guess.
- Let me see.
Let's take a look.
What's he now? About a year and a half? We need to have his mother's address for a follow-up.
- They live at Sisters, over on Grand.
- The shelter? - Don't we need parental consent? - That's why I told you.
I'm the mom.
All right, Ms.
Lopez.
Why don't you sign right there? - I don't know about this.
- Want me to send him home? Okay, next! - Charlie, shouldn't you be in school? - We're off.
It's Career Day.
- BP's 200 over 140.
- Try to relax, Mr.
Reynolds, okay? - Ultrasound's ready.
- Take a look.
Tell me what you see.
- You wanna start him on beta-blockers? - Yes.
Esmolol, 5 grams and 500 ml.
- And four of morphine.
- It's a triple-A about four cm.
- Dr.
Lewis, I was afraid I'd missed you.
- I'm on till 2.
- It won't be the same without you.
- Stop it.
It's hard enough.
Give Dr.
Carter the bullet.
hypertension, hypercholesterolemia.
One previous MI.
Pain began in left, lower quadrant a week ago.
The ultrasound shows an abdominal aneurysm, four cm.
- We'll take him off your hands.
- Not so fast, Dr.
Carter.
- Check his femoral pulses.
- The ultrasound indicates surgery.
- What do you think, Dr.
Doyle? - I'm with Carter.
Chance of rupture.
- Ten percent.
And the femoral pulses? - Two plus bilaterally.
So good blood flow to lower extremities.
- Ultrasound indicates a risk.
- Shows no leakage.
- Let's get a CT to confirm.
- You wanna manage it medically.
I'd like to try.
The machines can give us test results.
But they like to keep us here for our diagnostic judgment.
This is her last shift.
Maybe our last patient together.
- She's trying to bust me.
- One has to hold you surgeons back.
- Page me when you need me.
- Okay, let's get him to CT.
- Guess I got a lot to learn.
- Yeah, it takes practice.
Don't be afraid to step up.
You should have seen me in my first year.
Don't believe her.
She was always this good.
- Are you with the moving company? - No, I'm a friend of Susan's.
You're the one who's interested in taking over the lease? - Phyllis Dodds.
I'm the landlady.
- Hi, Phyllis.
- Are you okay? - It's just a muscle spasm.
Probably stress.
It's a great one bedroom.
Lots of closet space, nice cross-breeze and a quiet street.
- Yeah, I've spent some time here.
- You worked with Susan? - Three years.
Actually, more.
- Are you single? - Divorced.
And I've got my daughter every other Saturday.
No live-ins, no parties, no pets? - None of the above.
- A landlady's dream.
At least it worked for someone.
Oh, good.
All the boxes go.
The luggage stays.
Place looks a lot bigger without Susan's stuff, doesn't it? A whole lot emptier.
We're screwed.
We can pull all interns off their electives.
Unless Senior Residents lose vacation time we won't be able to cover the schedule.
- Are you okay? - I didn't get much sleep last night.
- What did you say after "screwed"? - It's gonna be a pain to lose Susan.
Big mistake for her.
Phoenix.
What was Morgenstern thinking letting her go? I wanna be supportive of lifestyle choices but we're getting the short end here.
- Good morning, all.
- Hang tough, Coach Pino.
got slammed into the board.
- Possible hip dislocation.
- Dr.
Weaver, can I take this one? - Did you guys nail him? - He told us to play the body.
Never apologize for a good hip check.
Right, coach? - Sure you're feeling okay? - Yeah.
Stiff muscles.
- Might be coming down with something.
- Go home.
Maybe your only chance.
I think I'm gonna stick around.
Hey.
So T-minus five hours and counting? - I'm getting nervous.
- You'll do great in Arizona.
The winters there are like heaven.
I don't wanna leave anyone in the lurch.
We'll muddle through.
I signed the lease.
Great! It'd be a shame to let that place go.
And I'll never forget your address.
Wanna help me with a teaching demo? - You give him five of morphine? - And Valium and 100 methohexital.
The first nurse, in this case Susan, applies counter traction.
Good job, Susan.
Then you grab behind the knee.
And you lift.
And you lift until you feel that hip slip back into place.
- That's it.
- Okay.
- Thanks, Susan.
- Anytime.
Anytime in the next four hours.
Dislocations aren't tough.
You'll get it.
I know.
I've done a bunch of them.
- Why did you ask for help? - I didn't.
- That was perfect.
- Will you take one for me? We will do anything for you, Dr.
Keaton.
- Say "discharge.
" - Discharge! - Great.
- There's Dr.
Benton.
The Herlihys are taking Megan home today.
Yeah, I heard.
Congratulations.
David, get one with Dr.
Benton in it, please.
- It would mean so much.
- Smile.
We owe you so much.
We're not usually shy about taking credit.
But in this case Megan deserves all the congratulations.
- We'll be in touch.
- Bye.
- That was awkward.
- Why? - I almost killed their baby.
- Never begrudge a good outcome.
- It's nothing to be proud of.
- But sometimes the gods smile.
- Hi.
- Carter, what are you doing here? Actually, I was coming to - To look at the literature review? - Yes, I was.
I am, if you are.
- The literature review? - I kidnapped your intern.
I hope you don't mind, but I'm up against a deadline so I asked Dr.
Carter to contribute to an article I'm writing.
- Yes, you did.
- As long as it doesn't interfere with your other work.
- No, this thing with Dr.
Keaton This article won't get in the way.
I can go over your first draft at 3.
Okay? Okay, see you 3.
- Clearing out your locker? - This is too weird.
- What time is your train? - 4:20.
I have to go by my house and pick up my stuff.
- I'm not cutting it too close, am I? - You're on until 2? There's no farewell thing going on, is there? - No.
Not that I've heard of.
- Okay, good.
- Mark is acting so odd.
- Well, he's gonna miss you.
He thinks I should go.
If I have to hear how great Phoenix is once more He's just trying to be a good sport, judging from how miserable he looks.
Having second thoughts? I never made a decision that seemed so right.
You know, once I made it, I just felt great.
- Of course I'm having second thoughts.
- I wish you weren't going.
- But you do look happy.
- Do I? I'm afraid that I'm not happy at all.
Just barging in on Chloe and Joe's happiness.
Well, she owes you a couple of barge-ins.
Susan, there you are.
- What's wrong? - I need a second opinion.
Sure.
See? Odd.
I wanna get your opinion on a patient.
- Are you coming down with something? - I hope not.
Exam Room 1, complains of shortness of breath.
Diffuse low voltage on her EKG.
I'm thinking pericarditis.
Get an echo.
- That's what I'd do.
- Could it be pulmonary embolism? She's at risk.
Abnormal EKG.
It could be lead placement.
- No, I'd go with the echo.
- You sure? It's a no-brainer.
You could always get a VQ scan if the echo's negative.
That's what I was thinking.
So I'll order an echo.
The Mutt and Jeff of emergency medicine pooling their expertise before she leaves us in the dust.
- Doug, stop.
Randi, call the lab, pick up these tests.
- Where have you been? - The Hellmobile.
Diaper rash, Curtain 3.
Saved it just for you.
Anspaugh made you ride the mobile again so soon? No.
The immunization program was Dr.
Ross' idea.
- Is this true? - It keeps me off the streets.
I got sunscreen.
I got a turquoise belt buckle.
- I got a snake bite kit.
- What for? Susan's farewell.
- And we've got a cactus-shaped cake.
- I don't know.
She'll hate this.
Of course she'll hate it.
That's why we're doing it.
- You look lousy.
- I've got this neck thing and fever.
- There's a flu around.
- You didn't do it? - You didn't tell her how you feel.
- She's leaving.
She's made her decision.
I don't see any point in saying anything.
In two hours, we'll have a 1 -week-old male baby on this table.
And what do we know about this poor soul.
He has a distended abdomen, visible peristalsis.
The upper-GI series showed a partial small bowel obstruction.
- When we open him up we expect? - A malrotation of the gut.
- Meaning? The 10th week of fetal development, the cephalic limb of the intestinal loop elongated and twisted 270 degrees.
- Begin with the duodenum.
What would you expect to see in a normal 1 -week-old? What? You mean, like the duodenum leads to? Close your eyes.
Try to see it.
The duodenum leads to jejunum, which connects to the ileum.
Okay, but slow down and tell me what you see.
- What do you mean? - Start with the image of a healthy gut.
I'm seeing the head of the pancreas.
It's like a tiny fist holding two straws.
You mean the mesenteric artery and vein.
It's nestled in the open sea of the duodenum.
And its surface is like fine pebbles.
A beautiful shade of tannish yellow.
Go on.
You try it.
Okay, the The pancreas is shaped like a tadpole with a big head.
It narrows into a tail that curls into the hilum of the spleen.
Go on.
Now see the spleen.
- Susan.
- Yes.
We had a rocky start, but I thought we worked on our relationship and developed a professional rapport.
- What's this about? - The smoker in 1.
I diagnosed her with a pulmonary embolism and consented her for a VQ.
- I thought it was Mark's patient.
- He asked me for my opinion.
- My beef is with him then.
Let me talk to him.
I think I know what the problem is.
- No.
Absolutely not.
- It ticks me off.
- I probably could go up there.
- No, you can't.
It wouldn't kill me to finish off this one shift up in Neuro.
It's the principle.
Last week Lydia went up there and it encouraged them to do it more.
I got called up to Neuro to fill in for the day.
May I speak to the nursing administrator.
Hathaway in the ER.
When do you max out on your pension? - Two more years.
- They are hassling the senior nurses.
Hey! What's in the box? Bridal Shop? - You and Al finally set the date? - No.
The opposite.
- She broke off with Al.
- I'm returning this ridiculous fake virgin outfit, and they'd better not offer me store credit.
- Sorry, Lydia.
- What did Al do? - Nothing.
That's the problem.
- He kept putting it off.
He didn't wanna get married.
I don't know why he proposed.
What's the matter with you guys? - They're all petrified to make a move.
- It's lack of spine, isn't it? Whatever you're talking about, I'm sure you're right.
Mark, I need to talk to you.
Mary.
Carol Hathaway in the ER.
I'm not doing to good.
One of my nurses just got floated up to Neuro.
I'm running a department here.
It doesn't benefit my nurses to be shifted all over the hospital.
No.
You know what? She's not going up.
She's not going up to Neuro.
Right.
Right.
- Hot stuff.
- Unfortunately, you still have to go.
But this is the last time.
I made an appointment with her.
I'm gonna stop this.
- Hang in there, Lydia.
- Don't worry about me.
You can't put me in the middle of your conflicts with Weaver.
You can't, because I'm not gonna be here.
I just trust your judgment.
I know what this is about, and I'm having a hard time too.
I think we've both been spoiled by what we have, the shorthand.
- It makes our jobs so much easier.
- Jobs.
Right.
In Phoenix, I'm afraid there won't be a single person in the ER that I can talk to.
- They've got great doctors there.
They have great doctors here.
The best I've ever worked with.
- You can rely on them.
- Thanks for the pep talk.
Mark, is there something else? No.
No, nothing else.
I could ask you to consult on the hives in 4.
It's time for us to stand on our own two feet.
Jeanie.
Jeanie.
Jeanie, I'm glad I caught you.
- Did you get the mortgage papers back? - No, that's what I wanted to tell you.
- AI, you promised.
- I talked to this lawyer.
He gave me some advice.
And Here.
Everything you said about our marriage.
About how you carried all the weight.
That's gonna stop.
- What is this? - Divorce papers.
I'm giving you the house, the car, everything.
And don't say no.
It's not just because you deserve it.
This guy helped me figure out that if I get my assets down and showed that my job has no insurance then I would get this state program for the working poor.
They offer the drugs I need.
It's a good deal.
But your income has to be less than $ 15,000 a year.
You don't have to worry about me anymore.
Okay? You just take care of yourself.
I gotta go.
Settle down.
Hold her.
Thank God she was passed out at Cubbie's.
Bartender got worried after she downed that sixth double bourbon.
- She looks full-term.
- Let go of me.
I'm out of No, you're not.
Security! We need Security! Damn! Damn this damn thing! Doyle, Ativan, two mg.
Ma'am, are you having contractions? I need a drink.
I need to get out of here! - Restraints.
You're not going anywhere.
Hold still, so we won't hurt your baby.
Go ahead and kill it.
I never wanted the little bastard.
- Too late to think about that now.
- Just sedate her.
I'll kill myself and take it with me.
Damned thing ruined my life.
- You're pissing me off, lady.
- Hold on, Doyle.
- I wanna die.
- Look out.
Her water broke.
We'd better get her up to OB.
- Fetal alcohol syndrome on the way.
- Need some help? We could use some muscle here.
Doyle, take her up to OB.
- She was trying to kill her baby.
- Alert Social Services.
- Will they do anything? - They'll try.
Keep your legs together, honey.
- That was ugly.
- It was criminal.
- Chaplain, got a minute? - Did you call for the last rites? No.
I wanted to see if you were free to see this woman.
She's in labor.
- Does she want a prayer? - No.
But I think her baby will.
Got a brittle diabetic in 2.
He came in with a glucose level of 406.
- Are you well? You look flushed.
- I'm fine.
He hadn't taken his insulin.
His BP was 210 over 115.
Off his dilt.
I gave him both.
But he wants to see Susan.
He always sees Dr.
Lewis.
- I can take it.
- Okay.
- Where's Dr.
Lewis? - She's busy right now.
I'm Dr.
Greene.
We've d Ábrided Mr.
Ceebar's ulcerated ankle.
- Do you have an endocrinologist? - Sort of.
The ER is really not the best place for you to manage your diabetes.
My ex stole 500 bucks from me.
Upsetting, but still no reason for you not to monitor your glucose.
I wanted to tell Dr.
Lewis.
Well, you can't see her right now.
Diabetes is a serious disease.
You can manage it if you follow the regimen.
But if you neglect it, you're at risk for kidney failure, blindness and vascular disease.
- Why? - Why can't I see Dr.
Lewis? - Should I try to find her? Look, Dr.
Lewis is leaving us.
She's not gonna work here anymore.
I didn't tell her about my car.
Somebody ran into it and didn't stop.
- Will you get Psych for Mr.
Ceebar? - I can find Dr - Get Psych! - Tell Dr.
Lewis Labs came back from the healthmobile.
Can you take a look at this CBC? - Crit's 28.
- Iron-deficiency anemia? No.
Normal MCV, no blasts.
Better get this kid in for a follow-up.
It's Ahmed Lopez.
The baby that kid brought in.
Charlie? Sisters of Mercy Shelter? I'll get the number.
I need a hand here.
- What's the problem? - I never felt better.
The guy's coughing his head off.
Best to bring him here.
- Now it's a crime to cough.
- Shut up and be grateful.
- I'll get a history.
- Cops get stranger all the time.
- Don't worry.
This isn't about you.
- Lydia.
- She hates me, doesn't she? - Well, she's pretty fed up.
I don't know how she got the idea I didn't wanna get married.
- You kept putting it off.
- That didn't mean I didn't want to.
- I know.
- You wanna be with her, be with her.
Yeah, you're right.
I woke up this morning, and it was like I was dying.
I couldn't breathe.
You ever get that? - Yeah.
- I got so crazed.
I tried to get the license.
I drove up to the church.
I tried to drag the priest over here to marry us right now.
- Lf she'll have me.
- What happened? They were all at a CPR class.
We do have a chaplain here in the hospital if you're serious.
- Yeah? - He's in Trauma 1, giving last rites.
Boy, oh, boy, oh, boy.
Look at that.
- Where's the cecum? - Can't see through all the small bowel.
It's pretty blue in here.
Let's eviscerate.
You wanna take care of that obstruction? Sure.
Metz.
Retractor.
- Look different from a healthy gut? - I'll say.
Visualize the transduodenal and peritoneal bands attached to the cecum and the ascending colon.
- I am.
- I'm putting traction on this mass twisting it counterclockwise.
It's pretty tangled.
- Like a drawer full of socks.
- I have to remember that one.
Okay, it's pinking up.
I don't think we have dead bowel.
- Do you have it? - Yeah.
- Everything is turned around in here.
- Tell me if you need me.
You better take it.
Okay, retract the intestines.
Metz.
Pick up.
Baby's name is Ahmed, mother's is Gloria.
I don't know what she looks like.
- He doesn't remember the mother.
- He took the blood without consent.
- I didn't hear that.
- That's great, Doug.
I know that all of your residents are single moms.
If you Okay, Sister, maybe I will.
Thank you.
Thank you.
- Don't ask.
- Don't worry, I won't.
- Has anybody seen Mr.
Ceebar? - Mr.
Ceebar.
A brittle diabetic? Yes.
Psych is here, but he's flown the coop.
All he needs is five minutes of TLC and a cup of hot tea.
Well, he's gone now.
Hey, look at that.
- Think he'll talk her into it? - Shouldn't be too hard.
- It's what she wants.
- Talk her into what? Living happily ever after.
- Sorry I couldn't step up.
- At least you knew you weren't ready.
The malrotation was more disorienting than I expected.
anomaly is knowing your embryology.
- I had reviewed that.
- Then you had 90 percent aced.
- What was the other 10 percent? - Being able to stand there and let the confused anatomy start to make its own sense.
- How? - By letting it happen.
Abnormalities in neonates can be overwhelming if broken into parts.
Aristotle would have made a lousy pediatric surgeon.
Sorry to interrupt.
They're calling us from the ER.
They need us.
- What is it? - A wedding.
Oh, my God! It wasn't a joke.
- Is this crazy? - Yeah.
This is crazy.
Good thing you had this old rag lying around.
Make it snappy.
They only gave me 20 minutes off.
- This veil is a little crushed.
- I'll go see if the coast is clear.
Hold still.
I don't wanna stick you.
- How do we look? - No traumas coming in.
- Let's go while the radio is silent.
- Am I too late? No.
Right this way.
Bride's side or groom's? - Okay.
They're a little drippy.
- Yeah? All right, everybody.
They're ready, okay? Right over there.
That'll be good.
Okay, ready? Dearly beloved Friends and colleagues we have come here today as part of God's eternal plan and on the spur of the moment to this holy place of life and death and healing to join Lydia Wright and Alfred - G Grabarsky.
- Grabarsky.
Anybody get a stool culture on Curtain Oh, my God! I'm sorry.
It's okay.
I'll go.
I did the rectal swab, and his chart's in Exam 1.
Best wishes, man.
Like all of us here, they've chosen as their life's work to care for and protect their community.
It's taxing and draining.
And at times, it's dangerous work.
Now Lydia and Alfred are taking on the care and protection for each other and the love they Dr.
Benton sends his apologies.
He was called into an emergency.
Today we witness and declare the sacred union between two Testicular torsion.
souls that feed each other with that love.
It's a love that sustains all their outer efforts.
A love that is rare and that should be treasured.
- A love that at times will glow - I need a hand here! and yet at other times, it will flicker.
And now the vows.
Do you Lydia take Alfred to love and cherish from this day forward till death do you part? - I do.
- And you Alfred take Lydia to love and cherish from this day forward till death do you part? I do.
I now pronounce you husband and wife.
You may kiss your bride.
Then he just handed you the divorce papers? - It wasn't like him.
- What do you mean? It's the most unselfish thing he's ever done.
- She's throwing the bouquet.
- Come on.
No pushing now.
Come on.
- Hey, Carol.
It's bouquet time.
- No, thank you.
Should we do the goodbye for Susan now while everyone's here? No.
We'll do it in an hour or so.
- Did you see those two? - You see them during the ceremony? It's pathetic.
I figured those two'd make a go of it.
- Best friends.
What more do you want? - Not me.
It's what Mark wants.
- Things happen or not for a reason.
- Why is she leaving? She doesn't have a life here.
And one, two, three! Oh, my God! - Oh, yeah, Susan! - Yeah! Congratulations! - You're next.
- Yeah, funny.
- That was kind of great, huh? - Yeah.
They seem happy.
Hey, Mark I proved I'm no good at goodbyes.
- Me neither.
- I'm sorry I snapped at you earlier.
- I just don't want to go unless I know we'll always be friends.
We will.
- You ready for me? - Come on in.
Almost there.
Why don't you shut the door? So about your literature review.
It's very complete.
I have a few quibbles about emphasis.
I'm not sure that Ladd warrants an entire paragraph.
- Probably not.
- But you have a very nice style.
- Easy to read, not a lot of jargon.
- Thank you.
I would ask you to co-author if you weren't first-year.
We need to be careful and not draw a lot of attention considering - Considering us? - Yes.
And what happened last Thursday and Saturday afternoon and evening? - Yes.
And Tuesday before rounds.
- We can talk about that.
The only thing we need to keep straight is that this is separate.
- Completely separate.
- From my work.
It shouldn't matter.
I'm not your boss.
- You're my boss's boss.
- Did you lock the door? Just so we both understand that this is strictly personal.
It has nothing to do with work.
Oh, I love that.
There are so many things I'm not gonna miss about this place.
Aftercare documentation is one of them.
I can't tell you how many hours I've spent doing this.
- You're the only one who ever bothers.
- You kidding me? Yeah.
- She's gonna leave at 2:00.
- Are they setting up? In the lounge.
I got a call from the D.
A.
Today about a drunk woman who came in in labor.
They're charging her for attempted murder.
- Social Services jumped on that one.
- They're acting on a call from us.
You've seen that crayon-in-the-nose trick before? Doctor, the address for Sisters of Mercy.
Yeah.
We can handle it together.
Dr.
Doyle, did you make a call to the 32nd Precinct today? Yeah.
I got a cousin there.
She wanted to kill her baby.
I was a witness.
We get a lot of women here with alcohol and drug problems.
- We let Social Services handle it.
- It can fall through the cracks.
Initiating criminal investigation wasn't your job.
But protecting the health of the baby.
Is that my job? We won't improve prenatal care for high-risk infants if we scare off the mothers.
- How about this? If I get to testify against the bitch, I'll do it on my own time.
I think we're gonna like her.
Randi, could you try and find me some aspirin? It doesn't work for us.
We never had floats in and out of the department.
- Budgets are tight, Carol.
- We're all aware of that.
The hospital values its registered nurses.
RNs are the best trained and most versatile part of the nursing staff.
We are also the most expensive part of that staff.
County has got to figure out ways to utilize RNs more effectively.
- At least have the floats make sense.
- Go on.
ER and ICU have more skills in common than ward nurses, Recovery or Neuro.
That's a very good point, Carol.
That is precisely why I keep trying to get you managers who are in the trenches, more active on the committees.
- We need your perspective.
- Mary, I'm swamped.
Okay, how about a deal? I can find ER floats to ICU per your suggestion.
In exchange, you sit on the hospital- wide re-engineering committee.
We only meet once a month.
- I stalled her with one last patient.
- Good.
She was out the door.
Mr.
Frick will keep her busy for a while.
- You got any tape? - Yeah.
Is Mark coming? - I beeped him twice.
- Sorry, folks.
MVA coming in.
Kindergarten carpool versus joy-riding teens.
- Could be as many as eight victims.
- There goes the party.
- What's the ETA? - They're pulling up now.
Let's go.
Come on.
That's me.
Runner-up for Mr.
Universe.
Call me a fool, doc.
But I'm betting on a comeback.
Haven't changed a lick since 1947.
I'm afraid you may have lost too much weight recently.
I'm in training.
Midwestern finals.
American bodybuilders.
70 and older.
Gotta take care of this damn sciatica.
- Oh, man.
That smarts.
- Why don't you take a seat again? - Do you know how this happened? - My B-12 shot.
Must have hit a nerve.
- You're injecting vitamins? - I stay clear of steroids.
That's good.
Scoot back.
Press against my hands.
Yeah, good.
- Any other complaints? - No.
Best I've looked in 10 years.
- When's the competition? - Mid-March.
I'll be 74 by then.
- And ready for a comeback.
- You think? Yeah.
Plenty of bed rest, anti- inflammatories and start back slowly.
- Thanks, doc.
- Okay.
- Fractured tib-fib.
- Honey, you're gonna be fine.
Order a portable C-spine and left tib-fib.
Come with me this way.
I'll find you a place to sit.
- My mom and dad are gonna kill me.
- I'll tell them it was my fault.
- Signing out, Randi.
- Thanks.
Good luck in Phoenix.
No.
This is the ER again.
We need a neurosurgeon now! Get him to the Suture Room.
Set me up with some 4.
0 nylon.
You have a ruptured spleen.
You need surgery.
It's my carpool.
All the parents need to be called.
Randi, come here and take these numbers down.
- I told you not to let him drive.
- He told me he knew how.
- We were just goofing around.
- Hush! Hold still.
Complains of chest pains, shortness of breath.
Diminished breath sounds on the left.
Get me a chest-tube tray.
We need an abdominal CT for the kid in Trauma 1.
- BP's coming down.
190 over 130.
- Poor cap refill.
Pulse ox 90.
Type and cross two units.
O-neg on the rapid infuser.
- X-ray's coming for the C-spine.
- Anybody need any help? - Susan, what are you still doing here? - You're gonna miss your train.
- Call us.
- Get some O-negative too.
BP's 200 over 140.
Left pupil's sluggish.
- Dusky, you wanna intubate? - Yes.
Possible subdural hematoma.
Mannitol, 90 grams IV.
Let's hyperventilate him.
All right? - Here you go.
- Okay.
Use suction if you need it.
Take your time.
He's breathing on his own.
- She didn't even leave a note.
- She was saying goodbye all day.
- One of the kids crashed in Radiology.
- Which one? - The fractured tib-fib.
- How did it happen? If it's okay, I'd love to get out of here by 7.
- You working on the literature review? - No.
I got a date.
Don't procrastinate and keep Keaton waiting.
It reflects poorly on me.
- She's a hard one to get, isn't she? - How do you figure? She's a great surgeon, but not much of a teacher.
- You don't think so? - Come on.
All that psychobabble? - Her explanations can be eccentric.
- She doesn't say what she wants.
Sometimes she does.
But I haven't been working with her like you have.
She's soft.
She doesn't act like a surgeon.
It is difficult to learn from someone who teaches by intuition.
Which I appreciate about your teaching.
Excuse me, Carter.
Carla? There you are.
I've been here for half an hour.
Why? - Kingston Mines.
Dinner? - That's tomorrow night.
- No, that's tonight.
- Anything you need? - No, Carter.
I'm sorry.
- Carla, this is Dr.
Carter.
- Carter, this is Carla Reece.
- Pleased to meet you.
I'm sorry.
I'm on till midnight tonight.
This is where you work until midnight.
- I'll walk you to your car.
- You've never been here? - No, I haven't.
- I should give you a tour.
- She's got plans.
- No.
I've been stood up.
If Trauma 1 is open, we could start there.
- Don't show me anything bloody.
- No, no.
What do you do, Carla? - I have this Caribbean restaurant.
- No kidding? My family used to sail to the islands every spring.
Half day Dr.
Ross? I was immunizing when you were hitting the snooze button.
I'm upset because I don't understand how you could send a surgical I asked if I should send him for a CT.
You said, "Go ahead.
" - I assumed he was stable.
- No, I asked for your call.
You weren't listening.
You were distracted.
You were looking for Susan, worried she'd left.
I understand.
But don't yell at me now.
Mark, grab your coat.
Let's go talk.
- Admin actually listened? - So no more floating? You laid down the law.
They won't be sending you to Neuro or the wards anymore.
They're gonna limit our floats to ICU.
- How's that any better? - Similar nursing skills.
We have to get it in our contract.
- Only way they'll respect us.
- They'll never respect us.
Dr.
Weaver is wondering where the nurses are.
I don't think it's so bad floating to I.
C.
U.
- I'm not going.
- They won't send you.
You're not close enough to your 20 years.
It's a compromise, but it's better than what was happening.
Careful, Carol.
You sound an awful lot like management.
- I didn't even say goodbye.
- That's not what you need to tell her.
- Too late now.
- When does her train leave? - 4:20.
- Under one hour.
They're usually late.
- She went home to get her luggage.
- I'm on till 11.
- You think I should just go? - You could.
It's impossible.
She's getting on a train.
She's made up her mind.
It may be.
But that's not the point.
- What would I say now? - What you wanted to for years.
You tell her how you feel or let her go without a word and regret it for the rest of your life.
And make yourself and everybody else around you miserable like you have today.
You're right.
- Wait.
Can you tell Kerry? - Go, go, go! This is great.
Oh, my goodness! - Is this where you operate on them? - We stabilize them here.
- Then we send them upstairs to the O.
R.
- Speaking of upstairs.
- Nice meeting you, Carla.
- Yes, thank you for showing me around.
- What's in here? - Just the Suture Room.
What goes on in here? We just take patients down here that we need to You're gonna mess up my reputation around here.
I've been wanting to do that since I came into this place.
- Oh, yeah? - Yeah.
I'm sorry I got to work late.
Well, there's late and there's later.
Taxi! Pull up.
Susan? - Suse, are you here? - Dr.
Greene.
You just missed her.
She left you a note on the mantel.
- Is that clock right, Sister? - Oh, yes.
I must be slow.
I got a friend trying to catch a train.
Sister Anne, try to get them to share.
We haven't had a Lopez all month.
- It's a mother and an infant.
- I know, doctor.
I'm sorry.
You could leave a note on the board.
Go! Go! Go, man! Southwest train.
Track 10.
Looking for the chief, sir? She got moved.
Track 6.
Susan! Susan! Susan! Susan! Susan! - All aboard! - Susan! Mark? Are you okay? - You came to say goodbye? - No.
Stay.
I want you to stay.
- But, Mark - I love you.
And I'm stupid for not saying it before.
No.
It's okay.
I knew.
- In a way, I knew.
- Aboard! Stay.
We belong together.
Tell me you don't feel the same.
I'm sorry.
Train's leaving, ma'am.
- We're right together.
- Mark you're my best friend.
I don't know how I'll make it without you.
- Don't go.
- I have to.
I don't belong here.
I have a new life going in a different direction.
Susan, I don't wanna lose you.
- Ma'am, we're leaving.
- I'll never forget you.
- I do love you.
- What? I love you! Bye.
The hospital is floating me to Neuro three times a week.
It's a miracle.
Abby.
Do us all a favor.
Ask her out.
- You wanna go out tonight? - I can't.
I've got plans.
I waited too long.
Missed my chance.
Blew it.
I'm leaving my Residency.
- Quitting? - Transferring.
- Where? - Phoenix.
If you don't have your child's card with you, let me know.
Chuny, can I get a hand in here, please? Okay, I'll be with you in a second.
Did everybody get a cookie? Excuse me, pal.
I need you to explain to her about the lead.
That ain't Spanish.
We need to take some blood to see if the baby's been exposed to lead.
- Lead is very bad for children.
- Okay.
- Lf there's a problem, we'll call you.
- Okay.
You sign this, and the nurse will take some blood.
- Okay.
- Next, please! - I think that was informed consent.
- Close enough.
- Hey, old man.
- You again? Yeah, I know Halloween.
Charlie, right? You gave me some condoms.
You were a couple of years late.
- You're telling me that's yours? - Why not? - His dad's a Pakistani dude.
- And his name is Lopez because Okay.
His mom, Gloria, is a friend of mine.
She got a job today, so I'm babysitting.
She heard they were giving out free shots.
Ahmed hasn't been seen since he was 4 months old? - I guess.
- Let me see.
Let's take a look.
What's he now? About a year and a half? We need to have his mother's address for a follow-up.
- They live at Sisters, over on Grand.
- The shelter? - Don't we need parental consent? - That's why I told you.
I'm the mom.
All right, Ms.
Lopez.
Why don't you sign right there? - I don't know about this.
- Want me to send him home? Okay, next! - Charlie, shouldn't you be in school? - We're off.
It's Career Day.
- BP's 200 over 140.
- Try to relax, Mr.
Reynolds, okay? - Ultrasound's ready.
- Take a look.
Tell me what you see.
- You wanna start him on beta-blockers? - Yes.
Esmolol, 5 grams and 500 ml.
- And four of morphine.
- It's a triple-A about four cm.
- Dr.
Lewis, I was afraid I'd missed you.
- I'm on till 2.
- It won't be the same without you.
- Stop it.
It's hard enough.
Give Dr.
Carter the bullet.
hypertension, hypercholesterolemia.
One previous MI.
Pain began in left, lower quadrant a week ago.
The ultrasound shows an abdominal aneurysm, four cm.
- We'll take him off your hands.
- Not so fast, Dr.
Carter.
- Check his femoral pulses.
- The ultrasound indicates surgery.
- What do you think, Dr.
Doyle? - I'm with Carter.
Chance of rupture.
- Ten percent.
And the femoral pulses? - Two plus bilaterally.
So good blood flow to lower extremities.
- Ultrasound indicates a risk.
- Shows no leakage.
- Let's get a CT to confirm.
- You wanna manage it medically.
I'd like to try.
The machines can give us test results.
But they like to keep us here for our diagnostic judgment.
This is her last shift.
Maybe our last patient together.
- She's trying to bust me.
- One has to hold you surgeons back.
- Page me when you need me.
- Okay, let's get him to CT.
- Guess I got a lot to learn.
- Yeah, it takes practice.
Don't be afraid to step up.
You should have seen me in my first year.
Don't believe her.
She was always this good.
- Are you with the moving company? - No, I'm a friend of Susan's.
You're the one who's interested in taking over the lease? - Phyllis Dodds.
I'm the landlady.
- Hi, Phyllis.
- Are you okay? - It's just a muscle spasm.
Probably stress.
It's a great one bedroom.
Lots of closet space, nice cross-breeze and a quiet street.
- Yeah, I've spent some time here.
- You worked with Susan? - Three years.
Actually, more.
- Are you single? - Divorced.
And I've got my daughter every other Saturday.
No live-ins, no parties, no pets? - None of the above.
- A landlady's dream.
At least it worked for someone.
Oh, good.
All the boxes go.
The luggage stays.
Place looks a lot bigger without Susan's stuff, doesn't it? A whole lot emptier.
We're screwed.
We can pull all interns off their electives.
Unless Senior Residents lose vacation time we won't be able to cover the schedule.
- Are you okay? - I didn't get much sleep last night.
- What did you say after "screwed"? - It's gonna be a pain to lose Susan.
Big mistake for her.
Phoenix.
What was Morgenstern thinking letting her go? I wanna be supportive of lifestyle choices but we're getting the short end here.
- Good morning, all.
- Hang tough, Coach Pino.
got slammed into the board.
- Possible hip dislocation.
- Dr.
Weaver, can I take this one? - Did you guys nail him? - He told us to play the body.
Never apologize for a good hip check.
Right, coach? - Sure you're feeling okay? - Yeah.
Stiff muscles.
- Might be coming down with something.
- Go home.
Maybe your only chance.
I think I'm gonna stick around.
Hey.
So T-minus five hours and counting? - I'm getting nervous.
- You'll do great in Arizona.
The winters there are like heaven.
I don't wanna leave anyone in the lurch.
We'll muddle through.
I signed the lease.
Great! It'd be a shame to let that place go.
And I'll never forget your address.
Wanna help me with a teaching demo? - You give him five of morphine? - And Valium and 100 methohexital.
The first nurse, in this case Susan, applies counter traction.
Good job, Susan.
Then you grab behind the knee.
And you lift.
And you lift until you feel that hip slip back into place.
- That's it.
- Okay.
- Thanks, Susan.
- Anytime.
Anytime in the next four hours.
Dislocations aren't tough.
You'll get it.
I know.
I've done a bunch of them.
- Why did you ask for help? - I didn't.
- That was perfect.
- Will you take one for me? We will do anything for you, Dr.
Keaton.
- Say "discharge.
" - Discharge! - Great.
- There's Dr.
Benton.
The Herlihys are taking Megan home today.
Yeah, I heard.
Congratulations.
David, get one with Dr.
Benton in it, please.
- It would mean so much.
- Smile.
We owe you so much.
We're not usually shy about taking credit.
But in this case Megan deserves all the congratulations.
- We'll be in touch.
- Bye.
- That was awkward.
- Why? - I almost killed their baby.
- Never begrudge a good outcome.
- It's nothing to be proud of.
- But sometimes the gods smile.
- Hi.
- Carter, what are you doing here? Actually, I was coming to - To look at the literature review? - Yes, I was.
I am, if you are.
- The literature review? - I kidnapped your intern.
I hope you don't mind, but I'm up against a deadline so I asked Dr.
Carter to contribute to an article I'm writing.
- Yes, you did.
- As long as it doesn't interfere with your other work.
- No, this thing with Dr.
Keaton This article won't get in the way.
I can go over your first draft at 3.
Okay? Okay, see you 3.
- Clearing out your locker? - This is too weird.
- What time is your train? - 4:20.
I have to go by my house and pick up my stuff.
- I'm not cutting it too close, am I? - You're on until 2? There's no farewell thing going on, is there? - No.
Not that I've heard of.
- Okay, good.
- Mark is acting so odd.
- Well, he's gonna miss you.
He thinks I should go.
If I have to hear how great Phoenix is once more He's just trying to be a good sport, judging from how miserable he looks.
Having second thoughts? I never made a decision that seemed so right.
You know, once I made it, I just felt great.
- Of course I'm having second thoughts.
- I wish you weren't going.
- But you do look happy.
- Do I? I'm afraid that I'm not happy at all.
Just barging in on Chloe and Joe's happiness.
Well, she owes you a couple of barge-ins.
Susan, there you are.
- What's wrong? - I need a second opinion.
Sure.
See? Odd.
I wanna get your opinion on a patient.
- Are you coming down with something? - I hope not.
Exam Room 1, complains of shortness of breath.
Diffuse low voltage on her EKG.
I'm thinking pericarditis.
Get an echo.
- That's what I'd do.
- Could it be pulmonary embolism? She's at risk.
Abnormal EKG.
It could be lead placement.
- No, I'd go with the echo.
- You sure? It's a no-brainer.
You could always get a VQ scan if the echo's negative.
That's what I was thinking.
So I'll order an echo.
The Mutt and Jeff of emergency medicine pooling their expertise before she leaves us in the dust.
- Doug, stop.
Randi, call the lab, pick up these tests.
- Where have you been? - The Hellmobile.
Diaper rash, Curtain 3.
Saved it just for you.
Anspaugh made you ride the mobile again so soon? No.
The immunization program was Dr.
Ross' idea.
- Is this true? - It keeps me off the streets.
I got sunscreen.
I got a turquoise belt buckle.
- I got a snake bite kit.
- What for? Susan's farewell.
- And we've got a cactus-shaped cake.
- I don't know.
She'll hate this.
Of course she'll hate it.
That's why we're doing it.
- You look lousy.
- I've got this neck thing and fever.
- There's a flu around.
- You didn't do it? - You didn't tell her how you feel.
- She's leaving.
She's made her decision.
I don't see any point in saying anything.
In two hours, we'll have a 1 -week-old male baby on this table.
And what do we know about this poor soul.
He has a distended abdomen, visible peristalsis.
The upper-GI series showed a partial small bowel obstruction.
- When we open him up we expect? - A malrotation of the gut.
- Meaning? The 10th week of fetal development, the cephalic limb of the intestinal loop elongated and twisted 270 degrees.
- Begin with the duodenum.
What would you expect to see in a normal 1 -week-old? What? You mean, like the duodenum leads to? Close your eyes.
Try to see it.
The duodenum leads to jejunum, which connects to the ileum.
Okay, but slow down and tell me what you see.
- What do you mean? - Start with the image of a healthy gut.
I'm seeing the head of the pancreas.
It's like a tiny fist holding two straws.
You mean the mesenteric artery and vein.
It's nestled in the open sea of the duodenum.
And its surface is like fine pebbles.
A beautiful shade of tannish yellow.
Go on.
You try it.
Okay, the The pancreas is shaped like a tadpole with a big head.
It narrows into a tail that curls into the hilum of the spleen.
Go on.
Now see the spleen.
- Susan.
- Yes.
We had a rocky start, but I thought we worked on our relationship and developed a professional rapport.
- What's this about? - The smoker in 1.
I diagnosed her with a pulmonary embolism and consented her for a VQ.
- I thought it was Mark's patient.
- He asked me for my opinion.
- My beef is with him then.
Let me talk to him.
I think I know what the problem is.
- No.
Absolutely not.
- It ticks me off.
- I probably could go up there.
- No, you can't.
It wouldn't kill me to finish off this one shift up in Neuro.
It's the principle.
Last week Lydia went up there and it encouraged them to do it more.
I got called up to Neuro to fill in for the day.
May I speak to the nursing administrator.
Hathaway in the ER.
When do you max out on your pension? - Two more years.
- They are hassling the senior nurses.
Hey! What's in the box? Bridal Shop? - You and Al finally set the date? - No.
The opposite.
- She broke off with Al.
- I'm returning this ridiculous fake virgin outfit, and they'd better not offer me store credit.
- Sorry, Lydia.
- What did Al do? - Nothing.
That's the problem.
- He kept putting it off.
He didn't wanna get married.
I don't know why he proposed.
What's the matter with you guys? - They're all petrified to make a move.
- It's lack of spine, isn't it? Whatever you're talking about, I'm sure you're right.
Mark, I need to talk to you.
Mary.
Carol Hathaway in the ER.
I'm not doing to good.
One of my nurses just got floated up to Neuro.
I'm running a department here.
It doesn't benefit my nurses to be shifted all over the hospital.
No.
You know what? She's not going up.
She's not going up to Neuro.
Right.
Right.
- Hot stuff.
- Unfortunately, you still have to go.
But this is the last time.
I made an appointment with her.
I'm gonna stop this.
- Hang in there, Lydia.
- Don't worry about me.
You can't put me in the middle of your conflicts with Weaver.
You can't, because I'm not gonna be here.
I just trust your judgment.
I know what this is about, and I'm having a hard time too.
I think we've both been spoiled by what we have, the shorthand.
- It makes our jobs so much easier.
- Jobs.
Right.
In Phoenix, I'm afraid there won't be a single person in the ER that I can talk to.
- They've got great doctors there.
They have great doctors here.
The best I've ever worked with.
- You can rely on them.
- Thanks for the pep talk.
Mark, is there something else? No.
No, nothing else.
I could ask you to consult on the hives in 4.
It's time for us to stand on our own two feet.
Jeanie.
Jeanie.
Jeanie, I'm glad I caught you.
- Did you get the mortgage papers back? - No, that's what I wanted to tell you.
- AI, you promised.
- I talked to this lawyer.
He gave me some advice.
And Here.
Everything you said about our marriage.
About how you carried all the weight.
That's gonna stop.
- What is this? - Divorce papers.
I'm giving you the house, the car, everything.
And don't say no.
It's not just because you deserve it.
This guy helped me figure out that if I get my assets down and showed that my job has no insurance then I would get this state program for the working poor.
They offer the drugs I need.
It's a good deal.
But your income has to be less than $ 15,000 a year.
You don't have to worry about me anymore.
Okay? You just take care of yourself.
I gotta go.
Settle down.
Hold her.
Thank God she was passed out at Cubbie's.
Bartender got worried after she downed that sixth double bourbon.
- She looks full-term.
- Let go of me.
I'm out of No, you're not.
Security! We need Security! Damn! Damn this damn thing! Doyle, Ativan, two mg.
Ma'am, are you having contractions? I need a drink.
I need to get out of here! - Restraints.
You're not going anywhere.
Hold still, so we won't hurt your baby.
Go ahead and kill it.
I never wanted the little bastard.
- Too late to think about that now.
- Just sedate her.
I'll kill myself and take it with me.
Damned thing ruined my life.
- You're pissing me off, lady.
- Hold on, Doyle.
- I wanna die.
- Look out.
Her water broke.
We'd better get her up to OB.
- Fetal alcohol syndrome on the way.
- Need some help? We could use some muscle here.
Doyle, take her up to OB.
- She was trying to kill her baby.
- Alert Social Services.
- Will they do anything? - They'll try.
Keep your legs together, honey.
- That was ugly.
- It was criminal.
- Chaplain, got a minute? - Did you call for the last rites? No.
I wanted to see if you were free to see this woman.
She's in labor.
- Does she want a prayer? - No.
But I think her baby will.
Got a brittle diabetic in 2.
He came in with a glucose level of 406.
- Are you well? You look flushed.
- I'm fine.
He hadn't taken his insulin.
His BP was 210 over 115.
Off his dilt.
I gave him both.
But he wants to see Susan.
He always sees Dr.
Lewis.
- I can take it.
- Okay.
- Where's Dr.
Lewis? - She's busy right now.
I'm Dr.
Greene.
We've d Ábrided Mr.
Ceebar's ulcerated ankle.
- Do you have an endocrinologist? - Sort of.
The ER is really not the best place for you to manage your diabetes.
My ex stole 500 bucks from me.
Upsetting, but still no reason for you not to monitor your glucose.
I wanted to tell Dr.
Lewis.
Well, you can't see her right now.
Diabetes is a serious disease.
You can manage it if you follow the regimen.
But if you neglect it, you're at risk for kidney failure, blindness and vascular disease.
- Why? - Why can't I see Dr.
Lewis? - Should I try to find her? Look, Dr.
Lewis is leaving us.
She's not gonna work here anymore.
I didn't tell her about my car.
Somebody ran into it and didn't stop.
- Will you get Psych for Mr.
Ceebar? - I can find Dr - Get Psych! - Tell Dr.
Lewis Labs came back from the healthmobile.
Can you take a look at this CBC? - Crit's 28.
- Iron-deficiency anemia? No.
Normal MCV, no blasts.
Better get this kid in for a follow-up.
It's Ahmed Lopez.
The baby that kid brought in.
Charlie? Sisters of Mercy Shelter? I'll get the number.
I need a hand here.
- What's the problem? - I never felt better.
The guy's coughing his head off.
Best to bring him here.
- Now it's a crime to cough.
- Shut up and be grateful.
- I'll get a history.
- Cops get stranger all the time.
- Don't worry.
This isn't about you.
- Lydia.
- She hates me, doesn't she? - Well, she's pretty fed up.
I don't know how she got the idea I didn't wanna get married.
- You kept putting it off.
- That didn't mean I didn't want to.
- I know.
- You wanna be with her, be with her.
Yeah, you're right.
I woke up this morning, and it was like I was dying.
I couldn't breathe.
You ever get that? - Yeah.
- I got so crazed.
I tried to get the license.
I drove up to the church.
I tried to drag the priest over here to marry us right now.
- Lf she'll have me.
- What happened? They were all at a CPR class.
We do have a chaplain here in the hospital if you're serious.
- Yeah? - He's in Trauma 1, giving last rites.
Boy, oh, boy, oh, boy.
Look at that.
- Where's the cecum? - Can't see through all the small bowel.
It's pretty blue in here.
Let's eviscerate.
You wanna take care of that obstruction? Sure.
Metz.
Retractor.
- Look different from a healthy gut? - I'll say.
Visualize the transduodenal and peritoneal bands attached to the cecum and the ascending colon.
- I am.
- I'm putting traction on this mass twisting it counterclockwise.
It's pretty tangled.
- Like a drawer full of socks.
- I have to remember that one.
Okay, it's pinking up.
I don't think we have dead bowel.
- Do you have it? - Yeah.
- Everything is turned around in here.
- Tell me if you need me.
You better take it.
Okay, retract the intestines.
Metz.
Pick up.
Baby's name is Ahmed, mother's is Gloria.
I don't know what she looks like.
- He doesn't remember the mother.
- He took the blood without consent.
- I didn't hear that.
- That's great, Doug.
I know that all of your residents are single moms.
If you Okay, Sister, maybe I will.
Thank you.
Thank you.
- Don't ask.
- Don't worry, I won't.
- Has anybody seen Mr.
Ceebar? - Mr.
Ceebar.
A brittle diabetic? Yes.
Psych is here, but he's flown the coop.
All he needs is five minutes of TLC and a cup of hot tea.
Well, he's gone now.
Hey, look at that.
- Think he'll talk her into it? - Shouldn't be too hard.
- It's what she wants.
- Talk her into what? Living happily ever after.
- Sorry I couldn't step up.
- At least you knew you weren't ready.
The malrotation was more disorienting than I expected.
anomaly is knowing your embryology.
- I had reviewed that.
- Then you had 90 percent aced.
- What was the other 10 percent? - Being able to stand there and let the confused anatomy start to make its own sense.
- How? - By letting it happen.
Abnormalities in neonates can be overwhelming if broken into parts.
Aristotle would have made a lousy pediatric surgeon.
Sorry to interrupt.
They're calling us from the ER.
They need us.
- What is it? - A wedding.
Oh, my God! It wasn't a joke.
- Is this crazy? - Yeah.
This is crazy.
Good thing you had this old rag lying around.
Make it snappy.
They only gave me 20 minutes off.
- This veil is a little crushed.
- I'll go see if the coast is clear.
Hold still.
I don't wanna stick you.
- How do we look? - No traumas coming in.
- Let's go while the radio is silent.
- Am I too late? No.
Right this way.
Bride's side or groom's? - Okay.
They're a little drippy.
- Yeah? All right, everybody.
They're ready, okay? Right over there.
That'll be good.
Okay, ready? Dearly beloved Friends and colleagues we have come here today as part of God's eternal plan and on the spur of the moment to this holy place of life and death and healing to join Lydia Wright and Alfred - G Grabarsky.
- Grabarsky.
Anybody get a stool culture on Curtain Oh, my God! I'm sorry.
It's okay.
I'll go.
I did the rectal swab, and his chart's in Exam 1.
Best wishes, man.
Like all of us here, they've chosen as their life's work to care for and protect their community.
It's taxing and draining.
And at times, it's dangerous work.
Now Lydia and Alfred are taking on the care and protection for each other and the love they Dr.
Benton sends his apologies.
He was called into an emergency.
Today we witness and declare the sacred union between two Testicular torsion.
souls that feed each other with that love.
It's a love that sustains all their outer efforts.
A love that is rare and that should be treasured.
- A love that at times will glow - I need a hand here! and yet at other times, it will flicker.
And now the vows.
Do you Lydia take Alfred to love and cherish from this day forward till death do you part? - I do.
- And you Alfred take Lydia to love and cherish from this day forward till death do you part? I do.
I now pronounce you husband and wife.
You may kiss your bride.
Then he just handed you the divorce papers? - It wasn't like him.
- What do you mean? It's the most unselfish thing he's ever done.
- She's throwing the bouquet.
- Come on.
No pushing now.
Come on.
- Hey, Carol.
It's bouquet time.
- No, thank you.
Should we do the goodbye for Susan now while everyone's here? No.
We'll do it in an hour or so.
- Did you see those two? - You see them during the ceremony? It's pathetic.
I figured those two'd make a go of it.
- Best friends.
What more do you want? - Not me.
It's what Mark wants.
- Things happen or not for a reason.
- Why is she leaving? She doesn't have a life here.
And one, two, three! Oh, my God! - Oh, yeah, Susan! - Yeah! Congratulations! - You're next.
- Yeah, funny.
- That was kind of great, huh? - Yeah.
They seem happy.
Hey, Mark I proved I'm no good at goodbyes.
- Me neither.
- I'm sorry I snapped at you earlier.
- I just don't want to go unless I know we'll always be friends.
We will.
- You ready for me? - Come on in.
Almost there.
Why don't you shut the door? So about your literature review.
It's very complete.
I have a few quibbles about emphasis.
I'm not sure that Ladd warrants an entire paragraph.
- Probably not.
- But you have a very nice style.
- Easy to read, not a lot of jargon.
- Thank you.
I would ask you to co-author if you weren't first-year.
We need to be careful and not draw a lot of attention considering - Considering us? - Yes.
And what happened last Thursday and Saturday afternoon and evening? - Yes.
And Tuesday before rounds.
- We can talk about that.
The only thing we need to keep straight is that this is separate.
- Completely separate.
- From my work.
It shouldn't matter.
I'm not your boss.
- You're my boss's boss.
- Did you lock the door? Just so we both understand that this is strictly personal.
It has nothing to do with work.
Oh, I love that.
There are so many things I'm not gonna miss about this place.
Aftercare documentation is one of them.
I can't tell you how many hours I've spent doing this.
- You're the only one who ever bothers.
- You kidding me? Yeah.
- She's gonna leave at 2:00.
- Are they setting up? In the lounge.
I got a call from the D.
A.
Today about a drunk woman who came in in labor.
They're charging her for attempted murder.
- Social Services jumped on that one.
- They're acting on a call from us.
You've seen that crayon-in-the-nose trick before? Doctor, the address for Sisters of Mercy.
Yeah.
We can handle it together.
Dr.
Doyle, did you make a call to the 32nd Precinct today? Yeah.
I got a cousin there.
She wanted to kill her baby.
I was a witness.
We get a lot of women here with alcohol and drug problems.
- We let Social Services handle it.
- It can fall through the cracks.
Initiating criminal investigation wasn't your job.
But protecting the health of the baby.
Is that my job? We won't improve prenatal care for high-risk infants if we scare off the mothers.
- How about this? If I get to testify against the bitch, I'll do it on my own time.
I think we're gonna like her.
Randi, could you try and find me some aspirin? It doesn't work for us.
We never had floats in and out of the department.
- Budgets are tight, Carol.
- We're all aware of that.
The hospital values its registered nurses.
RNs are the best trained and most versatile part of the nursing staff.
We are also the most expensive part of that staff.
County has got to figure out ways to utilize RNs more effectively.
- At least have the floats make sense.
- Go on.
ER and ICU have more skills in common than ward nurses, Recovery or Neuro.
That's a very good point, Carol.
That is precisely why I keep trying to get you managers who are in the trenches, more active on the committees.
- We need your perspective.
- Mary, I'm swamped.
Okay, how about a deal? I can find ER floats to ICU per your suggestion.
In exchange, you sit on the hospital- wide re-engineering committee.
We only meet once a month.
- I stalled her with one last patient.
- Good.
She was out the door.
Mr.
Frick will keep her busy for a while.
- You got any tape? - Yeah.
Is Mark coming? - I beeped him twice.
- Sorry, folks.
MVA coming in.
Kindergarten carpool versus joy-riding teens.
- Could be as many as eight victims.
- There goes the party.
- What's the ETA? - They're pulling up now.
Let's go.
Come on.
That's me.
Runner-up for Mr.
Universe.
Call me a fool, doc.
But I'm betting on a comeback.
Haven't changed a lick since 1947.
I'm afraid you may have lost too much weight recently.
I'm in training.
Midwestern finals.
American bodybuilders.
70 and older.
Gotta take care of this damn sciatica.
- Oh, man.
That smarts.
- Why don't you take a seat again? - Do you know how this happened? - My B-12 shot.
Must have hit a nerve.
- You're injecting vitamins? - I stay clear of steroids.
That's good.
Scoot back.
Press against my hands.
Yeah, good.
- Any other complaints? - No.
Best I've looked in 10 years.
- When's the competition? - Mid-March.
I'll be 74 by then.
- And ready for a comeback.
- You think? Yeah.
Plenty of bed rest, anti- inflammatories and start back slowly.
- Thanks, doc.
- Okay.
- Fractured tib-fib.
- Honey, you're gonna be fine.
Order a portable C-spine and left tib-fib.
Come with me this way.
I'll find you a place to sit.
- My mom and dad are gonna kill me.
- I'll tell them it was my fault.
- Signing out, Randi.
- Thanks.
Good luck in Phoenix.
No.
This is the ER again.
We need a neurosurgeon now! Get him to the Suture Room.
Set me up with some 4.
0 nylon.
You have a ruptured spleen.
You need surgery.
It's my carpool.
All the parents need to be called.
Randi, come here and take these numbers down.
- I told you not to let him drive.
- He told me he knew how.
- We were just goofing around.
- Hush! Hold still.
Complains of chest pains, shortness of breath.
Diminished breath sounds on the left.
Get me a chest-tube tray.
We need an abdominal CT for the kid in Trauma 1.
- BP's coming down.
190 over 130.
- Poor cap refill.
Pulse ox 90.
Type and cross two units.
O-neg on the rapid infuser.
- X-ray's coming for the C-spine.
- Anybody need any help? - Susan, what are you still doing here? - You're gonna miss your train.
- Call us.
- Get some O-negative too.
BP's 200 over 140.
Left pupil's sluggish.
- Dusky, you wanna intubate? - Yes.
Possible subdural hematoma.
Mannitol, 90 grams IV.
Let's hyperventilate him.
All right? - Here you go.
- Okay.
Use suction if you need it.
Take your time.
He's breathing on his own.
- She didn't even leave a note.
- She was saying goodbye all day.
- One of the kids crashed in Radiology.
- Which one? - The fractured tib-fib.
- How did it happen? If it's okay, I'd love to get out of here by 7.
- You working on the literature review? - No.
I got a date.
Don't procrastinate and keep Keaton waiting.
It reflects poorly on me.
- She's a hard one to get, isn't she? - How do you figure? She's a great surgeon, but not much of a teacher.
- You don't think so? - Come on.
All that psychobabble? - Her explanations can be eccentric.
- She doesn't say what she wants.
Sometimes she does.
But I haven't been working with her like you have.
She's soft.
She doesn't act like a surgeon.
It is difficult to learn from someone who teaches by intuition.
Which I appreciate about your teaching.
Excuse me, Carter.
Carla? There you are.
I've been here for half an hour.
Why? - Kingston Mines.
Dinner? - That's tomorrow night.
- No, that's tonight.
- Anything you need? - No, Carter.
I'm sorry.
- Carla, this is Dr.
Carter.
- Carter, this is Carla Reece.
- Pleased to meet you.
I'm sorry.
I'm on till midnight tonight.
This is where you work until midnight.
- I'll walk you to your car.
- You've never been here? - No, I haven't.
- I should give you a tour.
- She's got plans.
- No.
I've been stood up.
If Trauma 1 is open, we could start there.
- Don't show me anything bloody.
- No, no.
What do you do, Carla? - I have this Caribbean restaurant.
- No kidding? My family used to sail to the islands every spring.
Half day Dr.
Ross? I was immunizing when you were hitting the snooze button.
I'm upset because I don't understand how you could send a surgical I asked if I should send him for a CT.
You said, "Go ahead.
" - I assumed he was stable.
- No, I asked for your call.
You weren't listening.
You were distracted.
You were looking for Susan, worried she'd left.
I understand.
But don't yell at me now.
Mark, grab your coat.
Let's go talk.
- Admin actually listened? - So no more floating? You laid down the law.
They won't be sending you to Neuro or the wards anymore.
They're gonna limit our floats to ICU.
- How's that any better? - Similar nursing skills.
We have to get it in our contract.
- Only way they'll respect us.
- They'll never respect us.
Dr.
Weaver is wondering where the nurses are.
I don't think it's so bad floating to I.
C.
U.
- I'm not going.
- They won't send you.
You're not close enough to your 20 years.
It's a compromise, but it's better than what was happening.
Careful, Carol.
You sound an awful lot like management.
- I didn't even say goodbye.
- That's not what you need to tell her.
- Too late now.
- When does her train leave? - 4:20.
- Under one hour.
They're usually late.
- She went home to get her luggage.
- I'm on till 11.
- You think I should just go? - You could.
It's impossible.
She's getting on a train.
She's made up her mind.
It may be.
But that's not the point.
- What would I say now? - What you wanted to for years.
You tell her how you feel or let her go without a word and regret it for the rest of your life.
And make yourself and everybody else around you miserable like you have today.
You're right.
- Wait.
Can you tell Kerry? - Go, go, go! This is great.
Oh, my goodness! - Is this where you operate on them? - We stabilize them here.
- Then we send them upstairs to the O.
R.
- Speaking of upstairs.
- Nice meeting you, Carla.
- Yes, thank you for showing me around.
- What's in here? - Just the Suture Room.
What goes on in here? We just take patients down here that we need to You're gonna mess up my reputation around here.
I've been wanting to do that since I came into this place.
- Oh, yeah? - Yeah.
I'm sorry I got to work late.
Well, there's late and there's later.
Taxi! Pull up.
Susan? - Suse, are you here? - Dr.
Greene.
You just missed her.
She left you a note on the mantel.
- Is that clock right, Sister? - Oh, yes.
I must be slow.
I got a friend trying to catch a train.
Sister Anne, try to get them to share.
We haven't had a Lopez all month.
- It's a mother and an infant.
- I know, doctor.
I'm sorry.
You could leave a note on the board.
Go! Go! Go, man! Southwest train.
Track 10.
Looking for the chief, sir? She got moved.
Track 6.
Susan! Susan! Susan! Susan! Susan! - All aboard! - Susan! Mark? Are you okay? - You came to say goodbye? - No.
Stay.
I want you to stay.
- But, Mark - I love you.
And I'm stupid for not saying it before.
No.
It's okay.
I knew.
- In a way, I knew.
- Aboard! Stay.
We belong together.
Tell me you don't feel the same.
I'm sorry.
Train's leaving, ma'am.
- We're right together.
- Mark you're my best friend.
I don't know how I'll make it without you.
- Don't go.
- I have to.
I don't belong here.
I have a new life going in a different direction.
Susan, I don't wanna lose you.
- Ma'am, we're leaving.
- I'll never forget you.
- I do love you.
- What? I love you! Bye.