Chicago Med (2015) s04e03 Episode Script

1 Friends, let us raise a glass to dear Patrick Halstead.
May you be in Heaven an hour before the Devil knows you're dead.
- Sláinte! - Sláinte! - Let me get you another one.
- Yes, please.
- Mm-hmm.
- Thank you.
Will.
- Tommy.
- Hey.
Sorry about your dad.
My old man couldn't be here.
He he's not feeling so well.
- Sorry to hear it.
- Yeah.
You know, you could do me a solid, though.
Dad, he he won't go to a hospital.
Maybe you could come by the house, give him a look-see? Sorry, Tommy, I'm an ED doc.
Emergency medicine.
- All right.
- I hope he feels better.
Thanks, Will.
- Tommy.
- Yeah? Your father still running the neighborhood? You kidding me? He'll never let that go.
- All right, I'll drop by.
- Thanks a lot, Will.
You got it.
- You okay? - Great, man.
Oh, father dear I long to hear You speak of Erin's Isle Her lofty scenes, her valley's green Her mountains rude and wild They say it isn't So It's only what, five days till your hybrid OR's up and running? Four, actually, and I've still got personnel to train and logistics to figure out.
You're nervous about this, aren't you? I don't think I've ever seen you nervous.
It's refreshing.
Not necessarily attractive, but refreshing.
Help! Help me! My son can't breathe.
Okay, come with me.
It's okay, buddy.
- Dr.
Choi.
- What's going on? Looks like the early stages of respiratory failure.
Lay him down here.
Any medical history? He was born with bad kidneys.
They see him at the hospital in Gary, but I don't think they know what they're doing.
Daddy! My tummy hurts.
When's the last time he was dialyzed? I don't know.
My my ex deals with that.
Let's put him on oxygen, then let reno know he needs dialysis.
- It really hurts.
- I'm so sorry.
All right, Ben, we're gonna give you something that'll make you feel better in just a minute okay? - Here.
- Okay.
He's got a lot of fluid in his lungs.
Hopefully, the dialysis will bring it down.
Then we can discuss what to do next.
Yeah, of course, man, whatever you say.
- Dr.
Choi.
- Hold on one second, Maggie.
I know this isn't easy, but try to stay calm.
We're gonna take good care of your son.
Dr.
Choi.
Need to talk to you right now.
April.
Yeah? That dad, Chris Davis, there's a BOLO out for his arrest.
- A "be on the lookout?" - Yeah.
He kidnapped his son.
Apparently, he just got out of Joliet on parole.
Showed up at his ex-wife's, grabs his son, and takes off.
How's the boy? - End stage renal disease.
- Aw.
The poor kid.
I'll call PD.
Ms.
Goodwin, Ben's in bad enough shape without having him watch his dad get arrested and taken away.
Could we just - hold off until he's stabilized? - April.
He risked his freedom to bring Ben here.
He's not gonna leave.
I'm not sure that's our call.
Can you think of any medical reason why we should hold off? No.
I'll keep an eye on Ben.
- Go ahead and make the call.
- Okay then.
Really? Our first duty is to protect our patient.
How? By taking his dad away? We have no idea what this man is capable of.
Sharon.
Gwen.
Dr.
Lanik, new coat.
Since Dr.
Stohl is no longer here, Dr.
Lanik will be our interim chief of the ED.
Congratulations.
Thank you.
Excuse me.
You didn't consult me on this.
Seems to be your mission to fight me on everything.
Until that changes, I'm going to be making some decisions unilaterally.
Mr.
Nevins, I'm Dr.
Rhodes.
Nice to meet you.
- Call me Bill.
- All right, Bill it is.
So I understand you've got some new onset back pain, huh? Yeah, but it's not too bad.
It's nothing you need to get making a fuss about.
Yeah, well, fuss is kind of our thing here.
Now it looks like your C shows an aortic dissection, which means you've got a tear on the inside of your vessel wall.
Do you have any tingling in your arms? Nope.
Any palpitations, funny feelings in your chest? Nothing.
Seriously, I'm good to go.
Well, you might be right.
It looks like the tear is small, so if we can get you stabilized, we should be able to send you home to follow up with the cardiologist.
- That'd be great.
- All right.
Start on him an Esmolol drip, and if his systolic gets above 120, - let me know.
- Yes, doctor.
I'll be back to check in on you in a bit.
Thanks, doctor.
You ever taken a lead on a case before? - Not yet.
- Well, today's your lucky day, Mr.
and Mrs.
Harris, I'm student doctor Curry and this is Doctor Manning.
- I'm Lisa.
- Matt.
So you're 13 weeks pregnant with three days of abdominal pain.
Have you ever had pain like this before? No.
I'm going to examine you, if that's all right.
Okay, have you had any bleeding? No.
Okay, any complications with your pregnancy? No.
I mean, not with the pregnancy.
For years, doctors said Lisa could never get pregnant.
We tried and we prayed, but nothing worked, until, one day, it just happened.
Did they tell you why you couldn't get pregnant? Something about the shape of my uterus.
They did some tests, but whatever it is, it doesn't matter 'cause we finally have our miracle baby.
So the thing about human anatomy is that even when things may seem like a miracle You know, before we get much further, I think we should check your blood and send you over for a doppler, just to get some more information.
- Is that okay? - Yeah, that's okay.
Great.
We'll be back soon.
First trimester pain in a woman with anatomic abnormalities means that this pregnancy could be ectopic.
Yes, but that does not mean that we need to give her a physiology lesson.
We do if we want her to be informed about her condition.
She's entitled to her beliefs.
It is not our job to challenge them.
- It is when they're wrong.
- Ms.
Curry, we don't know what we're looking at yet, so just go order the tests.
Hey, Ben.
Feeling any better? No.
He's in SVT.
Give him 4 milligrams of Diltiazem over 5 minutes.
"SVT"? - What's that? - It's an arrhythmia.
You mean his heart? I thought the problem was his kidneys.
It is, but kidney failure can lead to dysfunction in other systems.
Will dialysis fix it? I mean, he's been doing that and he's still getting worse.
We need to give it a chance before I can assess what else he might need.
You didn't have to do this.
Sorry, legally I had to.
Hey, Benny.
Benny, I got to go away for a little while.
But Dr.
Choi is gonna take good care of you, okay? So you listen to him and do whatever he says, and I promise everything's gonna be okay.
- Okay? - Okay.
Okay.
I love you.
Okay.
Christopher Davis, you're under arrest for aggravated kidnapping, endangerment of a child, violation of an order of protection, and violation of parole.
Do everything you can for Ben.
Please.
All right, let's go.
Burgess.
Hold up.
What's up? His his son's really sick.
Could you keep him here till we have a better idea - of what's going? - That's not up to me.
I know.
If you want, I can I don't know call the State's Attorney and find out.
I'd appreciate it.
He can wait in there.
Okay.
Talbert.
Thanks.
- Is that the baby? - Yes.
What? Your pregnancy is ectopic, which means that the fetus is implanted outside of your uterus.
Okay, but you can put it back where it belongs right? Unfortunately, we can't.
And I'm afraid it's implanted on your vena cava, the large vessel that carries blood back to your heart.
And from the free fluid I'm seeing in your abdomen tells me that, unfortunately, the vessel is leaking.
So how do you stop it? I mean, you need an operation.
The surgeon will have to remove the fetus and then repair the vessel.
Wait, you mean we could lose the baby? I'm sorry, but you would in any case because of where it's implanted.
There's no possible way that it'll survive long enough to be viable.
In surgery, we'll keep your bleeding from getting out of control, so we need to get you up to the OR as soon as possible.
No.
- I'm sorry? - I am not having surgery.
I don't think you understand.
If we don't operate, you're going to die.
No, you don't understand.
This baby is a miracle.
And God will take care of it.
Bill, what's happening? It's like it's tearing a hole through my belly.
Maggie, we need to get Mr.
Nevins - to interventional now.
- I'm on it.
Bill, I think the tear in your aorta is getting larger, so we need to place a stent so it doesn't get any worse okay? - Yes, if you say so.
- Okay.
Maggie, get transport down.
We need to get him moving.
- IR's full.
- It can't wait.
Can they bump any cases? No, and both CT O.
R.
s are full too.
There's nowhere to go.
If his aorta ruptures, he's gonna bleed out.
Yeah.
I'm opening up my hybrid O.
R.
It's not ready yet, and it's not fully stocked.
Bill is too unstable.
I can't risk his aorta blowing while we wait to get him upstairs.
That team is not trained yet and it you haven't done a single run-through.
Dr.
Rhodes! Will, when was the last time you were here? Man, I can't even remember.
- Hey, Tim.
- Will.
What's the score? Just started.
- All right.
- Dad.
Hey, Dad.
Will Halstead's here.
William.
Still got the red hair.
- Nice to see you, Mr.
Burke.
- Please, Ray.
- Dad, I'll be in the kitchen.
- Yeah.
See you, Will.
And, listen, I'm sorry about your father.
Good guy, but a terrible poker face.
Always looked to the left when he had a good hand.
And he loved those Friday night games.
So what seems to be the problem? It's nothing.
Tommy's a worrywart.
I just been getting these dizzy spells.
Sometimes they'll lay me out a couple hours.
Well, sit down.
Let's have a listen.
This is what's missing from medicine these days, the face to face.
I'll take a house call over some giant hospital any day.
Can't say I blame you.
Yeah, you do have a little bit of a murmur.
Probably worth keeping an eye on.
So what are you up to these days? Still got that place down on Union? The Hall? Yeah.
Man, must be a heck of a business.
I tell you, I'm getting married soon, and all the places out there are either booked up or charging a fortune.
- Oh.
- Yeah.
So? Are you gonna ask me or what? - Ah, no, that's not why - Come on, kid.
You check in on me on your day off, you need a hall.
I'm not an idiot.
I don't mean to I'm happy to do it.
So just say yes.
You're too smart for me, Mr.
Burke.
Ray.
- I really appreciate it.
- Nah.
I gotta draw some blood.
Run some tests.
My favorite part.
All right, let's get this started.
- Where's Beth? - Stuck in the O.
R.
This wasn't on the schedule.
Gene, what's happening with the monitors? It's a brand new system.
I'm still figuring it out.
Dr.
Rhodes, patient's under.
I'm set.
Denise, what's the hold up? I can't find the right-sized guide wires.
All right, IV contrast, injector tubing, and 20 and 60 CC syringes.
I didn't know which ones you wanted.
- Thank you, Maggie.
- Welcome.
Dr.
Rhodes, I still can't find the correct guidewires.
Oh, that's the middle cabinet top left corner.
Iris, call upstairs.
We're not gonna need Beth.
- I can make the call.
- Nope.
I need you to scrub in.
What? I can't do that.
- You used to scrub, right? - Yeah, that's like forever ago.
I don't even know if I remember.
I need a pair of hands.
Go scrub in.
- April, take over.
- Yeah.
No problem.
Your patient, Mrs.
Harris, just passed the Brief Psychiatric Rating Scale with flying colors.
You actually think she's capable of making this decision? She is holding on to a very strong belief, but other than that she seems entirely reasonable.
"Reasonable"? She thinks God is going to save a fetus with a 0% chance of survival.
That's delusional.
Well, in my experience, it's not always so easy to figure out where belief ends and delusion begins.
I mean, faith in a supreme being is held by an overwhelming majority of humans.
Okay, but if we don't do something, she's going to die.
Can't force a procedure on her that she doesn't want.
We're her doctors.
Our job is to fix her, not argue about theology.
I'm sorry, but this is this is ridiculous.
Ms.
Curry, I appreciate that this is a complicated situation, but our job, in fact, is to treat our patients to the best of our ability while honoring their cultural, spiritual, and religious beliefs.
She's allowed to make her own decisions whether we agree with them or not.
What did the State's Attorney say about that kid's dad? Haven't heard back yet.
But does he have to wait in my treatment room? For now, yes, Ben needs a kidney transplant.
I want to see if Chris is a match.
- The man's going to jail.
- And his son is dying.
His boy needs a kidney.
We don't have a choice.
Almost done.
My ex is always telling me how they're doing just fine without me.
Then I saw him lying there, looking so sick.
Yeah For whatever it's worth, Ben may very well have died if you hadn't brought him here today.
Anyway, it's not like he's gonna miss me.
Never really been there for him in the first place.
I'll have the results soon.
What you got there? The Journal of "Computer Methods and Biomedicine.
" - MIT grad, right? - Yep.
- Looks very technical.
- It is.
But so is creating a biomolecular scaffolding to replicate human organs in vitro.
That's what I'm going to do as soon as I finish med school.
Sounds rewarding.
You know, in terms of Mrs.
Harris, I just want to clarify that the challenge when you're trying to evaluate a patient's ability to act in their own interests Oh, actually her labs are ready.
I-I should go check on them.
Femoral sheath is in.
Gene, get in closer.
Zooming in.
What? That bulge there, that's where his aortic wall is the weakest.
That wasn't there before.
That's because his aneurysm's enlarging.
We need to open him up.
What do you mean? His aorta is being squeezed closed.
I'm gonna try going in from the top.
Dr.
Rhodes, the team's not ready.
Let me just call upstairs We don't have time to go upstairs.
Dr.
Rhodes, we don't even have profusion down here.
So we'll do it without.
Set up for a thoracotomy.
- Dr.
Rhodes It's - Maggie! We are opening him up.
All right, you heard the man.
Let's get set up for a thoracotomy.
Let's go! I can't get a good angle on the aorta.
You opened his chest.
We didn't have a choice.
You told me yourself this room wasn't ready.
What if this patient doesn't survive? Connor, I advocated for this program.
For you.
And now you're gonna blow it up before it even starts? Damn it.
This isn't working.
Great.
How do you propose we get him upstairs with his chest open? I'm not going to.
Get me a five-inch 30 millimeter Dacron graft.
We're gonna cut out the damaged aorta and sew in a graft.
Prepare for cross clamp.
Cross clamp.
That only gives you 30 minutes even under the best of circumstances.
This is a terrible long shot.
Yeah, I understand the risk.
Fine, I'll scrub in.
Six and a half gloves.
No, I have everyone I need.
You wanna kill this man, fine.
Cross clamps times two.
Thank you.
Right away.
Natalie.
Hey, so you know how it's been impossible to find a venue for the wedding? - Mm-hmm.
- Well, I found one.
- You did? - And not just found it.
Killed it.
Seats 200, separate room for cocktails, and I got the place at cost.
How did you do that? The owner's a guy who knew my dad.
He wasn't feeling well, so I made a house call.
I looked him over and he insisted we take it.
Will, that's fantastic.
That's how Canaryville works: you scratch my back, I scratch yours.
- Dr.
Manning.
- Mm-hmm? The ICU just called.
Mrs.
Harris's pressure's dropping.
On my way.
- This is great.
- Yeah.
Let's go.
She's 90/60.
- What's going on? - Let's see.
You're losing too much blood.
We need to get you to surgery now.
I already told you no.
Honey, maybe we should listen to the doctors.
Not you too, Matt.
I am not having surgery.
- Lisa - Please stop.
For 12 years all I wanted was to bring a new life into this world, and finally God has rewarded my patience.
And I don't believe that He would turn around and take it all away.
What if He did take it away? What? If the fetus were to stop living because of the blood loss, would you give us permission to do the surgery then, to let us save your life? What are you why is she even talking about this? That's not gonna happen.
She's just asking.
So will you at least agree to that? If the fetus dies.
Fine, if that happened, which it won't, then yes, I would have a surgery.
Can we stop talking about this? Of course.
Bolus a liter of saline, and type and cross for six and six, and give her two units of uncrossmatched blood now.
We'll be back to check on your shortly okay? - Okay.
- Thank you.
Ms.
Curry, that was a disturbing, tactless question.
Why did you ask that? Because we we should know, right? To be prepared.
No, there is a difference between being prepared and terrifying a sick woman.
I'm at work.
What? Caught on fire? Emily, don't you know you can't put something in the microwave if it doesn't say microwave-safe? No, don't touch anything, okay? I'll take care of it when I get home.
- Nice.
- What? She's your sister.
Talk to her however you want.
- What's going on with you? - Nothing.
It's just unfortunate that you can't give anyone a break.
Me? You know, I can't win with you.
You disapproved when I was tough on Emily, then you walked out when I took her in, and now you're mad at me for telling her how to use the microwave so she doesn't burn my apartment down.
I'm not the problem here, April, you are.
- Hey, Joey.
- Hey.
Could you run a CBC, BMP, LFTs, and a thyroid panel on those please? Sure.
Ray Burke.
Oh, where's the Patient Accession Number? Doesn't have one.
It's for a friend.
I can't run blood work for anyone who's not a patient in the hospital.
Come on, Joey.
What's the big deal? Processing bodily fluids is highly regulated and if my numbers don't match up, then somebody's gonna know.
I'm sure you'll figure something out.
Sorry, man.
Nah, you're right.
We should play by the rules.
You remember last month? Your bronchitis? I gave you amoxicillin? Yeah.
I should fill out admission forms, submit them to your insurance, then we can have a Patient Accession Number on that too.
Friend's results should be ready in an hour.
What a saint.
Yeah.
What's going on? Mr.
Davis is a transplant match for his son.
We're taking him up to the O.
R.
No.
- We can't do that.
- Excuse me? He's the only donor within 500 miles.
- Ben needs his kidney.
- I'm sorry, but I have my orders.
You cannot deny that boy a transplant.
I don't want to, but the moment we take his father upstairs, he becomes our patient as well.
I understand transplant protocol.
So then you know that the dad is gonna spend a few days in the ICU, but then what? Jail while awaiting trial, and then prison.
Those are hardly ideal conditions in which to recover from major surgery.
We could very well lose him.
Find an acceptable donor.
Let's not lose anybody.
Gwen, we don't have time, and the father is a match.
You know the hospital's position on ultra high-risk patients, especially those who have a a proven history of making extremely poor decisions.
So you're sacrificing the child - to protect your statistics? - Our statistics, which allow us to remain an accredited transplant center serving this entire city, and that is my concern.
And it should be yours as well.
I let him know he won't be allowed to give Ben his kidney.
Any luck finding another donor? No.
I have a call into East Mercy.
There's a chance they may agree to let Chris donate there.
- Let's hope.
- Yeah.
Ray, I just want to let you know that your blood work looks good, but given your murmur, I do recommend you follow-up with a cardiologist.
Well, I'm sorry, but my specialty is emergency medicine.
You'd be better served And, Ray, I really appreciate that Okay, I'd be happy to.
You know, let me check my schedule, and I'll find a day that works and I'll stop by.
Ultrasound.
- Start the MTP.
- What's happening to her? Her internal bleeding is getting worse.
- Katie, call the O.
R.
- Lisa! BP's 92/51.
I need you to take you to surgery right now.
- No, my baby.
- Lisa, listen to her.
Mrs.
Harris, I need your consent.
- We don't have a lot of time.
- I can't find a heartbeat.
- What? - The fetus.
What is it? There's no heartbeat.
Its heart isn't beating.
No.
I'm sorry, but the fetus is no longer alive.
No.
I need to take you to surgery right now.
- Lisa, come on.
We have to go.
- My baby.
BP's 70/35.
Mrs.
Harris, look at me.
I need to take you to surgery right now.
If I don't, you will die.
Lisa.
Mrs.
Harris, please.
- Please.
- Okay.
All right, let's go! Time? Got 7 minutes.
Marty, the heart stopped.
Lost A-line waveform.
He's in PEA.
Get me epi.
- Maggie, do internal CPR.
- What? Put your hands around his heart.
All the way around his heart and pump.
- Is there no other option? - No, there's not.
You can do this.
Now keep squeezing.
Epi.
Squeeze harder.
Got a CPR waveform.
Stop.
And pump.
Let go.
Good job.
Six and a half minutes.
Hey.
I heard Ms.
Harris agreed to the surgery once she lost the fetal heartbeat.
They got to her in time.
She's gonna make it.
- Well, that's a relief.
- Yeah, but, even though the fetus wasn't viable, its heart was still beating - when they opened Lisa up.
- Really? Yeah, I've got to go tell tech that there was a malfunction with the ultrasound.
Huh.
The State's Attorney said we can't keep him here any longer.
Well, we're still waiting to hear back from East Mercy.
There's nothing I can do.
Dr.
Choi! He's in unstable SVT at 240.
He's not profusing.
2 milligrams of Adenosine.
- Adenosine's in.
- What's happening? Will someone tell me what's happening? Let him stay.
No change.
Charge at 20 and sync.
- Charged.
- Clear! Two more of Adenosine.
Charging to 40.
Adenosine's in.
No good.
Clear! Pulse is strong.
Regular.
Is he gonna be okay? His arrhythmia's are getting harder to convert.
He's gonna die? I'm sorry, Chris.
Let me see him.
Come on, please, man.
It's my son.
Let him.
- Stop.
- Not like that.
Daddy.
You're gonna be okay.
I love you, Ben.
I love you too.
Whoa.
Whoa.
Whoa.
Chris! Do the transplant.
You wanna do everything you can for him? Take my kidney.
I'm trying to find another hospital to do the surgery.
- I just need a little more time.
- No, he doesn't have time! Do it now! Do it now! No! - Stand down! - Pupil's are blown.
Start levophed, get him on a gurney, and tell the transplant team we're coming up now.
Okay.
Thought you'd like to know.
We just heard from East Mercy.
They would have done the transplant.
What did we do? You are a physician, Dr.
Lanik.
You know that when you make a decision, you don't always get the outcome that you want.
But that doesn't mean that the decision was wrong.
To have such faith in something, and then have it go so wrong.
Yeah.
Are you gonna are you gonna tell her about the the fetal heartbeat.
- I'm happy to.
- No.
No, I'll tell her.
I just hate to have to tell her at all.
I'm so sorry.
So I heard about the the false reading on the ultrasound.
Yeah, those those machines can be delicate.
One good hit to the transducer Save it.
You hacked the machine so that it wouldn't read the fetal heartbeat.
- No, I-I did not.
- You've been resistant to the patient's wishes from the start.
Because she was determined to kill herself.
Do you know that I can have you kicked out of medical school? - Kicked out? - Well, you committed a crime.
No, the machine malfunctioned.
Okay, I didn't do anything, and, by by the way, that woman is alive.
Doesn't anybody care about that? That's not the point.
- I know what the point - Clearly you don't! I didn't do it.
Well, I can't prove it, which makes you a very lucky young woman.
But you are severely deficient in attitude and temperament, and I'm going to keep a very close eye on you.
From now on, you and I are gonna go over all your charts and all your cases together.
Are you serious? Very.
Your numbers all look good, Bill, so we're gonna get you set up here, okay? Thanks, Doc.
I'll be back to check on you in the morning.
That was hell of a day.
Sure was.
We should do it again.
What? What do you say to heading up my team? Scrub in on all of my cases.
I'm a charge nurse.
Going back to the O.
R.
? That's sort of a demotion.
Think about it.
My patient pulled through.
I'm glad to hear it.
Look I am sorry that I threw you out of my OR.
It was a mistake.
It was inexcusable.
So how about a peace offering? I'll buy you a drink.
I don't care about you throwing me out.
What I can't stand is you acting so stupidly.
Willing to destroy your program in service of your arrogance and your ego.
So go enjoy your victory, but I don't want any part of it.
I'm gonna pick up some dinner and I'll meet you at your place.
Okay.
Oh, hey.
Do you think the hall would hold 250? I sent a picture of it to my mom, and now she wants to invite a few more cousins.
Yeah, of course.
Great.
- See you.
- Good.
Come here.
- Jay, what's up? - Get in the car.
What do you know about Ray Burke? Does some real estate, owns a bar, - and a construction company - And a reception hall.
Yeah.
You went to see him.
He wasn't feeling well, so I made a house call.
How do you know? Hey, Ray, I just want to let you know that your blood work looks good, but I do recommend that you follow up with a cardiologist.
I'm not going to a cardiologist.
I want you, Will.
And, you know, I'm giving you that hall for two grand.
That's practically for free.
Yeah what are you listening to my calls? - Ray's.
- Ray's? PD and the FBI have been investigating him for, like, two years, and then look who waltzes in My brother.
- Why are you investigating him? - 'Cause he's a gangster.
Come on.
What, he pays off a building inspector every once in a while? Try money laundering, fraud, embezzlement, and now you're involved with him.
Oh, I'm not involved with him.
Hey, I'm using his hall.
It's no big deal.
Yes, it is.
So whatever you're doing, stop.
Go home.