Chicago Med (2015) s04e13 Episode Script
Ghosts in the Attic
1 [all laughing.]
I mean - What's so funny? - Come on, April.
Tell him.
It's a nurse thing.
You wouldn't get it.
Come on.
Our shifts about to start.
Sorry.
I don't know why I'm so tired this morning.
Really you don't know? Oh, maybe I have some idea.
I'm just happy you're back home and the whole gun thing is behind us.
Excuse me, Dr.
Halstead.
Hey, Earl.
What's up? Sorry to interrupt but it's about your car.
[alarm blaring.]
Seems they pried the latch open.
Oh, my God, he literally just parked.
What was it, like ten minutes ago? My guess is whoever did this cased out Dr.
Halstead specifically.
Knew his schedule, what he might leave in the car.
Mine was the only car broken into? Yeah, seems so.
Oh, my God, Will.
I can't believe you left this back here.
Your laptop's inside.
I'm surprised they didn't take it.
They must have gotten scared off before they found it.
See anything missing, Dr.
Halstead? No, it doesn't look like it.
Well, you must have got lucky then.
[dramatic music.]
Here you go, Top Gun.
You're going to treatment 5.
And take Terry with you.
It seems like he needs something to do.
Come on.
Good morning, Mr.
Kaminsky.
Hi, I'm Dr.
Choi and this is Student Doctor McNeal.
I understand you're experiencing some palpitations in your chest? How about you unbutton your shirt so I can take a listen.
- Sure.
- I see we already took - your blood pressure.
- 226 over 117.
That's high, isn't it? A lot higher than I'd like to see it, yes.
All right, take a deep breath for me.
- [deep breathing.]
- And exhale? Then another? Exhale.
All right.
Bilateral crackles with mild rhonchi.
That doesn't sound good.
Not time to panic yet but it's good you came in.
I want to run a few tests and give you something to bring down that blood pressure.
Excuse me.
Hey, Hank.
Start an IV and give 20 labetalol, please.
Absolutely.
Let's get a CBC, CMP, troponins, and set him up with an EKG and renal ultrasound.
Right.
[clattering.]
Hey, Hank.
Everything all right? Where are you going? [muttering under breath.]
- Is he okay? - I'm sure it's nothing.
Terry, clean this up, and let's get that IV started.
All right.
It's okay.
It's okay.
[whimpering.]
Hey, what's going on? [eerie music.]
- Hey, what happened to Hank? - He's not feeling well.
Does he know that patient, Kaminsky? April, what's going on? Sorry.
Hey, hey, hey, come on.
It's me.
You always read me in.
Not this time.
- Maggie? - Yep? Patient in 2's got a small splenic crack without a blush.
Let's send her upstairs for observation.
- I'm on it.
- Thanks.
Morning.
That's really all you're going to say? Um, what else do you want me to say? Um, sorry would be a start? Yeah, I'm sorry things turned out this way.
Turned out? Things didn't turn out.
You accused me of sleeping with your detestable father.
I'm not going to keep rehashing this, Ava.
Oh, you poor thing.
Connor, incoming.
You're going to Baghdad.
- What do we got? - Bode Isiah, 23, motorcycle versus car, GCS 12, BP 110 over 70, heart rate 120, O2 sats 98%.
He's obviously in a lot of pain, seems to have taken most of the trauma to the torso.
All right, let's get a chest X-ray in here now.
All right, on my count.
One, two, three.
[grunts.]
All right, Bode, we're going to take care of that pain, okay? Give me 50 of fentanyl.
- Yeah.
- I'm HIV positive.
It's good to know but we're prepared for that, okay? Just let us take care of you.
All right, Bode.
Can you move your head up and down for me? There we go, very good.
Now how about left and right, okay? All right, C-spine's clear.
Let's roll him and get a board out.
- One, two, three? - Ahh! Hey, what's the hold up on the fentanyl I asked for? I already gave it to him.
All right, let's get the X-ray in.
Come on.
Oh, all right, Bode.
You've got a bunch of broken and displaced ribs.
In order to stop the pain we're going to have to surgically put them back into alignment with metal plates.
- Is that okay? - Okay.
All right, tell CT we're on our way up.
Let's get him ready to move.
All right? Let's go.
There are my two love birds.
I got a tough one in treatment 4.
Colon cancer.
- Who wants it? - I'll take it.
- Thanks.
- Yeah.
Can you take my stuff? - Sure.
- You all right? - Yeah.
- See ya.
See ya.
Dammit.
Yeah, I need to report a stolen firearm.
You know what? Let me call you back.
- Dr.
Halstead.
- Good morning.
You're a hard man to pin down.
What do you mean? Buddy, I heard you been skipping your sessions.
Therapy? Yeah, well, kinda busy saving lives down here.
Listen, for what it's worth, in my experience, this kind of trauma, you gotta take the treatment seriously or it'll bite you in the ass.
I mean, the stories I could tell you.
Drugs, alcohol, family issues.
Hey, why don't you just say it? All right, Natalie told you I bought a gun.
Well, it's gone, okay? It's not an issue anymore.
- Okay, we done? - Will, let me remind you your therapy is not elective.
Goodwin mandated it.
Come on, man.
I don't want to see you lose your job.
Appreciate it.
I'm not seeing any signs of concussion.
Are you sure it was a seizure that made you collapse? That's what my manager at the food co-op said but it was more of a dizzy spell.
Thinking it was a reaction to the chemo.
All right, well, I'm seeing in your chart that you're battling colon cancer.
Um, I'd like to send you for a set of scans - just to see what's going on.
- Scans? No, I don't want to blow my insurance up any more than I already have.
Plus, my oncologist scanned me just last week.
Well, in that case I will contact your oncologist directly so I can access your records.
I just need your written consent.
No, I don't want to bother her.
I'm feeling better.
I'll I'll make an appointment for the day after tomorrow.
- Jared! Oh, baby.
- Wha what are you doing here? I thought you were at the airport.
I was until Jason called me in a panic.
He overreacted, all right? You should be on your way to Phoenix.
- That conference is important.
- You are more important.
No way I can stay away for a week with you like this.
- This is my girlfriend, Lucy.
- How is he? We're trying to figure that out.
I'm telling you, it's a reaction to the chemo, all right? This isn't my first rodeo.
Chemo? I thought your last cycle ended three weeks ago.
- Three weeks? - Something like that.
That seems unlikely that would still be affecting you.
Do you mind if I take a look at your chemo port? I opted not to get one.
Nurses say my veins are easy to access.
So what's the plan? Well, since you don't want any scans, please just let us run some labs.
- No.
- Jared, please.
This is serious.
Okay.
- But just a blood test.
- Okay, I'll be back shortly.
Hey, can we get a CBC, CMP, magnesium and phosphates for Mr.
Bray? - No scans? - He won't let me.
- Huh.
- Yeah, weird, right? - Yeah.
- Speaking of, did you hear about what happened to Will's car? Yeah, it got broken into, right? Yeah, but nothing was stolen.
Not even a bag with his computer in it.
That's strange.
Sounds like Will got lucky.
That's exactly what Earl said.
Dr.
Choi, I just checked in on Mr.
Kaminsky.
Nurses still haven't drawn blood or sent him up for scans.
- What are they waiting for? - Don't know.
Can't get a straight answer.
Want me to do it? No, I'll handle this.
Hey.
Why is nobody filling the orders for my patient in 5? - Got busy.
- I need that work up now.
- Will you do it, please? - Sorry, gotta get - stat nitro to treatment 2.
- April.
Doris, I need you to draw blood in 5.
I'm sorry, I'm on a break, I gotta clock out.
Draw Mr.
Kaminsky's blood first or don't bother clocking back in.
[sighs.]
- Mags.
- Yep? You gotta reign in your nurses.
They're dropping the ball on my patient in 5.
Dr.
Choi, we're down a nurse.
We'll get to him.
Ow! Ow! - What's wrong? - She's hurting me.
His veins are impossible and he keeps moving.
- Stay still.
- Ow! Stop stabbing me.
- Doris.
- There we go.
All done.
[eerie music.]
Suddenly don't know your way around a rolling vein? It was a hard stick.
I gotta run this to the lab.
Mo, talk to me.
What happened with Hank today? Nothing.
He wasn't feeling good.
- Monique.
- You have to ask April.
I'm asking you.
We're talking about patient care, here.
This is serious, all right? Monique.
Your patient's a child molester.
What? He was Hank's piano teacher.
He raped him when he was a little boy.
Dr.
Lanik is wondering when his chest tube in T2 is getting set up.
You want me to do that before or after this MVC that just came in? How about both at the same time? Yeah.
Someone named Sydney Hawkins is asking for you out in the waiting room.
Said she's a friend of yours? Doesn't ring a bell.
I can tell her you're too busy.
No, I'll come out.
Okay.
Hello, Sydney? I'm Maggie Lockwood.
How can I help you? You don't remember me, do you? I'm Naomi's cousin.
From down round 41st and Langley? She was a year behind you at Wendell Phillips? Well, that was a bit ago, yeah? But I do remember Naomi.
Well, she said if I ever need anything at Med I should ask for you.
Okay, so what can I do for you? Well, just so you know, I'm not the kind of person that gets sick a lot.
- Mm-hmm.
- But I got this body pain that I just can't seem to shake.
If I had a regular doctor I'd go see 'em but, um, if you could hook a girl up that'd be cool.
Okay, listen, this is an E.
D.
We need to prioritize our emergencies.
Yeah, okay, well, if it's too hectic here, I mean, you could just give me something for the pain.
Okay, no one here is going to be able to do that for you until you are formally examined.
So why don't you come and take a seat over here.
Go ahead.
Yeah.
And we'll do our best to get to you, okay? All right.
Thank you for stepping out to see me.
- Of course.
- I appreciate it.
Mm-hmm.
Okay.
Need my hand back, Sydney.
Okay.
- Did you take her temperature? - 99.
6.
Just a bit elevated.
I can bump her up the triage list if you want.
Not necessary.
[dramatic music.]
Please tell me this wasn't your idea.
What? You know how unethical it is denying a patient care.
Treat him like a pin cushion? I should write you all up for what you've been doing.
Do you know what that guy did to Hank? He molested him, Ethan.
Regularly.
- During their piano lessons.
- It's terrible.
I know.
But it's not up to us to dole out justice.
Hank should call PD.
Press charges.
He did already, but it was Hank's word against Kaminsky's and the judge dismissed the whole thing before it even went to trial.
Yeah, and since Kaminsky wasn't even convicted he's not registered as a sex offender.
For all we know, he's still doing this to other little boys.
Look, I get why this upsets you.
It upsets me too.
But regardless of how awful this patient might be we have an ethical obligation to treat him as we would anyone else.
Fine, but there's nothing that says we have to make his stay a vacation.
He will get the bare minimum from me.
Look, if that's how you feel, maybe it's better you keep away all together.
No problem.
Mr.
Kaminsky's EKG and scans are done.
Your labs came back negative.
I'm not seeing any tumors or lesions.
That's good, right? Can I go home, now? You'll need a follow up with a primary care physician but it looks like you're responding to the labetalol we gave you so hopefully we can discharge you soon.
Thank you.
One last thing.
I didn't ask you earlier but hypertension can often be made worse by things like work related stress.
That wouldn't apply to me because I've always loved my job.
- And what's that? - I teach piano at my house.
For over 30 years now.
- You have a lot of students? - Enough to keep me occupied.
[laughs.]
What are you doing up here? Trauma patient with severely displaced rib fractures.
And you didn't page me? Dr.
Latham's held up in surgery but he wanted me to let your know that he reviewed your patient's chart and doesn't think Mr.
Isiah's a good candidate for surgery.
The patient's HIV puts him at too high of a risk for infection.
Plating his ribs is the only way to treat his pain.
Dr.
Latham says you're welcome to seek another opinion.
Well, that's just great.
Hey.
What about you? You're asking for my opinion now? Look, I know that I am the last person that you want to help but we shouldn't be afraid of surgery just because the patient has HIV.
Yeah.
Here.
I'm thinking three KLS titanium plates per side, - maybe four hours max.
- Okay.
I'll clear my schedule and do the surgery.
Really? Hey.
Thank you.
I'm not doing it for you, I'm doing it for your patient.
- Dr.
Halstead? - Yeah? I was waiting for you outside.
Sorry, I was with a patient.
Let's go.
- Mr.
Brays labs are back.
- Thank you.
So Jared, your liver enzymes were a little higher than expected given when you had your last chemo treatment, but everything else looks surprisingly good.
So he's out of the woods? Well, I still don't know what caused his seizure but, um, for now, your vital signs seem stable.
Listen, if I leave now, I can get to my first presentation in time.
I might just be able to make it.
You're going to leave this late? - You'll have to catch a red eye.
- That's okay.
I'm gonna go see if I can reschedule my flight.
Okay.
Dr.
Manning, can you pass me my bag, please? It's right over there.
Sure.
[dramatic music.]
- Here you go.
- Thank you.
No problem.
I'll be back to check on you soon.
[machine blaring.]
Pressure drop.
No pulse, he's in V-fib.
Terry, start compressions.
Doesn't make any sense.
He was fine five minutes ago.
Thought you were staying away from this patient.
He pushed the call button.
No one else was around.
- Charge to 200.
- Charged.
Clear.
Still in V-fib.
Push one milligram of epi.
Charging 200 again.
- Charged.
- Clear! He's asystole.
I think he's gone.
Dr.
Choi? Time of death, 14:42.
[machine flat lining.]
Not sure what I'm missing here, Dr.
Choi.
The patient responded to the labetalol so how'd he have a massive cardiac event out of the blue? I'm not sure.
I know they're pretty rare but at first I thought maybe a pheochromocytoma was responsible for spiking his BP but I don't see any tumors on these scans.
There must have been some other factor at play, right? How many doses of epi did we give Kaminsky when he died? According to the case notes, one, before he went asystolic.
Why? [dramatic music.]
There's four empty amps in the trash.
Really? How could that be? Follow the body down to the morgue, find Dr.
Shore, and ask her if she could tell me how much epinephrine Kaminsky had in his system when he died.
- Okay.
- And ask her - to keep it off the books.
- Off the books? Just do it.
[Heart rate machine beeping.]
[indistinct chatter.]
[drill buzzing.]
All right, that does it for this side.
Let's close him up and reposition him, - re-prep and re-drip.
- You got it.
His splintering was much more extensive than I thought from the scans so you made the right call.
Well, so far so good.
So a patient of mine sent over a bottle of Yamazaki 12 as a thank you for triple bypass.
Perhaps after we're done we could put a dent in it? - Look, Ava - One drink.
Connor, what are you so afraid of? Why did you agree to do the surgery? You trying to fix things between us? [somber music.]
So what if I was? Then this is not the time or the place.
I still have feelings for you, Connor.
Let me know when the team's ready to restart.
You know what I find most bewildering about all this? You've somehow convinced yourself that you're the victim here.
Dr.
Manning, Dr.
Manning, come quick.
[dramatic music.]
I was just about to leave when this happened.
Jared, can you talk to me? Push 2 of Ativan, stat! - What's going on? - He's having a seizure.
Ativan's in.
Jared, can you take a deep breath? Baby, can you hear me? What happened? You just had your second seizure today.
Jared, you need to get a CAT scan immediately.
- No, no, I'm fine.
- Jared.
I'm fine, really.
Don't don't let this stop you catching your flight.
- You should go.
- Are you crazy? I'm not leaving you now.
What about your job? None of that matters right now.
I'm not leaving your side until you're better.
[somber music.]
Hey, how's your patient doing? I'm not sure yet.
Hey, where'd you go? I was looking for you, I couldn't find you.
Well, I had to call the insurance company.
But I saw you talking with a cop.
Well, yeah, that was part of it.
I had to file a whole police report for the insurance claim.
Why would you file a police report? - Was something stolen? - Natalie, for the last time, nothing was stolen.
Hey, I just planted a patient in treatment 3 for you.
Sydney, right? I was just about to head in there.
All right.
Did I hear something about her being a friend of yours? She's not a friend of mine.
Okay.
Hey, sorry.
[sighs.]
It's just I know something about Sydney.
She has a reputation of being a bit of a grifter.
Heard she got arrested for solicitation last year.
I have sympathy for the girl but quite possibly she's just here to score some pills.
Yeah, good to know.
I'll proceed accordingly.
Yeah.
So you think Jared's lying to you? - Yes.
- Wow.
That's a pretty serious accusation.
His story just doesn't add up.
He won't show me his scans, he doesn't have a chemo port, and both his seizures today timed out perfectly to stop his girlfriend from going on her business trip.
Faking a cancer diagnoses for two years would take unbelievable commitment, and also, how do you explain the hair loss and other physical symptoms.
Well, I saw a Ziplock full of green pellets in his bag.
They looked just like the rat poison that my handyman uses in the basement.
If Jared is ingesting a small dose of a toxin like arsenic, it could easily mimic the side effects of chemo.
- Huh.
- I think he's harming himself and he needs to be evaluated.
Okay.
I will talk to him.
Thank you.
[tense music.]
Another here.
One last fracture here, 20 cc's, quarter-percent Marcaine, hand them to me.
Make that to me, Beth.
You want to do everything yourself? - I have the better angle.
- Not for the incision.
Okay, fine.
Give me the Marcaine.
Knife to me.
[tense music.]
- Ow! - She's cut.
[dramatic music.]
The patient's HIV positive.
Ava? It just nicked me.
It barely broke the skin.
I doused it with Betadine.
Doesn't matter.
Hospital protocol.
She's being sidelined? Because the patient is HIV positive you need to be seen in the infectious disease clinic, and start taking antiretrovirals immediately.
Now the medication can cause extreme nausea so I want you off surgical rotation, just for a few days, until you acclimate.
And if I end up contracting the virus, what happens to my career? There is such a small chance of that happening, you saw the patient's chart, he has a low viral load.
Let's not get ahead of ourselves.
Just start taking the meds right away and hopefully there won't be anything to worry about, okay? Ava, I am so sorry.
I don't even know what to say.
It's not your fault.
I was the one who reached for the tray like some idiot resident.
Well, let me at least take a look at your hand.
No, it's okay.
I'll be fine, Connor.
Ethan it's freezing.
Why'd you bring me up here? I got a preliminary report back from pathology and there was evidence Paul Kaminsky had high levels of epinephrine in his blood when he died.
- So? - So I'm not sure he died purely of natural causes and I need you to help me - understand what happened.
- Understand? What are you accusing me of something? We pushed one amp of epi when he coded, right? April, I found four empty amps altogether in the trash afterwards.
I can't seem to account for the other three.
Maybe another patient coded in that room - right before Kaminsky.
- Nothing was logged.
Maybe they forgot to log it.
I don't see what this has to do with me.
You were in Kaminsky's room just before he crashed.
- You think I killed him? - I'm just trying to understand how so much epinephrine got into his system.
- I don't believe this.
- April, please.
Just tell me what you were doing in that room.
He was dehydrated.
I gave him a glass of water.
So suddenly you're Florence Nightingale to this guy? I think we're done.
April, April, please, just you gotta be straight with me.
I'm trying to protect you from getting in any trouble here.
Really? 'Cause that's not what it feels like you're trying to do.
- So? - It's hard to say.
I mean, if we're seriously thinking Munchausen here it's a diagnosis of exclusion and I would just need a lot more time to eliminate the entire differential.
Well, we don't have more time.
He wants to be discharged now.
Nat, I understand.
He needs to be put on a psych hold.
Not only is he poisoning himself but he is controlling every aspect of his girlfriend's life.
Possibly, but he also could be a very sick guy clinging to his girlfriend during a traumatic period in his life.
It all comes down to whether we're willing to risk locking up a legitimately ill cancer patient on a hunch.
- And I'm just not there yet.
- But I'm sorry, Nat.
At this point we just don't have enough information to do anything but let him go.
1 and 2, you take this one.
- Maggie? - Yup? Dr.
Halstead needs you to page renal, stat.
Got it.
Where to? Treatment 3, Sydney Hawkins.
Sydney? Bolus another liter of saline.
- What's going on? - She's in septic shock.
Wait, wait, she was fine a minute ago.
Temp spiked out of nowhere, BP went in the tank.
- What? - Systolic's down to 89.
You can start an external jugular, stat.
- Here's a kit.
- Maggie.
You gotta step back.
[dramatic music.]
Did we get the infection in time? I don't know.
[sniffling.]
[crying.]
Lucy? You okay? - What's wrong? - My boss just fired me.
What? Why? Because I missed that conference.
They said they can no longer handle the unpredictability of my personal life.
And this is the second job I've lost in a year.
- I am so sorry.
- It's not fair.
It's really hard trying to take care of a loved one going through something like this.
I can imagine that going to the chemo treatments alone is like a full time job.
He actually doesn't let me go to chemo with him.
Really? Why? Probably just trying to protect me.
Maybe he thinks it'll stress me out too much.
Hey, Dr.
Manning.
When can I get out of here? I'm sorry, Jared, but I can't officially discharge you without a CAT scan.
Then I'll sign out against medical advice.
If that's what you wanna do but you're still pretty dehydrated so I would like to hang one more liter of fluid, and then we will get you on your way.
Sorry.
- What are you doing? - Uh Here you go.
We'll get you discharged soon.
You wanted proof? Here are the pellets.
Don't tell me you just took those right out of Jared's bag.
Given the circumstances I felt that I had to.
Dr.
Manning, I don't need to tell you that that's a very serious transgression.
His girlfriend deserves to know the truth.
I'm going to the lab to have these analyzed.
Have a seat, please.
The lab tested the pellets you took.
They came back positive, didn't they? Yes, for high levels of spirulina.
What? It's a vitamin supplement.
Not arsenic.
Jared realized you were suspicious so he gave us permission to access his medical records.
His oncologist at East Mercy just emailed this over.
All of Jared's appointments, prescriptions, chemo treatments, it's all there, including scans of the stage three malignant tumor in his colon.
You were absolutely right about one thing: He was hiding something.
The severity of his cancer.
- His prognosis is not good.
- I don't know what to say.
This is awful.
You're an excellent physician, Dr.
Manning, I realize you've been through a lot lately and against my better judgment, I'm going to bat for you on this, but it can't happen again.
This is so insane, Dr.
Charles.
I don't know what I was thinking.
When I ask myself that question, the answer usually ends up having something to do with me, you know, something going on in my life.
Could you have been projecting onto Lucy something that might be true for you? I don't know.
What I suspected.
Sepsis.
Yeah, from the little history I got from her I'm guessing this started as a kidney or urinary tract infection.
[sighs.]
I should have known it was serious.
I could have bumped Sydney up the list.
Oh, come on, Maggie.
No way you could have anticipated her being septic.
What's your prognosis? She gonna have a full recovery? She's in acute renal failure.
We'll take her up to the ICU and start her on dialysis right away but there's a good chance her kidneys are shot and she'll need a transplant.
Yeah.
[somber music.]
[sighs.]
- Maggie.
- Sydney.
How're you doing? Can I get you anything? I thought I just had the flu.
Sydney, I need you to know how sorry I am.
Oh, no.
I can't stop thinking about how if I wouldn't have come in today I would've been dead.
I'm grateful for you, Maggie.
Least I know I'm in good hands.
[moving music.]
Connor? I thought that you would want to know that Bode's surgery was successful.
He's already up and pain free.
Good, I'm glad.
Come in.
I also wanted to bring you this.
- Yamazaki 18? - I figured the least I could do was help you numb the pain.
Thank you.
Sadly, can't have any with my meds, doctor.
Right, yeah, uh, well, maybe we can celebrate when you get the "all clear".
Well, you can have some, right? You take it neat? I'm afraid I'm still on call.
Actually, I have to get back to Med.
Oh, sure.
- Good night.
- Good night.
Heads up, Choi.
We're reviewing the Kaminsky case for tomorrow's M&M.
- Okay.
- I see you didn't put down a cause of death, yet.
Something holding that up or is that just an oversight? Sorry, I just need to check something first.
I need your John Hancock before the end of the shift.
You'll have it.
Well, if something caused this guy's epinephrine levels to spike it's going to be on the adrenals but I'm not seeing anything.
Could you give them a closer look? Something's gotta be there, I know it.
I'm not supposed to be doing this without a formal inquiry.
I know, believe me.
You're doing me a huge favor, Nina.
You're gonna owe me for this one.
All right, let's see.
Well, I'll be darned.
Look.
I can't see anything.
There's your culprit.
Looks like a pheochromocytoma.
It's too small to show up on the scans.
Must have been what caused the high levels of epinephrine in this guy's system.
So he died purely of natural causes.
- Sure did.
- Thank you.
- You're the best.
- [laughs.]
[uplifting music.]
Dr.
Rhodes, hey, how's Dr.
Bekker? - She's hanging in there.
- I still can't believe it.
She's usually the most careful surgeon at Med.
Just not like her.
Not at all.
- Anyway, good night.
- Yeah, good night.
[dramatic music.]
What's this? This is what killed Paul Kaminsky.
An adrenal tumor.
Okay.
I am so sorry, April.
That was wrong of me.
- No kidding.
- If I'm being honest with myself I think I was hurt that you didn't trust me enough to read me in.
And then I started to mistrust you as well.
Well, maybe I shouldn't have cut you out.
It's not easy working so closely with someone you've been involved with.
But I'd like to think we can get past that and still be friends.
I don't know, Ethan.
You thought I could kill a patient.
Is that someone I really want as a friend? I heard about what happened.
You okay? What was stolen from your car today? Tell me the truth.
Natalie, I don't know what you're talking about.
All day I have been feeling like everything is a lie.
It's the same feeling I had on our wedding day.
Just tell me the truth.
What was stolen from your car today? - My gun.
- Your gun? - You swore to me it was gone.
- I went to turn it in.
I did.
I just needed more time.
Unbelievable.
I didn't know how to tell you.
I trusted you.
You have every right to be angry with me.
No, I don't want to hear any more lies.
- Natalie.
- It's over.
- You don't mean that.
- I do.
Good bye, Will.
I mean - What's so funny? - Come on, April.
Tell him.
It's a nurse thing.
You wouldn't get it.
Come on.
Our shifts about to start.
Sorry.
I don't know why I'm so tired this morning.
Really you don't know? Oh, maybe I have some idea.
I'm just happy you're back home and the whole gun thing is behind us.
Excuse me, Dr.
Halstead.
Hey, Earl.
What's up? Sorry to interrupt but it's about your car.
[alarm blaring.]
Seems they pried the latch open.
Oh, my God, he literally just parked.
What was it, like ten minutes ago? My guess is whoever did this cased out Dr.
Halstead specifically.
Knew his schedule, what he might leave in the car.
Mine was the only car broken into? Yeah, seems so.
Oh, my God, Will.
I can't believe you left this back here.
Your laptop's inside.
I'm surprised they didn't take it.
They must have gotten scared off before they found it.
See anything missing, Dr.
Halstead? No, it doesn't look like it.
Well, you must have got lucky then.
[dramatic music.]
Here you go, Top Gun.
You're going to treatment 5.
And take Terry with you.
It seems like he needs something to do.
Come on.
Good morning, Mr.
Kaminsky.
Hi, I'm Dr.
Choi and this is Student Doctor McNeal.
I understand you're experiencing some palpitations in your chest? How about you unbutton your shirt so I can take a listen.
- Sure.
- I see we already took - your blood pressure.
- 226 over 117.
That's high, isn't it? A lot higher than I'd like to see it, yes.
All right, take a deep breath for me.
- [deep breathing.]
- And exhale? Then another? Exhale.
All right.
Bilateral crackles with mild rhonchi.
That doesn't sound good.
Not time to panic yet but it's good you came in.
I want to run a few tests and give you something to bring down that blood pressure.
Excuse me.
Hey, Hank.
Start an IV and give 20 labetalol, please.
Absolutely.
Let's get a CBC, CMP, troponins, and set him up with an EKG and renal ultrasound.
Right.
[clattering.]
Hey, Hank.
Everything all right? Where are you going? [muttering under breath.]
- Is he okay? - I'm sure it's nothing.
Terry, clean this up, and let's get that IV started.
All right.
It's okay.
It's okay.
[whimpering.]
Hey, what's going on? [eerie music.]
- Hey, what happened to Hank? - He's not feeling well.
Does he know that patient, Kaminsky? April, what's going on? Sorry.
Hey, hey, hey, come on.
It's me.
You always read me in.
Not this time.
- Maggie? - Yep? Patient in 2's got a small splenic crack without a blush.
Let's send her upstairs for observation.
- I'm on it.
- Thanks.
Morning.
That's really all you're going to say? Um, what else do you want me to say? Um, sorry would be a start? Yeah, I'm sorry things turned out this way.
Turned out? Things didn't turn out.
You accused me of sleeping with your detestable father.
I'm not going to keep rehashing this, Ava.
Oh, you poor thing.
Connor, incoming.
You're going to Baghdad.
- What do we got? - Bode Isiah, 23, motorcycle versus car, GCS 12, BP 110 over 70, heart rate 120, O2 sats 98%.
He's obviously in a lot of pain, seems to have taken most of the trauma to the torso.
All right, let's get a chest X-ray in here now.
All right, on my count.
One, two, three.
[grunts.]
All right, Bode, we're going to take care of that pain, okay? Give me 50 of fentanyl.
- Yeah.
- I'm HIV positive.
It's good to know but we're prepared for that, okay? Just let us take care of you.
All right, Bode.
Can you move your head up and down for me? There we go, very good.
Now how about left and right, okay? All right, C-spine's clear.
Let's roll him and get a board out.
- One, two, three? - Ahh! Hey, what's the hold up on the fentanyl I asked for? I already gave it to him.
All right, let's get the X-ray in.
Come on.
Oh, all right, Bode.
You've got a bunch of broken and displaced ribs.
In order to stop the pain we're going to have to surgically put them back into alignment with metal plates.
- Is that okay? - Okay.
All right, tell CT we're on our way up.
Let's get him ready to move.
All right? Let's go.
There are my two love birds.
I got a tough one in treatment 4.
Colon cancer.
- Who wants it? - I'll take it.
- Thanks.
- Yeah.
Can you take my stuff? - Sure.
- You all right? - Yeah.
- See ya.
See ya.
Dammit.
Yeah, I need to report a stolen firearm.
You know what? Let me call you back.
- Dr.
Halstead.
- Good morning.
You're a hard man to pin down.
What do you mean? Buddy, I heard you been skipping your sessions.
Therapy? Yeah, well, kinda busy saving lives down here.
Listen, for what it's worth, in my experience, this kind of trauma, you gotta take the treatment seriously or it'll bite you in the ass.
I mean, the stories I could tell you.
Drugs, alcohol, family issues.
Hey, why don't you just say it? All right, Natalie told you I bought a gun.
Well, it's gone, okay? It's not an issue anymore.
- Okay, we done? - Will, let me remind you your therapy is not elective.
Goodwin mandated it.
Come on, man.
I don't want to see you lose your job.
Appreciate it.
I'm not seeing any signs of concussion.
Are you sure it was a seizure that made you collapse? That's what my manager at the food co-op said but it was more of a dizzy spell.
Thinking it was a reaction to the chemo.
All right, well, I'm seeing in your chart that you're battling colon cancer.
Um, I'd like to send you for a set of scans - just to see what's going on.
- Scans? No, I don't want to blow my insurance up any more than I already have.
Plus, my oncologist scanned me just last week.
Well, in that case I will contact your oncologist directly so I can access your records.
I just need your written consent.
No, I don't want to bother her.
I'm feeling better.
I'll I'll make an appointment for the day after tomorrow.
- Jared! Oh, baby.
- Wha what are you doing here? I thought you were at the airport.
I was until Jason called me in a panic.
He overreacted, all right? You should be on your way to Phoenix.
- That conference is important.
- You are more important.
No way I can stay away for a week with you like this.
- This is my girlfriend, Lucy.
- How is he? We're trying to figure that out.
I'm telling you, it's a reaction to the chemo, all right? This isn't my first rodeo.
Chemo? I thought your last cycle ended three weeks ago.
- Three weeks? - Something like that.
That seems unlikely that would still be affecting you.
Do you mind if I take a look at your chemo port? I opted not to get one.
Nurses say my veins are easy to access.
So what's the plan? Well, since you don't want any scans, please just let us run some labs.
- No.
- Jared, please.
This is serious.
Okay.
- But just a blood test.
- Okay, I'll be back shortly.
Hey, can we get a CBC, CMP, magnesium and phosphates for Mr.
Bray? - No scans? - He won't let me.
- Huh.
- Yeah, weird, right? - Yeah.
- Speaking of, did you hear about what happened to Will's car? Yeah, it got broken into, right? Yeah, but nothing was stolen.
Not even a bag with his computer in it.
That's strange.
Sounds like Will got lucky.
That's exactly what Earl said.
Dr.
Choi, I just checked in on Mr.
Kaminsky.
Nurses still haven't drawn blood or sent him up for scans.
- What are they waiting for? - Don't know.
Can't get a straight answer.
Want me to do it? No, I'll handle this.
Hey.
Why is nobody filling the orders for my patient in 5? - Got busy.
- I need that work up now.
- Will you do it, please? - Sorry, gotta get - stat nitro to treatment 2.
- April.
Doris, I need you to draw blood in 5.
I'm sorry, I'm on a break, I gotta clock out.
Draw Mr.
Kaminsky's blood first or don't bother clocking back in.
[sighs.]
- Mags.
- Yep? You gotta reign in your nurses.
They're dropping the ball on my patient in 5.
Dr.
Choi, we're down a nurse.
We'll get to him.
Ow! Ow! - What's wrong? - She's hurting me.
His veins are impossible and he keeps moving.
- Stay still.
- Ow! Stop stabbing me.
- Doris.
- There we go.
All done.
[eerie music.]
Suddenly don't know your way around a rolling vein? It was a hard stick.
I gotta run this to the lab.
Mo, talk to me.
What happened with Hank today? Nothing.
He wasn't feeling good.
- Monique.
- You have to ask April.
I'm asking you.
We're talking about patient care, here.
This is serious, all right? Monique.
Your patient's a child molester.
What? He was Hank's piano teacher.
He raped him when he was a little boy.
Dr.
Lanik is wondering when his chest tube in T2 is getting set up.
You want me to do that before or after this MVC that just came in? How about both at the same time? Yeah.
Someone named Sydney Hawkins is asking for you out in the waiting room.
Said she's a friend of yours? Doesn't ring a bell.
I can tell her you're too busy.
No, I'll come out.
Okay.
Hello, Sydney? I'm Maggie Lockwood.
How can I help you? You don't remember me, do you? I'm Naomi's cousin.
From down round 41st and Langley? She was a year behind you at Wendell Phillips? Well, that was a bit ago, yeah? But I do remember Naomi.
Well, she said if I ever need anything at Med I should ask for you.
Okay, so what can I do for you? Well, just so you know, I'm not the kind of person that gets sick a lot.
- Mm-hmm.
- But I got this body pain that I just can't seem to shake.
If I had a regular doctor I'd go see 'em but, um, if you could hook a girl up that'd be cool.
Okay, listen, this is an E.
D.
We need to prioritize our emergencies.
Yeah, okay, well, if it's too hectic here, I mean, you could just give me something for the pain.
Okay, no one here is going to be able to do that for you until you are formally examined.
So why don't you come and take a seat over here.
Go ahead.
Yeah.
And we'll do our best to get to you, okay? All right.
Thank you for stepping out to see me.
- Of course.
- I appreciate it.
Mm-hmm.
Okay.
Need my hand back, Sydney.
Okay.
- Did you take her temperature? - 99.
6.
Just a bit elevated.
I can bump her up the triage list if you want.
Not necessary.
[dramatic music.]
Please tell me this wasn't your idea.
What? You know how unethical it is denying a patient care.
Treat him like a pin cushion? I should write you all up for what you've been doing.
Do you know what that guy did to Hank? He molested him, Ethan.
Regularly.
- During their piano lessons.
- It's terrible.
I know.
But it's not up to us to dole out justice.
Hank should call PD.
Press charges.
He did already, but it was Hank's word against Kaminsky's and the judge dismissed the whole thing before it even went to trial.
Yeah, and since Kaminsky wasn't even convicted he's not registered as a sex offender.
For all we know, he's still doing this to other little boys.
Look, I get why this upsets you.
It upsets me too.
But regardless of how awful this patient might be we have an ethical obligation to treat him as we would anyone else.
Fine, but there's nothing that says we have to make his stay a vacation.
He will get the bare minimum from me.
Look, if that's how you feel, maybe it's better you keep away all together.
No problem.
Mr.
Kaminsky's EKG and scans are done.
Your labs came back negative.
I'm not seeing any tumors or lesions.
That's good, right? Can I go home, now? You'll need a follow up with a primary care physician but it looks like you're responding to the labetalol we gave you so hopefully we can discharge you soon.
Thank you.
One last thing.
I didn't ask you earlier but hypertension can often be made worse by things like work related stress.
That wouldn't apply to me because I've always loved my job.
- And what's that? - I teach piano at my house.
For over 30 years now.
- You have a lot of students? - Enough to keep me occupied.
[laughs.]
What are you doing up here? Trauma patient with severely displaced rib fractures.
And you didn't page me? Dr.
Latham's held up in surgery but he wanted me to let your know that he reviewed your patient's chart and doesn't think Mr.
Isiah's a good candidate for surgery.
The patient's HIV puts him at too high of a risk for infection.
Plating his ribs is the only way to treat his pain.
Dr.
Latham says you're welcome to seek another opinion.
Well, that's just great.
Hey.
What about you? You're asking for my opinion now? Look, I know that I am the last person that you want to help but we shouldn't be afraid of surgery just because the patient has HIV.
Yeah.
Here.
I'm thinking three KLS titanium plates per side, - maybe four hours max.
- Okay.
I'll clear my schedule and do the surgery.
Really? Hey.
Thank you.
I'm not doing it for you, I'm doing it for your patient.
- Dr.
Halstead? - Yeah? I was waiting for you outside.
Sorry, I was with a patient.
Let's go.
- Mr.
Brays labs are back.
- Thank you.
So Jared, your liver enzymes were a little higher than expected given when you had your last chemo treatment, but everything else looks surprisingly good.
So he's out of the woods? Well, I still don't know what caused his seizure but, um, for now, your vital signs seem stable.
Listen, if I leave now, I can get to my first presentation in time.
I might just be able to make it.
You're going to leave this late? - You'll have to catch a red eye.
- That's okay.
I'm gonna go see if I can reschedule my flight.
Okay.
Dr.
Manning, can you pass me my bag, please? It's right over there.
Sure.
[dramatic music.]
- Here you go.
- Thank you.
No problem.
I'll be back to check on you soon.
[machine blaring.]
Pressure drop.
No pulse, he's in V-fib.
Terry, start compressions.
Doesn't make any sense.
He was fine five minutes ago.
Thought you were staying away from this patient.
He pushed the call button.
No one else was around.
- Charge to 200.
- Charged.
Clear.
Still in V-fib.
Push one milligram of epi.
Charging 200 again.
- Charged.
- Clear! He's asystole.
I think he's gone.
Dr.
Choi? Time of death, 14:42.
[machine flat lining.]
Not sure what I'm missing here, Dr.
Choi.
The patient responded to the labetalol so how'd he have a massive cardiac event out of the blue? I'm not sure.
I know they're pretty rare but at first I thought maybe a pheochromocytoma was responsible for spiking his BP but I don't see any tumors on these scans.
There must have been some other factor at play, right? How many doses of epi did we give Kaminsky when he died? According to the case notes, one, before he went asystolic.
Why? [dramatic music.]
There's four empty amps in the trash.
Really? How could that be? Follow the body down to the morgue, find Dr.
Shore, and ask her if she could tell me how much epinephrine Kaminsky had in his system when he died.
- Okay.
- And ask her - to keep it off the books.
- Off the books? Just do it.
[Heart rate machine beeping.]
[indistinct chatter.]
[drill buzzing.]
All right, that does it for this side.
Let's close him up and reposition him, - re-prep and re-drip.
- You got it.
His splintering was much more extensive than I thought from the scans so you made the right call.
Well, so far so good.
So a patient of mine sent over a bottle of Yamazaki 12 as a thank you for triple bypass.
Perhaps after we're done we could put a dent in it? - Look, Ava - One drink.
Connor, what are you so afraid of? Why did you agree to do the surgery? You trying to fix things between us? [somber music.]
So what if I was? Then this is not the time or the place.
I still have feelings for you, Connor.
Let me know when the team's ready to restart.
You know what I find most bewildering about all this? You've somehow convinced yourself that you're the victim here.
Dr.
Manning, Dr.
Manning, come quick.
[dramatic music.]
I was just about to leave when this happened.
Jared, can you talk to me? Push 2 of Ativan, stat! - What's going on? - He's having a seizure.
Ativan's in.
Jared, can you take a deep breath? Baby, can you hear me? What happened? You just had your second seizure today.
Jared, you need to get a CAT scan immediately.
- No, no, I'm fine.
- Jared.
I'm fine, really.
Don't don't let this stop you catching your flight.
- You should go.
- Are you crazy? I'm not leaving you now.
What about your job? None of that matters right now.
I'm not leaving your side until you're better.
[somber music.]
Hey, how's your patient doing? I'm not sure yet.
Hey, where'd you go? I was looking for you, I couldn't find you.
Well, I had to call the insurance company.
But I saw you talking with a cop.
Well, yeah, that was part of it.
I had to file a whole police report for the insurance claim.
Why would you file a police report? - Was something stolen? - Natalie, for the last time, nothing was stolen.
Hey, I just planted a patient in treatment 3 for you.
Sydney, right? I was just about to head in there.
All right.
Did I hear something about her being a friend of yours? She's not a friend of mine.
Okay.
Hey, sorry.
[sighs.]
It's just I know something about Sydney.
She has a reputation of being a bit of a grifter.
Heard she got arrested for solicitation last year.
I have sympathy for the girl but quite possibly she's just here to score some pills.
Yeah, good to know.
I'll proceed accordingly.
Yeah.
So you think Jared's lying to you? - Yes.
- Wow.
That's a pretty serious accusation.
His story just doesn't add up.
He won't show me his scans, he doesn't have a chemo port, and both his seizures today timed out perfectly to stop his girlfriend from going on her business trip.
Faking a cancer diagnoses for two years would take unbelievable commitment, and also, how do you explain the hair loss and other physical symptoms.
Well, I saw a Ziplock full of green pellets in his bag.
They looked just like the rat poison that my handyman uses in the basement.
If Jared is ingesting a small dose of a toxin like arsenic, it could easily mimic the side effects of chemo.
- Huh.
- I think he's harming himself and he needs to be evaluated.
Okay.
I will talk to him.
Thank you.
[tense music.]
Another here.
One last fracture here, 20 cc's, quarter-percent Marcaine, hand them to me.
Make that to me, Beth.
You want to do everything yourself? - I have the better angle.
- Not for the incision.
Okay, fine.
Give me the Marcaine.
Knife to me.
[tense music.]
- Ow! - She's cut.
[dramatic music.]
The patient's HIV positive.
Ava? It just nicked me.
It barely broke the skin.
I doused it with Betadine.
Doesn't matter.
Hospital protocol.
She's being sidelined? Because the patient is HIV positive you need to be seen in the infectious disease clinic, and start taking antiretrovirals immediately.
Now the medication can cause extreme nausea so I want you off surgical rotation, just for a few days, until you acclimate.
And if I end up contracting the virus, what happens to my career? There is such a small chance of that happening, you saw the patient's chart, he has a low viral load.
Let's not get ahead of ourselves.
Just start taking the meds right away and hopefully there won't be anything to worry about, okay? Ava, I am so sorry.
I don't even know what to say.
It's not your fault.
I was the one who reached for the tray like some idiot resident.
Well, let me at least take a look at your hand.
No, it's okay.
I'll be fine, Connor.
Ethan it's freezing.
Why'd you bring me up here? I got a preliminary report back from pathology and there was evidence Paul Kaminsky had high levels of epinephrine in his blood when he died.
- So? - So I'm not sure he died purely of natural causes and I need you to help me - understand what happened.
- Understand? What are you accusing me of something? We pushed one amp of epi when he coded, right? April, I found four empty amps altogether in the trash afterwards.
I can't seem to account for the other three.
Maybe another patient coded in that room - right before Kaminsky.
- Nothing was logged.
Maybe they forgot to log it.
I don't see what this has to do with me.
You were in Kaminsky's room just before he crashed.
- You think I killed him? - I'm just trying to understand how so much epinephrine got into his system.
- I don't believe this.
- April, please.
Just tell me what you were doing in that room.
He was dehydrated.
I gave him a glass of water.
So suddenly you're Florence Nightingale to this guy? I think we're done.
April, April, please, just you gotta be straight with me.
I'm trying to protect you from getting in any trouble here.
Really? 'Cause that's not what it feels like you're trying to do.
- So? - It's hard to say.
I mean, if we're seriously thinking Munchausen here it's a diagnosis of exclusion and I would just need a lot more time to eliminate the entire differential.
Well, we don't have more time.
He wants to be discharged now.
Nat, I understand.
He needs to be put on a psych hold.
Not only is he poisoning himself but he is controlling every aspect of his girlfriend's life.
Possibly, but he also could be a very sick guy clinging to his girlfriend during a traumatic period in his life.
It all comes down to whether we're willing to risk locking up a legitimately ill cancer patient on a hunch.
- And I'm just not there yet.
- But I'm sorry, Nat.
At this point we just don't have enough information to do anything but let him go.
1 and 2, you take this one.
- Maggie? - Yup? Dr.
Halstead needs you to page renal, stat.
Got it.
Where to? Treatment 3, Sydney Hawkins.
Sydney? Bolus another liter of saline.
- What's going on? - She's in septic shock.
Wait, wait, she was fine a minute ago.
Temp spiked out of nowhere, BP went in the tank.
- What? - Systolic's down to 89.
You can start an external jugular, stat.
- Here's a kit.
- Maggie.
You gotta step back.
[dramatic music.]
Did we get the infection in time? I don't know.
[sniffling.]
[crying.]
Lucy? You okay? - What's wrong? - My boss just fired me.
What? Why? Because I missed that conference.
They said they can no longer handle the unpredictability of my personal life.
And this is the second job I've lost in a year.
- I am so sorry.
- It's not fair.
It's really hard trying to take care of a loved one going through something like this.
I can imagine that going to the chemo treatments alone is like a full time job.
He actually doesn't let me go to chemo with him.
Really? Why? Probably just trying to protect me.
Maybe he thinks it'll stress me out too much.
Hey, Dr.
Manning.
When can I get out of here? I'm sorry, Jared, but I can't officially discharge you without a CAT scan.
Then I'll sign out against medical advice.
If that's what you wanna do but you're still pretty dehydrated so I would like to hang one more liter of fluid, and then we will get you on your way.
Sorry.
- What are you doing? - Uh Here you go.
We'll get you discharged soon.
You wanted proof? Here are the pellets.
Don't tell me you just took those right out of Jared's bag.
Given the circumstances I felt that I had to.
Dr.
Manning, I don't need to tell you that that's a very serious transgression.
His girlfriend deserves to know the truth.
I'm going to the lab to have these analyzed.
Have a seat, please.
The lab tested the pellets you took.
They came back positive, didn't they? Yes, for high levels of spirulina.
What? It's a vitamin supplement.
Not arsenic.
Jared realized you were suspicious so he gave us permission to access his medical records.
His oncologist at East Mercy just emailed this over.
All of Jared's appointments, prescriptions, chemo treatments, it's all there, including scans of the stage three malignant tumor in his colon.
You were absolutely right about one thing: He was hiding something.
The severity of his cancer.
- His prognosis is not good.
- I don't know what to say.
This is awful.
You're an excellent physician, Dr.
Manning, I realize you've been through a lot lately and against my better judgment, I'm going to bat for you on this, but it can't happen again.
This is so insane, Dr.
Charles.
I don't know what I was thinking.
When I ask myself that question, the answer usually ends up having something to do with me, you know, something going on in my life.
Could you have been projecting onto Lucy something that might be true for you? I don't know.
What I suspected.
Sepsis.
Yeah, from the little history I got from her I'm guessing this started as a kidney or urinary tract infection.
[sighs.]
I should have known it was serious.
I could have bumped Sydney up the list.
Oh, come on, Maggie.
No way you could have anticipated her being septic.
What's your prognosis? She gonna have a full recovery? She's in acute renal failure.
We'll take her up to the ICU and start her on dialysis right away but there's a good chance her kidneys are shot and she'll need a transplant.
Yeah.
[somber music.]
[sighs.]
- Maggie.
- Sydney.
How're you doing? Can I get you anything? I thought I just had the flu.
Sydney, I need you to know how sorry I am.
Oh, no.
I can't stop thinking about how if I wouldn't have come in today I would've been dead.
I'm grateful for you, Maggie.
Least I know I'm in good hands.
[moving music.]
Connor? I thought that you would want to know that Bode's surgery was successful.
He's already up and pain free.
Good, I'm glad.
Come in.
I also wanted to bring you this.
- Yamazaki 18? - I figured the least I could do was help you numb the pain.
Thank you.
Sadly, can't have any with my meds, doctor.
Right, yeah, uh, well, maybe we can celebrate when you get the "all clear".
Well, you can have some, right? You take it neat? I'm afraid I'm still on call.
Actually, I have to get back to Med.
Oh, sure.
- Good night.
- Good night.
Heads up, Choi.
We're reviewing the Kaminsky case for tomorrow's M&M.
- Okay.
- I see you didn't put down a cause of death, yet.
Something holding that up or is that just an oversight? Sorry, I just need to check something first.
I need your John Hancock before the end of the shift.
You'll have it.
Well, if something caused this guy's epinephrine levels to spike it's going to be on the adrenals but I'm not seeing anything.
Could you give them a closer look? Something's gotta be there, I know it.
I'm not supposed to be doing this without a formal inquiry.
I know, believe me.
You're doing me a huge favor, Nina.
You're gonna owe me for this one.
All right, let's see.
Well, I'll be darned.
Look.
I can't see anything.
There's your culprit.
Looks like a pheochromocytoma.
It's too small to show up on the scans.
Must have been what caused the high levels of epinephrine in this guy's system.
So he died purely of natural causes.
- Sure did.
- Thank you.
- You're the best.
- [laughs.]
[uplifting music.]
Dr.
Rhodes, hey, how's Dr.
Bekker? - She's hanging in there.
- I still can't believe it.
She's usually the most careful surgeon at Med.
Just not like her.
Not at all.
- Anyway, good night.
- Yeah, good night.
[dramatic music.]
What's this? This is what killed Paul Kaminsky.
An adrenal tumor.
Okay.
I am so sorry, April.
That was wrong of me.
- No kidding.
- If I'm being honest with myself I think I was hurt that you didn't trust me enough to read me in.
And then I started to mistrust you as well.
Well, maybe I shouldn't have cut you out.
It's not easy working so closely with someone you've been involved with.
But I'd like to think we can get past that and still be friends.
I don't know, Ethan.
You thought I could kill a patient.
Is that someone I really want as a friend? I heard about what happened.
You okay? What was stolen from your car today? Tell me the truth.
Natalie, I don't know what you're talking about.
All day I have been feeling like everything is a lie.
It's the same feeling I had on our wedding day.
Just tell me the truth.
What was stolen from your car today? - My gun.
- Your gun? - You swore to me it was gone.
- I went to turn it in.
I did.
I just needed more time.
Unbelievable.
I didn't know how to tell you.
I trusted you.
You have every right to be angry with me.
No, I don't want to hear any more lies.
- Natalie.
- It's over.
- You don't mean that.
- I do.
Good bye, Will.