ER s04e16 Episode Script

ER Previously on ER John, what are you doing here? You asked me to help.
You don't want your parents to find out about the heroin.
I'm- I'm not! You need a research grant to cover your salary before the end of the year or look for a private practice.
I'm going to talk to her.
I know that I make him happy.
I know I do.
I can tell.
He just keeps giving me these mixed signals.
I'm like a magnet for needy people.
It's like they find me wherever I go.
Like I did? - You really don't need to leave.
- Yeah, I really do.
"My Brother's Keeper" You've been up all night? Just finishing.
Thanks, buddy.
You saved me.
How many pots of coffee did you burn through? You should update.
This word processor's archaic.
Nothing like waiting till the last minute.
Nice patch.
Yeah.
Well, gum wasn't working.
Don't laugh.
I haven't had a cigarette for 56 hours.
When is this thing? - What? - Your presentation.
- Are you going somewhere? - Yeah, to work.
- What about the luggage? - Cynthia's.
The airline screwed up.
- Does she know you have it? - She must.
Why are you hanging on to it? Well, you know, she quit before I got back.
If you don't wanna see her, you take it to work.
She picks it up.
You don't force her to come here.
Unless you do wanna see her.
You're right.
I just didn't know she was gonna take it so hard.
Cynthia? Cynthia, it's Mark.
Hello? Moving on.
Leason.
acute onset urticaria and wheezing.
Possible reaction to Naprosyn she takes for rheumatoid arthritis.
- Did you check her platelets? - No thrombocytopenia.
Jerry, a guy from Kinko's is gonna drop some stuff off.
Want a July issue of Parents? - Does that sound right? - Sounds good.
Did you get my memo reinstating formal rounds? - Can't have too many rounds.
- Like to join us? It's for Attending.
Watch that Naprosyn, it's got a long half-life.
- Can anyone take a transfer call? - Sure.
Okay, Meyer.
because he smelled bad.
He had a cough and nowhere to go, so he's here.
Sorry, Carter.
- Keep going.
- Matthews.
Little old lady Nervous? Don't you present your PCA research today? Yes, I do.
I read it.
You make some persuasive arguments.
I have questions about the methodology.
You could run into trouble.
- Too late, isn't it? - You could postpone.
I thought I was persuasive.
You were.
You convinced me PCA works, but you need to prove it.
- I did.
- Sorry I'm late.
- Your control group has a bias.
- What took you so long? - Construction on South Shore.
- What? - Did I miss rounds? - In progress.
Could you take over? Sure.
Anything interesting? Doug, seizing 5-year-old coming in.
Code 3.
Suspected poisoning.
- ETA? - Right now.
We can talk about this later.
It's all right.
You made your point.
- I was worried.
- Took longer than I thought.
- You finish? - Yep.
Adrian Reynolds, 6.
Found seizing by mom near basement sink.
Two seizures 3 minutes long.
Total of 5.
Trauma 2! - Hey, Doug.
You need a hand? - Yep.
Yeah, all right.
Send him over.
Dr.
Del Amico.
- I can get this.
- No, that's okay.
I'm fine.
- Yeah.
Well, we're here to serve.
- Where are we? Guy needs an enema in 3.
I'm out of here.
See you in 12 hours.
- I'll have something for you.
- I bet.
That was easy.
Mr.
Kyle's back.
End-stage lung cancer, Exam 2.
Carol said to give him to you.
Haven't you heard? Dr.
Greene kicked the habit.
Be right there, Lily.
You're still smoke-free? - You got a lot of charts.
- Guess I'd better get started.
- Jerry, what is all this? - A little spring cleaning.
Well, it's still winter.
Did Cynthia leave a forwarding address? - Not that I know of.
Why? - I've just got some of her stuff.
That's always awkward, isn't it? - What's the extension for Personnel? - They wouldn't know.
- She came in and picked up her check.
- When? A couple days ago.
Look at that.
Twinkies.
- You're not gonna eat that? - They have a shelf life of 7 years.
Jerry, call Poison Control.
Patch it through to Trauma 2 now, okay? Sure.
- Pupils are dilated.
- He's bradycardic.
Pulse ox, 90.
He's hot.
Temp's 103.
- Any vomiting? - Yeah.
- BP's 70 palp.
- Doesn't make sense.
- Glucose, 110.
- No history of epilepsy? - I didn't ask.
- He's seizing.
Let's give him one mg of Ativan.
- No idea what he took? - It was in this soda can.
Let's see that.
It ain't soda.
CBC, lytes, tox screen, give me a blood gas, blood alcohol.
Get that can to the lab.
Where's his parents? Right behind us.
They're bringing anything that could be toxic.
- Pulse, 45.
- .
5 of atropine.
- Lavage? - Not if it's alkali, acid or petroleum.
What did he take?! I took anthropology as an undergraduate.
Cro-Magnon man is considered a modern Homo sapien, just like you.
Thank you very much.
I didn't say he was as good-looking.
Let's bet on it.
Loser buys lunch.
- If you wanna take me to lunch- - If it isn't Lucy and Ricky.
You read today's Sun-Times? There's a feature on our Lizzie.
I've got a lapcholy.
"Risking her own life, the resourceful surgeon refused to abandon Leipzinger in the rubble.
The doctor's and patient's fate were now one.
" Not exactly.
You don't have a prosthetic.
- I read the article.
- I bet.
Not a very good picture of you, though.
We can't all have your devastating good looks.
"Despite her heroic efforts, County surgeons were unable to save the arm.
" - At least they didn't mention my name.
- It was an oversight, I'm sure.
Be sure you tell Larry King you only fly first-class.
I almost forgot.
Your six-month review.
I wish it could be as glowing as the article.
- How is he? - Is this from the house? A soda can.
What do you keep in it? - Nothing.
Soda.
- Oh, boy.
BP's 70/40.
Resps, 32 and shallow.
- What is all this? - Photography supplies.
Thinners.
I don't know how he got into it.
We need to know what he swallowed.
- Can't you tell? - He has conflicting symptoms.
- Treat him for everything.
- It could kill him.
Did you approve a transfer from Bellarmin? Motorcycle accident? A head injury.
John Doe, no ID.
Can't the poison kill him? - Can't the poison kill him? - Yes, it can.
BP's 85/50.
Pulse, 50.
Resps, 12.
- What's wrong? - He's unresponsive.
GCS, 7.
- Did he decompensate en route? - We picked him up this way.
They said it was concussion syndrome.
Brief LOC.
Stable vitals.
- No CT? - They said it was down.
- Uninsured.
Just needed observation.
- What, they lied to me? - Get a CT.
- Pulse ox is falling.
I can't believe they did this.
Should we control an airway? I knew it was a dump, but this is gross negligence.
Yeah.
Sorry.
Two of Versed, 150 sux and 10 of Pavulon.
- A 7.
5 ET tube.
- Got it.
Once we get you cleaned up, they'll let you back on.
It's not right.
I sold all my stuff to buy that ticket.
Yeah? Where were you going? Am going.
I am going.
San Francisco.
That sounds urgent.
I'm gonna get a chest x-ray, check out that cough.
My daughter's there.
I was hoping I could live with her for a while.
Maybe she could wire you money.
I don't have her phone number.
- You know where she lives? - In San Francisco.
I mean, do you have an address? Why do you care? I don't want you stranded in San Francisco.
That's my problem.
I'll meet you in CT.
Call me when Neurosurgery gets there.
Come on, Adrian.
Can you hear me? - What happened? - He's waking up.
- Did you find the poison? - No.
Listen to me.
I'm Dr.
Ross.
You're in a hospital.
You gotta tell us what you took.
You need to tell them what you drank.
- I don't know.
- Listen, buddy.
Adrian.
Stay with us.
Come on.
What was in the can? - Eric gave it to me.
- Eric? Who's Eric? Eric! He's having a seizure.
How many is that? - His fourth.
- They'll fry his brain.
- Phenobarb? - Keith, stop! - Doug? - Tube him.
- Don't! - What did you give him? Get Security.
Tell me what you said to him, you little bastard! Tell me what you gave him or I'll make you sorry you were born.
- He poisoned my son! - This doesn't help.
He's right, Keith.
Come on.
- Get back here, Eric! - I got him.
Eric? Eric? Hey, Eric? Buddy.
Hey, Eric.
Go away.
- Listen, I'm Dr.
Ross.
- So? You and I have to talk and we don't have a lot of time.
I'm not afraid of you.
It's just you and me here.
Your dad isn't here.
- He's not my dad.
- Okay.
Your brother is very sick.
- Half-brother.
- Your half-brother.
He'll die if you don't tell us what you gave him.
Is that what you want? - Hey, come on.
- I don't care.
I think you do.
I think you care.
Eric, come on.
Buddy.
Come on out.
Buddy, come on out.
I gotta talk to you.
Come on out.
Hey, there.
Come here, come here.
Listen to me.
What is it? Your stepfather did that to you? - He's gonna kill me.
- No, he's not.
This black bottle, print developer? - He mixed developer with insecticide.
- Cyanide.
- I got the kit.
- Where's Eric? He's all right.
Start with inhalation.
Amyl nitrate perle.
- Then sodium nitrate at 3% solution.
- Is he gonna be all right? Wait 15 minutes and then 30 cc's, What is wrong? Why won't you tell us? We're gonna take care of both of your kids.
No way.
I already washed him when he first came in.
What, with soap? I gave him the bar.
The rest was his business.
Can you also try adjoining cities? It's supposed to be on Bellflower Avenue.
If I don't get him clean, he's not getting on the plane.
- You know where the showers are.
- Dr.
Greene? Carol.
- Malik.
- See if you can get him clean clothes.
- Don't push it.
- Hey, Dr.
Greene? It's not trauma.
He's got a subarachnoid bleed, shouldn't have been transferred.
- What did Neurosurgery say? - I'm waiting.
Grab them and get them down here.
Find out what happened.
I'm already on it.
How are you feeling? Better? Steroids always seem to help.
Can you lean forward? Take a breath.
Again.
I think I need a little more theophylline.
I'll check the level.
We'll need a repeat chest film.
What for? To see the same ugly spots? I think the effusion, secondary to your cancer, is back.
If that's the case, we'll need to tap you.
You mean stick a needle in my chest again? It'll make you feel better.
No, thanks.
I think we'll have to admit you this time.
If you were dying, would you wanna spend the rest of your life here? You could go into respiratory failure.
Take me home, Rose.
I don't know, honey.
Maybe we should listen to him.
Rose, take me home, please? Your blood oxygen level is very low.
I'd like to put you on a monitor for a while.
Trust me, doc.
This is as good as I get.
There you are.
All ready for this carotid endarterectomy? Apparently, you don't think so.
You've had a chance to review your evaluation.
I thought I was generous.
I'd hate to catch you on one of your parsimonious days.
Let me make something clear.
I'm your biggest fan.
If I didn't think you showed potential, I wouldn't sponsor you.
Then what's the problem? - Frankly, you're distracted.
- Distracted? You came to study trauma surgery.
Lately, you're more interested in vocal cords and paramedics.
I see.
I suppose I should refocus my energies.
Exactly.
I'm starting a new study on the use of HemoAid in vascular procedures.
It's the artificial blood.
Thought you'd like in.
We could do a paper together.
The ER at Bellarmin as much as admitted he was a dump.
Couldn't get the neurosurgeon to come in.
- What's his name? - Zaccarria.
You know him? He has privileges here.
- It's a blown aneurysm all right.
- Yeah.
Jerk probably heard "uninsured John Doe" and went to his country club- He doesn't want to open himself up to malpractice without getting paid.
It's against the law and the Hippocratic oath.
It won't help much now.
He's got bifrontal intraparenchymal edema.
I'll put in an ICP monitor and manage him expectantly.
That's it? Continue the mannitol, keep his head elevated.
Maintain hyperventilation and wait.
- For him to die.
- Basically.
Were his chances better before the transfer? It's hard to say.
You don't know when the aneurysm blew.
There's no surgical option? The only thing you could try is a partial frontal lobectomy.
The chances that that would affect outcome are remote.
- So do it.
- I can't make that call.
- Who can? - Well, Dr.
Mack.
She's in surgery.
Hey, time to reset the clock.
- Yeah.
- At least take off the patch.
I did.
What are you doing? Well, the copy place swears that they sent the order over here.
The presentation? - Jerry says he never saw it.
- He was throwing a bunch of stuff out.
I knew it! - You kept the original? - No.
Can you help me or are you out of breath? How's that poison kid? He's gonna make it.
Medically he's fine.
Sometimes working with kids is great, but sometimes it really sucks.
Hold on.
Under that crate.
Under that crate.
What's that? Look at that.
What is that? Do they throw bio-hazard out here? It's probably just somebody's pudding.
Why were you so late this morning? I stopped by to check on Cynthia, see if she's all right.
Yeah? Is she? I don't know.
She moved.
Victoria's Secret catalog, huh? Look at the label.
Lily.
Lily! I feel bad, you know? I don't think it was fair.
I was pretty selfish.
I know all about being selfish.
What was really wrong with her? She was, you know, funny, supportive- - Good-looking.
- Yeah.
She was great in bed.
She was nice to me, which was different from most women in my life.
- Give her a call.
- She's unlisted.
There it is.
I'm gonna kill him.
Hold on to that.
Jerry! - Think he'll make chief of staff? - It's just to get closer to Carrie.
Yeah.
Then she'll console him, and then they'll get it on.
I don't know about that.
She's in love with Austin.
- This month.
- Wait.
Here, it's back on.
This is what I hate.
Here's Marlena in the hospital.
She's all made up, high heels.
Nobody's that gorgeous all the time.
You're prettier than she is.
That's the nicest thing anybody's said all year.
Don't get a big head.
Yeah, yeah, yeah.
You're all done.
Last round of chemo.
Congrats.
Next week we can go to a movie instead of filling me with nuke juice.
- That sounds fun.
- What do you wanna see? What movie? I don't know what my schedule is.
I'm working in the ER.
I'm done- - Working for my dad.
- You're done.
- You don't need me anymore.
- Don't need you now.
You do your thing.
I'll go get your meds.
Dr.
Ross.
Mary Jo Reynolds.
Thank you for saving my son.
Talk to the people upstairs.
They won't let Keith- We are concerned for the children's safety.
That's why he wants- Both your boys are to be placed in protective custody until the Dept.
of Children and Family Services investigates.
It was an accident.
Eric didn't mean to hurt Adrian.
This is Eric's way of hitting back.
Hitting back? Nobody hits Eric.
That's for the DCFS to determine.
No one needs to determine it.
It's the truth.
You don't understand.
Eric's out of control.
He has terrible tantrums.
He throws and kicks things.
He lies.
He kicks his teachers.
Keith has to be strict to keep him in line.
Strict? Burning cigarettes into his arm? That's strict? Eric did that to himself.
You can't keep our boys from us! - Keith's not gonna like this at all! - He'll get over it.
I'd avoid the men's bathroom if I were you.
- Who's got the kidney stone in 1? - I do.
He doesn't have money.
I'm worried about his mental health.
- All right.
Syncope in 3.
- Yeah, yeah.
Stick your head in the OR and find out how long she'll be.
The resident checked him.
Six ODs coming in.
Five minutes out.
Paramedics said the site looked like Jonestown.
Call Kerry.
We'll meet them outside.
I know it's unlisted, but listen she's his only daughter.
He needs a place to go.
Your guy passed his stone.
Thank you.
Don't go far.
We got multi-ODs coming in.
This is Dr.
Mark Greene from the ER at County General.
I have an older gentleman here who has no place to go.
His daughter is in the area but he doesn't have a number on her.
He says it's unlisted.
Could you help me? What's the name? Hooper.
Cynthia Hooper.
Okay, I've got your Scottie? Do you know where Scott went? He went home about 10 minutes ago.
I thought you were with him.
Thanks.
Respiratory arrest.
We intubated.
Pulse, 126.
BP's 30/60.
- What happened? - Bad heroin, 3 in respiratory arrest.
Roommate said they wanted to try a new mix after it killed guys in Detroit.
- Talk about a death wish! - Not today.
Another two of Narcan.
Prep a dopamine drip.
On my count.
- John! John! - Yeah? - Come here! - Go ahead.
I got it.
- What? - It's Chase.
- You know him? - It's his cousin.
How long's he been down? I found him in respiratory arrest - Asystole! - I got it.
Where are we? Epi times 2, 2 mgs atropine, Unresponsive to all.
Accucheck the glucose.
Get blood gas, CBC, lytes, tox screen, chest film.
I'll get the gas.
Don't do this, Chase.
Damn you, don't do this.
It looks like he aspirated.
Amp of bicarb.
High-dose epi, 7 mgs.
- Seven? - Yes, seven.
Now.
Take over for me.
Get a transthoracic pacemaker.
Blood gas: PO, 250, PCO, 265, pH 6.
9.
All right, come on.
- He's been down a long time.
- Let's roll him.
It's not capturing.
Turn up the gain.
Severe hypoxia.
- Crank it all the way! - It is.
He's probably brain-dead.
Come on.
Come on.
It might be PEA.
- No.
That's capturing.
- There's a carotid pulse.
Start a dopamine drip, 10 mgs per kilo.
Where's the vent? - I got a BP, 40 palp.
- How long was that? - I'm calling Respiratory.
- How long? he was down before I got there.
Tell the MICU we're on our way.
We need an EEG and a brain scan.
So where are you taking me? Somewhere cheap.
You won on a technicality.
That statue looked like a caveman.
Really? It reminded me of Romano.
That super-orbital torus, that prognathic jaw.
So much for evolution.
- A retrogression.
- Don't let him get to you.
Easy for you to say.
You're not a kept woman.
I need his sponsorship to stay in the U.
S.
He's trying to rattle you.
If he gives you valid criticism, then compensate.
Overcompensate.
And the study? - Well, do you have a choice? - Peter! His name will come first.
Hey, Jackie.
What are you doing here? Arranging a natural history exhibit for Humboldt Park.
What are you doing here? I'm settling a bet.
This is my colleague, Elizabeth.
This is my sister Jackie.
How do you do? - Very well.
And you? - Great.
Elizabeth's from England.
I was showing her around.
Oh, lucky you.
Peter's not usually so generous with his time.
Yeah.
Well, you know It's important that we support our colleagues.
Of course.
Yes.
We support each other quite often.
You've reached the Hooper residence.
I can't take your call right now, but please leave a message.
Thanks.
Hey.
You wanted to see me? Yeah.
A 4-year-old came in wheezing.
Did you get the EEG? Slow diffuse activity.
- You think I pushed too far? - No.
- I'd have done the same thing.
- I should've gotten him into detox.
If he didn't want to, it wouldn't work.
You helped him the only way he'd let himself be helped.
- A lot of good it did.
- Did you call your family? His folks are in Singapore.
My grandparents are on their way.
That's probably my neurosurgeon.
You'll be okay? Yeah.
Sure.
Impending respiratory failure.
BP's 90 palp.
Resps, 40.
O2's at 10 liters.
He fought us all the way.
Trauma 1.
He didn't wanna come, but I've never seen him this bad.
- You did the right thing.
- Pulse ox down to 88.
We started an IV.
He wouldn't let us intubate.
Okay.
Mr.
Kyle, we're gonna take care of you.
We're gonna get a chest x-ray.
We'll probably have to do that tap.
Will he be here long? I promised he wouldn't have to stay.
I'm afraid we'll have to admit him this time.
All right.
On my count.
- Can I help you? - Are you his doctor? Do you know him? I'm his son.
What happened? How did he get here? We're not exactly sure.
We don't even know his name.
Tom.
Tom Dibble.
- How did you find? - Cops.
They had his motorcycle.
They sent me to the wrong hospital.
- The other hospital sent him here.
- Why? What's wrong with him? He had a brain hemorrhage.
- He wasn't wearing his helmet? - Not from the trauma.
He had an aneurysm.
A vessel ruptured.
It probably caused the crash.
What do you do to fix it? We're trying to relieve the intracranial pressure with medication.
But it's not working? I'm waiting for Neurosurgery to take a look.
They can operate? There's a slim chance that a partial frontal lobectomy might work.
And if it doesn't? He'll die? He might.
That's a mess.
End-stage lung cancer.
- He's still alive? - If you call it living.
- He's a smoker, right? - Yeah.
Shouldn't you be at a podium? - You present today? - Let's go.
She's going? You use my computer, you don't tell me, but she gets to go? Someone has to hold cue cards.
- Can somebody see this colicky baby? - I'll take that.
No, no, I will.
I wouldn't want you to be late.
- Call me if you need a second opinion.
- I can handle it.
Is Scott upstairs? In the bathroom.
Jeanie! Jeanie, come look! I made a fort in my room! I want to check on your brother.
- He wants us to leave him alone.
- I know.
Get your sticker book and I'll meet you there.
Scott? Scottie.
Forgot your Zofran.
Where's your IV? - It's empty.
I took it out.
- By yourself? I saw you do it a hundred times.
You took off on me.
Ask my dad.
He'll pay your cab fare.
Your dad paid me to help you through your chemo but we don't have to stop being friends.
I have friends.
I don't need any more.
That sucks.
Why? I need all the friends I can get.
So how about Saturday? How about it? I can't go Friday, but I can Saturday.
Unless you're too cool.
You are pretty sorry.
Speak for yourself, Captain Baldy.
Next month my hair will grow back and you'll still be sorry.
Just for that, I get to pick the movie.
No way.
No chick flicks.
Oh, right, Mr.
Days of Our Lives.
I can't believe it.
She's quiet.
I'll give you a fact sheet on colic.
Let me stay until her next feeding so you can see how bad she gets.
No problem.
I'll check her in a little while.
Chuny, tell Mark I'm going over to the med school for a half an hour.
Hey, who called the Grim Reaper? What are you doing down here? I heard his family came in.
We're not ready to talk about organ donation.
I just came down to do an apnea test, see how close he was.
He's not brain-dead.
Neurosurgery said it's a matter of time.
- I don't care what they said.
- Dr.
Del Amico? Yeah.
Hold on.
I haven't given up on him yet.
What was that thing you said they could try? - A partial frontal lobectomy.
- No.
I'm sorry.
There's nothing more we can do.
- Your resident said it was possible.
- He shouldn't have.
It's worth a shot.
He's a Teamster.
He's got great insurance.
That isn't it.
It's just that surgery isn't warranted in this case.
He might die if you don't.
I'm afraid he will die, no matter what.
I want a second opinion.
You say one thing, she says another.
I'm the chief neurosurgeon.
You'll have to get it from another hospital.
- I want all of his records.
- Sure.
I'm really very sorry.
I wish I could help.
Excuse me for a second.
Pardon me, Dr.
Mack.
I don't understand.
He's right.
If the patient's gonna die, why not at least try? There's no indication for one.
Isn't it worth the effort? We don't perform brain surgery for the heck of it.
I understand that.
But someone needs to take a risk and try to help him.
Bellarmin dumped him.
We wanna harvest his organs.
He deserves a chance, no matter how remote.
There is no chance.
I appreciate that you wanna do something but know what you're talking about before you play on someone's hope.
That kid's already lost his father.
The heroin depressed his respiratory center, which led to cardiac arrest.
We got his heart going again but everything indicates his brain was deprived of oxygen for a significant time.
But you don't know for sure.
No.
His pupils are reactive.
He withdraws from painful stimuli but his brainwave activity is slow and diffuse.
- Speak English, son.
- He has probable brain damage.
- What's "probable"? - Can't be quantified.
It could run from memory impairment to a chronic vegetative state.
Did you know about this? - The drug use? - Yes, drug use! Oh, John.
- Did you think to do anything? - I helped him detox.
Where? Here? No, his apartment.
His apartment? What kind of medicine do you practice? There are centers that take care of this sort of thing.
He didn't want it that way.
- It was not your decision, John.
- No.
No.
It was his.
It should've been ours! He's on heroin, for God's sake! He had no ability to apply good judgment, but you should have.
Called your family! We could have handled it! I'm sorry.
I'll call Dr.
Levy.
We'll get him out of here.
Only one child reached the lockout dose- But for example, your sickle cell patient with the infarcted spleen you advocate letting them blunt their pain and mask symptoms? If you had a surgical belly, then there would still be other signs.
But still, pain is an important diagnostic indicator.
We're talking about kids.
You'd say "suck it up"? - I guess I'm from the old school.
- I think that's probably true.
Thank you, Dr.
Ross.
It was all quite thought-provoking.
Excellent work.
That's it, everybody- Actually, Don, I had a question for Dr.
Ross regarding the randomization of his control group.
Sure, Kerry.
Dr.
Greene, a minute? You've been here for six months.
Call me Mark.
Mark, I know this sounds rather morbid but I haven't had as much trauma experience as I had hoped.
I was wondering if you might be able to advise me on the times that a surgeon might sign up for ER coverage.
I hope you don't mind nights and weekends.
No.
That's what I'd presumed, actually.
The gunshot wounds and knife wounds taper off in the winter but spring's just around the corner.
Dr.
Greene, we need you in Trauma 1.
- What is it? - Lung cancer patient's coding.
- What happened? - I found him like this.
- No pulse.
- Let's get him on the gurney.
- Why was he out of bed? - Where's this blood from? - He probably hit his head.
- Bag him.
- Asystole.
- A mg of atropine, an amp of epi.
- This looks like an exit wound.
- What? Here's the entrance.
This is a gunshot wound.
- Somebody shot him? - Where's the wife? - Call Security.
- Wait, wait.
Dude capped himself.
- Why? - End-stage lung cancer.
It's awful.
Does suicide count as a DNR? Time of death, 17:05.
I'll try and find his wife.
Where's Gramps? You called him away from a union negotiation.
He'll have a strike starting at midnight if he doesn't settle it.
I'm heading uptown to this Kenner Neurology Institute.
Chase needs to be stable before he can be moved.
His blood pressure's supported by intravenous medications and he's having arrhythmia.
I've spoken to the internist.
I don't need you to explain.
I'm sorry.
If I could go back and change this, I would.
I assumed if he really needed help, he'd ask.
He did.
He asked me.
Did he tell you what made him start? I don't know.
Maybe he just felt overwhelmed.
I've never understood that about your generation or your parents' for that matter.
In our day, we embraced our responsibilities.
They defined us.
I don't blame you for this, John.
But I know you blame us.
- No, I don't.
- Yes, you do.
All your lives you've been indulged and considered it oppression.
You look after him tonight.
Good.
I'll be back in the morning.
There are areas where my knowledge and my experience exceed yours.
You should have consulted with me.
- You should have consulted me! - What's going on? She was about to release a 2-week-old baby with sepsis.
- Her temp was slightly below normal.
- You made a mistake.
Yeah, but that's not what this is about! It's not about you.
It's about me.
I'm the screw-up.
- What's the problem? - He has to redo his study after I found a flaw in his research.
First, there was no flaw.
Second, you ambushed me.
I tried to talk to you and you blew me off.
You left a sick kid here to undercut me in front of the Pediatrics staff.
I cannot allow you to push the use of PCA when the research doesn't support it.
- You are the self-appointed authority? - If I have to be! You didn't help.
You almost killed a kid.
- Screw you, Doug.
- Okay.
Both of you calm down! - Is the baby all right? - Fine.
I gave her antibiotics.
That's what's important.
From now on, a pediatrician is consulted in all Pedes cases.
- I am capable of treating children.
- Apparently not.
I know you're angry, but she's right.
Emergency physicians are fully qualified to handle- Hey, hey, hey! Guys! What are you doing? - Can you wait over there? - What are you doing? - We have to transfer him to Evanston.
- Why? He's too much to handle.
He can't control his rage.
Didn't you see the burns on his arm? They may have been self-inflicted.
So you're committing him? He tried to kill his brother, and he has no signs of remorse.
Did he show any to you? No, I Look, you might need to testify.
I'll let you know.
You okay? How'd it go today? Fun, fun, fun.
- Are we gonna do rounds? - Beats me.
The organ donation coordinator is coming down to talk to you.
Forget it.
He's getting the operation.
Listen, Alex when your father first came in I was frustrated, you know? I wanted to help.
I pushed really hard to find anything that might save his life.
Unfortunately, I was overly optimistic about his chances for survival.
There is no operation.
That was one doctor's opinion.
I got a surgeon at Bellarmin to do the lobectomy.
Bellarmin? All set.
I've booked an OR.
Who are you? David Zaccarria.
Is this the ER intern? I'm the doctor who treated this patient after you dumped him.
I didn't dump Mr.
Dibble.
No.
You dumped a John Doe.
Bellarmin paged you.
Aneurysm, no insurance, no interest from you.
We don't have time for this.
I have to get him to the OR.
- Hey, he's still my patient.
- Not anymore.
- Does Dr.
Mack know about this? - He has privileges.
I'm sorry.
Hello? Hello? Mark.
Hi.
Is this a bad time? - What are you doing here? - I got your luggage.
Oh, right.
Sure.
Hold on.
How did you find me? - Can I come in? - Oh, sure.
Of course.
You can put them right there.
Thank you.
I was wondering how I was gonna get those back.
So how are you? I'm, you know, good.
Same old stuff.
What about your mom? Better some days.
How about you? I'm okay.
It's a nice place.
I got a new job.
Administrative assistant for a law firm.
That's great.
Yeah.
I was surprised when I came back and you weren't working at the ER.
Well, I thought I needed to I needed a fresh start.
I couldn't really do that with you there.
Guess not.
Mom? Oh, Jason, honey.
What are you doing up? I'm thirsty.
I'll get you some water, then you've got to go back to bed.
This is my friend, Dr.
Greene.
Hi, Jason.
Here you go.
Jump in there, sweetie.
Sleep well.
- You got him back.
- Yeah.
- Good for you.
- Thanks.
I didn't just come here to give you your luggage back.
- I made a big mistake.
- You don't need to apologize.
No.
No.
I went after you.
I was a big girl, and I knew what I was doing.
No.
I think I made a big mistake.
I mean, we were great together.
Mark, you don't love me.
- I deserve better.
- You do.
- I could- - No.
You can't.
I'll miss you.
Me too.
Goodbye, Mark.
Hey, I'll do that.