Chicago Med (2015) s04e22 Episode Script

1 [PIANO PLAYS SOFTLY.]
- Hey.
- Thanks for coming.
Hospital food, I know.
But the French toast is surprisingly good.
Not at all.
Let's do it.
Okay.
But first I have a little something for you.
What are these? [CHUCKLES.]
Airline tickets to Honolulu.
For our wedding.
Where you wanted to go first time around, remember? But we couldn't afford it.
Danny, that is so sweet.
Thank you.
I don't know what to say.
How about, um, aloha? [LAUGHS.]
Honolulu, hmm! Take that.
- Whoa.
- What? What's this? Um, Robin gave it to me.
I don't really need it but you know it makes her happy so I'm going to do it.
- Come on, French toast.
- Come on, Waikiki! Finally you're going to learn how to surf, right? Remember you've just had abdominal surgery so be patient.
It takes a while to recover.
You need to be ambulatory.
Walk every day.
But don't push it.
Got it.
Great to see you two back together.
I like to think it was because of Bernie and me.
Whatever.
You know, when you go through something like this, makes you appreciate everything you have.
Good friends, a wonderful woman, a brand new baby.
Not to mention a wife and teenage daughter.
- Ethan.
- I know, I know.
But we're working something out.
I promise I'm going to take good care of your sister.
I look forward to hearing your plans.
Connor [TAKES DEEP BREATH.]
I hope you know I did everything I could for your father.
I do.
I'm here for you.
If there's if there's anything I can do.
Thank you.
Hey, Nina.
Uh, are you doing the autopsy on my dad? Yes, um before I start, maybe you want some time with him? Yeah, please.
Thank you.
[SOMBER MUSIC.]
I hated you.
I blamed you for Mom's death.
I blamed you for so many things.
Maybe I was seeing it all wrong.
You weren't the best dad.
But maybe if I'd been a better son you'd have been a better father.
Oh, man, I I'm sorry.
[INHALES.]
[EXHALES.]
- Remember our cochlear implant patient Peter Rush? Yeah.
Usher Syndrome.
Why, is he back? Is his eyesight worse? Yes, but that's not why he's here.
It's his wife, Bonnie.
- This way.
- Okay.
Hello, Bonnie.
- Who's that? - Dr.
Manning.
- Sorry.
I don't see too well.
- No need to apologize.
Congratulations on your marriage.
So what seems to be the trouble? She says she doesn't need to be here.
There's nothing wrong with her.
I made her come.
Her heart doesn't sound right.
Doesn't sound right? I had my head on her chest.
I heard it.
May I? [CLEARS THROAT.]
You heard right.
Sounds like a systolic murmur.
Do you ever feel dizzy or out of breath? Yes, you do.
Let's get her on the monitors.
Need a CBC, BMP, cardiac labs, a D-Dimer, chest x-ray And a 12-lead EKG and a cardiac echo.
Right.
She's saying sorry, he was right.
We'll be back when we get the results.
Dan.
I got a patient of yours, Delmar Brendl.
- Oh.
- Yeah, he won't let me treat him unless you're in the room.
- Hey, Del.
- Dr.
Charles, I'm fine.
- I really don't need to be here.
- He was found at the bottom of his stairs at his apartment building.
- I didn't get hurt.
- But he couldn't get up.
The manager called the paramedics.
Well, Del's been a patient of mine for a couple years now.
I'm treating him for generalized anxiety disorder, panic attacks, and making some real progress.
Mr.
Brendl, why weren't you able to get up? I don't know.
My right leg is a little weak.
And my left.
And my left arm.
- Anything else bothering you? - You mean like the headaches? Everybody gets headaches, right? Do me a favor.
Put your feet up.
Flex your foot like you're stepping on the gas.
The other side.
- Your left side's weaker.
- Yeah, I know.
I told you that.
It's no big deal.
Monique, let's get a 12-lead EKG, CT head, CTLS spine and No needles.
I hate needles.
And cardiac labs.
You can totally do this, Del.
Gonna be over in a flash, I promise you.
Ow, that really hurts! I haven't done anything.
Here.
Del, Del.
Look at me.
Right here, all right.
Doing great.
In through the nose.
Out through the mouth.
Gonna be fine.
[STRAINED BREATHING.]
When we woke up, I looked over and Henry had this rash all over.
- Okay if I look in your mouth? - Sure.
Ahh.
It's clear.
- Any trouble breathing? - No.
Mr.
Kupfer puts out a star for Christmas.
Yes he does, Joanie.
Honey, give us a second.
We're talking to the doctor.
It's Alzheimer's.
Well, your rash it's hives.
Pretty sure you're having an allergic reaction.
To what? He doesn't have any allergies.
People can develop them at any age.
April, let's give Mr.
Wilks 50 milligrams of Benadryl IV, 150 milligrams of Zantac IV.
Also, let's get a CBC and BMP and send a UA for tox and EO's.
Standard blood and urine tests.
Fist.
Let's see if the antihistamines get rid of your rash, make you feel better.
I'm afraid your husband's going to be here a few hours.
Oh, I'm not his wife.
Joanie's my wife.
- Am I sick? - No, honey, you're fine.
It's Henry.
I'll check back in a little bit.
Excuse me.
- Dad.
- Hi, honey.
Hey, uh, I need to talk to you.
Shoot.
Wedding in Hawaii? Right.
Dad, do you really think this is a good idea? Oh.
Honey, it's what your mom always wanted.
- Yeah, I know but - Oh, trust me.
She was delighted.
Delighted.
Yeah, of course she was.
I mean, she wouldn't want to disappoint you.
- What do you mean? - Mom is thrilled about the wedding, but she's not well.
She can't handle a trip to Hawaii.
She's gonna have a couple mai tais and sleep the whole flight.
Then once we get there she's not lifting a finger 'cause it's first class all the way.
You have my word on that.
Charles.
Mr.
Brendl's cardiac labs came back negative.
But his head CT showed a frontal mass with focal edema and midline shift.
- A tumor? - Very possibly.
Neurosurgery and Neurology want a stat MRI.
I mean, he's really claustrophobic.
The CT was bad enough, now with all the banging? He'll jump out of his skin.
Ingrid, got your text.
- What is it? - I just got some news, Will.
Tim Burke he's out of prison.
[TENSE MUSIC.]
Already? He only got a two-year sentence.
Model prisoner, no priors.
He's out on parole.
- Should I be worried? - Will You are responsible for his father and his brother being incarcerated.
This is hard for me to say, but I think the safest thing would be for you to relocate.
Out of state.
The purpose of the Glenn procedure is to improve Sophie's oxygenation and reduce pulmonary artery pressure.
- Any questions? - No.
The operation is not without risk, particularly in light of Sophie's previous surgery.
Each time you open the chest, it becomes more difficult.
We expect Sophie's adhesions to be extensive.
But we're optimistic.
She's a strong little girl.
Ah.
Okay, thank you.
[WHISPERS.]
Hey, you're doing great.
They're great surgeons, Phillip.
Sophie's in the very best hands.
You know, it might just be because you're here, but um I just think that everything's going to work out.
Yeah.
Oh, oh, it's terrible! Oh, God, that was terrible.
That was terrible.
The banging.
Oh, God.
- J-just get me out of here, man.
- You did great.
- Yeah.
- Absolutely great.
Del, this is Dr.
Abrams.
He is a neurosurgeon.
Best one in Chicago.
If not the entire United States.
- My mistake.
- Uh, s-surgeon? Yeah, you have a tumor.
A frontoparietal convexity meningioma.
- I have a tumor in my brain? - That's where the weakness is coming from.
But Dr.
Abrams is pretty sure that it's benign.
- And operable.
- Okay.
Okay, just knock me out and let's get it over with.
Here's the thing.
Because of the location of the tumor, it's going to have to be what we call an awake procedure.
Awake? Yeah, not the entire procedure.
You'll be anesthetized but then at a certain point we'll have to lower the sedation so I can monitor your motor functions.
So I'll just be lying there awake with the top of my skull off? - Yeah, more or less.
- I know it sounds extreme, but it's actually remarkably common.
No, forget it.
I-I'm not doing that.
Okay.
Um wait here, I'll be right back.
- Sam! - [SIGHS.]
Dan, he said no.
I'm not going to twist his arm.
I'll talk to him.
What? The guy's a terrible risk.
What if he flips out in surgery? He could herniate.
If he does that, I'll calm him down.
Really? I'd say you've done a piss poor job of that so far.
Sam, come on.
If you don't operate, that tumor's going to kill him.
All right, if you get him to agree, page me.
[TENSE MUSIC.]
- Looking for a job? - No.
Just curious.
- [SCOFFS.]
- There's a lot of jobs for E.
D.
docs out there, you know? Well, hey, nice to know you're wanted, right? Let's go.
Bonnie, Peter.
This is Dr.
Latham, our chief of cardiothoracic surgery.
He's made a diagnosis.
Your cardiac echo shows a condition which is Why don't you let me sign? With your permission, of course.
You know ASL? I try to learn a new language every year.
This year it's Hindi, last year ASL.
It's an elegant language.
Correct me if I make a mistake.
Okay.
Your cardiac echo shows a condition associated with hearing loss.
Mitral valve prolapse.
Is it serious? The leaflets of your mitral valve bulge when your heart contracts, allowing blood to leak back into your atrium.
I can repair with minimally invasive surgery.
She's asking if she really needs it.
She doesn't feel that bad.
It's better to do it before you feel really sick.
- There's less risk.
- Yeah.
And you're in danger of getting endocarditis.
It's a heart infection.
He's asking if he can go ahead and schedule the procedure.
[SOMBER MUSIC.]
- Mr.
Wilks' test results.
- Wife's got Alzheimer's but, hey, why should that slow you down? Go out, get another woman have her come live with you.
It's really nice, Ethan, when we actually agree on something.
Yeah.
Hey, Mr.
Wilks.
How are you feeling? - Better, thanks.
- I see your hives are fading.
And as I thought your blood work is normal.
I do recommend you see an allergist to figure out what you were sensitive to.
- I will.
- I will start your discharge.
While you're waiting, I'll get Joanie a bite.
- Pick me up something too.
- Okay.
Come on, Joanie.
How about some scrambled eggs? - [GASPS.]
Scrambled eggs! - Yes! Dr.
Rhodes Sophie just went up for a pre-op.
Good.
Yeah, uh can I ask you something? You've known Natalie for a while.
I mean, yeah, we've worked together for a few years.
So what do you think? Will she like it? Um it's a very nice ring.
Yeah, right, well I'd only propose if everything goes well.
- Right.
- Right.
Um Thanks, man.
[PENSIVE MUSIC.]
[TENSE MUSIC.]
Will, I need you.
They're bringing in Sydney Hawkins.
- Your kidney recipient? - Yeah.
You're going to Baghdad.
Sydney Hawkins, mid-30s, kidney transplant.
GCS 15.
BP 102/66.
HR 98.
Sats at 95.
Complaining of flu-like symptoms, edema, and left lower quadrant abdominal pain.
Maggie I'm sorry.
Sorry for what, Sydney? I I'm nothing but trouble.
No, you're not.
Don't say that.
On my count.
One, two, three! Four liters nasal O2, stat chest x-ray, CBC, BMP, cyclospirine and renal ultrasound.
Right.
Get a non-contrast CT abdomen and pelvis.
Take a look at her kidney as well.
She seems pretty uremic.
[DRAMATIC MUSIC.]
Sidney Hawkins.
Looks like she might be rejecting my kidney.
Maggie, I'm so sorry.
Help, help! Henry can't breathe! Somebody! He was just eating a sandwich and suddenly He's having an allergic reaction.
I've got to look in your mouth.
All right, tongue's swollen.
He's got hives in his mouth.
- Epi? - Yeah, .
3 milligrams IM and 125 of Solu-Medrol IV stat.
Let's get him on oxygen.
Another round of epi.
[PANICKED EFFORTS TO BREATHE.]
[RAPID BEEPS.]
Sat's at 86.
He's tripoding.
All right, he's in anaphylaxis.
I've got to intubate before his airway closes.
20 of etomidate, 100 of sux.
[GAGGING.]
I'm in.
Bag him.
89 they're coming up.
BP and heart rate are okay.
- He's stable.
- Oh, thank God! My God, what what what could've caused this? - What did he eat? - It was a roast beef sandwich.
Wait, where's Joanie? Where is she? Hey, did you see a woman leave this room - just a minute ago? - Yes, she's headed outside.
[CARS HONKING.]
Joanie! Oh, my God! [TIRES SQUEAL.]
[HORN HONKS.]
Joanie! Whoa, whoa, whoa, whoa, whoa! - [TIRES SQUEAL, HORN HONKS.]
- Whoa, whoa, whoa! Lots of cars.
Let's get you where it's safe.
[HORNS HONKING.]
Oh, honey! Honey! Oh, honey.
- Are you okay? - I'm okay.
Okay.
Connor.
Hey, Nina, what's up? Your father didn't have a history of diabetes, did he? Hmm.
No, why? He died from an overdose of insulin.
Insulin.
That doesn't make any sense.
It was synthetic.
Someone in the hospital gave it to him.
I have to label his death suspicious.
[TENSE MUSIC.]
So were they able to determine your father's cause of death? Uh no, not yet.
Such a sudden arrhythmia.
I'd have to guess it was a pulmonary embolism.
- Dr.
Rhodes - She's bleeding.
Suction.
Suction.
It's coming from her right atrium.
The adhesions from the sternum must've torn it open.
Dammit.
Let's do a sucker bypass.
Sats are down to 52.
11 blade and an aortic cannula.
[MEDICAL EQUIPMENT BEEPING.]
And - I'm in.
- Sats are up to 76.
80 Prolene stitch for the SVC cannula.
[CLUNK.]
Time to wake him up.
You ready? - Yes, sir.
- Lighten his sedation.
Maggie? Sydney's scans came back.
There's a tumor on her kidney.
That's what's been causing her kidney failure.
A tumor? Cancer? It looks that way.
We'll know more after the biopsy.
Oh, God, I gave her a bad kidney.
No, no, they examined your kidney thoroughly.
There was no sign of a tumor.
Sydney clearly developed it after her transplant.
[SIGHS.]
As if her life wasn't hard enough.
Well, let's hope they get it all and she recovers.
Sydney? Do you understand what's happening? They're trying to make me well.
That's right.
We're all just trying to make you well.
Thank you.
Go ahead.
[SOMBER MUSIC.]
I've excised the misshapen section of the valve.
I'm starting now to reconstruct.
[TENSE MUSIC.]
Surgery's going well.
No surprises.
What were we thinking? What's going on? Bonnie and I, we talked about having a baby.
So stupid.
Me going blind Bonnie with her heart - Her heart's going to be fine.
- But what next? [PENSIVE MUSIC.]
You know, Peter, none of us get any guarantees in life.
We all just face what comes.
I look at you and Bonnie and I think you two do great.
I think you two can handle almost anything.
[EXHALES.]
Mr.
Brendl, can you hear me? - Who's that? - That's Dr.
Abrams.
You're in surgery, Del, and it's going great.
I need to map different pathways in your brain so I'll be touching certain areas and asking you to respond to my questions.
Count to five for me.
[HEAVY BREATHING.]
One.
Two.
- So the top of my skull is off? - A portion of it, yes.
We talked about that, too.
Continue counting.
- My brain is just exposed? - Del, you've got this.
Deep breaths, okay? In through the nose [INHALES.]
Out through the mouth.
Three.
Four.
No, I want to stop.
Make him stop.
Del, it's okay.
You're doing great.
You got me into this.
Get me out? - Stop squirming.
- No, no, no, no, no, no, no! Del, look at me.
Right here, right here.
His breathing is too shallow.
He's retaining CO2.
- His brain's going to swell.
- Get me out, get me out! Either you do something or I'm going to re-sedate and end this.
Please, please, I can't stand it! Okay, Del.
I need you to tell me, how are your feet? - Can you feel your feet? - I can't, I can't! Dan! Del, I'm touching your right foot.
Can you feel me touching your right foot? Yeah, I can feel it.
Can we please stop? Okay, great.
Now how about your knee? I'm squeezing your right kneecap, can you feel that? - Yeah, I can feel it.
- So, so your feet, your stomach, your legs, your hands are all okay, right? - I'm okay.
- Yeah.
You're doing really, really well.
I mean, you're answering my questions.
I think that that means that maybe you can answer some of Dr.
Abrams' questions, too.
- What comes after three? - After three - After three - You know this one.
- Four.
- You're so much stronger than you think you are, you know that? - What did FDR say? - FDR? Come on, we talk about this all the time.
- Roosevelt.
- You have nothing to fear - But fear itself.
- That's right.
Raise your right index finger.
That's a lot of narrowing in the right branch.
And the left as well.
We need a new plan.
There's no way to anastomose to the trunk of the artery.
We need to attach further up the right side.
But if we don't attach to both sides, she'll only oxygenate half her blood.
It's a lot better than none.
She'll never sat above 75 for the rest of her life.
She'll be in heart failure by the age of 30! Which can be controlled by medications.
- Connor - I won't let this girl die because we tried to bite off more than we can chew.
I know this is a difficult time for you.
You've suffered a loss.
But I've seen you do things in the OR that I did not think possible.
This is not the time to back away from a challenge.
[TENSE MUSIC.]
- All right.
- [DEEP BREATH.]
Two anastomosis sets.
Let's move it.
- So what are you saying? - We think it was the roast beef sandwich that you're allergic to.
That's what kicked off the attack.
Roast beef? [SCOFFS.]
I've eaten roast beef my whole life.
I like roast beef.
Have you been in the woods recently? Woods? Yeah, I A month ago I went fishing in Kentucky.
Any tick bites? Yes, he called me and said there were ticks everywhere.
A bite from the lone star tick which is common in the Southeast like Kentucky can cause a sensitivity to meat.
You'll need to confirm with an allergist, but in the meantime it's best that you stay away from meat.
Oh, God.
Mr.
Wilks, we were very lucky with your wife today.
Has this happened before? She can wander off.
We have to keep an eye on her.
Yes, you do.
If you find you can't manage you know, there are facilities.
Oh, Joanie was in one.
Nice place.
But she was depressed.
Missed her house, Roxanne and me.
She's a lot happier now.
[SOMBER MUSIC.]
We missed her, too.
I know that look.
You don't approve of how we live.
[MUSIC SWELLS.]
I doubt you have any idea what it's like to little by little lose someone you care deeply about.
If it hadn't been for Roxanne's love and support I could never take care of Joanie.
It's not a perfect situation, but it's the best we can do.
Uh, excuse us.
You're gonna be okay.
Unusual arrangement but seems to work.
I guess.
People can live any way they want.
I'm glad to hear you say that.
- Emily called.
- Yeah? She and Bernie have a plan.
They'd like to discuss it with us over dinner.
What is this plan? I'm going to let Emily tell you.
[SIGHS.]
I informed Ms.
Rush that her surgery went well and that I anticipate that she'll only need to spend another three days in the hospital.
Oh, Dr.
Halstead.
Mr.
Rush asked me to tell you that they've decided they will try to have a baby.
A sheyne por.
Ah.
A lovely couple.
Thank you for asking me to consult.
- Thank you.
- Thank you.
A baby? They didn't think they could handle one.
Looks like they changed their mind.
I guess when you've already been through so much together Nothing much scares you.
Yeah.
[SERENE MUSIC.]
Snip.
[BREATHES DEEPLY.]
Time on pump? Three hours 14.
Should we take her off bypass? [MUSIC SOFTENS.]
[HEART MONITOR BEEPS.]
[MUSIC RESUMES.]
That should do it.
Pressure's good.
Normal rate and rhythm.
Sats are at 88.
She's going to make it.
Close, if you don't mind.
Not at all.
Hey.
What is it? I've decided I'm not going to relocate.
- Why? - I'm tired of being afraid.
I don't want to run away.
I'd like to think that you were staying because of me, but that's not the reason, is it? [SOMBER MUSIC.]
Natalie? My loss.
Be safe, okay? I was able to completely resect the tumor and as I expected it's benign.
Dr.
Charles, I couldn't have done it without you.
Thank you.
I'm the one you should be thanking, but so be it.
You should be proud of yourself.
The inspirational speech you gave that nutcase? [SHARP INHALE.]
The FDR quote? That was a dreadful cliché, but effective.
Yeah.
All right, Daniel, I'll bite.
What's the problem? Well um fear.
I think I'm having a really hard time facing the fact that I'm going to lose somebody that I love.
- And? - And what? Who doesn't have a hard time with that? Shrinks.
Have to make a meal out of everything.
Hey, honey.
It's Dad.
Um, I think I'm going to need your help with something.
Emily, there's more blankets for the guest room in the hall closet and pillows.
Thanks.
Mmm.
Ethan.
Do you want more chicken? No, thanks.
Jamie, did you put out fresh towels for Emily and your dad? [SIGHS.]
Mom Sorry, the bed's only a queen.
The king wouldn't fit.
It's okay.
I'm used to the couch.
You and Emily should sleep together so she can keep an eye on you.
Oh! Did you remember to take your stool softener? Oh! No, I didn't.
- I'll clear.
- Jamie can do that.
- Honey, I'll take the baby.
- No, sit.
I'm fine.
Okay.
I'll help him.
So you're not judging, right? No, no.
Hey, didn't I tell Emily how happy I was for her? Living together with Bernie's wife and daughter? I just couldn't tell how sincere you were.
[GROANS.]
Okay.
This might actually be the best solution.
Emily's always had trouble with stability.
Bernie's family seems pretty stable.
Look, what can I say? Everybody's happy.
So why shouldn't I be? - I have something to tell you.
- What? I'm late.
- Late? - My period.
Maggie.
They got the path results back on Sydney.
- The tumor is malignant.
- Oh, my God.
There is another issue.
Pathology says it's not primary kidney cancer.
What do you mean? The tumor is actually breast cancer.
Metastatic breast cancer.
Sydney has breast cancer? And it spread? Actually sh she doesn't.
You're saying that I have metastatic breast cancer? When was the last time you had a mammogram, Maggie? Um, I don't know.
I A while.
You're going to have a mammogram.
Today.
Now.
- Come on.
- No.
One second.
[SOBS.]
[MELANCHOLY MUSIC.]
Maggie You don't have to worry, Sydney.
You're going to be okay.
Thank you.
[RAGGED SIGH.]
- Sharon, I can handle this.
- Come on.
We did it.
We saved that little girl.
Yeah.
We're a great team.
Connor.
I'm so sorry about your father.
But now there's nothing keeping us apart.
[TENSE MUSIC.]
- What? - He's gone, you're free.
- No, Ava - No, no, no, listen to me.
We can be together now.
I think that you and I are way past that.
We're not.
We'll start over.
We'll just Ava, stop! Okay? We're finished.
That's it.
You ungrateful prick.
[SOMBER MUSIC.]
Rot in hell.
[HAWAIIAN GUITAR MUSIC PLAYS.]
Oh, my goodness.
This is so beautiful.
Thank you! Oh, my goodness gracious.
Oh! Not quite Hawaii but it's close, right? Yeah.
Oh, my goodness, look who's here! What are you guys doing here? - Hi, Mom.
- Oh, my God! - Congratulations, CeCe.
- Congratulations for what? Mrs.
C! I am so happy to finally be at your wedding.
Wedding? Now? If you'd still have me.
[SENTIMENTAL MUSIC.]
Come on, then.
I'm like, oh, my God.
Oh, my God.
- Carolyn, this is Keoni.
- Hi, Keoni.
- Welcome.
- Thank you.
In the Hawaiian language the Hawaiian for love is aloha.
You will share these leis.
Exchange them in the spirit of your aloha.
Sophie should be able to leave the hospital in about a week or ten days.
And after that she'll begin to thrive.
Hit her milestones Crawling, walking, growing.
Natalie You've helped me so much through a very difficult time.
I'm glad I could.
There's something I wanted to ask you.
Dr.
Manning, can I? - Will you give me a second? - Yeah.
- What is it? - Tim Burke's out of prison.
And I advised Will to relocate, but he won't Because of you.
He loves you.
He is brave and devoted and you will never find another guy like him.
You would be a fool not to take him back.
[CAR BEEPS.]
[DRAMATIC MUSIC.]
[ENGINE STARTS.]
Natalie.
What are you Agent Lee told me what was going on.
Will.
I am so sorry.
[TIRES SQUEALING.]
Whoa.
[TIRES SQUEAL.]
- [GRUNTS.]
- [EXCLAIMS.]
[MOANING.]
[TENSE MUSIC.]
Natalie! I got you.
Natalie.
No! Natalie Natalie, come on.
Wake up.