Chicago Med (2015) s05e03 Episode Script
In the Valley of the Shadows
1 Oh, no.
You are burning up.
And now you're on chemo for breast cancer.
I'm going to be careful.
- Oh, I'm sorry.
- I thought I had a patient.
Crockett Marcel.
Fourth year.
Surgery.
- Welcome back.
- And the concussion? I'm taking it slowly.
I just have to ask, do you love him? My relationship with Phillip is the only thing in my life that's working right now.
My lymphoma is progressing, and there's nothing more they can do.
I want to be there, for all of it.
Egg whites.
Whoa.
What's all this? It's a meringue.
For breakfast? No, it's for Robin's birthday.
It's for a Baked Alaska.
The meringue goes over the ice cream and the cake.
Robin's birthday isn't for a couple weeks, though, right? Yeah.
This is a test run.
- Oh.
- [LAUGHS.]
What's the fire extinguisher for? I'm gonna set it on fire.
Hey, how do you keep the ice cream from melting? That's what the test run's for.
- Ah.
- What a minute.
Hey, maybe I should play hooky today.
Stay home and be your official taster.
- [CLANGING.]
- Ow! - CeCe? - Oh, my goodness.
Honey, what happened? - I'm getting so clumsy, honey.
- Let me look.
No, no, please, please, please.
All right, I learned this one in Biophysics.
Yeah.
Stop it.
That's actually pretty cool.
It's all in the lips, ladies.
I bet.
Hey.
Looks like we're paired together today.
Lucky me.
Excuse me.
So, babe, that Crockett guy is working days now? What's the deal with him? Not sure he's my speed.
Strikes me as someone who doesn't take things seriously.
Yeah.
- Dr.
Choi.
- Yeah.
Treatment 4.
Maggs, Todd Shepard? Doesn't say what he's in here for.
Said he wanted to discuss it with a doctor.
No, I'm in the ED now.
Treatment Room 4.
How far away are you guys? You're positive you'll be here within the hour? All right, thanks.
Sorry, I really needed to make that call.
That's okay, Todd.
I go by Shep, if you don't mind.
Okay, Shep.
I'm Dr.
Choi.
What brings you in today? About six weeks ago, I was diagnosed with GBM.
It's a terminal - Terminal brain cancer.
- I'm sorry, Shep.
I've got all my medical records right here in case you're interested.
Are you experiencing any complications? Not exactly.
Excuse me one second.
The phone call I just made was to a company called CCI.
Camden Cryonics Institute.
They're gonna preserve me until a cure can be found for my condition.
They're on their way here now.
To freeze you? It's called vitrification, but yeah.
You understand you have to be declared dead first.
That's why I'm here.
For you to declare me dead, so to speak.
I'm sorry, Shep.
I'm confused.
The cocktail I've been drinking contains amitriptyline, lorazepam, and 200mg of amphetamines.
It should put me to sleep in a little over an hour, and arrest my heart sufficiently for you to declare me dead in about five.
I have a DNI and DNR.
My lawyer assures me Doris, come here.
We gotta pump his stomach.
Stop.
I refuse treatment.
Don't listen to him, Doris.
- Give me a tube.
- Assault! This doctor keeps touching me, I'll sue the whole lot of you.
Dr.
Choi.
Stop.
[DRAMATIC MUSIC.]
Here you can see the fracture of the distal radius.
Minimal displacement.
CeCe, are you all right? Maggie said you took some kind of fall.
Broke her wrist.
My arms aren't as long as they used to be.
I've seen worse.
Four to six weeks in a cast, you'll be fine.
What? Four to six weeks? But wait a minute.
I need to be able to use my arm.
And there's, like, another operation we could do? Normally, yeah, we would surgically insert a plate, shorten your recovery time, but I really wouldn't recommend that, Mrs.
Charles.
- Why? - It would just open the door to a whole host of other complications.
Given your condition, babe, it's just not worth it.
They're right, CeCe.
We'll just let ortho put a cast on it.
It's the least worst option, right? I'll go talk to the attending.
Wait a minute.
You okay, CeCe? She wants to make a Baked Alaska for Robin.
It was a flambé.
I was making her a flambé for her birthday.
Okay, I'll go to the bakery.
I'll get a big ol' cake, sparklers, and we'll do it up nice, all right? Daniel, I hate to pull you away, but we've got a situation.
It's fine, you can go.
Go.
It's fine.
I'm fine.
- Be right back.
- I'm fine.
- All right, you all right? - I'm fine.
He's committing suicide right in front of us.
How is this a gray area? Well, it's complicated due to his condition and his prognosis.
Have you had a chance to review Mr.
Shepard's medical records, Sam? Yeah, he's terminal.
I could go in and do a resection and aggressively radiate, but it'd buy him 12 to 15 months tops.
It's a question of when and not if with this guy.
And Mr.
Shepard has the right to refuse treatment.
He's just a kid.
- Not according to the law.
- He's 18.
He's talking about freezing his brain, for Chrissakes.
He thinks he's living in some kind of comic book.
Well, where are we with cryonics, Sam? I mean, is it possible to freeze the brain? Yeah, sort of, but that's the easy part.
Hard part's thawing it out again and having it still work, and that ain't even close to happening.
Mrs.
Goodwin, I need to lavage this kid's stomach right now, or else the drugs will get into his bloodstream.
We'll be forced to use supportive measures.
No, no, Mr.
Shepard has a DNI and a DNR, Dr.
Choi.
So unless the hospital deems him incapable of making an informed decision, we have to honor his wishes.
All right, so let's ascertain Mr.
Shepard's decisional capacity, and then go from there.
Uh, Daniel? Daniel? - Yeah.
- Mr.
Shepard? Yes, I will talk to him.
How long before he starts to lose consciousness? 40, 45 minutes.
Sharon, a word, please.
There's someone named Paula over there saying that she's here to shadow me.
Oh, Maggie, I'm sorry.
I intended to speak with you about that first.
For the next few weeks, Paula is going to be your new orientee, considering how much you have on your plate.
Sharon, really, I feel great.
Don't you feel worn down from your chemo? No.
And you're happy with your oncologist at East Mercy? They're treating me fine, Sharon.
And no one here knows anything, but if I've got someone shadowing me around, people here are gonna start asking questions.
- Well, it's too late.
- Paula's yours.
- But I just - Humor me.
- Hello, Keisha.
- Hi, I'm Dr.
Manning.
I hear you hurt your leg.
She tripped and fell carrying a cup of hot water for me out of the microwave.
Spilled all over her leg.
I'm sorry to hear that.
How about I take a look, all right? All right, let's see.
2 to 3% superficial partial thickness on the left anterior thigh.
She has a second-degree burn.
Oh, my God.
But it should be able to heal on its own without surgery, but it will take a few weeks.
I'm gonna do a quick scrub bedside just to speed up the process.
Will you start her on an IV? Is it gonna hurt her? No, I will give Keisha sedation.
She won't feel a thing.
Thank you for being so still, Keisha.
You are a very brave girl.
All right, I'll be back shortly.
Thank you.
Hey, guys.
- Hi.
- What are you doing here? I thought you were headed to the park.
Well, we were, but we were putting some snacks together.
We figured you might get hungry, so thought we'd stop by.
- What you got? - It's a cookie.
[GASPS.]
It's a cookie? [LAUGHTER.]
Thank you.
I'm gonna eat it with my lunch, okay? - Okay.
- Okay.
Well, why don't we let Mommy get back to work? I'll see you.
All right, let's head on out.
Oh, hey.
Don't work too hard.
See this door? We're gonna walk through this door here.
That Owen's getting so big.
Yeah.
Hey, so listen, I've been doing some research on post-traumatic injury rehabilitation, and there's this computerized training program funded by the Pentagon that's had some early success.
Now it's not on the market yet, but Abrams says there's a beta version upstairs you can try out.
It might help you get your memory back.
Keisha's ready to be debrided.
Thanks.
Will you hook her up to the monitors and prep her for 5mgs of etomidate? Mm-hmm.
And I can forward you the details on that program if you like.
Sure.
This outfit that you've contracted with, CCI? Uh-huh.
They're gonna store you indefinitely with the hope that in the future there will be a cure for the cancer that you have.
Yeah.
Sounds expensive.
I inherited some money when Gramps died.
Enough to cover it.
It is pretty far-out stuff, Shep.
You discussed any of this with your family? I tried.
Yeah.
They don't they don't get it.
They don't understand.
Look you're here to determine whether I'm sane enough to make a decision like this, aren't you? Yeah.
Here's a hypothetical.
If the hospital across the street could cure me, wouldn't you feel ethically compelled to send me there for treatment? I would.
Well, that's what I'm doing.
Sending myself to a better hospital.
Only the hospital I'm going to is in the future.
Have you really thought about what that future looks like? I mean It won't be recognizable.
You won't recognize yourself.
I mean, you're trading away potentially a year of your life.
I mean, that's something priceless for a huge unknown.
I mean, you understand that, right? Shep.
Shep.
Look, if we're gonna keep you alive, if you're having any second thoughts, we need to know that now.
You know the Apollo astronauts those rockets were just as likely to blow up as they were to propel them into space.
And the calculations made to bring them home they were done with pencil and paper.
Those astronauts had wives and kids and lives to live.
It had to have been crazy to climb into one of those capsules.
Don't you think? So? Finding somebody doesn't have the capacity to make an informed decision, I mean, it's a high hurdle He's committing suicide.
He's a danger to himself by definition.
Just put him on a psych hold.
Yeah, but if you follow his logic, he's not committing suicide.
He's doing precisely the opposite, and kind of remarkably clear-headed about the whole thing.
Then what about the medications he's taking for the GBM? The steroids, the anticonvulsives, those have been known to alter someone's personality, right? Yeah, but, I mean, we don't have a baseline to compare it to.
A determination like that at this point would be entirely subjective.
His parents are on their way, Dr.
Charles.
Maybe they'll get here in time to say good-bye to their son.
Hey, Dan.
It's Caroline.
She's insistent on having surgery.
I couldn't talk her out of it.
She's up in ortho.
Help! My baby's not breathing.
- Okay, help! - We've got a newborn.
Baghdad.
Let's go.
Cyanotic and unresponsive.
Let's get her on the monitors, and start bagging.
Deep lac on the left anterior chest.
Are you the mom? Yes.
Yes, I am.
What's your name? Nicole.
Is she gonna be okay? Can you tell me what happened, Nicole? I was driving to pick up some groceries, you know, and all of a sudden, the contractions started, like out of nowhere - Wait a second.
- You were just in labor? You delivered the baby yourself? In the backseat of my car.
- That was an accident - Whoa, whoa.
I was cutting the umbilical cord.
I was supposed to do that, wasn't I? - That's right.
- Heart rate's coming back up.
- She's still not breathing.
- I need to intubate.
Somebody get me a neonatal pack.
I can't believe you're even standing.
- Come on, let's get you looked at.
- I'm not leaving him.
Nicole, it's a girl.
Come on.
You've lost a lot of blood.
No.
Let her stay, Sexton.
Tube.
I'm in.
Bag and call neonatology.
Can someone get a chair for Mom here? I'm afraid, Mommy.
It's okay, baby.
The doctor said it wasn't going to hurt.
That's right, Keisha.
Now you may feel a little drowsy from the medication.
It's okay to close your eyes and go to sleep.
Monique? - She's a little hypotensive.
- Is it okay to proceed? - BP? - 96/60.
That's not too low.
She's probably just dehydrated.
Push the meds.
She's been complaining about feeling lethargic for a couple weeks now.
Her pediatrician couldn't find anything wrong.
I've been getting on her lately for being so lazy.
[MACHINE BEEPING.]
What's going on? - She's seizing.
- Push 1 of Ativan.
BP's crashing.
60/40.
Bolus 500ml of normal saline.
Keisha, talk to me.
Ma'am, I'm gonna need you to move over here.
- I need to intubate.
- Draw 50 of sux.
What's happening with my little girl? Your phone connects to the Carepoint - you're using, right? - Uh-huh.
I'm super-familiar with that, FYI.
Got my MICN certification last year, so whenever you're ready for me to do an incoming call, I can You know what'd be really helpful? You checking all the drug expiration dates.
The drug expirations? Yeah.
There are dates stamped on every package.
You can start with Pyxis over there, and then of course, all the crash carts.
Okeydokey.
Yeah.
Okeydokey.
- Girl sedated on a vent? - Mm-hmm.
Any idea what caused her to crash? Apparently, Keisha fell when she burned herself.
Maybe she bumped her head and caused an epidural bleed.
Walk me through what you know.
Maybe I can help.
The mother said Keisha ran a bit of a fever last week, but the pediatrician couldn't find anything out of the ordinary.
She was a little hypotensive when I had Monique push the ketamine, but nothing to precipitate this.
Ketamine? You mean etomidate, right? What? You had Monique push etomidate.
I heard you call it earlier.
Yeah, it's right here on the chart.
That's strange.
I-I don't know how I confused those two.
Whatever.
It doesn't matter.
There's no real clinical difference.
You feeling all right, Nat? Any headaches, problems concentrating I misspoke, Will.
Let's not make a big deal out of it.
[DRAMATIC MUSIC.]
What did you put in her side there? Well, your daughter's got a collapsed lung.
That tube's gonna help her breathe.
So how long until I'll be able to get her out of here? It's gonna be a while.
It'll be okay.
Have you thought of a name yet? Not really.
Okay, you don't need to do this right now, but before you leave, you're gonna need to fill out these forms for the birth certificate.
And we need to let your OB know that you delivered already.
If you give me a name I didn't really have an OB.
I mean, I had one, but they were all the way across town near where the baby's father lives, and we recently split, so Oh.
I'm sorry.
Here, I'll fill out as much as I can.
Oh, your hand.
Melissa, may I have some gauze, please? You know, I can't do any more than this without getting you admitted.
It's okay.
I'm all right.
You need to see a doctor, if for no other reason than to make sure you've passed all your placenta.
Dr.
Marcel, isn't that right? Please, don't separate me from my baby.
She needs me with her.
How about we just get you registered? That way, we can get you out of these clothes and into something more comfortable, then you can stay here with your child.
Okay.
Thank you.
April here will scare you up some scrubs.
- I'm sorry, Dr.
Marcel? - Mm-hmm? She really needs to be examined.
Ah, relax, Sexton.
We just saved a baby's life.
That's good news.
Look, something seems off with mom.
Why is she so resistant to being seen by a doctor? Who knows? Maybe she took a little something-something to get her through the birth, and now she's afraid of having her baby taken away.
I don't know, and neither do you.
But if she didn't just deliver this baby, it's our responsibility to find out.
Maybe we could figure out a way to draw her blood, check her hCG levels Oh.
You draw anyone's blood without consent, that's considered assault.
Now I don't know about you, but I like being a doctor, and not going to jail.
If you won't help me, I'll call DCFS in to interview her.
Nicole's a righty, by the way.
So? So if she actually injured her hand while cutting the umbilical cord, wouldn't it more likely be the free hand that got cut? - Hey.
- Hey.
So, what's up? I understand you're considering undergoing surgery to repair your wrist.
Yeah.
As your oncologist, I need to strongly urge you against that course of treatment.
- That's exactly what he said.
- Did you tell her to say that? Absolutely not.
Your immune system is profoundly compromised by the chemo.
The risk of post-surgical infection is very high.
I advise against even minor surgery unless absolutely necessary.
This is absolutely necessary because I'm making a Baked Alaska for my daughter, and I cannot do that with, like, a cast on my hand.
Caroline.
Robin would happily celebrate her birthday with a supermarket cupcake if she knew what the risks were.
This isn't about what Robin wants.
This is about what I want.
Why don't I give you two some privacy.
What? How about we just have them put a temp cast on it overnight, and then we can mull over the pluses, the minuses Dr.
Charles, sorry to interrupt, but you've been down to the ED.
And they specifically asked for you, Dr.
Charles.
Go, Daniel.
Go, please.
Heather.
Can you do me a favor and please try and make sure she does not get cleared for surgery until I get back? - Daniel.
- Please.
I just want to make sure she doesn't make any rash decisions.
Thank you.
For the record, CCI neither condones nor endorses the preemptive precipitation of clinical death.
That said, we are a service company.
Sure.
Hope the parents aren't gonna be too much of an impediment on this.
I don't want to step on anyone's toes here, but time really is of the essence.
The second he's declared dead, we need to start.
Is this what you're using to freeze him? We don't freeze anyone.
We're gonna vitrify him.
We replace his blood with a medical-grade antifreeze.
As soon as his body temp hits minus 124 degrees Celsius, the body's liquid rises so high in viscosity, no molecule can budge.
Takes about three hours.
You paged me? Yeah.
Parents wanted to speak with you.
Mr.
and Mrs.
Shepard, please.
This is Dr.
Charles.
Why is no one stopping my boy from doing this? Todd just turned 18.
He can't make a decision like this for himself.
[MACHINE BEEPING.]
He's bradying down.
What's that? His heart stopped.
Well, do something.
I'm not legally authorized to.
Please.
We only have so much time left with him.
We're not ready for him to die yet.
Have you noticed any personality changes in Shep since diagnosis? I don't know.
Has he been more impetuous, stubborn, less willing to listen to reason? Yes, of course.
I'm deeming the patient decisionally incapacitated.
As next of kin, you have the right to make medical decisions on his behalf.
Should we attempt to resuscitate? Yes.
All right, get me a crash cart! Start bagging.
Quick-look paddles.
Hey, give us some room! How long will he need to stay on support? Until the drugs work through his system.
A few more hours at least.
Thank you, Doctor.
Sure.
Guess you guys rushed here for nothing.
Well, transfer's already paid for, so we'll stand by if it's all the same.
Just in case.
You can hang in that room for the time being.
I didn't think you were buying my personality change argument.
Just erred on the side of caution.
You know, gave everybody a little more time.
You made the right call.
Hope so.
So what, you forbade me from having the surgery? Really? So we get married, and now I have to ask for permission for stuff, is that right? I wasn't Come here.
Come here.
I'm not forbidding anything.
I just want to make sure that we have enough time to think this through.
- I thought about it.
- I want the surgery.
- For a Baked Alaska? - Yes.
Do you know how crazy that sounds? It's not about the Baked Alaska.
It's about me showing love to the people I care about the way I want to.
Look, I know I'm not the best cook in the world, but I can figure out a whisk.
I'll help you.
We'll do it together.
No, no.
No! Time is precious, Daniel.
And I don't want to spend four weeks not being able to use my hand.
You knew who I was when you signed on for this.
You knew who I was.
No, this isn't what I signed up for.
You being reckless with your health, that wasn't the deal.
There's too much to lose here.
I think you're being a little selfish.
- So now I'm being selfish? - Really? I mean, I just found you again.
I want to have as much time with you as possible, and kind of hoping you feel the same way.
- I do, but you know what? - This is my choice.
Period.
You hear that? Period.
I tried to get her to let us examine her, but she refused, and given the circumstances of the delivery No, you did the right thing calling Child Services, April.
That's what we're here for.
Excuse me.
Ms.
Burke.
Nicole? Nicole, you gotta wake up.
We need to ask you a few questions.
She was feeling pretty anxious about her baby, so I gave her Ativan.
Should wear off in an hour or so.
Melissa, you'll notify us when she wakes up? Of course.
Thank you.
I cannot believe that you would undermine me like that.
Excuse me? You knew I was calling DCFS in to talk to her.
You sedated her on purpose.
Please.
You know what, you don't want to help, fine.
Just do me a favor.
Stay out of my way.
Goodwin got you a lackey? What did you do to get such special treatment? I'm just training her, Doris.
It's not permanent.
That's not what I heard.
Hmm.
Good thing I checked these.
Look how many had almost expired.
You know, if you want, I could rework things moving forward? Great.
So what's next? Actually, I'd love a cup of coffee.
Okay, I'll run down to the cafeteria.
- I prefer Dark Matter coffee.
- Oh.
There's one about 12 blocks from here.
Why don't you go get me a red-eye, and get yourself whatever you want? - Thanks.
- I'll be back in a jiff.
[SIGHS.]
Hey, um, Keisha's father Darrell arrived.
Had a lot of questions.
- I know.
- I need to go talk to them.
I'm not avoiding them.
I just don't have the answers yet.
What'd her CT show? Came back negative.
No bleed.
Blood work? Glucose and sodium are a little low, but otherwise normal.
I'm gonna do an LP, make sure we're not looking at something like meningitis.
You sure that's necessary? She spiking a fever? Well, not today, but her mom said she was last week, so I gotta check it off my list.
Hey, you want me to take over Keisha for you? What? Why? I just, Nat, it's been a long week.
You know, you were out of action for a while.
I'd understand if you're feeling a little rusty.
Maybe you should look into that program I mentioned earlier.
This is because I misspoke, isn't it? You are fixated on me getting my memory back.
Why? Nat, I just want you to get better.
I don't think that's it.
I think it's about you.
You want me to remember why I came to see you that night, so that maybe I'll tell you something you want to hear.
Natalie, no.
Stop it.
I am fine.
And I don't appreciate you talking to Dr.
Abrams about my health behind my back.
Monique, will you prep Keisha for an LP? - Okay.
- Thanks.
Actually, Monique, hold off on that.
I didn't want to have to tell you this, but I'm taking over the patient.
The parents have lost confidence in you.
They brought their daughter in to have her burn looked at, and now she's in a coma.
Will, please don't do this.
I'm sorry.
They want you off the case.
[SIGHS.]
Juliette! 23-year-old female, found down, intubated in the field, 18 gauge in the left arm.
She's eviscerated.
Baghdad.
Bowels wrapped in moist saline gauze.
She's gotten 500 mils of crystalloid.
- Let's go, everybody.
- Let's go, let's go.
All right, on my count.
One, two, three.
Get her on the monitors.
Heart rate's 130.
BP, 72/44.
Trigger the MTP.
Open the hybrid room.
I got you.
Open the hybrid.
Oh, man.
Her uterus is cut hide open.
Looks like she was pregnant.
Wait, what? Where's the baby? Where's this woman's baby? There was no baby on site.
It had to have been Nicole.
Okay, this woman who did this, her name is Nicole Burke.
She is in the NICU right now with the baby.
Come on, I'll show you.
Stop! Let the police do their job, Sexton.
Come here and help me retract.
You have to go up there fast.
- Oh, my God.
- I need some more lap sponges.
So what do you think? Can we save the uterus? I don't know.
It's looking pretty ratty.
Even if we can fix it, she'd run the risk of it rupturing with a future pregnancy.
I'd just do a hysterectomy.
Well, she's only 23, and I'm not sure her baby's gonna survive.
I'm gonna try and save it.
I'll go scrub, but for the record, this is against my better judgment.
You scrubbing in or not, Maggs? I'm coming.
Oh, hey, Maggie, are you all right? Should I jump in? I'm certified.
I'm fine.
Why does this keep happening? The drugs he took are making his heart stop, and until they clear his system Feels like only yesterday we were waiting to see what college he would get into.
Now We just couldn't let him go through with that plan of his, you know? The the thought of his head just floating in a canister in a warehouse somewhere Shep told me that he tried to talk to you two about this.
- Is that right? - Yeah.
I don't know if it's any comfort, but I was genuinely impressed with how much thought that he had put into this, and how much sense that it made to him.
Please, Dr.
Charles, tell us what we're missing.
Mrs.
Shepard, I've been doing this for a while, and on a good day, I'm just starting to think I might be learning my way around the human mind.
But trying to fathom the thinking of someone that's confronting their own mortality unless you're the one that's looking down that tunnel, I just don't know it's possible.
I think what we need to do is try and listen, understand, and respect that it's their journey to go on alone.
They got his heart back in rhythm.
You should go be with him.
What we need to do? You give us the power to make a decision, and then judge us for making it? Mr.
Shepard, believe me, I'm not judging anybody.
Anyone from rheumatology showed up yet? No.
Lean on them, okay? And run another set of labs.
- Mm-hmm.
- Oh, hey, there, again.
- Hi, Owen.
- Hi, Will.
After we got done in the park, we went to the movies, and then we figured we would come here and wait for Mommy.
Hey, Phillip? Yeah? Not so sure this is the best place for kids, you know? Some scary stuff happens here that maybe they can't unsee.
Oh, yeah.
That's a good point.
Um There we go.
Now there's nothing to unsee.
Right? We told your supervisor we didn't want you treating our daughter anymore.
I know, I just need to check one last thing.
Dr.
Manning.
I'll have to ask you to stay away from this patient.
I was wrong.
Okay, etomidate and ketamine are not the same thing.
A big difference is that etomidate unmasks adrenal insufficiencies.
While ketamine doesn't.
Yes.
You see the pigment spots on Keisha's foot? They are a sign that her adrenal glands are not producing enough cortisol.
100mg of hydrocortisone.
I don't understand.
Cortisol helps the body handle stress.
In its absence, even the stress of being examined by a doctor was enough to plummet Keisha into a coma.
[MACHINE BEEPS.]
BP's improving.
Her color's coming back.
She's trying to open her eyes.
Oh, my baby girl.
She's super cold.
I'm having trouble keeping her pressure up.
You need to pack her up now and get out.
I told you it wasn't worth it.
A knot, and I'm done.
You're pushing it, Dr.
Marcel.
And there, done.
Looks better than I thought.
Let's temp-close and get her upstairs.
Open up a vac sponge.
Maggie? I need to take a minute.
[PANTING.]
Maggs.
Sexton! Scrub in.
[CRYING.]
Hey.
If you need to go home early, I'm more than willing to cover for you.
You cover for me.
Your first day.
[LAUGHING.]
A little constructive criticism, Paula.
You have an insanely inflated sense of your own capabilities.
You know, "I'm certified doing this, so I did my dissertation on that.
" Please! Get out.
I'm sorry, but I refuse to be spoken to like that.
[SOBBING.]
Is she gonna make it? Yeah, she lost a lot of blood, but, yeah, I'm hopeful.
Do we know any more about what happened? The victim's name is Louisa Nash.
She and the assailant were coworkers.
This morning, Ms.
Burke invited Louisa over to give her some old baby clothes.
When her guard was down, she chloroformed her and forcibly removed the baby.
Who would ever do something like that? She lost her son recently to leukemia.
Maybe she had some sort of mental breakdown, I don't know.
We were lucky, we got an anonymous tip about Ms.
Burke, and that helped us find Louisa in time.
Suspect's hand needs redressing.
Is that something you can do here? I got it.
Take care of my baby, okay? Tell him I'll come for him as soon as I can.
This is getting to be a bit of a circus.
[OVERLAPPING CHATTER.]
Here, I'll take you out the back way.
What's going on? They're withdrawing support.
My wife and I decided we're going to honor our son's wishes.
This way, maybe someday, we'll get our son back.
[MONITOR DRONING.]
Time of death, 19:42.
So I'm thinking this might have been precipitated by some kind of underlying cause.
Maybe Addison's disease? I'm gonna have endocrinology come down and see her.
Thought it was clear I was gonna be the primary.
I'm sorry, but once I realized what caused her to crash, I had to act quickly.
I mean, Keisha could've died.
Oh.
My ride's here.
Adrenal crisis should've been on your differential from the start.
It was an odd presentation.
Or you just weren't thinking straight.
I'm gonna want to oversee all your cases moving forward, until we know for sure your TBI isn't adversely affecting your patients.
Are you serious? There's nothing wrong with me.
You don't have the authority.
I was hoping we could do this off-book.
If not, we can formalize it with Lanik and Goodwin.
I'm happy to talk to them.
Natalie It's for your own protection.
Why do I feel like you're punishing me for something else? Ready to go? Yep.
Louisa? Can you open your eyes for me? Hey.
You're at Gaffney Chicago Medical Center, in the ICU.
You sustained some injuries that required us to perform extensive surgery, but you are okay.
Would you like to meet your baby girl? Here she is.
We got lucky, police finding her in time.
Can I trust you to keep a secret? Yeah.
What? You know how that monster was so antsy to get out of here earlier? Mm-hmm.
Well, Dr.
Marcel gave her enough Ativan to knock her out, and while she was, he drew some blood and had her hCG levels checked to see if she really delivered that baby.
- What? - You can't tell anyone, April.
Crockett could get fired.
He's such a badass.
Do you know if he's seeing anybody? No, I don't.
- Paula quit? - Yeah.
She said, and I quote, the ED wasn't a healthy environment for her.
I had a feeling she couldn't cut it.
You chased her off, Maggie.
And I told you that I don't need the help.
You're being stubborn.
I have a hospital to run.
So, if you don't want us to treat you medically, then you're getting help.
- April? - Yeah? Thank you for scrubbing in for me today.
Yeah.
I'd like to start training you to take over the position formally.
Sure, of course.
It'll help me take some stuff off my plate.
Does that mean I'd be working with Dr.
Marcel? Is that a problem? No.
Start tomorrow.
Okay.
Thank you.
Thank you.
Do you really think I'll get better care here than at East Mercy? - Hey.
- Why didn't you wait for me? Because you were still on rounds and Sharon offered me a ride home.
- How did your, um - How'd your surgery go? I didn't get it.
- You didn't? - No.
They're, um, gonna check my wrist again in four weeks to see if I still need a cast.
[KETTLE WHISTLING.]
I'll get that for you.
You best not mess up my Baked Alaska.
No, ma'am.
You are burning up.
And now you're on chemo for breast cancer.
I'm going to be careful.
- Oh, I'm sorry.
- I thought I had a patient.
Crockett Marcel.
Fourth year.
Surgery.
- Welcome back.
- And the concussion? I'm taking it slowly.
I just have to ask, do you love him? My relationship with Phillip is the only thing in my life that's working right now.
My lymphoma is progressing, and there's nothing more they can do.
I want to be there, for all of it.
Egg whites.
Whoa.
What's all this? It's a meringue.
For breakfast? No, it's for Robin's birthday.
It's for a Baked Alaska.
The meringue goes over the ice cream and the cake.
Robin's birthday isn't for a couple weeks, though, right? Yeah.
This is a test run.
- Oh.
- [LAUGHS.]
What's the fire extinguisher for? I'm gonna set it on fire.
Hey, how do you keep the ice cream from melting? That's what the test run's for.
- Ah.
- What a minute.
Hey, maybe I should play hooky today.
Stay home and be your official taster.
- [CLANGING.]
- Ow! - CeCe? - Oh, my goodness.
Honey, what happened? - I'm getting so clumsy, honey.
- Let me look.
No, no, please, please, please.
All right, I learned this one in Biophysics.
Yeah.
Stop it.
That's actually pretty cool.
It's all in the lips, ladies.
I bet.
Hey.
Looks like we're paired together today.
Lucky me.
Excuse me.
So, babe, that Crockett guy is working days now? What's the deal with him? Not sure he's my speed.
Strikes me as someone who doesn't take things seriously.
Yeah.
- Dr.
Choi.
- Yeah.
Treatment 4.
Maggs, Todd Shepard? Doesn't say what he's in here for.
Said he wanted to discuss it with a doctor.
No, I'm in the ED now.
Treatment Room 4.
How far away are you guys? You're positive you'll be here within the hour? All right, thanks.
Sorry, I really needed to make that call.
That's okay, Todd.
I go by Shep, if you don't mind.
Okay, Shep.
I'm Dr.
Choi.
What brings you in today? About six weeks ago, I was diagnosed with GBM.
It's a terminal - Terminal brain cancer.
- I'm sorry, Shep.
I've got all my medical records right here in case you're interested.
Are you experiencing any complications? Not exactly.
Excuse me one second.
The phone call I just made was to a company called CCI.
Camden Cryonics Institute.
They're gonna preserve me until a cure can be found for my condition.
They're on their way here now.
To freeze you? It's called vitrification, but yeah.
You understand you have to be declared dead first.
That's why I'm here.
For you to declare me dead, so to speak.
I'm sorry, Shep.
I'm confused.
The cocktail I've been drinking contains amitriptyline, lorazepam, and 200mg of amphetamines.
It should put me to sleep in a little over an hour, and arrest my heart sufficiently for you to declare me dead in about five.
I have a DNI and DNR.
My lawyer assures me Doris, come here.
We gotta pump his stomach.
Stop.
I refuse treatment.
Don't listen to him, Doris.
- Give me a tube.
- Assault! This doctor keeps touching me, I'll sue the whole lot of you.
Dr.
Choi.
Stop.
[DRAMATIC MUSIC.]
Here you can see the fracture of the distal radius.
Minimal displacement.
CeCe, are you all right? Maggie said you took some kind of fall.
Broke her wrist.
My arms aren't as long as they used to be.
I've seen worse.
Four to six weeks in a cast, you'll be fine.
What? Four to six weeks? But wait a minute.
I need to be able to use my arm.
And there's, like, another operation we could do? Normally, yeah, we would surgically insert a plate, shorten your recovery time, but I really wouldn't recommend that, Mrs.
Charles.
- Why? - It would just open the door to a whole host of other complications.
Given your condition, babe, it's just not worth it.
They're right, CeCe.
We'll just let ortho put a cast on it.
It's the least worst option, right? I'll go talk to the attending.
Wait a minute.
You okay, CeCe? She wants to make a Baked Alaska for Robin.
It was a flambé.
I was making her a flambé for her birthday.
Okay, I'll go to the bakery.
I'll get a big ol' cake, sparklers, and we'll do it up nice, all right? Daniel, I hate to pull you away, but we've got a situation.
It's fine, you can go.
Go.
It's fine.
I'm fine.
- Be right back.
- I'm fine.
- All right, you all right? - I'm fine.
He's committing suicide right in front of us.
How is this a gray area? Well, it's complicated due to his condition and his prognosis.
Have you had a chance to review Mr.
Shepard's medical records, Sam? Yeah, he's terminal.
I could go in and do a resection and aggressively radiate, but it'd buy him 12 to 15 months tops.
It's a question of when and not if with this guy.
And Mr.
Shepard has the right to refuse treatment.
He's just a kid.
- Not according to the law.
- He's 18.
He's talking about freezing his brain, for Chrissakes.
He thinks he's living in some kind of comic book.
Well, where are we with cryonics, Sam? I mean, is it possible to freeze the brain? Yeah, sort of, but that's the easy part.
Hard part's thawing it out again and having it still work, and that ain't even close to happening.
Mrs.
Goodwin, I need to lavage this kid's stomach right now, or else the drugs will get into his bloodstream.
We'll be forced to use supportive measures.
No, no, Mr.
Shepard has a DNI and a DNR, Dr.
Choi.
So unless the hospital deems him incapable of making an informed decision, we have to honor his wishes.
All right, so let's ascertain Mr.
Shepard's decisional capacity, and then go from there.
Uh, Daniel? Daniel? - Yeah.
- Mr.
Shepard? Yes, I will talk to him.
How long before he starts to lose consciousness? 40, 45 minutes.
Sharon, a word, please.
There's someone named Paula over there saying that she's here to shadow me.
Oh, Maggie, I'm sorry.
I intended to speak with you about that first.
For the next few weeks, Paula is going to be your new orientee, considering how much you have on your plate.
Sharon, really, I feel great.
Don't you feel worn down from your chemo? No.
And you're happy with your oncologist at East Mercy? They're treating me fine, Sharon.
And no one here knows anything, but if I've got someone shadowing me around, people here are gonna start asking questions.
- Well, it's too late.
- Paula's yours.
- But I just - Humor me.
- Hello, Keisha.
- Hi, I'm Dr.
Manning.
I hear you hurt your leg.
She tripped and fell carrying a cup of hot water for me out of the microwave.
Spilled all over her leg.
I'm sorry to hear that.
How about I take a look, all right? All right, let's see.
2 to 3% superficial partial thickness on the left anterior thigh.
She has a second-degree burn.
Oh, my God.
But it should be able to heal on its own without surgery, but it will take a few weeks.
I'm gonna do a quick scrub bedside just to speed up the process.
Will you start her on an IV? Is it gonna hurt her? No, I will give Keisha sedation.
She won't feel a thing.
Thank you for being so still, Keisha.
You are a very brave girl.
All right, I'll be back shortly.
Thank you.
Hey, guys.
- Hi.
- What are you doing here? I thought you were headed to the park.
Well, we were, but we were putting some snacks together.
We figured you might get hungry, so thought we'd stop by.
- What you got? - It's a cookie.
[GASPS.]
It's a cookie? [LAUGHTER.]
Thank you.
I'm gonna eat it with my lunch, okay? - Okay.
- Okay.
Well, why don't we let Mommy get back to work? I'll see you.
All right, let's head on out.
Oh, hey.
Don't work too hard.
See this door? We're gonna walk through this door here.
That Owen's getting so big.
Yeah.
Hey, so listen, I've been doing some research on post-traumatic injury rehabilitation, and there's this computerized training program funded by the Pentagon that's had some early success.
Now it's not on the market yet, but Abrams says there's a beta version upstairs you can try out.
It might help you get your memory back.
Keisha's ready to be debrided.
Thanks.
Will you hook her up to the monitors and prep her for 5mgs of etomidate? Mm-hmm.
And I can forward you the details on that program if you like.
Sure.
This outfit that you've contracted with, CCI? Uh-huh.
They're gonna store you indefinitely with the hope that in the future there will be a cure for the cancer that you have.
Yeah.
Sounds expensive.
I inherited some money when Gramps died.
Enough to cover it.
It is pretty far-out stuff, Shep.
You discussed any of this with your family? I tried.
Yeah.
They don't they don't get it.
They don't understand.
Look you're here to determine whether I'm sane enough to make a decision like this, aren't you? Yeah.
Here's a hypothetical.
If the hospital across the street could cure me, wouldn't you feel ethically compelled to send me there for treatment? I would.
Well, that's what I'm doing.
Sending myself to a better hospital.
Only the hospital I'm going to is in the future.
Have you really thought about what that future looks like? I mean It won't be recognizable.
You won't recognize yourself.
I mean, you're trading away potentially a year of your life.
I mean, that's something priceless for a huge unknown.
I mean, you understand that, right? Shep.
Shep.
Look, if we're gonna keep you alive, if you're having any second thoughts, we need to know that now.
You know the Apollo astronauts those rockets were just as likely to blow up as they were to propel them into space.
And the calculations made to bring them home they were done with pencil and paper.
Those astronauts had wives and kids and lives to live.
It had to have been crazy to climb into one of those capsules.
Don't you think? So? Finding somebody doesn't have the capacity to make an informed decision, I mean, it's a high hurdle He's committing suicide.
He's a danger to himself by definition.
Just put him on a psych hold.
Yeah, but if you follow his logic, he's not committing suicide.
He's doing precisely the opposite, and kind of remarkably clear-headed about the whole thing.
Then what about the medications he's taking for the GBM? The steroids, the anticonvulsives, those have been known to alter someone's personality, right? Yeah, but, I mean, we don't have a baseline to compare it to.
A determination like that at this point would be entirely subjective.
His parents are on their way, Dr.
Charles.
Maybe they'll get here in time to say good-bye to their son.
Hey, Dan.
It's Caroline.
She's insistent on having surgery.
I couldn't talk her out of it.
She's up in ortho.
Help! My baby's not breathing.
- Okay, help! - We've got a newborn.
Baghdad.
Let's go.
Cyanotic and unresponsive.
Let's get her on the monitors, and start bagging.
Deep lac on the left anterior chest.
Are you the mom? Yes.
Yes, I am.
What's your name? Nicole.
Is she gonna be okay? Can you tell me what happened, Nicole? I was driving to pick up some groceries, you know, and all of a sudden, the contractions started, like out of nowhere - Wait a second.
- You were just in labor? You delivered the baby yourself? In the backseat of my car.
- That was an accident - Whoa, whoa.
I was cutting the umbilical cord.
I was supposed to do that, wasn't I? - That's right.
- Heart rate's coming back up.
- She's still not breathing.
- I need to intubate.
Somebody get me a neonatal pack.
I can't believe you're even standing.
- Come on, let's get you looked at.
- I'm not leaving him.
Nicole, it's a girl.
Come on.
You've lost a lot of blood.
No.
Let her stay, Sexton.
Tube.
I'm in.
Bag and call neonatology.
Can someone get a chair for Mom here? I'm afraid, Mommy.
It's okay, baby.
The doctor said it wasn't going to hurt.
That's right, Keisha.
Now you may feel a little drowsy from the medication.
It's okay to close your eyes and go to sleep.
Monique? - She's a little hypotensive.
- Is it okay to proceed? - BP? - 96/60.
That's not too low.
She's probably just dehydrated.
Push the meds.
She's been complaining about feeling lethargic for a couple weeks now.
Her pediatrician couldn't find anything wrong.
I've been getting on her lately for being so lazy.
[MACHINE BEEPING.]
What's going on? - She's seizing.
- Push 1 of Ativan.
BP's crashing.
60/40.
Bolus 500ml of normal saline.
Keisha, talk to me.
Ma'am, I'm gonna need you to move over here.
- I need to intubate.
- Draw 50 of sux.
What's happening with my little girl? Your phone connects to the Carepoint - you're using, right? - Uh-huh.
I'm super-familiar with that, FYI.
Got my MICN certification last year, so whenever you're ready for me to do an incoming call, I can You know what'd be really helpful? You checking all the drug expiration dates.
The drug expirations? Yeah.
There are dates stamped on every package.
You can start with Pyxis over there, and then of course, all the crash carts.
Okeydokey.
Yeah.
Okeydokey.
- Girl sedated on a vent? - Mm-hmm.
Any idea what caused her to crash? Apparently, Keisha fell when she burned herself.
Maybe she bumped her head and caused an epidural bleed.
Walk me through what you know.
Maybe I can help.
The mother said Keisha ran a bit of a fever last week, but the pediatrician couldn't find anything out of the ordinary.
She was a little hypotensive when I had Monique push the ketamine, but nothing to precipitate this.
Ketamine? You mean etomidate, right? What? You had Monique push etomidate.
I heard you call it earlier.
Yeah, it's right here on the chart.
That's strange.
I-I don't know how I confused those two.
Whatever.
It doesn't matter.
There's no real clinical difference.
You feeling all right, Nat? Any headaches, problems concentrating I misspoke, Will.
Let's not make a big deal out of it.
[DRAMATIC MUSIC.]
What did you put in her side there? Well, your daughter's got a collapsed lung.
That tube's gonna help her breathe.
So how long until I'll be able to get her out of here? It's gonna be a while.
It'll be okay.
Have you thought of a name yet? Not really.
Okay, you don't need to do this right now, but before you leave, you're gonna need to fill out these forms for the birth certificate.
And we need to let your OB know that you delivered already.
If you give me a name I didn't really have an OB.
I mean, I had one, but they were all the way across town near where the baby's father lives, and we recently split, so Oh.
I'm sorry.
Here, I'll fill out as much as I can.
Oh, your hand.
Melissa, may I have some gauze, please? You know, I can't do any more than this without getting you admitted.
It's okay.
I'm all right.
You need to see a doctor, if for no other reason than to make sure you've passed all your placenta.
Dr.
Marcel, isn't that right? Please, don't separate me from my baby.
She needs me with her.
How about we just get you registered? That way, we can get you out of these clothes and into something more comfortable, then you can stay here with your child.
Okay.
Thank you.
April here will scare you up some scrubs.
- I'm sorry, Dr.
Marcel? - Mm-hmm? She really needs to be examined.
Ah, relax, Sexton.
We just saved a baby's life.
That's good news.
Look, something seems off with mom.
Why is she so resistant to being seen by a doctor? Who knows? Maybe she took a little something-something to get her through the birth, and now she's afraid of having her baby taken away.
I don't know, and neither do you.
But if she didn't just deliver this baby, it's our responsibility to find out.
Maybe we could figure out a way to draw her blood, check her hCG levels Oh.
You draw anyone's blood without consent, that's considered assault.
Now I don't know about you, but I like being a doctor, and not going to jail.
If you won't help me, I'll call DCFS in to interview her.
Nicole's a righty, by the way.
So? So if she actually injured her hand while cutting the umbilical cord, wouldn't it more likely be the free hand that got cut? - Hey.
- Hey.
So, what's up? I understand you're considering undergoing surgery to repair your wrist.
Yeah.
As your oncologist, I need to strongly urge you against that course of treatment.
- That's exactly what he said.
- Did you tell her to say that? Absolutely not.
Your immune system is profoundly compromised by the chemo.
The risk of post-surgical infection is very high.
I advise against even minor surgery unless absolutely necessary.
This is absolutely necessary because I'm making a Baked Alaska for my daughter, and I cannot do that with, like, a cast on my hand.
Caroline.
Robin would happily celebrate her birthday with a supermarket cupcake if she knew what the risks were.
This isn't about what Robin wants.
This is about what I want.
Why don't I give you two some privacy.
What? How about we just have them put a temp cast on it overnight, and then we can mull over the pluses, the minuses Dr.
Charles, sorry to interrupt, but you've been down to the ED.
And they specifically asked for you, Dr.
Charles.
Go, Daniel.
Go, please.
Heather.
Can you do me a favor and please try and make sure she does not get cleared for surgery until I get back? - Daniel.
- Please.
I just want to make sure she doesn't make any rash decisions.
Thank you.
For the record, CCI neither condones nor endorses the preemptive precipitation of clinical death.
That said, we are a service company.
Sure.
Hope the parents aren't gonna be too much of an impediment on this.
I don't want to step on anyone's toes here, but time really is of the essence.
The second he's declared dead, we need to start.
Is this what you're using to freeze him? We don't freeze anyone.
We're gonna vitrify him.
We replace his blood with a medical-grade antifreeze.
As soon as his body temp hits minus 124 degrees Celsius, the body's liquid rises so high in viscosity, no molecule can budge.
Takes about three hours.
You paged me? Yeah.
Parents wanted to speak with you.
Mr.
and Mrs.
Shepard, please.
This is Dr.
Charles.
Why is no one stopping my boy from doing this? Todd just turned 18.
He can't make a decision like this for himself.
[MACHINE BEEPING.]
He's bradying down.
What's that? His heart stopped.
Well, do something.
I'm not legally authorized to.
Please.
We only have so much time left with him.
We're not ready for him to die yet.
Have you noticed any personality changes in Shep since diagnosis? I don't know.
Has he been more impetuous, stubborn, less willing to listen to reason? Yes, of course.
I'm deeming the patient decisionally incapacitated.
As next of kin, you have the right to make medical decisions on his behalf.
Should we attempt to resuscitate? Yes.
All right, get me a crash cart! Start bagging.
Quick-look paddles.
Hey, give us some room! How long will he need to stay on support? Until the drugs work through his system.
A few more hours at least.
Thank you, Doctor.
Sure.
Guess you guys rushed here for nothing.
Well, transfer's already paid for, so we'll stand by if it's all the same.
Just in case.
You can hang in that room for the time being.
I didn't think you were buying my personality change argument.
Just erred on the side of caution.
You know, gave everybody a little more time.
You made the right call.
Hope so.
So what, you forbade me from having the surgery? Really? So we get married, and now I have to ask for permission for stuff, is that right? I wasn't Come here.
Come here.
I'm not forbidding anything.
I just want to make sure that we have enough time to think this through.
- I thought about it.
- I want the surgery.
- For a Baked Alaska? - Yes.
Do you know how crazy that sounds? It's not about the Baked Alaska.
It's about me showing love to the people I care about the way I want to.
Look, I know I'm not the best cook in the world, but I can figure out a whisk.
I'll help you.
We'll do it together.
No, no.
No! Time is precious, Daniel.
And I don't want to spend four weeks not being able to use my hand.
You knew who I was when you signed on for this.
You knew who I was.
No, this isn't what I signed up for.
You being reckless with your health, that wasn't the deal.
There's too much to lose here.
I think you're being a little selfish.
- So now I'm being selfish? - Really? I mean, I just found you again.
I want to have as much time with you as possible, and kind of hoping you feel the same way.
- I do, but you know what? - This is my choice.
Period.
You hear that? Period.
I tried to get her to let us examine her, but she refused, and given the circumstances of the delivery No, you did the right thing calling Child Services, April.
That's what we're here for.
Excuse me.
Ms.
Burke.
Nicole? Nicole, you gotta wake up.
We need to ask you a few questions.
She was feeling pretty anxious about her baby, so I gave her Ativan.
Should wear off in an hour or so.
Melissa, you'll notify us when she wakes up? Of course.
Thank you.
I cannot believe that you would undermine me like that.
Excuse me? You knew I was calling DCFS in to talk to her.
You sedated her on purpose.
Please.
You know what, you don't want to help, fine.
Just do me a favor.
Stay out of my way.
Goodwin got you a lackey? What did you do to get such special treatment? I'm just training her, Doris.
It's not permanent.
That's not what I heard.
Hmm.
Good thing I checked these.
Look how many had almost expired.
You know, if you want, I could rework things moving forward? Great.
So what's next? Actually, I'd love a cup of coffee.
Okay, I'll run down to the cafeteria.
- I prefer Dark Matter coffee.
- Oh.
There's one about 12 blocks from here.
Why don't you go get me a red-eye, and get yourself whatever you want? - Thanks.
- I'll be back in a jiff.
[SIGHS.]
Hey, um, Keisha's father Darrell arrived.
Had a lot of questions.
- I know.
- I need to go talk to them.
I'm not avoiding them.
I just don't have the answers yet.
What'd her CT show? Came back negative.
No bleed.
Blood work? Glucose and sodium are a little low, but otherwise normal.
I'm gonna do an LP, make sure we're not looking at something like meningitis.
You sure that's necessary? She spiking a fever? Well, not today, but her mom said she was last week, so I gotta check it off my list.
Hey, you want me to take over Keisha for you? What? Why? I just, Nat, it's been a long week.
You know, you were out of action for a while.
I'd understand if you're feeling a little rusty.
Maybe you should look into that program I mentioned earlier.
This is because I misspoke, isn't it? You are fixated on me getting my memory back.
Why? Nat, I just want you to get better.
I don't think that's it.
I think it's about you.
You want me to remember why I came to see you that night, so that maybe I'll tell you something you want to hear.
Natalie, no.
Stop it.
I am fine.
And I don't appreciate you talking to Dr.
Abrams about my health behind my back.
Monique, will you prep Keisha for an LP? - Okay.
- Thanks.
Actually, Monique, hold off on that.
I didn't want to have to tell you this, but I'm taking over the patient.
The parents have lost confidence in you.
They brought their daughter in to have her burn looked at, and now she's in a coma.
Will, please don't do this.
I'm sorry.
They want you off the case.
[SIGHS.]
Juliette! 23-year-old female, found down, intubated in the field, 18 gauge in the left arm.
She's eviscerated.
Baghdad.
Bowels wrapped in moist saline gauze.
She's gotten 500 mils of crystalloid.
- Let's go, everybody.
- Let's go, let's go.
All right, on my count.
One, two, three.
Get her on the monitors.
Heart rate's 130.
BP, 72/44.
Trigger the MTP.
Open the hybrid room.
I got you.
Open the hybrid.
Oh, man.
Her uterus is cut hide open.
Looks like she was pregnant.
Wait, what? Where's the baby? Where's this woman's baby? There was no baby on site.
It had to have been Nicole.
Okay, this woman who did this, her name is Nicole Burke.
She is in the NICU right now with the baby.
Come on, I'll show you.
Stop! Let the police do their job, Sexton.
Come here and help me retract.
You have to go up there fast.
- Oh, my God.
- I need some more lap sponges.
So what do you think? Can we save the uterus? I don't know.
It's looking pretty ratty.
Even if we can fix it, she'd run the risk of it rupturing with a future pregnancy.
I'd just do a hysterectomy.
Well, she's only 23, and I'm not sure her baby's gonna survive.
I'm gonna try and save it.
I'll go scrub, but for the record, this is against my better judgment.
You scrubbing in or not, Maggs? I'm coming.
Oh, hey, Maggie, are you all right? Should I jump in? I'm certified.
I'm fine.
Why does this keep happening? The drugs he took are making his heart stop, and until they clear his system Feels like only yesterday we were waiting to see what college he would get into.
Now We just couldn't let him go through with that plan of his, you know? The the thought of his head just floating in a canister in a warehouse somewhere Shep told me that he tried to talk to you two about this.
- Is that right? - Yeah.
I don't know if it's any comfort, but I was genuinely impressed with how much thought that he had put into this, and how much sense that it made to him.
Please, Dr.
Charles, tell us what we're missing.
Mrs.
Shepard, I've been doing this for a while, and on a good day, I'm just starting to think I might be learning my way around the human mind.
But trying to fathom the thinking of someone that's confronting their own mortality unless you're the one that's looking down that tunnel, I just don't know it's possible.
I think what we need to do is try and listen, understand, and respect that it's their journey to go on alone.
They got his heart back in rhythm.
You should go be with him.
What we need to do? You give us the power to make a decision, and then judge us for making it? Mr.
Shepard, believe me, I'm not judging anybody.
Anyone from rheumatology showed up yet? No.
Lean on them, okay? And run another set of labs.
- Mm-hmm.
- Oh, hey, there, again.
- Hi, Owen.
- Hi, Will.
After we got done in the park, we went to the movies, and then we figured we would come here and wait for Mommy.
Hey, Phillip? Yeah? Not so sure this is the best place for kids, you know? Some scary stuff happens here that maybe they can't unsee.
Oh, yeah.
That's a good point.
Um There we go.
Now there's nothing to unsee.
Right? We told your supervisor we didn't want you treating our daughter anymore.
I know, I just need to check one last thing.
Dr.
Manning.
I'll have to ask you to stay away from this patient.
I was wrong.
Okay, etomidate and ketamine are not the same thing.
A big difference is that etomidate unmasks adrenal insufficiencies.
While ketamine doesn't.
Yes.
You see the pigment spots on Keisha's foot? They are a sign that her adrenal glands are not producing enough cortisol.
100mg of hydrocortisone.
I don't understand.
Cortisol helps the body handle stress.
In its absence, even the stress of being examined by a doctor was enough to plummet Keisha into a coma.
[MACHINE BEEPS.]
BP's improving.
Her color's coming back.
She's trying to open her eyes.
Oh, my baby girl.
She's super cold.
I'm having trouble keeping her pressure up.
You need to pack her up now and get out.
I told you it wasn't worth it.
A knot, and I'm done.
You're pushing it, Dr.
Marcel.
And there, done.
Looks better than I thought.
Let's temp-close and get her upstairs.
Open up a vac sponge.
Maggie? I need to take a minute.
[PANTING.]
Maggs.
Sexton! Scrub in.
[CRYING.]
Hey.
If you need to go home early, I'm more than willing to cover for you.
You cover for me.
Your first day.
[LAUGHING.]
A little constructive criticism, Paula.
You have an insanely inflated sense of your own capabilities.
You know, "I'm certified doing this, so I did my dissertation on that.
" Please! Get out.
I'm sorry, but I refuse to be spoken to like that.
[SOBBING.]
Is she gonna make it? Yeah, she lost a lot of blood, but, yeah, I'm hopeful.
Do we know any more about what happened? The victim's name is Louisa Nash.
She and the assailant were coworkers.
This morning, Ms.
Burke invited Louisa over to give her some old baby clothes.
When her guard was down, she chloroformed her and forcibly removed the baby.
Who would ever do something like that? She lost her son recently to leukemia.
Maybe she had some sort of mental breakdown, I don't know.
We were lucky, we got an anonymous tip about Ms.
Burke, and that helped us find Louisa in time.
Suspect's hand needs redressing.
Is that something you can do here? I got it.
Take care of my baby, okay? Tell him I'll come for him as soon as I can.
This is getting to be a bit of a circus.
[OVERLAPPING CHATTER.]
Here, I'll take you out the back way.
What's going on? They're withdrawing support.
My wife and I decided we're going to honor our son's wishes.
This way, maybe someday, we'll get our son back.
[MONITOR DRONING.]
Time of death, 19:42.
So I'm thinking this might have been precipitated by some kind of underlying cause.
Maybe Addison's disease? I'm gonna have endocrinology come down and see her.
Thought it was clear I was gonna be the primary.
I'm sorry, but once I realized what caused her to crash, I had to act quickly.
I mean, Keisha could've died.
Oh.
My ride's here.
Adrenal crisis should've been on your differential from the start.
It was an odd presentation.
Or you just weren't thinking straight.
I'm gonna want to oversee all your cases moving forward, until we know for sure your TBI isn't adversely affecting your patients.
Are you serious? There's nothing wrong with me.
You don't have the authority.
I was hoping we could do this off-book.
If not, we can formalize it with Lanik and Goodwin.
I'm happy to talk to them.
Natalie It's for your own protection.
Why do I feel like you're punishing me for something else? Ready to go? Yep.
Louisa? Can you open your eyes for me? Hey.
You're at Gaffney Chicago Medical Center, in the ICU.
You sustained some injuries that required us to perform extensive surgery, but you are okay.
Would you like to meet your baby girl? Here she is.
We got lucky, police finding her in time.
Can I trust you to keep a secret? Yeah.
What? You know how that monster was so antsy to get out of here earlier? Mm-hmm.
Well, Dr.
Marcel gave her enough Ativan to knock her out, and while she was, he drew some blood and had her hCG levels checked to see if she really delivered that baby.
- What? - You can't tell anyone, April.
Crockett could get fired.
He's such a badass.
Do you know if he's seeing anybody? No, I don't.
- Paula quit? - Yeah.
She said, and I quote, the ED wasn't a healthy environment for her.
I had a feeling she couldn't cut it.
You chased her off, Maggie.
And I told you that I don't need the help.
You're being stubborn.
I have a hospital to run.
So, if you don't want us to treat you medically, then you're getting help.
- April? - Yeah? Thank you for scrubbing in for me today.
Yeah.
I'd like to start training you to take over the position formally.
Sure, of course.
It'll help me take some stuff off my plate.
Does that mean I'd be working with Dr.
Marcel? Is that a problem? No.
Start tomorrow.
Okay.
Thank you.
Thank you.
Do you really think I'll get better care here than at East Mercy? - Hey.
- Why didn't you wait for me? Because you were still on rounds and Sharon offered me a ride home.
- How did your, um - How'd your surgery go? I didn't get it.
- You didn't? - No.
They're, um, gonna check my wrist again in four weeks to see if I still need a cast.
[KETTLE WHISTLING.]
I'll get that for you.
You best not mess up my Baked Alaska.
No, ma'am.