ER s05e05 Episode Script
Masquerade
Previously on ER: That was a great save.
Actually, I meant being your full-time P.
A.
Great.
I'd love that.
This is more of a formality than anything else.
For you, but you're my only intern.
I admire your fortitude, taking orders from a weasel like Dale.
Your presentation was everything we expected.
This is ridiculous.
Everyone thinks you can.
I'll talk to Dr.
Carter.
I can't start an IV.
I don't know how, never have.
If you ever lie to me again, look for another rotation.
Watch yourself.
Sorry.
She's in active labor.
Water broke in the rig.
Got to play catch.
Jerry, scarfing a little early dinner back there? What? Oh, no.
Good one, Chuny.
- Baby, baby! - Our mother-to-be? Good guess.
First name's Coco.
No last name or address.
- Collapsed in a crosswalk.
- Don't walk, don't talk.
Vitals are stable.
I can feel the head! Mr.
Potato Head! We took a peek, she's not crowning.
Crown me.
I'm the queen.
The prince is coming.
- What's your due date, Coco? - I don't like dates.
Too sweet.
Big one! Big pain! Ever delivered a baby? - No delivery.
- Let's go to Curtain Area 3.
B.
O.
A.
Kit, fetal monitor and baby warmer.
- Hey, Jerry? Page OB for me.
- You got it.
Dude, the eagle has landed.
Oh, Lydia.
I guess you didn't get my memo.
The p.
m.
Shift is not wearing costumes this year.
It scares the patients.
Things have been said about this set of gams, but scary isn't one of them.
It isn't very professional, so if you wouldn't mind changing I actually got some of these little jack-o'-lantern pins if you want to signify the holiday.
Fun.
I'm glad my "no costume" memo made it to some people.
This is my costume.
I'm dressed as a total stiff.
Oh.
Well, I guess I can make an exception.
Four-year-old child with puncture wounds.
- He's not in Trauma? - You wanted the children Get me an intubation tray now.
And I want four units of your blood.
What? Come on, this is funny.
You, of all people, should be able to joke.
I didn't think it was appropriate.
Surgilube on every phone in the ER, that's okay? I'm not in charge of the whole ER, just the Pedes ER.
The joke was on you, Doug, not on the Pedes ER.
But that seems to be one and the same.
What's that supposed to mean? - The memo in my box this morning.
- Yeah? I thought it was your Halloween prank.
What's wrong with this? What? Doug.
"All pediatric patients must be seen by Dr.
Ross prior to discharge.
Dr.
Ross will conduct a daily review on all pediatric patients.
" What's wrong with that? It means you sign off on Kerry Weaver's charts? - Yeah, and Mark.
- Yeah.
So you're psyched.
It's time for a change.
Like me.
I was a Transylvanian bat.
All right.
Enough.
- Good luck.
- Carol, could you come in here? What's up? Coco here claims to be Try for fetal heart tones.
I couldn't find them.
Find them.
Don't lose them.
Look in the Lost and Found.
Cervix isn't dilated.
No adnexal masses.
- She sure looks pregnant.
- I'm having a baby.
I appreciate a normal uterus and two liters of urine in her bladder.
Coco, we'll give you a bedpan.
Can you try and relax and relieve yourself? Shallow breath.
Nature's way.
- Want a Foley? - Yeah.
And a urine tox screen.
Call Psych while you're at it.
I can't believe you're wearing that.
It has got itchy.
But it's my first Halloween.
You were here last year.
I was stuck in the O.
R.
So no trick-or-treating apple-bobbing, hayrides.
- Hayrides? Isn't that how you celebrate Halloween? Riding in a cart full of hay with your sweetie, under the stars? Elizabeth, there are no hay carts in Chicago.
You know what I mean.
Celebrating the night.
Celebrating what? Kids rotting their teeth, getting stomachaches.
People wearing stupid I have a thing against costumes, you know? There must have been someone you wanted to be.
I'm a doctor.
That's who I wanted to be.
Yes, but as a child.
You must have wanted to be a spaceman or a footballer? Nope.
You really are extraordinary, Peter.
How about a knight in shining armor? - No.
- A cowboy? No.
Listen, let's go to Dempsey's.
They've got great food, and what is that? Swing dancing.
Elizabeth, there you are.
My sigmoid volvulus is red-lined and the labs aren't on the chart.
I checked the computer.
All but the electrolytes.
Checking isn't good enough.
The lab said the specimen was hemolyzed.
I'll call Phlebotomy.
Takes too long.
Redraw yourself and hand-carry it to the lab.
Yes, sir.
- Excuse me.
- You'll have to wait.
- Yeah? - I'm looking for Dr.
Greene.
Oh, damn! I needed to save that.
So I can find Dr.
Greene, where? You're gonna have to wait in Chairs.
Okey-doke.
Jerry, has the systems guy taken a look at this yet? He looked, but he didn't touch.
The work order wasn't cosigned.
Lily, what do you got there? This was sitting in the ambulance bay.
Look.
There's all kinds of stuff in this bag too.
Four-by-fours, Steri-Strips, IV tubing.
I'll take care of this.
- Really? You sure? - No worries.
- Thanks.
- Sure.
- Hey, Jerry.
- Hi.
You can't blow it off? Don't get me wrong.
I would love to attend your shindig but this is a Teamster party.
Your eyes are aglow with disability policies.
It's rare that a policy underwriter has an opportunity with a roomful of drunken manual laborers.
Sounds better than chaperoning a dorm party.
Everybody knows the best part of a bad party is sneaking out.
Preferably not alone.
So I might see you later? Or I'll make it up to you.
Dr.
Carter, hi.
I got the elbow films back on Mr Lucy, can you give us a second, please? Sure.
What did you say? I got the elbow films back on Mr.
Cahan and the CBC and chem panel on Ms.
Nicolara.
Thanks.
Looks good.
I thought about you and realized I left this in my car.
For the party? No.
You should start practicing your IVs.
I have been practicing.
Then this should be old hat.
Dr.
Carter, good.
These suckers are heavy.
- What are these? - Tomorrow's conference: "The Acute Abdomen in the Elderly.
" I pulled an ischemic bowel you had a few months ago.
I was hoping you'd present.
Never done that.
It's great experience if you're serious about being Chief Resident.
- Oh, I'm serious.
- I look forward to your presentation.
- Chief Resident.
Pretty cool.
- Yeah, pretty cool.
- Incoming.
- I got it! - What do we got? - Joe Chattarowski, 40.
Drank a quart of vodka.
Called - I need help, doc.
- Exam 2.
Drink every day, Mr.
Chattarowski? Yeah.
But I want to quit.
Are you serious? I'm dead serious.
- Not just looking for a place to sleep? - On my mother's eyes.
Can you admit me for detox, please? I think Miss Knight can help you out with that.
See if you can find him a detox bed.
Then practice on that arm.
Let's transfer him.
Ready? One, two, three.
Average daily census is 150.
We see 275 a day at Bellevue.
Impressive.
We're the second largest emergency department in the world.
I'll show you the trauma rooms.
Hey, Jerry? - Who's that? - With Dr.
Greene? That is Dr.
Litvak from New York.
Dan Litvak? Yeah.
He's here interviewing to be ER Chief.
Oh, my God! Dan Litvak.
He's national chair of the ACEP Panel for Practice Guidelines.
Lead article in last month's annals.
That's good, right? Hey, buddy.
I'm Dr.
Ross.
- What's your name? - Jared.
Pruritic rash from his makeup.
He's covered with hives.
- Has he had hives before? - No.
All right, any swelling in your mouth? Are you having trouble breathing? - My tongue feels big.
- Okay.
BP's 90/60.
Pulse 72.
Let's give him.
2 of sub-q epi, Benadryl 25 IV.
Is he going to be okay? He has a bad allergic reaction.
We'll treat him with IV medication, and watch him for a few hours.
Can I still go trick-or-treating? I don't think so, sweetie.
We'll find some fun stuff to do.
Fun stuff around here sucks.
What did you do with my baby? What did you? Where is my baby? Should I ask? Twenty-two-hundred cc's out so far.
Belly's flat.
I lost my baby.
Haldol, five milligrams I.
M.
Mark, I'm looking for your charts on last month's unscheduled returns.
Yeah.
I put them in your box.
Kerry, this is Dr.
Dan Litvak.
This is Dr.
Kerry Weaver, Interim Chief.
Nice to meet you.
Where are you from, Dr.
Litvak? New York.
Bellevue.
Just here to get a few tips? No, I just had my second interview for the Chief position.
Dr.
Greene is being kind enough to show me around.
Second interview? They want to meet with Dr.
Litvak one more time before tonight's vote.
I thought the vote wasn't until next Wednesday.
I have to hop a plane tonight.
They thought it would be best to know beforehand.
That's great.
The sooner the better.
I guess I'll just check my mailbox.
That's the competition, huh? Did you get that detox bed? No one called me back yet.
Got a flash and I am in.
Yes, you are.
I'm ready for the real thing.
Let's find out.
I'll talk you through Mr.
Chattarowski.
Okay.
Make sure we don't repeat our last IV fiasco.
Definitely won't happen again.
- It was my fault as much as yours.
- I wouldn't say that.
I should've supervised you and not let you get to that place.
From now on, we'll just take it one step at a time.
Carter, your drunk eloped.
- Chattarowski? - Does that mean he left? - Yep.
- Does anyone else need an IV? I've got it.
You wanted to be a superhero.
Tights, cape.
Yeah, wrong.
There was someone, wasn't there? Hey, look who's here.
Bye-bye, cutie-pie.
Hey, little bee.
Gosh, he's getting so big.
I know.
Eating me out of house and home.
- I didn't expect you.
- Just left Walt and Jackie's.
The annual blowout? I told Walt he should just put on one of his super-duper fly outfits he wore in the '70s.
That brother thinks polyester's gonna make a comeback.
Speaking of costumes, do you have any film left? Yes.
We should have one with his daddy.
- Absolutely.
- Would you do it? Sure.
Okay, ready? Feeling any better? All right, I guess.
What did you? What did you give me? Haldol, to calm you down.
I can't take that.
It's not good for my baby.
Coco, you don't have a baby.
But I will, really.
I'm in my first trimester.
Coco, you're not pregnant.
You were just retaining urine.
Carol.
You did a pregnancy test, didn't you? I'm starting to wish I had.
I'm schizophrenic and I had been taking respiradone.
But when I found out I was pregnant, I went off the medication so that the baby would be okay.
What will the Haldol do to the baby? If in fact you are pregnant there are reports of limb malformation.
Oh, my God! I'm so sorry, baby.
Aorta's clamped, pericardium's dry.
It looks like the heart is still empty.
Get two more units.
Chest tube's gushing.
It's over two liters.
Could be a hilar injury.
Let's set up for a right-sided thoracotomy.
Move! Ten blade.
We'll do a clamshell.
Call the blood bank for O-neg, and type-specific.
Rib-spreader.
Peter, cut across the sternum.
- I need a Lebsche knife.
- A what? A Lebsche and a mallet.
Move! Look.
Top drawer by the sink.
What you really need is a sternal saw.
A sternal saw is a tool for the O.
R.
, not the ER.
You know that.
Chest is full of blood.
Vascular clamp, more suction.
All right.
Can you locate the source? Move your hand.
Four units in.
Come on, Peter.
He's losing it faster than we can put it in.
- Damn! - Type-specific's here.
- Hang it on rapid infuser.
- I'm almost there.
Looks like right atrium.
Vicryl now! Move! There were faster ways to do that.
I am pregnant.
The test confirmed it.
We don't know if the Haldol affected the fetus.
We'll monitor the pregnancy with ultrasound.
Maybe I shouldn't have a baby.
Because of the Haldol? I didn't even tell my mom, you know? It was like she was so proud that I was in a halfway house.
I thought it would be okay.
I thought I could go off my meds, but I can't, can I? You'll probably have more incidents like this one.
I shouldn't go through with this.
You've been through a lot in a short amount of time.
Maybe you should just wait.
I shouldn't do this.
I shouldn't do this.
Think she'll terminate her pregnancy? That's the impression I got.
Probably be the best for her, and for you.
Yeah, it gets me off the hook.
Do you want to have a drink later? Decompress? I would, but Jen's back in town, and we have to have one of our "talks.
" It's not your day, Mark.
You can go now, Lucy.
We're caught up around here.
What about the Pedes ER? It's standing room only.
Doug Ross is in the groove, huh? No, you'd probably just slow him down.
Great.
It gives me more time to prepare for the party.
I'm sorry.
I didn't mean to upset the officer.
Found him back with a bottle of Night Train at Lucky's.
You need a revolving door here.
Well, well, well.
Long time no see, Mr.
Chattarowski.
So you know this guy? Yeah, had him in earlier.
Came in to get detoxed then left before we were finished.
- Next time I'll call the cops.
We can take it from here.
You're off anyway.
- Thanks.
- Curtain Area 2.
Mr.
Chattarowski, I'm Dr.
Greene.
This is Nurse Hathaway.
We'd like to welcome you back.
I know I screwed up, doc.
I'm a screwup by nature.
I want to make a clean start.
I really do.
You won't make a very clean start with booze in your hand.
That was my last drink.
I'm not gonna poison myself no more.
I promise.
Other than bloodshot, the eyes look okay.
Lean forward.
I'm gonna get clean and sober, doc.
You gotta be quiet so I can hear your lungs.
BP's 130 palp.
Mr.
Chattarowski, I'm gonna try and get you a detox bed.
But promise me you'll stay.
I promise.
I really do.
I'm gonna get clean and sober.
If you could just scoot over to this bed for me.
You think he'll stay? I was a cynic with Miss Coco and we saw how that worked out.
So karmically, I have to believe this guy.
Okay, Dr.
Karma.
But I'm gonna lock up his clothes so it's harder for him to escape this time.
Good idea.
Amanda, you have to stay still.
It'll only hurt for a second.
No, Daddy! - I'll give you some stickers.
- I don't want stickers, Daddy! - Is this really necessary? - Unfortunately, it is.
We have to take blood to do the test.
I want to go home.
- Everything all right? - Yes, fine.
My little girl's afraid of needles.
Is there a way to test her without all this? Yes, there is.
- What have we got? - Barbie Kligman, 11 -year-old, MVA.
Back-seat passenger with a lap belt.
complains of abdominal pain.
BP 105/70.
Pulse 95.
Let's get a CBC, Chem-20, type and hold and dip a urine.
Barbie, does your neck hurt? No.
Just my stomach.
Pulse ox is 98 on room air.
- Chest is clear.
- Okay.
Dale okay with this? Shouldn't be a problem.
Pupils are 5 mm and react to light.
Will she be okay? We're taking care of her.
- Pretty good seat-belt contusion.
- Yeah.
- Bowel sounds are absent.
- Hemoglobin's 14.
1.
- Listen, does this hurt? - Ow! - What? - She has a bruise that's often associated with small bowel injuries.
We'll do a CAT scan of the belly, but she may need exploratory surgery.
- Oh, my God.
- You'll be okay, Barbie.
Mommy and Daddy are here for you, okay? That's all it takes? The machine delivers lidocaine to the skin by iontophoresis.
No needles.
Dr.
Weaver, we meet again.
I thought you had a plane to catch.
Flight delay.
Hanging out here beats watered-down airport cocktails.
Can I play fly on the wall? Dr.
Ross' Pedes room.
Sure.
Hang out.
Here we go, sweetheart.
How are you, Amanda? - Okay.
- You're okay? Now this pad puts your skin to sleep.
You're not gonna feel anything.
Now, close your eyes, sweetheart.
You feel anything? - No.
- Okay.
That's amazing.
We tried numbing it with cream but it takes an hour.
This is great.
It really is.
What's it called again? Numby.
We did the phase-three clinical trials at Bellevue.
We've been using it for over a year now.
Hey, Dr.
Carter.
Nice costume.
I feel kind of lame.
Nobody dressed up.
Well, it's early yet.
People may still show.
The flier said 8.
Remember, these are med students.
They're busy.
Want me to get you some punch? Oh, later.
I gotta pull articles at the library for this conference tomorrow.
Think this party can chaperone itself? - I'll look after things for you.
- Why don't you do that? - How old is this girl? - 11.
- What's the glitter on her face? - She's a princess.
- Dale, get a clamp on that.
- Babcock, please.
There's a little bleeding around the duodenum.
Let's cauterize and explore the retroperitoneum.
Bovie.
- What are you doing for Halloween? - Nothing special.
I know a motel on Route 22.
Jungle-theme rooms.
- Metz.
- Ask for room 14.
Hanging vines.
You Tarzan, she Jane.
Know what I mean? I think we'll just stay in town.
- The pancreas looks good.
- No renal injuries here.
Hold on.
There's infrarenal mass.
Looks like a lumbar node.
Doesn't feel right.
Too rubbery.
There's one on this side too.
Could be lymphoma.
All right, let's send for a biopsy.
Number 15.
Everything okay on the wards? - Yes.
May I scrub in? - We could use your help.
Wonderful.
We just biopsied an abnormal lymph node on Barbie.
Why don't you take this specimen to Pathology and wait on the results.
Signed in three more kids.
We're stacked.
- We're getting to them.
- We need the main ER for the overflow.
I have to see these kids.
You saw Kerry.
It's a busy night, Doug.
You can't see them all by yourself.
Send the overflow to the main ER, but send me the kids' charts.
Of course.
The sickest ones, send them to me.
I wouldn't do it any other way.
What are you doing back so early? Me and Ariel are sick of trick-or- treating and Mom's running late.
- What are you watching? - Family Love Triangles.
- Educational TV, huh? - Yeah.
Mom says when we move to St.
Louis she's only gonna let me watch an hour of television a day.
When you move to St.
Louis? You didn't know? I think that's why Mom wanted to see you.
So it's a done deal then? My room will be twice as big.
And there's a park across the street for the dogs.
- Sounds nice.
- It's really pretty there.
Please don't tell her I told you, okay? Hey, my lips are sealed.
Repair transversely with running Vicryl 3-0.
Gentlemen, I have the results of your biopsy.
Guess what we saw under the microscope.
- Gotta be Hodgkin's.
- No.
- Metastatic adeno? - Wrong again.
Seminiferous tubules.
- What? - You're kidding? You biopsied two testicles.
It seems that Barbie is a boy.
Who knew there were so many texts on the bowel? This is just what I could get my hands on.
I suppose with all this intense interest that means our bowels are in good hands for many years to come, right? That's a nice thought.
Hey, sounds like the party's up and running.
Yeah! Dr.
Carter, the party picked up.
The beers are right there.
Nice aim, dude.
You almost put out the fire with that one.
Hey, Dr.
Carter.
Thanks, dude.
Okay, kids, that's it.
Party's over.
You can't stay here.
What's up? Were we too loud? - No, the furniture was too on fire.
- Oh, really? I'm sorry.
I'll be in my room studying.
Happy Halloween! She did it to me again.
She's in escrow and I heard about it from Rachel.
Maybe she was gonna tell you tonight? Maybe.
Or maybe she was just going to send me a postcard from St.
Louis.
You really had a good time with Rachel? Yeah.
Yeah, I did.
How's Chattarowski's detox search? They're all out of beds on Four East but I stood my ground and insisted that he was a good detox candidate.
They finally gave him a place on Four West.
You must owe them some favors.
A couple.
But it was worth it.
Well, you tried, you know? When we explored the retroperitoneum we discovered two small masses.
Masses? What kind of masses? We were concerned, so we sent down a frozen section of the biopsy that revealed testicular tissue.
What does that mean? Barbie has a condition called testicular feminization.
Genetically, she's a male with XY chromosomes.
During development, the fetal tissue was resistant to testosterone and the external genitalia developed as female.
There's gotta be a mistake.
No mistake.
The vagina's nothing but a blind pouch.
No uterus or ovaries.
She'll need to be on estrogen replacement therapy.
My little girl has testicles? We removed them because of the high incidence of malignant transformation.
I don't understand.
I changed her diapers.
I know every inch of her.
She's a boy? The genetics don't matter.
You've raised Barbie as a girl.
It's what she looks like.
It's her identity.
Nothing will change that.
But you have to understand that she'll never menstruate or bear children.
Obviously this has come as a shock.
You'll need time to adjust.
Barbie's recovering.
We'll refer you to a genetic counselor.
They'll help you decide when and how to tell her.
Thank you, doctor.
Nice job.
Thank you.
You forgot to mention they'll have to change Barbie's name to Ken.
After the day I've had, just line them up.
Word.
That's how you gotta do it.
Work hard, play hard.
I deserve to play hard.
I had to check all the stool samples for fecal leukocytes, dude.
You think that's bad? My Resident had me give physical exams to these homeless shelter guys.
One had maggots crawling all over an abscess.
At least your Residents acknowledge you.
Mine don't even know I'm here.
I get more respect from this rubber arm.
We might have saved this guy with the saw.
We could've cut the sternum in two seconds instead of chiseling for a minute.
The guy was dead.
A few seconds wouldn't have saved him.
It would've given him a chance.
We are not going to waste time training ER docs on equipment they'll use once a year.
If we had the saw, we could give midline thoracotomies for all penetrating chest traumas.
That's not the standard of care.
The standard of care gives miserable results.
If they arrest in the ambulance, If they arrest in the ER, Midline thoracotomy gives us better exposure to repair cardiac injuries.
If you're so damned interested in this, do a study.
- I will.
- Good.
I know the guy from Surgery to help you.
Peter? Kerry and I were discussing a study between ER and Surgery.
- A study? - Midline thoracotomy for chest trauma.
Is this because of today? Draw up a proposal with a budget and give it to me in two weeks.
- I will.
- Good.
Okay.
I don't think ER docs should play with a sternal saw.
- Neither do I.
- Then why support her? I'm not.
She'll spin her wheels, write a proposal and it won't pass the Human Subjects Committee in a million years.
- M&M? - Oh, no, no.
Listen, I made reservations at Dempsey's for 10.
Peter, I don't know.
I'm pretty swamped.
What? It's Halloween.
Yeah, but Dempsey's isn't really Halloween-y.
No, it'll keep.
Walt, what's up, man? It's me.
Listen, I need to ask you a favor.
See this one? That's the bull rider.
Oh, right.
The cute cowboy.
Dad! Rach, did I hear your order right? You hate rhubarb and walnuts.
I like it now.
Dad makes good pie.
- He always did.
- Jen, you trying to butter me up? No.
I just remember your mom's famous rhubarb pie recipe.
Sorry you're working with a cold.
Are you holding up? Yeah, it's just my sinuses.
Why don't you go wash your hands? Okay.
St.
Louis, huh? - She told you? - Slipped out.
It's a great job, Mark.
The schools are top-rate and It sounds good.
I was ready for a fight.
I think we've done enough fighting for a lifetime, don't you? Yeah.
In a perfect world we could both spend 365 days a year with her.
But we can't.
- St.
Louis isn't very far.
- No.
And I'll have holidays and summers.
Spending time with her this summer has made me think about how we've spent way too much time thinking about ourselves.
She told me you guys got along really well.
Yeah.
Yeah, it was It was a lot of fun.
Thank you.
Is it still Halloween? Yes.
You have a few more hours left.
I guess I won't be able to go trick-or-treating.
Not this year.
I'm sorry.
Some day, huh? That's okay.
The best part was making the costume anyway.
Me and my mom made it together.
Do you still have my tiara? Yes.
Yes, right here.
Wait.
Let me do that.
There.
How do I look? Like a beautiful fairy princess.
No! Drink up, Bernie.
Some people cannot hold their liquor! We should mess with his mind.
You mean the hand in the warm water trick? Not on the couch, Lucy.
Come on.
I got it.
I got it.
Come on, stop it.
Do you think he's okay? Yeah.
He's just a lightweight, that's all.
He has a strong pulse and he's still breathing.
You've been in the ER way too long.
Let's get this party started right! Willie? Willie? Shaving his head? That would be cruel and unusual.
This is mean.
This is mean! You ain't seen nothing yet.
Even drunk, that should still work.
No.
Stop, stop.
Wait, wait.
Willie? - Willie? - Willie, wake up! Someone needs to call 911, and go get Carter.
Get real.
If we call Carter, he'll narc.
Willie's in trouble.
We need to do something.
Bernie's right.
We can handle this.
This is not class, this is our friend.
You guys call 911.
I'm gonna go get Carter.
Dr.
Carter? Wake up, Dr.
Carter! Wake up! Okay, everybody back off.
Give him some air.
- Anybody call 911? - I did, Dr.
Carter.
Come on, Willie, wake up.
Wake up! A weak pulse, but he's not breathing.
Oh, man.
Gross! Can I do anything? What can I do? He vomited.
That's good, right? No, that's bad.
If he vomits and it gets in his lungs, he'll die of aspiration pneumonia.
His parents live in Downers Grove.
Give them a call.
We're up here! Second floor! "X"? What's that? - It's liquid Ecstasy.
- What is that? It's a narcotic.
Anybody else take it? I didn't know Willie took it.
- Branch took some earlier.
- I can't leave Willie.
I'll go.
It was clean.
They showed the replay a million times.
- It was a joke how offsides they were! - Dreamer.
Pay up.
- That was Lucky Liquor.
- A vagrant's best friend? They have a guy in a county patient gown trying to buy beer.
Whatever happened to "No shirt, no shoes, no service"? They'll stall him until someone comes for him but they won't hang on all day.
Tell you what Hey, Grabarsky.
You go and pick this guy up and we're even.
- How's that? - This drunk a friend? No, but he owes me more than you.
Consider him admitted.
- Where is he? - He went to take a shower.
- How's Willie? - Paramedics intubated him.
Liquid Ecstasy.
You'd think med students would know better.
Yeah, you would.
Branch! Branch! Branch, wake up! Let's get him out of here.
- He's not moving air.
- No pulse.
- Damn it! - I'll start chest compressions.
Where's the syringe? - Find the paramedics.
I'll do CPR.
- Okay.
Mr.
Lubin just spiked to 101.
4.
Go ahead and draw a fever workup.
Draw Setzer for a pre and post gentamicin level with the 11:00 dose.
- How's it going? - We're rather busy.
But I've got a great little intern helping me out.
Dale, listen.
It's 10:30 and you're not even on.
So sign out the scut.
That's what the on-call team is for.
Unless you have a problem with that? That's fine.
You ready? Give me 10 minutes to get back into my costume.
- You're really gonna wear it? - Of course.
Okay.
When you're ready, I'll be out front.
Tell me you wanted to be an airline pilot.
I don't even like taking the puddle-jumper to Cleveland.
Hurry up.
This is police harassment! Remember Rodney King! Dr.
G, here's your man.
Put up quite a fight.
Said it's Halloween and he's just playing dress up.
I am! Grabarsky, it's the wrong guy.
Lucky Liquor.
Big guy in a hospital gown.
He kind of looks like Jerry! Lloyd.
- What are you doing here? - Who's Lloyd? I'm that knucklehead's cousin.
Who knew they'd hit the genetic Powerball twice? Jerry? See, he needed a costume and there's a contest at the Elks Lodge I won "Honorable Mention," cuz.
Congratulations.
Need anything else, Doug? Other than a 48-hour day? I'm leaving.
See you bright and early.
- Bright and early.
- Yep.
- Doug, you did a nice job today.
- Not bad for a rookie Attending.
Let's see how you do with these.
What's that? Overflow charts for the pediatric patients in the main ER.
According to policy, you need to sign off on them.
You're loving this, aren't you? This Pedes ER isn't such a bad idea after all.
Happy Halloween, rookie.
Branch Crockett and Willie Goldman, ages 22 and 23.
Mixed overdose of alcohol and GHB.
Willie's intubated from a respiratory arrest.
Branch came back with epi after a full arrest.
A little late-night club-hopping? No, med school Halloween party.
All right, everybody.
On my count: One, two, three.
CBC, ABG, lytes, blood alcohol tox screen and a 12-lead.
Call Respiratory for a vent.
Someone call his parents.
- Lucy can do that.
- No, I'll help.
You're drunk.
You don't belong in here.
Now, get out.
Peter, have you gone completely balmy? Just getting funky.
Hey, meet my nephew, Peanut.
- Nice to meet you.
- Hello.
It's a hayride? - It's a hayride.
- So where to, Uncle Pete? Michigan Ave.
Pop that 8-track in.
Solid.
You don't get it? You never figured out who I wanted to be as a kid.
Oh, my God! Shaft! John Shaft.
Hey, Dr.
Weaver.
Off to enjoy All Hallows Eve? Actually, I am.
I just wanted to give you this bill.
$289?! You're lucky the wheelchair wasn't damaged.
It could've been worse.
I don't have 300 bucks.
I've arranged to take it out of your paycheck.
$28.
90 a week for the next 10 weeks.
That'll run right into the holidays.
Kerry, got a second? Yeah.
What's going on? I wanted to give you a heads-up on the committee vote.
That won't be announced until tomorrow.
Well, they've tallied it already, and they voted for Litvak.
They're gonna have to widen the office door for his swollen head.
Yeah, he's kind of an ass, isn't he? Well, if it means anything, I voted for you.
Thanks, Mark.
Which paycheck does this become effective? You know what? It doesn't.
- Are you serious? - I'm dead serious.
Give your cousin a wheelchair, give your maiden aunt a rapid infuser.
I don't give a damn.
You're getting obsessive.
Did I hand you angiocaths? - Yeah.
A gross.
- What's a gross? One-forty-four, and you did.
Are you listening? Yes, I am.
All work and no play makes Doug a dull boy.
Look at this.
I ordered three cases of Pedialyte, not Pediazole.
Doug, you all right? Oh, my God! Hold it! Put pressure on it! You bastard.
You can dish it out, you can't take it.
- Payback is a bitch, isn't it? - You suck.
Good evening.
I want to suck your blood.
No, I'm not kissing back.
Hey, Dr.
Carter.
Lucy.
How are they? They'll be fine.
I don't know what happened.
One second we were hanging out, then What happened was two of your classmates almost died.
I didn't know they were doing GHB.
You were in charge of the party.
I broke it up when things got out of hand.
You continued to party.
Two guys rolled out of here on gurneys.
Did I miss anything? The part about me not being able to police everyone.
And about you being the Resident Adviser and the one in charge.
You're right, Lucy.
I'm in charge.
It was stupid of me to think you were mature enough to take responsibility.
I never knew you didn't have rhythm.
You're messing up the greatest song.
Here we go.
- What is that? - It's my tambourine! That's a tambourine? Come on, come on, come on.
Get some rhythm in here.
Actually, I meant being your full-time P.
A.
Great.
I'd love that.
This is more of a formality than anything else.
For you, but you're my only intern.
I admire your fortitude, taking orders from a weasel like Dale.
Your presentation was everything we expected.
This is ridiculous.
Everyone thinks you can.
I'll talk to Dr.
Carter.
I can't start an IV.
I don't know how, never have.
If you ever lie to me again, look for another rotation.
Watch yourself.
Sorry.
She's in active labor.
Water broke in the rig.
Got to play catch.
Jerry, scarfing a little early dinner back there? What? Oh, no.
Good one, Chuny.
- Baby, baby! - Our mother-to-be? Good guess.
First name's Coco.
No last name or address.
- Collapsed in a crosswalk.
- Don't walk, don't talk.
Vitals are stable.
I can feel the head! Mr.
Potato Head! We took a peek, she's not crowning.
Crown me.
I'm the queen.
The prince is coming.
- What's your due date, Coco? - I don't like dates.
Too sweet.
Big one! Big pain! Ever delivered a baby? - No delivery.
- Let's go to Curtain Area 3.
B.
O.
A.
Kit, fetal monitor and baby warmer.
- Hey, Jerry? Page OB for me.
- You got it.
Dude, the eagle has landed.
Oh, Lydia.
I guess you didn't get my memo.
The p.
m.
Shift is not wearing costumes this year.
It scares the patients.
Things have been said about this set of gams, but scary isn't one of them.
It isn't very professional, so if you wouldn't mind changing I actually got some of these little jack-o'-lantern pins if you want to signify the holiday.
Fun.
I'm glad my "no costume" memo made it to some people.
This is my costume.
I'm dressed as a total stiff.
Oh.
Well, I guess I can make an exception.
Four-year-old child with puncture wounds.
- He's not in Trauma? - You wanted the children Get me an intubation tray now.
And I want four units of your blood.
What? Come on, this is funny.
You, of all people, should be able to joke.
I didn't think it was appropriate.
Surgilube on every phone in the ER, that's okay? I'm not in charge of the whole ER, just the Pedes ER.
The joke was on you, Doug, not on the Pedes ER.
But that seems to be one and the same.
What's that supposed to mean? - The memo in my box this morning.
- Yeah? I thought it was your Halloween prank.
What's wrong with this? What? Doug.
"All pediatric patients must be seen by Dr.
Ross prior to discharge.
Dr.
Ross will conduct a daily review on all pediatric patients.
" What's wrong with that? It means you sign off on Kerry Weaver's charts? - Yeah, and Mark.
- Yeah.
So you're psyched.
It's time for a change.
Like me.
I was a Transylvanian bat.
All right.
Enough.
- Good luck.
- Carol, could you come in here? What's up? Coco here claims to be Try for fetal heart tones.
I couldn't find them.
Find them.
Don't lose them.
Look in the Lost and Found.
Cervix isn't dilated.
No adnexal masses.
- She sure looks pregnant.
- I'm having a baby.
I appreciate a normal uterus and two liters of urine in her bladder.
Coco, we'll give you a bedpan.
Can you try and relax and relieve yourself? Shallow breath.
Nature's way.
- Want a Foley? - Yeah.
And a urine tox screen.
Call Psych while you're at it.
I can't believe you're wearing that.
It has got itchy.
But it's my first Halloween.
You were here last year.
I was stuck in the O.
R.
So no trick-or-treating apple-bobbing, hayrides.
- Hayrides? Isn't that how you celebrate Halloween? Riding in a cart full of hay with your sweetie, under the stars? Elizabeth, there are no hay carts in Chicago.
You know what I mean.
Celebrating the night.
Celebrating what? Kids rotting their teeth, getting stomachaches.
People wearing stupid I have a thing against costumes, you know? There must have been someone you wanted to be.
I'm a doctor.
That's who I wanted to be.
Yes, but as a child.
You must have wanted to be a spaceman or a footballer? Nope.
You really are extraordinary, Peter.
How about a knight in shining armor? - No.
- A cowboy? No.
Listen, let's go to Dempsey's.
They've got great food, and what is that? Swing dancing.
Elizabeth, there you are.
My sigmoid volvulus is red-lined and the labs aren't on the chart.
I checked the computer.
All but the electrolytes.
Checking isn't good enough.
The lab said the specimen was hemolyzed.
I'll call Phlebotomy.
Takes too long.
Redraw yourself and hand-carry it to the lab.
Yes, sir.
- Excuse me.
- You'll have to wait.
- Yeah? - I'm looking for Dr.
Greene.
Oh, damn! I needed to save that.
So I can find Dr.
Greene, where? You're gonna have to wait in Chairs.
Okey-doke.
Jerry, has the systems guy taken a look at this yet? He looked, but he didn't touch.
The work order wasn't cosigned.
Lily, what do you got there? This was sitting in the ambulance bay.
Look.
There's all kinds of stuff in this bag too.
Four-by-fours, Steri-Strips, IV tubing.
I'll take care of this.
- Really? You sure? - No worries.
- Thanks.
- Sure.
- Hey, Jerry.
- Hi.
You can't blow it off? Don't get me wrong.
I would love to attend your shindig but this is a Teamster party.
Your eyes are aglow with disability policies.
It's rare that a policy underwriter has an opportunity with a roomful of drunken manual laborers.
Sounds better than chaperoning a dorm party.
Everybody knows the best part of a bad party is sneaking out.
Preferably not alone.
So I might see you later? Or I'll make it up to you.
Dr.
Carter, hi.
I got the elbow films back on Mr Lucy, can you give us a second, please? Sure.
What did you say? I got the elbow films back on Mr.
Cahan and the CBC and chem panel on Ms.
Nicolara.
Thanks.
Looks good.
I thought about you and realized I left this in my car.
For the party? No.
You should start practicing your IVs.
I have been practicing.
Then this should be old hat.
Dr.
Carter, good.
These suckers are heavy.
- What are these? - Tomorrow's conference: "The Acute Abdomen in the Elderly.
" I pulled an ischemic bowel you had a few months ago.
I was hoping you'd present.
Never done that.
It's great experience if you're serious about being Chief Resident.
- Oh, I'm serious.
- I look forward to your presentation.
- Chief Resident.
Pretty cool.
- Yeah, pretty cool.
- Incoming.
- I got it! - What do we got? - Joe Chattarowski, 40.
Drank a quart of vodka.
Called - I need help, doc.
- Exam 2.
Drink every day, Mr.
Chattarowski? Yeah.
But I want to quit.
Are you serious? I'm dead serious.
- Not just looking for a place to sleep? - On my mother's eyes.
Can you admit me for detox, please? I think Miss Knight can help you out with that.
See if you can find him a detox bed.
Then practice on that arm.
Let's transfer him.
Ready? One, two, three.
Average daily census is 150.
We see 275 a day at Bellevue.
Impressive.
We're the second largest emergency department in the world.
I'll show you the trauma rooms.
Hey, Jerry? - Who's that? - With Dr.
Greene? That is Dr.
Litvak from New York.
Dan Litvak? Yeah.
He's here interviewing to be ER Chief.
Oh, my God! Dan Litvak.
He's national chair of the ACEP Panel for Practice Guidelines.
Lead article in last month's annals.
That's good, right? Hey, buddy.
I'm Dr.
Ross.
- What's your name? - Jared.
Pruritic rash from his makeup.
He's covered with hives.
- Has he had hives before? - No.
All right, any swelling in your mouth? Are you having trouble breathing? - My tongue feels big.
- Okay.
BP's 90/60.
Pulse 72.
Let's give him.
2 of sub-q epi, Benadryl 25 IV.
Is he going to be okay? He has a bad allergic reaction.
We'll treat him with IV medication, and watch him for a few hours.
Can I still go trick-or-treating? I don't think so, sweetie.
We'll find some fun stuff to do.
Fun stuff around here sucks.
What did you do with my baby? What did you? Where is my baby? Should I ask? Twenty-two-hundred cc's out so far.
Belly's flat.
I lost my baby.
Haldol, five milligrams I.
M.
Mark, I'm looking for your charts on last month's unscheduled returns.
Yeah.
I put them in your box.
Kerry, this is Dr.
Dan Litvak.
This is Dr.
Kerry Weaver, Interim Chief.
Nice to meet you.
Where are you from, Dr.
Litvak? New York.
Bellevue.
Just here to get a few tips? No, I just had my second interview for the Chief position.
Dr.
Greene is being kind enough to show me around.
Second interview? They want to meet with Dr.
Litvak one more time before tonight's vote.
I thought the vote wasn't until next Wednesday.
I have to hop a plane tonight.
They thought it would be best to know beforehand.
That's great.
The sooner the better.
I guess I'll just check my mailbox.
That's the competition, huh? Did you get that detox bed? No one called me back yet.
Got a flash and I am in.
Yes, you are.
I'm ready for the real thing.
Let's find out.
I'll talk you through Mr.
Chattarowski.
Okay.
Make sure we don't repeat our last IV fiasco.
Definitely won't happen again.
- It was my fault as much as yours.
- I wouldn't say that.
I should've supervised you and not let you get to that place.
From now on, we'll just take it one step at a time.
Carter, your drunk eloped.
- Chattarowski? - Does that mean he left? - Yep.
- Does anyone else need an IV? I've got it.
You wanted to be a superhero.
Tights, cape.
Yeah, wrong.
There was someone, wasn't there? Hey, look who's here.
Bye-bye, cutie-pie.
Hey, little bee.
Gosh, he's getting so big.
I know.
Eating me out of house and home.
- I didn't expect you.
- Just left Walt and Jackie's.
The annual blowout? I told Walt he should just put on one of his super-duper fly outfits he wore in the '70s.
That brother thinks polyester's gonna make a comeback.
Speaking of costumes, do you have any film left? Yes.
We should have one with his daddy.
- Absolutely.
- Would you do it? Sure.
Okay, ready? Feeling any better? All right, I guess.
What did you? What did you give me? Haldol, to calm you down.
I can't take that.
It's not good for my baby.
Coco, you don't have a baby.
But I will, really.
I'm in my first trimester.
Coco, you're not pregnant.
You were just retaining urine.
Carol.
You did a pregnancy test, didn't you? I'm starting to wish I had.
I'm schizophrenic and I had been taking respiradone.
But when I found out I was pregnant, I went off the medication so that the baby would be okay.
What will the Haldol do to the baby? If in fact you are pregnant there are reports of limb malformation.
Oh, my God! I'm so sorry, baby.
Aorta's clamped, pericardium's dry.
It looks like the heart is still empty.
Get two more units.
Chest tube's gushing.
It's over two liters.
Could be a hilar injury.
Let's set up for a right-sided thoracotomy.
Move! Ten blade.
We'll do a clamshell.
Call the blood bank for O-neg, and type-specific.
Rib-spreader.
Peter, cut across the sternum.
- I need a Lebsche knife.
- A what? A Lebsche and a mallet.
Move! Look.
Top drawer by the sink.
What you really need is a sternal saw.
A sternal saw is a tool for the O.
R.
, not the ER.
You know that.
Chest is full of blood.
Vascular clamp, more suction.
All right.
Can you locate the source? Move your hand.
Four units in.
Come on, Peter.
He's losing it faster than we can put it in.
- Damn! - Type-specific's here.
- Hang it on rapid infuser.
- I'm almost there.
Looks like right atrium.
Vicryl now! Move! There were faster ways to do that.
I am pregnant.
The test confirmed it.
We don't know if the Haldol affected the fetus.
We'll monitor the pregnancy with ultrasound.
Maybe I shouldn't have a baby.
Because of the Haldol? I didn't even tell my mom, you know? It was like she was so proud that I was in a halfway house.
I thought it would be okay.
I thought I could go off my meds, but I can't, can I? You'll probably have more incidents like this one.
I shouldn't go through with this.
You've been through a lot in a short amount of time.
Maybe you should just wait.
I shouldn't do this.
I shouldn't do this.
Think she'll terminate her pregnancy? That's the impression I got.
Probably be the best for her, and for you.
Yeah, it gets me off the hook.
Do you want to have a drink later? Decompress? I would, but Jen's back in town, and we have to have one of our "talks.
" It's not your day, Mark.
You can go now, Lucy.
We're caught up around here.
What about the Pedes ER? It's standing room only.
Doug Ross is in the groove, huh? No, you'd probably just slow him down.
Great.
It gives me more time to prepare for the party.
I'm sorry.
I didn't mean to upset the officer.
Found him back with a bottle of Night Train at Lucky's.
You need a revolving door here.
Well, well, well.
Long time no see, Mr.
Chattarowski.
So you know this guy? Yeah, had him in earlier.
Came in to get detoxed then left before we were finished.
- Next time I'll call the cops.
We can take it from here.
You're off anyway.
- Thanks.
- Curtain Area 2.
Mr.
Chattarowski, I'm Dr.
Greene.
This is Nurse Hathaway.
We'd like to welcome you back.
I know I screwed up, doc.
I'm a screwup by nature.
I want to make a clean start.
I really do.
You won't make a very clean start with booze in your hand.
That was my last drink.
I'm not gonna poison myself no more.
I promise.
Other than bloodshot, the eyes look okay.
Lean forward.
I'm gonna get clean and sober, doc.
You gotta be quiet so I can hear your lungs.
BP's 130 palp.
Mr.
Chattarowski, I'm gonna try and get you a detox bed.
But promise me you'll stay.
I promise.
I really do.
I'm gonna get clean and sober.
If you could just scoot over to this bed for me.
You think he'll stay? I was a cynic with Miss Coco and we saw how that worked out.
So karmically, I have to believe this guy.
Okay, Dr.
Karma.
But I'm gonna lock up his clothes so it's harder for him to escape this time.
Good idea.
Amanda, you have to stay still.
It'll only hurt for a second.
No, Daddy! - I'll give you some stickers.
- I don't want stickers, Daddy! - Is this really necessary? - Unfortunately, it is.
We have to take blood to do the test.
I want to go home.
- Everything all right? - Yes, fine.
My little girl's afraid of needles.
Is there a way to test her without all this? Yes, there is.
- What have we got? - Barbie Kligman, 11 -year-old, MVA.
Back-seat passenger with a lap belt.
complains of abdominal pain.
BP 105/70.
Pulse 95.
Let's get a CBC, Chem-20, type and hold and dip a urine.
Barbie, does your neck hurt? No.
Just my stomach.
Pulse ox is 98 on room air.
- Chest is clear.
- Okay.
Dale okay with this? Shouldn't be a problem.
Pupils are 5 mm and react to light.
Will she be okay? We're taking care of her.
- Pretty good seat-belt contusion.
- Yeah.
- Bowel sounds are absent.
- Hemoglobin's 14.
1.
- Listen, does this hurt? - Ow! - What? - She has a bruise that's often associated with small bowel injuries.
We'll do a CAT scan of the belly, but she may need exploratory surgery.
- Oh, my God.
- You'll be okay, Barbie.
Mommy and Daddy are here for you, okay? That's all it takes? The machine delivers lidocaine to the skin by iontophoresis.
No needles.
Dr.
Weaver, we meet again.
I thought you had a plane to catch.
Flight delay.
Hanging out here beats watered-down airport cocktails.
Can I play fly on the wall? Dr.
Ross' Pedes room.
Sure.
Hang out.
Here we go, sweetheart.
How are you, Amanda? - Okay.
- You're okay? Now this pad puts your skin to sleep.
You're not gonna feel anything.
Now, close your eyes, sweetheart.
You feel anything? - No.
- Okay.
That's amazing.
We tried numbing it with cream but it takes an hour.
This is great.
It really is.
What's it called again? Numby.
We did the phase-three clinical trials at Bellevue.
We've been using it for over a year now.
Hey, Dr.
Carter.
Nice costume.
I feel kind of lame.
Nobody dressed up.
Well, it's early yet.
People may still show.
The flier said 8.
Remember, these are med students.
They're busy.
Want me to get you some punch? Oh, later.
I gotta pull articles at the library for this conference tomorrow.
Think this party can chaperone itself? - I'll look after things for you.
- Why don't you do that? - How old is this girl? - 11.
- What's the glitter on her face? - She's a princess.
- Dale, get a clamp on that.
- Babcock, please.
There's a little bleeding around the duodenum.
Let's cauterize and explore the retroperitoneum.
Bovie.
- What are you doing for Halloween? - Nothing special.
I know a motel on Route 22.
Jungle-theme rooms.
- Metz.
- Ask for room 14.
Hanging vines.
You Tarzan, she Jane.
Know what I mean? I think we'll just stay in town.
- The pancreas looks good.
- No renal injuries here.
Hold on.
There's infrarenal mass.
Looks like a lumbar node.
Doesn't feel right.
Too rubbery.
There's one on this side too.
Could be lymphoma.
All right, let's send for a biopsy.
Number 15.
Everything okay on the wards? - Yes.
May I scrub in? - We could use your help.
Wonderful.
We just biopsied an abnormal lymph node on Barbie.
Why don't you take this specimen to Pathology and wait on the results.
Signed in three more kids.
We're stacked.
- We're getting to them.
- We need the main ER for the overflow.
I have to see these kids.
You saw Kerry.
It's a busy night, Doug.
You can't see them all by yourself.
Send the overflow to the main ER, but send me the kids' charts.
Of course.
The sickest ones, send them to me.
I wouldn't do it any other way.
What are you doing back so early? Me and Ariel are sick of trick-or- treating and Mom's running late.
- What are you watching? - Family Love Triangles.
- Educational TV, huh? - Yeah.
Mom says when we move to St.
Louis she's only gonna let me watch an hour of television a day.
When you move to St.
Louis? You didn't know? I think that's why Mom wanted to see you.
So it's a done deal then? My room will be twice as big.
And there's a park across the street for the dogs.
- Sounds nice.
- It's really pretty there.
Please don't tell her I told you, okay? Hey, my lips are sealed.
Repair transversely with running Vicryl 3-0.
Gentlemen, I have the results of your biopsy.
Guess what we saw under the microscope.
- Gotta be Hodgkin's.
- No.
- Metastatic adeno? - Wrong again.
Seminiferous tubules.
- What? - You're kidding? You biopsied two testicles.
It seems that Barbie is a boy.
Who knew there were so many texts on the bowel? This is just what I could get my hands on.
I suppose with all this intense interest that means our bowels are in good hands for many years to come, right? That's a nice thought.
Hey, sounds like the party's up and running.
Yeah! Dr.
Carter, the party picked up.
The beers are right there.
Nice aim, dude.
You almost put out the fire with that one.
Hey, Dr.
Carter.
Thanks, dude.
Okay, kids, that's it.
Party's over.
You can't stay here.
What's up? Were we too loud? - No, the furniture was too on fire.
- Oh, really? I'm sorry.
I'll be in my room studying.
Happy Halloween! She did it to me again.
She's in escrow and I heard about it from Rachel.
Maybe she was gonna tell you tonight? Maybe.
Or maybe she was just going to send me a postcard from St.
Louis.
You really had a good time with Rachel? Yeah.
Yeah, I did.
How's Chattarowski's detox search? They're all out of beds on Four East but I stood my ground and insisted that he was a good detox candidate.
They finally gave him a place on Four West.
You must owe them some favors.
A couple.
But it was worth it.
Well, you tried, you know? When we explored the retroperitoneum we discovered two small masses.
Masses? What kind of masses? We were concerned, so we sent down a frozen section of the biopsy that revealed testicular tissue.
What does that mean? Barbie has a condition called testicular feminization.
Genetically, she's a male with XY chromosomes.
During development, the fetal tissue was resistant to testosterone and the external genitalia developed as female.
There's gotta be a mistake.
No mistake.
The vagina's nothing but a blind pouch.
No uterus or ovaries.
She'll need to be on estrogen replacement therapy.
My little girl has testicles? We removed them because of the high incidence of malignant transformation.
I don't understand.
I changed her diapers.
I know every inch of her.
She's a boy? The genetics don't matter.
You've raised Barbie as a girl.
It's what she looks like.
It's her identity.
Nothing will change that.
But you have to understand that she'll never menstruate or bear children.
Obviously this has come as a shock.
You'll need time to adjust.
Barbie's recovering.
We'll refer you to a genetic counselor.
They'll help you decide when and how to tell her.
Thank you, doctor.
Nice job.
Thank you.
You forgot to mention they'll have to change Barbie's name to Ken.
After the day I've had, just line them up.
Word.
That's how you gotta do it.
Work hard, play hard.
I deserve to play hard.
I had to check all the stool samples for fecal leukocytes, dude.
You think that's bad? My Resident had me give physical exams to these homeless shelter guys.
One had maggots crawling all over an abscess.
At least your Residents acknowledge you.
Mine don't even know I'm here.
I get more respect from this rubber arm.
We might have saved this guy with the saw.
We could've cut the sternum in two seconds instead of chiseling for a minute.
The guy was dead.
A few seconds wouldn't have saved him.
It would've given him a chance.
We are not going to waste time training ER docs on equipment they'll use once a year.
If we had the saw, we could give midline thoracotomies for all penetrating chest traumas.
That's not the standard of care.
The standard of care gives miserable results.
If they arrest in the ambulance, If they arrest in the ER, Midline thoracotomy gives us better exposure to repair cardiac injuries.
If you're so damned interested in this, do a study.
- I will.
- Good.
I know the guy from Surgery to help you.
Peter? Kerry and I were discussing a study between ER and Surgery.
- A study? - Midline thoracotomy for chest trauma.
Is this because of today? Draw up a proposal with a budget and give it to me in two weeks.
- I will.
- Good.
Okay.
I don't think ER docs should play with a sternal saw.
- Neither do I.
- Then why support her? I'm not.
She'll spin her wheels, write a proposal and it won't pass the Human Subjects Committee in a million years.
- M&M? - Oh, no, no.
Listen, I made reservations at Dempsey's for 10.
Peter, I don't know.
I'm pretty swamped.
What? It's Halloween.
Yeah, but Dempsey's isn't really Halloween-y.
No, it'll keep.
Walt, what's up, man? It's me.
Listen, I need to ask you a favor.
See this one? That's the bull rider.
Oh, right.
The cute cowboy.
Dad! Rach, did I hear your order right? You hate rhubarb and walnuts.
I like it now.
Dad makes good pie.
- He always did.
- Jen, you trying to butter me up? No.
I just remember your mom's famous rhubarb pie recipe.
Sorry you're working with a cold.
Are you holding up? Yeah, it's just my sinuses.
Why don't you go wash your hands? Okay.
St.
Louis, huh? - She told you? - Slipped out.
It's a great job, Mark.
The schools are top-rate and It sounds good.
I was ready for a fight.
I think we've done enough fighting for a lifetime, don't you? Yeah.
In a perfect world we could both spend 365 days a year with her.
But we can't.
- St.
Louis isn't very far.
- No.
And I'll have holidays and summers.
Spending time with her this summer has made me think about how we've spent way too much time thinking about ourselves.
She told me you guys got along really well.
Yeah.
Yeah, it was It was a lot of fun.
Thank you.
Is it still Halloween? Yes.
You have a few more hours left.
I guess I won't be able to go trick-or-treating.
Not this year.
I'm sorry.
Some day, huh? That's okay.
The best part was making the costume anyway.
Me and my mom made it together.
Do you still have my tiara? Yes.
Yes, right here.
Wait.
Let me do that.
There.
How do I look? Like a beautiful fairy princess.
No! Drink up, Bernie.
Some people cannot hold their liquor! We should mess with his mind.
You mean the hand in the warm water trick? Not on the couch, Lucy.
Come on.
I got it.
I got it.
Come on, stop it.
Do you think he's okay? Yeah.
He's just a lightweight, that's all.
He has a strong pulse and he's still breathing.
You've been in the ER way too long.
Let's get this party started right! Willie? Willie? Shaving his head? That would be cruel and unusual.
This is mean.
This is mean! You ain't seen nothing yet.
Even drunk, that should still work.
No.
Stop, stop.
Wait, wait.
Willie? - Willie? - Willie, wake up! Someone needs to call 911, and go get Carter.
Get real.
If we call Carter, he'll narc.
Willie's in trouble.
We need to do something.
Bernie's right.
We can handle this.
This is not class, this is our friend.
You guys call 911.
I'm gonna go get Carter.
Dr.
Carter? Wake up, Dr.
Carter! Wake up! Okay, everybody back off.
Give him some air.
- Anybody call 911? - I did, Dr.
Carter.
Come on, Willie, wake up.
Wake up! A weak pulse, but he's not breathing.
Oh, man.
Gross! Can I do anything? What can I do? He vomited.
That's good, right? No, that's bad.
If he vomits and it gets in his lungs, he'll die of aspiration pneumonia.
His parents live in Downers Grove.
Give them a call.
We're up here! Second floor! "X"? What's that? - It's liquid Ecstasy.
- What is that? It's a narcotic.
Anybody else take it? I didn't know Willie took it.
- Branch took some earlier.
- I can't leave Willie.
I'll go.
It was clean.
They showed the replay a million times.
- It was a joke how offsides they were! - Dreamer.
Pay up.
- That was Lucky Liquor.
- A vagrant's best friend? They have a guy in a county patient gown trying to buy beer.
Whatever happened to "No shirt, no shoes, no service"? They'll stall him until someone comes for him but they won't hang on all day.
Tell you what Hey, Grabarsky.
You go and pick this guy up and we're even.
- How's that? - This drunk a friend? No, but he owes me more than you.
Consider him admitted.
- Where is he? - He went to take a shower.
- How's Willie? - Paramedics intubated him.
Liquid Ecstasy.
You'd think med students would know better.
Yeah, you would.
Branch! Branch! Branch, wake up! Let's get him out of here.
- He's not moving air.
- No pulse.
- Damn it! - I'll start chest compressions.
Where's the syringe? - Find the paramedics.
I'll do CPR.
- Okay.
Mr.
Lubin just spiked to 101.
4.
Go ahead and draw a fever workup.
Draw Setzer for a pre and post gentamicin level with the 11:00 dose.
- How's it going? - We're rather busy.
But I've got a great little intern helping me out.
Dale, listen.
It's 10:30 and you're not even on.
So sign out the scut.
That's what the on-call team is for.
Unless you have a problem with that? That's fine.
You ready? Give me 10 minutes to get back into my costume.
- You're really gonna wear it? - Of course.
Okay.
When you're ready, I'll be out front.
Tell me you wanted to be an airline pilot.
I don't even like taking the puddle-jumper to Cleveland.
Hurry up.
This is police harassment! Remember Rodney King! Dr.
G, here's your man.
Put up quite a fight.
Said it's Halloween and he's just playing dress up.
I am! Grabarsky, it's the wrong guy.
Lucky Liquor.
Big guy in a hospital gown.
He kind of looks like Jerry! Lloyd.
- What are you doing here? - Who's Lloyd? I'm that knucklehead's cousin.
Who knew they'd hit the genetic Powerball twice? Jerry? See, he needed a costume and there's a contest at the Elks Lodge I won "Honorable Mention," cuz.
Congratulations.
Need anything else, Doug? Other than a 48-hour day? I'm leaving.
See you bright and early.
- Bright and early.
- Yep.
- Doug, you did a nice job today.
- Not bad for a rookie Attending.
Let's see how you do with these.
What's that? Overflow charts for the pediatric patients in the main ER.
According to policy, you need to sign off on them.
You're loving this, aren't you? This Pedes ER isn't such a bad idea after all.
Happy Halloween, rookie.
Branch Crockett and Willie Goldman, ages 22 and 23.
Mixed overdose of alcohol and GHB.
Willie's intubated from a respiratory arrest.
Branch came back with epi after a full arrest.
A little late-night club-hopping? No, med school Halloween party.
All right, everybody.
On my count: One, two, three.
CBC, ABG, lytes, blood alcohol tox screen and a 12-lead.
Call Respiratory for a vent.
Someone call his parents.
- Lucy can do that.
- No, I'll help.
You're drunk.
You don't belong in here.
Now, get out.
Peter, have you gone completely balmy? Just getting funky.
Hey, meet my nephew, Peanut.
- Nice to meet you.
- Hello.
It's a hayride? - It's a hayride.
- So where to, Uncle Pete? Michigan Ave.
Pop that 8-track in.
Solid.
You don't get it? You never figured out who I wanted to be as a kid.
Oh, my God! Shaft! John Shaft.
Hey, Dr.
Weaver.
Off to enjoy All Hallows Eve? Actually, I am.
I just wanted to give you this bill.
$289?! You're lucky the wheelchair wasn't damaged.
It could've been worse.
I don't have 300 bucks.
I've arranged to take it out of your paycheck.
$28.
90 a week for the next 10 weeks.
That'll run right into the holidays.
Kerry, got a second? Yeah.
What's going on? I wanted to give you a heads-up on the committee vote.
That won't be announced until tomorrow.
Well, they've tallied it already, and they voted for Litvak.
They're gonna have to widen the office door for his swollen head.
Yeah, he's kind of an ass, isn't he? Well, if it means anything, I voted for you.
Thanks, Mark.
Which paycheck does this become effective? You know what? It doesn't.
- Are you serious? - I'm dead serious.
Give your cousin a wheelchair, give your maiden aunt a rapid infuser.
I don't give a damn.
You're getting obsessive.
Did I hand you angiocaths? - Yeah.
A gross.
- What's a gross? One-forty-four, and you did.
Are you listening? Yes, I am.
All work and no play makes Doug a dull boy.
Look at this.
I ordered three cases of Pedialyte, not Pediazole.
Doug, you all right? Oh, my God! Hold it! Put pressure on it! You bastard.
You can dish it out, you can't take it.
- Payback is a bitch, isn't it? - You suck.
Good evening.
I want to suck your blood.
No, I'm not kissing back.
Hey, Dr.
Carter.
Lucy.
How are they? They'll be fine.
I don't know what happened.
One second we were hanging out, then What happened was two of your classmates almost died.
I didn't know they were doing GHB.
You were in charge of the party.
I broke it up when things got out of hand.
You continued to party.
Two guys rolled out of here on gurneys.
Did I miss anything? The part about me not being able to police everyone.
And about you being the Resident Adviser and the one in charge.
You're right, Lucy.
I'm in charge.
It was stupid of me to think you were mature enough to take responsibility.
I never knew you didn't have rhythm.
You're messing up the greatest song.
Here we go.
- What is that? - It's my tambourine! That's a tambourine? Come on, come on, come on.
Get some rhythm in here.