ER s05e07 Episode Script
Hazed and Confused
Previously on ER: - Someone's down! - We have to wait for a secure area.
We should not be out here! I thought you smoothed things between ER and paramedics? You're my new intern.
I just gave you an order.
I wasn't aware Reece had a hearing problem.
My son is my business.
And I'm not interested in continuing as Interim Chief.
Beard is stuck! I wouldn't have asked if you had told me what you were doing.
Sorry you thought it was your business to ask me.
Carter? What are you doing here? Hey! Morning, Carter.
That's Grace Jones.
Hey, I didn't wake you up, did I? I mean, you're on at 7.
Yeah.
But no problem.
Good.
You settling in down there? Yes, I like it.
You have a very interesting CD collection.
What? I said, you have a very eclectic CD collection! Thanks.
Anything you want to listen to, just ask.
Don't ever touch it on your own, though.
I've rented to a lot of students, so I had to make that a rule.
Carter, let me make you one of these, man.
It'll slingshot you into your day.
You're in a really good mood.
I'm just so glad to be - Hey, can I ask you something? - Sure.
Do you find it easy to evaluate other people's work? Time to grade your student? I worry about being too harsh.
Does she deserve to be judged harshly? I want to be fair.
Lucy hasn't gotten off to a great start this year, clearly.
But she's smart and she's willing to work hard.
Maybe I should go easy, give her a chance to turn things around.
Go on.
Keep talking.
A stripper? I said, "Damn! Can't you cover that up?" She was destroying the magic.
I thought I'd ride along this morning.
It's more fun than the hospital, isn't it? He likes it on the frontlines, or we need closer supervision.
- Somebody's gotta keep an eye on you.
- Hey, doc.
Here! By the way, can I crash here tonight? My building's being fumigated.
Have to ask the captain.
Shouldn't be a problem.
You can sleep on a Barcalounger.
I've done that.
Who paged me? I got an 87-year-old man with cholangitis for you.
I stopped taking admits at 6:30.
Why didn't you page the on-call team? He came in while you were on call.
Dr.
Romano specifically asked for you.
- How sick is he? - He's septic, intubated hypotensive and in renal - No, no! This can't be happening.
Look, I haven't had a nap in the last I have to take a shower, I smell bad.
And you give me a patient sick as a dog? What does that say? What does that say? 6:38! I'm not on call! He's in Curtain 3.
We've all been there.
Shut up.
- Tony Broadway? - That a great porn star name, or what? - Carol, want to know your porno name? - What? Take your middle name and the street you live on.
Like, mine would be Anthony Broadway.
Tony Broadway.
You're mixed up.
That's your romance novelist's name.
- Excuse me? - Your porno name is your pet name with your mother's maiden name.
My name would be Nibbles McGee.
Nibbles.
That's a great porno name.
Mine would be Fluffy Florez.
If you don't have a pet? - Use one you had as a kid.
- Nibbles is a great name.
I don't think that's right.
- What would yours be? - Mine wouldn't work.
Have we gotten a package from Lakeside Supply? - This early? - It's supposed to arrive overnight.
Tell me when it's here.
Kerry, have you got a minute? We need to prepare these Attending schedules.
I'm not familiar with the computer down here.
It's a snap.
Jerry can take you through it.
- Can you give me a hand? - I got a lot of patients.
Dr.
Anspaugh, got a woman complaining about her bill.
She was charged for procedures not done.
Why are you telling me? Those calls go to the Chief of Emergency.
Or the Interim Chief.
Tell her you'll pull her chart and call her within two days.
I don't know how I'm supposed to learn in this environment.
Our relationship has turned adversarial and it's not good for the patients.
Dr.
Carter, we need to talk.
Hey, Lucy.
Is everything all right? You're talking to yourself.
Not a bad thing Actually, do you think I should sit down and talk to Dr.
Carter? Depends on how direct you want to be.
You don't want to be confrontational.
- You don't want him to be defensive.
- Right.
I'd do it over a meal.
Oh, like a chat.
I like that.
Makes sense.
Oh, damn! Hey, Lucy? Could you get me a tampon from the thingy? Oh, I got one here.
Damn it.
- There you go.
- Thanks a lot.
Peter, sorry I'm late.
I was in the ER with an admission you need to see.
- The problem? - 87-year-old male septic, with cholangitis.
He's on mezlo and Flagyl.
I got his pressure up with dopamine.
He's too sick for open surgery.
We'll do a decompression.
- I booked the O.
R.
- Busy night last night? Oh, God, horrible! Twelve admissions, plus this one.
I got an abdominal aortic aneurysm, stab wound to the chest fall from a second-story balcony.
They just kept coming.
I worked 36-hour shifts as an intern in England.
This makes me realize how long ago that was.
I'll take him down, and we'll round at 8, okay? Lovely.
Gives me enough time for prerounds and a shower.
You know, I bumped into David Kotlowitz an hour ago.
He's a terrific ENT.
He's done a lot of work with cochlear implants.
Did you tell him about Reece? No, I just told him I had a friend in need of talk on the subject.
Don't solicit medical advice on my behalf, all right? I worked with Kotlowitz.
That's why I brought it up.
- Lf you'd rather I hadn't - Yeah.
Fine, forget about it.
- What is that? A sternal saw? - Yes, it is.
- What's it doing here? - My midline thoracotomy proposal sailed through the Human Subjects Committee.
Nobody told me.
Well, I'm certified to use it, so we're up and running.
I thought we'd talk before it got underway.
Surgeons use it on odd days ER docs get it on evens.
Your turn's tomorrow.
Hey, bad news.
We're still not pregnant.
We'll redouble our efforts.
If it's more than three times a week we get diminishing returns.
Like reusing the same tea bag.
- There's a romantic idea.
- Wasn't very romantic, was it? Doug? I've got a lethargic infant not eating.
You better come see him.
- You okay? - Yeah.
Baby's name is Sun? Korean? Actually, it's Sun.
His mom's a little different.
All right, Mrs.
Everly.
I'm Dr.
Ross.
Can I take a look at Sun? I don't know what's wrong.
He won't nurse.
We'll figure it out.
Hey, you his big sister? What's your name? - Sky.
Hello, doctor.
- Well, hello, Sky.
Sun and Sky, huh? He was fine until a few days ago.
Then I noticed he wasn't nursing so well.
- Any solid foods or formula? - Oh, no.
Only my milk.
My breasts are engorged with him not eating.
When was the last time he pooped? - Oh, man.
When? - Yesterday morning.
- You sure? - Yes, I haven't changed him since.
We'll hydrate him.
Give him We'll have to do blood tests.
And I need your consent to do a spinal tap.
You stick a needle into his spine? Won't that hurt? We'll sedate him, no pain.
- Mom, it's gonna be okay.
- Do you think so, honey? We'll be right back, okay? Get a CBC, Chem-20 and blood cultures.
Can you assist with the LP? Sure, how do you sedate him? Propafol.
I'll get it from Pedes.
General anesthesia? Have we done that in the ER? First time for everything.
I'll take the proper precautions.
Yelling doesn't help! There's an ambulance out front.
- Thank God! - Don't open that door.
Get away from me! - Come on! - Get away from me! Don't touch me! - Yes, hello.
- We got a 911 call.
- I called.
- She shouldn't have called.
Get in here! - Where's the injured man? - This is not an emergency.
Everything's fine.
I don't need the hospital.
- Your name? - Richard Weingarten.
He let this lunatic drill a hole in his head.
I'm an emergency physician.
Let me take a look.
- I'm all right.
- Okay, just sit down here.
Sit down.
What are you ashamed of? - What happened? - It's called trepanation.
It's a centuries-old practice, a means of increasing brain blood volume.
- I had mine done in Amsterdam in 1968.
- Oh, God! It was like God lifted a weight from me.
It's a surgical drill.
We're going to the hospital.
You can't take me against my will.
I've studied this for years.
I didn't embark on it lightly.
Let us at least put a bandage on and get a blood pressure.
Okay, sir, just sign this.
It says you refuse treatment.
Go to the rig and get some saline.
- Come on, Rich.
We did it.
- The Internet! That's what started this whole thing! - Laura! - I hate it! - Get her outside.
- I hate it! - What are you doing? - Outside! - I don't want to go! - Calm down! I'll have you brought up on charges.
I want to go back inside! You're an intelligent person.
I don't want to take you against your will.
I had to do something.
All right.
Okay.
Doesn't look like you penetrated the dura.
All I want to do is put a sterile dressing on to clean the wound.
I'll leave you some saline and gauze so you or your friend, can keep it clean.
I forgot to bring any gauze.
I've held enough screaming babies to know.
They have to be sedated.
Doug? How you doing? You can't administer propafol to an infant.
You've done it upstairs for 10 years.
You're not an anesthesiologist.
I didn't think you'd have a problem.
Well, I do.
I have him on a cardiac monitor, pulse ox, dynamap and a crash cart.
You cannot just make up policy as you go along.
I'm trying to prevent pain, do what's best for this boy.
If you want to discuss policy, leave.
We'll do it later.
We will.
Dr.
Carter, want to grab lunch later? Let's see.
Tell me about this patient in Curtain 3.
Thirty-year-old male with pain on urination.
- The UA is negative for white cells.
- Chlamydia.
Do a sexual history? He had two partners last year, and used condoms.
So he claims.
Send up a DNA probe and treat empirically.
Treatment for chlamydia? Doxycycline BID, or a dose of Zithromax.
You should look at his chart - Hi, I'm Dr.
Carter.
- Hey.
I need to ask, do you always use condoms? Pretty much, yeah.
There's times where you haven't? Once or twice maybe, yeah.
That's all it takes.
We're gonna give you antibiotics.
I think you have a common infection called chlamydia.
What, VD? Sexually transmitted disease, yes.
She doesn't think so.
He also had conjunctivitis and arthralgias at the knee and ankle.
Mr.
Bussey, excuse us for a moment.
He was in Mexico and had diarrhea.
The timing and symptoms are classic for Reiter's.
- You could've included that.
- You cut me off.
- You could've said, "Reiter's.
" - I didn't get a word in.
You - I'm always doing what? - Like now, you're defensive.
You don't even hear me.
So, what's the treatment for Reiter's Syndrome? Indomethacin.
- We can still send off for chlamydia - No, you're right.
It's Reiter's.
Good pickup, Lucy.
Propafol is ideal for use in the ER.
First of all, onset is immediate, and it wears off in Don't you think a doctor should be trained? Got a gunshot to the chest coming.
The saw is sterilized in Trauma 1.
We need to be ready if this guy qualifies.
You'll document 10 critical times.
Clock starts when? Soon as the patient enters.
Don't they need to have cardiac arrest? He sounded okay.
Patients can deteriorate en route.
Forty-six-year-old man shot with a BB gun.
- Hemodynamically stable.
- A BB gun? The punk who shot me needs to be put under the jail.
Ten years old or not.
Let me up off of this, I can walk.
- Let him go.
- Doesn't need a thoracotomy.
- No, a tetanus shot and a Band-Aid.
- You can follow me, sir.
- Want to turn around, or can we hang? - No, take 10 minutes.
Hey, Carol.
What's going on? Just doing a quick blood draw.
So how's the clinic going today? Oh, I just love prenatal days.
Takes me back to my OB roots.
Why don't you let a nurse do that? Because I was trying to be discreet.
Let me do it.
It's kind of hard to stick yourself.
Thanks.
What labs you need? Just a CBC, check if I'm anemic.
Oh, I only ask because if you'd like I can run the results through the clinic.
Be more private.
That's a great idea.
What I'd really like is to check my hormone levels.
Oh, okay.
Infertility workup? - I don't want to discuss details.
- I wasn't trying to It'd be great if you run it through the clinic.
- Okay.
- Thanks.
Mark, glad I caught you.
I've had to move my surgical schedule.
Dr.
Lee's interview is pushed to 1:30.
- Is that a problem? - No, that's fine.
- Have you looked at her CV? - Impressive.
If she's half as impressive in person, she might be our next Chief.
And not a moment too soon.
Dr.
Greene, I didn't think you were gonna be around.
I was on a paramedic ride-along, and we brought in a patient.
So, you finish your student evaluation yet? I thought I had till the shift ends? No big deal, this afternoon's fine.
I wrote an evaluation for Lucy but I tore it up because I want to be fair.
You put something on paper that'll impact her life.
Just evaluate her work.
What are you talking about? I'm talking about your porn-star name.
Take your pet's name and your mother's maiden name.
- Try it.
Like mine is Rex Voytek.
- Oh, I know that game.
But it's your drag name, not porn.
- Drag name? - Yeah, the name of your pet and the street you're born on.
- I don't think so.
RuPaul had it on her show.
Leave some crumbs for the rest of us.
- Are you the cookie police? - Have some but I brought those for the docs and nurses.
- So you're the cookie fairy.
- Wait a minute.
- Don't worry.
- Bad enough you raid the icebox, now you want to call names? Conni, you begrudge us some juice? It's not like you bring anything in.
You should thank me for the cookie I keep from your fat snack hole.
You just keep talking, Morales.
- Hey, what's going on? - That one's got a problem.
- You antagonizing them? - He called Yosh a fairy.
I called him the cookie fairy.
It was a dumb joke.
A real dumb joke.
Ready to head back? Yeah, let's go.
I got no problem with him being a bone-smoker.
I was joking like I would with anybody.
Don't worry about it.
Write the discharge orders soon.
- Bed Control likes them by 12 noon.
- Yes, I am aware of that.
I told you I'd have a hard time seeing you as my intern.
It's complicated for a lot of reasons.
Dr.
Corday, Mr.
Frybush's creatinine is much higher.
Thank you.
Shall we call a renal consult? Yeah, this guy needs dialysis.
- So did you ever get that shower? - No, can you tell? Well, go ahead.
I'll cover SICU.
- I don't want special treatment.
- Turning down a shower? - I've got a lot of work.
- Okay, have it your way.
Gotta go find Weaver.
She's itching to use that saw.
Going to the roach coach.
Want something? Yes, a triple espresso.
Thank you, Kit.
Elizabeth? How would you like to scrub in on a bilateral adrenalectomy? Oh, I appreciate the offer, but I'm postcall.
I gotta finish my work, and I have to catch up on sleep.
A case like this comes once in a blue moon.
I'm up to my neck in ER garbage, but I'm not passing this up.
Well, it's been a while since my last adrenalectomy.
I'll do right, you do left.
I can get Dr.
Kennedy to cover your service.
Jeanie? The baby's spinal tap came back negative for meningitis.
What's going on? A lot.
We got to talk to the mom.
I'll take Sky out of the room.
She doesn't need to hear all this.
Good idea.
Her mom leans on her a lot, don't you think? - A smart kid, though.
- Yeah.
Okay.
Hey.
- What did you find? - Spinal tap was negative.
I have more questions.
Maybe Jeanie and Sky could take a walk.
I don't want to worry about her wandering.
I'd rather stay here with Mom.
Can she help me put some toys away while you talk? It's a good idea.
- Mind helping me? - I don't mind.
I'll be right back, Mom.
- See what toys we can find.
- Sure.
Okay, we need to see if we can figure out the cause of Sun's deterioration.
- Now, has he had a polio vaccine? - Oh, God, polio! He was vaccinated.
Is that effective? Do you have a doll at home? - No.
- No, really? I had one.
Dolls are for babies.
I'm a big girl.
- And how old are you? - Six.
Six.
After the adrenal vein, we'll work our way around the medial and inferior edges of the gland.
Cut, please.
And another tie.
Elizabeth, cut.
Elizabeth? Sorry.
Yes.
You do need a rest.
Why don't you step out? No, I'm fine.
I'm fine.
Go take a nap.
Sorry I dragged you along.
Dr.
Goodman? - Can I run something by you? - Make it quick.
Male with aphasia and arm weakness.
CT scan was normal.
Spinal fluid is clear.
I'm thinking vasculitis or MS? Send off a sed rate and a complement level in the CSF.
Look at the differential.
May be some zebras you haven't considered.
Okay.
Hey, Yosh, is that Lucy's palmtop? I love this.
She let me borrow it.
- Can I use it? When you're done.
- I'm done.
Here you go.
- Know how to work it? - Yeah, Lucy showed me once.
I'd hoped to avoid this.
But things haven't improved.
I don't know how I'm supposed to learn in this hostile environment.
Our relationship has turned completely adversarial and it's not good for the patients.
We need to talk.
This crazy bastard lets Dr.
Greene Iook inside the hole with a penlight.
- Unbelievable! - I thought I'd seen it all.
Doc writes him a scrip for antibiotics.
The guy thanks us for coming.
Yeah, I've got a way with ranting lunatics.
- I ain't kidding.
You do.
- Hey, what's up, guys? - We're all here.
- You're not on today.
Truth is, they're here because we got you something.
You like it? - It's great.
- You're one of the gang now.
- Almost.
- Almost? There's something every paramedic does.
It's only appropriate that you do too.
How many patients have you brought in strapped to a backboard with a collar? What do you have in mind? Come over to the table, we'll show you.
As a part of our training, we all get on the board ourselves.
You want me to lie on the board.
Don't worry.
We all did it.
- Comes with the coat.
- Gotta drop your pants.
No, he doesn't! Forget about that part, guys.
All right? Forget it.
I have to get back to the hospital.
Then don't fight.
Just lie down.
- Come on.
- Relax, guys, back off.
Let him do it on his own.
You want me to lie down.
- There.
- There you go.
Get him! Got the shower on? - Come on, the shower's on! - Get the shower! Stop it! Stop it! Take it easy, doc.
Hey, guys, guys.
Come on.
Let him up.
- Let him up.
- We weren't gonna hurt you.
Much.
It's all over for now.
Jer, know what your name is as a porn star? That game is tired.
- I've got the best, Satan Monroe.
- Your mother's maiden name is Satan? - Carol, I need you.
- What's wrong? Young woman complains of severe right lower quadrant pain.
Pregnancy test positive, a possible ectopic.
- Name? - Maria Jones.
Five pregnancies.
Two live births, two abortions.
Hi, Maria.
We're gonna take care of you.
- It hurts, it hurts! - All right.
Let's get a CBC, Beta HCG, Chem-20.
Type and cross two units, and start a line of saline.
- Did you do a pelvic? - No, she's in too much pain.
She said I'm pregnant.
Is my baby okay? Okay.
Let's do an ultrasound while we're at it.
It just hurts so bad! Okay, you're gonna be fine.
Sorry I'm late.
We were just about to start without you.
Dr.
Lee, Mark Greene.
Sorry if I held things up.
I'll try not to take it personally.
You've been flexible with your time.
We appreciate it.
- I'm happy to be here.
- Let's get right to it.
"Three years as associate chief.
Excellence in Clinical Teaching Award two years in a row.
" How do you think you can improve our department? You could benefit from an eight-bed observation unit for 23-hour stays.
Paid for how? We're a cash-poor county hospital.
- That's why you need it.
- Tell us more.
I set up a unit like it in Atlanta.
And it saved the hospital $2 million a year in unnecessary admissions.
What kind of patients are we talking about? - Lucy, take this.
- What is it? Your evaluation.
It's blank.
You fill it out since you think I'm so adversarial.
And keep track of this before someone walks away with it.
You listened to my notes? You're so sure I'd give you a bad evaluation you're planning a countermove.
A hostile workplace? I didn't know it's time for evaluation.
Please.
Why'd you want to have lunch? To get things out in the open.
Well, they're out in the open.
Why don't you fill that out, and let's see how fair-minded you can be.
- How long will they be upstairs? - Not much longer.
What was the name of the doll you had? - Baby.
- Was Baby a boy or a girl? She wasn't a boy or a girl.
She didn't have a penis or a vagina.
- What are you doing? - Letting him lick the spoon.
Does your brother lick the spoon? Sometimes, with things that he likes.
- Like what? Yogurt? - Sun doesn't like yogurt.
- What does he like? - Lots of things.
Does he like honey? Your little brother licks honey off of your spoon? - He likes it.
- Okay.
Sky, let's go find your mom and Dr.
Ross, okay? Okay.
- I like the observation unit idea.
- Good.
- Very good presentation.
- Thank you.
I'd be happy to give you a tour of the ER.
I don't need to be hand-held.
But I do want to walk around.
Feel free.
I'll catch up with you.
It's a pleasure.
- Mark, do you like her? - She's good.
You didn't say much.
Didn't think you're impressed.
I'd like to continue this in a less formal setting.
I'll see if she can come for dinner.
- Would you be? - I can't tonight.
I'm sorry.
Excuse me, Dr.
Anspaugh.
- Are you feeling better? - A little bit.
Going to the bathroom helped, huh? Maybe it was just gas pains.
You haven't had any bleeding, which is good.
You're further along than we thought.
Looks like 15 weeks.
- I wasn't even sure I was pregnant.
- Look.
Can you tell? Is it a boy or a girl? Can't say for sure.
It looks like a girl.
After having two boys, that'd be nice.
Well, I don't see a penis.
You can't always tell on an ultrasound.
You'll have to come back make sure she stays healthy.
I'll do that.
Come on, Corday.
Pull yourself together.
It's just a few more hours to go.
Elizabeth, can you do me a favor? Watch the service? I've gotta see Dr.
Kotlowitz.
- Really? - Yeah, I ran into him.
Actually, I went looking for him.
Peter, that's terrific.
Yes, go! - I can cover service.
- Thanks.
I need orders on a new admission.
I'm not in the mood for jokes.
- No, Mr.
Ramos is back.
- Ramos? Fem-pop bypass? I discharged him yesterday.
He's back with an infection and an asthma attack.
- You know the rules.
- Yep, I know.
He's mine.
He's on continuous albuterol.
Hello, Mr.
Ramos.
Let's take a look at your legs.
I was hoping you'd be here today.
Oh, where else would I possibly go? I asked the mom if she'd given the baby food.
Guess I talked to the wrong person.
The baby's lucky.
We can treat botulism.
- But what do we do to help Sky? - She's fine.
Her mom's draining her childhood.
As much neglect and abuse as I see, trust me, Sky is okay.
- She needs to be a little girl.
- Yeah, that's true.
Hey, guys.
Okay, now you can't give honey to your brother or to any baby because it can hurt them.
Honey can have botulism spores.
Their intestines are immature, and they can't kill off the spores.
He's maxed out with a pressure of 65.
Systemic resistance is 3500.
Let's start Levophed.
Dr.
Corday, I need you here.
Mr.
Ramos is pretty tight.
You okay? Yep, I'm fine.
- How much albuterol? - Twenty an hour.
- He's had Solu-Medrol.
- 125 in the ER.
- Okay, I'll push some magnesium.
- Magnesium? It relaxes the smooth muscles of the bronchioles.
Can you look at Mr.
Frybush? Give me five minutes, okay? Carter, can you explain this evaluation? If it's this bad, you should've come to me.
Do you have something against her? - Wait a sec - I want to see you and Lucy.
We're gonna figure this out.
Find her and then me.
- Can I hang on to that? - No! Sound like you're in a good mood.
Do me a favor? I need a place to crash.
Building's being fumigated.
Would Carol mind? - You kidding? Come over.
- Save me a few bucks.
- Sure thing, glad to have you.
- Thanks.
He's set up for another four hours of continuous.
Magnesium's on board.
- How are you feeling, Mr.
Ramos? - Dizzy.
- Whoa.
What's happening? - Maybe he's hypoxic.
- How much mag did you give him? - Two grams IV push, 40 cc's.
Forty cc's of 50 percent mag? Not 50 percent! Five percent! No, Dr.
Corday, you gave him 50 percent.
My God, you're right.
I gave him a lethal dose.
- He's not breathing.
- ET tube! Bradying down.
Heart rate's 30.
Two grams calcium gluconate.
Push an amp of atropine.
Bag him, prep for IJ.
I'll float a pacemaker.
- Lost the pulse, in P.
E.
A.
- I'll start compressions.
Seven and a half gloves and The cochlear implant is a miracle, and the technology keeps improving.
I'm impressed by what I read.
Don't read.
Talk to people who have it.
Talk to parents of kids I can get you in touch with people who faced the same.
Great, I've already heard an earful from the opponents, so The fanatics.
Well, they've got their agendas.
The level of passion with which these people attack you, it's bizarre.
Someone used the word "genocidal.
" Said I was eradicating deaf culture.
Deafness is not an alternative lifestyle.
People who claim it is are beyond reasoning with.
The thing I figure is why make an argument against hearing and speaking? Honestly, know what I think? I think it comes down to laziness.
A deaf person can function.
But some people don't want to exercise and do all the drills it takes.
Look, it's years of hard work.
Yeah, but they have the energy to attack me.
The hell with them.
Don't stand in my way when I'm trying to help a person function.
Why don't you tell me how you really feel? Anyway, you bring in your son and we'll see if he's a candidate.
Do you work closely with Dr.
Corday? Actually, she's my intern.
She told me about the fallout with Rocket Romano.
Oh, yeah.
Do you know if she's seeing anybody? I'm just wondering.
I'm pretty sure she's involved with somebody.
- I'm not surprised.
- Yeah.
- Oh, well.
- Thanks.
You bet, anytime.
Give me a call.
Check, please.
Systolic, 60 palp.
Come on.
Come on.
Come on.
We've got capture.
Turning the rate down to 80.
- Did you page Dr.
Benton? - Done.
- Pulse is stronger.
- Good.
Pupils are fixed and dilated.
That could be the atropine.
That, or he stroked out.
What happened? I gave him enough magnesium to cause a cardiac arrest.
- Twenty grams.
- Oh, no.
I looked at the label.
I thought it said 5 percent but it was 50 percent.
But I looked at the label.
- I got your blood work back.
- Thanks, Lynette.
Progesterone level's normal.
That's good news, you ovulated.
I've been trying to get pregnant, and I haven't.
- How long have you been at it? - Couple months.
Give yourself at least six months before you start worrying.
Yeah, you're right.
I'm crazy.
Maybe you guys need to increase your activity.
How often do you, you know, do the do? - What? - Oh, sorry, am I being indiscreet? Carol, what's the deal? I went to see your ectopic.
She's dressed, ready to leave.
- Maria Jones? - She pulled her IV? Maria, where are you going? I feel better.
I'm going home.
You were in so much pain, I couldn't examine you.
- But I'm better now.
- But, wait.
We need to make sure everything's okay with you.
Just let the doctor look you over.
Look, I just wanted to know if it was a boy or a girl.
Nothing's wrong, so why worry? Wait! You were faking those abdominal pains? - Are you crazy? - You weren't sure you were pregnant.
Why would you lie and cause all that drama to find out if it's a boy or a? - No, are you gonna abort this baby? - Let go of me! - Carol! - She's had two boys and two abortions.
Are you getting rid of this child? It's my baby and I'll do what I want.
I told you that ultrasound is inconclusive.
It could be a boy! Lady, take your hands off of me.
Carol, let her go.
Girls are trouble anyhow.
What's the matter with you? What's the matter with you?! How could you inject a patient with 20 grams of magnesium? I make no excuses.
It was a grievous error.
Where were you during this, Dr.
Benton? I was out of the hospital.
I came when I was paged.
It wouldn't have mattered, anyway.
You left your intern unsupervised.
This patient may have suffered brain injury.
I stopped by the unit.
Mr.
Ramos' eyes are open, and he's responding.
You are not to leave while on duty.
You are not to leave your intern unsupervised.
I know it's hard for us all to view Elizabeth as an intern.
But we've opened up this hospital to enormous liability.
I'll speak to Risk Management and the hospital attorneys.
They'll determine what information to release to the families.
Don't either of you discuss this with anyone.
Can we get together and not talk about this? I have to pick up my son from my sister's house.
All right.
You just need to get a good night's sleep.
I didn't fill this out.
- Who did? - She did.
- Why did she? - Because he told me to.
I didn't say to give it to him, I said to give it to me.
- No, you didn't.
- Okay, wait.
Don't talk to each other, talk to me.
Mark, I wanted to know how she thought she was doing before my final assessment.
I tried to put myself in his shoes and be critical.
He said, "fill it out" meaning "turn it in.
" - How could she assume that? Makes no sense.
That's part of his problem.
Incomplete directions.
I give incomplete directions? - Name a time.
- Just one? Tell her to name a time when I gave her incomplete directions.
- Okay, talk to each other.
Don't talk to me.
Whatever this is, I can't fix it.
Work it out, both of you.
Kerry, I need to talk to you about the x-ray report.
Please don't blow me off.
Sorry, trauma coming in.
Possible candidate for the thoracotomy study.
I didn't know that's running.
Stab wound to left chest.
Had a pulse in the field.
Gave him epi, 1500 cc's of saline.
Shocked him twice.
Great candidate.
The stopwatch? Right here.
You mind if I tag along? Now, start the timer.
Here we go.
On my count: One, two, three! Two units of O-neg on the infuser.
Get type-specific as soon as you can.
Ten blade, let's go.
Good breath sounds bilaterally.
Seven and a half gloves.
Okay, skin incision is complete.
Mark the time.
Saw, please.
- Sternal retractor.
- Good job! - I need a purple top.
- Pulse ox 85.
- Mark the time.
- Suction, please.
Pickups and Metz.
Looks like blood in the pericardium.
First hemoglobin is 9.
2.
Okay, pericardium is open.
Mark the time.
I see a stab wound to the left ventricle.
- What are we at? - Forty-two seconds.
Take over internal compressions.
Tamponade the wound.
2-O silk.
One horizontal mattress should do it.
- Two units are in.
- Hang another two.
How's the heart? - Starting to fill.
- Get the paddles ready.
Okay, cardiac injury is repaired.
Mark the time.
- V-fib.
- Charging to 20 and clear.
- Sinus rhythm.
- Cardiac activity restored, mark time.
- I've got a pulse.
- Excellent job, Kerry.
Dr.
Greene.
Dr.
Lee.
Finding your way around? Yes, thanks.
I wanted to ask you.
I didn't feel I connected with you at my interview.
- Is that a correct assessment? - How do you mean? I'd look over and wonder, "Am I making my best case?" It was a good interview I like this department and I want this job.
I'm one of the baddest ER bitches out there.
If I didn't make my best case before, I'd like to try again now.
Can I grab a soda and sit with you? Yeah, sure.
Call me when he's in Recovery.
- Don, I have something to confess.
- Oh? For a while I felt resentment when it became clear I wasn't your choice to run the Emergency Department full-time.
- It's not that you weren't qualified - Hold on.
Now I am so grateful to be putting all of myself into medicine.
And I want you to know there are no lingering hard feelings on my part.
Well, I must say I could sense the bad feelings.
I did wish there was something I could do because I value your friendship.
Well, how's the job search going? We interviewed a wonderful woman.
Amanda Lee, out of Atlanta.
- I don't know her.
- Join us for dinner? I'd love to hear what you think.
Don, I'm trying.
But I'm not all the way there yet.
Thanks.
Isn't it weird living with your boss? No, we get along okay.
Plus, it's a bargain.
All I have to do is some yard work, clean the gutters.
Do the stuff that she can't handle.
Roxanne, if you make me forget this day I will owe you the biggest favor.
- Lousy day, huh? - My med student is driving me crazy.
- Lucy.
There's so much I want to teach her.
And it's just not happening.
I don't think I'm a bad teacher.
I don't think she's a bad student.
You know what? I can say one good thing about Lucy.
She's not here.
Oh, you make a good point.
- Didn't mean to put you to work.
- Don't be silly.
It's gonna be nice.
- Want some more? - No, no.
It was good, though.
Hey, who's making all that noise? What's up, man? Come on.
Let's get ready to go, huh? Come on, say goodbye to Aunt Jackie.
Jackie, who gave him this phone? Oh, it's a toy, Peter.
It's a cute shape, and he likes it.
He probably saw you on it all day.
Hey, hey! I'm sorry.
You know, we went to a surgeon today.
I'm trying to do what's best, and I feel like I'm in a battlefield.
The more information I get, the less I know.
I don't have anybody to talk with.
What about Carla? Yeah, she's looking for me to take the lead on this thing.
I can't go back and forth over it with her.
Your girlfriend's a doctor.
Why can't you talk with Elizabeth? - Hey, hey.
- Peter? - Hey, come on.
- Peter? Come on.
Hey, man.
We should not be out here! I thought you smoothed things between ER and paramedics? You're my new intern.
I just gave you an order.
I wasn't aware Reece had a hearing problem.
My son is my business.
And I'm not interested in continuing as Interim Chief.
Beard is stuck! I wouldn't have asked if you had told me what you were doing.
Sorry you thought it was your business to ask me.
Carter? What are you doing here? Hey! Morning, Carter.
That's Grace Jones.
Hey, I didn't wake you up, did I? I mean, you're on at 7.
Yeah.
But no problem.
Good.
You settling in down there? Yes, I like it.
You have a very interesting CD collection.
What? I said, you have a very eclectic CD collection! Thanks.
Anything you want to listen to, just ask.
Don't ever touch it on your own, though.
I've rented to a lot of students, so I had to make that a rule.
Carter, let me make you one of these, man.
It'll slingshot you into your day.
You're in a really good mood.
I'm just so glad to be - Hey, can I ask you something? - Sure.
Do you find it easy to evaluate other people's work? Time to grade your student? I worry about being too harsh.
Does she deserve to be judged harshly? I want to be fair.
Lucy hasn't gotten off to a great start this year, clearly.
But she's smart and she's willing to work hard.
Maybe I should go easy, give her a chance to turn things around.
Go on.
Keep talking.
A stripper? I said, "Damn! Can't you cover that up?" She was destroying the magic.
I thought I'd ride along this morning.
It's more fun than the hospital, isn't it? He likes it on the frontlines, or we need closer supervision.
- Somebody's gotta keep an eye on you.
- Hey, doc.
Here! By the way, can I crash here tonight? My building's being fumigated.
Have to ask the captain.
Shouldn't be a problem.
You can sleep on a Barcalounger.
I've done that.
Who paged me? I got an 87-year-old man with cholangitis for you.
I stopped taking admits at 6:30.
Why didn't you page the on-call team? He came in while you were on call.
Dr.
Romano specifically asked for you.
- How sick is he? - He's septic, intubated hypotensive and in renal - No, no! This can't be happening.
Look, I haven't had a nap in the last I have to take a shower, I smell bad.
And you give me a patient sick as a dog? What does that say? What does that say? 6:38! I'm not on call! He's in Curtain 3.
We've all been there.
Shut up.
- Tony Broadway? - That a great porn star name, or what? - Carol, want to know your porno name? - What? Take your middle name and the street you live on.
Like, mine would be Anthony Broadway.
Tony Broadway.
You're mixed up.
That's your romance novelist's name.
- Excuse me? - Your porno name is your pet name with your mother's maiden name.
My name would be Nibbles McGee.
Nibbles.
That's a great porno name.
Mine would be Fluffy Florez.
If you don't have a pet? - Use one you had as a kid.
- Nibbles is a great name.
I don't think that's right.
- What would yours be? - Mine wouldn't work.
Have we gotten a package from Lakeside Supply? - This early? - It's supposed to arrive overnight.
Tell me when it's here.
Kerry, have you got a minute? We need to prepare these Attending schedules.
I'm not familiar with the computer down here.
It's a snap.
Jerry can take you through it.
- Can you give me a hand? - I got a lot of patients.
Dr.
Anspaugh, got a woman complaining about her bill.
She was charged for procedures not done.
Why are you telling me? Those calls go to the Chief of Emergency.
Or the Interim Chief.
Tell her you'll pull her chart and call her within two days.
I don't know how I'm supposed to learn in this environment.
Our relationship has turned adversarial and it's not good for the patients.
Dr.
Carter, we need to talk.
Hey, Lucy.
Is everything all right? You're talking to yourself.
Not a bad thing Actually, do you think I should sit down and talk to Dr.
Carter? Depends on how direct you want to be.
You don't want to be confrontational.
- You don't want him to be defensive.
- Right.
I'd do it over a meal.
Oh, like a chat.
I like that.
Makes sense.
Oh, damn! Hey, Lucy? Could you get me a tampon from the thingy? Oh, I got one here.
Damn it.
- There you go.
- Thanks a lot.
Peter, sorry I'm late.
I was in the ER with an admission you need to see.
- The problem? - 87-year-old male septic, with cholangitis.
He's on mezlo and Flagyl.
I got his pressure up with dopamine.
He's too sick for open surgery.
We'll do a decompression.
- I booked the O.
R.
- Busy night last night? Oh, God, horrible! Twelve admissions, plus this one.
I got an abdominal aortic aneurysm, stab wound to the chest fall from a second-story balcony.
They just kept coming.
I worked 36-hour shifts as an intern in England.
This makes me realize how long ago that was.
I'll take him down, and we'll round at 8, okay? Lovely.
Gives me enough time for prerounds and a shower.
You know, I bumped into David Kotlowitz an hour ago.
He's a terrific ENT.
He's done a lot of work with cochlear implants.
Did you tell him about Reece? No, I just told him I had a friend in need of talk on the subject.
Don't solicit medical advice on my behalf, all right? I worked with Kotlowitz.
That's why I brought it up.
- Lf you'd rather I hadn't - Yeah.
Fine, forget about it.
- What is that? A sternal saw? - Yes, it is.
- What's it doing here? - My midline thoracotomy proposal sailed through the Human Subjects Committee.
Nobody told me.
Well, I'm certified to use it, so we're up and running.
I thought we'd talk before it got underway.
Surgeons use it on odd days ER docs get it on evens.
Your turn's tomorrow.
Hey, bad news.
We're still not pregnant.
We'll redouble our efforts.
If it's more than three times a week we get diminishing returns.
Like reusing the same tea bag.
- There's a romantic idea.
- Wasn't very romantic, was it? Doug? I've got a lethargic infant not eating.
You better come see him.
- You okay? - Yeah.
Baby's name is Sun? Korean? Actually, it's Sun.
His mom's a little different.
All right, Mrs.
Everly.
I'm Dr.
Ross.
Can I take a look at Sun? I don't know what's wrong.
He won't nurse.
We'll figure it out.
Hey, you his big sister? What's your name? - Sky.
Hello, doctor.
- Well, hello, Sky.
Sun and Sky, huh? He was fine until a few days ago.
Then I noticed he wasn't nursing so well.
- Any solid foods or formula? - Oh, no.
Only my milk.
My breasts are engorged with him not eating.
When was the last time he pooped? - Oh, man.
When? - Yesterday morning.
- You sure? - Yes, I haven't changed him since.
We'll hydrate him.
Give him We'll have to do blood tests.
And I need your consent to do a spinal tap.
You stick a needle into his spine? Won't that hurt? We'll sedate him, no pain.
- Mom, it's gonna be okay.
- Do you think so, honey? We'll be right back, okay? Get a CBC, Chem-20 and blood cultures.
Can you assist with the LP? Sure, how do you sedate him? Propafol.
I'll get it from Pedes.
General anesthesia? Have we done that in the ER? First time for everything.
I'll take the proper precautions.
Yelling doesn't help! There's an ambulance out front.
- Thank God! - Don't open that door.
Get away from me! - Come on! - Get away from me! Don't touch me! - Yes, hello.
- We got a 911 call.
- I called.
- She shouldn't have called.
Get in here! - Where's the injured man? - This is not an emergency.
Everything's fine.
I don't need the hospital.
- Your name? - Richard Weingarten.
He let this lunatic drill a hole in his head.
I'm an emergency physician.
Let me take a look.
- I'm all right.
- Okay, just sit down here.
Sit down.
What are you ashamed of? - What happened? - It's called trepanation.
It's a centuries-old practice, a means of increasing brain blood volume.
- I had mine done in Amsterdam in 1968.
- Oh, God! It was like God lifted a weight from me.
It's a surgical drill.
We're going to the hospital.
You can't take me against my will.
I've studied this for years.
I didn't embark on it lightly.
Let us at least put a bandage on and get a blood pressure.
Okay, sir, just sign this.
It says you refuse treatment.
Go to the rig and get some saline.
- Come on, Rich.
We did it.
- The Internet! That's what started this whole thing! - Laura! - I hate it! - Get her outside.
- I hate it! - What are you doing? - Outside! - I don't want to go! - Calm down! I'll have you brought up on charges.
I want to go back inside! You're an intelligent person.
I don't want to take you against your will.
I had to do something.
All right.
Okay.
Doesn't look like you penetrated the dura.
All I want to do is put a sterile dressing on to clean the wound.
I'll leave you some saline and gauze so you or your friend, can keep it clean.
I forgot to bring any gauze.
I've held enough screaming babies to know.
They have to be sedated.
Doug? How you doing? You can't administer propafol to an infant.
You've done it upstairs for 10 years.
You're not an anesthesiologist.
I didn't think you'd have a problem.
Well, I do.
I have him on a cardiac monitor, pulse ox, dynamap and a crash cart.
You cannot just make up policy as you go along.
I'm trying to prevent pain, do what's best for this boy.
If you want to discuss policy, leave.
We'll do it later.
We will.
Dr.
Carter, want to grab lunch later? Let's see.
Tell me about this patient in Curtain 3.
Thirty-year-old male with pain on urination.
- The UA is negative for white cells.
- Chlamydia.
Do a sexual history? He had two partners last year, and used condoms.
So he claims.
Send up a DNA probe and treat empirically.
Treatment for chlamydia? Doxycycline BID, or a dose of Zithromax.
You should look at his chart - Hi, I'm Dr.
Carter.
- Hey.
I need to ask, do you always use condoms? Pretty much, yeah.
There's times where you haven't? Once or twice maybe, yeah.
That's all it takes.
We're gonna give you antibiotics.
I think you have a common infection called chlamydia.
What, VD? Sexually transmitted disease, yes.
She doesn't think so.
He also had conjunctivitis and arthralgias at the knee and ankle.
Mr.
Bussey, excuse us for a moment.
He was in Mexico and had diarrhea.
The timing and symptoms are classic for Reiter's.
- You could've included that.
- You cut me off.
- You could've said, "Reiter's.
" - I didn't get a word in.
You - I'm always doing what? - Like now, you're defensive.
You don't even hear me.
So, what's the treatment for Reiter's Syndrome? Indomethacin.
- We can still send off for chlamydia - No, you're right.
It's Reiter's.
Good pickup, Lucy.
Propafol is ideal for use in the ER.
First of all, onset is immediate, and it wears off in Don't you think a doctor should be trained? Got a gunshot to the chest coming.
The saw is sterilized in Trauma 1.
We need to be ready if this guy qualifies.
You'll document 10 critical times.
Clock starts when? Soon as the patient enters.
Don't they need to have cardiac arrest? He sounded okay.
Patients can deteriorate en route.
Forty-six-year-old man shot with a BB gun.
- Hemodynamically stable.
- A BB gun? The punk who shot me needs to be put under the jail.
Ten years old or not.
Let me up off of this, I can walk.
- Let him go.
- Doesn't need a thoracotomy.
- No, a tetanus shot and a Band-Aid.
- You can follow me, sir.
- Want to turn around, or can we hang? - No, take 10 minutes.
Hey, Carol.
What's going on? Just doing a quick blood draw.
So how's the clinic going today? Oh, I just love prenatal days.
Takes me back to my OB roots.
Why don't you let a nurse do that? Because I was trying to be discreet.
Let me do it.
It's kind of hard to stick yourself.
Thanks.
What labs you need? Just a CBC, check if I'm anemic.
Oh, I only ask because if you'd like I can run the results through the clinic.
Be more private.
That's a great idea.
What I'd really like is to check my hormone levels.
Oh, okay.
Infertility workup? - I don't want to discuss details.
- I wasn't trying to It'd be great if you run it through the clinic.
- Okay.
- Thanks.
Mark, glad I caught you.
I've had to move my surgical schedule.
Dr.
Lee's interview is pushed to 1:30.
- Is that a problem? - No, that's fine.
- Have you looked at her CV? - Impressive.
If she's half as impressive in person, she might be our next Chief.
And not a moment too soon.
Dr.
Greene, I didn't think you were gonna be around.
I was on a paramedic ride-along, and we brought in a patient.
So, you finish your student evaluation yet? I thought I had till the shift ends? No big deal, this afternoon's fine.
I wrote an evaluation for Lucy but I tore it up because I want to be fair.
You put something on paper that'll impact her life.
Just evaluate her work.
What are you talking about? I'm talking about your porn-star name.
Take your pet's name and your mother's maiden name.
- Try it.
Like mine is Rex Voytek.
- Oh, I know that game.
But it's your drag name, not porn.
- Drag name? - Yeah, the name of your pet and the street you're born on.
- I don't think so.
RuPaul had it on her show.
Leave some crumbs for the rest of us.
- Are you the cookie police? - Have some but I brought those for the docs and nurses.
- So you're the cookie fairy.
- Wait a minute.
- Don't worry.
- Bad enough you raid the icebox, now you want to call names? Conni, you begrudge us some juice? It's not like you bring anything in.
You should thank me for the cookie I keep from your fat snack hole.
You just keep talking, Morales.
- Hey, what's going on? - That one's got a problem.
- You antagonizing them? - He called Yosh a fairy.
I called him the cookie fairy.
It was a dumb joke.
A real dumb joke.
Ready to head back? Yeah, let's go.
I got no problem with him being a bone-smoker.
I was joking like I would with anybody.
Don't worry about it.
Write the discharge orders soon.
- Bed Control likes them by 12 noon.
- Yes, I am aware of that.
I told you I'd have a hard time seeing you as my intern.
It's complicated for a lot of reasons.
Dr.
Corday, Mr.
Frybush's creatinine is much higher.
Thank you.
Shall we call a renal consult? Yeah, this guy needs dialysis.
- So did you ever get that shower? - No, can you tell? Well, go ahead.
I'll cover SICU.
- I don't want special treatment.
- Turning down a shower? - I've got a lot of work.
- Okay, have it your way.
Gotta go find Weaver.
She's itching to use that saw.
Going to the roach coach.
Want something? Yes, a triple espresso.
Thank you, Kit.
Elizabeth? How would you like to scrub in on a bilateral adrenalectomy? Oh, I appreciate the offer, but I'm postcall.
I gotta finish my work, and I have to catch up on sleep.
A case like this comes once in a blue moon.
I'm up to my neck in ER garbage, but I'm not passing this up.
Well, it's been a while since my last adrenalectomy.
I'll do right, you do left.
I can get Dr.
Kennedy to cover your service.
Jeanie? The baby's spinal tap came back negative for meningitis.
What's going on? A lot.
We got to talk to the mom.
I'll take Sky out of the room.
She doesn't need to hear all this.
Good idea.
Her mom leans on her a lot, don't you think? - A smart kid, though.
- Yeah.
Okay.
Hey.
- What did you find? - Spinal tap was negative.
I have more questions.
Maybe Jeanie and Sky could take a walk.
I don't want to worry about her wandering.
I'd rather stay here with Mom.
Can she help me put some toys away while you talk? It's a good idea.
- Mind helping me? - I don't mind.
I'll be right back, Mom.
- See what toys we can find.
- Sure.
Okay, we need to see if we can figure out the cause of Sun's deterioration.
- Now, has he had a polio vaccine? - Oh, God, polio! He was vaccinated.
Is that effective? Do you have a doll at home? - No.
- No, really? I had one.
Dolls are for babies.
I'm a big girl.
- And how old are you? - Six.
Six.
After the adrenal vein, we'll work our way around the medial and inferior edges of the gland.
Cut, please.
And another tie.
Elizabeth, cut.
Elizabeth? Sorry.
Yes.
You do need a rest.
Why don't you step out? No, I'm fine.
I'm fine.
Go take a nap.
Sorry I dragged you along.
Dr.
Goodman? - Can I run something by you? - Make it quick.
Male with aphasia and arm weakness.
CT scan was normal.
Spinal fluid is clear.
I'm thinking vasculitis or MS? Send off a sed rate and a complement level in the CSF.
Look at the differential.
May be some zebras you haven't considered.
Okay.
Hey, Yosh, is that Lucy's palmtop? I love this.
She let me borrow it.
- Can I use it? When you're done.
- I'm done.
Here you go.
- Know how to work it? - Yeah, Lucy showed me once.
I'd hoped to avoid this.
But things haven't improved.
I don't know how I'm supposed to learn in this hostile environment.
Our relationship has turned completely adversarial and it's not good for the patients.
We need to talk.
This crazy bastard lets Dr.
Greene Iook inside the hole with a penlight.
- Unbelievable! - I thought I'd seen it all.
Doc writes him a scrip for antibiotics.
The guy thanks us for coming.
Yeah, I've got a way with ranting lunatics.
- I ain't kidding.
You do.
- Hey, what's up, guys? - We're all here.
- You're not on today.
Truth is, they're here because we got you something.
You like it? - It's great.
- You're one of the gang now.
- Almost.
- Almost? There's something every paramedic does.
It's only appropriate that you do too.
How many patients have you brought in strapped to a backboard with a collar? What do you have in mind? Come over to the table, we'll show you.
As a part of our training, we all get on the board ourselves.
You want me to lie on the board.
Don't worry.
We all did it.
- Comes with the coat.
- Gotta drop your pants.
No, he doesn't! Forget about that part, guys.
All right? Forget it.
I have to get back to the hospital.
Then don't fight.
Just lie down.
- Come on.
- Relax, guys, back off.
Let him do it on his own.
You want me to lie down.
- There.
- There you go.
Get him! Got the shower on? - Come on, the shower's on! - Get the shower! Stop it! Stop it! Take it easy, doc.
Hey, guys, guys.
Come on.
Let him up.
- Let him up.
- We weren't gonna hurt you.
Much.
It's all over for now.
Jer, know what your name is as a porn star? That game is tired.
- I've got the best, Satan Monroe.
- Your mother's maiden name is Satan? - Carol, I need you.
- What's wrong? Young woman complains of severe right lower quadrant pain.
Pregnancy test positive, a possible ectopic.
- Name? - Maria Jones.
Five pregnancies.
Two live births, two abortions.
Hi, Maria.
We're gonna take care of you.
- It hurts, it hurts! - All right.
Let's get a CBC, Beta HCG, Chem-20.
Type and cross two units, and start a line of saline.
- Did you do a pelvic? - No, she's in too much pain.
She said I'm pregnant.
Is my baby okay? Okay.
Let's do an ultrasound while we're at it.
It just hurts so bad! Okay, you're gonna be fine.
Sorry I'm late.
We were just about to start without you.
Dr.
Lee, Mark Greene.
Sorry if I held things up.
I'll try not to take it personally.
You've been flexible with your time.
We appreciate it.
- I'm happy to be here.
- Let's get right to it.
"Three years as associate chief.
Excellence in Clinical Teaching Award two years in a row.
" How do you think you can improve our department? You could benefit from an eight-bed observation unit for 23-hour stays.
Paid for how? We're a cash-poor county hospital.
- That's why you need it.
- Tell us more.
I set up a unit like it in Atlanta.
And it saved the hospital $2 million a year in unnecessary admissions.
What kind of patients are we talking about? - Lucy, take this.
- What is it? Your evaluation.
It's blank.
You fill it out since you think I'm so adversarial.
And keep track of this before someone walks away with it.
You listened to my notes? You're so sure I'd give you a bad evaluation you're planning a countermove.
A hostile workplace? I didn't know it's time for evaluation.
Please.
Why'd you want to have lunch? To get things out in the open.
Well, they're out in the open.
Why don't you fill that out, and let's see how fair-minded you can be.
- How long will they be upstairs? - Not much longer.
What was the name of the doll you had? - Baby.
- Was Baby a boy or a girl? She wasn't a boy or a girl.
She didn't have a penis or a vagina.
- What are you doing? - Letting him lick the spoon.
Does your brother lick the spoon? Sometimes, with things that he likes.
- Like what? Yogurt? - Sun doesn't like yogurt.
- What does he like? - Lots of things.
Does he like honey? Your little brother licks honey off of your spoon? - He likes it.
- Okay.
Sky, let's go find your mom and Dr.
Ross, okay? Okay.
- I like the observation unit idea.
- Good.
- Very good presentation.
- Thank you.
I'd be happy to give you a tour of the ER.
I don't need to be hand-held.
But I do want to walk around.
Feel free.
I'll catch up with you.
It's a pleasure.
- Mark, do you like her? - She's good.
You didn't say much.
Didn't think you're impressed.
I'd like to continue this in a less formal setting.
I'll see if she can come for dinner.
- Would you be? - I can't tonight.
I'm sorry.
Excuse me, Dr.
Anspaugh.
- Are you feeling better? - A little bit.
Going to the bathroom helped, huh? Maybe it was just gas pains.
You haven't had any bleeding, which is good.
You're further along than we thought.
Looks like 15 weeks.
- I wasn't even sure I was pregnant.
- Look.
Can you tell? Is it a boy or a girl? Can't say for sure.
It looks like a girl.
After having two boys, that'd be nice.
Well, I don't see a penis.
You can't always tell on an ultrasound.
You'll have to come back make sure she stays healthy.
I'll do that.
Come on, Corday.
Pull yourself together.
It's just a few more hours to go.
Elizabeth, can you do me a favor? Watch the service? I've gotta see Dr.
Kotlowitz.
- Really? - Yeah, I ran into him.
Actually, I went looking for him.
Peter, that's terrific.
Yes, go! - I can cover service.
- Thanks.
I need orders on a new admission.
I'm not in the mood for jokes.
- No, Mr.
Ramos is back.
- Ramos? Fem-pop bypass? I discharged him yesterday.
He's back with an infection and an asthma attack.
- You know the rules.
- Yep, I know.
He's mine.
He's on continuous albuterol.
Hello, Mr.
Ramos.
Let's take a look at your legs.
I was hoping you'd be here today.
Oh, where else would I possibly go? I asked the mom if she'd given the baby food.
Guess I talked to the wrong person.
The baby's lucky.
We can treat botulism.
- But what do we do to help Sky? - She's fine.
Her mom's draining her childhood.
As much neglect and abuse as I see, trust me, Sky is okay.
- She needs to be a little girl.
- Yeah, that's true.
Hey, guys.
Okay, now you can't give honey to your brother or to any baby because it can hurt them.
Honey can have botulism spores.
Their intestines are immature, and they can't kill off the spores.
He's maxed out with a pressure of 65.
Systemic resistance is 3500.
Let's start Levophed.
Dr.
Corday, I need you here.
Mr.
Ramos is pretty tight.
You okay? Yep, I'm fine.
- How much albuterol? - Twenty an hour.
- He's had Solu-Medrol.
- 125 in the ER.
- Okay, I'll push some magnesium.
- Magnesium? It relaxes the smooth muscles of the bronchioles.
Can you look at Mr.
Frybush? Give me five minutes, okay? Carter, can you explain this evaluation? If it's this bad, you should've come to me.
Do you have something against her? - Wait a sec - I want to see you and Lucy.
We're gonna figure this out.
Find her and then me.
- Can I hang on to that? - No! Sound like you're in a good mood.
Do me a favor? I need a place to crash.
Building's being fumigated.
Would Carol mind? - You kidding? Come over.
- Save me a few bucks.
- Sure thing, glad to have you.
- Thanks.
He's set up for another four hours of continuous.
Magnesium's on board.
- How are you feeling, Mr.
Ramos? - Dizzy.
- Whoa.
What's happening? - Maybe he's hypoxic.
- How much mag did you give him? - Two grams IV push, 40 cc's.
Forty cc's of 50 percent mag? Not 50 percent! Five percent! No, Dr.
Corday, you gave him 50 percent.
My God, you're right.
I gave him a lethal dose.
- He's not breathing.
- ET tube! Bradying down.
Heart rate's 30.
Two grams calcium gluconate.
Push an amp of atropine.
Bag him, prep for IJ.
I'll float a pacemaker.
- Lost the pulse, in P.
E.
A.
- I'll start compressions.
Seven and a half gloves and The cochlear implant is a miracle, and the technology keeps improving.
I'm impressed by what I read.
Don't read.
Talk to people who have it.
Talk to parents of kids I can get you in touch with people who faced the same.
Great, I've already heard an earful from the opponents, so The fanatics.
Well, they've got their agendas.
The level of passion with which these people attack you, it's bizarre.
Someone used the word "genocidal.
" Said I was eradicating deaf culture.
Deafness is not an alternative lifestyle.
People who claim it is are beyond reasoning with.
The thing I figure is why make an argument against hearing and speaking? Honestly, know what I think? I think it comes down to laziness.
A deaf person can function.
But some people don't want to exercise and do all the drills it takes.
Look, it's years of hard work.
Yeah, but they have the energy to attack me.
The hell with them.
Don't stand in my way when I'm trying to help a person function.
Why don't you tell me how you really feel? Anyway, you bring in your son and we'll see if he's a candidate.
Do you work closely with Dr.
Corday? Actually, she's my intern.
She told me about the fallout with Rocket Romano.
Oh, yeah.
Do you know if she's seeing anybody? I'm just wondering.
I'm pretty sure she's involved with somebody.
- I'm not surprised.
- Yeah.
- Oh, well.
- Thanks.
You bet, anytime.
Give me a call.
Check, please.
Systolic, 60 palp.
Come on.
Come on.
Come on.
We've got capture.
Turning the rate down to 80.
- Did you page Dr.
Benton? - Done.
- Pulse is stronger.
- Good.
Pupils are fixed and dilated.
That could be the atropine.
That, or he stroked out.
What happened? I gave him enough magnesium to cause a cardiac arrest.
- Twenty grams.
- Oh, no.
I looked at the label.
I thought it said 5 percent but it was 50 percent.
But I looked at the label.
- I got your blood work back.
- Thanks, Lynette.
Progesterone level's normal.
That's good news, you ovulated.
I've been trying to get pregnant, and I haven't.
- How long have you been at it? - Couple months.
Give yourself at least six months before you start worrying.
Yeah, you're right.
I'm crazy.
Maybe you guys need to increase your activity.
How often do you, you know, do the do? - What? - Oh, sorry, am I being indiscreet? Carol, what's the deal? I went to see your ectopic.
She's dressed, ready to leave.
- Maria Jones? - She pulled her IV? Maria, where are you going? I feel better.
I'm going home.
You were in so much pain, I couldn't examine you.
- But I'm better now.
- But, wait.
We need to make sure everything's okay with you.
Just let the doctor look you over.
Look, I just wanted to know if it was a boy or a girl.
Nothing's wrong, so why worry? Wait! You were faking those abdominal pains? - Are you crazy? - You weren't sure you were pregnant.
Why would you lie and cause all that drama to find out if it's a boy or a? - No, are you gonna abort this baby? - Let go of me! - Carol! - She's had two boys and two abortions.
Are you getting rid of this child? It's my baby and I'll do what I want.
I told you that ultrasound is inconclusive.
It could be a boy! Lady, take your hands off of me.
Carol, let her go.
Girls are trouble anyhow.
What's the matter with you? What's the matter with you?! How could you inject a patient with 20 grams of magnesium? I make no excuses.
It was a grievous error.
Where were you during this, Dr.
Benton? I was out of the hospital.
I came when I was paged.
It wouldn't have mattered, anyway.
You left your intern unsupervised.
This patient may have suffered brain injury.
I stopped by the unit.
Mr.
Ramos' eyes are open, and he's responding.
You are not to leave while on duty.
You are not to leave your intern unsupervised.
I know it's hard for us all to view Elizabeth as an intern.
But we've opened up this hospital to enormous liability.
I'll speak to Risk Management and the hospital attorneys.
They'll determine what information to release to the families.
Don't either of you discuss this with anyone.
Can we get together and not talk about this? I have to pick up my son from my sister's house.
All right.
You just need to get a good night's sleep.
I didn't fill this out.
- Who did? - She did.
- Why did she? - Because he told me to.
I didn't say to give it to him, I said to give it to me.
- No, you didn't.
- Okay, wait.
Don't talk to each other, talk to me.
Mark, I wanted to know how she thought she was doing before my final assessment.
I tried to put myself in his shoes and be critical.
He said, "fill it out" meaning "turn it in.
" - How could she assume that? Makes no sense.
That's part of his problem.
Incomplete directions.
I give incomplete directions? - Name a time.
- Just one? Tell her to name a time when I gave her incomplete directions.
- Okay, talk to each other.
Don't talk to me.
Whatever this is, I can't fix it.
Work it out, both of you.
Kerry, I need to talk to you about the x-ray report.
Please don't blow me off.
Sorry, trauma coming in.
Possible candidate for the thoracotomy study.
I didn't know that's running.
Stab wound to left chest.
Had a pulse in the field.
Gave him epi, 1500 cc's of saline.
Shocked him twice.
Great candidate.
The stopwatch? Right here.
You mind if I tag along? Now, start the timer.
Here we go.
On my count: One, two, three! Two units of O-neg on the infuser.
Get type-specific as soon as you can.
Ten blade, let's go.
Good breath sounds bilaterally.
Seven and a half gloves.
Okay, skin incision is complete.
Mark the time.
Saw, please.
- Sternal retractor.
- Good job! - I need a purple top.
- Pulse ox 85.
- Mark the time.
- Suction, please.
Pickups and Metz.
Looks like blood in the pericardium.
First hemoglobin is 9.
2.
Okay, pericardium is open.
Mark the time.
I see a stab wound to the left ventricle.
- What are we at? - Forty-two seconds.
Take over internal compressions.
Tamponade the wound.
2-O silk.
One horizontal mattress should do it.
- Two units are in.
- Hang another two.
How's the heart? - Starting to fill.
- Get the paddles ready.
Okay, cardiac injury is repaired.
Mark the time.
- V-fib.
- Charging to 20 and clear.
- Sinus rhythm.
- Cardiac activity restored, mark time.
- I've got a pulse.
- Excellent job, Kerry.
Dr.
Greene.
Dr.
Lee.
Finding your way around? Yes, thanks.
I wanted to ask you.
I didn't feel I connected with you at my interview.
- Is that a correct assessment? - How do you mean? I'd look over and wonder, "Am I making my best case?" It was a good interview I like this department and I want this job.
I'm one of the baddest ER bitches out there.
If I didn't make my best case before, I'd like to try again now.
Can I grab a soda and sit with you? Yeah, sure.
Call me when he's in Recovery.
- Don, I have something to confess.
- Oh? For a while I felt resentment when it became clear I wasn't your choice to run the Emergency Department full-time.
- It's not that you weren't qualified - Hold on.
Now I am so grateful to be putting all of myself into medicine.
And I want you to know there are no lingering hard feelings on my part.
Well, I must say I could sense the bad feelings.
I did wish there was something I could do because I value your friendship.
Well, how's the job search going? We interviewed a wonderful woman.
Amanda Lee, out of Atlanta.
- I don't know her.
- Join us for dinner? I'd love to hear what you think.
Don, I'm trying.
But I'm not all the way there yet.
Thanks.
Isn't it weird living with your boss? No, we get along okay.
Plus, it's a bargain.
All I have to do is some yard work, clean the gutters.
Do the stuff that she can't handle.
Roxanne, if you make me forget this day I will owe you the biggest favor.
- Lousy day, huh? - My med student is driving me crazy.
- Lucy.
There's so much I want to teach her.
And it's just not happening.
I don't think I'm a bad teacher.
I don't think she's a bad student.
You know what? I can say one good thing about Lucy.
She's not here.
Oh, you make a good point.
- Didn't mean to put you to work.
- Don't be silly.
It's gonna be nice.
- Want some more? - No, no.
It was good, though.
Hey, who's making all that noise? What's up, man? Come on.
Let's get ready to go, huh? Come on, say goodbye to Aunt Jackie.
Jackie, who gave him this phone? Oh, it's a toy, Peter.
It's a cute shape, and he likes it.
He probably saw you on it all day.
Hey, hey! I'm sorry.
You know, we went to a surgeon today.
I'm trying to do what's best, and I feel like I'm in a battlefield.
The more information I get, the less I know.
I don't have anybody to talk with.
What about Carla? Yeah, she's looking for me to take the lead on this thing.
I can't go back and forth over it with her.
Your girlfriend's a doctor.
Why can't you talk with Elizabeth? - Hey, hey.
- Peter? - Hey, come on.
- Peter? Come on.
Hey, man.