Chicago Med (2015) s05e09 Episode Script
I Can't Imagine the Future
1 I don't remember a lot.
There's something I want to ask you.
You've helped me through a very difficult time.
Do you love him? He slipped the ring on your finger when you were unconscious.
It doesn't matter because it's over.
And you, get out of my life.
Dr.
Manning.
Agent Lee told me what's going on.
Agent Lee told me what's going on.
[DRAMATIC MUSIC.]
Hi, April I've got your test results.
You couldn't tell me over the phone? Well, I just thought we should discuss this in person.
Okay.
Good news.
Your thyroid and pituitary tests are completely normal, and your HSG X-ray shows that your fallopian tubes are open.
Okay.
So what's the bad news? Your AMH and Antral Follicle count are low.
And your FSH is high.
Even though you're only in your thirties, that indicates that there's Early onset menopause? I like to call it exactly what it is, low ovarian reserve.
I'm the reason we haven't gotten pregnant.
Spontaneous pregnancy isn't impossible.
Dr.
Patchefsky the miscarriage a few years ago, and now this? Ethan wants a baby.
I can't I can't give him one.
April, this is far from hopeless.
Ethan should get tested, too.
And then the two of you might want to discuss IVF.
- IVF.
- Mm-hmm.
I'd recommend starting sooner than later.
With low ovarian reserve, you may not be responsive.
So I go home and I tell Ethan I'm going through menopause, and even with IVF, I still might not be able to get pregnant.
Couples work through this, April.
Was the gym crowded? What? You were gone a long time.
Oh.
Yeah, it was crowded.
Do you really have to leave? Yeah.
How can the Navy make you go for two months? Six weeks.
Told you.
Doc on a carrier had an MI.
Sounds pretty serious.
They called up a reservist.
"The Expectant Father"? Just living in the future.
God, Ethan.
What? I have to get ready for work.
Morning.
Hey.
How did you sleep? Great.
How's your pain, honey? You're not dressed.
Oh.
Yeah.
Thought maybe I'd stay home today.
Please don't try and talk me out of it.
Okay, I won't.
Thank you.
You're getting good at this marriage stuff.
Fourth time's a charm, I guess.
Danny? I want you to re-marry.
But I'm happily married to you.
Danny.
What are we having for breakfast, honey? What do you want? I know you heard me.
Pancakes, it is.
[SOBBING.]
Ben do you mind if I share with Maggie what I'm finding? Please do.
You're running a fever.
103.
2.
And you're tachycardic.
Rapid heart rate.
Of more concern, your white count is really low.
2.
2.
And your platelets are at 35.
Also low.
So not good.
No.
I'm sorry, Ben.
Not good.
So tired.
Why don't you get some rest? You let me know if he has any trouble breathing, and we'll increase his oxygen, okay? Make him as comfortable as possible.
Hey.
Dr.
Manning, I'm sorry to bother you.
- What's up? - Um, a I'm not sure how you want to handle this.
A pediatric patient of yours has just been brought in for a scheduled surgery.
All right, I'll go see the patient.
What's wrong? Well, it's, uh it's Phillip Davis's daughter.
Sophie.
I mean, I know that you and he Whatever happened between her father and me, Sophie is still my patient.
Right.
Sophie has had multiple procedures to correct congenital tricuspid atresia.
Why don't you come up and help me examine her? Okay, yeah.
Okay.
Dr.
Manning? That night of the accident Natalie? It was just like this.
Do you love him? It's weird.
Some things are starting to come back to me.
Phillip was there.
And some FBI agent.
And she wanted I can't remember.
Dr.
Manning? Yeah.
The family's waiting to see you.
Okay.
Let's go.
- Dr.
Manning? - Yes.
And this is fourth year medical student Ms.
Curry.
I'm Cheryl McFarland, Phillip's sister, Sophie's aunt.
This is my husband Jeremy.
Hi.
I'm sorry.
Do you live here? Streeterville.
Why? Phillip said he didn't have any family in Chicago.
Phillips says a lot of things.
He's a pathological liar.
Wow.
Um may I ask where is he? I don't know.
He asked us to meet him at the hospital.
When we got here, he was gone.
I don't understand.
He left Sophie.
He isn't coming back? I doubt it.
Well, you know what? All that matters right now is Sophie.
So why don't I take a look? Oh, hey, there.
There she is.
Hey, Mike.
We got your labs back.
Hmm? He's still kind of out of it.
Makes sense.
You're uremic.
My kidneys.
Afraid so.
Dialysis problem.
Your catheter's clotted off.
- That why he feel so lousy? - Yeah.
My brother's been on the transplant list for over a year.
I'd give him my kidney, but I'm not a match.
Well, the good news is that there was no sign of infection.
So if a kidney becomes available, you can have the surgery.
We're gonna get you through this.
Okay? All right.
So how you feeling, Dan? Okay.
Better.
- Good.
- He had us so worried.
He's never passed out before.
When you brought Dan in the ED yesterday, he was in a diabetic crisis.
Blood sugar 640, pH 7.
23.
The ketoacidosis is what caused you to lose consciousness.
But with the insulin drip and IV fluid, your numbers are looking better.
Thank God.
What about his kidneys? I am concerned.
I want a nephrologist to see you.
[KNOCKING AT DOOR.]
Excuse me.
Your patient's on the list for a new kidney, right? Yeah, he's had a hard time managing his diabetes.
Wrecked his kidneys.
Well, we might have one for him.
Might? Direct donor situation, but it's complicated.
We have a patient downstairs who also needs a kidney.
His brother's willing to donate, but isn't a match.
But turns out he is a match for your guy.
So if somebody from your guy's family matches our guy and is willing to donate, then our guy's brother will donate his kidney to your guy.
Quid pro quo.
- Domino transplant.
- Bingo.
Both go home with a kidney.
We just need a match.
I'll present the offer.
Great.
Jordy Collins, 16-year-old male with Down Syndrome.
Motor vehicle collision.
Okay, we're going to Baghdad.
- Is it okay if I take your pulse? - Yeah.
I'm his dad.
We were rear-ended.
We were going to the rink.
I think he got whiplash.
- I ice skate.
- That's really cool.
I can't ice skate to save my life.
[LAUGHS.]
Doris.
[DRAMATIC MUSIC.]
All right, on my count.
One, two, three.
- This is a big hospital.
- Sure is.
We're gonna take good care of you.
Jordy, anything else bothering you besides your neck? Uh-uh.
Good.
Chest X-ray.
Dad, anything in Jordy's history we should know about? - No, he's a healthy kid.
- I like to hear that.
Okay, I'm gonna listen to your heart.
Yeah, Jordy, your heart sounds real good.
Squeeze my hand, will you? Oof, you're strong.
This is a big camera.
It's gonna take a picture of you.
- Won't hurt a bit.
- Okay.
Everybody clear? Coming up.
[MACHINE WHIRS.]
Hey, chest looks good, too.
I'm gonna take this collar off and see what's what, okay? Okay.
All right.
Ow! Sorry, buddy.
Now we'll put that collar back on.
It could still just be whiplash, but I want to make sure there aren't any other injuries.
With your permission, I'd like to send Jordy for a CT of his head and neck.
- Sure.
- Great.
- You'll let radiology know, Doris? - Right.
We're gonna fix you up, get you back on that ice.
Okay.
Okay.
I'll check on you in a bit.
Hey, Dan.
Martha, Bill, this is Dr.
Marcel.
He's been treating the other kidney patient I told you about.
Am I a match to him? Is Dan gonna get a kidney? No, sir, you are not a match.
But, Mrs.
Schiller, you are.
- So I can donate? - Yes.
Wait, hold on.
Mom, I don't want you taking the risk with your blood pressure.
And that means that my son will get a kidney.
Yes.
From my patient's brother.
Wait.
Dan, I am your mother.
It's a kidney.
It's nothing.
What if something happens? Honey, you're my baby.
I can't imagine life without you.
When you have children of your own, you'll understand.
I'll give the transplant team a call, get things started.
Hey, did you hear the good news? - Yeah.
- All right, can we talk? - I'm busy, Ethan.
- It'll just take a second.
About your reaction to the book earlier, I know you're anxious about not getting pregnant.
- Let's just forget about it - Here's the plan.
I have some time this afternoon.
I'll go see a urologist.
- What? Why? - Get a semen analysis, - make sure I'm not shooting blanks.
- Oh, my God, Ethan.
Why do we have to talk about this all the time? Look, I just want to make sure I'm not the problem.
There is no problem.
Look, I'm not saying there is, but just in case.
- Oh, my I'm so sick of this.
- Sick of what? The pressure.
I don't even know if I want a baby anymore.
What are you saying? April.
[INDISTINCT CHATTER.]
Hey there, Jordy.
Good news.
CT scan is normal.
Can I go skate now? Jordy competes.
Special Olympics.
Wow.
Well, maybe you can go skate.
Tell me, how you feeling? Real good.
Hands feel funny.
- What? - Tingly.
Really? Both hands? Uh-huh.
What does that mean? Not sure.
Do you feel that? Uh-uh.
Squeeze my hand.
- Not so strong now, huh? - No.
Okay, Jordy, I want to run one more test before you go.
It's another type of scan called an MRI.
Dad? Okay.
Don't worry, Dad.
I'll be okay.
You're a champ.
I'll put that order in.
Okay.
Jeremy and I have decided we're going to try to adopt Sophie.
I'm really happy to hear that.
Maya.
Sophie's hit all her milestones, and her saturation's looking good at 85%.
This is Dr.
Frisch.
She will be doing Sophie's procedure.
Hello.
Did you know that the patient's father has instructed that if Sophie arrests, we are not to resuscitate? - What? - A DNR? You mean you're just supposed to let her die? No, I can't believe this.
Are you sure? It's right here in the chart.
Why would he do that? He wouldn't.
I mean, he couldn't.
Yes, he could.
Sophie's not perfect.
That makes her too much work.
But he's been so devoted to her.
I've seen him take such wonderful care of her.
Because he was getting something out of it.
You.
Now that you're not in the picture, he doesn't need Sophie anymore.
What? Look, can you get him to change his mind? I tried to call him.
He's not picking up.
I don't even know where he is.
Well, I'm not comfortable performing this surgery on a child with a DNR.
- Maya - I'm sorry.
Oh, my God.
We are gonna fight this.
Your donor's being prepped for surgery.
We'll take you up to the OR about an hour into her procedure.
Can't believe this is actually happening.
When do I go up? Your brother's organ transfer should take about two hours.
Then it's my turn? Right.
Dr.
Marcel, you have the honor.
Betty, are the antibiotics in? Yep.
2g Cefazolin.
Vitals stable? All good.
All right.
Let's begin.
[THERMOMETER BEEPS.]
His fever's up.
103.
6.
Maggie.
I'm right here, Ben.
Let me know if he needs anything.
Okay, thank you.
I had a dream.
I was fishing.
That sounds nice.
No.
I hate fishing.
[LAUGHS.]
There you go.
Mm.
That's better.
Ben.
Is there anyone I should call? You're the closest thing I got to family, Maggie.
Have you made any arrangements? I should've.
I just kept thinking about getting better not about my funeral.
My folks are in a cemetery in Florida.
I'd like my ashes to be with them.
Okay.
This doesn't make sense.
We have to do something, Mrs.
Goodwin.
- I'm sorry, Dr.
Manning.
- So that's it? There's no way to overturn this DNR? The father abandoned the baby.
We don't know that.
And Mr.
Davis left very clear instructions.
He claimed, and I quote, "My little girl has suffered enough, and if the good Lord decided to take her, we should let him".
That's ridiculous.
He's not even religious.
Dr.
Manning, both the ethics committee and legal said this DNR is valid.
And they won't approve emergency guardianship.
Ugh.
This is about the Davis baby? Yes.
Dr.
Frisch briefed me.
Can you convince her to do the operation? No, and I understand her refusal.
It's a very risky procedure, and the baby is likely to arrest.
Dr.
Rhodes performed the previous procedure.
That's right.
I'm sure if he were here, he would agree to do this.
I will do the surgery.
[MACHINE BEEPING.]
Dr.
Choi, something's wrong.
- Dan? - My chest hurts.
What's happening? No pulse.
V-fib.
Start bagging.
Charge to 200.
Sir, it's better if you left the room.
I'm not leaving my son.
Come on, Dan.
Come on, buddy.
You're gonna be all right.
Clear! Charged.
Still V-fib.
Charge to 200 again.
Milligram of epi.
Oh, God.
Still in V-fib.
Come on, Dan.
Come on.
- Dr.
Choi - Charge to 200 again.
- Come on.
- No.
Come on, come on, come on, come on, come on.
Clear.
No.
He's asystolic.
[GASPS.]
I'm so sorry, Bill.
[SOBBING.]
Dan, Dan.
Dan.
Time of death, 12:03.
[CRYING.]
Dan.
Okay.
Kidney is good to go.
Hold on.
His son died.
Mr.
Schiller has withdrawn consent.
What? He has medical power of attorney, and he's stopping the procedure.
He can't do that.
He wants his wife's kidney re-implanted.
That's insane.
No.
You may not transplant that kidney.
All right, everybody, sit tight.
This is ridiculous.
I have a kidney on ice in a cooler, and a patient in dire need of it.
The man just lost his son, the reason for the domino transplant in the first place.
Mrs.
Schiller gave consent.
When her son was alive, and now we have no way to know if she'd still feel the same way.
And we have no way to know that she wouldn't.
Doesn't matter.
It's the husband's decision.
Didn't you try to reason with him? When he was crying over his dead son's body, no.
That is not what I meant, and you know it.
All right, all right, you two.
Let's cool it.
Peter, do we know who owns this kidney? I have no idea.
We've never had a situation like this.
I need to consult with ethics, see if there's at least a precedent.
You do realize that we're under a time crunch here.
I realize.
Well, until we have a determination, keep Mrs.
Schiller stable, and get Mike Stowe prepped for surgery.
Yes, ma'am.
[DRAMATIC MUSIC.]
Jordy, Russell, this is Dr.
Abrams, our chief of neurosurgery.
Hi.
Jordy, your MRI revealed a condition called Atlantoaxial Instability.
Big words.
Yeah, and what it means is that your spine is built a little differently, and working in not quite the way it should.
Yeah, we see it in about 25% of DS patients.
I know.
Um, is there a way to treat it? Why don't we talk outside? Hey, Jordy, buddy.
I'll be right back, okay? - Okay.
- Okay.
So there are two options.
First, I can surgically repair the instability.
But it's an invasive, high-risk surgery.
It could fix the problem, or it could make things worse.
Severely limit Jordy's range of motion.
And the second option? Stabilize the spine with a halo vest type of brace wait for the whiplash to heal.
It's a much safer route, and that's what I'd recommend.
Dr.
Abrams? Atlantoaxial Instability is congenital, so eventually, Jordy's gonna need this surgery.
Right, but it is possible to put it off for years.
Uh Okay, no surgery.
I don't want to take the risk.
All right.
Thanks, Sam.
I don't know what I'm gonna tell Jordy.
Special Olympics won't let him compete with this condition.
He'd have to have it repaired.
This is gonna break his heart.
I feel bad for that family, but how much time does Mike have? He's gonna die without that kidney.
[PAGER BUZZES.]
This could be it.
Let's hope for good news.
So legal has made a determination.
Since Mrs.
Schiller's kidney had been removed from her body, the hospital's considered its caretaker.
The ethics committee believes that the kidney should go to Dr.
Marcel's patient as originally designated by the donor.
Mr.
Schiller's wishes will not be honored.
Gonna go scrub.
You know it's the right thing.
We're saving a life.
It's a little more nuanced than that.
Ethan, don't walk away.
April, there is a man who has to tell his wife when she wakes up from surgery that her kidney is gone and her son is dead.
You want to be there for that? I know.
It's a terrible situation.
You think I don't know that? This is the best outcome we could have.
You just want me to feel bad.
Is that it? What about you? You've been at me all day.
I don't know what's going on between us, but maybe it's a good thing I'm going away.
Daniel.
I thought you were taking the day off.
I am.
And I'm gonna need a few more.
I'm gonna take CeCe away for a couple days, to Mackinac Island.
Oh, well, that was always a special place for the two of you.
Yeah.
Anyway we're gonna have a party tonight.
Just for a few close friends, like you.
[LAUGHS.]
Kind of a like a bon voyage party.
Okay.
Hey.
None of that.
None of that, okay? It's just a little party.
Okay.
No, no, fix me! They have to fix me.
They have to fix me.
Fix me.
They have to fix me.
Just keep it down, okay? No.
Can I help? I told him what we were gonna do I don't want that.
I want them to fix me.
He wants the operation.
I want to skate.
Show him.
Show him me.
- Jordy - Show him me.
Show me? Video of Jordy skating.
I can fly.
You'll see.
Look, I'll forward it to you.
I can fly.
Jordy, okay, there are other things that you can do.
Okay, we'll find something else that you love just as No.
I want to fly.
I want to be free.
Ben, I'm concerned about your chest X-ray.
The patchy whiteout indicates diffuse airspace disease.
He's on a high-flow cannula.
That's not cutting it.
He's oxygenating poorly, and his pCO2 is rising.
He's in acute respiratory failure.
Ben, I'm gonna have to intubate you.
20 etomidate, 100 of sux.
Right.
Okay.
Okay, Ben.
Okay.
Meds are in.
I'm in.
Bag him, and I'll call for a vent.
I don't think he has long.
Okay.
I'm sorry.
Heart's beating.
Take her off bypass.
And she's off.
Pulmonary artery pressure is still high.
Unless we're able to lower it, she won't survive.
Put her back on bypass.
11-point scalpel and aortic punch.
Placing a 5mm fenestration so the extra pressure decompresses into her left atrium.
Pressure's still not lowering.
Put her on V-A ECMO? Not an option.
Violates the DNR.
[MACHINE BEEPING.]
Okay, she's in pulmonary edema, and failing.
Must be a structural issue we haven't found yet.
Ah, stenosis.
Prepare for angioplasty.
Look at me.
I'm flying! - Fastest skater on Earth.
- Thank you, Dad.
Ready? One, two - Okay, now make a funny face.
- Okay, one more.
No.
No! I can't stand it.
What do I do? Hey, guys.
Give us a couple minutes.
This is my fault.
I was always compensating for having a kid with Down's.
Just wanted to have a regular boy, so I pushed him into sports.
Maybe you did.
But he loves that sport.
Jordy's the most important thing in my life.
He's the best thing in my life.
I can't do anything that would cause him harm.
I get it.
I'm the one who told you this was a safer option, and I certainly understand your fears.
But maybe this isn't about you.
Maybe it's about Jordy and what he wants.
Dad? Dad? I watched that video.
He said "I can fly".
I saw that.
And he said, "I want to be free".
I saw that, too.
Dad? Daddy? Hey, buddy.
Twelve minutes.
Gotta finish up and take her off bypass.
Final knot on the patch is tied.
Cut the stitch.
Take her off bypass.
How's her pressure, Carl? PA pressure down to 50.
Was 80.
Good sign.
And good ventricular function.
I believe this little girl's health issues have been resolved.
Let's close.
I'm not coming home tonight.
I'll leave for my deployment from here.
Why? I'm gonna stay with Bill Schiller till his wife wakes up.
I want to be there for him.
Did you mean what you said? About not wanting to have a baby? I don't know what I want.
Well, you got six weeks to figure it out.
- Maggie? - Yeah.
Dr.
Lanik wants you.
Okay.
His O2 stats are 94%.
They're improving.
Look at his latest chest X-ray.
Lungs look a lot better.
I don't understand.
He's improving? Seems that way.
Labs are better, too.
White count up to 4, platelets up to 75.
Below normal, but a lot better than before.
How? Well, the only thing I can think they stopped his chemo.
That allowed his immune system to bounce back, fight the infection.
Keep your fingers crossed.
So are you gonna go fix me? Yes, I am.
Yep, you're gonna go to sleep, and when you wake up, everything's gonna be okay.
Okay.
[GASPS.]
Dr.
Manning? It was just like this.
Sophie was recovering from her surgery.
And Agent Lee Will loves you.
You would be a fool not to take him back.
Oh, my God.
I have been so unfair to Will.
All this time, I have been so unfair to Will.
Jordy should be back on the ice very soon.
[EXHALES.]
Thank God.
Let me know when he's competing.
I'd like to come.
I will.
Thank you.
Looks like Jordy gets to keep flying.
If it hadn't been for you Mike got a new kidney.
[EXHALES.]
Best news I've heard all day.
Glad we finally got there.
Thanks for your help.
Thank you.
[EXHALES.]
[DRAMATIC MUSIC.]
Are you sure you want to do this? We took Danny to Mackinac Island when he was a little boy.
He's loved it ever since.
[LAUGHS.]
They gave us a really good hotel room rate because we're going off-season.
- Bagged the honeymoon suite.
- Nice.
- Oh.
- Got the honeymoon suite.
[LAUGHTER.]
Here.
Blue ones are sugar-free.
I'll take your word for that.
You know, I think it's great that you guys are gonna finally get that honeymoon.
Yeah.
[DOOR OPENS.]
Oh, look who's here.
Hi, Mom.
Oh, my baby.
Baby.
She's here.
- Hi, Grandma.
- Hi, sweetie.
There's my baby.
There's my baby.
- Hey, Sharon, Bert.
- Hey.
Can you guys excuse us for a sec, please? Dad.
No, no.
Let it go.
Lovely day, lovely day Lovely day, lovely day There's my baby.
Uh, hey, Dad.
I want to go with you and Mom.
Oh, sweetie.
Of course you do.
It's just that your mom feels very strongly that it just be the two of us.
I'm so sorry.
I know.
I'll talk to her.
Honey, honey Dad, Dad.
Why not? Well, the way she explained it to me and trust me, we talked about it a lot is that she wants you to remember her the way she is tonight: happy and beautiful, and surrounded by her friends and family.
But, Dad, I'm never gonna see her again.
Oh, sweetie, I know how hard it is.
I do.
I just I'm just really trying to let her call the shots.
You know? And this is the way she wants it.
But to not be there and not to tell her [SOBS.]
Honey your mom knows that you love her.
And you know that she loves you.
Hey.
Lighten his sedation.
Ben, I'm gonna remove your tube.
[COUGHING.]
Okay, okay.
Okay.
Maggie.
Ben.
I'm alive.
Yes, sweetheart.
You are.
[HEARTFELT MUSIC.]
Look at me! I'm flying! [LAUGHS.]
Will.
I remember that night.
I was coming to tell you that I'm sorry for the way I treated you, that I was wrong.
Doesn't matter anymore.
No, it does, because that's not all.
No, you don't need to do this.
I do.
I do.
Because I came to tell you that I love you.
And I want to be with you.
Natalie, stop.
You told me to get out of your life.
I know, and I am so sorry.
You don't understand.
I did.
And it's been good for me.
It really has.
Will, we can figure No, we aren't good for one another.
All we do is hurt each other.
There was a time I couldn't imagine a future without you, but I can now, and I feel free.
Will I'm sorry, Natalie.
[DRAMATIC MUSIC.]
[CRYING.]
[DRAMATIC MUSIC.]
[WOLF HOWLS.]
There's something I want to ask you.
You've helped me through a very difficult time.
Do you love him? He slipped the ring on your finger when you were unconscious.
It doesn't matter because it's over.
And you, get out of my life.
Dr.
Manning.
Agent Lee told me what's going on.
Agent Lee told me what's going on.
[DRAMATIC MUSIC.]
Hi, April I've got your test results.
You couldn't tell me over the phone? Well, I just thought we should discuss this in person.
Okay.
Good news.
Your thyroid and pituitary tests are completely normal, and your HSG X-ray shows that your fallopian tubes are open.
Okay.
So what's the bad news? Your AMH and Antral Follicle count are low.
And your FSH is high.
Even though you're only in your thirties, that indicates that there's Early onset menopause? I like to call it exactly what it is, low ovarian reserve.
I'm the reason we haven't gotten pregnant.
Spontaneous pregnancy isn't impossible.
Dr.
Patchefsky the miscarriage a few years ago, and now this? Ethan wants a baby.
I can't I can't give him one.
April, this is far from hopeless.
Ethan should get tested, too.
And then the two of you might want to discuss IVF.
- IVF.
- Mm-hmm.
I'd recommend starting sooner than later.
With low ovarian reserve, you may not be responsive.
So I go home and I tell Ethan I'm going through menopause, and even with IVF, I still might not be able to get pregnant.
Couples work through this, April.
Was the gym crowded? What? You were gone a long time.
Oh.
Yeah, it was crowded.
Do you really have to leave? Yeah.
How can the Navy make you go for two months? Six weeks.
Told you.
Doc on a carrier had an MI.
Sounds pretty serious.
They called up a reservist.
"The Expectant Father"? Just living in the future.
God, Ethan.
What? I have to get ready for work.
Morning.
Hey.
How did you sleep? Great.
How's your pain, honey? You're not dressed.
Oh.
Yeah.
Thought maybe I'd stay home today.
Please don't try and talk me out of it.
Okay, I won't.
Thank you.
You're getting good at this marriage stuff.
Fourth time's a charm, I guess.
Danny? I want you to re-marry.
But I'm happily married to you.
Danny.
What are we having for breakfast, honey? What do you want? I know you heard me.
Pancakes, it is.
[SOBBING.]
Ben do you mind if I share with Maggie what I'm finding? Please do.
You're running a fever.
103.
2.
And you're tachycardic.
Rapid heart rate.
Of more concern, your white count is really low.
2.
2.
And your platelets are at 35.
Also low.
So not good.
No.
I'm sorry, Ben.
Not good.
So tired.
Why don't you get some rest? You let me know if he has any trouble breathing, and we'll increase his oxygen, okay? Make him as comfortable as possible.
Hey.
Dr.
Manning, I'm sorry to bother you.
- What's up? - Um, a I'm not sure how you want to handle this.
A pediatric patient of yours has just been brought in for a scheduled surgery.
All right, I'll go see the patient.
What's wrong? Well, it's, uh it's Phillip Davis's daughter.
Sophie.
I mean, I know that you and he Whatever happened between her father and me, Sophie is still my patient.
Right.
Sophie has had multiple procedures to correct congenital tricuspid atresia.
Why don't you come up and help me examine her? Okay, yeah.
Okay.
Dr.
Manning? That night of the accident Natalie? It was just like this.
Do you love him? It's weird.
Some things are starting to come back to me.
Phillip was there.
And some FBI agent.
And she wanted I can't remember.
Dr.
Manning? Yeah.
The family's waiting to see you.
Okay.
Let's go.
- Dr.
Manning? - Yes.
And this is fourth year medical student Ms.
Curry.
I'm Cheryl McFarland, Phillip's sister, Sophie's aunt.
This is my husband Jeremy.
Hi.
I'm sorry.
Do you live here? Streeterville.
Why? Phillip said he didn't have any family in Chicago.
Phillips says a lot of things.
He's a pathological liar.
Wow.
Um may I ask where is he? I don't know.
He asked us to meet him at the hospital.
When we got here, he was gone.
I don't understand.
He left Sophie.
He isn't coming back? I doubt it.
Well, you know what? All that matters right now is Sophie.
So why don't I take a look? Oh, hey, there.
There she is.
Hey, Mike.
We got your labs back.
Hmm? He's still kind of out of it.
Makes sense.
You're uremic.
My kidneys.
Afraid so.
Dialysis problem.
Your catheter's clotted off.
- That why he feel so lousy? - Yeah.
My brother's been on the transplant list for over a year.
I'd give him my kidney, but I'm not a match.
Well, the good news is that there was no sign of infection.
So if a kidney becomes available, you can have the surgery.
We're gonna get you through this.
Okay? All right.
So how you feeling, Dan? Okay.
Better.
- Good.
- He had us so worried.
He's never passed out before.
When you brought Dan in the ED yesterday, he was in a diabetic crisis.
Blood sugar 640, pH 7.
23.
The ketoacidosis is what caused you to lose consciousness.
But with the insulin drip and IV fluid, your numbers are looking better.
Thank God.
What about his kidneys? I am concerned.
I want a nephrologist to see you.
[KNOCKING AT DOOR.]
Excuse me.
Your patient's on the list for a new kidney, right? Yeah, he's had a hard time managing his diabetes.
Wrecked his kidneys.
Well, we might have one for him.
Might? Direct donor situation, but it's complicated.
We have a patient downstairs who also needs a kidney.
His brother's willing to donate, but isn't a match.
But turns out he is a match for your guy.
So if somebody from your guy's family matches our guy and is willing to donate, then our guy's brother will donate his kidney to your guy.
Quid pro quo.
- Domino transplant.
- Bingo.
Both go home with a kidney.
We just need a match.
I'll present the offer.
Great.
Jordy Collins, 16-year-old male with Down Syndrome.
Motor vehicle collision.
Okay, we're going to Baghdad.
- Is it okay if I take your pulse? - Yeah.
I'm his dad.
We were rear-ended.
We were going to the rink.
I think he got whiplash.
- I ice skate.
- That's really cool.
I can't ice skate to save my life.
[LAUGHS.]
Doris.
[DRAMATIC MUSIC.]
All right, on my count.
One, two, three.
- This is a big hospital.
- Sure is.
We're gonna take good care of you.
Jordy, anything else bothering you besides your neck? Uh-uh.
Good.
Chest X-ray.
Dad, anything in Jordy's history we should know about? - No, he's a healthy kid.
- I like to hear that.
Okay, I'm gonna listen to your heart.
Yeah, Jordy, your heart sounds real good.
Squeeze my hand, will you? Oof, you're strong.
This is a big camera.
It's gonna take a picture of you.
- Won't hurt a bit.
- Okay.
Everybody clear? Coming up.
[MACHINE WHIRS.]
Hey, chest looks good, too.
I'm gonna take this collar off and see what's what, okay? Okay.
All right.
Ow! Sorry, buddy.
Now we'll put that collar back on.
It could still just be whiplash, but I want to make sure there aren't any other injuries.
With your permission, I'd like to send Jordy for a CT of his head and neck.
- Sure.
- Great.
- You'll let radiology know, Doris? - Right.
We're gonna fix you up, get you back on that ice.
Okay.
Okay.
I'll check on you in a bit.
Hey, Dan.
Martha, Bill, this is Dr.
Marcel.
He's been treating the other kidney patient I told you about.
Am I a match to him? Is Dan gonna get a kidney? No, sir, you are not a match.
But, Mrs.
Schiller, you are.
- So I can donate? - Yes.
Wait, hold on.
Mom, I don't want you taking the risk with your blood pressure.
And that means that my son will get a kidney.
Yes.
From my patient's brother.
Wait.
Dan, I am your mother.
It's a kidney.
It's nothing.
What if something happens? Honey, you're my baby.
I can't imagine life without you.
When you have children of your own, you'll understand.
I'll give the transplant team a call, get things started.
Hey, did you hear the good news? - Yeah.
- All right, can we talk? - I'm busy, Ethan.
- It'll just take a second.
About your reaction to the book earlier, I know you're anxious about not getting pregnant.
- Let's just forget about it - Here's the plan.
I have some time this afternoon.
I'll go see a urologist.
- What? Why? - Get a semen analysis, - make sure I'm not shooting blanks.
- Oh, my God, Ethan.
Why do we have to talk about this all the time? Look, I just want to make sure I'm not the problem.
There is no problem.
Look, I'm not saying there is, but just in case.
- Oh, my I'm so sick of this.
- Sick of what? The pressure.
I don't even know if I want a baby anymore.
What are you saying? April.
[INDISTINCT CHATTER.]
Hey there, Jordy.
Good news.
CT scan is normal.
Can I go skate now? Jordy competes.
Special Olympics.
Wow.
Well, maybe you can go skate.
Tell me, how you feeling? Real good.
Hands feel funny.
- What? - Tingly.
Really? Both hands? Uh-huh.
What does that mean? Not sure.
Do you feel that? Uh-uh.
Squeeze my hand.
- Not so strong now, huh? - No.
Okay, Jordy, I want to run one more test before you go.
It's another type of scan called an MRI.
Dad? Okay.
Don't worry, Dad.
I'll be okay.
You're a champ.
I'll put that order in.
Okay.
Jeremy and I have decided we're going to try to adopt Sophie.
I'm really happy to hear that.
Maya.
Sophie's hit all her milestones, and her saturation's looking good at 85%.
This is Dr.
Frisch.
She will be doing Sophie's procedure.
Hello.
Did you know that the patient's father has instructed that if Sophie arrests, we are not to resuscitate? - What? - A DNR? You mean you're just supposed to let her die? No, I can't believe this.
Are you sure? It's right here in the chart.
Why would he do that? He wouldn't.
I mean, he couldn't.
Yes, he could.
Sophie's not perfect.
That makes her too much work.
But he's been so devoted to her.
I've seen him take such wonderful care of her.
Because he was getting something out of it.
You.
Now that you're not in the picture, he doesn't need Sophie anymore.
What? Look, can you get him to change his mind? I tried to call him.
He's not picking up.
I don't even know where he is.
Well, I'm not comfortable performing this surgery on a child with a DNR.
- Maya - I'm sorry.
Oh, my God.
We are gonna fight this.
Your donor's being prepped for surgery.
We'll take you up to the OR about an hour into her procedure.
Can't believe this is actually happening.
When do I go up? Your brother's organ transfer should take about two hours.
Then it's my turn? Right.
Dr.
Marcel, you have the honor.
Betty, are the antibiotics in? Yep.
2g Cefazolin.
Vitals stable? All good.
All right.
Let's begin.
[THERMOMETER BEEPS.]
His fever's up.
103.
6.
Maggie.
I'm right here, Ben.
Let me know if he needs anything.
Okay, thank you.
I had a dream.
I was fishing.
That sounds nice.
No.
I hate fishing.
[LAUGHS.]
There you go.
Mm.
That's better.
Ben.
Is there anyone I should call? You're the closest thing I got to family, Maggie.
Have you made any arrangements? I should've.
I just kept thinking about getting better not about my funeral.
My folks are in a cemetery in Florida.
I'd like my ashes to be with them.
Okay.
This doesn't make sense.
We have to do something, Mrs.
Goodwin.
- I'm sorry, Dr.
Manning.
- So that's it? There's no way to overturn this DNR? The father abandoned the baby.
We don't know that.
And Mr.
Davis left very clear instructions.
He claimed, and I quote, "My little girl has suffered enough, and if the good Lord decided to take her, we should let him".
That's ridiculous.
He's not even religious.
Dr.
Manning, both the ethics committee and legal said this DNR is valid.
And they won't approve emergency guardianship.
Ugh.
This is about the Davis baby? Yes.
Dr.
Frisch briefed me.
Can you convince her to do the operation? No, and I understand her refusal.
It's a very risky procedure, and the baby is likely to arrest.
Dr.
Rhodes performed the previous procedure.
That's right.
I'm sure if he were here, he would agree to do this.
I will do the surgery.
[MACHINE BEEPING.]
Dr.
Choi, something's wrong.
- Dan? - My chest hurts.
What's happening? No pulse.
V-fib.
Start bagging.
Charge to 200.
Sir, it's better if you left the room.
I'm not leaving my son.
Come on, Dan.
Come on, buddy.
You're gonna be all right.
Clear! Charged.
Still V-fib.
Charge to 200 again.
Milligram of epi.
Oh, God.
Still in V-fib.
Come on, Dan.
Come on.
- Dr.
Choi - Charge to 200 again.
- Come on.
- No.
Come on, come on, come on, come on, come on.
Clear.
No.
He's asystolic.
[GASPS.]
I'm so sorry, Bill.
[SOBBING.]
Dan, Dan.
Dan.
Time of death, 12:03.
[CRYING.]
Dan.
Okay.
Kidney is good to go.
Hold on.
His son died.
Mr.
Schiller has withdrawn consent.
What? He has medical power of attorney, and he's stopping the procedure.
He can't do that.
He wants his wife's kidney re-implanted.
That's insane.
No.
You may not transplant that kidney.
All right, everybody, sit tight.
This is ridiculous.
I have a kidney on ice in a cooler, and a patient in dire need of it.
The man just lost his son, the reason for the domino transplant in the first place.
Mrs.
Schiller gave consent.
When her son was alive, and now we have no way to know if she'd still feel the same way.
And we have no way to know that she wouldn't.
Doesn't matter.
It's the husband's decision.
Didn't you try to reason with him? When he was crying over his dead son's body, no.
That is not what I meant, and you know it.
All right, all right, you two.
Let's cool it.
Peter, do we know who owns this kidney? I have no idea.
We've never had a situation like this.
I need to consult with ethics, see if there's at least a precedent.
You do realize that we're under a time crunch here.
I realize.
Well, until we have a determination, keep Mrs.
Schiller stable, and get Mike Stowe prepped for surgery.
Yes, ma'am.
[DRAMATIC MUSIC.]
Jordy, Russell, this is Dr.
Abrams, our chief of neurosurgery.
Hi.
Jordy, your MRI revealed a condition called Atlantoaxial Instability.
Big words.
Yeah, and what it means is that your spine is built a little differently, and working in not quite the way it should.
Yeah, we see it in about 25% of DS patients.
I know.
Um, is there a way to treat it? Why don't we talk outside? Hey, Jordy, buddy.
I'll be right back, okay? - Okay.
- Okay.
So there are two options.
First, I can surgically repair the instability.
But it's an invasive, high-risk surgery.
It could fix the problem, or it could make things worse.
Severely limit Jordy's range of motion.
And the second option? Stabilize the spine with a halo vest type of brace wait for the whiplash to heal.
It's a much safer route, and that's what I'd recommend.
Dr.
Abrams? Atlantoaxial Instability is congenital, so eventually, Jordy's gonna need this surgery.
Right, but it is possible to put it off for years.
Uh Okay, no surgery.
I don't want to take the risk.
All right.
Thanks, Sam.
I don't know what I'm gonna tell Jordy.
Special Olympics won't let him compete with this condition.
He'd have to have it repaired.
This is gonna break his heart.
I feel bad for that family, but how much time does Mike have? He's gonna die without that kidney.
[PAGER BUZZES.]
This could be it.
Let's hope for good news.
So legal has made a determination.
Since Mrs.
Schiller's kidney had been removed from her body, the hospital's considered its caretaker.
The ethics committee believes that the kidney should go to Dr.
Marcel's patient as originally designated by the donor.
Mr.
Schiller's wishes will not be honored.
Gonna go scrub.
You know it's the right thing.
We're saving a life.
It's a little more nuanced than that.
Ethan, don't walk away.
April, there is a man who has to tell his wife when she wakes up from surgery that her kidney is gone and her son is dead.
You want to be there for that? I know.
It's a terrible situation.
You think I don't know that? This is the best outcome we could have.
You just want me to feel bad.
Is that it? What about you? You've been at me all day.
I don't know what's going on between us, but maybe it's a good thing I'm going away.
Daniel.
I thought you were taking the day off.
I am.
And I'm gonna need a few more.
I'm gonna take CeCe away for a couple days, to Mackinac Island.
Oh, well, that was always a special place for the two of you.
Yeah.
Anyway we're gonna have a party tonight.
Just for a few close friends, like you.
[LAUGHS.]
Kind of a like a bon voyage party.
Okay.
Hey.
None of that.
None of that, okay? It's just a little party.
Okay.
No, no, fix me! They have to fix me.
They have to fix me.
Fix me.
They have to fix me.
Just keep it down, okay? No.
Can I help? I told him what we were gonna do I don't want that.
I want them to fix me.
He wants the operation.
I want to skate.
Show him.
Show him me.
- Jordy - Show him me.
Show me? Video of Jordy skating.
I can fly.
You'll see.
Look, I'll forward it to you.
I can fly.
Jordy, okay, there are other things that you can do.
Okay, we'll find something else that you love just as No.
I want to fly.
I want to be free.
Ben, I'm concerned about your chest X-ray.
The patchy whiteout indicates diffuse airspace disease.
He's on a high-flow cannula.
That's not cutting it.
He's oxygenating poorly, and his pCO2 is rising.
He's in acute respiratory failure.
Ben, I'm gonna have to intubate you.
20 etomidate, 100 of sux.
Right.
Okay.
Okay, Ben.
Okay.
Meds are in.
I'm in.
Bag him, and I'll call for a vent.
I don't think he has long.
Okay.
I'm sorry.
Heart's beating.
Take her off bypass.
And she's off.
Pulmonary artery pressure is still high.
Unless we're able to lower it, she won't survive.
Put her back on bypass.
11-point scalpel and aortic punch.
Placing a 5mm fenestration so the extra pressure decompresses into her left atrium.
Pressure's still not lowering.
Put her on V-A ECMO? Not an option.
Violates the DNR.
[MACHINE BEEPING.]
Okay, she's in pulmonary edema, and failing.
Must be a structural issue we haven't found yet.
Ah, stenosis.
Prepare for angioplasty.
Look at me.
I'm flying! - Fastest skater on Earth.
- Thank you, Dad.
Ready? One, two - Okay, now make a funny face.
- Okay, one more.
No.
No! I can't stand it.
What do I do? Hey, guys.
Give us a couple minutes.
This is my fault.
I was always compensating for having a kid with Down's.
Just wanted to have a regular boy, so I pushed him into sports.
Maybe you did.
But he loves that sport.
Jordy's the most important thing in my life.
He's the best thing in my life.
I can't do anything that would cause him harm.
I get it.
I'm the one who told you this was a safer option, and I certainly understand your fears.
But maybe this isn't about you.
Maybe it's about Jordy and what he wants.
Dad? Dad? I watched that video.
He said "I can fly".
I saw that.
And he said, "I want to be free".
I saw that, too.
Dad? Daddy? Hey, buddy.
Twelve minutes.
Gotta finish up and take her off bypass.
Final knot on the patch is tied.
Cut the stitch.
Take her off bypass.
How's her pressure, Carl? PA pressure down to 50.
Was 80.
Good sign.
And good ventricular function.
I believe this little girl's health issues have been resolved.
Let's close.
I'm not coming home tonight.
I'll leave for my deployment from here.
Why? I'm gonna stay with Bill Schiller till his wife wakes up.
I want to be there for him.
Did you mean what you said? About not wanting to have a baby? I don't know what I want.
Well, you got six weeks to figure it out.
- Maggie? - Yeah.
Dr.
Lanik wants you.
Okay.
His O2 stats are 94%.
They're improving.
Look at his latest chest X-ray.
Lungs look a lot better.
I don't understand.
He's improving? Seems that way.
Labs are better, too.
White count up to 4, platelets up to 75.
Below normal, but a lot better than before.
How? Well, the only thing I can think they stopped his chemo.
That allowed his immune system to bounce back, fight the infection.
Keep your fingers crossed.
So are you gonna go fix me? Yes, I am.
Yep, you're gonna go to sleep, and when you wake up, everything's gonna be okay.
Okay.
[GASPS.]
Dr.
Manning? It was just like this.
Sophie was recovering from her surgery.
And Agent Lee Will loves you.
You would be a fool not to take him back.
Oh, my God.
I have been so unfair to Will.
All this time, I have been so unfair to Will.
Jordy should be back on the ice very soon.
[EXHALES.]
Thank God.
Let me know when he's competing.
I'd like to come.
I will.
Thank you.
Looks like Jordy gets to keep flying.
If it hadn't been for you Mike got a new kidney.
[EXHALES.]
Best news I've heard all day.
Glad we finally got there.
Thanks for your help.
Thank you.
[EXHALES.]
[DRAMATIC MUSIC.]
Are you sure you want to do this? We took Danny to Mackinac Island when he was a little boy.
He's loved it ever since.
[LAUGHS.]
They gave us a really good hotel room rate because we're going off-season.
- Bagged the honeymoon suite.
- Nice.
- Oh.
- Got the honeymoon suite.
[LAUGHTER.]
Here.
Blue ones are sugar-free.
I'll take your word for that.
You know, I think it's great that you guys are gonna finally get that honeymoon.
Yeah.
[DOOR OPENS.]
Oh, look who's here.
Hi, Mom.
Oh, my baby.
Baby.
She's here.
- Hi, Grandma.
- Hi, sweetie.
There's my baby.
There's my baby.
- Hey, Sharon, Bert.
- Hey.
Can you guys excuse us for a sec, please? Dad.
No, no.
Let it go.
Lovely day, lovely day Lovely day, lovely day There's my baby.
Uh, hey, Dad.
I want to go with you and Mom.
Oh, sweetie.
Of course you do.
It's just that your mom feels very strongly that it just be the two of us.
I'm so sorry.
I know.
I'll talk to her.
Honey, honey Dad, Dad.
Why not? Well, the way she explained it to me and trust me, we talked about it a lot is that she wants you to remember her the way she is tonight: happy and beautiful, and surrounded by her friends and family.
But, Dad, I'm never gonna see her again.
Oh, sweetie, I know how hard it is.
I do.
I just I'm just really trying to let her call the shots.
You know? And this is the way she wants it.
But to not be there and not to tell her [SOBS.]
Honey your mom knows that you love her.
And you know that she loves you.
Hey.
Lighten his sedation.
Ben, I'm gonna remove your tube.
[COUGHING.]
Okay, okay.
Okay.
Maggie.
Ben.
I'm alive.
Yes, sweetheart.
You are.
[HEARTFELT MUSIC.]
Look at me! I'm flying! [LAUGHS.]
Will.
I remember that night.
I was coming to tell you that I'm sorry for the way I treated you, that I was wrong.
Doesn't matter anymore.
No, it does, because that's not all.
No, you don't need to do this.
I do.
I do.
Because I came to tell you that I love you.
And I want to be with you.
Natalie, stop.
You told me to get out of your life.
I know, and I am so sorry.
You don't understand.
I did.
And it's been good for me.
It really has.
Will, we can figure No, we aren't good for one another.
All we do is hurt each other.
There was a time I couldn't imagine a future without you, but I can now, and I feel free.
Will I'm sorry, Natalie.
[DRAMATIC MUSIC.]
[CRYING.]
[DRAMATIC MUSIC.]
[WOLF HOWLS.]