ER s05e12 Episode Script
Double Blind
Previously on ER: Do you want to catch a movie tomorrow night? - You applied for the space program? - My second year.
Tonight's dinner is semi-formal.
So any slinky black number will do.
You want me to conduct a study at County General.
And the drug is for the treatment of fracture pain? Comparing it against acetaminophen with codeine.
- What's your son's medical condition? - ALD, Adrenoleukodystrophy.
- How old is he? - Eight.
Why? They usually don't make it past 10.
This must be Ricky.
I'm Carol.
I could have taken Lucy out for a pizza.
That's what my Residents did when I finished a rotation.
In my day, Residents always had their students over for a meal.
Makes for better mentoring.
That's why I invited Peter to join us.
Dr.
Benton's coming? He was your Resident.
Now Lucy's working with him.
It's much more civilized.
John, don't! No, no, no.
I thought peppers went in the blender.
- We run separate colors for the sauce.
- Good save.
You cool and peel them first.
Why don't you seed the Persian cukes? You know, it's funny.
I'm actually gonna miss having Lucy around.
That's how it works.
The instant students know enough to be of use they move to another rotation.
Lengthwise.
Lengthwise.
And then you seed them.
Okay? Emergency medicine may not be a bad choice for Lucy.
Well, she might feel differently after she has her Surgical rotation.
You know what? Why don't you? Why don't you chill the Pinot Grigio? In the freezer? IKeep your day job, Carter.
Well, let's see how you handle these.
Got it? All right, let's do it.
Do you have inside information on this drug? - This stuff really works? - Amazing.
Aaron broke his arm before, the pain was excruciating.
I'd like to buy stock in this.
This may be acetaminophen with codeine.
I know some patients in the study aren't getting the wonder drug.
Aaron is, and it's remarkable stuff.
They keep docs in the dark? It's a double-blind study.
Get your "insider trading" elsewhere.
See you in three weeks.
- Jeanie's gonna be late.
- Probably stuck in the snow.
She overslept.
Had a late night.
I wish we did.
We are going to kick-start the a.
m.
With a wake-up call from my main men: - Hetfield and Hammett.
- It's coming down.
I didn't expect to see you today.
The clinic's closed.
I organized a seminar on STDs and cervical cancer.
A gab session for women in the community.
That's a great idea.
Is that Metallica? You're a metalhead? You know this tune? Yeah.
Because it's banned in my house.
I thought women should know more about screening and prevention.
Absolutely.
I wish I could pay you overtime.
Don't worry.
I scored some grant money to pay for it.
Really? That'll run through the clinic? Yeah.
I got lucky.
I caught some dribbles off the gravy train.
I thought that was you.
Listen, I got your memo about the NASA offer.
The opportunity came out of the blue.
A year of training in Houston? It could be 18 months if they delay the launch.
- Don't do it.
- What? Obviously do what you must.
I wish you wouldn't.
- You kept me awake last night.
- I kept you awake? I do not want to run the Emergency Department without you.
What'll it take to get you to stay? Full tenure, effective today.
Well, I probably can't swing that.
But I could push up your eligibility.
Considering you in '02.
- Two thousand two? - Aught two.
Will somebody tell us what to call the future? You'd consider me for tenure in three years? We need you.
Think about it.
- I think you have a flair for this.
- I found my niche: Pulling drains.
Get the Penrose and not the T-tube.
Pull that, it's not a pretty sight.
Miss IKnight, you found your way to Dr.
Corday.
All the preop labs were in the charts.
I nearly kissed her.
Oh, none of that.
Not unless I get to watch.
I insisted you get a decent student.
- You could use backup with the scut.
- I live for scut.
I'd like you to assist this afternoon on a choledochojejunostomy.
- Choledochojejunostomy? - Oh, you can say it.
Would you like to do it? I'm waiting for the other shoe to drop.
No catch.
You've suffered enough.
I started the groundwork today to get your fellowship reinstated.
I'll be damned.
Should I feel special, or does he stare at everyone's breasts? No.
Only the females as far as I know.
It's good for the clinic.
You should know what grants are applied for.
- Lynette does have some good ideas.
- And you are the boss.
What the hell is that? - That is our new music program.
- You call that music? - I told you to start with Erykah Badu.
- It's for patients in Chairs.
Music helps people handle stress.
You're getting ready to DJ a party.
That's just a coincidence.
Somebody signed off on this.
- Who signed off on it? - Dr.
Lee.
Jerry, there is no Dr.
Lee.
There never was a Dr.
Lee.
- Is that siren in the music? - It's in the music.
Hey, we could use some extra muscle out here! Jerry, turn the music down and give Conni and me a hand.
Oh, boy! Gird your loins.
at the scene of a fire.
- This is one big woman.
- Probable anaphylaxis.
Her med alert bracelet said peanut allergy.
- Don't pull until we get a grip.
- Another gurney? Yeah.
A double-wide and a winch.
I hope the wheels don't snap.
Trauma 1, I'll be right there.
Talk to me, Doris.
Second victim is Fred Danziger.
He singed his mustache putting out the flame.
It's the first call this week where something was on fire.
She drags me away for nothing.
She could be right.
Singed facial hair could mean a burned airway.
Chuny, let's put Fred on a pulse ox and get a chest x-ray.
I had to force him.
This new policy sucks.
- Adding paramedics to fire trucks? - Yeah.
And the guys resent it.
They blame me for having to answer so many medical calls.
Nobody likes change.
You did the right thing.
So you passed out and took a fall? Angie found me.
- Is Angie your home-health aide? - She was.
They burn out fast with me.
You see my chart? Yes, sir.
Pancreatic cancer and mets to the liver.
I keep hoping that "end-stage" means it can't get any worse.
Nausea pretty bad? We're gonna hydrate you, see if that helps.
Would you like me to put your own robe back on? It can get chilly.
- Did Angie call my son? - I can find out.
Is that yours? Ten years ago I kicked my son out of the house over this stuff.
Now he gets it for me.
Helps with the nausea? Do you have to take it? Take what? - Can you open your eyes? - Unresponsive since the Valium.
Pulse ox is 99o/o.
Can you imagine lugging around all this fat? It didn't stop her from eating noodles at 9 a.
m.
Does Radiology stock extra-extra large? Better call the vet school.
Okay, everybody, settle down.
Miss Meredith, you've had a bad allergic reaction.
- The tube is to help you breathe.
- BP's 90/60.
Let's start dopamine at five mics per kilo.
- How many kilos? - You want a calculator? - What do you think, 275 pounds? - Oh, I'll take the over.
- Hey, were you looking for me? - Yeah.
Conni, start her at 750 mics.
Let me know how she does.
You're gonna be fine.
We got it under control.
As part of your workload you'll teach patient/doctor class to second-years.
Patient/doctor class? Students practice H & Ps on simulated patients.
I remember.
Bad actors pretended like they were sick.
I hated it.
Yeah? Why is that? Because it's fake.
Everybody knows it's fake.
It's a waste of time.
Yeah.
Well, starting tomorrow, you're gonna learn to hate it all over again.
It'll sharpen your teaching skills.
Did Lucy give me a bad evaluation? Lucy gave you a fair evaluation.
I'll put the teaching guide in your box.
The patient collapsed push-starting a car.
Slurred speech and right-side weakness.
Resolved in 30 minutes.
- Suggesting? - A T.
I.
A.
Dr.
Corday ordered doppler ultrasound in his carotid arteries.
- Which demonstrates what? - A 50o/o lesion on the left side.
This is a surgical candidate? - He's pretty old.
- How old? - He was push-starting a car.
- He claims not to know his age.
Well, wasn't your Civil War in the 1860s? According to Mr.
Barnes, he's roughly 140.
- Elizabeth, is now a good time? - I'm not sure.
Ms.
IKnight and I can handle this.
- Peter, 8:00.
- I don't know if I can make it.
We need to compile our sternal saw data by tomorrow.
Mr.
Barnes, what are you doing out of bed? I asked you to call me Charley.
You have to stay in your gown so Dr.
Benton can examine you.
Is that you? I don't mean no disrespect.
But when you get to be my age and you loll around in bed them rheumatoids kick in.
Pretty soon you can't move at all.
Unfortunately, you have blockage in your neck artery.
It puts you at risk for a stroke.
I can't have that.
Too many people counting on me.
Charley helps the older people in his neighborhood.
And the children.
They need sitters, those people working all day.
Are you her teacher? At the moment.
Then you know, you and I, we have the responsibility to pass on what life has taught us.
Can you fix me up? Well, there is a surgical option.
But I hesitate to use it on someone your age.
You ain't ever seen a patient my age.
You don't have to worry.
I can't be killed because I got a conjure on me.
I don't know what that means.
Of course you don't.
Because you are a man of science.
How else you gonna explain my being alive at all? When every other body, all the ones from slavery times done died 50 and 60 years ago.
Miss IKnight, what would you suggest? I'd call a Psych consult.
Is that the doc for loonies? Yes, sir.
Yes, it is.
He's outrageous.
He can be tasteless.
He certainly likes to throw his weight around.
So you can't corroborate any instances of sexual harassment? It's a very American thing, if I may say this penchant for turning personal issues into lawsuits.
The hospital's hope, of course, is for me as ombudsperson to address problems and avoid lawsuits.
Look, one has to be thick-skinned working around Dr.
Romano.
You roll with the punches, don't you? Whoever's complaining may be too fragile to practice medicine at all.
Her identity is confidential until I can assess if any action is warranted.
It's a delicate business.
Rarely do I hear the kind of slam dunk where Dr.
So-and-So made sexual advances.
She declined.
And then he either fired her or cut her funds.
Right.
Is Robert aware of this complaint? He doesn't know who came to me.
He could figure it out since I prevent the parties from working together.
I see.
It's my fault.
I let it go on too long.
It's not your fault.
We're gonna start a line.
- What's going on? - Remember Ricky? He hasn't had a bowel movement in three days.
His temp spiked to 101.
I let him get septic.
I've always been able to disimpact him.
You disimpact him at home? I usually use a glove and Vaseline.
The morphine's made him constipated.
Why is he on morphine? He's having pain from contractures.
That's what I think.
Ricky stopped speaking about a week ago.
I'm sorry.
He still opens his eyes sometimes.
- Is the morphine working for the pain? - I don't know.
- Oh, God! - It's all right.
I've got it.
I'm sorry.
It's just I know.
I know.
Everything he's been through I fall apart over this.
- It's okay.
It's okay.
I know.
When we got to Michigan Avenue, he just passed out.
- How long ago did he hit his head? - Four hours.
He was fixing a floodlight over our garage.
The ladder slipped.
But he seemed okay.
He just had a headache.
When you have a head injury, it's best to call the paramedics.
- I did call.
- Paramedics didn't show? No.
They came, but Jim seemed okay.
And then there was a fire somewhere and they got called away.
Jerry's gonna show you where you can park.
Jerry, I want you to call Dispatch.
Find out which unit responded to the Haggerty's call.
Ricky's resting.
His fever is due to an ear infection.
They're treating it with antibiotics.
- Thank you, Carol, for everything.
- Oh, sure.
Dr.
Ross will be out to talk to you about it.
You always see me when I'm such a wreck.
I usually cope better.
Well, sometimes coping too much can drive you crazy.
I meant to thank you.
The respite care has been wonderful.
Oh, good.
Did you get to your daughter's recital? I had the worker come back another time just so I could take a bath.
- Good for you.
- Yeah.
We had great news last week.
My daughter's blood test came back.
She's not a carrier.
- Oh, that's a relief.
- Thank God.
She'll never do this to her kids.
We'll keep him until his fever comes down.
I'll see you before you go, okay? Does this mean we have to reduce Ricky's morphine to prevent this? That's one thing we could do.
This was the hardest part with Michael.
I lost Ricky's older brother to ALD three years ago.
Right.
Now he can't tell me it hurts.
Somehow it's worse to see him suffering.
I'll check.
There may be something we can do for the pain.
- Okay.
- Okay.
I'm in.
Hyperventilate him.
BP 160/90.
Pulse 60.
Mannitol's in.
Your husband has a blown pupil.
I'm worried the bleeding in the skull could be putting pressure on his brain.
- CT's ready.
- We'll get a head CT to find out more.
Take Mrs.
Haggerty to Chairs.
Chuny, call Neurosurgery down here right away.
- I was afraid you weren't joining us.
- I'm looking forward to it.
You don't see a choledochojejunostomy every day.
When they shuffled the schedule, I was afraid I was gonna miss out.
The Resident let the patient eat, and we had to postpone.
That's the problem sometimes with Residents rotating in.
They're not up to it or don't care.
- Who was this Resident? - Third-year from Emergency.
- Doyle.
- Maggie Doyle? They think very highly of her.
She's being considered for Chief Resident.
The pickings must be slim this year.
I've always found her to be extremely capable.
I hear she makes a lot of women uncomfortable.
This is gonna be nifty.
Stones in the common bile duct distal to the sphincter of Oddi.
No kidding? My whole team is tied up in the O.
R.
Someone needs to scrub out and join us.
- That's why you have to wait.
- Look at the size of the clot.
It's compressing his brain.
Every second counts.
Chuny, shave the scalp.
Malik, open the burr hole tray.
You can't do burr holes in the ER.
You're not giving me any choice.
What size gloves do you take? I am not comfortable with this.
We can't wait without risking brain damage.
I'll try again to get someone down.
- Twelve blade.
- Pulse is down to 55.
- Self-retaining retractor.
- This is a mistake.
Pressure's up to 180/95.
That's the Cushing response.
It'll herniate unless we relieve the pressure.
Periosteal elevator.
- My Chief can be down in 20 minutes.
- Too long.
Hudson brace and perforator.
I can see the skull fracture line.
ABG is back: PH 7.
51, PCO-2's 25, PO-2's 350.
That's what we want.
Okay, I'm ready for the burr hole.
Can't you wait a few minutes? IKeep the irrigation coming.
I need to see what I'm doing.
Please not too deep.
That's okay.
I'm through the inner table.
Okay, there's the clot.
I need a dural suction catheter.
Pulse up to 170.
BP's 140/70.
- Pupils are equal.
- That's more like it.
Wet sterile gauze.
Let's get him to the O.
R.
I'll alert the team.
Tell them to take their time.
Hey, Dr.
Greene.
Nice job.
You got time for a quick question? Yeah, sure.
Can I account for a broken container in the study? One of the vials busted? The powder spilled into the envelope.
I'd just make a note of it.
We don't have many patients enlisted.
We won't use all the samples.
That's all I wanted to know.
You gonna make your lecture? The guy from NASA at the med school? Oh, right.
I almost forgot.
Mrs.
Haggerty, your husband's been stabilized and sent up to the O.
R.
- What? - Jerry.
Your husband has been sent up to Surgery.
Someone will take you up.
I'll take her up.
Dr.
Greene stabilized your husband.
He's doing fine.
Did you find out which paramedic unit left him with a brain bleed? It was an engine company that went out.
Doris Pickman was the paramedic.
Oh, boy.
The deputy chief will handle it.
Listen, call Dispatch back and tell them that I'm gonna follow up.
Oh, and Jerry, if you put that music back on, you're fired.
I'm sorry it's taking so long.
We put my fingertip on ice.
It'll be okay, right? It's a possibility we won't be able to reattach.
The surgeon will decide.
You're still waiting on Plastics? They swore he's on his way.
Did you find another candidate for that fracture study? No.
Just recording a broken container.
- Is he a plastic surgeon? - No.
Sorry.
You want something to drink? My dad's getting me a Coke.
It shouldn't be that much longer.
Did you find my son? His office said he was out on a sales call.
He's not picking up his cell phone.
We'll keep trying.
Thank you.
- Is the Zofran helping the nausea? - No.
I'm gonna ask the docs to add Reglan.
Don't bother.
They don't work.
Any chance you could wheel me outside for some fresh air? I can't take you to smoke marijuana.
Maybe your son can help you.
I'm really sorry.
Don't be.
I'm probably not able to inhale anyway.
The neuromuscular response can be studied since there's no gravitational force in the usual Z axis from head to toe.
Gentleman in the back.
What are the applications of this study? A loss of muscle tone in microgravity is an issue sci-fi movies have largely ignored.
Cosmonauts who spent months on Mir had to be carried from the spacecraft.
I'd like to kick off the Q and A with a question to you: What interested you in the astronaut program? I ask because a lot of candidates admit to childhood dreams of adventure the adrenaline of takeoff, the vastness of space.
The doctor who just walked in, would you respond? Well, for me, it was pretty much adventure.
The adrenaline of takeoff, the vastness of outer space.
Thank you for your candor, Dr? - Mark Greene.
- Dr.
Greene.
Doug Lowrey wanted me to look you up.
Dr.
Greene may be joining us as a payload specialist.
The real picture of your schedule, should you make it is one of routine.
In training, you'll spend a year repeating tasks following checklists, adapting to a regimen.
Everything you do is dictated by the ground crew.
You follow a precise minute-to-minute itinerary.
I'm sorry to disturb you.
I didn't know what to do.
I screwed up bad.
But the guy seemed fine at the scene.
The engine got the fire call, the guys were all so jazzed, I told the wife Doris, slow down.
- How's Mr.
Haggerty? - Epidural hematoma, but he's okay.
They pulled me off active duty.
They're doing an investigation.
He's worried about bad press.
Fire engine leaves an accident scene.
That's a medical error.
That's my call.
Maybe I was influenced by the firefighters.
They wanted to go.
That shouldn't cloud my judgment.
It'll ruin my record.
Take a breath.
I'll see what I can do.
- Will you? - I'll call the deputy chief now.
- Come on, doc.
- I'm not gonna do that.
You heard me.
Roll up your sleeves.
I'm not gonna arm-wrestle over surgery.
Are you scared to? Yeah.
Yeah.
Yeah, I am.
Well, I want the surgery.
That's all there is to it.
And that one doctor calculated that I was fit in the head.
Because you didn't mention you thought you were at Appomattox.
But there was another doctor who also said my FEV-1 was over 120 percent.
I think that's darn good.
They cleared you physically.
You're giving me that second-rate pill idea.
You think the medical treatment isn't convincing.
I use my judgment.
Your judgment is to put your arm next to mine, clasping my hand and we will arm-wrestle.
You will find out that old Charley's not as weak and puny as you think.
I never said I don't think you're puny.
But you don't believe I can't die.
I don't believe that one either.
I'll give you something you can believe.
Put your elbow right here.
Mr.
Barnes, come on.
Listen, if you don't give a man his measure of respect and you don't believe his history you're talking about a fight.
Oh, come on.
Don't make your elder beg.
Come on.
Go.
Dr.
Benton? There is an O.
R.
Available.
Hey, don't humor me now.
Oh, boy.
You win.
You win.
All right, go ahead.
Book the O.
R.
It's a new policy putting paramedics on fire trucks.
It'll take a while to work the kinks out.
I know Doris.
I work with her.
She deserves to be counseled, not put on a desk.
No, no, no.
This is my job.
- Is Doug Ross around? - Try Admit.
Deputy Chief Mead, please? Mark Greene again.
They let you out of the lab? I make deliveries for some customers.
I got the toxicology results on that powder you brought us.
Negative for codeine.
- Is that all you needed? - That'll do it.
When I heard you hand-carried it, I thought well, maybe you were back on the market.
Me? No.
I I called the HandiVan for the Abbotts.
Joi said you wanted a prescription.
- I'm on my way.
- Nice to see you.
- See you later.
- Ricky's temp is 98.
8.
- Which is good.
- You know back there that was nothing? Yeah, of course.
I'm afraid Lynette has appropriated the lounge.
The staff will have to gossip someplace else.
You knew about it? She showed me her proposal last week.
It's a good area for the clinic.
I know you can tell if he's cheating.
But some Your man don't take a shower before he leaves but he does when he gets home? He's cheating! The number of partners you have and he has can put you at risk for cervical cancer.
It can put you at risk for being a fool.
How young you were when you started having sex and smoking are factors.
That's right.
This is Carol Hathaway.
She runs the clinic here.
Nice to meet you all.
Oh, carry on.
I think it's a really important topic to be informed about.
Please feel free to come see us at the clinic anytime.
Thanks, Carol.
My apologies.
I'm Dr.
Baker.
Jeanie Boulet.
This is Donna.
- Her father should be back soon.
- This is the x-ray, Ms.
Boulet? I did a digital nerve block with Marcaine.
Amputated the distal phalanx.
We'll rongeur and do a V-Y flap.
You can put it back on, right? The blood vessels are too small.
Did you explain to her? I told her it may be a possibility.
But you guys put arms and stuff back on.
If you had cut your finger at the base, we'd have bigger arteries.
We'll trim down the bone and create a flap over the defect.
You mean I'll have a stump? Maybe we should talk to Donna's father.
Yes.
If we can get a Trauma Room, I'll do the procedure right away.
Don't worry.
We'll make you a small prosthetic tip.
I'm saying oldies are played out.
- People like the classics.
- Not ones you can't dance to.
You're gonna lose them.
Jerry, what is this? You wanted the rap turned off.
Actually, I said we need a desk clerk here, not a DJ.
Fine.
It's no more.
Forever gone.
What possessed you to pick that particular song? I don't know.
Just instinct.
I'm just going with the flow.
My mom used to play this album when I was a kid.
It was always, like, the ultimate freedom.
You know? Leave ground control behind and float way.
- Escape.
- Yeah.
The folks in the Waiting Area want to know if you could put Bowie back on? Jerry, do whatever you want, okay? Just use your best judgment.
All right.
Now, you give this to him every six hours if needed.
You don't exceed four doses in 24 hours.
Call me if it isn't working for him.
Watch your head.
Why didn't the genetics clinic suggest this medication? It's still part of a clinical trial with kids with fractures.
Perfectly safe for Ricky.
It might give him some relief.
- Do I need to fill any of this out? - I wouldn't bother.
He's not a candidate for the study.
Thank you.
Trauma 2 is open.
Can you assist me? I insist.
You blew by that like she was an annoyance in your busy day.
You said there's a parent here to give consent.
Find him.
I'll explain the procedure.
I'll do that.
I can't believe I get to scrub in on my first day.
- That's the best way to learn.
- Masks? Charley has a crowd in the Waiting Room.
Does anyone know where he's from? Been in the neighborhood for years.
That car he was push-starting? Registration expired in 1956.
He had terrible stories.
The first two branches of the internal carotid? The ophthalmic artery and the posterior communicating.
Okay, that's it.
You're ready.
Let's go.
Gown and glove Miss IKnight.
She doesn't know the ropes.
Just about to put him under.
IKeep your hands in front of you.
Don't reach for anything unless you're told.
- What if I have an itch? - Tell the nurse where.
What is that? - Dr.
Riggs? - He's bradying down.
- Atropine.
- One milligram onboard.
- Blood pressure's dropping.
- He's in V-fib.
- Grab the crash cart.
- I'm sterile! It doesn't make a difference.
Amp of epi.
Let's move.
Come on.
Clear! - Asystole.
- Start compressions.
- Epi and atropine onboard.
- Right.
What's the rhythm? - Got an idioventricular rhythm.
- Faint pulse.
- Try to get a BP.
- Can he still have surgery? No.
Let's get him a room in the ICU.
How long till spring? - This is the shortest day of the year.
- That's December.
We're past that.
I made up my mind.
I'm not going to Houston.
- Really? - It's an old dream.
You fooled me.
I thought you were ready to blast off.
I realized I didn't want to go.
I don't want to go anywhere.
This is what I do.
This is where I belong.
Lost that old restlessness? I guess.
Coming in? Come on in! It's cold! You went out of your way not to involve me.
- Why would I? - You knew I would object.
- Object to what? - All the women were African-American.
- Yeah.
- The clinic's for everyone.
- I didn't exclude anyone.
- Where did you advertise? I have a special interest in an underserved population that is particularly at risk.
- Latinos are even more at risk.
- Our death rate is higher.
Vietnamese women have worse statistics.
To get women to consider changing sexual habits, they need to feel open.
Women talk more freely among their own.
We'll have to hold seminars that target other populations.
Look, I did this on my own time out of my own interests.
I understand that.
But I can't have you pulling against me.
If you want to work in the clinic, adjust your project to include others.
Well, I guess you've given me something to think about.
Couple more stitches and the Y is closed.
See? What kind of music do you play, Donna? Folk and classical.
Some rock.
Well, Ms.
Boulet is right.
More 5-0 nylon, please.
A prosthetic will take some getting used to.
But with time, you'll be able to play just fine.
- What about computer games? - You'll never be able to touch them.
Your dad paid me to say that.
- Cut, please, Jenny.
- It's Jeanie.
Sorry, Ms.
Boulet.
- Honest.
I owe you my first born.
- You do that and you're on a desk.
- You saved my career.
- I gave you a chance to turn it around.
We'll work out a counseling schedule next week, okay? - Thanks.
- Where's Jerry? - We're in between sets.
- I was taking requests.
- Hey, you off? - Yeah.
Why? That guy in Exam 2 wanted to say goodbye.
Mr.
Ackerman? Pancreatic cancer? He's gonna have to stay the night.
Nobody can come until tomorrow.
Are you waiting for the health bus? We're all loaded up.
I just had another question for Dr.
Ross.
- Dr.
Ross is in a meeting.
- Is there something I can do? He gave some new medication to us.
I forgot to ask if it's all right to take with Robaxin.
My son has ALD.
He has a fracture? No.
But he was in pain.
Dr.
Ross thought this might help.
Where's your study envelope? He said we didn't need to bother.
Dr.
Ross did? Since my son isn't actually a candidate for the trial.
I see.
I heard your son couldn't make it.
You need this? Please.
Never mind.
Oh, God! Again? - Hey, is Doug still upstairs? - I don't know.
Well, I'm headed home.
Mark, what are you doing? Do you know anything about a boy with ALD? Ricky Abbott? Why was he given meds for the clinical trial? He wasn't.
Doug wouldn't do that.
Looks like he did.
Talk to Doug.
I'm sure there's an explanation.
Ms.
Boulet, I wanted to thank you for assisting on the finger flap.
Not at all.
And for reminding me to take time with our young patient.
I don't do well when I get behind schedule.
But that's no excuse.
- You were right, and I thank you.
- You're welcome.
Would you join me for an opening at the Art Institute this evening? This evening? I realize it's short notice.
It may be interesting: Raghubir Singh, an Indian photographer.
I don't know much about art.
I don't care about art.
I promised my wife, who died a few years ago I'd keep our membership and not become a Philistine without her.
I'm sorry to hear you lost your wife.
And my partner.
Jenny and I had a practice together for 15 years.
Her name was Jenny? You're a sweet angel.
Called for a consult? - Self-inflicted knife wounds.
- Quite a few of them.
He gave me a suturing refresher.
She's my angel.
That is not what he was calling me before the Haldol.
No blood in the urine but these two needed two-layer closures.
Good bowel sounds.
Belly's soft.
I wanted to mention to you I have been having a problem with Dr.
Romano.
IKerry spoke with me this morning without actually saying it was you.
I'm sorry I didn't ask before dragging your name in.
I don't think I can be of any help.
Well, no sign of any intra-abdominal bleed.
He's got another one on his back.
We'll have to lift him.
I hoped Romano would cool it if I confronted him.
But instead he threatened to blast me on my evaluation.
Dr.
Romano can be volatile.
You mean he's a mean-spirited little powermonger? That too.
Well, the kidneys look fine as well.
Whores! Whores! I want to die.
There's the Mr.
Michaels I know and love.
Look, Romano, he likes to push things to the limit.
I guess he thought anything goes with the gay chick.
I hope you're not going out on a limb.
He's a star.
Self-respect's a bitch.
- IKerry, do you have a moment? - Mark needs me.
You're leaving? - How about breakfast tomorrow? - That's more than a minute.
I may have some things to add to your inquiry.
I'll call you.
We'll set something up.
There she is.
Minnesota Fats.
- I was afraid I'd missed you.
- Hey, Reggie.
You'll give me a chance to win my money back? Playing pool two nights in a row is bad luck.
It's bad luck to play against you.
Where'd you learn? Signs of a misspent youth.
What do you say we go eat? I already have plans for tonight.
Something a new friend can barge in on? Opening at the Art Institute.
Say no more.
I'll catch you on the weekend.
I almost went straight to Anspaugh.
What the hell was Doug thinking? If we were exposed for breaking protocol on a federally funded trial They'd cut off research money and Medicare payments for years.
And it's against the law.
They brought me the study.
I got him onboard.
Mark, given the implications I don't think we have any choice but to handle this internally.
Cover it up.
If Anspaugh finds out, he has to react.
Nice position he put us in, huh? Do you have the key to the pain study cabinet? Come in and take a seat.
Any changes? Will he wake up? What do you think? His brain was deprived of a lot of oxygen during the cardiac arrest.
Old folks don't usually come back with full function after hypoxic insult.
It's a wait-and-see.
He could live like this for a while.
Forever.
Well, according to him.
What's his Glasgow score? An eight.
No spontaneous eye-opening.
No speaking.
Responds only to painful stimulus.
Excuse me.
I'm sorry.
I didn't expect this.
Well, neither did I.
Should I go tell his neighbors? No.
I'll do it.
Then to top it off, he goes to IKerry Weaver instead of coming to me.
But you gave Joi the meds? Mark said that he wasn't gonna use all the samples.
- That's not the point, is it? - What is the point? That breaking research protocol could damage the hospital's funding.
So you agree with them? I see their point.
You know how sick he is? Yeah, but that decision could have a larger impact.
The hospital's only at risk if someone goes out of their way to report me.
And believe me, it kills IKerry Weaver not to be able to do that.
I don't know what to say.
Doug, don't walk away.
Tonight's dinner is semi-formal.
So any slinky black number will do.
You want me to conduct a study at County General.
And the drug is for the treatment of fracture pain? Comparing it against acetaminophen with codeine.
- What's your son's medical condition? - ALD, Adrenoleukodystrophy.
- How old is he? - Eight.
Why? They usually don't make it past 10.
This must be Ricky.
I'm Carol.
I could have taken Lucy out for a pizza.
That's what my Residents did when I finished a rotation.
In my day, Residents always had their students over for a meal.
Makes for better mentoring.
That's why I invited Peter to join us.
Dr.
Benton's coming? He was your Resident.
Now Lucy's working with him.
It's much more civilized.
John, don't! No, no, no.
I thought peppers went in the blender.
- We run separate colors for the sauce.
- Good save.
You cool and peel them first.
Why don't you seed the Persian cukes? You know, it's funny.
I'm actually gonna miss having Lucy around.
That's how it works.
The instant students know enough to be of use they move to another rotation.
Lengthwise.
Lengthwise.
And then you seed them.
Okay? Emergency medicine may not be a bad choice for Lucy.
Well, she might feel differently after she has her Surgical rotation.
You know what? Why don't you? Why don't you chill the Pinot Grigio? In the freezer? IKeep your day job, Carter.
Well, let's see how you handle these.
Got it? All right, let's do it.
Do you have inside information on this drug? - This stuff really works? - Amazing.
Aaron broke his arm before, the pain was excruciating.
I'd like to buy stock in this.
This may be acetaminophen with codeine.
I know some patients in the study aren't getting the wonder drug.
Aaron is, and it's remarkable stuff.
They keep docs in the dark? It's a double-blind study.
Get your "insider trading" elsewhere.
See you in three weeks.
- Jeanie's gonna be late.
- Probably stuck in the snow.
She overslept.
Had a late night.
I wish we did.
We are going to kick-start the a.
m.
With a wake-up call from my main men: - Hetfield and Hammett.
- It's coming down.
I didn't expect to see you today.
The clinic's closed.
I organized a seminar on STDs and cervical cancer.
A gab session for women in the community.
That's a great idea.
Is that Metallica? You're a metalhead? You know this tune? Yeah.
Because it's banned in my house.
I thought women should know more about screening and prevention.
Absolutely.
I wish I could pay you overtime.
Don't worry.
I scored some grant money to pay for it.
Really? That'll run through the clinic? Yeah.
I got lucky.
I caught some dribbles off the gravy train.
I thought that was you.
Listen, I got your memo about the NASA offer.
The opportunity came out of the blue.
A year of training in Houston? It could be 18 months if they delay the launch.
- Don't do it.
- What? Obviously do what you must.
I wish you wouldn't.
- You kept me awake last night.
- I kept you awake? I do not want to run the Emergency Department without you.
What'll it take to get you to stay? Full tenure, effective today.
Well, I probably can't swing that.
But I could push up your eligibility.
Considering you in '02.
- Two thousand two? - Aught two.
Will somebody tell us what to call the future? You'd consider me for tenure in three years? We need you.
Think about it.
- I think you have a flair for this.
- I found my niche: Pulling drains.
Get the Penrose and not the T-tube.
Pull that, it's not a pretty sight.
Miss IKnight, you found your way to Dr.
Corday.
All the preop labs were in the charts.
I nearly kissed her.
Oh, none of that.
Not unless I get to watch.
I insisted you get a decent student.
- You could use backup with the scut.
- I live for scut.
I'd like you to assist this afternoon on a choledochojejunostomy.
- Choledochojejunostomy? - Oh, you can say it.
Would you like to do it? I'm waiting for the other shoe to drop.
No catch.
You've suffered enough.
I started the groundwork today to get your fellowship reinstated.
I'll be damned.
Should I feel special, or does he stare at everyone's breasts? No.
Only the females as far as I know.
It's good for the clinic.
You should know what grants are applied for.
- Lynette does have some good ideas.
- And you are the boss.
What the hell is that? - That is our new music program.
- You call that music? - I told you to start with Erykah Badu.
- It's for patients in Chairs.
Music helps people handle stress.
You're getting ready to DJ a party.
That's just a coincidence.
Somebody signed off on this.
- Who signed off on it? - Dr.
Lee.
Jerry, there is no Dr.
Lee.
There never was a Dr.
Lee.
- Is that siren in the music? - It's in the music.
Hey, we could use some extra muscle out here! Jerry, turn the music down and give Conni and me a hand.
Oh, boy! Gird your loins.
at the scene of a fire.
- This is one big woman.
- Probable anaphylaxis.
Her med alert bracelet said peanut allergy.
- Don't pull until we get a grip.
- Another gurney? Yeah.
A double-wide and a winch.
I hope the wheels don't snap.
Trauma 1, I'll be right there.
Talk to me, Doris.
Second victim is Fred Danziger.
He singed his mustache putting out the flame.
It's the first call this week where something was on fire.
She drags me away for nothing.
She could be right.
Singed facial hair could mean a burned airway.
Chuny, let's put Fred on a pulse ox and get a chest x-ray.
I had to force him.
This new policy sucks.
- Adding paramedics to fire trucks? - Yeah.
And the guys resent it.
They blame me for having to answer so many medical calls.
Nobody likes change.
You did the right thing.
So you passed out and took a fall? Angie found me.
- Is Angie your home-health aide? - She was.
They burn out fast with me.
You see my chart? Yes, sir.
Pancreatic cancer and mets to the liver.
I keep hoping that "end-stage" means it can't get any worse.
Nausea pretty bad? We're gonna hydrate you, see if that helps.
Would you like me to put your own robe back on? It can get chilly.
- Did Angie call my son? - I can find out.
Is that yours? Ten years ago I kicked my son out of the house over this stuff.
Now he gets it for me.
Helps with the nausea? Do you have to take it? Take what? - Can you open your eyes? - Unresponsive since the Valium.
Pulse ox is 99o/o.
Can you imagine lugging around all this fat? It didn't stop her from eating noodles at 9 a.
m.
Does Radiology stock extra-extra large? Better call the vet school.
Okay, everybody, settle down.
Miss Meredith, you've had a bad allergic reaction.
- The tube is to help you breathe.
- BP's 90/60.
Let's start dopamine at five mics per kilo.
- How many kilos? - You want a calculator? - What do you think, 275 pounds? - Oh, I'll take the over.
- Hey, were you looking for me? - Yeah.
Conni, start her at 750 mics.
Let me know how she does.
You're gonna be fine.
We got it under control.
As part of your workload you'll teach patient/doctor class to second-years.
Patient/doctor class? Students practice H & Ps on simulated patients.
I remember.
Bad actors pretended like they were sick.
I hated it.
Yeah? Why is that? Because it's fake.
Everybody knows it's fake.
It's a waste of time.
Yeah.
Well, starting tomorrow, you're gonna learn to hate it all over again.
It'll sharpen your teaching skills.
Did Lucy give me a bad evaluation? Lucy gave you a fair evaluation.
I'll put the teaching guide in your box.
The patient collapsed push-starting a car.
Slurred speech and right-side weakness.
Resolved in 30 minutes.
- Suggesting? - A T.
I.
A.
Dr.
Corday ordered doppler ultrasound in his carotid arteries.
- Which demonstrates what? - A 50o/o lesion on the left side.
This is a surgical candidate? - He's pretty old.
- How old? - He was push-starting a car.
- He claims not to know his age.
Well, wasn't your Civil War in the 1860s? According to Mr.
Barnes, he's roughly 140.
- Elizabeth, is now a good time? - I'm not sure.
Ms.
IKnight and I can handle this.
- Peter, 8:00.
- I don't know if I can make it.
We need to compile our sternal saw data by tomorrow.
Mr.
Barnes, what are you doing out of bed? I asked you to call me Charley.
You have to stay in your gown so Dr.
Benton can examine you.
Is that you? I don't mean no disrespect.
But when you get to be my age and you loll around in bed them rheumatoids kick in.
Pretty soon you can't move at all.
Unfortunately, you have blockage in your neck artery.
It puts you at risk for a stroke.
I can't have that.
Too many people counting on me.
Charley helps the older people in his neighborhood.
And the children.
They need sitters, those people working all day.
Are you her teacher? At the moment.
Then you know, you and I, we have the responsibility to pass on what life has taught us.
Can you fix me up? Well, there is a surgical option.
But I hesitate to use it on someone your age.
You ain't ever seen a patient my age.
You don't have to worry.
I can't be killed because I got a conjure on me.
I don't know what that means.
Of course you don't.
Because you are a man of science.
How else you gonna explain my being alive at all? When every other body, all the ones from slavery times done died 50 and 60 years ago.
Miss IKnight, what would you suggest? I'd call a Psych consult.
Is that the doc for loonies? Yes, sir.
Yes, it is.
He's outrageous.
He can be tasteless.
He certainly likes to throw his weight around.
So you can't corroborate any instances of sexual harassment? It's a very American thing, if I may say this penchant for turning personal issues into lawsuits.
The hospital's hope, of course, is for me as ombudsperson to address problems and avoid lawsuits.
Look, one has to be thick-skinned working around Dr.
Romano.
You roll with the punches, don't you? Whoever's complaining may be too fragile to practice medicine at all.
Her identity is confidential until I can assess if any action is warranted.
It's a delicate business.
Rarely do I hear the kind of slam dunk where Dr.
So-and-So made sexual advances.
She declined.
And then he either fired her or cut her funds.
Right.
Is Robert aware of this complaint? He doesn't know who came to me.
He could figure it out since I prevent the parties from working together.
I see.
It's my fault.
I let it go on too long.
It's not your fault.
We're gonna start a line.
- What's going on? - Remember Ricky? He hasn't had a bowel movement in three days.
His temp spiked to 101.
I let him get septic.
I've always been able to disimpact him.
You disimpact him at home? I usually use a glove and Vaseline.
The morphine's made him constipated.
Why is he on morphine? He's having pain from contractures.
That's what I think.
Ricky stopped speaking about a week ago.
I'm sorry.
He still opens his eyes sometimes.
- Is the morphine working for the pain? - I don't know.
- Oh, God! - It's all right.
I've got it.
I'm sorry.
It's just I know.
I know.
Everything he's been through I fall apart over this.
- It's okay.
It's okay.
I know.
When we got to Michigan Avenue, he just passed out.
- How long ago did he hit his head? - Four hours.
He was fixing a floodlight over our garage.
The ladder slipped.
But he seemed okay.
He just had a headache.
When you have a head injury, it's best to call the paramedics.
- I did call.
- Paramedics didn't show? No.
They came, but Jim seemed okay.
And then there was a fire somewhere and they got called away.
Jerry's gonna show you where you can park.
Jerry, I want you to call Dispatch.
Find out which unit responded to the Haggerty's call.
Ricky's resting.
His fever is due to an ear infection.
They're treating it with antibiotics.
- Thank you, Carol, for everything.
- Oh, sure.
Dr.
Ross will be out to talk to you about it.
You always see me when I'm such a wreck.
I usually cope better.
Well, sometimes coping too much can drive you crazy.
I meant to thank you.
The respite care has been wonderful.
Oh, good.
Did you get to your daughter's recital? I had the worker come back another time just so I could take a bath.
- Good for you.
- Yeah.
We had great news last week.
My daughter's blood test came back.
She's not a carrier.
- Oh, that's a relief.
- Thank God.
She'll never do this to her kids.
We'll keep him until his fever comes down.
I'll see you before you go, okay? Does this mean we have to reduce Ricky's morphine to prevent this? That's one thing we could do.
This was the hardest part with Michael.
I lost Ricky's older brother to ALD three years ago.
Right.
Now he can't tell me it hurts.
Somehow it's worse to see him suffering.
I'll check.
There may be something we can do for the pain.
- Okay.
- Okay.
I'm in.
Hyperventilate him.
BP 160/90.
Pulse 60.
Mannitol's in.
Your husband has a blown pupil.
I'm worried the bleeding in the skull could be putting pressure on his brain.
- CT's ready.
- We'll get a head CT to find out more.
Take Mrs.
Haggerty to Chairs.
Chuny, call Neurosurgery down here right away.
- I was afraid you weren't joining us.
- I'm looking forward to it.
You don't see a choledochojejunostomy every day.
When they shuffled the schedule, I was afraid I was gonna miss out.
The Resident let the patient eat, and we had to postpone.
That's the problem sometimes with Residents rotating in.
They're not up to it or don't care.
- Who was this Resident? - Third-year from Emergency.
- Doyle.
- Maggie Doyle? They think very highly of her.
She's being considered for Chief Resident.
The pickings must be slim this year.
I've always found her to be extremely capable.
I hear she makes a lot of women uncomfortable.
This is gonna be nifty.
Stones in the common bile duct distal to the sphincter of Oddi.
No kidding? My whole team is tied up in the O.
R.
Someone needs to scrub out and join us.
- That's why you have to wait.
- Look at the size of the clot.
It's compressing his brain.
Every second counts.
Chuny, shave the scalp.
Malik, open the burr hole tray.
You can't do burr holes in the ER.
You're not giving me any choice.
What size gloves do you take? I am not comfortable with this.
We can't wait without risking brain damage.
I'll try again to get someone down.
- Twelve blade.
- Pulse is down to 55.
- Self-retaining retractor.
- This is a mistake.
Pressure's up to 180/95.
That's the Cushing response.
It'll herniate unless we relieve the pressure.
Periosteal elevator.
- My Chief can be down in 20 minutes.
- Too long.
Hudson brace and perforator.
I can see the skull fracture line.
ABG is back: PH 7.
51, PCO-2's 25, PO-2's 350.
That's what we want.
Okay, I'm ready for the burr hole.
Can't you wait a few minutes? IKeep the irrigation coming.
I need to see what I'm doing.
Please not too deep.
That's okay.
I'm through the inner table.
Okay, there's the clot.
I need a dural suction catheter.
Pulse up to 170.
BP's 140/70.
- Pupils are equal.
- That's more like it.
Wet sterile gauze.
Let's get him to the O.
R.
I'll alert the team.
Tell them to take their time.
Hey, Dr.
Greene.
Nice job.
You got time for a quick question? Yeah, sure.
Can I account for a broken container in the study? One of the vials busted? The powder spilled into the envelope.
I'd just make a note of it.
We don't have many patients enlisted.
We won't use all the samples.
That's all I wanted to know.
You gonna make your lecture? The guy from NASA at the med school? Oh, right.
I almost forgot.
Mrs.
Haggerty, your husband's been stabilized and sent up to the O.
R.
- What? - Jerry.
Your husband has been sent up to Surgery.
Someone will take you up.
I'll take her up.
Dr.
Greene stabilized your husband.
He's doing fine.
Did you find out which paramedic unit left him with a brain bleed? It was an engine company that went out.
Doris Pickman was the paramedic.
Oh, boy.
The deputy chief will handle it.
Listen, call Dispatch back and tell them that I'm gonna follow up.
Oh, and Jerry, if you put that music back on, you're fired.
I'm sorry it's taking so long.
We put my fingertip on ice.
It'll be okay, right? It's a possibility we won't be able to reattach.
The surgeon will decide.
You're still waiting on Plastics? They swore he's on his way.
Did you find another candidate for that fracture study? No.
Just recording a broken container.
- Is he a plastic surgeon? - No.
Sorry.
You want something to drink? My dad's getting me a Coke.
It shouldn't be that much longer.
Did you find my son? His office said he was out on a sales call.
He's not picking up his cell phone.
We'll keep trying.
Thank you.
- Is the Zofran helping the nausea? - No.
I'm gonna ask the docs to add Reglan.
Don't bother.
They don't work.
Any chance you could wheel me outside for some fresh air? I can't take you to smoke marijuana.
Maybe your son can help you.
I'm really sorry.
Don't be.
I'm probably not able to inhale anyway.
The neuromuscular response can be studied since there's no gravitational force in the usual Z axis from head to toe.
Gentleman in the back.
What are the applications of this study? A loss of muscle tone in microgravity is an issue sci-fi movies have largely ignored.
Cosmonauts who spent months on Mir had to be carried from the spacecraft.
I'd like to kick off the Q and A with a question to you: What interested you in the astronaut program? I ask because a lot of candidates admit to childhood dreams of adventure the adrenaline of takeoff, the vastness of space.
The doctor who just walked in, would you respond? Well, for me, it was pretty much adventure.
The adrenaline of takeoff, the vastness of outer space.
Thank you for your candor, Dr? - Mark Greene.
- Dr.
Greene.
Doug Lowrey wanted me to look you up.
Dr.
Greene may be joining us as a payload specialist.
The real picture of your schedule, should you make it is one of routine.
In training, you'll spend a year repeating tasks following checklists, adapting to a regimen.
Everything you do is dictated by the ground crew.
You follow a precise minute-to-minute itinerary.
I'm sorry to disturb you.
I didn't know what to do.
I screwed up bad.
But the guy seemed fine at the scene.
The engine got the fire call, the guys were all so jazzed, I told the wife Doris, slow down.
- How's Mr.
Haggerty? - Epidural hematoma, but he's okay.
They pulled me off active duty.
They're doing an investigation.
He's worried about bad press.
Fire engine leaves an accident scene.
That's a medical error.
That's my call.
Maybe I was influenced by the firefighters.
They wanted to go.
That shouldn't cloud my judgment.
It'll ruin my record.
Take a breath.
I'll see what I can do.
- Will you? - I'll call the deputy chief now.
- Come on, doc.
- I'm not gonna do that.
You heard me.
Roll up your sleeves.
I'm not gonna arm-wrestle over surgery.
Are you scared to? Yeah.
Yeah.
Yeah, I am.
Well, I want the surgery.
That's all there is to it.
And that one doctor calculated that I was fit in the head.
Because you didn't mention you thought you were at Appomattox.
But there was another doctor who also said my FEV-1 was over 120 percent.
I think that's darn good.
They cleared you physically.
You're giving me that second-rate pill idea.
You think the medical treatment isn't convincing.
I use my judgment.
Your judgment is to put your arm next to mine, clasping my hand and we will arm-wrestle.
You will find out that old Charley's not as weak and puny as you think.
I never said I don't think you're puny.
But you don't believe I can't die.
I don't believe that one either.
I'll give you something you can believe.
Put your elbow right here.
Mr.
Barnes, come on.
Listen, if you don't give a man his measure of respect and you don't believe his history you're talking about a fight.
Oh, come on.
Don't make your elder beg.
Come on.
Go.
Dr.
Benton? There is an O.
R.
Available.
Hey, don't humor me now.
Oh, boy.
You win.
You win.
All right, go ahead.
Book the O.
R.
It's a new policy putting paramedics on fire trucks.
It'll take a while to work the kinks out.
I know Doris.
I work with her.
She deserves to be counseled, not put on a desk.
No, no, no.
This is my job.
- Is Doug Ross around? - Try Admit.
Deputy Chief Mead, please? Mark Greene again.
They let you out of the lab? I make deliveries for some customers.
I got the toxicology results on that powder you brought us.
Negative for codeine.
- Is that all you needed? - That'll do it.
When I heard you hand-carried it, I thought well, maybe you were back on the market.
Me? No.
I I called the HandiVan for the Abbotts.
Joi said you wanted a prescription.
- I'm on my way.
- Nice to see you.
- See you later.
- Ricky's temp is 98.
8.
- Which is good.
- You know back there that was nothing? Yeah, of course.
I'm afraid Lynette has appropriated the lounge.
The staff will have to gossip someplace else.
You knew about it? She showed me her proposal last week.
It's a good area for the clinic.
I know you can tell if he's cheating.
But some Your man don't take a shower before he leaves but he does when he gets home? He's cheating! The number of partners you have and he has can put you at risk for cervical cancer.
It can put you at risk for being a fool.
How young you were when you started having sex and smoking are factors.
That's right.
This is Carol Hathaway.
She runs the clinic here.
Nice to meet you all.
Oh, carry on.
I think it's a really important topic to be informed about.
Please feel free to come see us at the clinic anytime.
Thanks, Carol.
My apologies.
I'm Dr.
Baker.
Jeanie Boulet.
This is Donna.
- Her father should be back soon.
- This is the x-ray, Ms.
Boulet? I did a digital nerve block with Marcaine.
Amputated the distal phalanx.
We'll rongeur and do a V-Y flap.
You can put it back on, right? The blood vessels are too small.
Did you explain to her? I told her it may be a possibility.
But you guys put arms and stuff back on.
If you had cut your finger at the base, we'd have bigger arteries.
We'll trim down the bone and create a flap over the defect.
You mean I'll have a stump? Maybe we should talk to Donna's father.
Yes.
If we can get a Trauma Room, I'll do the procedure right away.
Don't worry.
We'll make you a small prosthetic tip.
I'm saying oldies are played out.
- People like the classics.
- Not ones you can't dance to.
You're gonna lose them.
Jerry, what is this? You wanted the rap turned off.
Actually, I said we need a desk clerk here, not a DJ.
Fine.
It's no more.
Forever gone.
What possessed you to pick that particular song? I don't know.
Just instinct.
I'm just going with the flow.
My mom used to play this album when I was a kid.
It was always, like, the ultimate freedom.
You know? Leave ground control behind and float way.
- Escape.
- Yeah.
The folks in the Waiting Area want to know if you could put Bowie back on? Jerry, do whatever you want, okay? Just use your best judgment.
All right.
Now, you give this to him every six hours if needed.
You don't exceed four doses in 24 hours.
Call me if it isn't working for him.
Watch your head.
Why didn't the genetics clinic suggest this medication? It's still part of a clinical trial with kids with fractures.
Perfectly safe for Ricky.
It might give him some relief.
- Do I need to fill any of this out? - I wouldn't bother.
He's not a candidate for the study.
Thank you.
Trauma 2 is open.
Can you assist me? I insist.
You blew by that like she was an annoyance in your busy day.
You said there's a parent here to give consent.
Find him.
I'll explain the procedure.
I'll do that.
I can't believe I get to scrub in on my first day.
- That's the best way to learn.
- Masks? Charley has a crowd in the Waiting Room.
Does anyone know where he's from? Been in the neighborhood for years.
That car he was push-starting? Registration expired in 1956.
He had terrible stories.
The first two branches of the internal carotid? The ophthalmic artery and the posterior communicating.
Okay, that's it.
You're ready.
Let's go.
Gown and glove Miss IKnight.
She doesn't know the ropes.
Just about to put him under.
IKeep your hands in front of you.
Don't reach for anything unless you're told.
- What if I have an itch? - Tell the nurse where.
What is that? - Dr.
Riggs? - He's bradying down.
- Atropine.
- One milligram onboard.
- Blood pressure's dropping.
- He's in V-fib.
- Grab the crash cart.
- I'm sterile! It doesn't make a difference.
Amp of epi.
Let's move.
Come on.
Clear! - Asystole.
- Start compressions.
- Epi and atropine onboard.
- Right.
What's the rhythm? - Got an idioventricular rhythm.
- Faint pulse.
- Try to get a BP.
- Can he still have surgery? No.
Let's get him a room in the ICU.
How long till spring? - This is the shortest day of the year.
- That's December.
We're past that.
I made up my mind.
I'm not going to Houston.
- Really? - It's an old dream.
You fooled me.
I thought you were ready to blast off.
I realized I didn't want to go.
I don't want to go anywhere.
This is what I do.
This is where I belong.
Lost that old restlessness? I guess.
Coming in? Come on in! It's cold! You went out of your way not to involve me.
- Why would I? - You knew I would object.
- Object to what? - All the women were African-American.
- Yeah.
- The clinic's for everyone.
- I didn't exclude anyone.
- Where did you advertise? I have a special interest in an underserved population that is particularly at risk.
- Latinos are even more at risk.
- Our death rate is higher.
Vietnamese women have worse statistics.
To get women to consider changing sexual habits, they need to feel open.
Women talk more freely among their own.
We'll have to hold seminars that target other populations.
Look, I did this on my own time out of my own interests.
I understand that.
But I can't have you pulling against me.
If you want to work in the clinic, adjust your project to include others.
Well, I guess you've given me something to think about.
Couple more stitches and the Y is closed.
See? What kind of music do you play, Donna? Folk and classical.
Some rock.
Well, Ms.
Boulet is right.
More 5-0 nylon, please.
A prosthetic will take some getting used to.
But with time, you'll be able to play just fine.
- What about computer games? - You'll never be able to touch them.
Your dad paid me to say that.
- Cut, please, Jenny.
- It's Jeanie.
Sorry, Ms.
Boulet.
- Honest.
I owe you my first born.
- You do that and you're on a desk.
- You saved my career.
- I gave you a chance to turn it around.
We'll work out a counseling schedule next week, okay? - Thanks.
- Where's Jerry? - We're in between sets.
- I was taking requests.
- Hey, you off? - Yeah.
Why? That guy in Exam 2 wanted to say goodbye.
Mr.
Ackerman? Pancreatic cancer? He's gonna have to stay the night.
Nobody can come until tomorrow.
Are you waiting for the health bus? We're all loaded up.
I just had another question for Dr.
Ross.
- Dr.
Ross is in a meeting.
- Is there something I can do? He gave some new medication to us.
I forgot to ask if it's all right to take with Robaxin.
My son has ALD.
He has a fracture? No.
But he was in pain.
Dr.
Ross thought this might help.
Where's your study envelope? He said we didn't need to bother.
Dr.
Ross did? Since my son isn't actually a candidate for the trial.
I see.
I heard your son couldn't make it.
You need this? Please.
Never mind.
Oh, God! Again? - Hey, is Doug still upstairs? - I don't know.
Well, I'm headed home.
Mark, what are you doing? Do you know anything about a boy with ALD? Ricky Abbott? Why was he given meds for the clinical trial? He wasn't.
Doug wouldn't do that.
Looks like he did.
Talk to Doug.
I'm sure there's an explanation.
Ms.
Boulet, I wanted to thank you for assisting on the finger flap.
Not at all.
And for reminding me to take time with our young patient.
I don't do well when I get behind schedule.
But that's no excuse.
- You were right, and I thank you.
- You're welcome.
Would you join me for an opening at the Art Institute this evening? This evening? I realize it's short notice.
It may be interesting: Raghubir Singh, an Indian photographer.
I don't know much about art.
I don't care about art.
I promised my wife, who died a few years ago I'd keep our membership and not become a Philistine without her.
I'm sorry to hear you lost your wife.
And my partner.
Jenny and I had a practice together for 15 years.
Her name was Jenny? You're a sweet angel.
Called for a consult? - Self-inflicted knife wounds.
- Quite a few of them.
He gave me a suturing refresher.
She's my angel.
That is not what he was calling me before the Haldol.
No blood in the urine but these two needed two-layer closures.
Good bowel sounds.
Belly's soft.
I wanted to mention to you I have been having a problem with Dr.
Romano.
IKerry spoke with me this morning without actually saying it was you.
I'm sorry I didn't ask before dragging your name in.
I don't think I can be of any help.
Well, no sign of any intra-abdominal bleed.
He's got another one on his back.
We'll have to lift him.
I hoped Romano would cool it if I confronted him.
But instead he threatened to blast me on my evaluation.
Dr.
Romano can be volatile.
You mean he's a mean-spirited little powermonger? That too.
Well, the kidneys look fine as well.
Whores! Whores! I want to die.
There's the Mr.
Michaels I know and love.
Look, Romano, he likes to push things to the limit.
I guess he thought anything goes with the gay chick.
I hope you're not going out on a limb.
He's a star.
Self-respect's a bitch.
- IKerry, do you have a moment? - Mark needs me.
You're leaving? - How about breakfast tomorrow? - That's more than a minute.
I may have some things to add to your inquiry.
I'll call you.
We'll set something up.
There she is.
Minnesota Fats.
- I was afraid I'd missed you.
- Hey, Reggie.
You'll give me a chance to win my money back? Playing pool two nights in a row is bad luck.
It's bad luck to play against you.
Where'd you learn? Signs of a misspent youth.
What do you say we go eat? I already have plans for tonight.
Something a new friend can barge in on? Opening at the Art Institute.
Say no more.
I'll catch you on the weekend.
I almost went straight to Anspaugh.
What the hell was Doug thinking? If we were exposed for breaking protocol on a federally funded trial They'd cut off research money and Medicare payments for years.
And it's against the law.
They brought me the study.
I got him onboard.
Mark, given the implications I don't think we have any choice but to handle this internally.
Cover it up.
If Anspaugh finds out, he has to react.
Nice position he put us in, huh? Do you have the key to the pain study cabinet? Come in and take a seat.
Any changes? Will he wake up? What do you think? His brain was deprived of a lot of oxygen during the cardiac arrest.
Old folks don't usually come back with full function after hypoxic insult.
It's a wait-and-see.
He could live like this for a while.
Forever.
Well, according to him.
What's his Glasgow score? An eight.
No spontaneous eye-opening.
No speaking.
Responds only to painful stimulus.
Excuse me.
I'm sorry.
I didn't expect this.
Well, neither did I.
Should I go tell his neighbors? No.
I'll do it.
Then to top it off, he goes to IKerry Weaver instead of coming to me.
But you gave Joi the meds? Mark said that he wasn't gonna use all the samples.
- That's not the point, is it? - What is the point? That breaking research protocol could damage the hospital's funding.
So you agree with them? I see their point.
You know how sick he is? Yeah, but that decision could have a larger impact.
The hospital's only at risk if someone goes out of their way to report me.
And believe me, it kills IKerry Weaver not to be able to do that.
I don't know what to say.
Doug, don't walk away.