ER s05e14 Episode Script

Previously on ER: I offer up my services.
The burns are well-healed.
Tell me how it happened.
You put the patient first.
That's what we're supposed to do.
When you prescribe schedule-two narcotics, we cosign the order.
We should arrange for a PCA.
Hook Ricky up to an IV that would deliver pain medication at home.
Sign off on the Dilaudid.
I can't sign off on that.
He's not on our service.
Hey.
Doug? - What time is it? - It's almost 6.
It's very strong.
How's Ricky? He's still alive.
- How's Joi? - She's not so good.
It's amazing he made it through the night.
I've gotta get to work.
What time's your shift? Seven.
I'll see you there.
Doug? Thanks.
For what? For staying last night.
I love this time of night, just before dawn.
So quiet, peaceful.
When they're babies, it's the best time.
You complain about it but it's when you're closest to them.
Singing to them in the dark, nursing.
Get any sleep? I must have.
I closed my eyes for a moment, and he was laughing.
He was getting up to go to school, kidding me about how much I worry.
He always used to do that.
Try to cheer me up, make me laugh.
Oh, God - When was his last booster? - An hour ago.
It won't give me more.
Mommy? - Go back to sleep, sweetheart.
- I'm thirsty.
I'll get you a drink of water, okay? It's okay, buddy.
I'll take care of you.
Dr.
Ross? I increased the Dilaudid.
It'll make it more difficult for him to breathe.
I don't know how much more of this I can take.
Will you please help us? Please? I can't watch him suffer anymore.
He's suffered enough.
No more.
No more.
Recent springlike temperatures will give way to freezing rain and snow.
Oh, man! I'm supposed to go ice fishing tonight.
Al and I are supposed to go to Wisconsin to ski.
Skiing in Wisconsin? That's an oxymoron.
Cross-country.
It's great exercise.
You're the moron.
Sitting on the lake in winter with your pole.
"Oxymoron.
" It's a figure of speech in which contradictory terms or ideas are combined.
I know what it means.
I think you're a fool for freezing on a lake.
Who gave him that "Improve Your Vocabulary" calendar? I did.
It broadens his horizons.
What's today's word? Today's word is: "Ratiocination.
" That's gonna come in handy in daily conversation.
Has anyone seen Carol? It's "ratiocination.
" And it's "to reckon, to reason, especially using formal logic.
" Jesuit high school.
Hathaway's in Sutures.
You're kidding! "Rocket" Romano? It's temporary until your committee finds a permanent department head.
- Why Romano? - What? What about Romano? Anspaugh's made him Acting Chief.
Of Emergency Medicine? Hey, I'm not happy about it either.
He's an egotistical, arrogant mean-spirited, sexist little bullet-head.
Good morning, doctors.
News of my recent appointment precedes me, I take it.
What? No popping of champagne? No ticker tape? Excuse me.
I have a patient.
Looking forward to working together again, Maggie.
I took the liberty of reassigning a few minor tasks.
Greene, you'll handle chart review, Residents and medical students timecards and patient complaints.
Dr.
Weaver, joint commission report is due.
I'd like a weekly census divided into Surgery, Pedes, and Medicine.
I'd like a daily list of all consults.
You'll sit on the budget committee and handle all billing questions and insurance approvals.
What do you do? I supervise you.
Delegation: One of the eight hallmarks of effective leadership.
Well, if you need me I'll be in surgery.
Oh "Bullet-head.
" I'm offended.
Aren't you, Dr.
Greene? Deeply, deeply wounded by your callous and uncaring remark.
In fact, I might have to start an investigation and interview others who might have been hurt by your vicious invective in the past.
This is gonna be fun.
Just get his coat and sweater off.
IKid eats nothing but French fries and pizza.
The mom doesn't understand why he's constipated.
So how was Ricky when you left? Alive.
I better go.
I'm behind already.
- Lunch? - Sure.
You sure look beautiful.
How do you do that without sleep? Good genes.
You look like hell.
- It's a chick flick.
- It's romantic.
Isn't it four hours long? The special effects are great.
- IKate Winslet gets naked.
- That's encouraging.
- What you got? - Fender bender.
Tender abdomen.
- Have you seen Titanic? - Chick flick.
That's what I said.
Lucy rented it, wants me to watch it with her.
Leonardo DiCaprio, hoop skirts and tragic love is my idea of hell.
Whatever happened to the sensitive '90s male? The ones who love romantic candlelight dinners? They're all gay, aren't they? I don't want to ruin it, Dale, but in the end, the ship sinks.
I hate you both.
Nice package, huh? So, you two getting serious? She is.
Have you two? Consummated? I couldn't discuss it if I had.
It would damage her reputation.
I'll tell you this much, though: Thongs.
When the lighting's right, you can see through her scrubs.
"E.
" "S.
" Make it a little rounder.
Yeah.
"E.
" Reece.
That's hard.
You'll get the hang of it.
How long will it take? It depends on how much you practice.
You're learning a new language.
- Reece is already getting it.
- He's a kid.
It's easier.
He wants to communicate.
That's it for today.
How often should we - You and me? - Yeah.
I would recommend three times a week.
A hundred and fifty bucks a week? There's good video available.
But I think one-on-one is better.
Mr.
Ekabo, how are you? Fine.
How did it go with the urologist? Did you see the doctor? Yeah.
Everything's good.
If you have any questions about a procedure or what the doctor's telling you, I'd be happy to answer them.
No questions.
No.
You didn't go see the urologist, did you, Mr.
Ekabo? Why not? I have not told my wife about my needing a doctor.
She will be frightened.
Would you like me to explain it to her? - You would do that? - I'd be happy to.
We got a kid coming in.
Full arrest.
- How long? - Coming up now.
Bring your wife around.
We'll talk.
Then we can go ahead and set up that urologist appointment.
Okay? Where's that snow we're supposed to get? You know what they say: The calm before the storm.
Eight-year-old male found unresponsive in bed at home.
Asystole, began CPR in the field.
- Joi? - What do we got? End-stage ALD.
He's Doug's patient.
- How long has he been down? - We got him 15 minutes ago.
He wasn't expected to make it.
His mother wanted him to die at home.
Joi, why did you call the paramedics? I didn't.
Do you want us to use extraordinary measures? - No, I don't.
- But I do.
- Who are you? - Ricky's father.
Your son is at the end stages of a painful terminal illness.
Extending his life will only prolong his agony.
Doctor, please don't let him die.
Intubation kit.
The leg isn't broken.
- I need you.
- They're much tougher than you think.
Ricky Abbott's back.
His father is insisting we resuscitate him.
Carol, what meds is he on? Where's Carol? She left to get Doug.
He's on Dilaudid for the pain.
Two milligrams of Narcan.
Chuny, why don't you take Mr.
And Mrs.
Abbott to Chairs? What's going on? Mr.
Abbott asked us to try to resuscitate.
Atropine.
Two of epi.
He shouldn't have made it through the night.
- Who the hell are you? - I'm Dr.
Ross.
He was in my care.
Son of a bitch! Get him out of here! Get your hands off me.
Still flatline.
Oh, please.
Please.
Sorry, Mr.
Abbott.
Time of death, 9:42.
You'll need a couple of sutures.
You want me to get Plastics? No, you can do it.
What was that all about? I didn't even know there was a father.
Is he gonna be okay? A couple of stitches.
How's Mike Tyson? He went to make a phone call, took the girl.
Did Joi mention there was a father? She told me they were separated.
You went down like a brick.
Cheap shot.
Guy caught me off balance.
I didn't realize you had a glass jaw.
Child support my med school loans.
I don't know how I'll shake it.
How much do you have to pay in school loans? Over 120 grand.
Oh, that's barbaric.
Payment's 700 a month.
That's a quarter of my take-home pay.
Money woes, Peter? Every Resident's chief complaint.
I'll never understand this country's insistence on forcing its highly-trained Residents to live in poverty.
Only way the public health system can afford to provide care the freeloaders.
By freeloaders, you mean people without education job training, children and the infirm.
Like I said, freeloaders.
You are a despicable human being.
Do you know that? - Having trouble making ends meet? - Things are tight.
Why don't you apply to a Locum Tenens program? A Locum what? Tenens.
Filling in for vacationing surgeons in rural hospitals in Minnesota, the Dakotas, on your vacation.
They don't have staff to cover when somebody's out.
They pay a bundle.
What's a "bundle"? Eight, ten grand for a couple weeks.
Where's the big storm? Should be any minute now.
They're closing all those schools at lunch recommending people leave early.
They emphasized the importance of leaving early to get home safely.
No, Jerry.
- The National Weather Service - I said, no.
Anspaugh said it might be months before we get a new Chief.
Months with Romano? Did we do some- thing in a past life to deserve this? There's Viking in my family.
Maybe I pillaged Northern Europe.
- Pillaged? Cool.
- Bet you looked great in a horn hat.
Maybe you should consider re-applying.
Once foolish, twice stupid.
Don might entertain renewed interest.
I spoke to him about you.
I don't know if I could go through all that again.
- Can I tell him you seemed interested? - How about "intrigued"? Excuse me.
I'm looking for Mr.
Abbott.
- Who? - Richard Abbott.
His son Ricky died here this morning.
I'm Dr.
Greene.
I was with him earlier, but I haven't seen him.
I work with Richard down at the state attorney's office.
He's asked us to open an investigation about his son's death.
Have the police arrived yet? Hi.
How are you? I'm fine.
I'm sorry Richard hit you.
We've been separated since Michael died.
I called him yesterday to tell him Ricky That he should probably try to come see him.
He was at a conference in Houston, so I left a message.
And when he arrived this morning and saw that Ricky was gone he kind of lost it.
He just wasn't ready.
It's time for you to let the nurses finish up with Ricky.
Have you made arrangements for him? I think I'll go to the same funeral home that took care of Michael.
I'll call them.
Give me the number, I'll call them.
Thanks.
Got a moment? What's up, Mark? The police are here.
Mr.
Abbott is accusing you of murdering his son.
She was hit in the face kickboxing.
Not kickboxing.
Tae-Bo class.
It's aerobics, but better.
It's supposed to be good for losing weight.
- I lost 16 pounds.
- Sixteen pounds? Wow! I had everybody spread out enough, but a new guy shows up and she got kicked.
Did you lose consciousness? No, but I was pretty dizzy.
- How long did it take to lose? - Just melted off.
I hope this won't keep me from getting back to class.
Fundus is sharp, no papilledema.
- Want to palpate the orbit? - No.
- Is it expensive? - Not bad.
It's worth it.
You feel this? - Any numbness? - No.
- Do you have early classes? - Any visual changes? Shapes? Things out of focus? I teach a 5:30 class.
If you buy 20, you get five free.
- No kidding? - Where's a phone? There's a pay phone.
No step-off.
I'm concerned about your blurred vision.
Let's get some facial films and a visual acuity.
If you think you can tear yourself away for five minutes, stitch her up.
- Your wish is my command.
- Irrigate and suture.
I don't usually get a lunch break.
I eat out of the vending machines.
First, lidocaine to numb the area.
Then you'll feel a little bit of wetness as I irrigate the wound.
- Dr.
Carter? - Yeah? The cut's pretty deep.
Should I do a few subcutaneous first? Yeah, absolutely.
I'll check back with you in a bit.
Was he staring at my ass? The coroner's coming over to get the body and do an autopsy.
Roger Julian's coming from Genetics.
Says Ricky was on his service.
Wants to know where the mother got Dilaudid.
He was dying.
You promised IKerry and I that you wouldn't prescribe - He was in pain.
- You promised yesterday! - The mother was begging me.
- Where did you get the machine? - I got it from Carol's clinic.
- Come here.
Carol's clinic doesn't have PCAs.
She called in a favor, got it from one of her suppliers.
The police are on their way to Joi Abbott's house.
They have a warrant to impound the PCA.
Are they gonna find anything strange? - Like what? - Like the machine set with enough to kill 10 grown men? - I don't know.
- What? You set it! This boy was suffering.
He had end-stage ALD, in agony.
The mother was watching him die.
Did you help him along? I gave the mother the entry code and showed her how to change the dosage.
I don't know what she did afterwards.
You would've done the same.
Anspaugh's coming with Romano and Julian.
Doug got the PCA and the Dilaudid through Carol's clinic.
What? When? Right after he told us he wouldn't.
We'll have to tell Anspaugh about Doug violating the pain study protocol and our covering it up.
They're gonna scrutinize everything he's prescribed.
They'll interview the mother.
It'll come out.
What's wrong with you?! We trusted you, and you immediately choose to betray that trust.
I'm done defending you.
- You've been trying to nail me.
- I don't "nail" colleagues.
If you want to destroy your own career, that's fine.
Stay away from mine.
Have you called an attorney? I don't need an attorney.
It was the right thing to do, Mark.
He had a degenerative genetic disorder.
His brother died of the same disease several years ago.
I have a child.
I don't know what I'd do under similar circumstances.
Look, I know Mr.
Abbott is upset, but his son died.
There's nothing Dr.
Ross or any other physician could do about it.
This PCA machine: It delivers pain medication to the patient? A steady dose through an IV.
Can the patient or their parent program the machine to increase the dosage if the patient is in pain? No.
They can give a booster every hour.
But they need a code to change the dosage.
That way they can't mess up.
That's what I thought.
I was surprised when Mrs.
Abbott said Dr.
Ross had given her the code and showed her how to change the dosage before he left.
Why do you think he would do that? You covered up a serious breach of a federally-funded program? It was in the hospital's best interest to keep it from becoming public.
It'll go public now, in connection with a high-profile euthanasia case.
- Where did Ross get a PCA? - The clinic.
- God, what a fiasco! - What about Ross? Take him out back and shoot him.
We'll convene a meeting of the disciplinary committee and investigate.
Okay, but don't conclude it until we know if the father's going to sue.
Ross keeps working? You can have him dispense aspirin if you want to, I don't care.
- Don't take any further action.
- What about Hathaway's clinic? Close it.
Public Relations will handle all the press inquiries.
Dr.
Romano and I will make sure the staff cooperates with the police.
That's it.
IKerry, Mark I don't know what to say.
When the dust settles, I'll personally chair an investigation into this and the appropriate disciplinary action will be taken.
And on a more personal note I don't think I've ever been more disappointed.
IKerry, I'm sorry this I just beat it in.
The roads are getting really slick.
It took me forever to navigate the IKennedy.
Traffic was backed up for miles.
What's the matter? Somebody die? Somebody we know? Dr.
Ross lost the ALD kid.
The police are in Trauma Two.
The boy's father accused Doug of giving him an overdose.
- Oh, my God! - Coroner took the body.
- Police are interviewing.
- Where's Doug? In the Pedes Room, I think.
Have you seen the labs on that drunk with the head lac? No, but he threw up on me again.
Third scrub top today.
We should wire a bucket to his head like a feed bag for horses.
Any word on Doug Ross? Police are interviewing Dr.
Greene.
Have you seen Lucy? Dr.
Edson keeps calling.
Last time I saw her she was Hey, where's my kickboxer? Dr.
Weaver moved her into Exam Two when that MI came in.
Lucy was still working on her.
Suturing? - That should've taken two minutes.
- I haven't seen her.
My heart's really pumping.
- You're getting it.
- Five, six seven, eight, and Dr.
Carter, are you okay? Don't move.
Chuny, a backboard and a hard collar.
I don't see any other blood.
Nice kick.
Damn! - What happened? - I kicked him in the chest.
I was practicing my Tae-Bo.
Now we're gonna roll him.
Back under there.
- Watch your stethoscope, man.
- Pull back.
On my count.
One, two, three.
- So it's good, huh? - Terrific.
I'm definitely going.
Maybe I'll come with you.
Hey, Doug, I just heard.
- You okay? - Yeah.
Didn't anyone explain Ricky's medical condition to them? And they're still pursuing it? Apparently so.
I don't believe this.
Can I do anything for you? Do you need anything? You know, you're the first person to ask me that all day.
No, I'm fine.
Thanks.
I'm supposed to work a fast track, but I can get someone to cover.
I don't have much to do.
Weaver pulled me away from seeing patients.
Told me to sit here and catch up on paperwork.
For how long? From the tone of her voice, I'd guess maybe forever.
What did Mark say? They're closing ranks, covering their asses.
Dr.
Ross? You have a couple minutes? I'm gonna grab some coffee.
You set? I'm down the hall in 117.
Meet you there in five? Okay.
Dr.
Greene? I'm sorry.
Is this not a good time? No, it's fine.
Come on in.
Do you remember my wife, IKubby? Sure.
Hi.
Did you two talk about this? His back? It is worse? His back is better.
I suggested he see a urologist for his other problem.
It's possible that he may need surgery.
Surgery? If this is uncomfortable for you, I can leave for a few minutes No, please.
Stay.
- How you doing? - Hey.
Have a seat, doctor.
Are you sure you don't want coffee? I got an extra one.
I'll have to drink it myself.
Who's that? Detective Brannigan.
He's part of the felony review team.
We investigate all the first-degree murder cases.
I'm not trying to hang you out to dry or ruin your career.
But if you showed Mrs.
Abbott how to alter the PCA to deliver a fatal dose of Dilaudid, you can be held accountable for Ricky's death.
Now, Miss Hathaway said that Ricky was getting eighty mics of Dilaudid an hour through the PCA.
"Mics" is micrograms? And that Ricky's mother could give him a booster of an additional 120 every two hours.
That's right.
She was uncertain as to how much Dilaudid you'd placed in the machine.
It was empty when Detective Brannigan examined it a few minutes ago.
Mr.
Sullivan I've dedicated my life to pediatric medicine.
I've cared for dozens of dying kids.
IKids in agony, pain you and I can't even imagine.
Ricky Abbott was gonna die.
Not in a month or a week, or a day.
In hours.
And nothing I did or could have done was gonna change that.
His mother had already watched one son die from the disease.
She was sitting there watching her second son dying a horrible death from something that she passed on to him.
Sometimes it's impossible to save a kid's life.
And the only thing we can do is save them from suffering leave them with a little dignity.
In the end, that's all they have.
Tell me, were you relieving the child's suffering or were you relieving your own? If you were so certain you were doing the right thing why didn't you administer the lethal dose yourself? You're the doctor.
You could've stayed and made sure there were no complications.
That he really did die with dignity.
But you left.
You knew that killing that child was wrong.
That's why you snuck out of the house before dawn.
You didn't want to be there, did you? You didn't want to be there because you knew killing Ricky Abbott was wrong.
I don't see a broken rib.
Maybe a hairline fracture.
- It's like an elephant sat on my chest.
- Don't get up.
How did you get that cut? I think I hit it with the chart.
You've taken martial arts before.
IKarate when I was, like, 7.
It can't hurt that bad.
It's tiny.
It doesn't even need a stitch.
Baby.
There.
Better? Much.
I'm a doctor, you're a student.
So we shouldn't be doing this.
The storm's finally here.
Romano closed my clinic.
Why? Because I helped you get the PCA.
Well, Ricky was dying.
I was there.
I know he was dying.
I didn't know you were gonna help his mother use a piece of my equipment to administer a lethal dose of Dilaudid.
I didn't want to get you involved.
But Doug, I was involved.
I mean, were you planning on telling me any of this, ever? I don't know.
I hadn't decided.
What about you promising Mark never to prescribe narcotics? Had you decided on sharing that information with me? I thought it was right.
Damn the consequences, right? I was willing to live with the consequences.
Mark and IKerry are facing disciplinary action.
My clinic has been closed which means hundreds of patients have no place else to go.
The police are questioning the entire ER staff.
Your actions carry consequences, Doug.
It's not just about you.
Do you even give a damn? Don't do that.
Don't walk away.
Why not? You don't need anybody else.
You are a country unto yourself.
You make decisions, ruin peoples' lives.
- Narcissism, elevated to a high art.
- Carol, Carol What? I'm sorry.
That's what you always say, Doug.
Some of the roadways are impassable, as you can see from this video.
Both of the airports, Midway and O'Hare, are closed I'll never get home.
Somebody beep me? - I did.
Where have you been? - Upstairs with Legal.
We are stacked up.
When Romano closed Carol's clinic, all her cases got dumped onto us.
Most of them are in Chairs.
Jerry, stop watching TV and get your tail over here.
How long are the police keeping Trauma Two? I don't know.
Why does Carter have so many old cases up? He got kicked in the chest.
Lucy's working on him.
Could this day get any worse? Conni, go tell the clinic patients we won't get to them today.
They might as well go home.
Chuny, go see how Carter's doing.
If he can't work, we'll call in the Jeopardy Resident.
- You got it.
- Damn it, Jerry! Stop watching that TV or I'll come over there rip it off the wall with my hands and beat you to death! - Wait.
Wait.
- I almost got it.
No, I mean, really.
Wait.
Yeah, this isn't right.
- We can't be doing this.
- Why not? Well, because there are rules.
You think we'd get in trouble? Not we.
Me.
Dr.
Carter, you in there? You locked that door, right? Yeah.
Absolutely.
Both of them? Dr.
Carter, you okay? - Just a second.
- What are you doing? You just locked the door.
She knows somebody's in here.
How are you feeling? Much better.
Thank you.
- He didn't need any stitches.
- Good.
- I'm going back to work.
- You're inside out.
Your sweater.
You've got it on inside out.
When did it stop snowing? A few minutes ago.
We don't look much like dangerous felons.
Speak for yourself.
I'm so sorry about all this.
You okay? Are you? I've had better days.
Yeah.
You know, when When Michael died I cried for days.
I felt that I'd died too.
That I'd never feel love or joy again.
Then Ricky came and read to me.
He'd sit on the end of the bed and tell me these stupid jokes that he'd heard in second grade and he'd smile.
God I wish you'd seen him like that.
You still have your daughter.
I guess I should go back inside and see if my ex-husband's ready to let me talk to her.
Thank you, Dr.
Ross for everything.
The 92-year-old dislocated ankle in Exam One has been reduced.
Give her a Vicodin and tell her to stay off her skates.
Ninety-two years old and she still skates? - You have something on your neck.
- Where? - There.
- It looks like somebody bit you.
I think I might've hit something when I fell down.
- You bit me.
- What? No, I didn't.
Guess I must've gotten carried away.
Now, that's what I'm talking about.
Roxanne called, twice.
- So - So? - So what, Jerry? - So, Lucy Come on.
Everybody knows.
- I heard it from the cashier.
- Sheri from Radiology.
- I'm not having this conversation.
- Answer the MICN.
Nothing happened.
- I gotta talk to you.
- I got patients.
Listen, I'm gonna go to Anspaugh.
I'll tell him I coerced you and IKerry to go along on the drug protocol.
- Coerced? How? - I'll say I promised I'd do it myself.
And that's why you didn't report it.
I think there's been enough lying.
Why don't we just stick to the truth? - I'm trying to help.
- I don't want help.
I made decisions of my own free will.
I'll stand behind them.
You don't believe me.
I don't know what to believe.
You lie, undermine my authority every chance you get bend the rules to fit your needs.
"I'll just lie my way out of it.
" I'm just trying to do you a favor.
Don't.
I'll be lucky if I survive the ones you've already done.
We got a school bus flipped over.
Firemen need a doctor on the scene.
- Where? - Downtown somewhere.
Some kids may die before we can get them out.
Weaver wants you to go.
Unit 62's waiting for you.
- How many? - Fifteen, nine are still trapped.
A snowplow blade went into the bus.
- Where are you going? - You need me.
- You are off the service.
- I'm coming.
The hell you are! - Ready to go, doc? - Yeah, let's do it! - Get back inside.
- You got kids dying.
Maybe you'll think about that next time.
- Where are you going? - I'm driving myself.
- I'm coming.
- You don't have a coat.
I'll get one.
Just wait.
Wait for me! We got the jaws working the forward section.
We got three kids trapped under the blade.
I was afraid they'd bleed out before we could get them out.
I got a crane coming to lift the plow.
Driver tried to stop but it's pure ice.
Plow hit him.
We'll go in through the side window and climb down to reach them.
Doc, it's pretty bad in there.
Watch your step.
- Skipper? - Yeah? We're gonna need O-neg.
Lots of it, okay? And get some propane heaters before these kids freeze to death.
Hey, turn this up.
I love this song.
Earth, Wind and Fire? My dad used to love them.
Dating me.
Junior high.
So you never asked me if I did it.
I hope you did.
I wouldn't want to suffer the way he did.
I've thought about that a lot.
You know, Jeanie, you never talk about your HIV.
Hold on!