Chicago Med (2015) s05e18 Episode Script
In the Name of Love
1
The night that you left,
I kissed Crockett.
I'm sorry.
April? Really? Huh? All this time acting like this? - Come on! - Hey! I couldn't let you keep treating patients.
I had to make your addiction known.
- What you did was a betrayal.
- You're an excellent doctor.
I wasn't about to let you throw your life away.
You were right.
They gave me my life back.
[DRAMATIC MUSIC.]
It's beautiful, Ben.
You're beautiful.
I pronounce you husband and wife.
[LAUGHTER, APPLAUSE.]
I'll say it till the day I die: there is no better pizza than Chicago deep dish.
But it's not even pizza.
It's lasagna.
We're gonna have to agree to disagree.
I will not agree to disagree.
No, you are flat wrong.
Flat.
The way that pizza should be.
Lasagna, huh? That's good.
Smart lady.
No, Dr.
Charles, not you too.
I don't know that That you and Dr.
Asher were - Friends.
- Yeah.
Good.
That's good.
And? And she needs a strong support system right now.
So I'm glad that she has you as a as a friend.
Look, I get it.
Romantic relationships are discouraged during the first year of recovery.
Neurochemically, very little difference between the dopamine rush that we get from drugs and alcohol and the rush that we get from romance.
Well, you know, I'm sure as with anything, there are exceptions to the rule.
I have never actually seen that go well.
Well, at least not in my, you know, three decades of experience counseling people in recovery.
Next! Hey.
So how are things with Ethan? Okay, I guess.
I tried to get him to talk about it, and he hasn't wanted to.
Hmm, maybe that's his way of processing.
Yeah.
Maybe.
Will, you're up.
Ambo's landed.
You're going to Trauma 2.
All right.
Evelyn Myers.
49-year-old female with progressive early-onset Alzheimer's.
Passed out at home.
Did a 12-lead in the ambo.
She's got peaked T Waves.
And did she hit her head when she passed out? Her daughter, Molly, didn't think so.
No overt signs of head trauma.
I'm pretty sure that she didn't, but I was in the other room when it happened.
I shouldn't have left her alone.
Evelyn, I'm Dr.
Halstead.
All right, on my count.
One, two, three.
- Thanks, guys.
- Yup.
[SUSPENSEFUL MUSIC.]
Rhonchi, both sides.
Blunted breath sounds at the base.
2 plus pitting edema.
Yeah.
Molly, is your mom on any medications for kidney disease? I'm not sure.
She takes something called Capto - Captopril? - I think so.
Sorry, I'm not with her every day.
I'm just home for spring break.
Any family history of kidney problems? Uh, yeah, yeah.
My grandma, my mom's mom, she had something wrong with her kidneys.
My dad will know what it's called.
- CBC, CMP stat.
- What's going on? [SIGHS.]
Molly, I told you to call me if anything happened with Mom.
Sorry, Dad.
I just freaked out.
It's okay.
- Hi, I'm Dr.
Halstead.
- Elliot.
Elliot, well, we still need labs, but I suspect Evelyn's in acute renal failure.
In which case, she needs emergency dialysis.
No.
No dialysis.
It's against Evelyn's advance directive.
Don't listen to him.
He lies.
Evelyn, honey, you signed an advance directive.
Advance directive? What is that, Dad? No, I didn't sign anything.
No.
You don't want dialysis, my love.
Yes, I do.
I do! Help me! - Hey, take a look.
Did you get Mrs.
Myers' lab work back? She's profoundly uremic and hyperkalemic.
She's not making urine.
If we don't dialyze her, she'll die.
Well, I've reviewed her advance directive.
She prepared it shortly after her Alzheimer's diagnosis, and I'll tell you, Mrs.
Myers outlined a number of interventions she didn't want including dialysis.
And she appointed her husband to be her proxy when she could no longer speak for herself.
But she can speak for herself, and she has changed her mind.
I mean, people can modify their advanced directives at any time, right? As long as they still have decisional capacity.
Well, you do an evaluation and then we'll take it from there.
Great.
- Sharon? - Yeah.
Your assistant called.
Michael's plane has landed.
Oh, good.
It's silly, I know, but he's 33 years old.
- Mm-hmm.
- I still get nervous when he flies.
[LAUGHTER.]
I guess I just feel a lot better when I know he's got two feet back on the ground.
Well, he's your baby boy.
- How long is he in town? - Just 24 hours.
Interviewing for a sales job at Kender Bio Systems.
I would love to have at least one of my kids living in the city.
- [CHUCKLES.]
- Need some help over here! - [GROANS.]
- This is Nick Elms.
Experiencing severe abdominal pain.
Haven't finished uploading his information into the system.
I can tell you anything you need to know.
I'm his wife, Alice.
- Trini, where we headed? - 4's open.
- [GROANS.]
- Just breathe.
All right, Mr.
Elms, we're gonna take you right here.
- [GROANS.]
- Ready? One, two, three.
There you go.
All right.
When did the pain start? Last night.
Nick has a condition called familial adenomatous polyposis.
- It causes polyps in his - Colon and rectum.
- I'm familiar.
- [BREATHES HEAVILY.]
- When was he first diagnosed? - Five years ago.
It had already developed into colorectal cancer.
He had multiple runs of chemo, but it came back again last year.
He developed congestive heart failure from the chemo.
Nick, can you tell me when you had your last bowel movement? Yesterday morning.
No, the day before.
All right, well, we do need a CT scan, but I'm worried there's a colonic obstruction.
[GROANS.]
Which means a colostomy, right? Mm-hmm.
My doc warned me that was coming.
Well, it may be short term.
In as a little as 12 weeks, they can reverse That's long term for me, Doc.
I got four months left at the most.
I really gotta spend it defecating into a bag? [CHUCKLES.]
[GROANS.]
Hey, Mags, can you page general surgery for a consult? Patient is Nick Elms.
Late stage colorectal cancer due to FAP.
Suspected colonic obstruction.
- Mm-hmm.
- Thank you.
Got it.
- Hey, Mags.
- Mm-hmm? I can do the consult.
You sure? I thought you were clocking out.
Yeah, well, I got nowhere to be till cocktail hour.
[CHUCKLES.]
Have at it.
- [KNOCK ON DOOR.]
- Come in.
Bert.
What's up? Sorry to show up unannounced.
I spoke with Michael.
With him in town, I thought it would be a good opportunity to smooth things over with him.
Our relationship hasn't been the best since the divorce.
That's between you and Michael.
I just thought if I told him about us Whoa, whoa, whoa.
Uh, told him what exactly? Jus that we've been seeing each other.
[SOMBER MUSIC.]
I should've checked with you first.
Yeah.
That would've been nice.
And now we're seeing each other? We're seeing each other? We go out once a week, Sharon.
What would you call it? Look, Bert, I don't have time for this.
Okay.
Babe, what are you doing here? And who's your sidekick? This is Auggie, one of my students.
Auggie this is my wife, Ms.
Lockwood.
Nonsense.
You call me Maggie.
- Hi, Maggie.
- What's going on, little man? Auggie has cirrhosis from something they call chronic autoimmune - Autoimmune chronic hepatitis? - Yup, that.
And when he showed up at school this morning, he sounded winded.
He was running a slight fever as well.
All right, little man.
Why don't you come with me, fellas? We're going right here.
Babe, why don't you help Auggie hop up and grab a seat? All right.
Why don't you scoot back, Auggie? There you go.
And I am gonna grab you all the fruit snacks you could want.
I don't have any money.
You're a very important person, Auggie.
The fruit snacks are on the house.
Give me a sec.
Earl.
Do you mind keeping my friend Auggie company for a sec? Oh, no.
Not at all.
Awesome.
Auggie, this is Earl.
He works here.
Hey, big man.
All right, buddy, give me some.
Bop, bam, boom.
Did you get ahold of his parents? Auggie's in foster care.
I haven't been able to reach his foster mom, Ruth, just yet.
- But I'll keep trying.
- All right.
I'll go get a doctor and some fruit snacks.
Oh, babe, did you remember to To call the spa at the resort? We're booked for a couples massage on the beach tomorrow morning.
[SQUEALS.]
Joy, you fractured your distal fibula.
It doesn't require surgery, but you'll need to be in a boot for 6-8 weeks.
I feel like I'm cursed.
You know, I started this diet two months ago.
I can't lose any weight.
That's why I joined the gym.
I thought I had to exercise more.
Babe, what happened? You passed out on the treadmill? Dr.
Choi, Nurse Sexton, this is Max, my fiancé.
I was telling them the reason I joined the gym is 'cause I was having trouble losing weight.
- You look great.
- Max! It's not about that, right? Now I just wanna get healthier.
Well, Joy, there are certain conditions that could make weight loss difficult, but most of them are commonly treatable.
While you're here, we can run some tests if you don't mind waiting a bit.
- Sounds good.
- April, let's get a CBC, FSH, TSH, and a cortisol level to start.
- Okay.
- We'll see you in a bit.
All right.
Thanks.
Hey Ethan, listen, man, I How'd it go? Evelyn definitely does not have decisional capacity.
I mean, she didn't understand the treatment being offered or even that she had an issue with her kidneys in the first place.
Did she seem depressed? Suicidal? No, I wouldn't say that.
So, she still possesses the will to live.
She just can't articulate it clearly.
Well, except that when she was of sound mind, she made it very clear in writing and to her husband Who she seems highly suspicious of, by the way.
That's not uncommon.
I mean, it's often the primary caregivers that get the brunt of the paranoia in situations like this.
Well, I I don't know.
Maybe it's worth convening an ethics committee then? An ethics committee? Yeah, just get some other perspectives.
Will, I don't think that's necessary.
I gave her a very thorough evaluation.
I'm confident in my assessment.
Yeah, but ultimately, it is subjective.
- Your opinion - That's right.
My professional opinion, which is based on Decades of experience.
I know.
That's right.
Decades of experience.
[TENSE MUSIC.]
I'll see ya.
Oh.
âWhy does it look like that? Ascites.
Fluid accumulates in the peritoneal cavity.
Can happen in patients with cirrhosis.
[GROANS.]
Did you tell Ruth that your belly was hurting this morning? She goes to work before the school bus comes.
Auggie, I'm going to need to do a procedure called paracentesis.
What I'll do is I'll insert a needle A needle into my tummy to get all the bad stuff out.
It's not so bad, Mr.
Campbell.
Just sounds scary.
So I'll be performing the abdominal portion of the surgery robotically, while Dr.
Castaneda works endoscopically from below.
Dr.
Manning.
Perfect timing.
Good morning, Dr.
Marcel.
Robots and endoscopes? Doesn't sound like a colostomy.
Yeah, Nick and Alice and I were discussing it and we're gonna take a different approach.
Transanal Total Mesorectal Excision.
TaTME.
I'm sorry, forgive me.
I'm not familiar with it.
I am aware of TME, which is a major surgery.
Right, well, this is a new approach that allows for better visualization and removal of tumors in the lower rectum.
Well, I'm sure you've explained the risks to Nick and Alice.
I sure have.
Yeah? We're ready to move Mr.
Elms upstairs.
Great.
All right.
So I'll see you in a couple hours.
- Thanks.
Dr.
Marcel.
- All right.
Alice, I'll see you.
- Crockett.
- Yeah? Why would you suggest a radical surgery for a terminal patient? Even if it's successful, it is highly unlikely it's gonna save his life.
But it could buy him more time and a better quality of life.
Yeah, if he doesn't die on the table, which is a real risk, given his heart problems.
And I didn't sugarcoat that risk.
He has seen many surgeons, and none of them have put this option on the table.
Yeah, 'cause most of them are gutless, obsessed with their stats.
Okay, you say gutless.
I'd say pragmatic.
Oof.
I see us edging towards a semantics debate.
I know when I'm out of my depth.
[SIGHS.]
Why don't you just stay with me? No, the company's putting me up at the Peninsula.
Ooh, fancy! They must really want you.
- Mm-hmm.
- [CHUCKLES.]
So I gotta ask about this nonsense Dad was talking.
It's not for real, right? [BOTH SIGH.]
Wait, you're not seriously considering taking Dad back? Michael.
He he walked out after 35 years of marriage.
Ink was barely dry on the divorce papers - when he started seeing someone else.
- Your father and I had a drink.
Maybe he read more into it.
So you're not dating or anything? No.
I figured he was full of it.
[CHUCKLES.]
So are we still on for dinner? I got us a reservation at Swift & Sons for seven.
No, no, no! That's too expensive! - Only the best for my mom! - [CHUCKLES.]
And the company's paying for it.
[LAUGHTER.]
Hey, are you busy tonight? This new Thai place opened up in the neighborhood.
- Wanna give it a whirl? - Let's give it a whirl.
Seven-ish? Works for me.
Dr.
Choi, something's wrong! [MACHINES BEEPING.]
5 of Ativan.
Has Joy ever had a seizure before? No.
Never.
Joy? Babe? Well, I thought you said all her labs were normal.
- They were.
- Meds are in.
Well, so, is this like an allergic reaction to something you gave her? We only gave her ibuprofen, and she's had that before.
"TaTME: Innovative Surgery for Rectal Cancer", co-authored by Crockett Marcel, M.
D.
Oh, you internet stalking me, Manning? Don't flatter yourself.
I found it when I was researching the procedure.
Good for you.
You spent your lab-year studying the technique.
You did your fellowship in the surgical center that helped pioneer it.
Which makes me, what? Highly qualified to perform the procedure? No, it makes you biased and motivated by professional advancement.
You see what you want to see.
Excuse me.
You are potentially costing Nick the chance to see the birth of his child.
What, so you can get a shot at performing a complex surgery? I answer to my patients, not to you.
- Sats are down to 85.
- Get her on a mask.
What's wrong with her? She has fluid in her lungs.
Another dose of Lasix.
I gave her 10mg an hour ago.
It's not working.
Just do it.
- Where's your father? - We went to get his coffee.
Stats are still dropping.
You have to do something! Help her! Molly, I would need to intubate.
- So do that.
- I can't.
It's against your mom's advanced directive.
Mom, you have to listen to me, okay? You want the doctor to help you, right? Mom, please.
[MOANS.]
What was that, Mom? [MOANS.]
- Molly? - That's right.
It's me.
It's Molly.
She hasn't called me Molly in months.
Evelyn? Do you want me to save your life? Yeah, I need a verbal response.
Do I have your permission to intubate, to save your life? Yes or no? Yes.
Intubation.
Give 70 of ketamine.
Mom, it's gonna be okay.
Okay, I'm in.
Bag her.
Oh, my God.
What the hell did you just do? I mean, really.
This is like déjà vu.
Getting sued didn't teach you why you don't ignore an advance directive? Ms.
Goodwin, this is a completely different situation.
I wasn't ignoring the patient's wishes, I was honoring them, and her daughter will back me up on that.
- [KNOCK ON DOOR.]
- Yes? Peter Kalmick is waiting for you in the board room.
Tell him I'll be right there.
Excuse me while I attempt to clean up your mess.
Dr.
Charles, you weren't there.
Oh, come on, Will.
An Alzheimer's patient has a fluctuation in cognition doesn't mean they've recovered their decisional capacity.
I mean, when Evelyn was making her wishes known, she certainly understood that.
The most important thing she understood is that eventually this disease was going to take everything from her.
Signing that piece of paper was her final act of self-determination.
- Alice.
- Dr.
Manning.
I was just heading up to pre-op to meet Nick.
Oh, good.
I'm so glad I caught you.
You know, everything just moved so quickly this morning.
I wanted to make sure that you are onboard with the surgery.
I'm not.
Well, did you tell Nick how you feel? I begged him not to do it, especially after Dr.
Marcel warned us about the risks, but Nick was adamant.
He said he wanted to help improve the treatment options for our son, even if it meant he may not live to see him.
Your son.
He could inherit the FAP gene.
There's a 50% chance.
[SIGHS.]
This pregnancy was a surprise.
When we found out, all Nick could think about was our baby's future, and doing everything he could to prevent our son from facing the same fate.
[SOMBER MUSIC.]
Trini, will you take over for a minute? I'll be right back.
A word outside? Auggie's primary physician sent over his medical records.
Turns out he's supposed to have paracentesis every two weeks, but he hasn't shown up to his last couple appointments.
No wonder his ascites got so bad.
Yeah, I'm calling Child Protective Services.
Yeah, whoa, whoa, whoa.
Hold on a second.
Dr.
Lanik, can you please wait until we speak to his caregiver? Maybe there's a reasonable explanation.
I thought she was MIA.
I'm working on trying to reach her.
[SIGHS.]
Fine.
You have until 4:00, but if she is not here in the flesh, I'm making the call.
[TENSE MUSIC.]
Maybe you don't want to take care of her anymore.
You know that isn't true.
You know I'd do anything for your mom.
Then you can't let her die.
I won't let you! Honey Ms.
Myers? My name is Sharon Goodwin.
I'm in charge of patient services here at the hospital.
Yeah, I saw you talking to my dad.
What if I don't want the doctors to take out my mom's breathing tube? Would I have to sue my dad? Well Before we get into logistics, are you sure you want to do that? Do you really believe your father isn't acting in your mother's best interests? [SNIFFLES.]
I mean, he loves her.
I just I don't want to lose her.
[SOBS.]
I don't know what to do.
My mom kept me in the dark about all of this.
[SOMBER MUSIC.]
You know, when parents don't share things with their children, it's usually out of a desire to protect them.
I suspect your mother knew how painful it would be for you to know her wishes.
And she didn't want to place the burden of carrying them out on your shoulders.
She put a lot on my dad's shoulders.
Yes.
Because she knew he could handle it.
But you're right, it is a lot, and he's going to need you.
You're going to need each other.
[MACHINE WHIRRS.]
Dr.
Marcel, you should be seeing me.
Yup, seeing your sponge now.
Nice to finally meet up.
Okay, let's bring the pressure down to 12.
Ready to take the rectum out? You bet.
Here we go, Nick.
[SUSPENSEFUL MUSIC.]
Joy, your seizure was caused by high levels of ammonia in your blood.
How'd she get ammonia in her blood? Testing revealed Joy has a urea cycle disorder.
It's a genetic condition that causes a deficiency in one of the six enzymes responsible for removing ammonia from the bloodstream.
But if it's genetic, why was I never diagnosed as a child? With milder forms of the disorder, often undiagnosed until a trigger unmasks it.
Such as childbirth Another possible trigger can be a dramatic increase in protein intake.
Could you be taking in more protein with your new diet? Not really.
I actually cut out red meat and most dairy.
What about protein bars or shakes? No.
I drink green smoothies.
Triggers aside, how do you treat it? Well, you're going to have to be on an enzyme supplement for the rest of your life, and maintain a very low protein diet.
We can manage that.
Right, babe? Yeah.
Joy, just so you understand, if you don't regulate your protein intake, there can be serious consequences.
Understood.
Now, even a few high protein meals I said I understand, Dr.
Choi.
What, do you think because I'm fat I have no self-control? No.
Not at all.
I'm just suggesting if protein is the trigger Yeah, and I just told you that it wasn't.
Dr.
Choi, may I speak with you outside, please? Excuse us.
- What? - You're so suspicious of Joy.
I can't help but wonder if you're projecting.
I'm not projecting anything.
The only trigger that makes sense is protein.
So she's either lying about what she's eating, or she's in denial.
I am so sorry I missed your calls.
My manager doesn't allow us to check our messages while we're working.
This should never have happened.
We know that Auggie has missed his last two doctor's appointments.
And I'm really sorry about that.
I I do my best to get him there, but the clinic's 40 miles from my house.
I I don't have a car, and I can't always get off of work.
Is there someone else that could help out? Maybe a babysitter that could take him? Who's gonna pay for that? Ms.
Johnson, we're supposed to report this as neglect.
But if we do that, they might remove Auggie from your home.
- Maybe you should.
- What? Maybe you should report it.
[SOMBER MUSIC.]
I love that little boy.
I love him, but But it's too much.
It's too much.
And I can't.
Alice.
He did well, Alice.
Real well.
You can visit him in the recovery room shortly.
- Oh, thank God.
- [CHUCKLES.]
[SOBS.]
So, what happens now? Evelyn's family is gonna take her home to receive hospice care until she dies.
I wasn't trying to prove you wrong today, if that's what you're thinking.
Will, I never thought of you as a spiteful person.
But we all have a tendency to put blinders on when we're confronted with things that we don't wanna hear.
[INDISTINCT CHATTER.]
That's why we thought it would be better for you go live with another family.
Since she can't always take you to the doctor when you need it.
She doesn't want you to get sick again, Auggie.
I know it's scary going to live somewhere new.
I'm not scared.
I know why she doesn't want me.
Oh, sweetie, it's not that she doesn't want you.
- She just - No one wants a sick kid.
Max, I know Joy wants to be discharged, but this meal plan she's on, is she adhering to it? Yeah.
Because her tests results and what she's saying, they don't add up.
Max Okay, um I have an idea of what's going on.
Sometimes I wake up in the middle of the night, and I hear Joy downstairs in the kitchen.
And in the morning, there's food missing from the fridge and the pantry.
Have you ever talked to her about it? No, I'm guessing she's real self-conscious.
That's why she does it after I'm asleep.
Yeah.
Sounds like she may have a binge-eating disorder.
I like to bring in psychiatry to come speak with her.
No.
I know her, and an ambush will just humiliate her.
This has to be dealt with now.
If she overloads on protein again, it could kill her.
- God.
- Tell you what.
I'll let you speak with Joy first.
Come on.
I can't do this.
Joy doesn't binge in the middle of the night.
I've been slipping protein powder in her green smoothies.
Why? I read protein powder can make you gain weight by increasing your overall caloric Why were you trying to make Joy gain weight? I wasn't trying to make her gain weight, I was trying to keep her from losing weight.
- I know it sounds insane.
- And criminal.
I wasn't gonna do it forever.
Just long enough for for her to get discouraged and stop dieting.
And I never meant to hurt her.
I was scared that if Joy lost weight, she'd leave me.
[TENSE MUSIC.]
You need to tell Joy the truth or I will.
[CHUCKLES.]
So Alice and I were talking, Doc, and while we really would like to name our son in your honor.
Oh! We're just not sure about Crockett.
[LAUGHTER.]
It is a statement.
That's for sure.
I don't suppose you have a middle name that's a little more - [GROANS.]
- Nick? Nick? Honey, what's wrong? Okay, take slow, deep breaths.
Nice and easy, okay? Nick, bud? Talk to me.
Let's get a mask on him.
[WHEEZING.]
Let's go.
Come on.
Drop it.
- Heart rate's 133.
BP's 77.
- Nick, Nick.
I need you to breathe.
- Hey, Nick? - He's in VFib! - Nick, honey, wake up.
- Nick! No pulse.
All right, let's go.
Bag him.
Milligram of epi.
Let's go.
Come on.
Paddles and charge to 200.
- Oh, my God! - [PADDLES WHIRR.]
Nick? Charged.
Clear.
Let's go.
Come on.
Another round of epi.
Let's go.
- Charge 200.
- Charged.
Clear! Nick? Nick, can you hear me? I am right here, honey.
Nick.
Epi and charge.
Let's go.
Clear.
You'll be fine.
He's asystole.
No Come on! No.
No.
No.
No.
No.
No.
Time of death, 16:54.
[SOBS.]
No! [SOMBER MUSIC.]
Thank you so much, Ms.
Gastern.
âBye-bye.
DCFS is going to start looking for a new foster placement for Auggie tomorrow.
What about tonight? Well, I got him a bed on the peds floor.
And since Earl is back for the night shift, he promised that he would try to check in on Auggie upstairs.
- [CELL PHONE VIBRATES.]
- That's good.
Taxi's here.
We should Right.
Baby.
- Just, uh - Yeah.
Okay.
I'll call the airline and the hotel, reschedule.
And we'll spend the night with Auggie.
You know how amazing you are? Mmm.
[CHUCKLES.]
You're pretty amazing yourself, Mr.
Ben Campbell.
I'm a lucky man.
Go ahead, and yes, you are.
- Oh, thank you.
- Joy.
You should know what Max did was a form of assault.
And I can call CPD, and you can press charges against him.
No, no, you don't have to call them.
I'm not pressing charges.
Joy, he lied to you, betrayed your trust.
You don't have to act like nothing happened.
No, I know what Max did was so messed up, but we talked it out.
You know, and he was acting from a place of fear and insecurity, and you know, Max is a good person.
Okay, I know his heart.
Can I just go? Take care.
Unbelievable.
If it were me, I'd be furious.
- Anyone would.
- Really? - Of course.
- Then why aren't you? - What? - Ethan, I lied to you.
Oh, God.
April I betrayed your trust.
Look, what do you want me to say? That I can't believe you kissed someone else? Someone we work with? You want to know how crazy it makes me that I have to see that son of a bitch every day? - Is this what you want to hear? - Yeah, I do.
I want to know what you're feeling.
Why? Why couldn't you just tell me? Why did it take physically harming yourself to come clean? Are you in love with him? What? No! Of course not.
It was just a meaningless attraction.
Well, if it's so meaningless, why are we even talking about it? Because I You deserve to know everything.
Ethan, I love you.
I made a mistake.
That day, when I found out I couldn't have children You pushed me away and ran into another man's arms.
Hey.
You called it.
Played out just like you said it would.
You don't know what killed Nick.
He was tachycardic, hypotensive, and desatting.
Classic trifecta.
Had to be a PE.
If that's the case, then the clot could have been there prior to the surgery.
I mean, Nick had pretty much been bedridden for months.
Surgery caused it.
End of story.
You don't know that.
You know if I hadn't put that surgery on the table, chances are he'd still be alive.
Crockett.
Sometimes in the ED, we get tunnel vision.
All we can see is the patient in front of us.
But Nick could see past that, beyond his own benefit, and I think you did too.
You know, with new surgery, the more you do it, the better you'll get, the more lives you'll save.
And maybe you couldn't save Nick's, but maybe someday, you'll save his son's.
Hey! We still on for The Green Mill, Crockett? The next set starts in an hour.
Yeah, of course, darling.
Okay.
Good night, Dr.
Manning.
Night.
[CHUCKLES.]
[CLEARS THROAT.]
Hey, Mom, you look nice.
[CHUCKLES.]
Thank you.
- What's Dad doing here? - I invited him.
It's good to see you, son.
If he's staying, I'm leaving.
Sit down.
Now this Cold War you've got going with your father ends tonight.
After what he did to you? Forget it.
You don't know the full story.
What are you talking about? Look I thought I was protecting you and David and Tara by not talking to you about the divorce.
But it was painful.
Yeah, and Dad caused that pain.
Son, the end of any relationship, especially one with a 35-year history, is complicated.
But the bottom line, Michael, is you can spend your whole life looking back and pointing fingers, or you could choose to move forward.
I I don't know what's to come of your father and me, but it's time for this family to start healing.
You need your father, and your father needs you.
Let's start by having dinner.
You wanna come up? I cleared out my liquor cabinet, but I do have a pretty stellar tea collection.
But you know, if tea is not your thing, I can make a gin and tonic, sans the gin.
No, it's not I want to come up.
I do.
I just wonder if that's a good idea.
Okay.
You may be surprised to hear this, but there's actually very little neurochemical difference between drug addiction And romance addiction? And should something go wrong inside the relationship, it increases the chances of relapse.
Yeah.
I've been going to the meetings, Will.
This stuff's been drilled into my head.
So, um, what do we do? Let's go up and discuss it.
I'm sorry.
April? Really? Huh? All this time acting like this? - Come on! - Hey! I couldn't let you keep treating patients.
I had to make your addiction known.
- What you did was a betrayal.
- You're an excellent doctor.
I wasn't about to let you throw your life away.
You were right.
They gave me my life back.
[DRAMATIC MUSIC.]
It's beautiful, Ben.
You're beautiful.
I pronounce you husband and wife.
[LAUGHTER, APPLAUSE.]
I'll say it till the day I die: there is no better pizza than Chicago deep dish.
But it's not even pizza.
It's lasagna.
We're gonna have to agree to disagree.
I will not agree to disagree.
No, you are flat wrong.
Flat.
The way that pizza should be.
Lasagna, huh? That's good.
Smart lady.
No, Dr.
Charles, not you too.
I don't know that That you and Dr.
Asher were - Friends.
- Yeah.
Good.
That's good.
And? And she needs a strong support system right now.
So I'm glad that she has you as a as a friend.
Look, I get it.
Romantic relationships are discouraged during the first year of recovery.
Neurochemically, very little difference between the dopamine rush that we get from drugs and alcohol and the rush that we get from romance.
Well, you know, I'm sure as with anything, there are exceptions to the rule.
I have never actually seen that go well.
Well, at least not in my, you know, three decades of experience counseling people in recovery.
Next! Hey.
So how are things with Ethan? Okay, I guess.
I tried to get him to talk about it, and he hasn't wanted to.
Hmm, maybe that's his way of processing.
Yeah.
Maybe.
Will, you're up.
Ambo's landed.
You're going to Trauma 2.
All right.
Evelyn Myers.
49-year-old female with progressive early-onset Alzheimer's.
Passed out at home.
Did a 12-lead in the ambo.
She's got peaked T Waves.
And did she hit her head when she passed out? Her daughter, Molly, didn't think so.
No overt signs of head trauma.
I'm pretty sure that she didn't, but I was in the other room when it happened.
I shouldn't have left her alone.
Evelyn, I'm Dr.
Halstead.
All right, on my count.
One, two, three.
- Thanks, guys.
- Yup.
[SUSPENSEFUL MUSIC.]
Rhonchi, both sides.
Blunted breath sounds at the base.
2 plus pitting edema.
Yeah.
Molly, is your mom on any medications for kidney disease? I'm not sure.
She takes something called Capto - Captopril? - I think so.
Sorry, I'm not with her every day.
I'm just home for spring break.
Any family history of kidney problems? Uh, yeah, yeah.
My grandma, my mom's mom, she had something wrong with her kidneys.
My dad will know what it's called.
- CBC, CMP stat.
- What's going on? [SIGHS.]
Molly, I told you to call me if anything happened with Mom.
Sorry, Dad.
I just freaked out.
It's okay.
- Hi, I'm Dr.
Halstead.
- Elliot.
Elliot, well, we still need labs, but I suspect Evelyn's in acute renal failure.
In which case, she needs emergency dialysis.
No.
No dialysis.
It's against Evelyn's advance directive.
Don't listen to him.
He lies.
Evelyn, honey, you signed an advance directive.
Advance directive? What is that, Dad? No, I didn't sign anything.
No.
You don't want dialysis, my love.
Yes, I do.
I do! Help me! - Hey, take a look.
Did you get Mrs.
Myers' lab work back? She's profoundly uremic and hyperkalemic.
She's not making urine.
If we don't dialyze her, she'll die.
Well, I've reviewed her advance directive.
She prepared it shortly after her Alzheimer's diagnosis, and I'll tell you, Mrs.
Myers outlined a number of interventions she didn't want including dialysis.
And she appointed her husband to be her proxy when she could no longer speak for herself.
But she can speak for herself, and she has changed her mind.
I mean, people can modify their advanced directives at any time, right? As long as they still have decisional capacity.
Well, you do an evaluation and then we'll take it from there.
Great.
- Sharon? - Yeah.
Your assistant called.
Michael's plane has landed.
Oh, good.
It's silly, I know, but he's 33 years old.
- Mm-hmm.
- I still get nervous when he flies.
[LAUGHTER.]
I guess I just feel a lot better when I know he's got two feet back on the ground.
Well, he's your baby boy.
- How long is he in town? - Just 24 hours.
Interviewing for a sales job at Kender Bio Systems.
I would love to have at least one of my kids living in the city.
- [CHUCKLES.]
- Need some help over here! - [GROANS.]
- This is Nick Elms.
Experiencing severe abdominal pain.
Haven't finished uploading his information into the system.
I can tell you anything you need to know.
I'm his wife, Alice.
- Trini, where we headed? - 4's open.
- [GROANS.]
- Just breathe.
All right, Mr.
Elms, we're gonna take you right here.
- [GROANS.]
- Ready? One, two, three.
There you go.
All right.
When did the pain start? Last night.
Nick has a condition called familial adenomatous polyposis.
- It causes polyps in his - Colon and rectum.
- I'm familiar.
- [BREATHES HEAVILY.]
- When was he first diagnosed? - Five years ago.
It had already developed into colorectal cancer.
He had multiple runs of chemo, but it came back again last year.
He developed congestive heart failure from the chemo.
Nick, can you tell me when you had your last bowel movement? Yesterday morning.
No, the day before.
All right, well, we do need a CT scan, but I'm worried there's a colonic obstruction.
[GROANS.]
Which means a colostomy, right? Mm-hmm.
My doc warned me that was coming.
Well, it may be short term.
In as a little as 12 weeks, they can reverse That's long term for me, Doc.
I got four months left at the most.
I really gotta spend it defecating into a bag? [CHUCKLES.]
[GROANS.]
Hey, Mags, can you page general surgery for a consult? Patient is Nick Elms.
Late stage colorectal cancer due to FAP.
Suspected colonic obstruction.
- Mm-hmm.
- Thank you.
Got it.
- Hey, Mags.
- Mm-hmm? I can do the consult.
You sure? I thought you were clocking out.
Yeah, well, I got nowhere to be till cocktail hour.
[CHUCKLES.]
Have at it.
- [KNOCK ON DOOR.]
- Come in.
Bert.
What's up? Sorry to show up unannounced.
I spoke with Michael.
With him in town, I thought it would be a good opportunity to smooth things over with him.
Our relationship hasn't been the best since the divorce.
That's between you and Michael.
I just thought if I told him about us Whoa, whoa, whoa.
Uh, told him what exactly? Jus that we've been seeing each other.
[SOMBER MUSIC.]
I should've checked with you first.
Yeah.
That would've been nice.
And now we're seeing each other? We're seeing each other? We go out once a week, Sharon.
What would you call it? Look, Bert, I don't have time for this.
Okay.
Babe, what are you doing here? And who's your sidekick? This is Auggie, one of my students.
Auggie this is my wife, Ms.
Lockwood.
Nonsense.
You call me Maggie.
- Hi, Maggie.
- What's going on, little man? Auggie has cirrhosis from something they call chronic autoimmune - Autoimmune chronic hepatitis? - Yup, that.
And when he showed up at school this morning, he sounded winded.
He was running a slight fever as well.
All right, little man.
Why don't you come with me, fellas? We're going right here.
Babe, why don't you help Auggie hop up and grab a seat? All right.
Why don't you scoot back, Auggie? There you go.
And I am gonna grab you all the fruit snacks you could want.
I don't have any money.
You're a very important person, Auggie.
The fruit snacks are on the house.
Give me a sec.
Earl.
Do you mind keeping my friend Auggie company for a sec? Oh, no.
Not at all.
Awesome.
Auggie, this is Earl.
He works here.
Hey, big man.
All right, buddy, give me some.
Bop, bam, boom.
Did you get ahold of his parents? Auggie's in foster care.
I haven't been able to reach his foster mom, Ruth, just yet.
- But I'll keep trying.
- All right.
I'll go get a doctor and some fruit snacks.
Oh, babe, did you remember to To call the spa at the resort? We're booked for a couples massage on the beach tomorrow morning.
[SQUEALS.]
Joy, you fractured your distal fibula.
It doesn't require surgery, but you'll need to be in a boot for 6-8 weeks.
I feel like I'm cursed.
You know, I started this diet two months ago.
I can't lose any weight.
That's why I joined the gym.
I thought I had to exercise more.
Babe, what happened? You passed out on the treadmill? Dr.
Choi, Nurse Sexton, this is Max, my fiancé.
I was telling them the reason I joined the gym is 'cause I was having trouble losing weight.
- You look great.
- Max! It's not about that, right? Now I just wanna get healthier.
Well, Joy, there are certain conditions that could make weight loss difficult, but most of them are commonly treatable.
While you're here, we can run some tests if you don't mind waiting a bit.
- Sounds good.
- April, let's get a CBC, FSH, TSH, and a cortisol level to start.
- Okay.
- We'll see you in a bit.
All right.
Thanks.
Hey Ethan, listen, man, I How'd it go? Evelyn definitely does not have decisional capacity.
I mean, she didn't understand the treatment being offered or even that she had an issue with her kidneys in the first place.
Did she seem depressed? Suicidal? No, I wouldn't say that.
So, she still possesses the will to live.
She just can't articulate it clearly.
Well, except that when she was of sound mind, she made it very clear in writing and to her husband Who she seems highly suspicious of, by the way.
That's not uncommon.
I mean, it's often the primary caregivers that get the brunt of the paranoia in situations like this.
Well, I I don't know.
Maybe it's worth convening an ethics committee then? An ethics committee? Yeah, just get some other perspectives.
Will, I don't think that's necessary.
I gave her a very thorough evaluation.
I'm confident in my assessment.
Yeah, but ultimately, it is subjective.
- Your opinion - That's right.
My professional opinion, which is based on Decades of experience.
I know.
That's right.
Decades of experience.
[TENSE MUSIC.]
I'll see ya.
Oh.
âWhy does it look like that? Ascites.
Fluid accumulates in the peritoneal cavity.
Can happen in patients with cirrhosis.
[GROANS.]
Did you tell Ruth that your belly was hurting this morning? She goes to work before the school bus comes.
Auggie, I'm going to need to do a procedure called paracentesis.
What I'll do is I'll insert a needle A needle into my tummy to get all the bad stuff out.
It's not so bad, Mr.
Campbell.
Just sounds scary.
So I'll be performing the abdominal portion of the surgery robotically, while Dr.
Castaneda works endoscopically from below.
Dr.
Manning.
Perfect timing.
Good morning, Dr.
Marcel.
Robots and endoscopes? Doesn't sound like a colostomy.
Yeah, Nick and Alice and I were discussing it and we're gonna take a different approach.
Transanal Total Mesorectal Excision.
TaTME.
I'm sorry, forgive me.
I'm not familiar with it.
I am aware of TME, which is a major surgery.
Right, well, this is a new approach that allows for better visualization and removal of tumors in the lower rectum.
Well, I'm sure you've explained the risks to Nick and Alice.
I sure have.
Yeah? We're ready to move Mr.
Elms upstairs.
Great.
All right.
So I'll see you in a couple hours.
- Thanks.
Dr.
Marcel.
- All right.
Alice, I'll see you.
- Crockett.
- Yeah? Why would you suggest a radical surgery for a terminal patient? Even if it's successful, it is highly unlikely it's gonna save his life.
But it could buy him more time and a better quality of life.
Yeah, if he doesn't die on the table, which is a real risk, given his heart problems.
And I didn't sugarcoat that risk.
He has seen many surgeons, and none of them have put this option on the table.
Yeah, 'cause most of them are gutless, obsessed with their stats.
Okay, you say gutless.
I'd say pragmatic.
Oof.
I see us edging towards a semantics debate.
I know when I'm out of my depth.
[SIGHS.]
Why don't you just stay with me? No, the company's putting me up at the Peninsula.
Ooh, fancy! They must really want you.
- Mm-hmm.
- [CHUCKLES.]
So I gotta ask about this nonsense Dad was talking.
It's not for real, right? [BOTH SIGH.]
Wait, you're not seriously considering taking Dad back? Michael.
He he walked out after 35 years of marriage.
Ink was barely dry on the divorce papers - when he started seeing someone else.
- Your father and I had a drink.
Maybe he read more into it.
So you're not dating or anything? No.
I figured he was full of it.
[CHUCKLES.]
So are we still on for dinner? I got us a reservation at Swift & Sons for seven.
No, no, no! That's too expensive! - Only the best for my mom! - [CHUCKLES.]
And the company's paying for it.
[LAUGHTER.]
Hey, are you busy tonight? This new Thai place opened up in the neighborhood.
- Wanna give it a whirl? - Let's give it a whirl.
Seven-ish? Works for me.
Dr.
Choi, something's wrong! [MACHINES BEEPING.]
5 of Ativan.
Has Joy ever had a seizure before? No.
Never.
Joy? Babe? Well, I thought you said all her labs were normal.
- They were.
- Meds are in.
Well, so, is this like an allergic reaction to something you gave her? We only gave her ibuprofen, and she's had that before.
"TaTME: Innovative Surgery for Rectal Cancer", co-authored by Crockett Marcel, M.
D.
Oh, you internet stalking me, Manning? Don't flatter yourself.
I found it when I was researching the procedure.
Good for you.
You spent your lab-year studying the technique.
You did your fellowship in the surgical center that helped pioneer it.
Which makes me, what? Highly qualified to perform the procedure? No, it makes you biased and motivated by professional advancement.
You see what you want to see.
Excuse me.
You are potentially costing Nick the chance to see the birth of his child.
What, so you can get a shot at performing a complex surgery? I answer to my patients, not to you.
- Sats are down to 85.
- Get her on a mask.
What's wrong with her? She has fluid in her lungs.
Another dose of Lasix.
I gave her 10mg an hour ago.
It's not working.
Just do it.
- Where's your father? - We went to get his coffee.
Stats are still dropping.
You have to do something! Help her! Molly, I would need to intubate.
- So do that.
- I can't.
It's against your mom's advanced directive.
Mom, you have to listen to me, okay? You want the doctor to help you, right? Mom, please.
[MOANS.]
What was that, Mom? [MOANS.]
- Molly? - That's right.
It's me.
It's Molly.
She hasn't called me Molly in months.
Evelyn? Do you want me to save your life? Yeah, I need a verbal response.
Do I have your permission to intubate, to save your life? Yes or no? Yes.
Intubation.
Give 70 of ketamine.
Mom, it's gonna be okay.
Okay, I'm in.
Bag her.
Oh, my God.
What the hell did you just do? I mean, really.
This is like déjà vu.
Getting sued didn't teach you why you don't ignore an advance directive? Ms.
Goodwin, this is a completely different situation.
I wasn't ignoring the patient's wishes, I was honoring them, and her daughter will back me up on that.
- [KNOCK ON DOOR.]
- Yes? Peter Kalmick is waiting for you in the board room.
Tell him I'll be right there.
Excuse me while I attempt to clean up your mess.
Dr.
Charles, you weren't there.
Oh, come on, Will.
An Alzheimer's patient has a fluctuation in cognition doesn't mean they've recovered their decisional capacity.
I mean, when Evelyn was making her wishes known, she certainly understood that.
The most important thing she understood is that eventually this disease was going to take everything from her.
Signing that piece of paper was her final act of self-determination.
- Alice.
- Dr.
Manning.
I was just heading up to pre-op to meet Nick.
Oh, good.
I'm so glad I caught you.
You know, everything just moved so quickly this morning.
I wanted to make sure that you are onboard with the surgery.
I'm not.
Well, did you tell Nick how you feel? I begged him not to do it, especially after Dr.
Marcel warned us about the risks, but Nick was adamant.
He said he wanted to help improve the treatment options for our son, even if it meant he may not live to see him.
Your son.
He could inherit the FAP gene.
There's a 50% chance.
[SIGHS.]
This pregnancy was a surprise.
When we found out, all Nick could think about was our baby's future, and doing everything he could to prevent our son from facing the same fate.
[SOMBER MUSIC.]
Trini, will you take over for a minute? I'll be right back.
A word outside? Auggie's primary physician sent over his medical records.
Turns out he's supposed to have paracentesis every two weeks, but he hasn't shown up to his last couple appointments.
No wonder his ascites got so bad.
Yeah, I'm calling Child Protective Services.
Yeah, whoa, whoa, whoa.
Hold on a second.
Dr.
Lanik, can you please wait until we speak to his caregiver? Maybe there's a reasonable explanation.
I thought she was MIA.
I'm working on trying to reach her.
[SIGHS.]
Fine.
You have until 4:00, but if she is not here in the flesh, I'm making the call.
[TENSE MUSIC.]
Maybe you don't want to take care of her anymore.
You know that isn't true.
You know I'd do anything for your mom.
Then you can't let her die.
I won't let you! Honey Ms.
Myers? My name is Sharon Goodwin.
I'm in charge of patient services here at the hospital.
Yeah, I saw you talking to my dad.
What if I don't want the doctors to take out my mom's breathing tube? Would I have to sue my dad? Well Before we get into logistics, are you sure you want to do that? Do you really believe your father isn't acting in your mother's best interests? [SNIFFLES.]
I mean, he loves her.
I just I don't want to lose her.
[SOBS.]
I don't know what to do.
My mom kept me in the dark about all of this.
[SOMBER MUSIC.]
You know, when parents don't share things with their children, it's usually out of a desire to protect them.
I suspect your mother knew how painful it would be for you to know her wishes.
And she didn't want to place the burden of carrying them out on your shoulders.
She put a lot on my dad's shoulders.
Yes.
Because she knew he could handle it.
But you're right, it is a lot, and he's going to need you.
You're going to need each other.
[MACHINE WHIRRS.]
Dr.
Marcel, you should be seeing me.
Yup, seeing your sponge now.
Nice to finally meet up.
Okay, let's bring the pressure down to 12.
Ready to take the rectum out? You bet.
Here we go, Nick.
[SUSPENSEFUL MUSIC.]
Joy, your seizure was caused by high levels of ammonia in your blood.
How'd she get ammonia in her blood? Testing revealed Joy has a urea cycle disorder.
It's a genetic condition that causes a deficiency in one of the six enzymes responsible for removing ammonia from the bloodstream.
But if it's genetic, why was I never diagnosed as a child? With milder forms of the disorder, often undiagnosed until a trigger unmasks it.
Such as childbirth Another possible trigger can be a dramatic increase in protein intake.
Could you be taking in more protein with your new diet? Not really.
I actually cut out red meat and most dairy.
What about protein bars or shakes? No.
I drink green smoothies.
Triggers aside, how do you treat it? Well, you're going to have to be on an enzyme supplement for the rest of your life, and maintain a very low protein diet.
We can manage that.
Right, babe? Yeah.
Joy, just so you understand, if you don't regulate your protein intake, there can be serious consequences.
Understood.
Now, even a few high protein meals I said I understand, Dr.
Choi.
What, do you think because I'm fat I have no self-control? No.
Not at all.
I'm just suggesting if protein is the trigger Yeah, and I just told you that it wasn't.
Dr.
Choi, may I speak with you outside, please? Excuse us.
- What? - You're so suspicious of Joy.
I can't help but wonder if you're projecting.
I'm not projecting anything.
The only trigger that makes sense is protein.
So she's either lying about what she's eating, or she's in denial.
I am so sorry I missed your calls.
My manager doesn't allow us to check our messages while we're working.
This should never have happened.
We know that Auggie has missed his last two doctor's appointments.
And I'm really sorry about that.
I I do my best to get him there, but the clinic's 40 miles from my house.
I I don't have a car, and I can't always get off of work.
Is there someone else that could help out? Maybe a babysitter that could take him? Who's gonna pay for that? Ms.
Johnson, we're supposed to report this as neglect.
But if we do that, they might remove Auggie from your home.
- Maybe you should.
- What? Maybe you should report it.
[SOMBER MUSIC.]
I love that little boy.
I love him, but But it's too much.
It's too much.
And I can't.
Alice.
He did well, Alice.
Real well.
You can visit him in the recovery room shortly.
- Oh, thank God.
- [CHUCKLES.]
[SOBS.]
So, what happens now? Evelyn's family is gonna take her home to receive hospice care until she dies.
I wasn't trying to prove you wrong today, if that's what you're thinking.
Will, I never thought of you as a spiteful person.
But we all have a tendency to put blinders on when we're confronted with things that we don't wanna hear.
[INDISTINCT CHATTER.]
That's why we thought it would be better for you go live with another family.
Since she can't always take you to the doctor when you need it.
She doesn't want you to get sick again, Auggie.
I know it's scary going to live somewhere new.
I'm not scared.
I know why she doesn't want me.
Oh, sweetie, it's not that she doesn't want you.
- She just - No one wants a sick kid.
Max, I know Joy wants to be discharged, but this meal plan she's on, is she adhering to it? Yeah.
Because her tests results and what she's saying, they don't add up.
Max Okay, um I have an idea of what's going on.
Sometimes I wake up in the middle of the night, and I hear Joy downstairs in the kitchen.
And in the morning, there's food missing from the fridge and the pantry.
Have you ever talked to her about it? No, I'm guessing she's real self-conscious.
That's why she does it after I'm asleep.
Yeah.
Sounds like she may have a binge-eating disorder.
I like to bring in psychiatry to come speak with her.
No.
I know her, and an ambush will just humiliate her.
This has to be dealt with now.
If she overloads on protein again, it could kill her.
- God.
- Tell you what.
I'll let you speak with Joy first.
Come on.
I can't do this.
Joy doesn't binge in the middle of the night.
I've been slipping protein powder in her green smoothies.
Why? I read protein powder can make you gain weight by increasing your overall caloric Why were you trying to make Joy gain weight? I wasn't trying to make her gain weight, I was trying to keep her from losing weight.
- I know it sounds insane.
- And criminal.
I wasn't gonna do it forever.
Just long enough for for her to get discouraged and stop dieting.
And I never meant to hurt her.
I was scared that if Joy lost weight, she'd leave me.
[TENSE MUSIC.]
You need to tell Joy the truth or I will.
[CHUCKLES.]
So Alice and I were talking, Doc, and while we really would like to name our son in your honor.
Oh! We're just not sure about Crockett.
[LAUGHTER.]
It is a statement.
That's for sure.
I don't suppose you have a middle name that's a little more - [GROANS.]
- Nick? Nick? Honey, what's wrong? Okay, take slow, deep breaths.
Nice and easy, okay? Nick, bud? Talk to me.
Let's get a mask on him.
[WHEEZING.]
Let's go.
Come on.
Drop it.
- Heart rate's 133.
BP's 77.
- Nick, Nick.
I need you to breathe.
- Hey, Nick? - He's in VFib! - Nick, honey, wake up.
- Nick! No pulse.
All right, let's go.
Bag him.
Milligram of epi.
Let's go.
Come on.
Paddles and charge to 200.
- Oh, my God! - [PADDLES WHIRR.]
Nick? Charged.
Clear.
Let's go.
Come on.
Another round of epi.
Let's go.
- Charge 200.
- Charged.
Clear! Nick? Nick, can you hear me? I am right here, honey.
Nick.
Epi and charge.
Let's go.
Clear.
You'll be fine.
He's asystole.
No Come on! No.
No.
No.
No.
No.
No.
Time of death, 16:54.
[SOBS.]
No! [SOMBER MUSIC.]
Thank you so much, Ms.
Gastern.
âBye-bye.
DCFS is going to start looking for a new foster placement for Auggie tomorrow.
What about tonight? Well, I got him a bed on the peds floor.
And since Earl is back for the night shift, he promised that he would try to check in on Auggie upstairs.
- [CELL PHONE VIBRATES.]
- That's good.
Taxi's here.
We should Right.
Baby.
- Just, uh - Yeah.
Okay.
I'll call the airline and the hotel, reschedule.
And we'll spend the night with Auggie.
You know how amazing you are? Mmm.
[CHUCKLES.]
You're pretty amazing yourself, Mr.
Ben Campbell.
I'm a lucky man.
Go ahead, and yes, you are.
- Oh, thank you.
- Joy.
You should know what Max did was a form of assault.
And I can call CPD, and you can press charges against him.
No, no, you don't have to call them.
I'm not pressing charges.
Joy, he lied to you, betrayed your trust.
You don't have to act like nothing happened.
No, I know what Max did was so messed up, but we talked it out.
You know, and he was acting from a place of fear and insecurity, and you know, Max is a good person.
Okay, I know his heart.
Can I just go? Take care.
Unbelievable.
If it were me, I'd be furious.
- Anyone would.
- Really? - Of course.
- Then why aren't you? - What? - Ethan, I lied to you.
Oh, God.
April I betrayed your trust.
Look, what do you want me to say? That I can't believe you kissed someone else? Someone we work with? You want to know how crazy it makes me that I have to see that son of a bitch every day? - Is this what you want to hear? - Yeah, I do.
I want to know what you're feeling.
Why? Why couldn't you just tell me? Why did it take physically harming yourself to come clean? Are you in love with him? What? No! Of course not.
It was just a meaningless attraction.
Well, if it's so meaningless, why are we even talking about it? Because I You deserve to know everything.
Ethan, I love you.
I made a mistake.
That day, when I found out I couldn't have children You pushed me away and ran into another man's arms.
Hey.
You called it.
Played out just like you said it would.
You don't know what killed Nick.
He was tachycardic, hypotensive, and desatting.
Classic trifecta.
Had to be a PE.
If that's the case, then the clot could have been there prior to the surgery.
I mean, Nick had pretty much been bedridden for months.
Surgery caused it.
End of story.
You don't know that.
You know if I hadn't put that surgery on the table, chances are he'd still be alive.
Crockett.
Sometimes in the ED, we get tunnel vision.
All we can see is the patient in front of us.
But Nick could see past that, beyond his own benefit, and I think you did too.
You know, with new surgery, the more you do it, the better you'll get, the more lives you'll save.
And maybe you couldn't save Nick's, but maybe someday, you'll save his son's.
Hey! We still on for The Green Mill, Crockett? The next set starts in an hour.
Yeah, of course, darling.
Okay.
Good night, Dr.
Manning.
Night.
[CHUCKLES.]
[CLEARS THROAT.]
Hey, Mom, you look nice.
[CHUCKLES.]
Thank you.
- What's Dad doing here? - I invited him.
It's good to see you, son.
If he's staying, I'm leaving.
Sit down.
Now this Cold War you've got going with your father ends tonight.
After what he did to you? Forget it.
You don't know the full story.
What are you talking about? Look I thought I was protecting you and David and Tara by not talking to you about the divorce.
But it was painful.
Yeah, and Dad caused that pain.
Son, the end of any relationship, especially one with a 35-year history, is complicated.
But the bottom line, Michael, is you can spend your whole life looking back and pointing fingers, or you could choose to move forward.
I I don't know what's to come of your father and me, but it's time for this family to start healing.
You need your father, and your father needs you.
Let's start by having dinner.
You wanna come up? I cleared out my liquor cabinet, but I do have a pretty stellar tea collection.
But you know, if tea is not your thing, I can make a gin and tonic, sans the gin.
No, it's not I want to come up.
I do.
I just wonder if that's a good idea.
Okay.
You may be surprised to hear this, but there's actually very little neurochemical difference between drug addiction And romance addiction? And should something go wrong inside the relationship, it increases the chances of relapse.
Yeah.
I've been going to the meetings, Will.
This stuff's been drilled into my head.
So, um, what do we do? Let's go up and discuss it.