ER s06e03 Episode Script
Greene with Envy (aka Lawrence of Northwestern)
E.
R.
Previously on ER What time are you off? Now.
You should all offer Dr.
Corday your congratulations since most of you will be working with her in her new position as associate chief of surgery.
What's all this about, Robert? No "Thank you I'm honored"? No "I hope I don't dissapoint"? You still want to marry me? - Yes.
- Ok.
So, she's looking at surgery? Has to have a mastectomy, I'm affraid.
What about Reece, eh? You ever think of that? I mean you want to take him away from his father? You may not even be his father.
What? Hi.
I'm here to see Dr.
Weaver.
- She went that way handing out badges.
- Excuse me? "Creativity, accountability, respect, excellence.
" That's a lot to live up to.
- He's looking for Dr.
Weaver.
- This way.
- Help me.
I'm dying here - You'll be all right.
Let's go.
Sit here.
- Lucy this guy has a little cut on his arm.
- A cut?! The bitch stabbed me! What'd she stab you with, sir? - Carving knife.
Like I'm a damn steak or something! There goes the ulnar! You're killing me! Just breathe.
I'm sorry.
Sit down, please.
Hold still.
Don't be such a baby.
We can't help you unless you stop.
Look me in the eye.
Hold still.
- Are you a doctor? - Keep the pressure on.
We'll use this to make a tourniquet.
Get his arm out.
Put your arm out.
Come on around this side.
- Pump it up to 180.
- Keep breathing.
Relax.
- We got 180.
- All right, take your hand off.
Creativity.
That's what's on your badge.
Who are you? Sorry I'm late.
You all right? Get me some curved Kellys and Vicryl, I'll be even better.
Good to see you.
Lucy, this is Dr.
Gabriel Lawrence, our new Attending.
How do you do? - Mark.
- I know, I'm late.
Meet Gabe Lawrence.
This is Dr.
Mark Greene.
Dr.
Lawrence, it's a pleasure to meet you.
I've heard a lot about you.
Don't hold it against me.
- Were you in an accident? - No, I started my shift a little early.
- I'm sorry? - Gabe's from New Western - as our new Attending.
- As our new Attending.
- We're incredibly lucky to have him.
- Absolutely.
We're gonna take the grand tour.
Would you like to come with us? I've done the tour.
I'm gonna get this.
- What do you got, Doris? - A 28-year-old fell off his bike.
I didn't fall.
A cab cut me off.
Passed out for two minutes.
Small contusions to his Forehead.
Vitals are stable.
- Reece might not be yours? - That's what she said.
- You think she lying? - I don't know.
I wasn't with her 24 hours a day.
Oh, man, oh, man, oh, man.
- She's gonna use this against me, isn't she? - She can't.
If Carla had any doubts she should've raised them at the petition to determine parentage three months ago.
She didn't, so it's moot.
It's not a problem.
You've put yourself through a hell of a lot for this.
Maybe we should make sure he's yours? - Do a DNA test.
- No.
Peter, you hired me to protect your interests.
If you want a way out, she gave you one.
We'll have to intubate.
Okay, on my count.
One, two, three.
Good.
- What do we got? -16-year-old male.
Single GSW to the left chest.
I'm gonna put him in a chest tube.
Can you intubate? I think I can manage.
number-eight ET tube.
- Help.
- You're gonna be okay.
What's his name? Joshua Fox.
That's his only I.
D.
he had.
They'll put a tube down your throat to help you breathe.
- Can you call his family? - Off a video card? It's all we've got.
Thora-Seal's ready.
Hook me up.
What's this about a rescheduled surgery this afternoon? Got a cancellation, so I moved up a mastectomy.
Oh, well, you can hold it back down.
I've got an elective hernia.
I'm sorry.
I'm not going to torture a woman for another two weeks just so some man can have his groin patched.
Once again, male surgeons decide- Ok, I surrender.
Hormones talking.
You can have your surgery.
I'm in.
Bag him.
Well, It doesn't seem to be much blood in here at all.
I'll sew the tube in.
An O silk.
Good breath.
Call ICU.
- See if we can get him a bed? - Sure.
Be right back.
So, Dr.
Cordey, the mastectomy coming in today, is it Elaine Nichols? - I thought that wasn't until- - I moved it forward.
Sure that's the right thing to do? Isn't it kind of fast? - Why are you so interested? - She's a friend of the family.
Really? Then I shouldn't be discussing it with you, should I? Make sure you get a chest film.
Lucy, you finished assisting Dr.
Carter.
Good.
I have something for you.
The Chicago Gazette is sending over a reporter today.
Mostly to do a puff piece on me.
But they also want to take a look at the ER.
Why are you telling me? Well, because you're going to show them around let him see what heroes we all are.
How we save kiddies' lives.
Etcetera.
Blow my trumpet.
- You do that better yourself.
- Look at you.
Look at me.
- Who'd you rather spend and hour with? - You have a point.
- Next time wear a helmet.
- Come on, doc, Give me a break.
How about a fractured skull? Want to be fed through a tube? Be my guest.
Okay, I'll wear the helmet.
Can I go now? Not yet.
We need a head CT.
What's that? My Core Values badge.
Creativity, Accountability, Respect, Excellence.
All that and beautiful too.
You must be some kind of nurse.
I am.
- Why doesn't Dr.
Grumpy have one? - Guess I'm out of the loop.
It looks like you've got a broken arm, Loren.
We're gonna need some x-rays.
Any other sign of trauma? Contusion to the right shoulder, ecchymosis of the face and right hip And slight wrist tenderness to the wrist.
- How far did you fall, Loren? - I'm not sure.
Can you tell me how you fell? Did you fall like this, or did you fall more on your hand? Yes.
- What, on your hand? - I don't remember.
I'm sorry.
Don't worry.
Don't worry.
That's what we have x-rays for.
So I'll get an AP, and a lateral of the forearm, as well as wrist and elbow films.
Sure, we don't want to miss anything.
It's busy.
I know, Patient through-time is longer than at New Western.
But our census is bigger.
OH, busy is good.
Busy keeps you young.
I'll just take a look at that fellow in Three.
Look at that.
How cute is that.
Thanks, guys.
- What's in here, it's so heavy? - Something to spice up your wedding night.
Conni! You shouldn't have.
Spice up mi wedding night? Sure! Nice hot gumbo to keep up his strength.
Jenny, It's this your last shift for a while? Yep, catching a plane at 6:00 to New Orleans.
Then in the morning, Reggie will make me an honest woman and I'm going to show him the town.
Show him a wild time in New Orleans, honey! I'm sure he'll be very happy.
Didn't I give you a Core Values badge? - A toddler chewed it.
- There you go.
Always wear it.
I will.
I guess you can take it off on your wedding night.
Now, open your eyes.
Relax.
What three things did I ask you to remember? - Dog, fire truck and Brigitte Bardot.
- Excellent.
Dates me, I know, but your first love is always your strongest.
You must be Dr.
Lawrence? John Carter, Senior Resident.
As usual, I'm learning how to be a doctor from my patient.
Meet Mr.
Ulman.
Minor head trauma, brief LOC.
You tell me what reflex would indicate increased intracranial pressure.
- A blown pupil? - Not a reflex.
Observe.
I scratch the thenar eminence.
I look for ipsilateral contractions of the muscles of the chin muscles.
I see none.
Therefore I diagnose no significant head injury.
It's called Radovici's sign.
You can dress, my friend.
I'll see about getting you discharged.
- Thanks a lot, Doc! - My pleasure.
Radovici's sign? Pretty cool.
- Try it on your next head trauma.
- I will.
- Got that migraine in Four? - Yeah, sure.
I'll tell you how I remember.
Radovici sounds like radish.
I pluck the radish with my thumb Daycare said he cried all day, tugging on his ear.
Temp's 101.
Must be a load off having a daycare center here.
- Does his mom work too? - Yeah.
It must be tough on the both of you.
Such a sweet kid.
- How's his ear? - He's got a nasty looking otitis.
- Is he allergic to any medication? - No.
Ok.
Some Tylenol for the pain, and let's put him on amoxicillin for 10 days.
Did you have ear infections as a kid? No, why? Is just they often run in families.
Yeah, well, you know, he probably got it in daycare.
I mean, there is a Lot of sick kids up there.
You wanna leave him here with me until his temperature goes down? Yeah, sure.
I know.
Come on, come on.
All right.
There you go.
Has ICU found a bed for Joshua Fox yet? The gunshot wound kid in Trauma One.
Well, call them again.
- Have you seen my bicycle guy? - Isn't he still in courtain Three? Spandex-butt? Yeah, he was discharged by GL.
- Who's GL? - Gabriel Lawrence.
All right, the good-looking older guy.
I just saw him going to the lounge with Dr.
Corday.
A Frenchman, Dr.
René Laënnec rather than press his ear to mademoiselle's magnificent breast rolled-up a newspaper instead and used that to listen to her heart.
Voilà, the first stethoscope! Voilà, the first sensitive male doctor in history! Dr.
Green, you know who invented the stethoscope? I don't.
Did you discharge my patient? I don't believe so.
Mr.
Ulman.
Fell off his bike.
I wasn't aware he's your patient.
He was.
I'd ordered a head CT which he obviously didn't get.
Don't worry.
I performed a thorough neurological exam.
He didn't need a CT.
The lost of consciousness put him a risk factor of intracranial hemorrhage.
Minuscule risk.
I gave him a head-injury instructions sheet.
If he has any warning signs, he'll come back.
He lives alone.
If he slips into a coma, no one knows.
This isn't like New Western.
County patients tend to be a little less reliable when it comes to follow-up.
I'm aware of that, Dr.
Green.
That's why I told him to call me in four hours to tell me how he's doing.
Difficult if he's passed out on the floor.
What would you do? Without seeing the patient, I'd rather- No, I'd like to know.
What would you do? Fell off his bike.
Lost consciousness.
You did a complete neuro exam? Yes, he was alert and oriented.
Full balance, recall, normal reflexes.
- How long was lost of consciousness? - Less than two minutes.
- You visualized the fundi? - Discs were sharp.
I think Dr.
Greene was just being very thorough.
Sounds like a "no" to me.
Look at it this way.
We just saved Mr.
Ulman $800.
- "A" for Accountability.
- Right.
Yeah but she really does meet all the requirements.
I really couldn't agree with you more on this- - Can I talk to you? - You'll get back to me later, right? - As soon as I can.
- What's up? What's up? Why you didn't tell me you were hiring Lawrence? I only found out that he was available two days ago.
So, in two days you didn't have time for a five-minute conversation? Mark, look, I mean, the man's a legend.
He's one of the founding fathers of emergency medicine.
We're so lucky to have him.
Couldn't you have the courtesy to at least tell me first? It's called respect, Kerry.
Look, it's even on your stupid badge.
Elaine.
- Heard you were coming in today.
- Did you? - I asked you to leave me alone.
- Yeah, I know.
I know that you did and I'm sorry.
But I really need to talk to you.
Because it's Because I don't want you to have the wrong idea about me.
I don't.
I want you to know that I'm here for you.
And that for me this wasn't just about- - Sex? - Yeah.
- It wasn't about that.
- It was for me.
If we're talking needs, John, I don't need you to feel sorry or worried.
Or tender or anything.
I just need you to go away.
I don't wanna go away.
Loren Johnson's X-ray.
Mid-shaft fracture of the radius.
No injury to the wrist or elbow.
She was lucky.
- Maybe not.
- What's this? Some more of Loren Johnson.
I pulled her records.
See these calluses? Healed rib fractures.
And this, some kind of blunt trauma.
Maybe a baseball bat.
She wants to go home as soon as we splint her arm.
You know, this is only her second visit here.
But she has been to Mercy three times, McGaw twice, Ravenswood once.
This time, I don't want her to go home.
- Dr.
Kovac? - Yes? Yes.
Hi, I'm Loren's husband, Pauly.
I just want to thank you for looking after her so well.
Loren wasn't clear on how the accident exactly happened.
Maybe that's because she's a little bit embarrassed about it, isn't that right, Loren? How did it happen? She was up a ladder in our bedroom hanging drapes and lost her footing.
Asked her not to do it by herself, didn't I, honey? Yes, you did.
Shall I splint her? - Mark, can I have a word-? - Lizzy, Paula Trancoso, Chicago Gazette.
Elizabeth Corday, My associate Head of Surgery.
And Mark Greene, one or our ER docs.
You' re wearing scrubs.
Yes, it was my idea.
I wanted to blend in.
Elizabeth was gonna show Paula around the ER.
You don't mind, Mark? If you feel Dr.
Corday has the time Had I known that the Gazette was gonna send you, my dear, I would have made time in my schedule.
But as it is, I'll have to leave you to the tender mercies of Dr.
Corday.
Well, this is the ER, obviously.
- This is Josh's cousin.
- Great.
Josh.
Josh, your cousin's here.
How's he doing? He looks a lot worse than he is.
His lung collapsed so we put a tube in his chest.
You can talk to him if you want.
- He's taching at 140.
- Josh, are you in pain? - BP 180 over 120.
- Call Benton.
- Maybe he's hemorrhaging.
Let's spin the crit.
- His pulse is up to 160.
You'll have to wait outside.
Wait outside, please.
Go outside.
Come on.
What is it? Does the chest tube hurt you? - What have we got? - He's tachy at 160.
- What's his crit? - Drawing it.
You having trouble breathing? You were shot.
Yes, we know.
My God! He's the shooter.
I'll call Security.
- Hey, hold it right there! - He's got a gun! Drop it! Get down! - We need a gurney over here.
- Looks like an abdominal wound.
- Get a backboard, over here! - Strong carotid pulse.
- His chest's clear.
His name? - McGinnis.
Joe McGinnis.
- Need help? - We're fine.
I want two lines NG and a Foley.
Roll him gently.
Gently.
On my count.
One, two, three, lift.
CBC, coag, type and cross for four.
Call O.
R.
BP's 130 over 80.
Pulse is 96.
No visible GSWs to chest or abdomen.
Let's roll him.
See anything back there? Any blood? - Nothing on the back.
- All right, check the extremities.
- Where's the blood from? - Looks like he cut his hand.
- Did he even get shot? - No, he fainted.
- Is this the guy who got shot? You need me? - Yes, his hand needs suturing.
Suturing? That's it? I want every piece of equipment checked for damage.
I don't want anybody seizing because their IVs are punctured.
- Nineteen patients all accounted for.
- Nobody's hurt? Nothing serious, apart from the guard.
Two flesh wounds from ricochets.
Some glass cuts and contusions from diving to the floor.
That's all.
That's all? There must've been about 20 bullets flying around.
Guess we got lucky.
MVA, SUV versus truck.
broke his nose when the airbag inflated.
- My wife and child were- - They are just behind you.
Wife has a few minor scrapes, little boy is Ok.
Why the cops? What's going on here? Curtain Three! - What do we got? - Boy's named David.
He's nine.
Slightly tachy 110.
BP's 115 over 83.
Chest pain.
One, two, three! Hi, David, I'm Cleo.
Do you know what happened to you? We were in an accident.
This truck just hit us.
Son of a bitch came right through the red.
Look, I know my nose is broken.
Why are you fiddling with my face for? Just checking to see if anything else is broken, Mr.
Bradley.
If David's okay, we don't have to stay do we? Lungs clear bilaterally.
Still tachycardic.
We called our doctor from the ambulance.
He said they should take us to Ambrose.
But the paramedics said you were closest.
They are allowed to do that, the paramedics.
Can they go against the patients' wishes? Get a crit, UA, C-spine and chest film.
Until I do these tests, David's not going anywhere.
Elaine? - Is everything all right? - Everything is fine.
I just think maybe this has been too fast for me.
So, I wanna go home and think about it.
You know, I could use some fresh air myself.
Why don't we take a walk? - Want to say goodbye to anybody else? - I've been doing that all day.
You didn't think you were to sneak out on us, did you girl? Beautiful.
How will I get it on the plane? Leave Reggie behind and put them on his seat.
- Thank you.
- Take care.
- See you.
- Thanks.
Jeany I need to see you in here and you too, Reggie.
- But my shift is over - I know.
- We have a plane to catch.
- I know.
Come on.
Carlos! What's going on? Ask Adele.
She really put herself on the line for this.
We're gonna let you take Carlos.
Really? On a temporary basis.
And once you get yourself approved as a foster parent then we can consider something more official and permanent.
Thank you.
You're welcome.
I guess we're not going to New Orleans.
We can still get married here in Chicago.
We could try the courthouse.
When? Today.
- Dr.
Lawrence.
- Dr.
Greene.
I've got her.
Next time, could you sign up on the board? Paperwork! You can run, but you can't hide.
- She's really hurting this time.
- You been sick with fever, Cristal? Vomiting a little? No.
Just hurting.
She's had a sickle crisis before? The same as last month.
We're gonna get you something for the pain, and then we're gonna run some tests.
CBC, chem panel and a UA, please.
- Is that the sickle-cell girl? - Yeah.
Could you add a retic count and a Beta HCG? You got it.
Can we go now, doctor, before another gang band start sooting out the place? - I need to talk to you first.
- Sure, what about? It's just some forms to fill out.
Please.
Something wrong? I have to inform you Mr.
Johnshon that I believe you're mentally ill.
What?! - Because of your illness you can reasonably- - You're the one who's ill! What the hell do you think-? Okay, I get it.
I'm in the nuthouse, huh? "Due to your illness, you can reasonably be expected to inflict serious physical harm on yourself or on others.
Therefore you're subject to involuntary admision and are in need of immediate hospitalization.
" Wait till my lawyer gets ahold of you.
You have no criteria to hold him.
Her x-rays are my criteria.
If she won't press charges, they mean nothing.
He's gonna get up to Psych, and they'll send him right back down and he'll go home.
I don't care about him.
I care about her.
We can do nothing or we can do something.
This way she has a chance.
I can't really run away.
Can I? You can delay, but not for long.
Elaine, if you are worried about reconstruction, I can make an appointment with a plastic surgeon, and you can just- What will happen to it? After you cut it off? - Now you're being morbid.
- Why? It's a part of me.
It'll go to Pathology and then it'll be got rid of.
Thrown in the trash.
Just medical waste.
I'll have a blob of gel instead.
What will it feel like when I touch it? When somebody else touches it? Elaine, lots of women have this type of surgery.
I can't imagine feeling anything.
And If I can't, how will anybody else? How can I be with anybody again? - You can't let this define you.
- It's hard not to.
I was happy with who I was.
That's exactly who you'll still be.
I'd better come back in.
I may be vain, but I'm not stupid.
- Can you do something for me? - Of course.
When you cut, you cut everything.
Don't leave anything.
Cut it all.
You know the only good thing about sickle cell gene? - There isn't anything good.
- No, no, there is.
You know, there is a disease called malaria that kills almost a million children a year.
What do you think protects people against malaria? The sickle-cell gene.
That isn't a bad thing, is it? - Thank you.
- My pleasure.
She should drink lots of liquids and bring her right back if she has more pain.
- Sure.
Say thank you, Cristal.
- Thank you.
You're welcome.
You can get dressed and go home now.
Over here.
Over here.
Thank you.
- The labs come back yet? - No, not yet.
Let me know if they do.
Dr.
Kovac.
Carl De Raad, Psychiatry.
Your psychiatric hold: way out of line, my friend.
Why? Because to justify certification a patient has to be a danger to himself or others.
He is a danger to others.
Come on, just look at his wife.
She said she fell off a ladder.
Until she says different, nothing we can do.
I'm sorry.
- Have you talked to him? - I've seen him.
Dr Kovac, I know why you did it.
But I'm not even gonna take him upstairs for evaluation.
I'm going to release him.
Can you do me a favor? Can you talk to him at least? - What's the point? - Please.
You and me, let's talk to him.
The crazy foreigner.
They should put these on you, you know? Why? I'm not going to hit your wife.
I never hurt my wife.
Never.
Mr.
Johnson, settle down.
We just want to talk to you.
Well talk to her.
Go ahead, ask her.
Have I ever hurt you? No! Will you let him go, please? - You want us to release him? - Please.
OK.
Let him go.
How long before you hit her again? On the way home? Or maybe wait till you get drunk? Have a bad day at work? - What are you doing? - One thing I don't understand.
The X-rays show your wife had three cracked ribs.
Here: - How'd it happen? - Leave it, Kovac.
She fell off a ladder again? Or what? Was it down the stairs, maybe- Can you shut this guy up? - Did you just kick her? - That's enough.
To break her ribs you'd have to stamp on her chest.
What a man! Shut up! Go on, then.
Screw you.
- I'll kill him! - No! I'll kill him! - Calm down, Mr.
Johnson! - Get off of me! I'm gonna kill him! - See? Danger to others.
- Get out of here! See? All right.
Mark, Beta HCG on the sickler.
- Where are they? - They walked out a couple of minutes ago.
Lawrence, we got a problem here.
Mr.
Powell? - We need you to come back into the hospital.
- But we just left.
Your daughter needs another test.
But we've seen the doctor.
Cristal is feeling much better.
- What is it? - She needs to come back.
- Excuse me? - The ICON is positive.
She has to come right back in.
Now.
Dr.
Finch, Sam Jacobs.
I just want to thank you for looking after one of my favorite families so very well.
We haven't quite finished the tests.
I've made arrangements for David to be transfered to Ambrose.
If you'd be so kind as to sign him.
I'm not happy about moving him.
I've looked it.
His C-spine's clear.
An ambulance is waiting.
He complained of back pain at the scene.
I'm still waiting on a second crit.
When you get that, fax it over to me.
It'll be a half an hour, that's all.
In half an hour, Dr.
Finch, he'll be under observation at Ambrose, not taking up precious space here.
We ready to roll, Sam? Are we, Dr.
Finch? - There's the ovary.
- It looks pretty normal.
- What are you looking for? - There.
Mass in the fallopian tube.
- What is it? - Fetal pole and heartbeat.
- What did he say? - There's a heartbeat.
- What are you saying? - There's a heartbeat.
- Your daughter's pregnant.
- No, she's 12 years old! - There's got to be a mistake.
- There's no mistake.
She's pregnant.
The fetus is in the fallopian tube, not the uterus.
- I want a second opinion.
- I'm the second opinion.
We're lucky we caught this early enough.
Your daughter needs surgery now.
If it ruptures, it could be very dangerous.
I'm gonna call the O.
R.
- Were you checking up on me? - Just watching out for the patients.
Will there be video games? Sure.
Video games, TV, your own room.
Just like a hotel.
What's your favorite game? David? David? David, can you hear me? Stop! What? Why are we stopping? - He's tacky.
Get a BP.
- I can't get a pressure.
No pulse on the left.
Go to trauma.
- I don't want him staying here.
- He has to.
- Need a hand? - Eight years old.
Name is David, in rapid deceleration.
MVA, crashed while being transferred to Ambrose.
Probable a traumatic rupture at the junction of the subclavian and aortic arch.
- Why was he being transfered? - All right, we' re going to have to crack him.
- Sorry.
Sorry.
- Thoracotomy tray.
Where is Kerry? She said she'd be here.
- You know this place closes at 5? - Yeah, we know.
- Do we really need two? - Two witnesses, yes.
Right, suction.
Start a round with the packed cells.
- He's in V-tach.
-60 of lidocaine.
- Son of a bitch.
I can't find the source.
- He's still in V-tach.
Stand by with the paddles.
I've never done one like this before.
- Why don't you talk me through it? - Keep suctioning.
You have to- Connie, would you get that woman out of here! Ma'am, you have to leave.
- Peter, need any help? - Please, Mark, get that woman out of here.
- Get your hands off me.
- Out! Gonna clamp distally to the left subclavian.
Open the pleura to identify the area that's leaking.
Release the clamp distally to identify the leak.
- I see it.
- Now evacuate the hematoma.
Put a curved Potts underneath the leak to leave the aorta patent.
Now clamp above the tear.
There you go, Carter, You just isolated the leak.
Nice work, Carter.
Do you Reginald Moore take this woman to be your lawful wedded wife to live together in the state of matrimony to love her, honor and keep her through sickness and prosperity whatever your future might be? I do.
- I think he needs a feeding.
- Okay.
Just one second.
Sorry.
Hi.
Are you hungry? It's okay.
Go on.
And do you Jeanie Boulay take this man as your lawful wedded husband to live together in the state of matrimony to love, honor and keep him through sickness and prosperity whatever your future might be? I do! No, it's not unusual.
This is a teaching hospital and Residents are here to learn.
So they are allowed to practice on patients.
How else do they learn? A little tough on whoever they learn on, isn't it? The residents are carefully supervised.
What I saw wasn't carefully supervised.
Well, I'm sure you've seen enough, didn't you?.
It was really really nice to meet you.
And I do look forward to reading your article.
Mark, thank God I got rid of her.
Yeah, careful she doesn't turn up somewhere else disguised as a surgeon.
- Did she get in the way in Trauma? - Yeah.
- Mark, I didn't ask to be her tour guide.
- Well, you didn't say no.
- How's it going? - Fine.
Heard about your Psych hold.
Yeah, I'm very popular with Psychiatry.
They took him upstairs for assessment.
Maybe they'll hold him.
I don't think so.
I provoked him, in front of witnesses.
Maybe now she'll see how he's really like, you know.
You don't think she knows? Yeah, I know, it's hopeless.
Maybe not.
She didn't go upstairs with him.
Lucy took her to the cafeteria.
Fingers crossed.
David's stabilized.
He's in surgery.
Barring any complications, he'll be okay.
If you want to go and see him the nurse will take you.
- Thank you.
- Thank you, doctor.
Dr.
Finch.
You did well to catch that.
If we'd waited for the tests, we'd would have seen this.
We could've operated in a controlled manner rather than having to rip an - We had no choice.
- I did.
I shouldn't have let myself listen to you.
- How are you feeling? - Okay.
It went well.
There was no evidence the cancer had spread.
But we will have to wait for the pathology reports on the lymph nodes.
I got a plastic surgeon in to close, so we could minimize scarring.
And of course within the next couple of weeks we can begin reconstruction.
When can I go home? Well, we had to put in some drains to collect any accumulating fluid.
Like I'm a sewer system.
Most likely it'll just be for the night.
So you'll be able to go home tomorrow.
Now, I've given the nurse all my numbers.
So if you need anything, you have any questions, just call anytime.
Thanks.
Oh, Dr.
Kovak, now that Dr.
Lawrence is here I don't believe that we're gonna be needing you anymore, ok?.
Okay.
- Hey, are you on tonight? - No, I'm not.
- How much fluid did you give him? - Two liters wide open.
- What do we got? - Seventeen-year-old, 3 gunshot wounds to the right chest.
One to the left.
BP 90 over 60, pulse 120.
Intubated in the field.
- He needs a bilateral chest tube.
- One for you and one for me.
Malucci, you do a central line.
On my count.
One, two, three.
- Two chest tubes and a central line.
- Only got one chest tray.
- Get another.
- We'll share.
10-blade.
- BP's 80.
Pulse ox 92.
- Curved Kelly.
- Twenty cc's for the lab.
- O-neg is here.
Chest tube.
Get this damn thing out of my way! Somebody grab this badge and flip it.
- Stitch, please.
- I'm in.
Lock and load the infuser.
- BP's down to 70.
-100 cc's on the right.
- We got bleeding on your side, Dr.
Greene.
- Ok, where's Benton? He got off at 6.
We need a surgeon down here now! Give me the Foley.
Come on! - What are you doing? - Check the balloon.
- What are you doing? - Check the balloon.
Come on.
If we can't put pressure on the bleeder from the outside, we do it on the inside.
Pressure's down to 60.
All right, tell me when.
There's 30 cc's.
- Chest tube output's down to a trickle.
- Pressure's up to 80.
Old army trick to tamponade the subclavian.
- Cool.
- Very cool.
Let's get him up to the O.
R.
Dr.
Carter? - How is she? - She's resting comfortably.
You can go in if you like.
- Hey, Luka.
- Hey.
- Want a lift? - In that? It's my mom's.
I had to pick up some stuff from work.
- What, baby stuff? - Yeah.
Okay.
- Here we are.
- Yeah.
Let's see - Let's get him this.
- He's 9 months old.
You're never too early to start.
Carlos, do you think your daddy's silly? What about this? You like one of these? "Pull over.
Pull over.
" He is silly.
Elizabeth, I wanted to apologize for being abrupt.
- You mean rude.
- Yes.
I'll think about it.
You could apologize actually for that crap at the head CT.
What?! No way on earth will I apologize for that.
You put me on the spot.
Yeah, but I expected you to give the right answer.
The right answer? That Lawrence is still bugging you, isn't he? Just because he can diagnose something without having to order every test in the book.
He may have some fancy moves in Trauma but he doesn't know how to function in an inner-city ER.
- You're afraid you might learn something? - He's too slow, he spends hours with every patient, and then he ties up the residents chattering on about the Radovici sign.
- The what? - You don't know about that? - No, what is it? - I don't think I should tell you.
Mark.
Just one more.
Come on, Reece, please.
Okay.
Maybe not.
What are you doing? What are you doing? What are you doing? Jackie, you think he looks like me? I hope not.
He's got enough problems.
Hey, when I was a kid, did I have a lot of ear infections? I don't know, Peter.
I was your sister, not your mother.
You were a scrawny little thing.
Always coming down with something.
No wonder you got into medicine.
Thanks.
I'll take him up to bed.
- Do the washing up.
- All right.
Dry up too.
Don't leave everything just sitting on the side.
I love you.
Do you love me? Get out of here.
Come on, my baby.
- You live here? - I told you it's in the water.
- Yeah, but I mean, is it sanitary? - Sure.
- What do you do in winter? - In winter I go south.
Like the birds.
- Thank you for the lift.
- Sure.
See you.
Sure.
You scratch the thenar eminence causing ipsilateral contractions of the chin muscles.
Definitely contracting.
- Is that a good thing? - Sadly, no.
It indicates increased intracranial pressure.
Disturbances of the brain.
Which explains why you're working with Romano.
R.
Previously on ER What time are you off? Now.
You should all offer Dr.
Corday your congratulations since most of you will be working with her in her new position as associate chief of surgery.
What's all this about, Robert? No "Thank you I'm honored"? No "I hope I don't dissapoint"? You still want to marry me? - Yes.
- Ok.
So, she's looking at surgery? Has to have a mastectomy, I'm affraid.
What about Reece, eh? You ever think of that? I mean you want to take him away from his father? You may not even be his father.
What? Hi.
I'm here to see Dr.
Weaver.
- She went that way handing out badges.
- Excuse me? "Creativity, accountability, respect, excellence.
" That's a lot to live up to.
- He's looking for Dr.
Weaver.
- This way.
- Help me.
I'm dying here - You'll be all right.
Let's go.
Sit here.
- Lucy this guy has a little cut on his arm.
- A cut?! The bitch stabbed me! What'd she stab you with, sir? - Carving knife.
Like I'm a damn steak or something! There goes the ulnar! You're killing me! Just breathe.
I'm sorry.
Sit down, please.
Hold still.
Don't be such a baby.
We can't help you unless you stop.
Look me in the eye.
Hold still.
- Are you a doctor? - Keep the pressure on.
We'll use this to make a tourniquet.
Get his arm out.
Put your arm out.
Come on around this side.
- Pump it up to 180.
- Keep breathing.
Relax.
- We got 180.
- All right, take your hand off.
Creativity.
That's what's on your badge.
Who are you? Sorry I'm late.
You all right? Get me some curved Kellys and Vicryl, I'll be even better.
Good to see you.
Lucy, this is Dr.
Gabriel Lawrence, our new Attending.
How do you do? - Mark.
- I know, I'm late.
Meet Gabe Lawrence.
This is Dr.
Mark Greene.
Dr.
Lawrence, it's a pleasure to meet you.
I've heard a lot about you.
Don't hold it against me.
- Were you in an accident? - No, I started my shift a little early.
- I'm sorry? - Gabe's from New Western - as our new Attending.
- As our new Attending.
- We're incredibly lucky to have him.
- Absolutely.
We're gonna take the grand tour.
Would you like to come with us? I've done the tour.
I'm gonna get this.
- What do you got, Doris? - A 28-year-old fell off his bike.
I didn't fall.
A cab cut me off.
Passed out for two minutes.
Small contusions to his Forehead.
Vitals are stable.
- Reece might not be yours? - That's what she said.
- You think she lying? - I don't know.
I wasn't with her 24 hours a day.
Oh, man, oh, man, oh, man.
- She's gonna use this against me, isn't she? - She can't.
If Carla had any doubts she should've raised them at the petition to determine parentage three months ago.
She didn't, so it's moot.
It's not a problem.
You've put yourself through a hell of a lot for this.
Maybe we should make sure he's yours? - Do a DNA test.
- No.
Peter, you hired me to protect your interests.
If you want a way out, she gave you one.
We'll have to intubate.
Okay, on my count.
One, two, three.
Good.
- What do we got? -16-year-old male.
Single GSW to the left chest.
I'm gonna put him in a chest tube.
Can you intubate? I think I can manage.
number-eight ET tube.
- Help.
- You're gonna be okay.
What's his name? Joshua Fox.
That's his only I.
D.
he had.
They'll put a tube down your throat to help you breathe.
- Can you call his family? - Off a video card? It's all we've got.
Thora-Seal's ready.
Hook me up.
What's this about a rescheduled surgery this afternoon? Got a cancellation, so I moved up a mastectomy.
Oh, well, you can hold it back down.
I've got an elective hernia.
I'm sorry.
I'm not going to torture a woman for another two weeks just so some man can have his groin patched.
Once again, male surgeons decide- Ok, I surrender.
Hormones talking.
You can have your surgery.
I'm in.
Bag him.
Well, It doesn't seem to be much blood in here at all.
I'll sew the tube in.
An O silk.
Good breath.
Call ICU.
- See if we can get him a bed? - Sure.
Be right back.
So, Dr.
Cordey, the mastectomy coming in today, is it Elaine Nichols? - I thought that wasn't until- - I moved it forward.
Sure that's the right thing to do? Isn't it kind of fast? - Why are you so interested? - She's a friend of the family.
Really? Then I shouldn't be discussing it with you, should I? Make sure you get a chest film.
Lucy, you finished assisting Dr.
Carter.
Good.
I have something for you.
The Chicago Gazette is sending over a reporter today.
Mostly to do a puff piece on me.
But they also want to take a look at the ER.
Why are you telling me? Well, because you're going to show them around let him see what heroes we all are.
How we save kiddies' lives.
Etcetera.
Blow my trumpet.
- You do that better yourself.
- Look at you.
Look at me.
- Who'd you rather spend and hour with? - You have a point.
- Next time wear a helmet.
- Come on, doc, Give me a break.
How about a fractured skull? Want to be fed through a tube? Be my guest.
Okay, I'll wear the helmet.
Can I go now? Not yet.
We need a head CT.
What's that? My Core Values badge.
Creativity, Accountability, Respect, Excellence.
All that and beautiful too.
You must be some kind of nurse.
I am.
- Why doesn't Dr.
Grumpy have one? - Guess I'm out of the loop.
It looks like you've got a broken arm, Loren.
We're gonna need some x-rays.
Any other sign of trauma? Contusion to the right shoulder, ecchymosis of the face and right hip And slight wrist tenderness to the wrist.
- How far did you fall, Loren? - I'm not sure.
Can you tell me how you fell? Did you fall like this, or did you fall more on your hand? Yes.
- What, on your hand? - I don't remember.
I'm sorry.
Don't worry.
Don't worry.
That's what we have x-rays for.
So I'll get an AP, and a lateral of the forearm, as well as wrist and elbow films.
Sure, we don't want to miss anything.
It's busy.
I know, Patient through-time is longer than at New Western.
But our census is bigger.
OH, busy is good.
Busy keeps you young.
I'll just take a look at that fellow in Three.
Look at that.
How cute is that.
Thanks, guys.
- What's in here, it's so heavy? - Something to spice up your wedding night.
Conni! You shouldn't have.
Spice up mi wedding night? Sure! Nice hot gumbo to keep up his strength.
Jenny, It's this your last shift for a while? Yep, catching a plane at 6:00 to New Orleans.
Then in the morning, Reggie will make me an honest woman and I'm going to show him the town.
Show him a wild time in New Orleans, honey! I'm sure he'll be very happy.
Didn't I give you a Core Values badge? - A toddler chewed it.
- There you go.
Always wear it.
I will.
I guess you can take it off on your wedding night.
Now, open your eyes.
Relax.
What three things did I ask you to remember? - Dog, fire truck and Brigitte Bardot.
- Excellent.
Dates me, I know, but your first love is always your strongest.
You must be Dr.
Lawrence? John Carter, Senior Resident.
As usual, I'm learning how to be a doctor from my patient.
Meet Mr.
Ulman.
Minor head trauma, brief LOC.
You tell me what reflex would indicate increased intracranial pressure.
- A blown pupil? - Not a reflex.
Observe.
I scratch the thenar eminence.
I look for ipsilateral contractions of the muscles of the chin muscles.
I see none.
Therefore I diagnose no significant head injury.
It's called Radovici's sign.
You can dress, my friend.
I'll see about getting you discharged.
- Thanks a lot, Doc! - My pleasure.
Radovici's sign? Pretty cool.
- Try it on your next head trauma.
- I will.
- Got that migraine in Four? - Yeah, sure.
I'll tell you how I remember.
Radovici sounds like radish.
I pluck the radish with my thumb Daycare said he cried all day, tugging on his ear.
Temp's 101.
Must be a load off having a daycare center here.
- Does his mom work too? - Yeah.
It must be tough on the both of you.
Such a sweet kid.
- How's his ear? - He's got a nasty looking otitis.
- Is he allergic to any medication? - No.
Ok.
Some Tylenol for the pain, and let's put him on amoxicillin for 10 days.
Did you have ear infections as a kid? No, why? Is just they often run in families.
Yeah, well, you know, he probably got it in daycare.
I mean, there is a Lot of sick kids up there.
You wanna leave him here with me until his temperature goes down? Yeah, sure.
I know.
Come on, come on.
All right.
There you go.
Has ICU found a bed for Joshua Fox yet? The gunshot wound kid in Trauma One.
Well, call them again.
- Have you seen my bicycle guy? - Isn't he still in courtain Three? Spandex-butt? Yeah, he was discharged by GL.
- Who's GL? - Gabriel Lawrence.
All right, the good-looking older guy.
I just saw him going to the lounge with Dr.
Corday.
A Frenchman, Dr.
René Laënnec rather than press his ear to mademoiselle's magnificent breast rolled-up a newspaper instead and used that to listen to her heart.
Voilà, the first stethoscope! Voilà, the first sensitive male doctor in history! Dr.
Green, you know who invented the stethoscope? I don't.
Did you discharge my patient? I don't believe so.
Mr.
Ulman.
Fell off his bike.
I wasn't aware he's your patient.
He was.
I'd ordered a head CT which he obviously didn't get.
Don't worry.
I performed a thorough neurological exam.
He didn't need a CT.
The lost of consciousness put him a risk factor of intracranial hemorrhage.
Minuscule risk.
I gave him a head-injury instructions sheet.
If he has any warning signs, he'll come back.
He lives alone.
If he slips into a coma, no one knows.
This isn't like New Western.
County patients tend to be a little less reliable when it comes to follow-up.
I'm aware of that, Dr.
Green.
That's why I told him to call me in four hours to tell me how he's doing.
Difficult if he's passed out on the floor.
What would you do? Without seeing the patient, I'd rather- No, I'd like to know.
What would you do? Fell off his bike.
Lost consciousness.
You did a complete neuro exam? Yes, he was alert and oriented.
Full balance, recall, normal reflexes.
- How long was lost of consciousness? - Less than two minutes.
- You visualized the fundi? - Discs were sharp.
I think Dr.
Greene was just being very thorough.
Sounds like a "no" to me.
Look at it this way.
We just saved Mr.
Ulman $800.
- "A" for Accountability.
- Right.
Yeah but she really does meet all the requirements.
I really couldn't agree with you more on this- - Can I talk to you? - You'll get back to me later, right? - As soon as I can.
- What's up? What's up? Why you didn't tell me you were hiring Lawrence? I only found out that he was available two days ago.
So, in two days you didn't have time for a five-minute conversation? Mark, look, I mean, the man's a legend.
He's one of the founding fathers of emergency medicine.
We're so lucky to have him.
Couldn't you have the courtesy to at least tell me first? It's called respect, Kerry.
Look, it's even on your stupid badge.
Elaine.
- Heard you were coming in today.
- Did you? - I asked you to leave me alone.
- Yeah, I know.
I know that you did and I'm sorry.
But I really need to talk to you.
Because it's Because I don't want you to have the wrong idea about me.
I don't.
I want you to know that I'm here for you.
And that for me this wasn't just about- - Sex? - Yeah.
- It wasn't about that.
- It was for me.
If we're talking needs, John, I don't need you to feel sorry or worried.
Or tender or anything.
I just need you to go away.
I don't wanna go away.
Loren Johnson's X-ray.
Mid-shaft fracture of the radius.
No injury to the wrist or elbow.
She was lucky.
- Maybe not.
- What's this? Some more of Loren Johnson.
I pulled her records.
See these calluses? Healed rib fractures.
And this, some kind of blunt trauma.
Maybe a baseball bat.
She wants to go home as soon as we splint her arm.
You know, this is only her second visit here.
But she has been to Mercy three times, McGaw twice, Ravenswood once.
This time, I don't want her to go home.
- Dr.
Kovac? - Yes? Yes.
Hi, I'm Loren's husband, Pauly.
I just want to thank you for looking after her so well.
Loren wasn't clear on how the accident exactly happened.
Maybe that's because she's a little bit embarrassed about it, isn't that right, Loren? How did it happen? She was up a ladder in our bedroom hanging drapes and lost her footing.
Asked her not to do it by herself, didn't I, honey? Yes, you did.
Shall I splint her? - Mark, can I have a word-? - Lizzy, Paula Trancoso, Chicago Gazette.
Elizabeth Corday, My associate Head of Surgery.
And Mark Greene, one or our ER docs.
You' re wearing scrubs.
Yes, it was my idea.
I wanted to blend in.
Elizabeth was gonna show Paula around the ER.
You don't mind, Mark? If you feel Dr.
Corday has the time Had I known that the Gazette was gonna send you, my dear, I would have made time in my schedule.
But as it is, I'll have to leave you to the tender mercies of Dr.
Corday.
Well, this is the ER, obviously.
- This is Josh's cousin.
- Great.
Josh.
Josh, your cousin's here.
How's he doing? He looks a lot worse than he is.
His lung collapsed so we put a tube in his chest.
You can talk to him if you want.
- He's taching at 140.
- Josh, are you in pain? - BP 180 over 120.
- Call Benton.
- Maybe he's hemorrhaging.
Let's spin the crit.
- His pulse is up to 160.
You'll have to wait outside.
Wait outside, please.
Go outside.
Come on.
What is it? Does the chest tube hurt you? - What have we got? - He's tachy at 160.
- What's his crit? - Drawing it.
You having trouble breathing? You were shot.
Yes, we know.
My God! He's the shooter.
I'll call Security.
- Hey, hold it right there! - He's got a gun! Drop it! Get down! - We need a gurney over here.
- Looks like an abdominal wound.
- Get a backboard, over here! - Strong carotid pulse.
- His chest's clear.
His name? - McGinnis.
Joe McGinnis.
- Need help? - We're fine.
I want two lines NG and a Foley.
Roll him gently.
Gently.
On my count.
One, two, three, lift.
CBC, coag, type and cross for four.
Call O.
R.
BP's 130 over 80.
Pulse is 96.
No visible GSWs to chest or abdomen.
Let's roll him.
See anything back there? Any blood? - Nothing on the back.
- All right, check the extremities.
- Where's the blood from? - Looks like he cut his hand.
- Did he even get shot? - No, he fainted.
- Is this the guy who got shot? You need me? - Yes, his hand needs suturing.
Suturing? That's it? I want every piece of equipment checked for damage.
I don't want anybody seizing because their IVs are punctured.
- Nineteen patients all accounted for.
- Nobody's hurt? Nothing serious, apart from the guard.
Two flesh wounds from ricochets.
Some glass cuts and contusions from diving to the floor.
That's all.
That's all? There must've been about 20 bullets flying around.
Guess we got lucky.
MVA, SUV versus truck.
broke his nose when the airbag inflated.
- My wife and child were- - They are just behind you.
Wife has a few minor scrapes, little boy is Ok.
Why the cops? What's going on here? Curtain Three! - What do we got? - Boy's named David.
He's nine.
Slightly tachy 110.
BP's 115 over 83.
Chest pain.
One, two, three! Hi, David, I'm Cleo.
Do you know what happened to you? We were in an accident.
This truck just hit us.
Son of a bitch came right through the red.
Look, I know my nose is broken.
Why are you fiddling with my face for? Just checking to see if anything else is broken, Mr.
Bradley.
If David's okay, we don't have to stay do we? Lungs clear bilaterally.
Still tachycardic.
We called our doctor from the ambulance.
He said they should take us to Ambrose.
But the paramedics said you were closest.
They are allowed to do that, the paramedics.
Can they go against the patients' wishes? Get a crit, UA, C-spine and chest film.
Until I do these tests, David's not going anywhere.
Elaine? - Is everything all right? - Everything is fine.
I just think maybe this has been too fast for me.
So, I wanna go home and think about it.
You know, I could use some fresh air myself.
Why don't we take a walk? - Want to say goodbye to anybody else? - I've been doing that all day.
You didn't think you were to sneak out on us, did you girl? Beautiful.
How will I get it on the plane? Leave Reggie behind and put them on his seat.
- Thank you.
- Take care.
- See you.
- Thanks.
Jeany I need to see you in here and you too, Reggie.
- But my shift is over - I know.
- We have a plane to catch.
- I know.
Come on.
Carlos! What's going on? Ask Adele.
She really put herself on the line for this.
We're gonna let you take Carlos.
Really? On a temporary basis.
And once you get yourself approved as a foster parent then we can consider something more official and permanent.
Thank you.
You're welcome.
I guess we're not going to New Orleans.
We can still get married here in Chicago.
We could try the courthouse.
When? Today.
- Dr.
Lawrence.
- Dr.
Greene.
I've got her.
Next time, could you sign up on the board? Paperwork! You can run, but you can't hide.
- She's really hurting this time.
- You been sick with fever, Cristal? Vomiting a little? No.
Just hurting.
She's had a sickle crisis before? The same as last month.
We're gonna get you something for the pain, and then we're gonna run some tests.
CBC, chem panel and a UA, please.
- Is that the sickle-cell girl? - Yeah.
Could you add a retic count and a Beta HCG? You got it.
Can we go now, doctor, before another gang band start sooting out the place? - I need to talk to you first.
- Sure, what about? It's just some forms to fill out.
Please.
Something wrong? I have to inform you Mr.
Johnshon that I believe you're mentally ill.
What?! - Because of your illness you can reasonably- - You're the one who's ill! What the hell do you think-? Okay, I get it.
I'm in the nuthouse, huh? "Due to your illness, you can reasonably be expected to inflict serious physical harm on yourself or on others.
Therefore you're subject to involuntary admision and are in need of immediate hospitalization.
" Wait till my lawyer gets ahold of you.
You have no criteria to hold him.
Her x-rays are my criteria.
If she won't press charges, they mean nothing.
He's gonna get up to Psych, and they'll send him right back down and he'll go home.
I don't care about him.
I care about her.
We can do nothing or we can do something.
This way she has a chance.
I can't really run away.
Can I? You can delay, but not for long.
Elaine, if you are worried about reconstruction, I can make an appointment with a plastic surgeon, and you can just- What will happen to it? After you cut it off? - Now you're being morbid.
- Why? It's a part of me.
It'll go to Pathology and then it'll be got rid of.
Thrown in the trash.
Just medical waste.
I'll have a blob of gel instead.
What will it feel like when I touch it? When somebody else touches it? Elaine, lots of women have this type of surgery.
I can't imagine feeling anything.
And If I can't, how will anybody else? How can I be with anybody again? - You can't let this define you.
- It's hard not to.
I was happy with who I was.
That's exactly who you'll still be.
I'd better come back in.
I may be vain, but I'm not stupid.
- Can you do something for me? - Of course.
When you cut, you cut everything.
Don't leave anything.
Cut it all.
You know the only good thing about sickle cell gene? - There isn't anything good.
- No, no, there is.
You know, there is a disease called malaria that kills almost a million children a year.
What do you think protects people against malaria? The sickle-cell gene.
That isn't a bad thing, is it? - Thank you.
- My pleasure.
She should drink lots of liquids and bring her right back if she has more pain.
- Sure.
Say thank you, Cristal.
- Thank you.
You're welcome.
You can get dressed and go home now.
Over here.
Over here.
Thank you.
- The labs come back yet? - No, not yet.
Let me know if they do.
Dr.
Kovac.
Carl De Raad, Psychiatry.
Your psychiatric hold: way out of line, my friend.
Why? Because to justify certification a patient has to be a danger to himself or others.
He is a danger to others.
Come on, just look at his wife.
She said she fell off a ladder.
Until she says different, nothing we can do.
I'm sorry.
- Have you talked to him? - I've seen him.
Dr Kovac, I know why you did it.
But I'm not even gonna take him upstairs for evaluation.
I'm going to release him.
Can you do me a favor? Can you talk to him at least? - What's the point? - Please.
You and me, let's talk to him.
The crazy foreigner.
They should put these on you, you know? Why? I'm not going to hit your wife.
I never hurt my wife.
Never.
Mr.
Johnson, settle down.
We just want to talk to you.
Well talk to her.
Go ahead, ask her.
Have I ever hurt you? No! Will you let him go, please? - You want us to release him? - Please.
OK.
Let him go.
How long before you hit her again? On the way home? Or maybe wait till you get drunk? Have a bad day at work? - What are you doing? - One thing I don't understand.
The X-rays show your wife had three cracked ribs.
Here: - How'd it happen? - Leave it, Kovac.
She fell off a ladder again? Or what? Was it down the stairs, maybe- Can you shut this guy up? - Did you just kick her? - That's enough.
To break her ribs you'd have to stamp on her chest.
What a man! Shut up! Go on, then.
Screw you.
- I'll kill him! - No! I'll kill him! - Calm down, Mr.
Johnson! - Get off of me! I'm gonna kill him! - See? Danger to others.
- Get out of here! See? All right.
Mark, Beta HCG on the sickler.
- Where are they? - They walked out a couple of minutes ago.
Lawrence, we got a problem here.
Mr.
Powell? - We need you to come back into the hospital.
- But we just left.
Your daughter needs another test.
But we've seen the doctor.
Cristal is feeling much better.
- What is it? - She needs to come back.
- Excuse me? - The ICON is positive.
She has to come right back in.
Now.
Dr.
Finch, Sam Jacobs.
I just want to thank you for looking after one of my favorite families so very well.
We haven't quite finished the tests.
I've made arrangements for David to be transfered to Ambrose.
If you'd be so kind as to sign him.
I'm not happy about moving him.
I've looked it.
His C-spine's clear.
An ambulance is waiting.
He complained of back pain at the scene.
I'm still waiting on a second crit.
When you get that, fax it over to me.
It'll be a half an hour, that's all.
In half an hour, Dr.
Finch, he'll be under observation at Ambrose, not taking up precious space here.
We ready to roll, Sam? Are we, Dr.
Finch? - There's the ovary.
- It looks pretty normal.
- What are you looking for? - There.
Mass in the fallopian tube.
- What is it? - Fetal pole and heartbeat.
- What did he say? - There's a heartbeat.
- What are you saying? - There's a heartbeat.
- Your daughter's pregnant.
- No, she's 12 years old! - There's got to be a mistake.
- There's no mistake.
She's pregnant.
The fetus is in the fallopian tube, not the uterus.
- I want a second opinion.
- I'm the second opinion.
We're lucky we caught this early enough.
Your daughter needs surgery now.
If it ruptures, it could be very dangerous.
I'm gonna call the O.
R.
- Were you checking up on me? - Just watching out for the patients.
Will there be video games? Sure.
Video games, TV, your own room.
Just like a hotel.
What's your favorite game? David? David? David, can you hear me? Stop! What? Why are we stopping? - He's tacky.
Get a BP.
- I can't get a pressure.
No pulse on the left.
Go to trauma.
- I don't want him staying here.
- He has to.
- Need a hand? - Eight years old.
Name is David, in rapid deceleration.
MVA, crashed while being transferred to Ambrose.
Probable a traumatic rupture at the junction of the subclavian and aortic arch.
- Why was he being transfered? - All right, we' re going to have to crack him.
- Sorry.
Sorry.
- Thoracotomy tray.
Where is Kerry? She said she'd be here.
- You know this place closes at 5? - Yeah, we know.
- Do we really need two? - Two witnesses, yes.
Right, suction.
Start a round with the packed cells.
- He's in V-tach.
-60 of lidocaine.
- Son of a bitch.
I can't find the source.
- He's still in V-tach.
Stand by with the paddles.
I've never done one like this before.
- Why don't you talk me through it? - Keep suctioning.
You have to- Connie, would you get that woman out of here! Ma'am, you have to leave.
- Peter, need any help? - Please, Mark, get that woman out of here.
- Get your hands off me.
- Out! Gonna clamp distally to the left subclavian.
Open the pleura to identify the area that's leaking.
Release the clamp distally to identify the leak.
- I see it.
- Now evacuate the hematoma.
Put a curved Potts underneath the leak to leave the aorta patent.
Now clamp above the tear.
There you go, Carter, You just isolated the leak.
Nice work, Carter.
Do you Reginald Moore take this woman to be your lawful wedded wife to live together in the state of matrimony to love her, honor and keep her through sickness and prosperity whatever your future might be? I do.
- I think he needs a feeding.
- Okay.
Just one second.
Sorry.
Hi.
Are you hungry? It's okay.
Go on.
And do you Jeanie Boulay take this man as your lawful wedded husband to live together in the state of matrimony to love, honor and keep him through sickness and prosperity whatever your future might be? I do! No, it's not unusual.
This is a teaching hospital and Residents are here to learn.
So they are allowed to practice on patients.
How else do they learn? A little tough on whoever they learn on, isn't it? The residents are carefully supervised.
What I saw wasn't carefully supervised.
Well, I'm sure you've seen enough, didn't you?.
It was really really nice to meet you.
And I do look forward to reading your article.
Mark, thank God I got rid of her.
Yeah, careful she doesn't turn up somewhere else disguised as a surgeon.
- Did she get in the way in Trauma? - Yeah.
- Mark, I didn't ask to be her tour guide.
- Well, you didn't say no.
- How's it going? - Fine.
Heard about your Psych hold.
Yeah, I'm very popular with Psychiatry.
They took him upstairs for assessment.
Maybe they'll hold him.
I don't think so.
I provoked him, in front of witnesses.
Maybe now she'll see how he's really like, you know.
You don't think she knows? Yeah, I know, it's hopeless.
Maybe not.
She didn't go upstairs with him.
Lucy took her to the cafeteria.
Fingers crossed.
David's stabilized.
He's in surgery.
Barring any complications, he'll be okay.
If you want to go and see him the nurse will take you.
- Thank you.
- Thank you, doctor.
Dr.
Finch.
You did well to catch that.
If we'd waited for the tests, we'd would have seen this.
We could've operated in a controlled manner rather than having to rip an - We had no choice.
- I did.
I shouldn't have let myself listen to you.
- How are you feeling? - Okay.
It went well.
There was no evidence the cancer had spread.
But we will have to wait for the pathology reports on the lymph nodes.
I got a plastic surgeon in to close, so we could minimize scarring.
And of course within the next couple of weeks we can begin reconstruction.
When can I go home? Well, we had to put in some drains to collect any accumulating fluid.
Like I'm a sewer system.
Most likely it'll just be for the night.
So you'll be able to go home tomorrow.
Now, I've given the nurse all my numbers.
So if you need anything, you have any questions, just call anytime.
Thanks.
Oh, Dr.
Kovak, now that Dr.
Lawrence is here I don't believe that we're gonna be needing you anymore, ok?.
Okay.
- Hey, are you on tonight? - No, I'm not.
- How much fluid did you give him? - Two liters wide open.
- What do we got? - Seventeen-year-old, 3 gunshot wounds to the right chest.
One to the left.
BP 90 over 60, pulse 120.
Intubated in the field.
- He needs a bilateral chest tube.
- One for you and one for me.
Malucci, you do a central line.
On my count.
One, two, three.
- Two chest tubes and a central line.
- Only got one chest tray.
- Get another.
- We'll share.
10-blade.
- BP's 80.
Pulse ox 92.
- Curved Kelly.
- Twenty cc's for the lab.
- O-neg is here.
Chest tube.
Get this damn thing out of my way! Somebody grab this badge and flip it.
- Stitch, please.
- I'm in.
Lock and load the infuser.
- BP's down to 70.
-100 cc's on the right.
- We got bleeding on your side, Dr.
Greene.
- Ok, where's Benton? He got off at 6.
We need a surgeon down here now! Give me the Foley.
Come on! - What are you doing? - Check the balloon.
- What are you doing? - Check the balloon.
Come on.
If we can't put pressure on the bleeder from the outside, we do it on the inside.
Pressure's down to 60.
All right, tell me when.
There's 30 cc's.
- Chest tube output's down to a trickle.
- Pressure's up to 80.
Old army trick to tamponade the subclavian.
- Cool.
- Very cool.
Let's get him up to the O.
R.
Dr.
Carter? - How is she? - She's resting comfortably.
You can go in if you like.
- Hey, Luka.
- Hey.
- Want a lift? - In that? It's my mom's.
I had to pick up some stuff from work.
- What, baby stuff? - Yeah.
Okay.
- Here we are.
- Yeah.
Let's see - Let's get him this.
- He's 9 months old.
You're never too early to start.
Carlos, do you think your daddy's silly? What about this? You like one of these? "Pull over.
Pull over.
" He is silly.
Elizabeth, I wanted to apologize for being abrupt.
- You mean rude.
- Yes.
I'll think about it.
You could apologize actually for that crap at the head CT.
What?! No way on earth will I apologize for that.
You put me on the spot.
Yeah, but I expected you to give the right answer.
The right answer? That Lawrence is still bugging you, isn't he? Just because he can diagnose something without having to order every test in the book.
He may have some fancy moves in Trauma but he doesn't know how to function in an inner-city ER.
- You're afraid you might learn something? - He's too slow, he spends hours with every patient, and then he ties up the residents chattering on about the Radovici sign.
- The what? - You don't know about that? - No, what is it? - I don't think I should tell you.
Mark.
Just one more.
Come on, Reece, please.
Okay.
Maybe not.
What are you doing? What are you doing? What are you doing? Jackie, you think he looks like me? I hope not.
He's got enough problems.
Hey, when I was a kid, did I have a lot of ear infections? I don't know, Peter.
I was your sister, not your mother.
You were a scrawny little thing.
Always coming down with something.
No wonder you got into medicine.
Thanks.
I'll take him up to bed.
- Do the washing up.
- All right.
Dry up too.
Don't leave everything just sitting on the side.
I love you.
Do you love me? Get out of here.
Come on, my baby.
- You live here? - I told you it's in the water.
- Yeah, but I mean, is it sanitary? - Sure.
- What do you do in winter? - In winter I go south.
Like the birds.
- Thank you for the lift.
- Sure.
See you.
Sure.
You scratch the thenar eminence causing ipsilateral contractions of the chin muscles.
Definitely contracting.
- Is that a good thing? - Sadly, no.
It indicates increased intracranial pressure.
Disturbances of the brain.
Which explains why you're working with Romano.