Chicago Med (2015) s06e09 Episode Script
For the Want of a Nail
Dean Archer,
my senior medical officer in the Navy.
Why don't you shadow me to get the lay of the land? It's an ED.
I think I know the lay.
There's one thing I need to be clear about.
In this ED, I'm in charge.
The trial needs a chance to prove the drug can work.
I can help you start sorting through those files.
Thanks, April.
Wouldn't it be great if the boys could grow up together? They want to adopt Auggie.
See how happy he was today? It's okay, baby.
He should be with his brother.
Auggie's gone, huh? Mm-hmm.
Took off with the Carters this morning.
I'm heading over to the Med thrift shop to donate the stuff he left behind.
Must be hard right now.
Mm, he's with his brother.
He's safe, he's happy.
When Ben and I took him in, that's all we wanted for him.
And you'll stay in contact? Yeah, we're talking about heading out to California to see him this summer.
It'll be here before you know it.
Yeah.
- Morning, Dr.
Manning.
- Morning, Dr.
Marcel.
How's your mom recuperating? Any problems with the LVAD? - She's feeling great.
- Good.
She wanted me to express her gratitude.
Oh, well, you know, I hear it's important to impress the mom when squiring the daughter.
Mm.
I so wanna make out with you right now.
Oh.
But not here.
Perhaps some other time, then, my lady.
Mm.
Hey, Will.
Do you have any updates on the clinical trial? I have some free time now.
Well, last few days I've just been combing through data.
Kind of a one-person job.
Maybe I can search the recent patient files? See if any of them are good candidates? Sure.
That'd be great.
Okay.
Ramona Davis, 30 years old, BP 122 over 80, HR 115, sats 100%.
- Ramona, what happened? - My foot it's excruciating.
Mm-hmm.
Dispatch told us she called 911 after shooting herself in the foot with a nail gun.
How'd you get that gash on your head? She was passed out when we found her.
Yeah.
'Cause it hurts like hell.
Okay, well, we're gonna take good care of you and then give you something for the pain.
One, two, three.
All right.
Thanks, guys.
Breath sounds bilaterally.
Ramona, can you move your head up and down, side to side? Good, C-spine's clear.
Let's get a head CT on the books.
Wait a minute.
Where am I? You're at the hospital, Ramona.
You had an accident.
No, no, no, no.
Which which hospital? Chicago Med.
I was supposed to go to East Mercy.
Don't worry.
We're gonna take good care of you here.
Need to get that shoe off to get an X-ray.
No, don't, don't, don't.
Ramona, we're just trying to figure out - the best way to get this - No, I said don't touch it! No doctor at Chicago Med is treating me! - Okay, ma'am, please - No! - All right.
- All right.
I need restraints! It's okay, it's okay.
Settle down.
I was nailing down some lattice.
I I I thought I was aiming the nail gun at the ground.
I shot myself; it was stupid.
Can I go now? Yeah, but you told us that you fell and hit your head? To knock yourself out, you gotta assume that's gonna be a pretty serious bump.
But I'm sure they can figure it out at East Mercy.
So you want to go to East Mercy 'cause you think that you're gonna get better treatment there? Yeah.
They don't tie you to your bed.
Huh.
Well, if you think that you can calm down a little bit, I don't see why we can't take those off.
How does that sound? Okay.
Great Great.
Can you send me to East Mercy now? Ramona, we are required to make sure you're stable before we transfer you.
There's a nail in my foot.
It is not going to kill me.
No, but let us do a CT, okay? Make sure there's no serious injury from your fall.
And then we'll send you on your way.
If that's what it takes, okay, okay.
I'll let radiology know.
But no one touches the nail.
Ah, thank you.
Hey, care for a cup? Poured me an extra one by mistake.
Thanks, but I'm trying to kick caffeine.
Ah.
More for me, then.
- Doing scheduling, huh? - Yeah.
More 12-hour shifts.
I liked to stick to eight-hour shifts back when I was running Milbrook.
Keeps the troops fresh.
Yeah, we tried that.
But I found this is better for patient care.
- Less handovers.
- Mm-hmm.
Well, sure.
As long as you don't burn your team out in the process.
- Well.
- Huh? Specifically if they're not drinking caffeine.
Hey, I've been meaning to ask you.
How you adjusting so far? It's a good fit.
And, uh, you and me? I'm good, I'm good with the chain of command.
Dr.
Choi, I could use another set of eyes.
I just sent you the deets.
Yeah, sure.
We should grab a drink after work, hmm? All right, Cap'n.
Mr.
and Mrs.
Campos? - Hi, I'm Dr.
Choi.
- Ah.
Louisa, please.
And this is Hector.
I hear you're having some trouble breathing.
Patient's reported a fever that spikes up and down erratically.
Sustained period of shortness of breath.
Looks like your ears are swollen.
- Does it hurt when I touch it? - It's pretty itchy, too.
Yeah, okay.
Can you tell me when was the first time you started feeling sick? About three days ago.
He works at a meatpacking plant out in Cicero.
They've had a bunch of COVID outbreaks in the past.
I was worried that there might be another.
I'm just I'm so relieved that that test came out negative.
That's a good start.
We're supposed to see our granddaughter in two weeks.
She's turning one.
We still haven't met her due to social distancing.
Sure.
His lungs sound congested.
- How are his sats? - 89 and trending lower.
All right, let's up him to high-flow cannula.
Okay.
What do you think this might be? Hard to say.
Perhaps some kind of pneumonia.
But let's grab a chest X-ray and a CT to rule out PE.
Also a CBC, BMP, blood and urine cultures as well.
Roger.
We'll figure out what's causing this, okay? - Excuse me.
- Thank you.
And this here is a subdural hematoma with mass effect.
So what? Ramona, you have a bleed in your brain from where you hit your head.
- Not gonna stop on its own.
- It requires a craniotomy.
It's a pretty significant surgery.
We had a deal.
I get the scan that you wanted, you let me go to the hospital of my choice.
If we don't treat this soon, you will die.
So let me go treat it.
Ramona, could you give us a second? Dr.
Halstead? Okay, what is with her and East Mercy? I have no idea, but I think we gotta let her go.
Wait a minute.
What? This bleed in her brain is a ticking time bomb.
Which is why we have to do it right now.
I mean, she's clearly not gonna change her mind, so the sooner we get her over there, the sooner she gets the treatment she needs.
I'll arrange the transfer.
I'll set up the ambo and forward her scans over to East Mercy.
Natalie? Darby.
Hi, I haven't seen you in, like, forever.
Yeah.
It's been over a year now.
Wow.
Our kids go to preschool together.
- Ah.
- How's Owen been doing? He's driving his grandmother crazy.
- How's Sebastian? - Driving me crazy.
I forgot you worked here.
I would've asked to see you.
You're in good hands with Dr.
Archer here.
If you don't mind me asking, what brought you in today? A pain you would not believe.
Like someone stabbing me with a harpoon.
Well, I don't see anything here that's acute, but I would like to send you to get a CT scan if you don't mind.
Should give us a clearer picture.
Sure.
CT away.
Hopefully, we can get the kids together soon.
Yeah, see ya.
Hey, Dean.
About that ultrasound.
Mm-hmm? So I'm not trying to step on any toes, here.
Maybe you didn't want to say anything in front of the patient, but I was seeing some swelling around the gallbladder.
Well, perhaps.
But the bile duct was still normal-size in character, there's no evidence of stones or fluid around the gallbladder, and only a mild amount of thickening.
But the gallbladder wall was inflamed and it's not normal and it could still be causing her symptoms.
Why don't we wait for the CT scan before jumping to any conclusions? Okay? - Um, excuse me.
- Mm-hmm? Where can I put this for donation? Leave it on the counter.
- Okay.
- Thanks.
This baby blanket, how much is it? $5.
Oh.
Too much.
Oh, here, and I'll keep this.
I've changed my mind.
Okay.
Hi, I, uh, couldn't help but overhear over there.
It's big for a baby blanket, but it's teddy bear-soft.
How much is it? I'm on a tight budget.
No, it's a gift.
- You mean it? - Yeah, please.
- Thank you so much.
- My pleasure.
- I'm Maggie, by the way.
- Tionne.
- Is this your first? - Mm-hmm.
You have kids? I Tionne, you're bleeding.
- Oh, my God.
- I got you.
I'm a nurse over at Med around the corner.
Get me an ambulance, please.
I can't afford a fancy hospital like Chicago Med.
It won't be an issue, I promise you.
Just hold on to me, okay? We'll figure it out.
Tionne stopped hemorrhaging once we arrived.
How are you feeling otherwise? Fine.
Till today.
This will pinch.
All right, Tionne.
I wanna give you an exam, but first, I wanna do an ultrasound to see where your placenta is.
Did your doctor tell you your placenta's low? No, I don't got a doctor.
I have no insurance.
All right.
Well, I'm gonna press this down on your belly and take a look, okay? All right.
Now let's look.
Okay.
Well, your placenta is covering your cervix.
Tionne, it's probably what caused the bleeding.
- Is the baby okay? - It appears so, yes.
But I'm gonna take a look inside now and see what's going on, okay? Okay.
Thank you.
Tionne, you're bleeding heavily again.
We need to get you to the operating room.
- The operating room? - Yes.
You need surgery to deliver your baby.
And cut me open? It's what's best for your baby, okay? Tionne, is there anyone that we can call? Someone that should be here with you right now? Um, my mom's taking care of my grandma Downstate.
She can't get here till tomorrow.
Can Maggie come with? So someone's there for the baby while I'm asleep? You're gonna be fine, Tionne.
Okay.
This picture's showing some bilateral infiltrates.
I'm confused.
Does he have pneumonia or not? Certainly not full-blown pneumonia at this point, no.
Did you see the tips of his fingers and toes? How blue they're getting? The scan's showing he has a lot of inflammation in his body.
It could be affecting his circulation.
If I don't make it through this, give my cross to the baby.
Hector, don't talk like that.
Let's up his oxygen, get a mask on him.
Hey, Hector.
If I had to guess, you've got some kind of infection, so we're gonna start you on some broad-spectrum antibiotics, see what effect they have.
And in the meantime, we'll take a closer look at your blood, try to get our arms around what's going on, okay? It's okay.
Something's not adding up, Dr.
Choi.
His symptoms say pneumonia for sure, but he's not producing a steady cough and his white count's totally normal.
And then there's that crazy ear thing? I'm sorry to be a buttinsky, but I love a tricky diagnosis.
- You mind if I take a look? - Sure.
You think maybe it's an HIV-related syndrome? Let's test to definitively rule it out.
Also scan his legs.
See if there's any signs of DVT.
Well, you'd have seen them on the scan if it was a pulmonary embolism, now.
Now, I think young Driskell here is on to something.
His inflammation of the ear cartilage, yeah? Well, Dr.
Choi thinks it's most likely a rash or a reaction to the infection.
Well, or it could be the key to this whole thing.
You know, they say if you hear hoofbeats, think horses.
But if I were you, Dr.
Driskell, I'd be on the lookout for zebras.
Maybe sarcoidosis or peripheral vasculitis? I'm gonna hold off on that, Dean.
Give the antibiotics a chance to take effect.
Occam's razor and all.
I wanna check off all the boxes before we go hunting for zebras.
That's certainly a viable strategy as well.
Dr.
Archer? CT just sent over the scans you requested for Treatment 4.
Ah, thank you, thank you.
And I apologize if I overstepped.
Okay.
Could you hold on, please? Dr.
Charles, wait.
I am on the line with East Mercy.
There's a problem.
I'm not treating her.
Ramona Davis has been trouble for a long time.
- Frequent flier? - Yes.
Every two, three weeks for the past year.
She shows up, insists that only I treat her.
She's obsessed with me.
Last week, she came in.
She claimed she lost feeling in her hands, but it was clear she was making it up.
And was this the first time it seemed like she was faking symptoms? First time I called her on it.
She flipped out, accused me of malpractice, threatened to sue me, the hospital.
It got pretty intense.
You know, that might explain why she showed up with a nail in her foot.
I mean, if she had actually made it over to you today, there's no way you could say she was making that up.
- Excuse me, Dr.
Bridges.
- Look, I've gotta run.
I hope Ramona gets the help she needs, but I can't be the one to give it to her.
Completely get it.
Thank you for your time, Doctor.
I'll cancel the ambo.
So if you're right and she injured herself with the nail, then you can put her on a psych hold.
But even on a hold, she could still refuse surgery.
Yeah, she still has decisional capacity, right? Okay.
But we gotta convince her to stay and have the surgery.
Her life is at stake.
Dean, Darby says you're discharging her? I wrote her a script for extra-strength Pepcid, see how she fares.
You mind if I take a look at the CT? See? Nothing here tells a different story than the ultrasound.
Still seems to me that the gallbladder is infected.
Well, I disagree and I'm just trying to spare the patient an operation.
Well, what if it's an operation that she needs? Maybe a second opinion from a surgeon is warranted? Well, I also happen to be a board-certified surgeon myself, but thanks very much for your input, Dr.
Manning.
Excuse me.
What doctor refuses to treat a patient? My dad is a doctor and he went out of his way to help anyone who needed it no matter what.
You know, I can't speak for your father, but I know plenty of doctors who decide not to engage with patients, you know, for a number of reasons.
Like what? Well, for instance, let's say if the doctor feels that there's a lack of boundaries.
Boundaries between Dr.
Bridges and me? Listen, Dr.
Bridges made it very clear to me it's important to him that you get the medical care that you need.
- He did? - Yeah.
Well, I, um I-I do know that doctors won't operate on their loved ones.
That's right.
It's considered an ethical issue if a doctor is too close to their patient.
Of course.
Dr.
Bridges has feelings for me.
It all makes sense now.
In any case, how about we get you into surgery? - Okay.
- Great.
Is there anybody that you would like me to call, or But could you call Dr.
Bridges and let him know that I'm getting the operation? Be happy to do that for you.
Oh, and how about I tell the surgeons to take that nail out of your foot while they're at it? What do you say? Okay.
Great.
Okay.
I'll be back in a bit.
Ultrasound for Mr.
Campos came up clean.
There's no evidence of DVT.
Dr.
Choi.
My Hector can't breathe! Sats in the 70s.
Heart rate's dropping, too.
BP 97 over 68.
Hector? He's not protecting his airway.
We need to intubate.
20 of etomidate, 100 of sux.
He was all right a minute ago.
Oh, my God! Please don't let him die! Why is this happening? Baby's not coming.
I need to extend my hysterotomy.
When I saw now, Maggie, give me fundal pressure.
Got it.
Now.
Okay.
There we go.
- Suction.
- All righty.
- Okay, buddy.
- I got him.
Here we go.
There.
Heart rate is 140.
Gonna get ready to rotate.
Huh.
- Is that a dimple? - Unfortunately, yes.
So your gallbladder appears to be inflamed.
I suggest we remove it.
Better safe than sorry.
It's a relatively simple procedure.
I'll go in with an itty, bitty, little scope and just slide it right out of there.
You'll barely notice the scars.
- And this pain will go away? - Possibly, if the gallbladder is the issue.
Which I believe it is.
Okay, then.
I'm here already, so Let's do it.
Okay, we'll get you upstairs in a jiff, all right? - Thank you.
- You bet.
Doc.
Have them set up for a laparoscopic cholecystectomy pronto, would you? - Yeah.
- Great.
Boy, boy, boy.
You two must be pretty pleased with yourselves, aren't you? Excuse me? Yeah, the only way a patient can get a second opinion in the ED is to ask for a doctor by name.
So? So Darby's never even been a patient here at Med.
There's no way she'd know who you were, unless somebody slipped her your name.
Dean, I understand you're upset, okay? No one likes to be disagreed with.
You went behind my back.
Regardless of how this played out, Dean, I'm involved now and I happen to agree - with Dr.
Manning's diagnosis.
- Okay.
But you also happen to be in cahoots.
I'm sorry.
Cahoots? You guys are having an intimate relationship, right? Aren't you? We are professional colleagues and that is all that should concern you.
This morning, I saw the way you two were looking at each other.
- Okay, forget that guy.
- Mm-hmm.
- You okay? - Yeah.
All right.
I'm gonna head upstairs.
- You page me if you need me.
- Okay.
Just forwarded you a new patient chart from Sunday.
Stage two heart failure.
Might be a good candidate for the trial.
All right.
Let me take a look.
Sabeena, nice to see you.
I have a meeting upstairs.
Can I borrow you for a moment? Sure.
Be right back.
Good news.
We're closing enrollment on the trial.
Turns out you're such an effective recruiter, we have more than enough data to work with moving forward.
Well, that is good news.
Kender's CEO asked if you golf.
I do not golf, but give me a week and I'll figure it out.
I expect nothing less from you.
This patient I sent you might be perfect.
Virani just told me we're closing admissions.
So you can stop looking for candidates, but refer that one to cardiology.
Thanks anyway.
Bone marrow biopsy came back negative.
We CAT scanned his brain, abdomen, and pelvis.
All totally normal.
No evidence of malignancy.
Maybe we should be looking for autoimmune issues.
Perhaps, but his ANA is normal.
I mean, you can't rule out an autoimmune disorder entirely.
But a tissue biopsy suggests it's not sarcoidosis.
So in other words, we still don't know anything? You might wanna get Infectious Disease on this.
Thanks, Doc.
Uh, Ethan.
If you don't mind, I've been giving your case some thought.
And based on the symptoms that your patient's been exhibiting, I think he may have some rare autoinflammatory syndrome.
It's called VEXAS.
VEXAS? Never heard of that.
It's a genetic mutation.
They've only diagnosed, like, 25 cases.
Symptoms include blood clots, fevers, inflammation of the cartilage, and lung tissue.
It would certainly explain the crazy constellation of symptoms, but I'm still not looking for zebras yet.
I know, I'm sorry for getting in your face over this.
But, uh, I just don't want to be doing to you what was done to me.
What are you talking about? Uh, some doctor sticking his neck in, questioning the care I'm giving.
Who? I was just double doc'd by Manning and Marcel.
They sent my patient up to surgery against my medical advice.
- Okay.
- Yeah.
And they're secretly dating, which, frankly, raises ethical concerns.
I didn't know.
But, um, plenty of doctors have dated in the past.
I admit I have myself.
It's never really been an issue before.
Well, but you can see how it would be, right? Let's say they made a mistake with this patient.
It could make them susceptible to a malpractice suit.
And you've got to believe that the hospital would want cover over something like that.
I hear you, Dean, but honestly, I've got bigger issues to deal with at the moment.
Well, it's your ship.
Here he is.
I'm Dr.
Watkins, Tionne.
Meet your baby boy.
Oh, my God.
- He's so beautiful.
- Yes, he is.
I can't believe he's mine.
When can I take him home? I wanna keep him under observation for a few weeks on account of how early he was.
You should also know that he has a birth defect.
Spina bifida occulta.
What what does that mean? His vertebrae didn't fully form in utero.
There are small gaps in between the bones of his spine.
- Is he going to live? - Oh, yes.
I know it sounds bad, but I've seen many babies born with spina bifida who grow up to be just fine.
How did it happen? It could've been a number of things.
Your genetics, something about the environment you were living in during pregnancy, your nutrition.
Something I ate? Or more like an insufficient amount of folic acid.
That's a nutrient that's found in vitamin B-rich foods.
- How was I supposed to know? - Most women don't.
They find out from their doctor.
I can't believe I hurt my baby.
No.
I promise you, Tionne.
I'm so sorry.
Please forgive me.
- How you feeling? - I'm fine.
I don't see what the big deal was.
Did you talk to Dr.
Bridges? You know, I did.
Um, we were able to have a nice, long talk this time.
And, you know, he told me about your dad.
I was so sorry to hear that he passed away last year.
What did he say about me? Well, really, we mostly talked about your dad, you know, and how rough that must've been on you.
I mean, I know how hard it was on me when my dad died.
Yeah.
Yeah, it was terrible.
He - he was a wonderful man.
- Yeah.
And you know, Dr.
Bridges said that he was actually the one who tried to save him, right? And that's how that's how you met him.
I really don't want to talk about this.
Where is my stuff? I want to call Dr.
Bridges, let him know I'm okay.
I totally get that it makes you uncomfortable to talk about Dr.
Bridges and your dad.
- Really, I - Okay, okay.
I see where you're going with this.
My father and Dr.
Bridges have nothing to do with each other.
Dr.
Bridges cares for me so much so that he wouldn't even treat me.
You said so yourself.
Well, no.
You actually said that.
I just confirmed that it would've been an ethical issue if Dr.
Bridges had feelings for you.
But wait are you saying, Ramona, that you don't feel like your father cared for you? I want to talk to Dr.
Bridges right now.
Ramona, I'm so sorry, but Dr.
Bridges doesn't want to talk to you.
But you said that he wanted me to get the care that I need.
He does because he's your doctor.
But that's all that he is.
Ramona I'm really worried about you and particularly the circumstances surrounding your injuries, right? Which is why I want to hold you here at the hospital for a few days because, well, frankly, I'm concerned that you're a danger to yourself.
My injuries? You've seen the nail in my foot.
You think I put it there on purpose? This is outrageous.
Get me that walker in the corner.
Listen, I can understand why you're upset; really, I can.
But there's something important going on here and we're gonna have to talk about it sooner or later.
- If you won't get it, I will.
- No, Ramona.
Ramona, you need to stay in bed.
Ramona, Ramona I will sue you.
I will sue this hospital.
- Walter, Walter! - No, stop! - Ramona, you need to - No, stop! No! Back in bed.
Soft restraints, please.
Get off! Let go of me! Let go of me! No! You can't do this! No! Let go of me! Stop, please! Two of Ativan.
- Hey, Nat.
- Hey.
So, uh, you and Crockett? - Dean told you.
- Yeah.
All right, look.
He was about to send a patient home with a severely infected gallbladder, okay? We wouldn't have known about it had I not sent Crockett in.
- It was the right thing to do.
- Sure.
But being right about the medicine doesn't excuse the way you went about things.
Fine.
It won't happen again.
And listen.
If you and Crockett are seeing each other outside of work, then you'll need to go to HR and declare that that's the case.
What? Oh, come on.
Did you declare your relationship with April to HR? No, we didn't and we probably should've.
But April and I were never in the position to double doc anybody.
But HR? Really, Ethan? I'm just trying to protect you and the hospital from any legal recourse.
Okay? So please take it seriously.
Oh, my God.
- Thank you.
- Madeline.
Are you here to see Tionne Jefferson? She put in a request with the charge nurse.
Why? Is she giving her baby over to DCFS? Maggie, you know I can't reveal those details.
I'm so annoyed with him right now.
- With Ethan or Archer? - Both, I guess.
But mostly Ethan.
You don't want to go to HR? It's a violation of our privacy, Crockett.
Yeah, okay.
Then forget it.
Well, Ethan's not just gonna let this go.
- So - Right.
Okay.
So we go to HR.
No big deal.
Right? I mean, unless you have reservations.
No.
It's just the whole going public of it all.
You know, I can just hear what people are gonna say.
- It's it's - Oh.
So that's what this is about.
You're worried about what other people think.
I'm no.
But you do have reservations.
Okay.
Your call, Nat.
I'm gonna get out of these scrubs.
Ethan.
I checked in with the lab, saw your patient's bone marrow sample's there for testing, so I asked the tech to go ahead and take a look at the myeloid cells.
See if your patient has VEXAS after all.
- Hector's not your patient.
- Oh.
Well, see, I thought you said that it wasn't such a big deal about Manning and Marcel before, so.
Look, I didn't think it was an issue that they were in a relationship, not that it's okay to start running tests on other doctors' patients.
Ah, well, little hard knowing which rules to follow when some of them aren't enforced.
You're being disingenuous.
You're right.
Anyway, I'm just letting you know you might hear something about this VEXAS.
Dr.
Charles.
There you are.
I was just on my way to see you.
Ramona, shouldn't you shouldn't you be in bed? I slipped my restraints.
I really needed to talk to you.
I have a confession to make.
Okay.
You were right.
I did shoot myself with a nail gun to see Dr.
Bridges.
Uh-huh.
And there's something wrong with me.
I know that now.
Well, you know, sometimes, um, being honest with yourself, that can be very freeing.
It's just a lot, you know? To lose your dad.
And it's so helpful to find people who know what that feels like.
Right.
Like Dr.
Bridges.
No.
No, I was talking about you.
I am so lucky to have met you.
You don't need to be nervous around me.
I am very comfortable around you.
And I'm pretty sure that you're going to be the best doctor I've ever had.
Miss Davis.
- There you are.
- Hi, Miss Davis.
You gave us quite a scare.
Let's go back upstairs.
Yeah.
Really good idea for you to get some rest now.
Okay, Ramona? Um, I will, um, I will make sure that I look in on you tomorrow, okay? Good night.
Goodbye, Dr.
Charles.
I really can't wait.
Okay.
There.
I saw that DCFS was here.
You're thinking about giving your baby up for adoption? I don't deserve him.
Tionne, there's no evidence that you're responsible for your baby's birth defect.
But I could've been.
I made so many mistakes in my life.
What if I mess up again? What if I can't take care of him right? You can.
You're not alone.
You got family.
And there's support groups for new moms in your situation.
I can put you in touch.
I've been planning.
I can get him what he needs.
But maybe what he really needs is a better mother.
I gave my baby up for adoption.
I was 16.
Seemed like the right thing to do at the time.
But there was this voice in the back of my head that That told me not to do it.
And I ignored it.
And that voice, now, is all that I hear.
You love that little boy.
I can see it.
And I think that's all that matters.
All I'm saying is that make sure that whatever decision you make You don't end up living a life of regret.
Hey, Dean.
You were right.
Genetic sequencing found that mutation.
It's VEXAS.
Hot damn.
I've already started treatment.
Just amazing catch, man.
Thanks.
Thank you.
And, um, again, sorry for overstepping.
- No, no need.
- Okay.
All right.
Maggie.
I heard you came back today.
- Is everything okay? - It is now.
I'm thinking about reconnecting with my daughter.
Wow.
Is that even a possibility? Mm-hmm.
There's a program affiliated with DCFS that helps birth parents track down the children they put up for adoption.
Spoke to Madeline Gastern and it may take a while, but I might be able to make it happen.
Sharon? Well, that's a big move to make.
Are you sure about this? There's a wound in my heart that won't heal and Auggie leaving has only made it worse.
- I have to do something.
- I understand.
But it's been over 20 years.
That child is a grown woman now.
All the more reason to do it.
She and I can finally have all of our questions answered.
But have you considered maybe she hasn't been asking those questions? Look, I'm not saying don't do it.
Just be prepared, Maggie.
She may not want to reconnect.
- Crockett.
- Yeah? - Hey.
- Hey.
- You headed home? - Yep.
Here.
"Consensual Relationship Declaration"? What, are you gonna start a bonfire or something? Look everything I said earlier was coming from a place of fear.
Okay? I don't have reservations about us.
And the last thing I wanna do is break things off, so Mm.
You wanna know how I feel? Of course.
You got a pen? Yes.
- Can you turn around? - Okay.
You are too much.
You know people are gonna talk.
So let 'em.
Why don't you shadow me to get the lay of the land? It's an ED.
I think I know the lay.
There's one thing I need to be clear about.
In this ED, I'm in charge.
The trial needs a chance to prove the drug can work.
I can help you start sorting through those files.
Thanks, April.
Wouldn't it be great if the boys could grow up together? They want to adopt Auggie.
See how happy he was today? It's okay, baby.
He should be with his brother.
Auggie's gone, huh? Mm-hmm.
Took off with the Carters this morning.
I'm heading over to the Med thrift shop to donate the stuff he left behind.
Must be hard right now.
Mm, he's with his brother.
He's safe, he's happy.
When Ben and I took him in, that's all we wanted for him.
And you'll stay in contact? Yeah, we're talking about heading out to California to see him this summer.
It'll be here before you know it.
Yeah.
- Morning, Dr.
Manning.
- Morning, Dr.
Marcel.
How's your mom recuperating? Any problems with the LVAD? - She's feeling great.
- Good.
She wanted me to express her gratitude.
Oh, well, you know, I hear it's important to impress the mom when squiring the daughter.
Mm.
I so wanna make out with you right now.
Oh.
But not here.
Perhaps some other time, then, my lady.
Mm.
Hey, Will.
Do you have any updates on the clinical trial? I have some free time now.
Well, last few days I've just been combing through data.
Kind of a one-person job.
Maybe I can search the recent patient files? See if any of them are good candidates? Sure.
That'd be great.
Okay.
Ramona Davis, 30 years old, BP 122 over 80, HR 115, sats 100%.
- Ramona, what happened? - My foot it's excruciating.
Mm-hmm.
Dispatch told us she called 911 after shooting herself in the foot with a nail gun.
How'd you get that gash on your head? She was passed out when we found her.
Yeah.
'Cause it hurts like hell.
Okay, well, we're gonna take good care of you and then give you something for the pain.
One, two, three.
All right.
Thanks, guys.
Breath sounds bilaterally.
Ramona, can you move your head up and down, side to side? Good, C-spine's clear.
Let's get a head CT on the books.
Wait a minute.
Where am I? You're at the hospital, Ramona.
You had an accident.
No, no, no, no.
Which which hospital? Chicago Med.
I was supposed to go to East Mercy.
Don't worry.
We're gonna take good care of you here.
Need to get that shoe off to get an X-ray.
No, don't, don't, don't.
Ramona, we're just trying to figure out - the best way to get this - No, I said don't touch it! No doctor at Chicago Med is treating me! - Okay, ma'am, please - No! - All right.
- All right.
I need restraints! It's okay, it's okay.
Settle down.
I was nailing down some lattice.
I I I thought I was aiming the nail gun at the ground.
I shot myself; it was stupid.
Can I go now? Yeah, but you told us that you fell and hit your head? To knock yourself out, you gotta assume that's gonna be a pretty serious bump.
But I'm sure they can figure it out at East Mercy.
So you want to go to East Mercy 'cause you think that you're gonna get better treatment there? Yeah.
They don't tie you to your bed.
Huh.
Well, if you think that you can calm down a little bit, I don't see why we can't take those off.
How does that sound? Okay.
Great Great.
Can you send me to East Mercy now? Ramona, we are required to make sure you're stable before we transfer you.
There's a nail in my foot.
It is not going to kill me.
No, but let us do a CT, okay? Make sure there's no serious injury from your fall.
And then we'll send you on your way.
If that's what it takes, okay, okay.
I'll let radiology know.
But no one touches the nail.
Ah, thank you.
Hey, care for a cup? Poured me an extra one by mistake.
Thanks, but I'm trying to kick caffeine.
Ah.
More for me, then.
- Doing scheduling, huh? - Yeah.
More 12-hour shifts.
I liked to stick to eight-hour shifts back when I was running Milbrook.
Keeps the troops fresh.
Yeah, we tried that.
But I found this is better for patient care.
- Less handovers.
- Mm-hmm.
Well, sure.
As long as you don't burn your team out in the process.
- Well.
- Huh? Specifically if they're not drinking caffeine.
Hey, I've been meaning to ask you.
How you adjusting so far? It's a good fit.
And, uh, you and me? I'm good, I'm good with the chain of command.
Dr.
Choi, I could use another set of eyes.
I just sent you the deets.
Yeah, sure.
We should grab a drink after work, hmm? All right, Cap'n.
Mr.
and Mrs.
Campos? - Hi, I'm Dr.
Choi.
- Ah.
Louisa, please.
And this is Hector.
I hear you're having some trouble breathing.
Patient's reported a fever that spikes up and down erratically.
Sustained period of shortness of breath.
Looks like your ears are swollen.
- Does it hurt when I touch it? - It's pretty itchy, too.
Yeah, okay.
Can you tell me when was the first time you started feeling sick? About three days ago.
He works at a meatpacking plant out in Cicero.
They've had a bunch of COVID outbreaks in the past.
I was worried that there might be another.
I'm just I'm so relieved that that test came out negative.
That's a good start.
We're supposed to see our granddaughter in two weeks.
She's turning one.
We still haven't met her due to social distancing.
Sure.
His lungs sound congested.
- How are his sats? - 89 and trending lower.
All right, let's up him to high-flow cannula.
Okay.
What do you think this might be? Hard to say.
Perhaps some kind of pneumonia.
But let's grab a chest X-ray and a CT to rule out PE.
Also a CBC, BMP, blood and urine cultures as well.
Roger.
We'll figure out what's causing this, okay? - Excuse me.
- Thank you.
And this here is a subdural hematoma with mass effect.
So what? Ramona, you have a bleed in your brain from where you hit your head.
- Not gonna stop on its own.
- It requires a craniotomy.
It's a pretty significant surgery.
We had a deal.
I get the scan that you wanted, you let me go to the hospital of my choice.
If we don't treat this soon, you will die.
So let me go treat it.
Ramona, could you give us a second? Dr.
Halstead? Okay, what is with her and East Mercy? I have no idea, but I think we gotta let her go.
Wait a minute.
What? This bleed in her brain is a ticking time bomb.
Which is why we have to do it right now.
I mean, she's clearly not gonna change her mind, so the sooner we get her over there, the sooner she gets the treatment she needs.
I'll arrange the transfer.
I'll set up the ambo and forward her scans over to East Mercy.
Natalie? Darby.
Hi, I haven't seen you in, like, forever.
Yeah.
It's been over a year now.
Wow.
Our kids go to preschool together.
- Ah.
- How's Owen been doing? He's driving his grandmother crazy.
- How's Sebastian? - Driving me crazy.
I forgot you worked here.
I would've asked to see you.
You're in good hands with Dr.
Archer here.
If you don't mind me asking, what brought you in today? A pain you would not believe.
Like someone stabbing me with a harpoon.
Well, I don't see anything here that's acute, but I would like to send you to get a CT scan if you don't mind.
Should give us a clearer picture.
Sure.
CT away.
Hopefully, we can get the kids together soon.
Yeah, see ya.
Hey, Dean.
About that ultrasound.
Mm-hmm? So I'm not trying to step on any toes, here.
Maybe you didn't want to say anything in front of the patient, but I was seeing some swelling around the gallbladder.
Well, perhaps.
But the bile duct was still normal-size in character, there's no evidence of stones or fluid around the gallbladder, and only a mild amount of thickening.
But the gallbladder wall was inflamed and it's not normal and it could still be causing her symptoms.
Why don't we wait for the CT scan before jumping to any conclusions? Okay? - Um, excuse me.
- Mm-hmm? Where can I put this for donation? Leave it on the counter.
- Okay.
- Thanks.
This baby blanket, how much is it? $5.
Oh.
Too much.
Oh, here, and I'll keep this.
I've changed my mind.
Okay.
Hi, I, uh, couldn't help but overhear over there.
It's big for a baby blanket, but it's teddy bear-soft.
How much is it? I'm on a tight budget.
No, it's a gift.
- You mean it? - Yeah, please.
- Thank you so much.
- My pleasure.
- I'm Maggie, by the way.
- Tionne.
- Is this your first? - Mm-hmm.
You have kids? I Tionne, you're bleeding.
- Oh, my God.
- I got you.
I'm a nurse over at Med around the corner.
Get me an ambulance, please.
I can't afford a fancy hospital like Chicago Med.
It won't be an issue, I promise you.
Just hold on to me, okay? We'll figure it out.
Tionne stopped hemorrhaging once we arrived.
How are you feeling otherwise? Fine.
Till today.
This will pinch.
All right, Tionne.
I wanna give you an exam, but first, I wanna do an ultrasound to see where your placenta is.
Did your doctor tell you your placenta's low? No, I don't got a doctor.
I have no insurance.
All right.
Well, I'm gonna press this down on your belly and take a look, okay? All right.
Now let's look.
Okay.
Well, your placenta is covering your cervix.
Tionne, it's probably what caused the bleeding.
- Is the baby okay? - It appears so, yes.
But I'm gonna take a look inside now and see what's going on, okay? Okay.
Thank you.
Tionne, you're bleeding heavily again.
We need to get you to the operating room.
- The operating room? - Yes.
You need surgery to deliver your baby.
And cut me open? It's what's best for your baby, okay? Tionne, is there anyone that we can call? Someone that should be here with you right now? Um, my mom's taking care of my grandma Downstate.
She can't get here till tomorrow.
Can Maggie come with? So someone's there for the baby while I'm asleep? You're gonna be fine, Tionne.
Okay.
This picture's showing some bilateral infiltrates.
I'm confused.
Does he have pneumonia or not? Certainly not full-blown pneumonia at this point, no.
Did you see the tips of his fingers and toes? How blue they're getting? The scan's showing he has a lot of inflammation in his body.
It could be affecting his circulation.
If I don't make it through this, give my cross to the baby.
Hector, don't talk like that.
Let's up his oxygen, get a mask on him.
Hey, Hector.
If I had to guess, you've got some kind of infection, so we're gonna start you on some broad-spectrum antibiotics, see what effect they have.
And in the meantime, we'll take a closer look at your blood, try to get our arms around what's going on, okay? It's okay.
Something's not adding up, Dr.
Choi.
His symptoms say pneumonia for sure, but he's not producing a steady cough and his white count's totally normal.
And then there's that crazy ear thing? I'm sorry to be a buttinsky, but I love a tricky diagnosis.
- You mind if I take a look? - Sure.
You think maybe it's an HIV-related syndrome? Let's test to definitively rule it out.
Also scan his legs.
See if there's any signs of DVT.
Well, you'd have seen them on the scan if it was a pulmonary embolism, now.
Now, I think young Driskell here is on to something.
His inflammation of the ear cartilage, yeah? Well, Dr.
Choi thinks it's most likely a rash or a reaction to the infection.
Well, or it could be the key to this whole thing.
You know, they say if you hear hoofbeats, think horses.
But if I were you, Dr.
Driskell, I'd be on the lookout for zebras.
Maybe sarcoidosis or peripheral vasculitis? I'm gonna hold off on that, Dean.
Give the antibiotics a chance to take effect.
Occam's razor and all.
I wanna check off all the boxes before we go hunting for zebras.
That's certainly a viable strategy as well.
Dr.
Archer? CT just sent over the scans you requested for Treatment 4.
Ah, thank you, thank you.
And I apologize if I overstepped.
Okay.
Could you hold on, please? Dr.
Charles, wait.
I am on the line with East Mercy.
There's a problem.
I'm not treating her.
Ramona Davis has been trouble for a long time.
- Frequent flier? - Yes.
Every two, three weeks for the past year.
She shows up, insists that only I treat her.
She's obsessed with me.
Last week, she came in.
She claimed she lost feeling in her hands, but it was clear she was making it up.
And was this the first time it seemed like she was faking symptoms? First time I called her on it.
She flipped out, accused me of malpractice, threatened to sue me, the hospital.
It got pretty intense.
You know, that might explain why she showed up with a nail in her foot.
I mean, if she had actually made it over to you today, there's no way you could say she was making that up.
- Excuse me, Dr.
Bridges.
- Look, I've gotta run.
I hope Ramona gets the help she needs, but I can't be the one to give it to her.
Completely get it.
Thank you for your time, Doctor.
I'll cancel the ambo.
So if you're right and she injured herself with the nail, then you can put her on a psych hold.
But even on a hold, she could still refuse surgery.
Yeah, she still has decisional capacity, right? Okay.
But we gotta convince her to stay and have the surgery.
Her life is at stake.
Dean, Darby says you're discharging her? I wrote her a script for extra-strength Pepcid, see how she fares.
You mind if I take a look at the CT? See? Nothing here tells a different story than the ultrasound.
Still seems to me that the gallbladder is infected.
Well, I disagree and I'm just trying to spare the patient an operation.
Well, what if it's an operation that she needs? Maybe a second opinion from a surgeon is warranted? Well, I also happen to be a board-certified surgeon myself, but thanks very much for your input, Dr.
Manning.
Excuse me.
What doctor refuses to treat a patient? My dad is a doctor and he went out of his way to help anyone who needed it no matter what.
You know, I can't speak for your father, but I know plenty of doctors who decide not to engage with patients, you know, for a number of reasons.
Like what? Well, for instance, let's say if the doctor feels that there's a lack of boundaries.
Boundaries between Dr.
Bridges and me? Listen, Dr.
Bridges made it very clear to me it's important to him that you get the medical care that you need.
- He did? - Yeah.
Well, I, um I-I do know that doctors won't operate on their loved ones.
That's right.
It's considered an ethical issue if a doctor is too close to their patient.
Of course.
Dr.
Bridges has feelings for me.
It all makes sense now.
In any case, how about we get you into surgery? - Okay.
- Great.
Is there anybody that you would like me to call, or But could you call Dr.
Bridges and let him know that I'm getting the operation? Be happy to do that for you.
Oh, and how about I tell the surgeons to take that nail out of your foot while they're at it? What do you say? Okay.
Great.
Okay.
I'll be back in a bit.
Ultrasound for Mr.
Campos came up clean.
There's no evidence of DVT.
Dr.
Choi.
My Hector can't breathe! Sats in the 70s.
Heart rate's dropping, too.
BP 97 over 68.
Hector? He's not protecting his airway.
We need to intubate.
20 of etomidate, 100 of sux.
He was all right a minute ago.
Oh, my God! Please don't let him die! Why is this happening? Baby's not coming.
I need to extend my hysterotomy.
When I saw now, Maggie, give me fundal pressure.
Got it.
Now.
Okay.
There we go.
- Suction.
- All righty.
- Okay, buddy.
- I got him.
Here we go.
There.
Heart rate is 140.
Gonna get ready to rotate.
Huh.
- Is that a dimple? - Unfortunately, yes.
So your gallbladder appears to be inflamed.
I suggest we remove it.
Better safe than sorry.
It's a relatively simple procedure.
I'll go in with an itty, bitty, little scope and just slide it right out of there.
You'll barely notice the scars.
- And this pain will go away? - Possibly, if the gallbladder is the issue.
Which I believe it is.
Okay, then.
I'm here already, so Let's do it.
Okay, we'll get you upstairs in a jiff, all right? - Thank you.
- You bet.
Doc.
Have them set up for a laparoscopic cholecystectomy pronto, would you? - Yeah.
- Great.
Boy, boy, boy.
You two must be pretty pleased with yourselves, aren't you? Excuse me? Yeah, the only way a patient can get a second opinion in the ED is to ask for a doctor by name.
So? So Darby's never even been a patient here at Med.
There's no way she'd know who you were, unless somebody slipped her your name.
Dean, I understand you're upset, okay? No one likes to be disagreed with.
You went behind my back.
Regardless of how this played out, Dean, I'm involved now and I happen to agree - with Dr.
Manning's diagnosis.
- Okay.
But you also happen to be in cahoots.
I'm sorry.
Cahoots? You guys are having an intimate relationship, right? Aren't you? We are professional colleagues and that is all that should concern you.
This morning, I saw the way you two were looking at each other.
- Okay, forget that guy.
- Mm-hmm.
- You okay? - Yeah.
All right.
I'm gonna head upstairs.
- You page me if you need me.
- Okay.
Just forwarded you a new patient chart from Sunday.
Stage two heart failure.
Might be a good candidate for the trial.
All right.
Let me take a look.
Sabeena, nice to see you.
I have a meeting upstairs.
Can I borrow you for a moment? Sure.
Be right back.
Good news.
We're closing enrollment on the trial.
Turns out you're such an effective recruiter, we have more than enough data to work with moving forward.
Well, that is good news.
Kender's CEO asked if you golf.
I do not golf, but give me a week and I'll figure it out.
I expect nothing less from you.
This patient I sent you might be perfect.
Virani just told me we're closing admissions.
So you can stop looking for candidates, but refer that one to cardiology.
Thanks anyway.
Bone marrow biopsy came back negative.
We CAT scanned his brain, abdomen, and pelvis.
All totally normal.
No evidence of malignancy.
Maybe we should be looking for autoimmune issues.
Perhaps, but his ANA is normal.
I mean, you can't rule out an autoimmune disorder entirely.
But a tissue biopsy suggests it's not sarcoidosis.
So in other words, we still don't know anything? You might wanna get Infectious Disease on this.
Thanks, Doc.
Uh, Ethan.
If you don't mind, I've been giving your case some thought.
And based on the symptoms that your patient's been exhibiting, I think he may have some rare autoinflammatory syndrome.
It's called VEXAS.
VEXAS? Never heard of that.
It's a genetic mutation.
They've only diagnosed, like, 25 cases.
Symptoms include blood clots, fevers, inflammation of the cartilage, and lung tissue.
It would certainly explain the crazy constellation of symptoms, but I'm still not looking for zebras yet.
I know, I'm sorry for getting in your face over this.
But, uh, I just don't want to be doing to you what was done to me.
What are you talking about? Uh, some doctor sticking his neck in, questioning the care I'm giving.
Who? I was just double doc'd by Manning and Marcel.
They sent my patient up to surgery against my medical advice.
- Okay.
- Yeah.
And they're secretly dating, which, frankly, raises ethical concerns.
I didn't know.
But, um, plenty of doctors have dated in the past.
I admit I have myself.
It's never really been an issue before.
Well, but you can see how it would be, right? Let's say they made a mistake with this patient.
It could make them susceptible to a malpractice suit.
And you've got to believe that the hospital would want cover over something like that.
I hear you, Dean, but honestly, I've got bigger issues to deal with at the moment.
Well, it's your ship.
Here he is.
I'm Dr.
Watkins, Tionne.
Meet your baby boy.
Oh, my God.
- He's so beautiful.
- Yes, he is.
I can't believe he's mine.
When can I take him home? I wanna keep him under observation for a few weeks on account of how early he was.
You should also know that he has a birth defect.
Spina bifida occulta.
What what does that mean? His vertebrae didn't fully form in utero.
There are small gaps in between the bones of his spine.
- Is he going to live? - Oh, yes.
I know it sounds bad, but I've seen many babies born with spina bifida who grow up to be just fine.
How did it happen? It could've been a number of things.
Your genetics, something about the environment you were living in during pregnancy, your nutrition.
Something I ate? Or more like an insufficient amount of folic acid.
That's a nutrient that's found in vitamin B-rich foods.
- How was I supposed to know? - Most women don't.
They find out from their doctor.
I can't believe I hurt my baby.
No.
I promise you, Tionne.
I'm so sorry.
Please forgive me.
- How you feeling? - I'm fine.
I don't see what the big deal was.
Did you talk to Dr.
Bridges? You know, I did.
Um, we were able to have a nice, long talk this time.
And, you know, he told me about your dad.
I was so sorry to hear that he passed away last year.
What did he say about me? Well, really, we mostly talked about your dad, you know, and how rough that must've been on you.
I mean, I know how hard it was on me when my dad died.
Yeah.
Yeah, it was terrible.
He - he was a wonderful man.
- Yeah.
And you know, Dr.
Bridges said that he was actually the one who tried to save him, right? And that's how that's how you met him.
I really don't want to talk about this.
Where is my stuff? I want to call Dr.
Bridges, let him know I'm okay.
I totally get that it makes you uncomfortable to talk about Dr.
Bridges and your dad.
- Really, I - Okay, okay.
I see where you're going with this.
My father and Dr.
Bridges have nothing to do with each other.
Dr.
Bridges cares for me so much so that he wouldn't even treat me.
You said so yourself.
Well, no.
You actually said that.
I just confirmed that it would've been an ethical issue if Dr.
Bridges had feelings for you.
But wait are you saying, Ramona, that you don't feel like your father cared for you? I want to talk to Dr.
Bridges right now.
Ramona, I'm so sorry, but Dr.
Bridges doesn't want to talk to you.
But you said that he wanted me to get the care that I need.
He does because he's your doctor.
But that's all that he is.
Ramona I'm really worried about you and particularly the circumstances surrounding your injuries, right? Which is why I want to hold you here at the hospital for a few days because, well, frankly, I'm concerned that you're a danger to yourself.
My injuries? You've seen the nail in my foot.
You think I put it there on purpose? This is outrageous.
Get me that walker in the corner.
Listen, I can understand why you're upset; really, I can.
But there's something important going on here and we're gonna have to talk about it sooner or later.
- If you won't get it, I will.
- No, Ramona.
Ramona, you need to stay in bed.
Ramona, Ramona I will sue you.
I will sue this hospital.
- Walter, Walter! - No, stop! - Ramona, you need to - No, stop! No! Back in bed.
Soft restraints, please.
Get off! Let go of me! Let go of me! No! You can't do this! No! Let go of me! Stop, please! Two of Ativan.
- Hey, Nat.
- Hey.
So, uh, you and Crockett? - Dean told you.
- Yeah.
All right, look.
He was about to send a patient home with a severely infected gallbladder, okay? We wouldn't have known about it had I not sent Crockett in.
- It was the right thing to do.
- Sure.
But being right about the medicine doesn't excuse the way you went about things.
Fine.
It won't happen again.
And listen.
If you and Crockett are seeing each other outside of work, then you'll need to go to HR and declare that that's the case.
What? Oh, come on.
Did you declare your relationship with April to HR? No, we didn't and we probably should've.
But April and I were never in the position to double doc anybody.
But HR? Really, Ethan? I'm just trying to protect you and the hospital from any legal recourse.
Okay? So please take it seriously.
Oh, my God.
- Thank you.
- Madeline.
Are you here to see Tionne Jefferson? She put in a request with the charge nurse.
Why? Is she giving her baby over to DCFS? Maggie, you know I can't reveal those details.
I'm so annoyed with him right now.
- With Ethan or Archer? - Both, I guess.
But mostly Ethan.
You don't want to go to HR? It's a violation of our privacy, Crockett.
Yeah, okay.
Then forget it.
Well, Ethan's not just gonna let this go.
- So - Right.
Okay.
So we go to HR.
No big deal.
Right? I mean, unless you have reservations.
No.
It's just the whole going public of it all.
You know, I can just hear what people are gonna say.
- It's it's - Oh.
So that's what this is about.
You're worried about what other people think.
I'm no.
But you do have reservations.
Okay.
Your call, Nat.
I'm gonna get out of these scrubs.
Ethan.
I checked in with the lab, saw your patient's bone marrow sample's there for testing, so I asked the tech to go ahead and take a look at the myeloid cells.
See if your patient has VEXAS after all.
- Hector's not your patient.
- Oh.
Well, see, I thought you said that it wasn't such a big deal about Manning and Marcel before, so.
Look, I didn't think it was an issue that they were in a relationship, not that it's okay to start running tests on other doctors' patients.
Ah, well, little hard knowing which rules to follow when some of them aren't enforced.
You're being disingenuous.
You're right.
Anyway, I'm just letting you know you might hear something about this VEXAS.
Dr.
Charles.
There you are.
I was just on my way to see you.
Ramona, shouldn't you shouldn't you be in bed? I slipped my restraints.
I really needed to talk to you.
I have a confession to make.
Okay.
You were right.
I did shoot myself with a nail gun to see Dr.
Bridges.
Uh-huh.
And there's something wrong with me.
I know that now.
Well, you know, sometimes, um, being honest with yourself, that can be very freeing.
It's just a lot, you know? To lose your dad.
And it's so helpful to find people who know what that feels like.
Right.
Like Dr.
Bridges.
No.
No, I was talking about you.
I am so lucky to have met you.
You don't need to be nervous around me.
I am very comfortable around you.
And I'm pretty sure that you're going to be the best doctor I've ever had.
Miss Davis.
- There you are.
- Hi, Miss Davis.
You gave us quite a scare.
Let's go back upstairs.
Yeah.
Really good idea for you to get some rest now.
Okay, Ramona? Um, I will, um, I will make sure that I look in on you tomorrow, okay? Good night.
Goodbye, Dr.
Charles.
I really can't wait.
Okay.
There.
I saw that DCFS was here.
You're thinking about giving your baby up for adoption? I don't deserve him.
Tionne, there's no evidence that you're responsible for your baby's birth defect.
But I could've been.
I made so many mistakes in my life.
What if I mess up again? What if I can't take care of him right? You can.
You're not alone.
You got family.
And there's support groups for new moms in your situation.
I can put you in touch.
I've been planning.
I can get him what he needs.
But maybe what he really needs is a better mother.
I gave my baby up for adoption.
I was 16.
Seemed like the right thing to do at the time.
But there was this voice in the back of my head that That told me not to do it.
And I ignored it.
And that voice, now, is all that I hear.
You love that little boy.
I can see it.
And I think that's all that matters.
All I'm saying is that make sure that whatever decision you make You don't end up living a life of regret.
Hey, Dean.
You were right.
Genetic sequencing found that mutation.
It's VEXAS.
Hot damn.
I've already started treatment.
Just amazing catch, man.
Thanks.
Thank you.
And, um, again, sorry for overstepping.
- No, no need.
- Okay.
All right.
Maggie.
I heard you came back today.
- Is everything okay? - It is now.
I'm thinking about reconnecting with my daughter.
Wow.
Is that even a possibility? Mm-hmm.
There's a program affiliated with DCFS that helps birth parents track down the children they put up for adoption.
Spoke to Madeline Gastern and it may take a while, but I might be able to make it happen.
Sharon? Well, that's a big move to make.
Are you sure about this? There's a wound in my heart that won't heal and Auggie leaving has only made it worse.
- I have to do something.
- I understand.
But it's been over 20 years.
That child is a grown woman now.
All the more reason to do it.
She and I can finally have all of our questions answered.
But have you considered maybe she hasn't been asking those questions? Look, I'm not saying don't do it.
Just be prepared, Maggie.
She may not want to reconnect.
- Crockett.
- Yeah? - Hey.
- Hey.
- You headed home? - Yep.
Here.
"Consensual Relationship Declaration"? What, are you gonna start a bonfire or something? Look everything I said earlier was coming from a place of fear.
Okay? I don't have reservations about us.
And the last thing I wanna do is break things off, so Mm.
You wanna know how I feel? Of course.
You got a pen? Yes.
- Can you turn around? - Okay.
You are too much.
You know people are gonna talk.
So let 'em.