ER s06e13 Episode Script
Be Still My Heart
E.
R.
E.
R.
6x13 "BE STILL MY HEART" Dad, what are you doing? Going through your mother's record collection.
The one from San Diego with that old turntable, now you can throw it out? She did go through some strange musical phases.
Bless her heart.
The dance phase.
Cha-cha-cha! Tango.
And the lounge lizard phase, Tom Jones.
I like a good show tune myself.
Remember "Oklahoma! "? "Oklahoma! "? How could I not? You played it for me when I was a kid.
Then you won't mind one more.
As long as it means no more "cha-cha-cha.
" - I gotta shave.
- Go ahead.
Don't want to be late.
I thought surgeons were supposed to have horrible hours.
Up very early.
We do.
I was up very late.
- I see your father's been here.
- What? Crown Essential Bouquet.
Over a year ago.
I don't think I've even used it.
Well, I must be off.
- What time is your angioplasty? - What? You mentioned a laser angioplasty.
I thought I would observe.
- Why would you want to do that? - Well, my work with lasers is so - Esoteric? - Romantic.
Wandering through the atmosphere, watching the stars twinkle.
I thought I'd come and see the practical approach.
I don't think it's even allowed.
I'm sure as associate chief of surgery you could make arrangements.
Anyway, I'll call and check.
Perhaps I'll just drop by.
Wait! Mother, I don't think that's such a good idea! I wanted to get by a pharmacy to pick up some refills on those prescriptions.
I'm not gonna give you any scripts.
I need the Combivent and the Vanceril.
I still got the Theo-Dur.
You have emphysema.
- I haven't needed O-2 for two months.
- You haven't seen the doctor in six.
- You need to see a pulmonologist.
- Damn doctors.
Ask a million questions when all you need is the medicine.
It's not good medicine- For one family member to look after another.
Why have a son for a doctor when he can't give a prescription? - It's not that I can't.
- No, no.
It's just that you won't.
- Give these charts to Dr.
Weaver.
- She's off today.
Hold this.
- What's this? - Hearts.
Valentine's Day.
You give people flowers, cards, tell them how much you love them.
- Happy Valentine's Day! - Thank you.
That is so sweet.
Don't they have Valentine's Day in Croatia? Yes, we do.
We even have these little hearts.
"Be mine.
" - Don't eat them.
- "Dear one.
" - I gotta get to Radiology.
- "Cut-tie pie.
" - That's "cutie pie.
" - Oh, thank you.
I'm Abby Lockheart.
We'll help you.
Could you find that young doctor? He took care of my husband after the fire.
- What was his name? - Dr.
Malucci? - No.
- Carter? - Yes, that's it.
- We'll find him for you.
- Do you have a cough, Mrs.
Connelly? - No.
- Pulse is thready.
- Any pain in your belly? - No.
- Any aching? I'm 81 years old, dear.
I ache all over.
One, two, three.
- There you go.
- Any pain when you urinate? - I seem to go all the time.
- We'll run some tests.
- BP's 80/50.
- I'll find Dr.
Carter.
- Thank you.
- It's probably urosepsis.
Start her on a liter of saline, send her to CBC, a chem panel blood cultures and a urine culture.
What about antibiotics? Confirm the diagnosis.
I'll see what Carter wants to start her on.
Mark! Hi.
We have to stop meeting like this.
Tell me we're going out to dinner alone.
Valentine's Day? I wouldn't miss it.
Fun morning with your mother? She's threatening to visit me at work.
- I'll finally get to meet her.
- Don't hold your breath.
This is the woman who didn't even phone me when she got into town.
Remind me again why you invited her to stay with you.
Don't go there or I'll throw you into the snow.
Could you remind me again? - I can't believe- You! - You asked for it! You asked for it! Paul Sobriki? Watch out! - Truce.
- You promise? - I promise.
- You promise? - I promise.
- Scout's honor? Scout's honor.
I'm done.
- Promise? - Yeah.
Yeah.
- Just the snowballs, I guess, huh? - Sorry.
So you've got a bad headache? - Have you had them before? - I took aspirin.
- Where is the pain? - It's around my right eye.
- Are you nauseated? - Yeah.
Does light bother your eyes? Why don't we find a room and get you checked out? Did you hit your head? Let him answer.
- He's my patient.
- You weren't around.
- I'm here now, okay? - This collar's pretty tight.
Good morning, one and all.
Who's running this? - Dr.
Chen, give me the bullet.
- George Hudson, 55, rear-ended- Complains of mild headache.
- Mr.
Hudson, I'm Dr.
Greene.
- Actually, it's Dr.
Hudson.
Did anybody ask Dr.
Hudson what his specialty is? Family medicine.
I'm from Philadelphia.
I'm here a couple days taking a CME course.
I've landed myself some eager Residents.
- You have.
- They ask the right questions.
- I'm glad.
- They don't wait to hear the answers.
- My apologies.
- Let them continue.
- You don't mind? - No, it's kind of amusing.
I was a house officer once myself.
Continue your evaluation.
I'll be back to go over your workup.
- Scream if you need me.
- June Connelly? You saw her husband a few months ago.
- I saw hundreds of patients since then.
- Do you have a minute? - I'm going to see a patient.
- This won't take long.
I'll be there.
I have a 23-year-old student with right periorbital headache associated with nausea.
No fever, no history of migraines.
This one is classic.
I'm thinking six of Imitrex, sub-q? - Sounds good.
- You won't examine him? I trust you.
Let me know how he does.
- Is that a little more comfortable? - Yes, thank you.
- Mrs.
Connelly.
- Yes.
Here you are.
- You probably don't remember me.
- Yes, I do.
How are you feeling? Well, not too bad.
They're taking very good care of me.
I'm sure.
You're in very good hands.
Pressure's up to 85, systolic.
Dipped 4-plus positive for nitrates and leukocytes.
- Which antibiotic do you want? - Amp and gent.
Try 500 milligrams of Levaquin, IV piggyback.
It's once-a-day dosing, a little less nephrotoxic.
Could I talk to you for a second? - Mrs.
Connelly? - Yes.
- I'll see you later, okay? - Yes.
Thank you.
- You're very welcome.
- Bye.
- Pressure's low.
- She has bacteria in her bloodstream.
We need to get her pressure up using fluids and inotropic support.
Are you sure she wants all that? We should do everything we can.
We'll do what she wants.
That may not include machines and tubes.
In OB, doing everything was pretty much automatic.
This isn't OB.
Talk to her.
- Following Lucy's patient? - She presented it.
If you're gonna supervise, do it more closely.
- What's going on? - I was coming to get you.
- Name? - Paul Sobriki.
How are you feeling? My wife doesn't like the diner either, and I - He suddenly started babbling.
- He's puking.
- He's altered.
Why didn't you get me? - I was on my way.
You can meet me there.
Don't tell them.
It could be encephalitis or meningitis.
You should've told me this.
He seemed fine.
And I was coming to get you.
Give him two of Ativan, IV push.
Check his calcium thyroid panel and tox screen.
I'll get an LP kit.
- What have we got? - Insulinoma.
Gretel had seizures.
Gretel? The patient? The workup was negative, except for low blood glucose.
Which suggested an insulin-producing adenoma.
CT showed a nodule in the pancreas.
I hope it's not malignant.
That's very caring of you.
I am capable of that on occasion.
This is one of them.
I want to see her- - I haven't even- - You can finish up later.
She's ready for you, Dr.
Romano.
There, Gretel.
There, there.
There, there.
Good girl.
- Robert, this is a dog.
- Correction.
This is my dog.
Ativan put him right out.
- Draw the lidocaine.
- One and four for cell count.
Protein and glucose in 2, and Gram's stain and culture in 3.
You got it.
- Change over to a 27-gauge needle.
- I always do.
- Very good.
- Okay.
I'm ready.
- Hold him! - What do I do? - Hold him! - Stop! Paul, relax! It's okay! Just calm down! Calm down! What's in my back? Give him two of Ativan.
Lucy, keep going.
We'll get blood in the spinal fluid.
It's not gonna get any easier.
I feel some resistance.
- Just keep advancing.
- I'm not getting any fluid.
- Do you feel a pop? - No.
Keep going.
- I can't.
- Yes, you can.
Stop, please.
- You're hurting me.
Stop.
- Check the stylet.
- All right.
We got it.
- Great.
Paul, just relax.
Just relax.
Just relax.
Hey, crystal clear.
Good job.
I have my breeds mixed up.
I thought they were wiry little runts, like that Australian silky thing.
No, the Bouvier is robust, squarely built, well-muscled.
A hearty dog, you could say, Dr.
Romano.
- Except for the pancreas.
- Lizzie, Alex, how's Gretel's BP? I don't know.
We don't have a dog cuff.
Then start an arterial line and hook her to a monitor.
- An arterial line? - Pretend you're in dog lab.
- That's what I'm doing.
- Lizzie! It's not proper to be operating on your dog.
I'm chief of staff.
Is that proper enough? Would you have me leave her to some poodle surgeon? Curved Crile to clamp off that bleeder.
Dr.
Hudson has oat cell carcinoma.
We asked him about previous hospitalizations.
Had chemotherapy, now in remission.
Now presents with a mediastinal mass, which is why he's flushed.
- Superior Vena Cava Syndrome.
- The prognosis- Which is why we should blast him with radiation to shrink the tumor.
Recent literature shows chemotherapy can reduce the tumor in two days.
We should treat him with platinum and VP-16.
Which does Dr.
Hudson want? Did you even ask him? I was about to, when Malucci- Stop it, both of you.
I'll check in on another patient.
Then I'll see Dr.
Hudson.
- I'll present him with his options.
- What will we do? You are going to watch me and say nothing.
- How are you feeling? - Pretty darn good here.
- Pressure's 100/70.
- The fluids are making you feel better.
Oh, no.
I think it's this young man here who is making me feel better.
He gave me a Valentine's Day card.
That's very thoughtful of Yosh.
Could we get you anything? - I am a little thirsty.
- Okay.
- I'll get some ice chips.
- Thanks.
I'm a bit chilly.
Maybe you could help me get my sweater.
- Sure.
- Yes.
It's down there.
I didn't expect a card this year.
- With Barry gone.
- I'm sorry about your husband.
He was awfully sweet about these little celebrations and anniversaries and things.
He always remembered.
Some of my lady friends had to remind their husbands.
I had to remind mine he was married.
- That's not good.
- No.
It definitely wasn't.
Well did you see this pin? Barry gave that to me last year.
I didn't bother to tell him that he had given me the exact same pin the year before.
That was very kind of you.
- It's lovely, isn't it? - Yes, it is.
Yes.
"Be still my heart.
" That's what Barry would say.
And I I still am.
I tried calling your wife again.
I got the machine.
Yeah.
When she goes shopping with her friends I think she's getting me something for Valentine's Day.
Your spinal tap was negative.
- You stuck me for nothing? - We had to rule out meningitis.
Sure.
Okay.
Yeah.
I have to go back to the diner.
- What diner? - Where I study.
My books are there.
- Do other students study there? - Sometimes.
Usually they go to the library.
We had those muggings.
- I read about that.
- It could happen again.
Someone tried to mug you? Could've.
It's a long way from where I park, and there are lot of bushes.
- I'd like to go soon.
- We have to do a CAT scan of your head.
That's an x-ray, right? Isn't that bad? - They shoot radiation through you- - It's not enough to do any harm.
- CT's ready.
- Thanks.
We'll be right there.
I did a hernia on a gorilla once.
Med school.
- Dear God! - Gretel's brother had a hernia.
Let me guess.
Hansel? I'm sure you find it amusing that I'd care so much about a dog.
There's so much about you that we don't know, Robert.
What's going on? She's tachycardic.
- It's a seizure.
- We've lost her IV.
- It's making her hypoglycemic.
- I can't get the line in.
Get me an amp of 50% glucose! Get out of the way! ET tube's come out.
She's hypoxic.
- Tube her again! - She's in V-fib.
Get me the paddles.
- Stand back.
- Hold on.
I said, stand back.
Clear! Superior Vena Cava Syndrome.
That gives me what? A year? Radiation therapy is the standard of care.
No.
Chemotherapy is an option.
It could take two days to resolve your symptoms.
I'm worried the headache could indicate elevated intracranial pressure.
I think it's more likely a product of listening to your Residents argue.
That was a joke.
We can begin the radiation therapy right away.
I had a patient who went with radiation and developed a terrible esophagitis.
Pain, bleeding, couldn't eat for two months.
If I've only got a year, I at least want to be able to eat.
I'll go with the chemotherapy, Dr.
Greene.
He told the waitress at the diner he was coming here.
- Is that where you study? - We meet at the library.
- But the last couple months - Did something happen? He's gotten so weird.
He's wearing the same clothes.
What about his grades? We went to college together.
He did well.
But he's been cutting classes.
- You socialize with him and his wife? - Not much anymore.
He keeps picking fights with me about nothing.
Keeps accusing me of stealing his parking place.
Stupid stuff like that.
- Is it something serious? - We don't know enough yet.
- Should I go in? - Let him sleep.
You can see him later.
What is it? Pressure's down to 75.
I paged Dr.
Carter.
Mrs.
Connelly? Mrs.
Connelly? What do you want to do? Abby, what do you want to do? - Carter? - Not now.
Paul Sobriki- It might be psychiatric.
Not now, okay? - What happened? - Her pressure's 75, systolic.
She's on dopamine, - She's still not making urine.
- She didn't want any heroic measures.
- I had to get her pressure up.
- Dopamine's a resuscitation drug.
She said no tubes or machines.
Dopamine's okay.
- What if it's not enough? - We give more fluids.
You'll put her into congestive heart failure, flood her lungs.
Then what? Will you intubate? - Will you? - I'll stop the fluids if I have to.
She'll have to be admitted to the ICU.
Pressure's 90 on 10 mics of dopamine.
She's making some urine.
Good, good, good.
- It's working.
- Yeah, maybe.
I don't know what you want! Don't follow me anymore! - What's going on? - Paul's going off.
- He's trying to mess with me! - Is this your patient? - He's Lucy's patient.
- You're supervisor.
- He followed me down here.
- I was concerned.
- Why's he up? - I don't know.
- I wanted a drink of water.
- Okay.
Dr.
Greene! Dr.
Hudson's going south.
I'll take care of this.
Get Paul settled back into his bed.
- I don't want him to come! - He's not coming.
- You all right? - Yeah.
I got to get back.
You'll tell that other doctor? - Yeah, sure.
- Dr.
Hudson? He's altered.
Unarousable.
Elevated ICP.
Get a Radiation Oncology fellow down here right away.
- I'll call them.
- He wanted chemotherapy.
He won't make it to chemo.
- We need to intubate.
- I'll do it! Why don't I do it? - Feeling better? - I'm kind of tired.
- Lucy? - I'll be right back.
What's with your patient? Dr.
Greene pulled him out of a fight with his friend.
- Abby's looking for you.
- He might be schizophrenic.
- He meets the DSM-IV criteria.
- Did you page a psych consult? I was waiting to present him to you.
Get them down here, hand this guy off.
Patients are waiting.
It's so hard to breathe.
How's she doing? Pressure's down, 85/55 on maximum dopamine.
She's got rales all the way up to the apices.
- Pulmonary edema from all the fluid.
- She was hypotensive.
Still is.
Her BP's too low for nitroglycerine or morphine.
You could try 40 of Lasix.
Pulse ox is down, 79 on 100% oxygen.
- I'm going to intubate.
- No.
She has an infection we can treat.
She only needs to be intubated for a day until it clears up.
You don't know that.
She has multiple organ failure.
You may never be able to extubate.
Then what? She spends two months hooked up to every machine known to man? I know.
I just want to make sure that I- It's not about what you want.
What happened when she stopped breathing? It's called Cheyne-Stokes respiration.
It's associated with heart failure.
- You change your shirt? - Yeah.
I saw four 6-year-olds.
I think they ate too many of those little hearts you warned me about.
- All over me.
- Welcome to the ER Valentine's Day.
Multiple trauma coming in.
Five minutes out.
- Prep the Trauma Room.
- Meet you there.
Watch out for the rebound phenomenon with the glucose.
- We'll monitor her closely.
- Does Gretel have insurance? We've had enough jokes for one day.
I wasn't joking.
Certain vets offer- My God! Elizabeth.
There you are.
I've visited every department looking for you.
Good heavens! Mother, this is Dr.
Robert Romano.
This is my mother, Isabelle Corday.
She's visiting from London briefly.
Lizzie never mentioned a thing.
Pleasure.
Likewise.
This, I take it, is not the laser angioplasty.
This is Gretel, who's been suffering from an insulinoma.
Thanks to a brilliant assist, she'll be fine.
Yes.
I know how hard Elizabeth trained.
- We should- - How are you enjoying Chicago? I'm here for a series of lectures.
Adaptive Optics, Wave-Particle Duality.
I don't know why you'd want to tax your mind with that.
- We have a wonderful city.
- I'm giving the lectures.
I should get Gretel settled in Recovery.
It was nice meeting you.
And you.
- Please don't ask about the dog.
- Was it an Old English? Bouvier.
I'm being paged to the ER.
- I don't think I've seen that yet.
- Good.
Good.
- Did I hear multiple trauma? - Mom, Dad and two kids.
Help me.
front-seat passenger.
Ejected 20 feet from the vehicle.
Pulseless.
Two liters of saline en route.
Robby, 11, rear-seat passenger.
Left wrist pain.
Alert and oriented.
No LOC.
BP is 110/68, pulse, 110.
And we've got Julia, 5.
Also rear-seat passenger.
No head trauma.
No LOC.
Multiple facial abrasions.
BP is 104/60.
Pulse is 96.
- What was your name, sweetie? - Julia.
Where's Mommy? Come on, baby.
- What is it? - Multiple trauma.
- This is my mother.
- How are you? - You better stay here.
- Of course.
- Aren't they bringing my dad? - They are.
- Where did they take Mommy? - They're helping her.
Let's go help you.
All right, let's go! On my count.
One, two, three.
Driver needed extrication.
- The husband? - I think so.
- Hold compressions.
- Heart rate, 40.
No pulse.
She's in P.
E.
A.
Pulse ox, 82.
She's dusky.
Set up for bilateral chest tubes.
- Is your wrist sore? - A little.
- Can you tell me what happened? - A car hit us.
It was going fast.
Robby, let's make sure you're okay.
Come back.
I was sitting behind Mommy.
I hit my face on a broken window.
We'll clean those scrapes.
- Hit your head or pass out? - No.
- What about you, Julia? - Can I go see my mom? Restrained driver with significant passenger-space intrusion.
The fire department had to extricate him.
Lost his pulse.
No time to tube him.
Broke the steering wheel with his chest.
Anything? Tension pneumo on the left.
Get a needle.
- Betadine.
- I'll intubate.
- Sit down so I can examine you.
- No, thank you.
It's probably just a sprain.
- How about you? Is this sore? - Aren't they gonna let us see Dad? They'll let us know, honey.
I'll clean up these abrasions with saline.
Get a left-wrist film for Robby and keep it in a splint.
Order a right-knee film for Julia.
My knee's okay.
I want to go see my mom.
-1200 cc's out the chest tube.
- Run in 2 units of O-neg.
- Pulse ox, 73.
- What's on the monitor? - V-fib.
- Charge to 200.
Stand by with epi.
- And clear.
- Clear.
- Charge to 300.
- What's your plan? Two chest tubes and a pericardiocentesis.
Good rush of air.
Hold on compressions.
Got a pulse.
Let's try for a pressure.
Chest-tube tray.
Let's prep the left side.
Let's move.
- Systolic's 60.
- That's a start.
Keep the O-neg coming.
Get 4 units type-specific.
Ten blade.
- Call for a vent.
-32 French.
- How are they doing? - It doesn't look so good.
Just keep your elbow at a right angle like this.
Thanks.
- It hurts? - A little.
- Hook him up now! - Peter.
Come on, let's move! Let's start him on 100%.
AC of 14, 800 tidal volume.
- He's bleeding out! - We lost the pulse! Start compressions again! Where are you going? We gotta fix you up.
Why don't you come back with me? -60 cc's out.
- Another liter out the chest.
- You want to keep autotransfusing? - No.
Hold compressions.
Asystole.
That's it.
Time of death, 15:35.
Please be sure she's cleaned up.
How's he doing? - Bleeding out through his chest.
- The wife's dead.
- Should we prep for a thoracotomy? - It's a full arrest from blunt trauma.
- Isn't there something else we can try? - He probably tore his aorta.
We can't save him.
You can stop compressions.
Asystole.
Time of death, 15:37.
- What shall we do about the children? - I'll tell them.
I'll go with you.
Can you make sure? Both their parents are dead.
Oh, God! - What are we gonna do? - We need to let them know.
That asthma boy, his sats are dropping and he's starting to have retractions.
- Thanks, Lydia.
- It's okay.
- Robby and Julia.
- Thanks.
Hello, Robby.
Julia.
- I'm Dr.
Kovac.
This is Nurse Hathaway.
- I'll wait outside.
No, please stay.
We need to talk to you about your mom and dad.
The accident was pretty bad.
- The car was going really fast.
- Yeah.
We and the other doctors worked really hard to help your parents but their injuries were very, very serious.
And despite everything we tried to do, we were not able to save them.
And they died.
But I know they'd be so relieved to know that you' re both okay.
I want to see them.
Okay.
I'll tell you what to expect when we go in the room.
To help them breathe, we put a tube in the mouth.
That will still be in there.
You will see other tubes under the collarbone and in the arm that we used to give them medicine.
And they had a lot of scrapes and bruises from the accident.
That's okay.
It's all right.
It's all right.
It's all right.
Mom.
- You're early.
- Didn't want to miss the party.
- ER.
- You missed the decorating.
Luck of the schedule.
- She's answering the phones.
- Dr.
Hudson's making movements.
- That's good.
- Chen and Malucci are with him.
Doing nothing, I hope.
- He's starting to make- - Purposeful movements.
Could you take a deep breath in and then exhale? Dr.
Malucci? Good NIF and tidal volume.
Okay.
Dr.
Hudson, we can extubate you if you're ready.
All right.
Take another deep breath in.
And exhale.
Very good.
- What happened? - Dr.
Chen? - You had papilledema.
- We did radiation.
They'll take you upstairs and take it from there.
I guess I owe you my thanks for going against my wishes.
It did set a bad example for my Residents.
But you're welcome.
Radiation was the right call after all.
Chemo would've worked if he hadn't had increased ICP.
Do you know why I only had one child? I didn't want to listen to them arguing in the car.
You don't know what she looks like, but have you seen my mother? I do know what she looks like.
I met her.
She's delightful.
We're going out to dinner tonight.
- We? - You, me, your mother and my father.
- How did that happen? - I'm not sure.
She has a certain way about her.
I'm going to pick up my dad.
She's at Doc Magoo's having a coffee.
Mother! - I thought I'd lost you.
- No.
By now I know this place like the back of my hand.
I met your Mark.
Yeah.
So I understand.
And? He has a way about him, doesn't he? Arranging this dinner tonight.
He seems to want me to meet his father.
- Don't be silly.
- That's all right.
I don't mind.
By the way, Elizabeth, I had no idea.
- About what? - About what you do.
I had no idea.
- This coffee's weak.
- You can have some more after dinner.
I'm sure by then I'll be on to the gin.
- What are you doing in here? - I wanted coffee.
- That nurse wasn't around.
- Let's get back.
- You're having a party here? - Yes.
Let's go.
- Shouldn't it be bigger? - Shouldn't it be red? Come on, Dad.
They are waiting.
- I don't like being set up.
- You're not being set up.
- It's freezing.
- I imagine this was Elizabeth's idea.
- Not that I don't like her.
- It's just dinner.
This is not my first barbecue.
Your mother hasn't been gone but for five months.
Okay, fine.
You stay here.
I'm going in.
She's a Brit too, huh? Yeah, Dad, she's British.
We should've had them over to our house, played Tom Jones.
Would you rather just go home? Lucy.
I'll be right back.
- What happened to Psych? - They're backed up.
Pick up some other patients.
Have you sutured the leg lac yet? - I'm on my way.
- Let Malik stay with this guy.
Just forget it, Carter! - My father thinks this was your idea.
- Mom thinks it was yours.
She was straddling the patient, pumping on his chest.
That's nothing.
Mark saved this chopper pilot in San Diego.
Kid had a tension pneumatic something.
Shoved a tube in the side of his chest.
Elizabeth put a tube down a man's throat.
That's more difficult than putting it into his chest.
- How's it going? - We're talking about many pilots.
- She was saving a family.
- You're getting on well? - Absolutely.
- Couldn't be better.
- What the hell? - It's a place where people sing along.
You mean, like a karaoke thing? Well, not really.
It's too bad they couldn't get someone good.
She is doing well.
She's already chasing rabbits in her sleep.
Yeah, yeah.
Does everyone think I'm completely nuts? Of course not.
Only those of us who were in the surgery.
I live alone.
When I come home, it's just Gretel.
Right? If you showed the same compassion for people that you show for.
Never mind.
She's NPO.
No food until she's passed gas.
- Give me a break.
She's a dog.
- Has she passed gas? Dr.
Romano, the biscuit.
- Thank you.
- You're welcome.
He has a really lovely voice.
Can you sing, Mark? Nope.
It's rather brave.
When I was a kid, he used to do this to embarrass me.
Parents don't try to embarrass their children.
It's too easy to do it by accident.
He is pretty fearless.
She's not in any pain.
I know.
And I know you were right.
She was right.
- Let me know if you need anything.
- Thanks.
Asystole.
Time of death, 19: 19.
Be still my heart.
I can't believe your mother knows all the words.
We watched this movie 100 times when I was a girl.
- You liked it that much? - No.
She saw it as an object lesson.
That women shouldn't define themselves through men.
Sorry? Well, Gigi was in love with Gaston.
But Gaston only wanted her to be his courtesan.
She agreed, and her great aunt and her grandmother gave her lessons.
Then Gigi was unhappy.
So she told Gaston- Please stop, okay? I can't handle this evening getting any more bizarre.
All right, then.
There's warmer places to be alone.
The furnace room in the basement and the incubators up in the NICU.
I'd like to see you in an incubator.
I'm happy to try.
Well You know, all those years as an OB nurse 98% of what you see is just pure joy.
It's the happiest day of most people's lives.
And the tragedy is horrible.
Because it's a life cut short.
A mom, a baby Sure.
Today was the first day I saw an old person die.
I'm not used to it.
You want the good news or the bad? Give me the bad.
You never get used to it.
The good news is, you never get used to it.
At least I haven't.
So you may have come up here to be alone, but you're not.
You think they started the party without us? I certainly hope not.
Heads will roll.
So this is your Valentine's Day party? Don't ask me.
It's my first one.
- We have a bigger knife in the lounge.
- Couldn't find it.
A lot more fun than OB.
We really like to party down here in the ER.
Lucy didn't suture that leg lac? He's been here for four hours.
- Where is she? - Waiting on a psych consult.
Her patient in Curtain 3.
- I wasn't sure you'd make it.
- Who can resist blue cake? Yuck! - The patients don't mind this music? - What? Somebody! Lucy.
R.
E.
R.
6x13 "BE STILL MY HEART" Dad, what are you doing? Going through your mother's record collection.
The one from San Diego with that old turntable, now you can throw it out? She did go through some strange musical phases.
Bless her heart.
The dance phase.
Cha-cha-cha! Tango.
And the lounge lizard phase, Tom Jones.
I like a good show tune myself.
Remember "Oklahoma! "? "Oklahoma! "? How could I not? You played it for me when I was a kid.
Then you won't mind one more.
As long as it means no more "cha-cha-cha.
" - I gotta shave.
- Go ahead.
Don't want to be late.
I thought surgeons were supposed to have horrible hours.
Up very early.
We do.
I was up very late.
- I see your father's been here.
- What? Crown Essential Bouquet.
Over a year ago.
I don't think I've even used it.
Well, I must be off.
- What time is your angioplasty? - What? You mentioned a laser angioplasty.
I thought I would observe.
- Why would you want to do that? - Well, my work with lasers is so - Esoteric? - Romantic.
Wandering through the atmosphere, watching the stars twinkle.
I thought I'd come and see the practical approach.
I don't think it's even allowed.
I'm sure as associate chief of surgery you could make arrangements.
Anyway, I'll call and check.
Perhaps I'll just drop by.
Wait! Mother, I don't think that's such a good idea! I wanted to get by a pharmacy to pick up some refills on those prescriptions.
I'm not gonna give you any scripts.
I need the Combivent and the Vanceril.
I still got the Theo-Dur.
You have emphysema.
- I haven't needed O-2 for two months.
- You haven't seen the doctor in six.
- You need to see a pulmonologist.
- Damn doctors.
Ask a million questions when all you need is the medicine.
It's not good medicine- For one family member to look after another.
Why have a son for a doctor when he can't give a prescription? - It's not that I can't.
- No, no.
It's just that you won't.
- Give these charts to Dr.
Weaver.
- She's off today.
Hold this.
- What's this? - Hearts.
Valentine's Day.
You give people flowers, cards, tell them how much you love them.
- Happy Valentine's Day! - Thank you.
That is so sweet.
Don't they have Valentine's Day in Croatia? Yes, we do.
We even have these little hearts.
"Be mine.
" - Don't eat them.
- "Dear one.
" - I gotta get to Radiology.
- "Cut-tie pie.
" - That's "cutie pie.
" - Oh, thank you.
I'm Abby Lockheart.
We'll help you.
Could you find that young doctor? He took care of my husband after the fire.
- What was his name? - Dr.
Malucci? - No.
- Carter? - Yes, that's it.
- We'll find him for you.
- Do you have a cough, Mrs.
Connelly? - No.
- Pulse is thready.
- Any pain in your belly? - No.
- Any aching? I'm 81 years old, dear.
I ache all over.
One, two, three.
- There you go.
- Any pain when you urinate? - I seem to go all the time.
- We'll run some tests.
- BP's 80/50.
- I'll find Dr.
Carter.
- Thank you.
- It's probably urosepsis.
Start her on a liter of saline, send her to CBC, a chem panel blood cultures and a urine culture.
What about antibiotics? Confirm the diagnosis.
I'll see what Carter wants to start her on.
Mark! Hi.
We have to stop meeting like this.
Tell me we're going out to dinner alone.
Valentine's Day? I wouldn't miss it.
Fun morning with your mother? She's threatening to visit me at work.
- I'll finally get to meet her.
- Don't hold your breath.
This is the woman who didn't even phone me when she got into town.
Remind me again why you invited her to stay with you.
Don't go there or I'll throw you into the snow.
Could you remind me again? - I can't believe- You! - You asked for it! You asked for it! Paul Sobriki? Watch out! - Truce.
- You promise? - I promise.
- You promise? - I promise.
- Scout's honor? Scout's honor.
I'm done.
- Promise? - Yeah.
Yeah.
- Just the snowballs, I guess, huh? - Sorry.
So you've got a bad headache? - Have you had them before? - I took aspirin.
- Where is the pain? - It's around my right eye.
- Are you nauseated? - Yeah.
Does light bother your eyes? Why don't we find a room and get you checked out? Did you hit your head? Let him answer.
- He's my patient.
- You weren't around.
- I'm here now, okay? - This collar's pretty tight.
Good morning, one and all.
Who's running this? - Dr.
Chen, give me the bullet.
- George Hudson, 55, rear-ended- Complains of mild headache.
- Mr.
Hudson, I'm Dr.
Greene.
- Actually, it's Dr.
Hudson.
Did anybody ask Dr.
Hudson what his specialty is? Family medicine.
I'm from Philadelphia.
I'm here a couple days taking a CME course.
I've landed myself some eager Residents.
- You have.
- They ask the right questions.
- I'm glad.
- They don't wait to hear the answers.
- My apologies.
- Let them continue.
- You don't mind? - No, it's kind of amusing.
I was a house officer once myself.
Continue your evaluation.
I'll be back to go over your workup.
- Scream if you need me.
- June Connelly? You saw her husband a few months ago.
- I saw hundreds of patients since then.
- Do you have a minute? - I'm going to see a patient.
- This won't take long.
I'll be there.
I have a 23-year-old student with right periorbital headache associated with nausea.
No fever, no history of migraines.
This one is classic.
I'm thinking six of Imitrex, sub-q? - Sounds good.
- You won't examine him? I trust you.
Let me know how he does.
- Is that a little more comfortable? - Yes, thank you.
- Mrs.
Connelly.
- Yes.
Here you are.
- You probably don't remember me.
- Yes, I do.
How are you feeling? Well, not too bad.
They're taking very good care of me.
I'm sure.
You're in very good hands.
Pressure's up to 85, systolic.
Dipped 4-plus positive for nitrates and leukocytes.
- Which antibiotic do you want? - Amp and gent.
Try 500 milligrams of Levaquin, IV piggyback.
It's once-a-day dosing, a little less nephrotoxic.
Could I talk to you for a second? - Mrs.
Connelly? - Yes.
- I'll see you later, okay? - Yes.
Thank you.
- You're very welcome.
- Bye.
- Pressure's low.
- She has bacteria in her bloodstream.
We need to get her pressure up using fluids and inotropic support.
Are you sure she wants all that? We should do everything we can.
We'll do what she wants.
That may not include machines and tubes.
In OB, doing everything was pretty much automatic.
This isn't OB.
Talk to her.
- Following Lucy's patient? - She presented it.
If you're gonna supervise, do it more closely.
- What's going on? - I was coming to get you.
- Name? - Paul Sobriki.
How are you feeling? My wife doesn't like the diner either, and I - He suddenly started babbling.
- He's puking.
- He's altered.
Why didn't you get me? - I was on my way.
You can meet me there.
Don't tell them.
It could be encephalitis or meningitis.
You should've told me this.
He seemed fine.
And I was coming to get you.
Give him two of Ativan, IV push.
Check his calcium thyroid panel and tox screen.
I'll get an LP kit.
- What have we got? - Insulinoma.
Gretel had seizures.
Gretel? The patient? The workup was negative, except for low blood glucose.
Which suggested an insulin-producing adenoma.
CT showed a nodule in the pancreas.
I hope it's not malignant.
That's very caring of you.
I am capable of that on occasion.
This is one of them.
I want to see her- - I haven't even- - You can finish up later.
She's ready for you, Dr.
Romano.
There, Gretel.
There, there.
There, there.
Good girl.
- Robert, this is a dog.
- Correction.
This is my dog.
Ativan put him right out.
- Draw the lidocaine.
- One and four for cell count.
Protein and glucose in 2, and Gram's stain and culture in 3.
You got it.
- Change over to a 27-gauge needle.
- I always do.
- Very good.
- Okay.
I'm ready.
- Hold him! - What do I do? - Hold him! - Stop! Paul, relax! It's okay! Just calm down! Calm down! What's in my back? Give him two of Ativan.
Lucy, keep going.
We'll get blood in the spinal fluid.
It's not gonna get any easier.
I feel some resistance.
- Just keep advancing.
- I'm not getting any fluid.
- Do you feel a pop? - No.
Keep going.
- I can't.
- Yes, you can.
Stop, please.
- You're hurting me.
Stop.
- Check the stylet.
- All right.
We got it.
- Great.
Paul, just relax.
Just relax.
Just relax.
Hey, crystal clear.
Good job.
I have my breeds mixed up.
I thought they were wiry little runts, like that Australian silky thing.
No, the Bouvier is robust, squarely built, well-muscled.
A hearty dog, you could say, Dr.
Romano.
- Except for the pancreas.
- Lizzie, Alex, how's Gretel's BP? I don't know.
We don't have a dog cuff.
Then start an arterial line and hook her to a monitor.
- An arterial line? - Pretend you're in dog lab.
- That's what I'm doing.
- Lizzie! It's not proper to be operating on your dog.
I'm chief of staff.
Is that proper enough? Would you have me leave her to some poodle surgeon? Curved Crile to clamp off that bleeder.
Dr.
Hudson has oat cell carcinoma.
We asked him about previous hospitalizations.
Had chemotherapy, now in remission.
Now presents with a mediastinal mass, which is why he's flushed.
- Superior Vena Cava Syndrome.
- The prognosis- Which is why we should blast him with radiation to shrink the tumor.
Recent literature shows chemotherapy can reduce the tumor in two days.
We should treat him with platinum and VP-16.
Which does Dr.
Hudson want? Did you even ask him? I was about to, when Malucci- Stop it, both of you.
I'll check in on another patient.
Then I'll see Dr.
Hudson.
- I'll present him with his options.
- What will we do? You are going to watch me and say nothing.
- How are you feeling? - Pretty darn good here.
- Pressure's 100/70.
- The fluids are making you feel better.
Oh, no.
I think it's this young man here who is making me feel better.
He gave me a Valentine's Day card.
That's very thoughtful of Yosh.
Could we get you anything? - I am a little thirsty.
- Okay.
- I'll get some ice chips.
- Thanks.
I'm a bit chilly.
Maybe you could help me get my sweater.
- Sure.
- Yes.
It's down there.
I didn't expect a card this year.
- With Barry gone.
- I'm sorry about your husband.
He was awfully sweet about these little celebrations and anniversaries and things.
He always remembered.
Some of my lady friends had to remind their husbands.
I had to remind mine he was married.
- That's not good.
- No.
It definitely wasn't.
Well did you see this pin? Barry gave that to me last year.
I didn't bother to tell him that he had given me the exact same pin the year before.
That was very kind of you.
- It's lovely, isn't it? - Yes, it is.
Yes.
"Be still my heart.
" That's what Barry would say.
And I I still am.
I tried calling your wife again.
I got the machine.
Yeah.
When she goes shopping with her friends I think she's getting me something for Valentine's Day.
Your spinal tap was negative.
- You stuck me for nothing? - We had to rule out meningitis.
Sure.
Okay.
Yeah.
I have to go back to the diner.
- What diner? - Where I study.
My books are there.
- Do other students study there? - Sometimes.
Usually they go to the library.
We had those muggings.
- I read about that.
- It could happen again.
Someone tried to mug you? Could've.
It's a long way from where I park, and there are lot of bushes.
- I'd like to go soon.
- We have to do a CAT scan of your head.
That's an x-ray, right? Isn't that bad? - They shoot radiation through you- - It's not enough to do any harm.
- CT's ready.
- Thanks.
We'll be right there.
I did a hernia on a gorilla once.
Med school.
- Dear God! - Gretel's brother had a hernia.
Let me guess.
Hansel? I'm sure you find it amusing that I'd care so much about a dog.
There's so much about you that we don't know, Robert.
What's going on? She's tachycardic.
- It's a seizure.
- We've lost her IV.
- It's making her hypoglycemic.
- I can't get the line in.
Get me an amp of 50% glucose! Get out of the way! ET tube's come out.
She's hypoxic.
- Tube her again! - She's in V-fib.
Get me the paddles.
- Stand back.
- Hold on.
I said, stand back.
Clear! Superior Vena Cava Syndrome.
That gives me what? A year? Radiation therapy is the standard of care.
No.
Chemotherapy is an option.
It could take two days to resolve your symptoms.
I'm worried the headache could indicate elevated intracranial pressure.
I think it's more likely a product of listening to your Residents argue.
That was a joke.
We can begin the radiation therapy right away.
I had a patient who went with radiation and developed a terrible esophagitis.
Pain, bleeding, couldn't eat for two months.
If I've only got a year, I at least want to be able to eat.
I'll go with the chemotherapy, Dr.
Greene.
He told the waitress at the diner he was coming here.
- Is that where you study? - We meet at the library.
- But the last couple months - Did something happen? He's gotten so weird.
He's wearing the same clothes.
What about his grades? We went to college together.
He did well.
But he's been cutting classes.
- You socialize with him and his wife? - Not much anymore.
He keeps picking fights with me about nothing.
Keeps accusing me of stealing his parking place.
Stupid stuff like that.
- Is it something serious? - We don't know enough yet.
- Should I go in? - Let him sleep.
You can see him later.
What is it? Pressure's down to 75.
I paged Dr.
Carter.
Mrs.
Connelly? Mrs.
Connelly? What do you want to do? Abby, what do you want to do? - Carter? - Not now.
Paul Sobriki- It might be psychiatric.
Not now, okay? - What happened? - Her pressure's 75, systolic.
She's on dopamine, - She's still not making urine.
- She didn't want any heroic measures.
- I had to get her pressure up.
- Dopamine's a resuscitation drug.
She said no tubes or machines.
Dopamine's okay.
- What if it's not enough? - We give more fluids.
You'll put her into congestive heart failure, flood her lungs.
Then what? Will you intubate? - Will you? - I'll stop the fluids if I have to.
She'll have to be admitted to the ICU.
Pressure's 90 on 10 mics of dopamine.
She's making some urine.
Good, good, good.
- It's working.
- Yeah, maybe.
I don't know what you want! Don't follow me anymore! - What's going on? - Paul's going off.
- He's trying to mess with me! - Is this your patient? - He's Lucy's patient.
- You're supervisor.
- He followed me down here.
- I was concerned.
- Why's he up? - I don't know.
- I wanted a drink of water.
- Okay.
Dr.
Greene! Dr.
Hudson's going south.
I'll take care of this.
Get Paul settled back into his bed.
- I don't want him to come! - He's not coming.
- You all right? - Yeah.
I got to get back.
You'll tell that other doctor? - Yeah, sure.
- Dr.
Hudson? He's altered.
Unarousable.
Elevated ICP.
Get a Radiation Oncology fellow down here right away.
- I'll call them.
- He wanted chemotherapy.
He won't make it to chemo.
- We need to intubate.
- I'll do it! Why don't I do it? - Feeling better? - I'm kind of tired.
- Lucy? - I'll be right back.
What's with your patient? Dr.
Greene pulled him out of a fight with his friend.
- Abby's looking for you.
- He might be schizophrenic.
- He meets the DSM-IV criteria.
- Did you page a psych consult? I was waiting to present him to you.
Get them down here, hand this guy off.
Patients are waiting.
It's so hard to breathe.
How's she doing? Pressure's down, 85/55 on maximum dopamine.
She's got rales all the way up to the apices.
- Pulmonary edema from all the fluid.
- She was hypotensive.
Still is.
Her BP's too low for nitroglycerine or morphine.
You could try 40 of Lasix.
Pulse ox is down, 79 on 100% oxygen.
- I'm going to intubate.
- No.
She has an infection we can treat.
She only needs to be intubated for a day until it clears up.
You don't know that.
She has multiple organ failure.
You may never be able to extubate.
Then what? She spends two months hooked up to every machine known to man? I know.
I just want to make sure that I- It's not about what you want.
What happened when she stopped breathing? It's called Cheyne-Stokes respiration.
It's associated with heart failure.
- You change your shirt? - Yeah.
I saw four 6-year-olds.
I think they ate too many of those little hearts you warned me about.
- All over me.
- Welcome to the ER Valentine's Day.
Multiple trauma coming in.
Five minutes out.
- Prep the Trauma Room.
- Meet you there.
Watch out for the rebound phenomenon with the glucose.
- We'll monitor her closely.
- Does Gretel have insurance? We've had enough jokes for one day.
I wasn't joking.
Certain vets offer- My God! Elizabeth.
There you are.
I've visited every department looking for you.
Good heavens! Mother, this is Dr.
Robert Romano.
This is my mother, Isabelle Corday.
She's visiting from London briefly.
Lizzie never mentioned a thing.
Pleasure.
Likewise.
This, I take it, is not the laser angioplasty.
This is Gretel, who's been suffering from an insulinoma.
Thanks to a brilliant assist, she'll be fine.
Yes.
I know how hard Elizabeth trained.
- We should- - How are you enjoying Chicago? I'm here for a series of lectures.
Adaptive Optics, Wave-Particle Duality.
I don't know why you'd want to tax your mind with that.
- We have a wonderful city.
- I'm giving the lectures.
I should get Gretel settled in Recovery.
It was nice meeting you.
And you.
- Please don't ask about the dog.
- Was it an Old English? Bouvier.
I'm being paged to the ER.
- I don't think I've seen that yet.
- Good.
Good.
- Did I hear multiple trauma? - Mom, Dad and two kids.
Help me.
front-seat passenger.
Ejected 20 feet from the vehicle.
Pulseless.
Two liters of saline en route.
Robby, 11, rear-seat passenger.
Left wrist pain.
Alert and oriented.
No LOC.
BP is 110/68, pulse, 110.
And we've got Julia, 5.
Also rear-seat passenger.
No head trauma.
No LOC.
Multiple facial abrasions.
BP is 104/60.
Pulse is 96.
- What was your name, sweetie? - Julia.
Where's Mommy? Come on, baby.
- What is it? - Multiple trauma.
- This is my mother.
- How are you? - You better stay here.
- Of course.
- Aren't they bringing my dad? - They are.
- Where did they take Mommy? - They're helping her.
Let's go help you.
All right, let's go! On my count.
One, two, three.
Driver needed extrication.
- The husband? - I think so.
- Hold compressions.
- Heart rate, 40.
No pulse.
She's in P.
E.
A.
Pulse ox, 82.
She's dusky.
Set up for bilateral chest tubes.
- Is your wrist sore? - A little.
- Can you tell me what happened? - A car hit us.
It was going fast.
Robby, let's make sure you're okay.
Come back.
I was sitting behind Mommy.
I hit my face on a broken window.
We'll clean those scrapes.
- Hit your head or pass out? - No.
- What about you, Julia? - Can I go see my mom? Restrained driver with significant passenger-space intrusion.
The fire department had to extricate him.
Lost his pulse.
No time to tube him.
Broke the steering wheel with his chest.
Anything? Tension pneumo on the left.
Get a needle.
- Betadine.
- I'll intubate.
- Sit down so I can examine you.
- No, thank you.
It's probably just a sprain.
- How about you? Is this sore? - Aren't they gonna let us see Dad? They'll let us know, honey.
I'll clean up these abrasions with saline.
Get a left-wrist film for Robby and keep it in a splint.
Order a right-knee film for Julia.
My knee's okay.
I want to go see my mom.
-1200 cc's out the chest tube.
- Run in 2 units of O-neg.
- Pulse ox, 73.
- What's on the monitor? - V-fib.
- Charge to 200.
Stand by with epi.
- And clear.
- Clear.
- Charge to 300.
- What's your plan? Two chest tubes and a pericardiocentesis.
Good rush of air.
Hold on compressions.
Got a pulse.
Let's try for a pressure.
Chest-tube tray.
Let's prep the left side.
Let's move.
- Systolic's 60.
- That's a start.
Keep the O-neg coming.
Get 4 units type-specific.
Ten blade.
- Call for a vent.
-32 French.
- How are they doing? - It doesn't look so good.
Just keep your elbow at a right angle like this.
Thanks.
- It hurts? - A little.
- Hook him up now! - Peter.
Come on, let's move! Let's start him on 100%.
AC of 14, 800 tidal volume.
- He's bleeding out! - We lost the pulse! Start compressions again! Where are you going? We gotta fix you up.
Why don't you come back with me? -60 cc's out.
- Another liter out the chest.
- You want to keep autotransfusing? - No.
Hold compressions.
Asystole.
That's it.
Time of death, 15:35.
Please be sure she's cleaned up.
How's he doing? - Bleeding out through his chest.
- The wife's dead.
- Should we prep for a thoracotomy? - It's a full arrest from blunt trauma.
- Isn't there something else we can try? - He probably tore his aorta.
We can't save him.
You can stop compressions.
Asystole.
Time of death, 15:37.
- What shall we do about the children? - I'll tell them.
I'll go with you.
Can you make sure? Both their parents are dead.
Oh, God! - What are we gonna do? - We need to let them know.
That asthma boy, his sats are dropping and he's starting to have retractions.
- Thanks, Lydia.
- It's okay.
- Robby and Julia.
- Thanks.
Hello, Robby.
Julia.
- I'm Dr.
Kovac.
This is Nurse Hathaway.
- I'll wait outside.
No, please stay.
We need to talk to you about your mom and dad.
The accident was pretty bad.
- The car was going really fast.
- Yeah.
We and the other doctors worked really hard to help your parents but their injuries were very, very serious.
And despite everything we tried to do, we were not able to save them.
And they died.
But I know they'd be so relieved to know that you' re both okay.
I want to see them.
Okay.
I'll tell you what to expect when we go in the room.
To help them breathe, we put a tube in the mouth.
That will still be in there.
You will see other tubes under the collarbone and in the arm that we used to give them medicine.
And they had a lot of scrapes and bruises from the accident.
That's okay.
It's all right.
It's all right.
It's all right.
Mom.
- You're early.
- Didn't want to miss the party.
- ER.
- You missed the decorating.
Luck of the schedule.
- She's answering the phones.
- Dr.
Hudson's making movements.
- That's good.
- Chen and Malucci are with him.
Doing nothing, I hope.
- He's starting to make- - Purposeful movements.
Could you take a deep breath in and then exhale? Dr.
Malucci? Good NIF and tidal volume.
Okay.
Dr.
Hudson, we can extubate you if you're ready.
All right.
Take another deep breath in.
And exhale.
Very good.
- What happened? - Dr.
Chen? - You had papilledema.
- We did radiation.
They'll take you upstairs and take it from there.
I guess I owe you my thanks for going against my wishes.
It did set a bad example for my Residents.
But you're welcome.
Radiation was the right call after all.
Chemo would've worked if he hadn't had increased ICP.
Do you know why I only had one child? I didn't want to listen to them arguing in the car.
You don't know what she looks like, but have you seen my mother? I do know what she looks like.
I met her.
She's delightful.
We're going out to dinner tonight.
- We? - You, me, your mother and my father.
- How did that happen? - I'm not sure.
She has a certain way about her.
I'm going to pick up my dad.
She's at Doc Magoo's having a coffee.
Mother! - I thought I'd lost you.
- No.
By now I know this place like the back of my hand.
I met your Mark.
Yeah.
So I understand.
And? He has a way about him, doesn't he? Arranging this dinner tonight.
He seems to want me to meet his father.
- Don't be silly.
- That's all right.
I don't mind.
By the way, Elizabeth, I had no idea.
- About what? - About what you do.
I had no idea.
- This coffee's weak.
- You can have some more after dinner.
I'm sure by then I'll be on to the gin.
- What are you doing in here? - I wanted coffee.
- That nurse wasn't around.
- Let's get back.
- You're having a party here? - Yes.
Let's go.
- Shouldn't it be bigger? - Shouldn't it be red? Come on, Dad.
They are waiting.
- I don't like being set up.
- You're not being set up.
- It's freezing.
- I imagine this was Elizabeth's idea.
- Not that I don't like her.
- It's just dinner.
This is not my first barbecue.
Your mother hasn't been gone but for five months.
Okay, fine.
You stay here.
I'm going in.
She's a Brit too, huh? Yeah, Dad, she's British.
We should've had them over to our house, played Tom Jones.
Would you rather just go home? Lucy.
I'll be right back.
- What happened to Psych? - They're backed up.
Pick up some other patients.
Have you sutured the leg lac yet? - I'm on my way.
- Let Malik stay with this guy.
Just forget it, Carter! - My father thinks this was your idea.
- Mom thinks it was yours.
She was straddling the patient, pumping on his chest.
That's nothing.
Mark saved this chopper pilot in San Diego.
Kid had a tension pneumatic something.
Shoved a tube in the side of his chest.
Elizabeth put a tube down a man's throat.
That's more difficult than putting it into his chest.
- How's it going? - We're talking about many pilots.
- She was saving a family.
- You're getting on well? - Absolutely.
- Couldn't be better.
- What the hell? - It's a place where people sing along.
You mean, like a karaoke thing? Well, not really.
It's too bad they couldn't get someone good.
She is doing well.
She's already chasing rabbits in her sleep.
Yeah, yeah.
Does everyone think I'm completely nuts? Of course not.
Only those of us who were in the surgery.
I live alone.
When I come home, it's just Gretel.
Right? If you showed the same compassion for people that you show for.
Never mind.
She's NPO.
No food until she's passed gas.
- Give me a break.
She's a dog.
- Has she passed gas? Dr.
Romano, the biscuit.
- Thank you.
- You're welcome.
He has a really lovely voice.
Can you sing, Mark? Nope.
It's rather brave.
When I was a kid, he used to do this to embarrass me.
Parents don't try to embarrass their children.
It's too easy to do it by accident.
He is pretty fearless.
She's not in any pain.
I know.
And I know you were right.
She was right.
- Let me know if you need anything.
- Thanks.
Asystole.
Time of death, 19: 19.
Be still my heart.
I can't believe your mother knows all the words.
We watched this movie 100 times when I was a girl.
- You liked it that much? - No.
She saw it as an object lesson.
That women shouldn't define themselves through men.
Sorry? Well, Gigi was in love with Gaston.
But Gaston only wanted her to be his courtesan.
She agreed, and her great aunt and her grandmother gave her lessons.
Then Gigi was unhappy.
So she told Gaston- Please stop, okay? I can't handle this evening getting any more bizarre.
All right, then.
There's warmer places to be alone.
The furnace room in the basement and the incubators up in the NICU.
I'd like to see you in an incubator.
I'm happy to try.
Well You know, all those years as an OB nurse 98% of what you see is just pure joy.
It's the happiest day of most people's lives.
And the tragedy is horrible.
Because it's a life cut short.
A mom, a baby Sure.
Today was the first day I saw an old person die.
I'm not used to it.
You want the good news or the bad? Give me the bad.
You never get used to it.
The good news is, you never get used to it.
At least I haven't.
So you may have come up here to be alone, but you're not.
You think they started the party without us? I certainly hope not.
Heads will roll.
So this is your Valentine's Day party? Don't ask me.
It's my first one.
- We have a bigger knife in the lounge.
- Couldn't find it.
A lot more fun than OB.
We really like to party down here in the ER.
Lucy didn't suture that leg lac? He's been here for four hours.
- Where is she? - Waiting on a psych consult.
Her patient in Curtain 3.
- I wasn't sure you'd make it.
- Who can resist blue cake? Yuck! - The patients don't mind this music? - What? Somebody! Lucy.