ER s06e16 Episode Script
Under Control
E.
R.
Previously on E.
R.
Morning, Elisabeth.
I've got it, I've got it.
Damn it! - You're sure you want to go in there? - Oh, yeah.
We're not gonna be able to talk.
Let's go get some coffee.
Come on.
Why didn't you tell me? I didn't want it to define me, Mark.
I didn't wanna see it in people's eyes.
I didn't want to see it at all.
And I'm scared.
E.
R.
6x16 "UNDER CONTROL" Pass me some tape.
Not that much.
Dad, you gotta finish up, okay? I'm on at three.
You got that bulb? Lucky I found it.
They don't make these anymore.
Bet we haven't seen these slides in 25 years.
Your mom had me drag that camera all over.
I made an appointment for you on Monday with the oncologist.
I said I didn't want that.
Can you just talk to him? You got that bulb? Don't get fingerprints on it.
- They said the cancer was incurable.
- Doesn't mean we can't treat it.
Plug that in, will you? Our trip to the Grand Canyon.
You bought the wrong bulb.
This was in the closet.
I always pack that last.
Be a dear and empty me the top drawer.
I can't stay long.
I've got an incarcerated hernia in the O.
R.
What shall I do with this? - Would you return it to David? - He wore only one sock home? He's a sweet man.
Much like his son.
- Does that mean you approve? - I've seen you glow whenever he's around.
You two belong together.
Since when are you an expert on relationships? I've enjoyed being single.
I've no regrets.
But what about you, Elizabeth? What will make you happy? You want to discuss it as you're about to leave? Why don't you drop by the hospital? We'll grab a coffee.
Yes.
Absolutely.
I'd love that.
Mother? Would you return those as well? - Welcome back, Carter.
- Thank you, Haleh.
- How are you feeling? - Ready to go.
I saw your MRI.
You're recovering just fine.
Yeah.
I'll get rid of these soon.
Carter, take your time.
Don't push it.
All right? John, how are you doing? - Tell me if you need anything.
- I'm okay.
- Seen Abby? - Not lately.
Labs are back on two of her patients.
You're late.
Deal with this.
- Where's Kovac and Weaver? - They're on tonight.
You're the man.
- Did you check my x-ray? - Can you take her? - I've got four already.
- Randi, find this woman's doctor.
- We got angry patients waiting.
- It's Saturday.
Everyone shows up.
- You tell them that.
- Dr.
Greene? Phone.
It's your dad.
Phone book? Try the desk drawer.
Dad, I can't hold.
- Has anyone seen the Xeroform? - It's here under the Tegaderm.
So, what time do you get off? Ten.
- Got plans for tonight? - Washing my hair.
- Have fun.
- Not the bedroom desk.
Frank Bacon, ICU charge nurse.
Passed out in the unit.
- I'm fine.
Can I go to work? - After we clear you, Mr.
Bacon.
- Call me Frank.
- Mark, three patients left.
Dad, I gotta go.
Call 411.
Problem? Do something.
Randi, hand me the phone.
Haleh, bring the rolling cart.
Chen, Abby, Malucci, over here.
We're gonna do power rounds.
- Carter? - Paramedics are bringing an O.
D.
in.
Ready for that? All right.
It's yours.
- How are you? - It won't stop.
Dr.
Dave will be back in a minute.
Randi, I need a nasal speculum and a Merocel sponge in 3-A.
Thanks.
- Kim Tadlock, ascites.
- CBC and a three-way of the abdomen.
- Check for a fluid wave? - Get the labs first.
3-C? - I've got him.
- Cute guy with syncope.
All right.
Let's go.
- Where's she going? - Romano wants cuts through the jaw.
Ever see a tongue-blade test? Ma'am, I want you to bite down on this as hard as you can.
Chen, you give it a twang.
Let us know if it hurts, okay? All right, no fracture.
Cancel the CT.
- That's it? - A simple stick does the trick.
One.
Two.
Three.
- Adam Pulido, 38, probable overdose.
- I wanna die.
- What did he take? - I found Benadryl packs.
- Anything else? - Leave me alone.
Start with a CBC, EKG, blood and urine tox screen.
Move, I need to do this.
- Do it on the other side.
- The IV's there.
- Carol, your nanny's on the phone.
- Ask her to hold.
- She's new.
- Take it.
-110/78.
He's stable.
- Hello? Did you try the bouncy seat? That stops her from crying sometimes.
- Get away! - Come on! - I gotta go.
- Let go of me! - Calm down.
- You okay? I'm okay.
Get him some soft restraints.
Got a lot of fluid in there.
So the colon cancer spread? Yeah.
They said it could happen.
I didn't respond to chemo.
We should tap your belly.
That's pretty tender.
- Could I interest you in some morphine? - Really? Last time they wouldn't give it to me until I saw the surgeon.
Well, nobody should sit around in pain.
You've been paying attention on rounds, huh? Be back with the morphine.
- What's this? - Nursing schedule.
- You need to be monitored.
- I'm fine.
You know the drill.
Let's hook you up.
So your blood pressure is 90- That's normal.
All those years of triathlon, you know? - We still need to monitor you.
- I know why I fainted.
I ran 12 miles today.
I skipped breakfast.
- Want something from the cafeteria? - No.
Never touch that stuff.
What is that on your chain there? It's an ancient Roman coin.
Found it in the Mediterranean.
- Oh, really? - Yeah.
Here, let me help you with that.
Thank you.
You need some help over there, Dr.
Chen? No.
Everything is under control.
Good.
No, Dad.
I don't care if they have the part.
We'll talk about this later, all right? - Difference of opinion? - He's driving me crazy.
My mom's unpredictable.
Suddenly, she wants to parent.
He won't even discuss treatment options.
For what? - His emphysema.
- Is he worse? I think so.
- What've you got? - History of angina.
Chest pain.
- Need a monitored bed.
- We're full.
- Close to criticals.
- No.
We can handle this.
Okay.
Let's move the TIA to 5.
CHF to 3.
And we're gonna put him in 2.
- See you next trauma.
- Randi, I'm gonna get a refill.
- Sorry.
You want some privacy? - No.
I'm done.
We staffed okay for tonight? Down a nurse.
I'm working on it.
What did I do with the lid? This it? Thanks.
Some days they take a bottle.
Other days they just want mom.
- Carter needs you.
- Can you cover? Sorry.
GSW to the head coming in.
I'll get the gunshot.
- How much Ativan? - Four.
- Push two more.
- Stats down to 81.
- Intubation tray.
- He's seizing? Overdose is worse than we thought.
He's not breathing.
BP's only 60 systolic.
All right.
Start dopamine.
You all right? Just pump up the bed.
- Bradying down.
- Get Mark.
No.
I can do it.
That's high enough.
Connie, page the renal fellow.
This guy needs dialysis.
All right.
I'm in.
- Know who shot him? - No.
Probably a drug deal gone bad.
Abby, glove up.
You're gonna put in a central line.
On my count.
One.
Two.
Three.
Order a head CT and lateral C-spine.
There's gray matter everywhere.
Start mannitol and hyperventilate.
We have an organ donor here.
- BP's 80 palp.
- Let's get his pressure up.
Is this a good angle? Aim it towards the sternal notch.
Hit the clavicle.
March it down slowly until you slip under the bone.
Lower the angle or you'll give him a pneumothorax.
- I'm up against the bone.
- Reposition.
- Mark, we need that line in now.
- Give her a chance.
This guy's brain-dead.
- Nothing.
- We're not perfusing his organs.
I'll have to do it.
Got a driver's license.
Robert Jackson from Naperville.
He's 18.
Track down his parents.
We need their consent to make him a donor.
Got it.
Let's get two liters on the rapid infuser.
His QRS is widening.
He needs dialysis.
Dialysis is not used in Benadryl overdose.
I read a case where hemoperfusion worked.
Extra-corporeal elimination won't work.
We should try.
I'm not putting this man at risk for hemolysis for an unproven procedure you read about.
Excuse me.
This is not a renal case.
Like hell it isn't.
- Push more bicarb? - Won't help.
Run of seven.
Damn it.
I'll write the dialysis orders.
A nephrologist has to do that.
The article says exactly what to do.
Kerry did hemoperfusion on an O.
D.
We should do it.
I know this will work.
Write out the orders.
I know a dialysis nurse.
Set me up for a femoral line.
- Wanna run this? - Sure.
- Pulseless.
- Abby? - Defibrillate at 200.
- Sounds good.
- Charged and ready.
- Clear.
- Get water! - Turn off the oxygen.
- In V-tach.
- Start compressions.
- Oh, it smells! - Two prep razors.
- I got this side.
- Abby, get the paddles.
- Rambo.
Why are you here? - He's my patient.
- But your name's Frank.
- My nickname from Desert Storm.
Clear! Normal sinus.
- I've never seen that happen.
- Me either.
Sometimes you wing it.
Exam 2 is set up for charcoal hemoperfusion for that O.
D.
Good.
Keep me posted.
What's up? - Dropped his pressure.
- Lily, two more units.
- You don't have much time.
- I know.
We need to get him to the O.
R.
- You find his family? - It's a phony license.
- Kids buy them on the street.
- Has he been reported missing? - Sent his photo out.
So far, nothing.
- We need that consent.
Pressure's up to 90.
That's encouraging.
It could take hours to line up the procurement teams.
- Be realistic.
- I'll save five lives with his organs.
- He could arrest.
- I won't let him.
Let Kate sleep for an hour.
Then wake her for her bottle.
I'll talk to you later.
Carol, I need 3-0 nylon.
Dori, I think we are ready.
- You okay? - I contaminated my gloves.
- Sorry.
- Just give me another pair.
Did Dr.
Krupp say why he's using citrate? He always uses heparin.
I'll page him.
He say when to check an A.
C.
T.
? Do it 30 minutes into the run.
I better check.
He's very particular.
Dori, these aren't his orders.
He won't help us.
We got them from a journal.
I won't do this without him.
His complexes are narrowing.
- I'll lose my job.
- Save his life.
No.
We're stopping.
- I'll take responsibility.
- Carter, can you explain? - I told you about it.
- He told you nephrology said no? - It's working.
Let us finish.
- Carter, step out.
Carol, monitor his vitals.
Keep the dialysis going.
Sorry, Dori.
I'll speak with the renal service.
You have a problem, come to me.
- He's improving.
- You didn't give me - the whole story.
- I can handle this.
- It's your first day back.
- Mark, we need you.
I wanna know everything you do.
Six months old: fever, vomiting.
Had a seizure.
- Where's Cleo? - It's her day off.
- Has she had seizures before? - No.
- And the vomiting started? - When she woke up.
- What's her name? - Estrella.
Is she okay? She looks dehydrated.
Chuny, set up an interosseus line.
Bolus, 20 per kilo of saline.
She's tachy at 160.
CBC, lytes, blood and urine cultures.
Full septic workup.
- What are you doing? - Giving her fluids.
Please don't hurt her.
Take her out.
Bring her back after the spinal tap.
- No.
I want to stay with the baby.
- Come on, honey.
- Please.
Can I stay with my baby? - It's okay.
- Still normal sinus.
How long? - Until your lytes come back.
- And my patients? - Told the unit you took a sick day.
Then I guess I'm your prisoner.
Have you seen Dr.
Greene? He's supposed to help me.
He's in Trauma.
I can do it.
- Kim, this is Dr.
Chen.
- Hey, doc.
I've numbed the left quadrant.
Use a Z-track so it won't leak.
And what labs should I send off? Cell count, glucose, protein, Gram's stain, and culture.
- Thanks.
- No problem.
There's the fluid.
- Good flow.
You got it? - Thank you.
I'll be in Exam 4.
- Well, it wasn't so bad.
- Actually, it's starting to hurt.
I'll readjust the catheter.
If I were you, I'd order an upright chest film, stat.
- Lost the pulse.
- In V-tach.
Charge the paddles to 20.
Bag her.
- What's going on? - Septic or meningitis.
Clear.
- Yes, Carter? - I can come back.
Charge.
What's up? My O.
D.
's QRS is down to.
12.
He's off pressors.
Clear.
- Go on.
- Can I extubate him? - Charging.
- In a half hour.
- Clear.
- Thanks.
- What are you doing? - Checking labs.
- No patients allowed.
- He's a nurse.
I let him.
- Frank, why are you here? - My labs came back.
- Your patient has a low sodium.
- That's all the water I drank.
- Just need to fluid-restrict.
- Let's go back to bed.
She wants to keep me here.
- He's a piece of work.
- You're not? - What's that mean? - Eating cereal out of an emesis basin? - Randi, did my nanny call again? - No, thank God.
What is that? Nothing around except cereal and a jar of milk.
- A jar of milk? - Yeah.
- Oh, God, Malucci! - What? - Resume compressions.
- She's in V-fib.
She should come around with 0-2 and epi.
- Mark, our guy's crashing.
- Clear.
No change.
- What's happened? - He's hypotensive.
Starting Levophed.
Chuny, procainamide, 100 slow IV push.
Shock again.
- You gonna call it? - I want him to be a donor.
Not without his consent.
- Last epi? - Four minutes.
- Another cc.
- Get a court order? Not in this case.
- I'll keep him up till we find family.
- Fine.
- Shock again.
- Clear.
The black stripe is air under the diaphragm.
- The needle perforated the colon.
- It hurts like hell.
I'm really sorry.
Perforation is a known complication of the procedure.
- What do we do now? - We could operate to repair the defect.
How long will I be in the hospital? A week.
But then a two-month recovery.
Doc, they don't expect me to live that long.
What happens if I don't have the operation? The hole could seal off.
But you'd probably develop an infection, peritonitis.
- And then I'd die.
- Yeah.
- More atropine.
- Pacer pads ready.
- Holding compressions.
- Still flatline.
CBC and lytes are normal.
What is wrong with this baby? - Start pacing at 180.
- Pacer's on.
No capture.
Turn up the gain.
Come on.
- Still no capture.
- Turn up the rate.
Can't feel a pulse.
More epi? - How many rounds so far? - Seven.
Stop bagging.
That's it.
We're done.
Clean up the baby before I bring in the mother.
I don't want the surgery.
- It's the only way- - I understand.
But I don't want another surgery.
Well, then we- We could treat you with antibiotics and hope for the best.
I'm sorry.
Would you excuse me? I'll be right back.
Dr.
Benton? Aren't we supposed to fix our mistakes? Usually.
Your patient has end-stage cancer.
Sugery is only going to prolong is suffering.
- You have to respect his wishes.
- He's gonna die because I made a mistake.
- He's gonna die anyway.
- We need you over here.
- What is it? Doctor, please help me.
My baby.
- Give her something? - No.
- My baby.
- Pilar.
- She's still warm.
Do something.
- Pilar, we tried.
I explained that.
No.
She's still warm.
My baby.
Please.
Use your machines, give her the medicine.
Blow in her mouth.
Make her breathe.
- We can't.
- Yes, you can! You can! You're a good doctor.
You can save her.
Please.
She's still warm, my baby.
Pilar, she's dead.
I'm sorry.
- What's up? - Cops found him under the El.
- How are you doing? - Kiss my ass.
Start a banana bag, order a head CT and prep him for sutures.
- What do you got? - CVA and two new patients to present.
- And Frank's workup? - I'm fine.
He saw us get slammed so he pitched in.
There's a complication with my colon-cancer patient.
- Thought I was gonna supervise.
- You were busy.
I asked Dr.
Chen.
If you'd given a history, you'd have tapped the midline - instead of perfing the bowel.
- He spiked a fever.
He's septic.
- Make sure he's comfortable now.
- I'd like to stay with him.
We need you here.
Nurses can take care of him.
After your shift, go to Pathology and practice procedures with Dr.
Upton.
Dr.
Greene, got a live one here! What happened? I'm feeding my buddy's Gila monster, when it bites me.
He won't let go.
- We have to kill it? - As a last resort.
Grab a couple of vascular clamps.
I'm not going near that thing.
- I got it.
- All right.
Thanks.
- Please, don't hurt him.
- I'll do my best.
Those jaws are awfully strong.
- Malucci, get ready to catch him.
- In what? Grab a kick bucket.
All right.
Here we go.
Nice and easy.
Do it together.
Almost.
Almost.
There! - Now what do I do? - Call Animal Control or the zoo.
Need some help? Why don't you monitor his vitals, three grams of Unasyn and irrigate the wound.
- How is he? - He's on dopamine and Levophed.
- He won't last.
- V-tach.
Charge the paddles.
- No, he's a DNR.
- Let me code him.
- It's futile.
- I'm pushing lidocaine.
You're tying up nurses and a trauma room on a case going nowhere.
Stop.
His organs are viable.
His family would want some good out of this.
- Normal sinus.
Want a lidocaine drip? - I'll start one.
Don't keep flogging him.
I mean it.
He's a DNR.
Labs are back from Trauma 2.
Tox screen's positive for amphetamines.
Let me see.
- Oh, man.
- What? - It's the baby.
- She was killed with amphetamines? The labs came back on Estrella.
She tested positive for amphetamines.
My baby died from drugs? Could anyone have given something to her? - No one has drugs at home.
- Know anyone who uses? Friends or relatives? - Pilar, what is it? - I work two jobs.
I get so tired, I take something to stay awake.
But I never bring it home.
Are you nursing the baby? Pilar, do you nurse your baby? The drugs are in the breast milk.
I love my baby.
I would never hurt her.
God forgive me, I would never hurt her.
I didn't know.
Really, I didn't know.
I didn't know.
I didn't know.
Mother, are you there? I'm involved in a case.
I can't make it for coffee, so page me.
I completely forgot to give you a message.
Your mom's taken an earlier flight and can't meet you.
That's all? Are you all right? Are you keeping an eye on that gunshot kid? I canceled a date with my mother, but she stood me up first.
That's parents for you.
Get me Burch's lytes, Davis' dig, Nguyen's coags.
- You got it.
- How we doing? - Don't worry.
I'm moving the meat.
- I've waited an hour for CT results.
- I'm holding for it.
- Page Flint.
Hold on, I can access his roto-viewer.
- My patient needs morphine.
- I checked.
He's asleep.
Check again.
I don't want him in pain.
- What happened? - He was short of breath.
- Why not call? - You couldn't do anything.
- It started when? - Few days ago.
Pulse ox 82.
Decreased breath sounds.
- It's probably just a chest cold.
- Move him, nice and easy.
I'm not that sick! I can do it myself! - Do you want a blood gas? - Yes, CBC, coags and a portable chest.
I should've seen the doctor on Monday.
Can you be quiet and take a deep breath? - I think there's fluid in your lungs.
- You "think"? Lean forward.
Fluid's halfway up.
Why did you wait so long? You could've passed out- - Don't scold me.
- We need to drain the fluid.
What's wrong? Pleural effusion.
Needs a thoracentesis.
He wants to stick a needle in me.
You're a surgeon.
You do it.
- That's a bad idea.
- I can handle this.
He thinks a doctor shouldn't treat family.
- It's a simple procedure.
- I want Elizabeth to be my doctor.
Fine.
- Lizard guy's crashing.
- Why wasn't I told? He just went south.
- His pressure's 60.
- Gila venom.
Two liters of saline.
- What do you need? - .
3 of epi and 50 of Benadryl.
Here you go.
Who's smoking? - I don't smell anything.
- It's out there.
- That's my hernia patient.
- Tell him to smoke outside.
Bad cocaine overdose.
Pressure's sky-high.
- BP's 260/140.
- I've been waiting five hours.
Get that cigarette out of here! Start with Osmolal and phentolamine.
There's a psych patient ready to jump.
- Clear a trauma room.
- I'm on it.
My patient's son wants to talk to you.
- Want a Foley? - Why ask me? Do it.
- I can't get a second IV.
- Why? She has good veins.
- How about my patient? - I've got two patients.
Deal with it.
The guy just jumped! They said it was a stage-four lung cancer.
Doctors said it can't be cut out or cured.
Sometimes chemotherapy can shrink the tumor and lengthen survival.
- I know all about that.
- Are you interested? - Mark sure seems to be.
- What about you? What do you want? I want to live out the remainder of my life as normal as I can.
I don't wanna be hooked up to a bunch of tubes, puking all for the sake of a few extra miserable weeks.
When we get the fluid off, you'll feel a lot better.
I'm gonna numb you up.
This will sting a bit.
Ready when you are.
- Stick around, fresh trauma coming in.
- Page Corday.
- You doing okay? - You late for something? I'll see you later.
- Sorry about your patient.
- Which? Your belly tap in Curtain 3 expired.
Why didn't anybody tell me? My patient dies, I'm the last to know.
Pulse is weak.
Start two large-bore IVs.
Decreased breath sounds.
Get a chest tube.
- Want help? - No thanks.
What's he doing here? - It's a long story.
- Carter, everything okay? - How'd it happen? - Psych patient jumped.
- Looks like a few broken ribs.
- Get X-ray here.
Hey, get the crash cart! Frank? Airway's clear.
He's breathing.
- What happened? - Probably vasovagalled.
- Good pulse.
We're okay.
- I'll get a BP.
Gotta intubate.
Push 15 of etomidate, 100 of sux.
- Chest tube.
- I'll do it.
- I got it.
We gotta move fast.
- How can I help? Run the HemoCue.
- Need a hand? - No.
Work on that HemoCue.
- It's the nanny.
The twins are crying.
- Take over for me.
I'm in a trauma.
I can't do that now.
- Ten blade and a Kelly.
- Check the cuff.
- I can't.
- What's the pulse ox? It's 92.
- We're okay.
- Okay.
- Just put Kate's ear to the phone.
-32 French.
You call that a lullaby? Give me cricoid pressure.
Okay, I'm in.
Let's bag him.
O silk on a needle driver.
Good breath sounds.
Open the Xeroform.
Hey, call Respiratory for a vent.
You've had quite a day, huh? Randi, I'll be suturing in Exam 4.
- I can pick up a few of your patients.
- Just take the new ones.
- Oh, sorry, Carol.
Pedes is full.
- These are my girls.
- They've gotten so big.
- Is your nanny sick? She's new.
They were fussy, so she brought them.
- They look content.
- They're always happy after nursing.
- They miss their mom.
- We'll be in the lounge.
Curtain 2 is going up.
- Sorry to cause so much trouble.
- It's nothing.
Feel better.
- What's wrong with Super Nurse? - He's being admitted.
What, to the Psych ward? To Medicine.
I diagnosed his Addison's disease.
He'll be fine soon.
Good pickup.
I'm gonna go up to the fifth floor, keep him company.
- Time of death, 21:37.
- I'll get the death kit.
His organs could've saved many lives.
I couldn't do a thing.
- You had no choice.
- Why couldn't they find his family? Probably a runaway.
He's someone's son.
His parents don't even know he's here.
They may never know.
- Can you sign a discharge order? - Which patient? - Dr.
Greene's father.
- I'll be right out.
You never said your father has cancer.
He didn't want anybody to know.
You told him to follow up with Oncology? - He doesn't want to.
- Navelbine has no side effects.
- It'll shrink the tumor.
- I've given him those options.
It'll improve quality of life.
Talk to him.
He'll listen.
- It's his decision.
- Explain.
He'll change his mind.
- I have to respect his wishes.
- He's my father.
I wanna help him.
If you really want to help, just be there for him.
I won't just sit there when there's more I can do.
The patient donated his body for educational use.
For anatomy class? We often allow students to practice procedures here on the fresh cadaver.
Dr.
Greene mentioned that you needed work on your central lines.
Put your finger in the sternal notch.
Enter between the middle and proximal third of the clavicle.
- I'm sorry.
I can't do this.
- You're doing fine.
He was my patient.
You want to stop? No.
Why don't you take me through it? Aim just above and posterior to your index finger.
Crazy day, huh? - John, are you still in a lot of pain? - It's not too bad.
It seems like you're having a hard time getting around in Trauma.
I'm okay.
The first day back can be rough.
Every day gets a little bit easier.
Have you talked to anybody about what happened? - And your family's been supportive? - Yeah, really, I'm okay.
You might benefit from the TENS unit or acupuncture.
Thanks.
I'll let you know.
I need a PT/PTT on De Salvo.
Heading home? I can take a cab if you have other plans.
Don't be ridiculous.
We're going home.
- Good night.
- Good night.
- Your shoelaces are untied.
- I can't bend down after that needle.
Don't fall and break your neck.
From this angle.
The one.
Just cut it in there.
Just hit a little bit to the left.
And let it - slide down.
- Too much thinking.
I go by instinct.
Do it your way.
All right how about the six in the corner- Yeah, right.
Here we go.
- What about the laws of physics? - You distracted me.
Yeah.
Excuse me.
- You left me nothing.
- What? Go for the eleven.
- Are you crazy? I can't make that.
- Of course you can.
Come here.
Just call it.
Eleven in the corner pocket.
Just line it up.
Now hit it to the right.
It'll slide right down the rail.
- Trust me.
Nice and easy.
- Trust you.
All right.
See? How's that? It's not bad.
What? We'd have served a late dinner for you.
Soup's fine.
- You're looking well, John.
- Thank you.
I started back to work today.
- Shouldn't you have more time off? - I did okay.
Actually, it was kind of tough.
I didn't know if I'd make it through the day.
I felt, I don't know, afraid.
- Afraid of what? - That I couldn't handle it.
But you did.
I know we've had our disagreements about your career.
But I can see now that medicine is what you love.
When you were in high school, you'd drop by unexpectedly.
I'd make cocoa and we'd talk.
I remember.
We haven't done this in a long time.
I know.
- Where is that? Mammoth? - No.
Lake Tahoe.
I lost $200 at the craps table.
- Next slide.
- This is a fancy machine.
Had I seen this one, I wouldn't have fixed the old one.
- San Diego? - That was the Santa Barbara trip.
You were 7.
Taught you to swim underwater.
Your mother never did like motels, so we rented an RV.
Planting the garden.
- You used to make me pull the weeds.
- I did not.
You remember you always wanted to grow a watermelon tree? You planted the seeds you saved in your mother's petunias.
- Never did get a watermelon.
- You sure killed off the petunias.
I forgot all about that.
I thought this was the vacation box.
Why'd your mother take this? I guess she liked what she saw.
R.
Previously on E.
R.
Morning, Elisabeth.
I've got it, I've got it.
Damn it! - You're sure you want to go in there? - Oh, yeah.
We're not gonna be able to talk.
Let's go get some coffee.
Come on.
Why didn't you tell me? I didn't want it to define me, Mark.
I didn't wanna see it in people's eyes.
I didn't want to see it at all.
And I'm scared.
E.
R.
6x16 "UNDER CONTROL" Pass me some tape.
Not that much.
Dad, you gotta finish up, okay? I'm on at three.
You got that bulb? Lucky I found it.
They don't make these anymore.
Bet we haven't seen these slides in 25 years.
Your mom had me drag that camera all over.
I made an appointment for you on Monday with the oncologist.
I said I didn't want that.
Can you just talk to him? You got that bulb? Don't get fingerprints on it.
- They said the cancer was incurable.
- Doesn't mean we can't treat it.
Plug that in, will you? Our trip to the Grand Canyon.
You bought the wrong bulb.
This was in the closet.
I always pack that last.
Be a dear and empty me the top drawer.
I can't stay long.
I've got an incarcerated hernia in the O.
R.
What shall I do with this? - Would you return it to David? - He wore only one sock home? He's a sweet man.
Much like his son.
- Does that mean you approve? - I've seen you glow whenever he's around.
You two belong together.
Since when are you an expert on relationships? I've enjoyed being single.
I've no regrets.
But what about you, Elizabeth? What will make you happy? You want to discuss it as you're about to leave? Why don't you drop by the hospital? We'll grab a coffee.
Yes.
Absolutely.
I'd love that.
Mother? Would you return those as well? - Welcome back, Carter.
- Thank you, Haleh.
- How are you feeling? - Ready to go.
I saw your MRI.
You're recovering just fine.
Yeah.
I'll get rid of these soon.
Carter, take your time.
Don't push it.
All right? John, how are you doing? - Tell me if you need anything.
- I'm okay.
- Seen Abby? - Not lately.
Labs are back on two of her patients.
You're late.
Deal with this.
- Where's Kovac and Weaver? - They're on tonight.
You're the man.
- Did you check my x-ray? - Can you take her? - I've got four already.
- Randi, find this woman's doctor.
- We got angry patients waiting.
- It's Saturday.
Everyone shows up.
- You tell them that.
- Dr.
Greene? Phone.
It's your dad.
Phone book? Try the desk drawer.
Dad, I can't hold.
- Has anyone seen the Xeroform? - It's here under the Tegaderm.
So, what time do you get off? Ten.
- Got plans for tonight? - Washing my hair.
- Have fun.
- Not the bedroom desk.
Frank Bacon, ICU charge nurse.
Passed out in the unit.
- I'm fine.
Can I go to work? - After we clear you, Mr.
Bacon.
- Call me Frank.
- Mark, three patients left.
Dad, I gotta go.
Call 411.
Problem? Do something.
Randi, hand me the phone.
Haleh, bring the rolling cart.
Chen, Abby, Malucci, over here.
We're gonna do power rounds.
- Carter? - Paramedics are bringing an O.
D.
in.
Ready for that? All right.
It's yours.
- How are you? - It won't stop.
Dr.
Dave will be back in a minute.
Randi, I need a nasal speculum and a Merocel sponge in 3-A.
Thanks.
- Kim Tadlock, ascites.
- CBC and a three-way of the abdomen.
- Check for a fluid wave? - Get the labs first.
3-C? - I've got him.
- Cute guy with syncope.
All right.
Let's go.
- Where's she going? - Romano wants cuts through the jaw.
Ever see a tongue-blade test? Ma'am, I want you to bite down on this as hard as you can.
Chen, you give it a twang.
Let us know if it hurts, okay? All right, no fracture.
Cancel the CT.
- That's it? - A simple stick does the trick.
One.
Two.
Three.
- Adam Pulido, 38, probable overdose.
- I wanna die.
- What did he take? - I found Benadryl packs.
- Anything else? - Leave me alone.
Start with a CBC, EKG, blood and urine tox screen.
Move, I need to do this.
- Do it on the other side.
- The IV's there.
- Carol, your nanny's on the phone.
- Ask her to hold.
- She's new.
- Take it.
-110/78.
He's stable.
- Hello? Did you try the bouncy seat? That stops her from crying sometimes.
- Get away! - Come on! - I gotta go.
- Let go of me! - Calm down.
- You okay? I'm okay.
Get him some soft restraints.
Got a lot of fluid in there.
So the colon cancer spread? Yeah.
They said it could happen.
I didn't respond to chemo.
We should tap your belly.
That's pretty tender.
- Could I interest you in some morphine? - Really? Last time they wouldn't give it to me until I saw the surgeon.
Well, nobody should sit around in pain.
You've been paying attention on rounds, huh? Be back with the morphine.
- What's this? - Nursing schedule.
- You need to be monitored.
- I'm fine.
You know the drill.
Let's hook you up.
So your blood pressure is 90- That's normal.
All those years of triathlon, you know? - We still need to monitor you.
- I know why I fainted.
I ran 12 miles today.
I skipped breakfast.
- Want something from the cafeteria? - No.
Never touch that stuff.
What is that on your chain there? It's an ancient Roman coin.
Found it in the Mediterranean.
- Oh, really? - Yeah.
Here, let me help you with that.
Thank you.
You need some help over there, Dr.
Chen? No.
Everything is under control.
Good.
No, Dad.
I don't care if they have the part.
We'll talk about this later, all right? - Difference of opinion? - He's driving me crazy.
My mom's unpredictable.
Suddenly, she wants to parent.
He won't even discuss treatment options.
For what? - His emphysema.
- Is he worse? I think so.
- What've you got? - History of angina.
Chest pain.
- Need a monitored bed.
- We're full.
- Close to criticals.
- No.
We can handle this.
Okay.
Let's move the TIA to 5.
CHF to 3.
And we're gonna put him in 2.
- See you next trauma.
- Randi, I'm gonna get a refill.
- Sorry.
You want some privacy? - No.
I'm done.
We staffed okay for tonight? Down a nurse.
I'm working on it.
What did I do with the lid? This it? Thanks.
Some days they take a bottle.
Other days they just want mom.
- Carter needs you.
- Can you cover? Sorry.
GSW to the head coming in.
I'll get the gunshot.
- How much Ativan? - Four.
- Push two more.
- Stats down to 81.
- Intubation tray.
- He's seizing? Overdose is worse than we thought.
He's not breathing.
BP's only 60 systolic.
All right.
Start dopamine.
You all right? Just pump up the bed.
- Bradying down.
- Get Mark.
No.
I can do it.
That's high enough.
Connie, page the renal fellow.
This guy needs dialysis.
All right.
I'm in.
- Know who shot him? - No.
Probably a drug deal gone bad.
Abby, glove up.
You're gonna put in a central line.
On my count.
One.
Two.
Three.
Order a head CT and lateral C-spine.
There's gray matter everywhere.
Start mannitol and hyperventilate.
We have an organ donor here.
- BP's 80 palp.
- Let's get his pressure up.
Is this a good angle? Aim it towards the sternal notch.
Hit the clavicle.
March it down slowly until you slip under the bone.
Lower the angle or you'll give him a pneumothorax.
- I'm up against the bone.
- Reposition.
- Mark, we need that line in now.
- Give her a chance.
This guy's brain-dead.
- Nothing.
- We're not perfusing his organs.
I'll have to do it.
Got a driver's license.
Robert Jackson from Naperville.
He's 18.
Track down his parents.
We need their consent to make him a donor.
Got it.
Let's get two liters on the rapid infuser.
His QRS is widening.
He needs dialysis.
Dialysis is not used in Benadryl overdose.
I read a case where hemoperfusion worked.
Extra-corporeal elimination won't work.
We should try.
I'm not putting this man at risk for hemolysis for an unproven procedure you read about.
Excuse me.
This is not a renal case.
Like hell it isn't.
- Push more bicarb? - Won't help.
Run of seven.
Damn it.
I'll write the dialysis orders.
A nephrologist has to do that.
The article says exactly what to do.
Kerry did hemoperfusion on an O.
D.
We should do it.
I know this will work.
Write out the orders.
I know a dialysis nurse.
Set me up for a femoral line.
- Wanna run this? - Sure.
- Pulseless.
- Abby? - Defibrillate at 200.
- Sounds good.
- Charged and ready.
- Clear.
- Get water! - Turn off the oxygen.
- In V-tach.
- Start compressions.
- Oh, it smells! - Two prep razors.
- I got this side.
- Abby, get the paddles.
- Rambo.
Why are you here? - He's my patient.
- But your name's Frank.
- My nickname from Desert Storm.
Clear! Normal sinus.
- I've never seen that happen.
- Me either.
Sometimes you wing it.
Exam 2 is set up for charcoal hemoperfusion for that O.
D.
Good.
Keep me posted.
What's up? - Dropped his pressure.
- Lily, two more units.
- You don't have much time.
- I know.
We need to get him to the O.
R.
- You find his family? - It's a phony license.
- Kids buy them on the street.
- Has he been reported missing? - Sent his photo out.
So far, nothing.
- We need that consent.
Pressure's up to 90.
That's encouraging.
It could take hours to line up the procurement teams.
- Be realistic.
- I'll save five lives with his organs.
- He could arrest.
- I won't let him.
Let Kate sleep for an hour.
Then wake her for her bottle.
I'll talk to you later.
Carol, I need 3-0 nylon.
Dori, I think we are ready.
- You okay? - I contaminated my gloves.
- Sorry.
- Just give me another pair.
Did Dr.
Krupp say why he's using citrate? He always uses heparin.
I'll page him.
He say when to check an A.
C.
T.
? Do it 30 minutes into the run.
I better check.
He's very particular.
Dori, these aren't his orders.
He won't help us.
We got them from a journal.
I won't do this without him.
His complexes are narrowing.
- I'll lose my job.
- Save his life.
No.
We're stopping.
- I'll take responsibility.
- Carter, can you explain? - I told you about it.
- He told you nephrology said no? - It's working.
Let us finish.
- Carter, step out.
Carol, monitor his vitals.
Keep the dialysis going.
Sorry, Dori.
I'll speak with the renal service.
You have a problem, come to me.
- He's improving.
- You didn't give me - the whole story.
- I can handle this.
- It's your first day back.
- Mark, we need you.
I wanna know everything you do.
Six months old: fever, vomiting.
Had a seizure.
- Where's Cleo? - It's her day off.
- Has she had seizures before? - No.
- And the vomiting started? - When she woke up.
- What's her name? - Estrella.
Is she okay? She looks dehydrated.
Chuny, set up an interosseus line.
Bolus, 20 per kilo of saline.
She's tachy at 160.
CBC, lytes, blood and urine cultures.
Full septic workup.
- What are you doing? - Giving her fluids.
Please don't hurt her.
Take her out.
Bring her back after the spinal tap.
- No.
I want to stay with the baby.
- Come on, honey.
- Please.
Can I stay with my baby? - It's okay.
- Still normal sinus.
How long? - Until your lytes come back.
- And my patients? - Told the unit you took a sick day.
Then I guess I'm your prisoner.
Have you seen Dr.
Greene? He's supposed to help me.
He's in Trauma.
I can do it.
- Kim, this is Dr.
Chen.
- Hey, doc.
I've numbed the left quadrant.
Use a Z-track so it won't leak.
And what labs should I send off? Cell count, glucose, protein, Gram's stain, and culture.
- Thanks.
- No problem.
There's the fluid.
- Good flow.
You got it? - Thank you.
I'll be in Exam 4.
- Well, it wasn't so bad.
- Actually, it's starting to hurt.
I'll readjust the catheter.
If I were you, I'd order an upright chest film, stat.
- Lost the pulse.
- In V-tach.
Charge the paddles to 20.
Bag her.
- What's going on? - Septic or meningitis.
Clear.
- Yes, Carter? - I can come back.
Charge.
What's up? My O.
D.
's QRS is down to.
12.
He's off pressors.
Clear.
- Go on.
- Can I extubate him? - Charging.
- In a half hour.
- Clear.
- Thanks.
- What are you doing? - Checking labs.
- No patients allowed.
- He's a nurse.
I let him.
- Frank, why are you here? - My labs came back.
- Your patient has a low sodium.
- That's all the water I drank.
- Just need to fluid-restrict.
- Let's go back to bed.
She wants to keep me here.
- He's a piece of work.
- You're not? - What's that mean? - Eating cereal out of an emesis basin? - Randi, did my nanny call again? - No, thank God.
What is that? Nothing around except cereal and a jar of milk.
- A jar of milk? - Yeah.
- Oh, God, Malucci! - What? - Resume compressions.
- She's in V-fib.
She should come around with 0-2 and epi.
- Mark, our guy's crashing.
- Clear.
No change.
- What's happened? - He's hypotensive.
Starting Levophed.
Chuny, procainamide, 100 slow IV push.
Shock again.
- You gonna call it? - I want him to be a donor.
Not without his consent.
- Last epi? - Four minutes.
- Another cc.
- Get a court order? Not in this case.
- I'll keep him up till we find family.
- Fine.
- Shock again.
- Clear.
The black stripe is air under the diaphragm.
- The needle perforated the colon.
- It hurts like hell.
I'm really sorry.
Perforation is a known complication of the procedure.
- What do we do now? - We could operate to repair the defect.
How long will I be in the hospital? A week.
But then a two-month recovery.
Doc, they don't expect me to live that long.
What happens if I don't have the operation? The hole could seal off.
But you'd probably develop an infection, peritonitis.
- And then I'd die.
- Yeah.
- More atropine.
- Pacer pads ready.
- Holding compressions.
- Still flatline.
CBC and lytes are normal.
What is wrong with this baby? - Start pacing at 180.
- Pacer's on.
No capture.
Turn up the gain.
Come on.
- Still no capture.
- Turn up the rate.
Can't feel a pulse.
More epi? - How many rounds so far? - Seven.
Stop bagging.
That's it.
We're done.
Clean up the baby before I bring in the mother.
I don't want the surgery.
- It's the only way- - I understand.
But I don't want another surgery.
Well, then we- We could treat you with antibiotics and hope for the best.
I'm sorry.
Would you excuse me? I'll be right back.
Dr.
Benton? Aren't we supposed to fix our mistakes? Usually.
Your patient has end-stage cancer.
Sugery is only going to prolong is suffering.
- You have to respect his wishes.
- He's gonna die because I made a mistake.
- He's gonna die anyway.
- We need you over here.
- What is it? Doctor, please help me.
My baby.
- Give her something? - No.
- My baby.
- Pilar.
- She's still warm.
Do something.
- Pilar, we tried.
I explained that.
No.
She's still warm.
My baby.
Please.
Use your machines, give her the medicine.
Blow in her mouth.
Make her breathe.
- We can't.
- Yes, you can! You can! You're a good doctor.
You can save her.
Please.
She's still warm, my baby.
Pilar, she's dead.
I'm sorry.
- What's up? - Cops found him under the El.
- How are you doing? - Kiss my ass.
Start a banana bag, order a head CT and prep him for sutures.
- What do you got? - CVA and two new patients to present.
- And Frank's workup? - I'm fine.
He saw us get slammed so he pitched in.
There's a complication with my colon-cancer patient.
- Thought I was gonna supervise.
- You were busy.
I asked Dr.
Chen.
If you'd given a history, you'd have tapped the midline - instead of perfing the bowel.
- He spiked a fever.
He's septic.
- Make sure he's comfortable now.
- I'd like to stay with him.
We need you here.
Nurses can take care of him.
After your shift, go to Pathology and practice procedures with Dr.
Upton.
Dr.
Greene, got a live one here! What happened? I'm feeding my buddy's Gila monster, when it bites me.
He won't let go.
- We have to kill it? - As a last resort.
Grab a couple of vascular clamps.
I'm not going near that thing.
- I got it.
- All right.
Thanks.
- Please, don't hurt him.
- I'll do my best.
Those jaws are awfully strong.
- Malucci, get ready to catch him.
- In what? Grab a kick bucket.
All right.
Here we go.
Nice and easy.
Do it together.
Almost.
Almost.
There! - Now what do I do? - Call Animal Control or the zoo.
Need some help? Why don't you monitor his vitals, three grams of Unasyn and irrigate the wound.
- How is he? - He's on dopamine and Levophed.
- He won't last.
- V-tach.
Charge the paddles.
- No, he's a DNR.
- Let me code him.
- It's futile.
- I'm pushing lidocaine.
You're tying up nurses and a trauma room on a case going nowhere.
Stop.
His organs are viable.
His family would want some good out of this.
- Normal sinus.
Want a lidocaine drip? - I'll start one.
Don't keep flogging him.
I mean it.
He's a DNR.
Labs are back from Trauma 2.
Tox screen's positive for amphetamines.
Let me see.
- Oh, man.
- What? - It's the baby.
- She was killed with amphetamines? The labs came back on Estrella.
She tested positive for amphetamines.
My baby died from drugs? Could anyone have given something to her? - No one has drugs at home.
- Know anyone who uses? Friends or relatives? - Pilar, what is it? - I work two jobs.
I get so tired, I take something to stay awake.
But I never bring it home.
Are you nursing the baby? Pilar, do you nurse your baby? The drugs are in the breast milk.
I love my baby.
I would never hurt her.
God forgive me, I would never hurt her.
I didn't know.
Really, I didn't know.
I didn't know.
I didn't know.
Mother, are you there? I'm involved in a case.
I can't make it for coffee, so page me.
I completely forgot to give you a message.
Your mom's taken an earlier flight and can't meet you.
That's all? Are you all right? Are you keeping an eye on that gunshot kid? I canceled a date with my mother, but she stood me up first.
That's parents for you.
Get me Burch's lytes, Davis' dig, Nguyen's coags.
- You got it.
- How we doing? - Don't worry.
I'm moving the meat.
- I've waited an hour for CT results.
- I'm holding for it.
- Page Flint.
Hold on, I can access his roto-viewer.
- My patient needs morphine.
- I checked.
He's asleep.
Check again.
I don't want him in pain.
- What happened? - He was short of breath.
- Why not call? - You couldn't do anything.
- It started when? - Few days ago.
Pulse ox 82.
Decreased breath sounds.
- It's probably just a chest cold.
- Move him, nice and easy.
I'm not that sick! I can do it myself! - Do you want a blood gas? - Yes, CBC, coags and a portable chest.
I should've seen the doctor on Monday.
Can you be quiet and take a deep breath? - I think there's fluid in your lungs.
- You "think"? Lean forward.
Fluid's halfway up.
Why did you wait so long? You could've passed out- - Don't scold me.
- We need to drain the fluid.
What's wrong? Pleural effusion.
Needs a thoracentesis.
He wants to stick a needle in me.
You're a surgeon.
You do it.
- That's a bad idea.
- I can handle this.
He thinks a doctor shouldn't treat family.
- It's a simple procedure.
- I want Elizabeth to be my doctor.
Fine.
- Lizard guy's crashing.
- Why wasn't I told? He just went south.
- His pressure's 60.
- Gila venom.
Two liters of saline.
- What do you need? - .
3 of epi and 50 of Benadryl.
Here you go.
Who's smoking? - I don't smell anything.
- It's out there.
- That's my hernia patient.
- Tell him to smoke outside.
Bad cocaine overdose.
Pressure's sky-high.
- BP's 260/140.
- I've been waiting five hours.
Get that cigarette out of here! Start with Osmolal and phentolamine.
There's a psych patient ready to jump.
- Clear a trauma room.
- I'm on it.
My patient's son wants to talk to you.
- Want a Foley? - Why ask me? Do it.
- I can't get a second IV.
- Why? She has good veins.
- How about my patient? - I've got two patients.
Deal with it.
The guy just jumped! They said it was a stage-four lung cancer.
Doctors said it can't be cut out or cured.
Sometimes chemotherapy can shrink the tumor and lengthen survival.
- I know all about that.
- Are you interested? - Mark sure seems to be.
- What about you? What do you want? I want to live out the remainder of my life as normal as I can.
I don't wanna be hooked up to a bunch of tubes, puking all for the sake of a few extra miserable weeks.
When we get the fluid off, you'll feel a lot better.
I'm gonna numb you up.
This will sting a bit.
Ready when you are.
- Stick around, fresh trauma coming in.
- Page Corday.
- You doing okay? - You late for something? I'll see you later.
- Sorry about your patient.
- Which? Your belly tap in Curtain 3 expired.
Why didn't anybody tell me? My patient dies, I'm the last to know.
Pulse is weak.
Start two large-bore IVs.
Decreased breath sounds.
Get a chest tube.
- Want help? - No thanks.
What's he doing here? - It's a long story.
- Carter, everything okay? - How'd it happen? - Psych patient jumped.
- Looks like a few broken ribs.
- Get X-ray here.
Hey, get the crash cart! Frank? Airway's clear.
He's breathing.
- What happened? - Probably vasovagalled.
- Good pulse.
We're okay.
- I'll get a BP.
Gotta intubate.
Push 15 of etomidate, 100 of sux.
- Chest tube.
- I'll do it.
- I got it.
We gotta move fast.
- How can I help? Run the HemoCue.
- Need a hand? - No.
Work on that HemoCue.
- It's the nanny.
The twins are crying.
- Take over for me.
I'm in a trauma.
I can't do that now.
- Ten blade and a Kelly.
- Check the cuff.
- I can't.
- What's the pulse ox? It's 92.
- We're okay.
- Okay.
- Just put Kate's ear to the phone.
-32 French.
You call that a lullaby? Give me cricoid pressure.
Okay, I'm in.
Let's bag him.
O silk on a needle driver.
Good breath sounds.
Open the Xeroform.
Hey, call Respiratory for a vent.
You've had quite a day, huh? Randi, I'll be suturing in Exam 4.
- I can pick up a few of your patients.
- Just take the new ones.
- Oh, sorry, Carol.
Pedes is full.
- These are my girls.
- They've gotten so big.
- Is your nanny sick? She's new.
They were fussy, so she brought them.
- They look content.
- They're always happy after nursing.
- They miss their mom.
- We'll be in the lounge.
Curtain 2 is going up.
- Sorry to cause so much trouble.
- It's nothing.
Feel better.
- What's wrong with Super Nurse? - He's being admitted.
What, to the Psych ward? To Medicine.
I diagnosed his Addison's disease.
He'll be fine soon.
Good pickup.
I'm gonna go up to the fifth floor, keep him company.
- Time of death, 21:37.
- I'll get the death kit.
His organs could've saved many lives.
I couldn't do a thing.
- You had no choice.
- Why couldn't they find his family? Probably a runaway.
He's someone's son.
His parents don't even know he's here.
They may never know.
- Can you sign a discharge order? - Which patient? - Dr.
Greene's father.
- I'll be right out.
You never said your father has cancer.
He didn't want anybody to know.
You told him to follow up with Oncology? - He doesn't want to.
- Navelbine has no side effects.
- It'll shrink the tumor.
- I've given him those options.
It'll improve quality of life.
Talk to him.
He'll listen.
- It's his decision.
- Explain.
He'll change his mind.
- I have to respect his wishes.
- He's my father.
I wanna help him.
If you really want to help, just be there for him.
I won't just sit there when there's more I can do.
The patient donated his body for educational use.
For anatomy class? We often allow students to practice procedures here on the fresh cadaver.
Dr.
Greene mentioned that you needed work on your central lines.
Put your finger in the sternal notch.
Enter between the middle and proximal third of the clavicle.
- I'm sorry.
I can't do this.
- You're doing fine.
He was my patient.
You want to stop? No.
Why don't you take me through it? Aim just above and posterior to your index finger.
Crazy day, huh? - John, are you still in a lot of pain? - It's not too bad.
It seems like you're having a hard time getting around in Trauma.
I'm okay.
The first day back can be rough.
Every day gets a little bit easier.
Have you talked to anybody about what happened? - And your family's been supportive? - Yeah, really, I'm okay.
You might benefit from the TENS unit or acupuncture.
Thanks.
I'll let you know.
I need a PT/PTT on De Salvo.
Heading home? I can take a cab if you have other plans.
Don't be ridiculous.
We're going home.
- Good night.
- Good night.
- Your shoelaces are untied.
- I can't bend down after that needle.
Don't fall and break your neck.
From this angle.
The one.
Just cut it in there.
Just hit a little bit to the left.
And let it - slide down.
- Too much thinking.
I go by instinct.
Do it your way.
All right how about the six in the corner- Yeah, right.
Here we go.
- What about the laws of physics? - You distracted me.
Yeah.
Excuse me.
- You left me nothing.
- What? Go for the eleven.
- Are you crazy? I can't make that.
- Of course you can.
Come here.
Just call it.
Eleven in the corner pocket.
Just line it up.
Now hit it to the right.
It'll slide right down the rail.
- Trust me.
Nice and easy.
- Trust you.
All right.
See? How's that? It's not bad.
What? We'd have served a late dinner for you.
Soup's fine.
- You're looking well, John.
- Thank you.
I started back to work today.
- Shouldn't you have more time off? - I did okay.
Actually, it was kind of tough.
I didn't know if I'd make it through the day.
I felt, I don't know, afraid.
- Afraid of what? - That I couldn't handle it.
But you did.
I know we've had our disagreements about your career.
But I can see now that medicine is what you love.
When you were in high school, you'd drop by unexpectedly.
I'd make cocoa and we'd talk.
I remember.
We haven't done this in a long time.
I know.
- Where is that? Mammoth? - No.
Lake Tahoe.
I lost $200 at the craps table.
- Next slide.
- This is a fancy machine.
Had I seen this one, I wouldn't have fixed the old one.
- San Diego? - That was the Santa Barbara trip.
You were 7.
Taught you to swim underwater.
Your mother never did like motels, so we rented an RV.
Planting the garden.
- You used to make me pull the weeds.
- I did not.
You remember you always wanted to grow a watermelon tree? You planted the seeds you saved in your mother's petunias.
- Never did get a watermelon.
- You sure killed off the petunias.
I forgot all about that.
I thought this was the vacation box.
Why'd your mother take this? I guess she liked what she saw.