ER s06e21 Episode Script

E.
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E.
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6x21 "SUCH SWEET SORROW" Sweetheart, go back to sleep, okay? What happened? Did you have a bad dream? Oh, man, T ess.
You're killing me.
Abby? - Abby! - Y eah? A 22-year-old with pelvic pain is coming in.
Okay.
- You getting up? - Yep.
You want me to wake Malucci? Nope.
I'm up.
I'm sorry.
- How long was I out? - About 20 minutes.
That must be why I feel so refreshed.
Is this a med-student hazing or do you guys just hate me? You're younger than us, prettier than us and skinnier than us.
We hate you.
- Thanks for the candor.
- Anytime.
It's cold out here.
I should've brought my jacket.
Go back in.
We don't need your help pushing a gurney.
You know, I never actually thought I'd get into med school.
I was just looking for a change.
Stop talking before one of us hits you.
I love you.
Do I tell you that enough? I love you.
- I didn't know you play basketball.
- I don't.
Helo, Tess.
Did you let your mommy sleep for a change? No, she did not.
Did I make you angry? - The flowers on your birthday? - No.
They were beautiful.
They weren't animal crackers, huh? You heard about that? Are you still in love with him? I don't know.
I'm too angry with him to think straight.
- I would think so.
- Why? No.
Doug didn't know I was pregnant when he left.
He didn't come back when he knew.
Well, it wasn't all Doug.
I could've gone with him.
- He asked me to.
- Why didn't you? Pride.
I wanted him to stay for me.
I thought I should be at least that important to him.
I still love my wife.
But it's time to get on with my life.
Let's help your mommy get inside, huh? Here we go.
Like a cowboy.
- Slide your bottom down a bit.
- I hate these! How many sex partners have you had? - One.
- Do you use condoms? Most of the time.
Am I pregnant? No.
The urine test came back negative.
- That didn't hurt at all.
- Warm water.
I know a few tricks.
You don't freeze them? I'll tell my gynecologist.
- Cultures? - GC and chlamydia? I might have chlamydia? We check everybody for STDs.
Discharge at the cervix.
I've had a boyfriend for a year.
If he gave me an STD, I'll kill him.
We haven't made a diagnosis yet.
Speculum's coming out.
I'll move your cervix.
Tell me if it hurts.
Sorry.
Only way to do that.
I'll be gentle with your ovaries.
Put your legs down.
You seem fine.
It's probably PID.
- PID? - Pelvic inflammatory disease.
You'll get antibiotics, pills and a painkiller.
You can get dressed.
a gram of Zithromax and 550 of Anaprox.
Hang on there for 30 minutes, make sure she doesn't have an allergic reaction.
- Should Malucci sign off? - Let him sleep.
- I'll find Weaver.
- She's on her second double this week.
- I wouldn't.
- She's upstairs.
CCU had a code.
Mark's back today.
If Weaver gets nastier, I'm calling Animal Control.
- Amira! Amira! - Frank.
- Where's Amira? - Got off at 7:00.
- Who are you? - Frank.
Personnel sent me.
- Any experience? -26 years as a cop.
- In medicine? - Had my knee replaced.
- Why are all these people here? - Sick? What an astute, penetrating observation.
- Where are the doctors? - I don't know.
- No docs.
Abby's in Sutures.
- Malucci? - He's asleep in Exam 1.
- Kovac? Foreign guy? He and a some nurse came in together and took her babies upstairs to daycare.
- Dr.
Chen? Dr.
Carter? - I think they're in the lounge.
It's 7:05.
Was there a natural disaster I'm unaware of? An earthquake? Or has been Chicago swallowed by a drowning sinkhole? Could you stop yelling at me? I was here on time.
Mark will be in by 10.
He went to the mortuary.
Still have that whistle? Phone everybody who's supposed to be here and scream at their machine that they're late.
And if they answer, tell them they're fired.
Rise and shine! Patients are waiting! Dr.
Malucci, if I don't see you standing over a sick patient looking compasionate and engaged in the next 30 seconds, you're gonna spend the next week doing disimpactions and yeast infections! - I'm up, chief, I'm up.
True.
- I go away for 20 minutes and this place goes to hell! The lounge? She uses a whistle? - You okay, John? - Yeah.
I'm fine.
- You look terrible.
- Thank you.
- What time do you have? -7:05.
The 7:00 shift starts at 7:00.
That means you see patients at 7:00.
Clear? Move it! County's not paying you to drink coffee! Somebody woke up on the wrong side of the coffin.
T oday ought to be fun.
Weak and dizzy, Exam 2.
Abdominal pain, Curtain 1.
- Bleeding hemorrhoids in 8.
- Chief! - And a boil that needs lancing.
- T errific.
- Is that unbridled enthusiasm? - Can't wait.
Keep an eye on your med student.
- Where's Abby? - PID down in Sutures.
You're supervising? Take the pyelo lady in Curtain 3.
Rule-out Ml or a nail through the hand? Both.
A terminal cancer patient's coming in.
Let's go.
Plenty more where these came from.
I went to medical school for a butt boil? Could be worse.
There's an explosive diarrhea.
- You don't look so good.
- So I hear.
I'm having trouble sleeping.
Read the Annals at bedtime.
Puts me right out.
Want me to dip a urine on our pyelo? I'll be in after I use the bathroom.
- You on all night? - I swapped shifts with Cleo.
I got Rage Against the Machine tickets.
- Right in the pit.
- Lucky you.
Weaver's got it in for me.
What'd I do to Festus? - You call her Festus.
- Not to her face.
- How's it going? - All right.
- I couldn't wake her up.
- BP is 85 over 60.
- She hasn't eaten in two days.
- Fluids? Some ginger ale.
She had a bowel obstruction last month.
The tumor spread to her liver and diaphragm.
- Could be encephalopathic.
- What's that mean? Her liver isn't removing toxins.
That might be why she can't wake up.
Here we go.
Gently now.
And one, two, three.
Get CBC, 'lytes, liver panel and PT.
Her resps are down to eight.
Your wife's breathing's very slow.
- We may have to decide to intubate.
- Oh, God.
- Is she a "do-not-resuscitate"? - Yes.
She doesn't want any machines.
She'll get IV fluids to make her more comfortable.
Could you show the O'Briens to the waiting area? Let's find you some crayons and coloring books, okay? Bye-bye, Mommy.
- Come on, sweetheart.
- I brought her things.
That's my job.
She likes to have her things with her.
We need a place to put them.
Could you hold onto them a while? All right, sweetie.
All right.
Come on.
- So, Mrs? - Wyatt.
- How long have you had the burning? - Couple of days.
Usually clears up.
- Any fever? -101.
4.
Open your mouth for me.
Weaver sent you a wheezer.
Would you excuse me? - History of asthma? - Since I was a kid.
Get him into bed.
Give him five of albuterol.
Sit up, please.
Does this hurt? - Oh! Oh! Y eah.
- You've got pyelonephritis.
- Is it serious? - You'll be fine.
- Need a hand? - No, no.
I've got this.
- Ever been on steroids? - Last year.
Few weeks.
for continuous nebs.
- Your last period? - A month ago.
- You sure? I'm waiting on labs.
- I got them.
Thanks.
- Any allergies? - I get hives from sulfa.
- What inhalers do you use? - Ventolin and Vanceril.
- Any chance you're pregnant? - Definitely not.
I got scared when I couldn't wake her.
You were right to call 911.
She's dehydrated.
I tried to make her drink.
She's so weak she can't swallow.
- She hardly holds a straw.
- Labs are back.
- Her liver's not clotting.
- What does that mean? It indicates severe liver failure.
Can anything be done? Not really.
We can only make her comfortable now.
So this is it? I think probably so.
Oh, boy.
- Where are my girls? - They're in the lounge with a nurse.
Do everything you can.
I don't want her to suffer.
Please.
Of course not.
Come back if you have fever or vomiting.
- I'll get a list of STD clinics.
- I'll be outside.
I need a smoke.
- But you'll quit really soon, right? - Absolutely.
ceftriaxone and Zithromax.
- Could you sign the chart? - Benton on? Benton traded with Corday and Cleo's off too.
Shocking.
This date's wrong.
T oday's the 11 th, not the 1 Oth.
- I thought tomorrow's the 11 th.
- Today is, all day.
I expected today to be awful, but it seems okay.
Venus out of alignment with Jupiter? No, nothing like that.
Jupiter has eight moons.
Shall I name them? - Who is this guy? - Frank.
A temp.
Now let's see.
Inner moons: - Metis, Adrastea, Amalthea- - I believe you.
Hemorrhoid guy's suppository is not helping.
Outer moons: lo, Europa, Ganymede, Callisto.
- What's he saying? - Moons.
Saturn has 18 moons.
Shall I name them? - No.
- The PID girl collapsed in the bay.
- What happened? - She's breathing.
Barely a pulse.
She needs two large-bore IVs, two liters saline.
- Wake up.
- Is it an ectopic? - No, ICON's negative.
- BP 70 palp.
- Her doctor? - Malucci.
- I'll get him.
- Mix up dopamine.
Get her on the gurney.
One, two, three.
- Pressure's 85.
- Up dopamine to 12 mics.
HemoCue's 14.
1.
Right adnexa's normal.
Left side, there's a mass and free fluid.
Damn it! - What is it? - It's septic and hypotensive.
- Should I page GYN? - No.
Dial 7614 for me.
- Temp 102.
- It's the infection.
Got them.
It's Lockhart.
I need to redline a ruptured TOA.
Page the chief resident.
- What's going on? - My patient's syncopal.
- Dropped her pressure.
- Patient? - What patient? - PID you discharged.
- Pressure's 100.
- Let's move her.
Maybe a hemorrhagic ovarian cyst? No, mass is loculated.
She spiked a fever.
You got a loculated mass? I wouldn't know one if it bit me on the ass.
- You haven't gotten your antibiotics.
- No.
- Sorry, I've been busy.
- I wrote the order 45 minutes ago.
You wanted continuous albuterol and steroids for him.
- When can you do it? - When I'm done.
Forget it.
I'll go get your antibiotics.
- When did you get back? - 20 minutes ago.
Still holding.
- I'm so sorry about your dad.
- Thanks.
Are you okay? I tried calling a couple of times.
Rachel came and we're just hanging out.
I'm trying to get my father into a VA cemetery.
- I'm transferred again.
- Didn't he want to be near your mom? I don't know.
He didn't want to be any trouble.
- Suggested I put him out with the trash.
- That was helpful.
Complained about mortuary vultures too.
I got another recording telling me to hold.
- You look beat.
- Tess hasn't been sleeping.
- Teething probably.
- So Luka said.
- He sees them enough to know.
- Don't give me a hard time about that.
- I'm struggling enough with this as it is.
- I think It's great.
I want you happy.
Why do I still feel so unsure? Maybe you're just afraid of making yourself vulnerable again.
- She's waking up.
- Tell me if you need anything.
Thanks.
Connie, could you get Weaver for me? - Where am I? - We're in the hospital, sweetheart.
- No.
No, I don't want that.
- Mrs.
O'Brien.
I'm Carol, a nurse.
We're giving you fluids through an IV because you stopped drinking.
That's why you didn't wake up today.
I want to go home.
Please.
Honey, we need to get you admitted to the hospital so you can feel better.
No.
I want to go home.
You want to go home? You don't want to be put onto any machines? Please, no machines.
They can help you if we stay.
They'll give you something for the pain.
- Mr.
O'Brien? - Please, sweetheart.
Please start a morphine drip.
I think we should explore home hospice care.
An ambulance could take her home.
Can someone take care of pain medication? It's clearly what she wants.
She's dying.
She doesn't know what she wants.
I think she does.
She was very clear.
Doesn't she deserve to die where she wants to? With her family? In her own bed? Good.
Why don't you tell her? It'll help calm her down.
I really didn't need this today.
Call Social Services.
Maybe we should admit her.
Get her buffed- - Please.
- She'd go home eventually.
She wants to go.
We can't keep her here.
She wants to die.
We have to respect her wishes.
She's in excruciating pain.
We didn't explain the options to her.
Just call and set it up.
All right.
This'll take 20 minutes.
You should feel better in two days.
A nurse will give you your prescriptions.
How do you feel? Steroids and albuterol help? - I feel much better.
- Amazing stuff.
You okay, Mrs.
Wyatt? Hard to breathe - Are you having chest pain? - No.
- This happen to you before? - When I got Bactrim.
- Bactrim? - I told you I'm allergic to sulfa.
Feeling dizzy - Just lie down.
Lie down.
- You need some help? No.
Everything's under control.
- How are you, Mrs.
Wyatt? - Not too good.
- What happened? - Nothing.
- Somebody hit the call button.
- I did.
- What? - She could hardly breathe! - What happened? - She complained of hives.
- I gave her a subcu epi.
- Where's the blood from? - She must've pulled out her IV.
- Why would she? How would I know that? Start another line.
Give her 50 of Benadryl, You nodded off for a second.
Good pulse and respirations.
- Want any fluids? - How about a liter over an hour? This won't be pretty.
Why was a critical patient discharged? She wasn't critical then.
Her vitals were stable.
- You didn't appreciate the mass? - No.
Who supervised? Dr.
Malucci? - Didn't you appreciate anything? - I didn't.
What were you wearing? Oven mitts? Dr.
Malucci never had a chance to examine the patient.
Get your stories straight.
I never called him in.
Have you recently graduated from med school? I thought my OB/GYN experience qualified me.
I was wrong.
So you discharged a patient examined and treated by a student? She could've died! You're years from the experience for these decisions.
- I know.
- Oh, good! I'd like to speak with Dr.
Malucci.
Can I say something? Your cause is better served by keeping your mouth shut.
When Residents arrive here, we size you up.
We have great hopes for you.
We want you to succeed.
Gradually, through interaction, we form opinions.
Do you want to know the staff's opinion of you? You're lazy, sloppy.
Your careless attitude as a physician endangers patients' lives, as witnessed today.
None of us thinks you're much of a doctor.
Emotionally, he's depressed one moment, elated the next.
- Have you talked to him? - I tried to ask him how he's doing.
He's not forthcoming.
- Is he seeing anyone? - Let's get out of the hallway.
Can you give us a minute? - A therapist? I don't know.
- Shouldn't he? - I'm not a psychiatrist.
- You think it's none of my business.
- The DMS IV- - You're a shrink? He has violent mood swings.
He's deeply depressed or he's manic.
- You're suggesting he's bipolar.
- Is there a family history? He was almost killed.
He feels guilty about Lucy's death.
- I'd be moody too.
- But are you sure that's all it is? I may be wrong, but what if I'm right? If we care, don't we owe it to him to try and find out? - How's she doing? - Breathing's agonal.
Resps are seven.
- So she's not getting any better? - I'm afraid not.
We're trying to rehydrate her.
and we called Social Services to help set up the hospice care.
Where are your daughters? Down in the cafeteria, getting something to eat with some of the nurses.
She's been sleeping so peacefully.
You should have seen her two years ago.
She was so beautiful.
Alive and vibrant.
Always laughing.
I wish I could have it back.
The time I missed with her.
Traveling for work, late nights at the office.
All the weekends I was prepping for trial.
And when she was first diagnosed I kept working.
Can you believe that? Instead of spending time with her, I kept working.
I'm gonna call Social Services again.
See what's keeping them.
Thanks.
She's not breathing.
- Oh, God! - Shelagh? Please, the girls aren't here.
I didn't think it would happen this fast.
- Connie, can you help me? - She's a DNR.
- We can stimulate her breathing.
- They didn't say goodbye.
- I'll get Weaver.
- No, I want you to go and get Kovac.
Tell him I need him, then go downstairs and get the daughters.
- Come on, Shelagh.
- Shelagh.
- Come on.
- Please, God.
Not yet.
Please.
- What happened? - End-stage ovarian cancer.
- She stopped breathing.
- Why are you baggin her.
Let's intubate.
- We can't.
She's a DNR.
- Then let her go.
Her daughters haven't said goodbye yet.
Please.
I thought we had more time.
Can we use a nasal trumpet? The children haven't had a chance to say goodbye to her dying mother.
It's not a ventilator.
Please? - Where are the trumpets? - I'll get it.
I'm in.
She's breathing.
- What's going on? - We put in a nasal trumpet.
- She's DNR.
- We didn't intubate.
- We're helping the airway- - You resuscitated her.
- She's your patient? - Yes, she's my patient.
Her daughters didn't say goodbye.
Will you excuse us for a moment? - You violated a patient's wishes.
- I did what I thought best.
- That's not your decision! - I'm sorry.
Damn right! You're a senior staff member.
We discussed this earlier.
I told you exactly what I wanted done! Respect my authority or don't work here! If she codes again, neither of you are to touch her.
Is that clear? I'm sorry, Luka.
Luka, don't just walk- You're here? I thought you'd be upstairs all day.
- I saw Kerry about Malucci.
- What did he do? I just discussed it.
Can I tell you later? - Sure.
- Get your dad sorted out? - Where is he now? - Actually, in the trunk of my car.
I had no time to go home.
- Where's Rachel? - With Jen's parents, being spoiled.
You might like these back.
I shouldn't keep them.
- My father gave them to you.
- It was very sweet.
But I just think it's a bad idea.
Rachel should have them.
I was Don't read too much into this.
- Do I do that? - You do it regularly.
- An acute Ml is coming in.
I'll be right there.
Are you still coming by tonight? - Where will Rachel sleep? - In the living room.
- I'm not off till 12.
- I'll leave the light on.
- You put me in a bad position.
- I know.
She's my superior.
I can't lose my job.
You've every reason to be mad.
- You took advantage of our relationship.
- I did what I thought was right.
- Damn the consequences.
- In this case yes.
You can make that decision for yourself, but not for me.
- You're really mad.
- Yes, I am! Why are you smiling? - I thought I was immune.
- Well, you're not! Luka, I'm sorry.
- Really.
It will never happen again.
- Good.
- And thank you.
- For what? For helping her.
You're welcome.
What? Nothing.
- You sure? - Yeah.
"Good night, little house, and good night, mouse.
Good night, comb.
Good night, brush.
" - Now can you see the mouse? - There's the mouse.
Guys, your mom's ready to see you now.
Could you take Jennifer? Sure.
We'll be in in a minute.
Don't you want to see your mom? She's going to die, isn't she? It's not fair.
No, it's not.
I don't want to only have a dad.
I want to be a family, like we used to be.
Come on.
We should go.
You ready? Hi, Mommy.
Hi, there.
How's my girl? What are you doing? Gathering my thoughts.
- You've been in here a while? - I finished some sutures.
I'm hanging out.
Is that a problem? No.
Some of us are just worried about you.
You don't need to be.
How are you? Seeing anybody? A therapist? - Need a referral? - Sure.
Nadio gave me some names.
That'd be great.
- It might help.
- Yeah, you're right.
I'll go.
Did Social Services get your patient home? No.
She died.
- I'm sorry.
- She was end-stage.
- Would you like to get some dinner? - Sure.
We don't have to.
That would be nice.
Miss Hathaway? I'll find you when I'm off.
I just want to thank you for everything you did for us today.
You're welcome.
Do you believe that we have soul mates? That there's only one person we're supposed to find? Only one person we can really love? I didn't used to.
But I do now.
She was the love of my life.
I'll never love anyone the way I loved her.
I need some more atropine.
- Where's Mark? - Everything all right? - Where's Mark? - Exam 1.
I got to go.
Tell Kerry I won't be in tomorrow.
- Twins okay? - I'll drop them at my mom's.
- What? - I'll call you from the plane.
Plane? - Where's Kovac? - Curtain 3.
- I can't have dinner with you tonight.
- Okay.
I'm so sorry.
For what? I have to find out.
Find out what? If he's still in love with me.
Because I'm still in love with him.
I am.
I've been in love with him since I was 23.
He's everything to me.
He's my life.
I'm complete when I'm with him.
I'm empty when we're apart.
He's the father of my children.
And he's my soul mate.
You'll find someone.
You will.
You're a wonderful man.
Someone who'll love you the way your wife loved you.
You'll find her.
You will.
You will find her.
Seattle? Seattle? Ramp four.
Hurry! They're in final boarding.
Seattle? All right.
Have a good flight.
Fasten your seat belt.
You almost missed it.
Yeah.
I almost did.
Dad, you're crazy.
This is your grandfather's favorite spot in Chicago.
Right here.
It's beautiful.
I have to go to San Diego next week to bury his ashes next to your grandmother's.
Can you come with me? Sure.
I'd like that.
- You miss him, huh? - Yeah.
I do.
It's kind of funny.
Why? We didn't like each other much for a long time.
How come? I can't remember now.
Probably mostly my fault.
I have something for you.
These were your grandmother's.
- Like them? - They're beautiful.
Can I put them on you? Turn around.
You look lovely.
Thank you.
Promise me you won't grow up too fast, okay? - Where are the girls? - With my mom.
It's beautiful here.