Chicago Med (2015) s07e07 Episode Script

1 No! Is there any chance the Vas-COM caused this? It's certainly possible.
Then Dr.
Cooper may have killed her.
Dr.
Marcel, I already told you Back off, Dr.
Blake.
I'm considering applying for a fellowship in transplant surgery.
Did you get any sleep last night? Didn't we just have this conversation? I was mothering you, and I shouldn't.
I won't do it again.
You've essentially been parenting your mother.
I don't want to be here! Do you know anyone I can call to get an illegally-parked van towed? It's gone! They towed it.
Stay with me tonight, okay? We'll figure it out.
Oh, you'll know this one.
Outdated surgical procedure misused to treat mental disorders.
Eight letters.
- Breakfast.
- Too many letters.
Can I see your arm? Oh, sorry.
It was in the bathroom.
- It just looked so - No, no, no.
No, wear it.
No, it looks good on you.
That's looking better.
I should hope so.
I'm a model patient.
Could use some improvement in the roommate department, though.
Think maybe you could clean up a little bit while I'm at work today? Wouldn't be an issue if you loaned me the $500 to get my van out of the impound.
I already told you.
Money's tight until the end of the month.
Some anonymous jerk makes a phone call, and like that, I'm out of my home and a pile of cash.
Seem fair to you? Mom, I promise I'm gonna help you.
But at least right now, you have a roof over your head.
And a doting daughter.
I gotta run.
I'm late for work.
Lobotomy.
Eight letters.
Oh, oh, oh.
What I was saying was like, hey, Trish Hey.
You two are so cute together.
Anyone ever tell you that you could be sisters? Oh, come on, girl.
Say it again.
[CHUCKLES.]
Come on.
Oh, trust me.
That was meant more as a compliment to me than an insult to you.
Why would she say we look alike? Does she know about us? Trish? No.
Okay, that makes it sound like there's someone who does.
I'm right.
Somebody does know.
- Okay, yes.
Sharon does.
- Ms.
Goodwin? Is that how I got this job? No, I can assure you that.
No, it almost worked against you.
Sharon was very reticent when she found out.
So she doesn't even want me here? That's not what I'm trying to say.
Does anyone actually think that I belong here? Whoa, whoa, whoa.
- No one else knows.
I swear.
- Okay.
- Except for Dr.
Charles.
- What? Oh, my God, everyone's gonna think that I'm here - because of nepotism.
- It was in confidence.
I promise, he's not gonna tell anybody, I swear.
Okay, but she knows, Maggie.
Vanessa, you don't have to prove yourself to anybody.
We've got a trauma incoming.
We're up.
Astrid Meadows, 21 years old, punched her fist through a plate glass window.
Looked like arterial bleeding at the forearm.
Controlled with a tourniquet.
All right.
Astrid, I'm Dr.
Taylor.
We're going to take care of you.
Oh, my God, they're still here! - Who's still here? - The snakes.
They're coming out of the vents.
Why isn't anybody doing anything? We think she might be tripping.
Okay.
On my count.
One, two, three.
Thank you, gentlemen.
Let's get her on monitors and hang a new bag.
Okay, let's set up a CBC, BMP, and send the blood for a full tox.
Let's open up a minor tray.
- You got it.
- Okay.
Relax for me, relax for me.
Thank you.
Okay, Astrid, let's see what we're dealing with here.
It's definitely the radial artery.
- Ow! - Let's inflate this cuff.
All right, here you go, sweetie.
Yes.
- There you go.
- Two hemostats.
Please! Please, just make them stop.
Hold on, sweetie.
Hold on, hold on.
Just hang in there.
Okay, bleeding's under control.
Let's get this tied up.
Get me 2-0 silk ties.
I'll get you an extra set of hands.
Okay.
Erika, can you go help Dr.
Taylor, please? Thank you.
[INDISTINCT CHATTER.]
Why is everyone standing around? Excuse me.
Hey, Mags.
Long time no see.
Dr.
Choi.
[DRAMATIC MUSIC.]
All right, everybody get back to work, yeah.
Hey, listen.
Whenever you find time, first round's on you.
[CHUCKLES.]
Hey.
Great to have you back, man.
Thanks, man.
You too.
Gotta say, bud, the cane? Nice touch.
Ah, it's just a temporary thing.
So look, us gunshot survivors, we got to stick together.
You know what I'm saying? So, I'm around.
I appreciate it.
- Great to have you back.
- Thanks.
Thank you.
Hey.
So, I take it your physical therapy's gone well? I'm feeling stronger every day.
Just just trying my best to stay out from under the knife.
Glad to hear it.
And Dr.
Archer tells me you're feeling like you're ready to come back.
- Yes, ma'am.
- We'd be happy to have him.
Hospital policy is you have to undergo evaluation before coming back from an injury.
I've been staying up-to-date with the journals and the latest COVID protocols.
Good.
Well, if you two will excuse me.
It's good to have you back, Dr.
Choi.
Thank you, ma'am.
Okay, let's hit the sim lab and see if we can help you get your sea legs back again, eh? Dean, I never got the chance to thank you in person.
Trying to sweet talk your way out of this eval? I'm serious, man.
You pushed for my spinal reconstruction.
Without you, I probably wouldn't be standing here.
Well, you might not have gotten shot if it weren't for me.
Don't think that hasn't been keeping me up at night.
[ELEVATOR DINGS.]
Hey, uh, you know, we're already past that.
No need to look back, right? And can't say I wouldn't take a bullet for you.
Okay, liver function's looking good.
Incision's healing nicely.
No sign of infection.
Did a pretty good job, if I say so myself.
That's good.
Would've been awkward if I had to sue you.
Oh, right? - Thanks.
- You okay? So, unless you notice any changes, we'll see you in a couple of weeks for a final checkup.
- A couple weeks? - Yeah.
I'll have to find an excuse to see you before that.
How about drinks? Oh, Avery, I don't think it's appropriate for me to date a patient.
I was just saying drinks but I mean, yeah, a date works.
Well, I should let you get back to my mother.
Still trying out for the team? Yeah.
Been shadowing the past few weeks.
Observed a pancreatic transplant the other day.
Your mother's a very talented surgeon.
And she grants you the privilege of observing.
I didn't peg you as the type to sit on the sidelines.
But hey, you decide you're ready to play, you know how to reach me.
A full bar the whole day.
They have if you're hungry and there's food, whatever, there's things like lobster and crab legs.
There's all kind of canapés.
Inconclusive.
Neither Cooper nor the Vas-COM were deemed responsible for Eleanor Holt's death.
Now, they're aware that Cooper inserted that monitor twice, right? Even after you raised questions about its safety? I mean, were his clinical decisions questionable? Yes.
But no one seemed comfortable saying he was negligent.
A patient died on our watch, Dr.
Halstead.
Someone needs to be held responsible.
I'm going to that critical care conference with Matt today.
Maybe he'll open up in a more social environment.
Yeah.
Maybe.
So, these snakes that you saw earlier today, when you punched through the window, were you trying to to get away from them? Were you trying to escape? I'm tired.
I don't really feel like talking.
All right, well then, why don't you get a little rest, and then maybe we talk some more later? - Yeah.
- All right.
Nice to meet you, Astrid.
I thought the hallucinations were drug-induced, but the tox screen came back negative for controlled substances.
Okay, so we can cross those off our list.
You think this might be some kind of psychotic break? Maybe.
You know, could be schizophrenia.
I mean, she's the age when these things start to present themselves.
She was saying that her hallucinations were more visual in nature, correct? - Snakes, yeah.
- Isn't schizophrenia mostly associated with hallucinations in the audio modality? I I was reading about this study in 2014 with the Oxford University Press.
They cited a close to two to one prevalence.
Two to one for me, that's still unsettled science.
Dr.
Charles, Dr.
Taylor, these are Astrid's parents.
Becky and Tom Meadows.
- My baby? - Yeah.
I understand you're a psychiatrist? I wanted to talk to you about the possibility of keeping Astrid here on a psych hold.
You know, Mr.
Meadows, I I haven't been able to properly evaluate your daughter yet.
This all started about six months ago.
Overnight it seemed, bam, the hallucinations, the erratic behavior.
We we can't protect her anymore.
Did you talk to him about having her committed? You know, I would really love to hear more about your daughter's history.
Maybe we can find someplace more private and talk a bit? - Sure.
- Great.
Thank you.
Baghdad! Nathan Daniels.
40-year-old male, high speed MVC.
Significant c-spine deformity.
GCS 3.
Heart rate 105.
BP 120/66.
His son's in the ambo behind us.
Okay, on my count, gently.
One, two, three.
Pupils are reactive.
Feeling a bony step-off on the c-spine.
Diminished breath sounds, left side.
We need an X-ray.
Yep.
Non-reactive to pain in the lower extremities.
- X-ray.
- Clear.
White out in the left lung.
Hemothorax.
Heart rate's 130, BP's down 90/55.
Give me a chest tube kit.
I'm in.
C-spine's clear.
Where where's my Dad? Is he okay? Yeah.
My friend Dr.
Hammer's taking care of him right over there.
- I I need to see him.
- Hey, EJ, EJ.
Look, look, I know you're worried, but right now let's just stay focused on you for a bit longer, okay? Gotta check out that arm.
[GRUNTS.]
Clear.
Mid-shaft radial fracture with mild angulation.
EJ, you might need surgery, but, in the meantime, is there anyone we can call? Like your mom or maybe a grandparent? No, he my dad's all I have left.
Please, you can't let him die.
Please, you you have to let me see him.
Please.
All right.
Look, I'm gonna go check on him right now.
All right? But Nancy here has to take you for a CT scan.
We have to see if you have a concussion.
I know.
It'll be all right.
- Okay? - Okay.
How's the dad? Not good.
Not moving his extremities.
Sending him for a panscan and a neck CTA.
Stat paged neurosurgery.
- Dad? - Wait! - Dad? - Hold on, hold on.
- Dad? Dad - Whoa.
Hold up.
Hold up, EJ.
wait, wait, no.
Hold up.
- Is he gonna be okay? - Come on.
- What's wrong with him? - Come on, come on.
You don't need to see this.
Come on.
Hey, Dr.
Blake.
I saw we found a liver for our patient, Sheldon West.
Take a look.
Oh, yeah.
Labs look good.
No abnormalities.
Very nice.
Note the measurements.
The donor liver's too large for Sheldon's abdomen.
So what? You're not going to accept? Well, as a rule, I don't like forcing square pegs into round holes.
Yeah, but Sheldon's got a MELD score of 38.
He's running out of time.
He'll tolerate another round of liver dialysis while we wait for a better match.
Uh, Dr.
Blake.
Sorry, if you'd indulge me, what about a hepatectomy? Trim the liver to size? That adds time to the procedure that Sheldon won't have.
Well, I've done dozens out of the ED.
If you'll allow me to assist, I'm confident I can pull it off.
Wait, wait, stop.
Is my Dad gonna walk again? EJ, right? It's too early to say.
But he's in good hands with Dr.
Abrams.
Are you off to surgery for your arm? You think it can wait? I I don't want anything to happen to my Dad while I'm out.
How about I make you a deal? You stick to your surgery, and I'll keep you looped in before anything happens.
Sound good? - Okay.
- Okay.
- Thanks.
- Yeah.
Thank you.
So what's the word? Mr.
Daniels is an ASIA A at C5.
Complete injury.
No motor or sensory functions below the neck.
That's catastrophic.
He's tetraplegic.
That would be my assessment.
I assume you ordered a CT scan? The results just came in.
Bilateral jumped facets at C5 and 6.
Well, there's no chance his cord is getting perfused when his spine's that maligned.
We need to get him in traction now.
I'll grab the traction cart.
- Okay, sat's at 75.
- Almost got it.
70.
You've run out of time, Ethan.
Come on.
Come on.
- 68.
He's bradying down.
- [MACHINES BEEPING.]
I'm in.
I'm in.
Nah, that's it.
That's it.
Your patient's coding.
[BEEPING.]
I guess I'm a little rustier than I thought.
Are you gonna stand there while he arrests or what? Aye, Chief.
[CLEARS THROAT.]
Starting compressions.
Dr.
Taylor.
Dr.
Charles, Uh I didn't see you there.
My allergies were acting up.
So, I heard that you sent Astrid Meadows for an MRI? I did.
Yeah, but not but not without cause.
When you were with her parents, I took the opportunity to re-examine her, and I noticed increased tone in her injured arm, which is to be expected.
But then I also realized that it was in her other arm.
- Slow down a little bit.
- Right.
Of course.
Yes.
So I decided to take note of the reflexes that are affected on both sides of her body.
And then that's when I realized that something else might be going on here, an underlying condition.
Maybe something neurological or musculoskeletal or Well, you know, I did give her some Haldol.
Which, you know, could explain the diminished reflexes.
Perhaps.
Nonetheless, I felt it prudent to order an MRI.
And honestly, the results were interesting.
You want to take a look? You know, if you look here and here, you can see the T2 white matter changes.
I mean, that could be MS, right? And that could explain the rigidity in her arms, or maybe even the hallucinations.
You know what? Interpreting MRIs can be tricky, all right? For instance, I mean, these white matter changes, they could also just be normal aging.
I-I think we want to careful about getting too far ahead of ourselves here.
You know? Dr.
Taylor? You got an intake in T3.
I'll be right there.
I just wanted to be diligent.
That's great.
Will Halstead? We're over here.
Hi, Jessa.
Listen, I heard about what happened to Eleanor Holt, and I just wanted to extend my condolences.
Yeah, thank you.
There was an M&M this morning.
What'd they determine? That's confidential, Jessa.
I really can't get into it.
Oh, my gosh, of course.
It's just I'm just at the beginning of my career, and I really don't want to be associated with a potentially defective product.
So I guess what I'm wondering is do you think it was the Vas-COM itself, or was Dr.
Cooper possibly at fault? - Hey guys, how's it going? - Matt.
Hello, Matt! Um, I was just telling Will over here how excited I am to have you both at the hospitality suite later.
Room 1202.
It's gonna be a blast.
- There's canapés and crab legs.
- It sounds fantastic.
I think I'm gonna walk the floor though first.
Halstead, let's do this.
Ride shotgun with me.
Yes, sir.
See you later, Jessa.
Yeah.
So, Jessa's questioning my decision-making in regards to Eleanor's care? I wouldn't take it personally.
I'm sure she's just protecting her employer.
That's okay.
I, um I've been second-guessing my decisions myself.
Oh, yeah? If you were a bottle of tequila, where would you be hiding right now? Great.
Thank you for responding so quickly.
I promise to be brief.
Over the past few weeks, we've seen an uptick in patient complications in regards to the Vas-COM cardiac monitor, including a recent tragic death.
So, starting immediately, the hospital will discontinue the use of the Vas-COM until it can be proven to be totally safe.
About damn time.
Are we sure about the math on this one? Maybe we're seeing more problems with the Vas-COM but that might be because there's a lot more being used than ever before.
Exactly.
I have 11 in use right now in cardiac recovery.
Like, what am I supposed to do? Swap them out? Yes.
Return to the methods and devices before Vas-COM.
That'd be going backward.
You can't tie our hands like that clinically.
I'm confident you'll make do.
Thank you all in advance for your compliance.
Yep.
- Adding another two pounds.
- Take it slow.
We don't want to damage the ligaments any more than they already are.
All right.
Let's get another image.
Clear.
Okay, alignment looks better.
Should reduce pressure from the cord.
Oh, good, you didn't kill him.
The hospital has been unable to find any next of kin of legal age to make decisions on Mr.
Daniels' behalf, so the law says it's now our call on how to proceed.
So, what are our options? Well, given the injury's to his c-spine, our only option is an anterior cervical discectomy and fusion.
Stabilization is the quickest road to recovery for Nathan.
Oh, good.
I'm glad I have your approval.
I've got an OR opening up in a few hours.
I'll have my team transfer him up there then.
Wait, what about the cord swelling? You could decompress it posteriorly, improve flow.
No, the injury's complete.
Decompression won't restore function that isn't there.
But we both know swelling can mask an incomplete injury.
A more aggressive approach could restore his motor function.
Nathan could walk again.
Not according to his ASIA results.
The man's got virtually no function left to restore.
But still, we should get EJ's input and see if this is what either of them would want.
Kid's 15 years old.
So, you're welcome to inform him as to what we're doing, but we're not conducting a straw poll here, Dr.
Hammer.
The decision's been made.
[SOMBER MUSIC.]
- All set for you, Dr.
Marcel.
- Okay.
I can't get it to lay posteriorly.
Maybe I can push the stomach to the left more.
Liver's still too large.
Well, I I've got more room to resect tissue.
Not much, from the looks of it.
I can make it work.
Let's hope so.
Dr.
Taylor, did I hear that you gave Astrid a spinal tap? I just wanted to make sure we weren't looking at MS.
I thought that we covered that earlier.
Oh, and all the labs are back.
They're negative across the board.
Okay, so it's official.
No MS? It still doesn't rule out something neurological.
Maggie, I want to order another MRI, but this time with contrast.
Okay, wait.
Look, Vanessa.
This young lady, she's been through a traumatic event.
Right? She's in a vulnerable place.
And now we've spent the last couple of hours sliding her in and out of metal tubes, sticking big needles in her back.
Her parents are talking about having her committed.
I just want to make sure that this diagnosis is correct.
And I applaud your drive in trying to figure out what's going on here.
But I also would encourage you to think of her as, I don't know, more as a human being and less maybe as a test you're gonna get graded on.
I mean, I think it's it's just important to strike a balance there.
Okay? - Yeah.
- Great.
Thank you.
Mags, page me once she becomes lucid.
Thank you.
You mean, he's going to be paralyzed? Like totally paralyzed? Look, EJ, I know this is difficult.
But the important thing is that cognitively, your father should make a full recovery.
He won't be able to to walk, or or ride his bike, or even eat on his own.
He wouldn't want to live like that.
There's got to be another way.
Actually, there is another option.
If we fuse your father's spine and then decompress the spinal cord with a procedure called a laminectomy, there's a chance that he could regain some or all of his motor function.
But it is extremely high risk with very little chance of success.
It doubles the length of the surgery, and there's a very good chance that it could make his injury worse.
Or kill him.
I know my dad.
That's a risk he'd be willing to take.
I'll speak with Dr.
Abrams.
Dr.
Hammer, can I speak with you outside? What are you doing? EJ has a right to know his options.
You made him think he has a choice.
It's his father.
His life, his future.
The future you're promising him, you can't deliver.
But EJ said this is what his father would want.
Yeah, he's 15 and recovering from a trauma.
He's just a kid.
Yeah, and I'm gonna do everything in my power to help him stay that way.
Damn it.
It still doesn't fit.
Suction.
I mean, I can't remove any more tissue - and keep the liver viable.
- How's our patient, Marty? Temp is down and he's coagulopathic.
Well, if we can't make our square peg any smaller, maybe we can make the round hole larger.
What are you suggesting? That we expand the abdominal cavity? There's not enough posterior space, right? So, can we make the diaphragm larger? Oh I see, that'll create some space for us to maneuver the liver into position, yeah.
Okay.
Get Dr.
Marcel a scalpel.
- Okay.
- Let's go.
Sharon, hey.
Sorry for the intrusion.
You remember Roger Flanagan, from the Board? Yes.
I just saw your son-in-law, Dr.
Cooper, at the M&M.
Sad business.
To what do I owe this pleasure? First of all, I want to salute you on the stand you took with the department heads.
What happened with that patient is a tragedy, and we need to make sure it doesn't happen again.
I appreciate that.
That said, we want to make sure we're in the clear legally.
Peter, you identified a couple of potential soft spots, didn't you? You know, Vasik could say we're in breach of contract.
Or worse, pursue a defamation claim.
And that gets in front of the wrong judge, we could be looking at a pretty hefty payout.
That's why the Board's decided to hold off on banning the Vas-COM just yet.
Instead, we'd like to form a committee to investigate any claims of malfunction.
And when we get all the data in, we can make a studied decision.
I see.
Always good to see you, Sharon.
Indeed.
[HEAVY MUSIC.]
I thought you were looking at breaking into the big leagues.
I don't follow.
Device reps don't like doing business if the doctors - don't have a good time.
- Well, well.
Why is that? Sober doctors aren't as corruptible.
Look, companies like Vasik, they want to make sure that when push comes to shove, you won't suddenly get a bad case of ethics.
Oh, well Excuse me, I just go to Oh, I tell you, once you get used to the taste, it goes down smooth.
So, do you feel like you've been morally compromised, promoting the Vas-COM? How else are you supposed to get the crab legs? [LAUGHS.]
I mean, Vas Vasik's giving you more than crab legs, right? How much we talking about? Look at you, you greedy little bastard.
No wonder Vasik's trying to get their hooks in you.
Come on, let's just what you say we what you say we take this party up a notch? Just a little? Mm-hmm! - Come on, come on.
- Sats down to 65.
- I'm calling it.
- I'm almost in.
No, come on, your patient's hypoxic.
It's over.
Come on, man.
No one goes down that fast.
Listen, Ethan, we both know how quickly a situation like this can go south.
This is why you need to be prepared if you're going to return to the ED.
You don't think I know that? Come on, man, let me go again.
Let's go again.
Why exactly are we doing this? An EEG can determine Astrid's brain activity that might be useful in in realizing diagnoses such as epilepsy or a tumor.
I thought we determined she was suffering from some kind of psychiatric disorder? Just want to make sure there's no underlying causes.
Dr.
Taylor? Can I get a moment? I thought we decided to put a pause on the battery of tests.
I know, but I needed to to rule out epilepsy as an underlying cause.
You know, I gotta be honest with you, I'm a little concerned.
I think you're pushing way too hard here.
- No.
- Yeah.
And I think that maybe you should take a little break.
I think you should go home - Go home? - And get some rest.
Yeah.
Dr.
Charles, I know that you think I don't belong here - but I assure you - Whoa, whoa, whoa.
I didn't say that.
Why would I think that? Maggie told me you that know about me and her, that she's my birth mother.
[MACHINES BEEPING.]
[ALARM WHISTLE.]
BP spiked, 160 over 100.
Super tachy, heart rate's in the 150s.
Is she having a seizure? The EEG says that's not what's happening.
- Then what is happening? - Push 10 of labetalol.
And get her on oxygen.
Astrid, can you hear me? Astrid? - Why is this happening? - You know, I don't know.
It's usually caused by traumatic brain injury.
Vitals are stabilizing.
BP's back to normal.
Heart rate 78.
Astrid? You with me? Why is her arm still doing that? Can you relax your arm for me, Astrid? Okay.
Let's get another MRI, this time with contrast.
And I want a full metabolic genetic panel.
It's okay.
We got you.
- Can I get one more? - Mm-hmm.
Okay, patch is in.
The cut diaphragm should accommodate the liver now.
Should's not gonna cut it.
This is our last chance.
Okay, liver's in.
Not out of the woods yet.
Still need to attach the vessels.
Let's get started with the hepatic vein.
Okay.
[SNIFFS.]
You wanna hit some of this, buddy? - Nah, I'm okay.
- Good for you, Will.
That's good.
That's good.
You you you keep making the good choices.
You leave the bad choices to moi.
[SNORTS.]
Matt, do you think putting another Vas-COM on Eleanor was a bad choice? What do you think? We knew there might be contraindications.
Why'd you do it? You still haven't figured that out yet? - God.
That's weird.
- You all right? Yeah.
My arm's my arm's tight.
- Let me check.
- I'm good, I'm good.
I don't feel so good.
- Let's get you some fresh air.
- Yeah.
No, no, no, let's get you out - let's get you out of here.
- Okay.
Just take it easy.
Deep breaths.
- There you go, you got it.
- I'm good.
I'm good.
All right.
Yeah, you're good.
Let's sit you down, get you a glass of water.
You'll be good as new.
Oh, damn it.
Come on.
Talk to me.
- Oh, my God, what's happening? - Call 911.
Come on.
Stevie, what's going on? I'm doing a second ASIA exam.
Abrams already made the call.
That was before Nathan's spine was in traction.
And you think the stabilized alignment will improve Nathan's score? It's the only way to change Abrams' mind, get him to go for the decompressive laminectomy.
- Did you see that? - Yeah.
Reflexive muscle contraction.
Way beneath the zone of injury.
He's still got motor function.
He might not be completely paralyzed.
Dr.
Abrams, I need to show you something.
Am I missing something? His pelvis just flinched a second ago.
It was a subtle finding.
Glad to see you two sat for your neurosurgery boards - while I was away.
- I know what I saw.
I think that Mr.
Daniels has a Grade B incomplete injury.
He has motor function to salvage if we decompress the cord.
He could get his legs back.
Well, that would change the calculus.
But you better be certain you saw what you saw.
Because if you're not, and this man dies on my table, you'll be the ones to explain why to his son.
We're sure.
Okay.
Let's do it.
.
Talk to me - .
Cocaine-induced MI - Shocked three times in the field.
Intermittent ROSC.
Ethan, need an extra set of hands.
- That Matt Cooper? - Yeah.
All right, on my count.
One, two, three.
Get him up on the monitors.
Milligram of epi.
- You got a pulse? - Still in V-fib.
Let's run the code.
Doris, compressions.
- You got it.
- Where's the defibrillator? T4.
Ethan, intubate while I grab the paddles.
- Hold compressions.
- Clear.
- Sats are dropping 78.
- Hang on.
Sats down to 74.
- Dr.
Choi? - Doris I'm in.
How we looking? Sats are coming back up.
- Still in V-fib.
- Another milligram of epi.
Charge to 200.
- Okay, clear.
- Clear.
[MACHINES BEEPING.]
Got a pulse.
Sinus tach.
Just like riding a bike, right? 12-lead EKG, chest x-ray, and page cardiology.
So, Astrid the good news is that your hallucinations are not being caused by any kind of underlying mental illness.
So I'm not going crazy? Well, no.
But a genetic panel has revealed that you have a disorder called metachromatic leukodystrophy or MLD.
MLD causes the brain and nervous system to progressively lose its function.
The first symptoms are often psychotic episodes, followed by a host of others such as poor muscle function like we witnessed.
So this is going to get worse? Hopefully we can mitigate its progression with meds.
And the fact that you haven't shown any symptoms until recently is a really, really good sign.
It means we caught it early and should point to a better outcome going forward.
At least I know what's going on with me.
Such a huge relief.
Thank you.
Thank you.
Dr.
Blake? Oh.
Fundraiser for the program.
12 hours in the OR, and they still expect me to wear heels.
- Right.
Ha.
- What do you need? Look, I just wanted to say that I realize I might have painted you into a corner, you know, you and the team, pushing for that surgery.
And I I wanted to apologize.
Why? I've been waiting two weeks for the Crockett who threw me off my daughter's case to show up in my OR.
Nice he could finally make it.
Self-doubt's not a good look on you.
Have a good night, Dr.
Marcel.
Nathan, this is Dr.
Abrams.
Can you move your left foot for me? Can you wiggle your toes? Nathan, can you wiggle your toes for me? Come on, Dad.
Please.
Thank you.
Thank you.
Happy we could help.
Excuse me.
Hell of a call today.
Hey, what's wrong? I'm just so relieved.
I wasn't sure I was making the right call.
But you did.
It all worked out.
You fought for a 15-year-old, and you won.
I don't know.
I feel like maybe the 15-year-old I was fighting for today was me.
I was EJ's age when I had to start taking care of my mom.
It took so much out of me.
It still does.
Want to talk about it? Grab a beer? I wish.
I can't tonight.
I got to get home to my mom.
- It's all good.
- Yeah.
See you tomorrow.
I'll see you tomorrow.
- Thank you for today.
- Yeah.
Dr.
Charles? You have a minute? Yeah.
Come on in.
I just wanted to come up and apologize.
What for? I accused you of thinking that I didn't belong here and that wasn't right.
I realize that I was projecting my own insecurities - onto you.
- No apology necessary.
Matter of fact, I'm glad you stopped by because I wanted to commend you on your stick-to-itiveness today, really.
Thank you.
Thank you.
That means a lot.
But you know what really sucks? What really sucks is when capable people like yourself feel like they need, I don't know, a little, um a little extra help to keep up.
What do you mean? What I mean is, I don't know, like what, caffeine pills or too many energy drinks, or I mean, God forbid, straight up pharmaceuticals, you know? If you're talking about the pill I took this morning, I I told you that it was for my allergies.
I'm not on anything.
Look, Vanessa, all I'm saying is that I really understand the kind of pressure you're under I should get back to the floor.
But thank you so much, Dr.
Charles.
I appreciate it.
Hey.
I heard what happened.
How's he doing? Seems he dodged a bullet.
But it's too soon to tell.
I was so close to getting him to confess.
Well, an experience like this has been known to change a man.
Guess we'll have to wait to see what effect it has on him.
You cleaned.
The landlord was on my ass about it.
Looks good.
Hey, Mom, you know I always do my best to take care of you.
I know, hon.
That avocado toast this morning was actually pretty good.
Ha ha.
Good.
Well, I more meant if I push you or overstep, it's only 'cause I love you.
What's this about? You were so adamant about not staying in the hospital.
And I was afraid that you wouldn't take care of yourself after you left, so I had your van towed.
What? I thought that if you just stayed with me for a few weeks, that I could take care of you while you took your antibiotics.
My home.
You took my home from me.
I know I was wrong.
I am sorry.
I did it to protect you.
I didn't know what else to My whole life.
How could you? Stop, stop! Mom, please.
Please, let's just talk about this.
- You lied to me! - Come on.
No, Mom, please.
Stop it, Mom.
God - I'm I'm sorry.
- No.
I'm okay.
I'm okay.
Mom, I'm okay.
What are you doing? Mom, what are you doing? I gotta go.
No, no.
Come on, Mom, please, Mom.
Mom, stop.
Mom! [DOOR SLAMS.]
[WOLF HOWLS.]