Chicago Med (2015) s08e02 Episode Script

1
My son, 15 years ago,
I lost him to drugs.
I just don't know where he is.
- You have a call from
- Sean Archer.
An inmate at Cook County Jail.
Dad?
You have a relationship
with our perfect daughter.
I'm married, and I love my husband.
And I can't be a part of that.
You all right?
All my clothes, everything, it's gone.
Jessa Rinaldi,
I'm placing you under arrest.
You're charged with aggravated arson
and one count of attempted murder
against Dr. Will Halstead.
Hey, are people still
coming in and out of here?
Yeah, my contractor came by last week
to work up an estimate.
You know, he thinks
we can salvage a lot of this.
Now I'm just waiting on the
friggin' insurance company
to approve my claim.
Well, you're in violation
of building code
sections 13-117-12 and 125.
And until such a time they're remedied,
a fine of $700 will be assessed daily.
Oh, hey, hey, hey.
Can you give me a break here?
I don't know what I'm supposed to do.
Hey, if it were up to me,
I'd call in a wrecking ball
and get it over with.
You got old.
Yeah, it's been a while, so
15 years.
I wasn't sure you were coming in.
Well, I would have come earlier,
but it turns out that
it takes a while to get
granted visitation.
So I was talking to your lawyer.
A Lisa Bly?
From the public defender's office?
- Mm-hmm.
- She said something
- about a plea deal.
- Yeah, we talked it over.
She didn't think it was
a good idea to fight this.
Doesn't sound like she fills
you with confidence, does she?
I'm gonna get you a new lawyer,
somebody who knows
what the hell they're doing.
It's okay. I'm cool with it.
You're cool with it,
just staying in prison?
That can't possibly be what you want.
Can we change the subject, please?
Oh, for Christ's sake!
Sean, you've been like this
since you were a kid.
You're always giving up
on things too easily.
Kind of like how you gave up on me.
Are you still using?
Hmm?
You know what? This was not a good idea.
Hey, I'm just trying
I'm hanging up now, Dad.
We should do this again sometime,
maybe in another 15 years.
Wait a second. I'm just trying to
$700 a day. Can you believe that?
It's like I just got hit
by a truck and they want me
to donate the little bit
of blood I have left.
Maybe you should just
tear it down like the guy said.
Are you kidding me?
Hannah, I got way too much invested.
No, screw them.
I'm gonna file an appeal.
It's been, what, like,
a month since the fire?
- Yeah, and?
- I'm feeling like you're
embracing this modern-day Job
thing a bit too vigorously.
Hey, we could use the two of you.
So do you think I'm acting
like some kind of martyr?
I'm just saying that
the sooner you let this go,
the sooner you can move on
with your life.
Nine-year-old male, 25 mile
per hour motor vehicle crash.
Mom and son both restrained and stable.
No loss of consciousness.
Kid complaining of pain in right arm.
Mom has no vocal complaints.
She's coming in right behind us.
I got Mom.
It looks like they might
be living out of their car,
for what it's worth.
Good to know. Thanks.
Hey there. I'm Dr. Halstead.
Actually, I'm Will.
- What's your name?
- Henry.
Can I ask what you got in that jar?
It's a chrysalis.
One day, it's gonna turn
into a butterfly.
That is super cool.
Would it be all right if
Nurse Doris here holds on to it
- while I look at your arm?
- Thanks.
- Let's get X-ray in here.
- Yeah.
Now let's look at this arm.
- Does it hurt?
- Yes.
I know. I'm sorry, buddy.
Okay, that's it.
Anything else hurt?
- No.
- Good.
Now, do you remember what happened?
We were looking for a new parking spot,
and I don't know,
Mom just kind of drove
off the side of the road.
Okay. We're gonna get a quick
picture of your arm, all right?
Hey, you're being really brave.
All right, X-ray up.
Well, now that doesn't look too bad.
All right, Henry, I'm gonna go
talk to your mom for a minute.
I'll be right back.
Here you go.
How are we looking?
X-ray is clear.
Beyond a scrape or two,
I'd say she's doing all right.
Ms. Mitchell, I'm Dr. Halstead.
I just saw your son.
He's fine, except for some arm pain.
The X-ray showed a nondisplaced
distal radius fracture,
just a fancy way
of saying he broke his arm.
What?
It'll heal quickly with a simple cast.
I just need your consent to treat him.
No.
Excuse me?
What have you done with my boy?
Henry's right next door.
Who are you? What am I doing here?
- Jenny, you had a car crash.
- I don't believe you.
You've been brought to Chicago Med.
I'm Dr. Asher. This is Dr. Halstead.
You're with the collection
agency, aren't you?
I told you already.
You can't have our souls.
- Okay, whoa, whoa, whoa.
- Okay, all right.
Give five of Haldol.
- Jenny
- Let me out of here!
- It's okay, Jenny.
- Right now!
Calm down. Let us help you.
Nobody touches my son!
No.
Hey, can I get
everyone's attention, please?
Thank you.
I'm sure that you have
all noticed lately
that we are running low
on a number of key supplies
Dialysis tubing, contrast dye, syringes.
And I am just as frustrated
as all of you are
at the seemingly intractable
and unpredictable
supply chain disruptions,
but we are working to find solutions.
Meanwhile, I'd like to remind you
that we are all in this together.
Be mindful of that, all right?
Let's all get back to work.
Are you two looking for a consult?
Yeah, I got a nine-year-old
in three with a broken arm
whose mom won't give us consent
to treat him.
Her behavior suggests some
kind of psychiatric disorder.
- We were forced to sedate her.
- What did you give her?
She still seems pretty animated.
Five of Haldol.
Maybe she's a little resistant to it.
Yeah, at least now
you can go speak with her
and convince her to let us help her son.
You know, I'd rather wait for the labs
and see what the tox screen says.
What about the boy?
I'll go talk to him.
Any other family around?
Father, grandfather?
No, none that we could find.
Okay, I'll report back.
Ah, there's a vaguely familiar face.
You're finally back
from vacation, I see.
You know, for a second there,
I thought we lost you for good.
Hey, I came in early
to get a coffee with you.
You weren't in.
Yeah, I had to get my oil changed,
but you look well-rested.
No cell service, no Wi-Fi.
Just surf, sand,
and the stars for two weeks.
- Yeah.
- I am, as they say,
totally chill.
Excuse me, Dr. Archer.
I was wondering if I could
go over this patient with you.
First year resident, Dr. Zach Hudgins.
Allow me to introduce you
to one of your attendings,
Dr. Ethan Choi.
I'm sure Dr. Choi would be,
like, totally happy to assist.
Pleasure to meet you, sir.
Hi, Zach. What do we got here?
51-year-old male, progressive cough,
congestion in his chest.
His sats are kind of crappy.
Crappy, you say?
- Low 90s, high 80s.
- Did you get a chest X-ray?
That's happening now,
but here's the thing.
The patient has advanced stage ALS.
Kind of a detail you might
want to lead with, Zach.
- What's the patient's name?
- Albert.
Albert Marrero.
Ooh, let me see that.
Albert Marrero.
Take a deep breath.
All I have.
Well, I think
you're holding out on me, Al.
So I understand you two go back a ways.
Dean first to diagnose.
It's a little over six years ago now.
I won that bet, by the way, Al.
Check's in the mail.
Well, I don't think
you have a pneumonia yet.
Your X-ray is okay,
but these things can lag
by a day or two.
Oh, goody.
But your lungs do sound a little junky.
You're just not clearing
your secretions adequately.
ALS can weaken your diaphragm,
and thus, your cough
just isn't strong enough.
We call it plugging,
but it could be
a little difficult to clear.
Right, which is why
I think it would be prudent
to just run a bronchoscope
down there and clear it all up.
No muss, no fuss.
Would you need to put me under?
Light sedation, so as
to make it easier to intubate.
No.
Al, it would only be temporary.
It's not as invasive as it sounds.
I have a DNI.
I don't have control
over what this disease
is doing to my body.
I, at least, want to keep
control over how I die.
Al, look, we're getting way
too ahead of ourselves here.
We're just talking
about clearing some mucus.
Dean, can I talk to you?
Sure.
Excuse us.
Hey, Dean, I think
we can clear the plugging
- without bronching him.
- Eh, doubtful.
Put the percussion
vest on him, chest BT,
breathing treatments,
just like a CF patient.
Come on. It's worth a shot.
Yeah.
Huh, only a two?
It's okay if it hurts
more than that, you know?
Matter of fact, what I'm hearing is
that the higher the number,
the more likely the nurses are
to bring you some ice cream
from the cafeteria.
I'm just saying.
My arm really doesn't hurt that bad.
Okay.
Are you here
to take me away from my mom?
No, Henry, I'm not.
Why are you
Why are you asking me that?
A lot of people have
been talking about that.
What I really want to talk to you about
is this beautiful chrysalis you have.
How long have you had it for?
Maybe a month or so.
Your mom get that for you?
Mm-mm-mm.
Has she been going through
a bit of a tough time recently?
See those markings
at the bottom of the wings?
And that means it's a girl.
No kidding?
You know, I didn't know that.
She might not look so good now,
but pretty soon, she's gonna break out
and be beautiful again.
I know it.
I tell you what, that's
one gutsy little kid in there.
Look, far as I can tell, his
mom started to act out around,
I don't know, 1st of the year.
Psychotic break?
I don't think so.
I mean, bipolar, schizophrenia,
they just rarely present
this late in life.
- Mm.
- Tox screens come back yet?
Clear. Nothing in the blood or urine.
Okay, well, I want to take a look
and then maybe try and have
a conversation with the mom.
- Mm-hmm.
- So what about Henry?
His arm is stable, right?
I mean, not getting any worse.
We got a bit of time.
How long is a bit?
I mean, this kid needs our attention
in more ways than one.
Mom clearly can't help him.
They're living out of their car.
I think we should double doc his consent
or get a court order.
In order to do that, though, Will,
I've got to declare her
incapable of caring for her child,
which means put her on a psych hold,
which means getting DCFS involved.
Look, I'm worried about the kid too.
I just really want to make sure
we're right before we go there.
- Yeah, of course.
- Okay.
Okay.
- Maggie? Maggie?
- Yeah.
Grant, what are you doing here?
- Is everything okay?
- Look.
Keith here had an accident
on the worksite.
They asked us to wait
for an intake nurse,
but I was hoping maybe I had
enough pull to cut the line.
I don't know.
We kind of have a system here.
Hey, Grant. What's up?
We've got a bit of a situation here, V.
Okay, yeah, let's take a look.
Room five is okay, isn't it?
- Sure.
- Okay, come on.
We were doing some site prep
for a new sports therapy clinic
I designed down in Hyde Park.
Anyway, the team was clearing
some dead trees, and
Okay. Okay, how about I take a look?
Let's see.
Don't touch it, okay?
Let's just have you chill here
for a second
while we come up with a game plan.
Thanks, Vanessa, Maggie.
We're gonna need a CT of this.
Put the order in. I'll call CAT scan.
Okay.
Dr. Choi!
- What's going on?
- He's really struggling.
- O2 sats 82 and falling.
- Nasal cannula.
You can't clear the mucus.
Don't worry, Al.
- We'll get you through this.
- Help me sit him forward.
Now bang on his back.
No, use your fist!
- Pound with your first hard!
- Sats at 70s.
- I don't want to hurt him.
- For Christ's sakes.
Get out of here.
There it is.
I'm not losing this one, not today.
I know it might not
seem like it at the moment,
but you, Keith, are a lucky guy.
Somehow this stick managed
to lodge itself cleanly
along the side of your orbit
without penetrating your eyeball.
So we can just go ahead
and take it right out.
- Right now?
- It'll be fine.
Are you sure
you're qualified to do this?
Well, she finished
top of her class, Keith.
I can give you something to
calm your nerves, if you'd like.
No, no, just get it over with.
Okay.
Hold still.
There. All done.
Thank you.
How does it feel?
It still hurts a ton,
but yeah, better than a second ago.
Yeah, we'll give you
something for the pain.
In the meantime, if you
could just follow my finger.
Yeah.
Did you just see that,
how steady her hand is
- and how confident?
- I know.
It's like we created
some kind of Jedi Knight.
I'm honestly just blown away.
She's your spitting image, Maggie.
It's crazy how that works.
Any word yet from ophthalmology?
They're swamped.
They say they'll be down this afternoon.
I really don't want to discharge Keith
until they see him.
If you've got to get back to work,
I can call you when we're done here.
Oh, no, Keith's worked for me
for, like, 15 years.
I'm staying until he's cleared to go.
But maybe we can all
have lunch together.
Yeah, that's a great idea.
I don't know.
I don't think I can get away.
Oh, come on, Maggie. It'll be fun.
I'm sorry. Crockett,
Kai, we have incoming.
Please, Maggie. Could you just for me?
Okay, but not for another hour.
Let's go!
We're going to Baghdad. What do we got?
Julián Sanchez, GSW.
Two holes, left thigh,
maybe through and through.
Moderate blood loss in the field.
Put a pressure dressing on it,
but not actively bleeding now.
Dropped his pressure in the ambo.
Gave him a liter of fluid.
BP now 100 with a heart rate of 125.
Okay, Julián, I'm Dr. Marcel.
We're gonna take good care of you, okay?
Hang in there, bud.
Okay, everyone. Nice and easy.
- On my
- On my count.
One, two, three.
Easy, easy.
Let's get him up on monitors.
Okay, DP and PT pulse has diminished.
Let's strip and flip him, make
sure there's no other holes.
Okay, here we go.
One, two, three.
Easy, easy.
Just two in the thigh.
No active bleeding.
Okay, let's have X-ray get us
a quick chest and pelvis, okay?
Why do we need a chest X-ray?
He was only shot in the leg.
One whole bullet in,
one whole bullet out.
Make sure they connect.
He was shot twice.
Bullets travel
in unexpected ways, right?
How would you feel if you
left a bullet in his chest?
- X-ray is ready.
- Okay, you know what?
Why don't you go tell Maggie
that we're gonna need an angio
to find where the injury
to the artery is.
I'll finish up here.
Jenny?
How are you doing?
I'm Dr. Charles.
They sent you in here
to get my consent, didn't they?
Who's "they"?
The other ones pretending to be doctors.
That redheaded one tried to convince me
my son had a broken arm.
You know, Dr. Halstead is,
in fact, a doctor.
And you know, Jenny, he wasn't lying.
I mean, I can show you the X-ray.
You think I can't tell a fake?
I want to see your supervisor,
or I swear, I
Jenny?
You all right? What's going on?
Who are you again?
I'm Dr. Charles,
and we were just talking
about Henry, about your son.
I already told you.
I'm not giving anyone permission
to treat my son.
Well, you know what?
I'd like to get your permission
to treat you,
if that's okay.
Me?
There's nothing wrong with me.
But unfortunately,
we can't release you or Henry
before we rule out any trauma
from the car crash.
So if it's okay,
I'd just like to send you
upstairs for a quick scan.
And as soon as that's done,
I'm free to go?
I tell you what,
how about we do the scan
and see what it tells us
and then go from there?
Does that sound like a plan?
Okay.
Did you get her consent?
Not exactly.
I want to send her upstairs
for a head CT with contrast.
And also, can you tell Sam
I want his eyes on this too?
- Roger.
- So what's going on?
You know, it just doesn't seem like
a garden-variety psychosis, you know?
There's this odd rhythm to it.
And she had this temporary loss
of mentation.
And I really think we could be looking
at something neurosurgical.
Let me guess.
Henry's broken arm has to wait?
Well, just bear with me, buddy.
Let's take a look at this scan,
and I think
we're gonna get some clarity.
We can continue riding out
the percussion vest and nebs.
With a little more time,
there's a chance it could work.
But not a good enough chance.
The only way to clear
the plugging for sure
and restore your breathing
is with a bronchoscope.
No intubation.
I think we've established by now, Al,
that I'm no alarmist,
so believe me when I say this.
This thing will kill you today,
right here in this room.
If it does, I'm okay.
I'm ready.
Really?
Just like that? Really?
You can honestly tell me
that you've got nothing left
to live for?
Your son, how's he doing?
Wife's pregnant again.
My second grandchild.
See?
That's something
to look forward to, isn't it?
It's my biggest fear, Dean,
being stuck helpless on a vent.
I promise you, Al.
I will not let that happen.
Hey, what's going on here?
Why isn't my patient prepped for angio?
You're not gonna believe this.
Apparently, they can't
find any contrast dye.
Are you kidding me?
We need to look at the femoral artery.
His AVIs are at 0.7.
Hey, man, it's not my fault.
Talk to this guy.
All right, keep an eye on his vitals.
I'll see if radiology has any.
You lucked out.
This is literally the last drop
of contrast we got.
You're kidding.
Blame COVID or the war in Ukraine.
I don't know.
She had no response to the Haldol?
Nada, and these weird lapses
in awareness.
Hmm.
And as you know,
resistance to antipsychotics
can sometimes mean
Something's going on
with her neurotransmitters.
Yeah.
- Hey, Gene?
- Yeah?
I was told you might have
some contrast dye left.
Not after the scan, I don't.
Oh, no, no, no, no. Stop, stop.
I need that dye.
I honestly don't even know why
we're having this conversation.
This is triage 101, head over leg.
With all due respect, Sam,
perhaps it's not so cut and dry
in this case.
What happens, Dr. Marcel,
if you're not able
to perform your angiogram?
Well, I'll probably have to
filet the poor guy's thigh open
in order to find and fix the damage.
It'll be a much bigger surgery
with more blood loss and a greater risk.
Dr. Charles?
You know, truthfully,
I'm not completely comfortable
making the case that our patient
is of any greater need
than Dr. Marcel's.
Well, I am. Look, Sharon.
If I'm being asked
to follow the breadcrumbs
of Ms. Mitchell's symptomology,
I'm suspecting
she might have an astrocytoma
or maybe a leaking aneurysm.
Now, there's no way of knowing
for certain, however,
without a CT with contrast.
But I can assure you,
if those are the possibilities,
without intervention,
her outcome is gonna be
a whole lot worse
than a limp for a few months.
I'm sorry, but that sounds so nebulous.
I mean, we know precisely
what we have to lose or gain
with our patient.
You're just on a fishing expedition.
- Who's this guy?
- Kai Tanaka-Reed.
First year surgical resident.
It's a pleasure to meet you.
You're a intern, Kai.
Learn not to speak unless spoken to.
Okay, can't we just dilute the
dye enough for two procedures?
We could, but we risk the chance
of neither scan being adequate.
Look, there's no ideal option here,
but for now, head over leg.
The hospital is going to prioritize
the CT scan for Ms. Mitchell.
Once again, Sharon,
you've proven yourself
wise beyond your years.
I'll see you up in radiology.
- Well, this sucks.
- It is what it is.
Have Maggie prep an OR.
- Where are we?
- Just getting the RSI drugs.
All right. Let's tube him.
Yes, sirree. Let's let's do that.
You all right?
Your hands look a bit shaky.
Just feel like I'm auditioning here.
That's not the trachea.
Neither is that.
What's taking so long?
Zach is having a little difficulty.
It's just not lining up for some reason.
What's the matter? You've
never done one of these before?
No, I haven't.
Are you kidding?
My med school all but
shut down during the pandemic.
Said it was too big a liability
to have us interact with patients,
so we did everything online.
But I'm a fast learner.
Yeah, I don't have time for handholding.
I'll do it myself. Get out of the way.
No, I'm gonna need to use a GlideScope.
Keep bagging him until I get back.
Bag him! Bag, go!
- These kids, I swear.
- Yeah.
Hey, before you get started,
I wanted to tell you about a
book I picked up on the beach.
It's about a death doula.
Nancy, where'd that GlideScope blade go?
It's over there in the cabinet.
It's all about helping people transition
from one plane of existence to the next.
Uh-huh.
I'm wondering
if we're doing that with Al.
What?
Honoring his journey.
You want to translate that
into English for me?
I don't think we should
be doing this bronchoscopy.
Wait, you don't think we should be doing
everything we can to keep him alive?
Not if he doesn't want us to.
So what, you catch a few juicy waves,
and all of a sudden, you're
preaching palliative care now?
Maybe. When it's appropriate.
This is an ED, Ethan.
We save lives here.
We don't end them,
at least not on purpose.
Maybe you should have
stayed on that beach.
Mm-mm, mm-mm.
Don't change a thing,
'cause you look fine as you is.
- Ben, what are you doing here?
- You remember?
My biannual to check my blood markers.
- Right.
- Yeah.
I was supposed to get in and out,
but they said something
about a shortage on syringes.
Can't get to me
till later this afternoon.
Oh.
But the good news is
that I am free for lunch.
- You want to grab a sandwich?
- Mm-hmm.
You know what, I am tired
of the same old, same old.
There is a food truck out there
that I'd like to try.
Okay.
Where's my angio patient?
Are we all good?
Okay, let's do a run.
What's going on here?
Trying to get an angio done.
I thought we already established
we can't do that without contrast.
I found a workaround using CO2 instead.
CO2?
It works a lot like a contrast.
Yes, I'm aware, but
it's ten times as dangerous.
If a gas bubble finds its way
up to his heart
We're injecting into
the arterial system, Crockett,
below the diaphragm.
We're all good.
- Hold on.
- CO2 has been delivered.
Look, right there. That's the injury.
Should we stent or go and open?
Damn it, drop the head.
Sats are plummeting here, guys.
- 80 and falling.
- What's going on?
Vapor lock. Move the C-arm.
Move it. Move it.
A gas bubble is occluding
the venous return
- to the heart.
- But that's impossible.
- Well, clearly not.
- Now down to 79.
He's getting super tachy.
Let's wire a catheter up to his heart.
No, no time.
We have to change his position.
See if we can get the blood
past the bubble.
Hope the CO2 reabsorbs.
Put your hand on his back.
Give him a couple of pats.
Right there.
That's it.
Come on, Julián.
Come on, Julián. Stay with me.
Sats are back up. 91 and climbing.
Vapor lock cleared.
Oh, man.
You're lucky that didn't kill him.
Let's set up to open.
I don't get it, Crockett.
How the hell did that bubble
find its way to his heart?
We'll find out,
but it's Dr. Marcel.
I'm not sure I'm reading this right,
but her scan looks completely clear.
Yeah, it's a surprise to me too.
I was convinced we'd find something.
I'm so seldom wrong.
Where is my son? Where is he?
- Jenny, Jenny.
- Come on.
- We're gonna get out of here.
- Jenny.
Henry has a broken arm.
Your son has a broken arm, Jenny.
- We need some help here!
- Jenny, listen
You said if I agreed
to that test, I'd be done.
I am tired of waiting.
You've got to let us
take care of your son.
- Four of Versed IM.
- Please!
- Listen to the doctors!
- Security!
Just do as I say.
Mom! My chrysalis!
- For God's sake.
- Whoa, whoa.
Jenny, careful, careful.
Watch it. Hurry up.
No, let go of me!
Let's put you back in the bed, bud.
It's okay. She's okay. You're okay.
- No!
- It'll be okay.
No, no, no.
Are you finally gonna
give me my court order?
So DCFS will take
temporary custody of the boy
until the mother's deemed ready
to resume her parental responsibilities.
How long do you plan to hold her for?
72 hours, for now.
Well, we'll just
take it day by day then.
Dr. Asher, let's get her
prepped for transfer upstairs.
Okay, Henry, we are ready
to put a cast on that arm.
Really important question.
What color would you like?
We can do green, purple, blue.
Blue, I guess.
Blue coming right up.
Where did those people take my mom?
So your mom is gonna be
resting here in the hospital
for a little while,
but when we're finished here,
this nice woman is gonna find you
a cozy place to sleep tonight.
How does that sound?
Hi, Henry. My name is Madeline.
You know, we can put that
in a specimen cup, if you like.
I promise to keep it safe.
Chest X-ray looks better.
Airway pressures are down.
It looks like the bronch did the trick.
Just like we should have done
from the beginning.
Let's lighten his sedation.
Come grab me when he's ready
to have the tube taken out.
You got it.
- Hey, Maggie.
- Oh, hey.
Hey, sorry about lunch.
I just couldn't pull away.
Yeah, I saw you and Ben head out.
Looked like you were trying
to keep him and Grant apart.
That's 'cause I was.
I haven't told Ben about Grant yet.
Oh.
I feel bad for pressuring you
to join us earlier.
It wasn't very sensitive of me.
Look, I really don't want
to make anything strained
between you and Ben.
It's not your fault.
It's just something I have to deal with.
Okay, let's see how bad the damage is.
- Oh.
- Oh, man.
Clamps.
Suction.
Okay.
Yep, here's how the bubble
got to his heart.
- A fistula.
- What? Where?
Do you see the mix
of dark and bright red blood?
So the bullet hit
both the artery and the vein
when it went between them,
fusing them together.
Look. You see that?
That's how the CO2 got up there so fast.
Yeah, like a superhighway
straight to the heart.
Well, nobody could have foreseen that.
So the delusions,
the volatile mood swings.
We could be looking at some kind
of atypical bipolar disorder.
I mean, at this point,
it very well could be.
We could start her
on a course of olanzapine
and see how she responds.
- You're moving her upstairs?
- Yeah.
Millie, we might as well get that going.
Okay.
Hey, listen, I pulled the tape
from when Jenny had that episode.
You see how everything
just kind of falls
off the ledge here,
her heart rate sats, her BP?
Whatever's happening with her
just has to be physiological, right?
It's what I've been saying all along,
but you know, the scan came back clean.
Well, we took this X-ray
of her chest upon intake.
And you see this area of haziness
around her mediastinum?
Is it just me, or does that
appear to be abnormally wide?
- It's definitely wide.
- And there's no certain way
to tell without more detail, but
Often caused by a tumor.
And that can trigger
an autoimmune response
in the brain, right, like psychosis?
Absolutely, and would completely explain
these dropouts she's been having.
Hey, Dr. Cuevas, could we hold
off on that transfer, please?
Dr. Asher, nice work.
Ophtho cleared you to go home.
I made you a follow-up appointment
a week from now, but from what she says,
you shouldn't have any long-term issues
with your vision.
The patch stays on, though, for now.
- Thank you, Dr. Taylor.
- Yeah.
Okay, let's go over your
at-home and care instructions.
- Excuse me.
- Yeah.
Hey.
I wanted to thank you again
for helping Keith out here.
This is an ED, Grant.
We would have done that for anybody.
Still, I just wanted to let you know
how much I appreciate it.
The world works in funny ways,
doesn't it?
You know, I really got
a lot of work to get done
before my shift ends, so
Hey, Grant. We're a little understaffed.
Do you mind helping out
and wheeling out Keith for me?
That's okay. I can walk.
- Hospital policy, sorry.
- No worries.
- I got it, Taylor.
- Thanks.
All right, let's get you home.
Excuse me.
Please, after you.
Vanessa.
So I'm finally done.
Should I stick around
and give you a ride?
Sure. Thanks, babe.
Al, can you hear me?
Okay.
Okay, we're gonna take this tube out now
by putting you on
a spontaneous breathing trial.
So I want you to give me
some slow, deep breaths.
All right?
Okay, that's right. Slow and deep.
Slow and deep. Don't chase after it.
The air will come.
Just slow and deep.
That's right.
- What's his RSBI reading?
- 130.
Are you sure you're reading that right?
The vent says so,
and I calculated it as well.
Okay.
Okay.
- Hey, maybe we should stop.
- No, no, no, no, he can
He'll get there.
All right.
Let's put him on a rate.
We'll resedate him.
I'm sorry, Al.
It's too soon to take you off.
So we're gonna take
a couple of steps back,
and we'll try again
a little later, okay?
Please don't, Al. Al.
No, no, no, no, Al. Al, don't.
- Get self-restraints, please.
- Al, stop.
Put him back on Precedex.
I'm sorry, Al, we're
gonna have to resedate you
to ease your discomfort.
I'm gonna get you off this thing.
I promise.
So am I gonna be able to walk?
Walk, run, jump, whatever.
When the ambo was bringing me in,
I didn't think I was gonna make it.
Thank you, Dr. Marcel.
Let's not have to do
this again, all right?
Thank you so much.
You bet.
So is this how it's gonna be?
How what's gonna be?
You taking credit for everything.
I was just as responsible as you
for saving that guy's life,
maybe more so.
Really? After that stunt you pulled?
That stunt pointed us
directly to the problem
and saved his leg.
All day long,
you've been talking down to me.
I was right about the bullet holes.
You never gave me props for that.
And then, you left it to me
to duke it out with Abrams
over the contrast dye.
You can't be serious right now.
All I'm asking for is
credit where credit's due.
It's not that big a deal.
You're right.
I should have given you credit.
I was very impressed
with the way
you nearly killed our patient.
Did I tell you lately
how much I love you?
Ben, I need to tell you something.
I know. I know, you don't
really want to go bowling.
- No.
- I can tell.
- You were a little lukewarm.
- No, it's not about that.
About a month or so ago,
I helped Vanessa
with finding and reaching out
to her biological father.
His name is Grant Young,
and he's an architect in town.
Okay.
I didn't want
to tell you about it earlier
because I didn't know
how you were gonna take it.
I'm just wondering
why you're telling me this now.
Because he came in as a patient today.
Not as a patient.
It was one of his employees.
So he was here,
and you didn't mention that?
Listen, I made it very clear to Grant
that I am not interested
in reconnecting with him
in any way, shape, or form.
Ben.
You felt the need to tell him that?
No, I didn't want there
to be any confusion.
And it's going good
between him and Vanessa.
She seems happy.
Glad to hear it.
- Dr. Marcel?
- Hey.
I was wondering how today went
with young Dr. Tanaka-Reed.
Yeah, fine.
Not according to him.
He filed a complaint with HR and claimed
you were disrespectful
and condescending.
Did he now?
And we are required to
take every complaint seriously,
though I suspect he must have done
something pretty egregious
to raise your hackles.
You care to file a countercomplaint?
No.
You sure?
I could have him reassigned.
No, not necessary.
I'm sure Dr. Tanaka-Reed and myself
will find some common ground
moving forward.
Like you said, we're all
in this together, right?
Hey, Doris said something
about Jenny being in surgery.
Yeah, we located a small
tumor on her mediastinum.
Daniel thinks that might have been
what caused the psychosis.
Really?
Mommy!
My baby boy!
Oh, look at your arm.
I'm so sorry.
I'm so sorry.
It's okay. It's okay.
I'm okay.
I thought you were trying
to hurt me and Henry.
- I'm I didn't understand.
- It's all right.
You're not gonna have to worry
about that anymore.
Mommy, look, my chrysalis.
It turned into a butterfly.
It's so beautiful.
What's that?
Your new best friend
for the next two weeks.
Welcome to boot camp.
I'm sure you already know
this about your old man,
that
I've got a tendency
to override everything
but the sound of my own voice.
I don't know if you have anything
that you want to say to me
after all this time,
but if there is
I'd like to try my best to listen.