Chicago Med (2015) s08e04 Episode Script

Dr. Halstead, pharmacy
won't release the medication.
I've got an idea.
There's a region-wide shortage.
I can't have it
turning into the Wild West.
I think we're already there.
I'm a recovering addict.
I need to earn my reputation
back with everyone.
But with you, it doesn't feel
like that's ever gonna happen.
You suffered a stroke.
If I can't operate again,
what does it matter?
If it had been me on the table,
I'm pretty sure he would
have done the same thing.
Hey. Sorry I'm late, Dean.
I don't know what was going on
with traffic today.
I got caught up in it too. You know,
you can blame the HyperTrain
unveiling for that one.
It shut down the Red Line.
A lot more people on the road.
- HyperTrain?
- Yeah.
You know, Jack Dayton's new toy.
Oh, yeah.
Jack Dayton. Right, Mr. Megabucks.
Yeah. Yeah, sure, genius.
That HyperTrain is supposed
to revolutionize public transportation
by moving twice the speed of the L.
Meanwhile, it takes us schmucks in cars
twice as long to get to work.
How come Blake's locker is empty?
You hadn't heard?
Blake tendered her resignation.
She's taking a job
at Brigham and Women's.
- Boston?
- Uh-huh.
Guess she's good enough
to perform surgery again.
- When did all this happen?
- Oh, I don't know.
I got an email about it last night.
When is she leaving? She can't leave.
I need to talk to her.
You probably blame yourself, huh?
No answer?
Voicemail.
All right. I got to go talk to her.
- I'll be back in an hour, okay?
- All right.
Just don't make it any more than that.
Hey, Candace. I'm Dr. Asher.
- Hi.
- All right.
Well, it says in here
that you are at 28 weeks.
- Mm-hmm.
- So how's your pregnancy been?
You know, it was going great,
but my lower back started hurting
about a week ago, this sharp pain.
- And it's only gotten worse.
- Mm-hmm.
And I called my OB this morning.
And she told me to come here right away.
Okay. Have you had any
abdominal pains, any cramping?
No. No, just my back.
Okay, CBC, CMP,
and urine cultures, please.
Ooh.
- You okay?
- No, no, no.
It's good. She's, um
She's kicking. I'm sorry.
I've had three miscarriages
over the last six years.
And I'm alone right now with
my husband away on business,
so I'm kind of on edge.
Well, that's totally understandable.
Let's get your feet up here,
get you comfy.
We'll put you
on a fetal heart rate monitor
just to make sure that
that baby is happy and healthy.
All right? I'll be right back.
Thank you.
- Maggie, you're back.
- Hey.
- Yeah.
- How was your honeymoon?
- It was Paris, right?
- Mm-hmm.
Mm, nice.
Oh, wait.
Paris sounds so great.
I've never been anywhere.
I have a passport.
I've just never used it.
It'll happen.
Thank you.
Dr. Asher.
Just a reminder, you still need
to submit your urine sample
for your weekly drug test.
Right. Of course.
I've been doing it
the last six months now.
How could I forget?
Okay, then.
Nope. No pedestrian access here.
Oh, come on, man.
My friend's building is up on Ontario.
Sorry, the barricade
is here for a reason.
Jack Dayton, he's showing off
his new HyperTrain down there.
Whoa!
What happened?
The train jumped the tracks!
Hey, come on! Come on!
Are there more people down there?
Come on, come on. Let's go, let's go.
Go. Come on.
Hello?
Is anybody in there?
Help!
Hello?
Over here!
Hello?
Help us, please! Help us!
Hold on! I'm coming!
Oh, over here!
Hey!
Oh, thank God.
I tried 911, but there's no
service down here, of course.
- I'm Jack Dayton.
- Yeah, I know.
- Are you hurt?
- I can't tell.
My leg's stuck.
Easy, easy, easy.
All right. Here we go.
One, two, three.
Ow!
Come here.
Your left knee. Here, sit down.
Let me take a look at that knee.
- It can wait.
- I'm a doctor.
Over there
in the conductor's compartment.
His name is Nathaniel. He works for me.
He was driving the train. Come on.
Nathaniel, can you hear me, bud?
Keep your weight off that left knee.
Hey, buddy. Can you hear me?
- Ah!
- There you go.
Ah, ah!
All right. I think we can pull him out.
I can't I can't breathe.
Looks like the lithium ion
battery got dislodged,
hit him in the chest.
Okay.
All right. Here we go.
All right, I want you to
I want you to grab him by his ankles.
Nathaniel, I'm gonna bring you
up a little bit, OK?
Okay.
Keep going. Right here.
- Yeah.
- Right here.
Okay, okay.
It's gonna be all right.
It's gonna be all right.
I got you, buddy. I got you.
There you go.
Okay, look at me.
Nathaniel, you have a flailed chest
and likely a hemopneumothorax, okay?
What does that mean?
He broke several ribs on both sides,
which is now causing
a free-floating segment.
His lung is likely collapsed,
and his chest is filled
with blood and air.
- Let's get him out of here.
- No, no, no, no.
Sounds like the tunnel
is still coming down around us.
Yeah, then we better move quick.
- Come on.
- No, no, no.
If we try to move him,
we could make it worse.
All right, then. I'll go get some help.
No, it's too dangerous
the way I came in.
- All right?
- So what do we do?
We wait until CFD comes to get us out.
It's the safest option, all right?
I need to get control of this bleed.
I need to create a pressure
dressing for this wound.
Give me your tie.
Hang in there for me, Nathaniel.
And you're gonna feel
some pressure, okay?
Okay.
Morning, Dr. Taylor.
Hey.
Rose, Emmanuel, this is Dr. Halstead.
Hi. Sorry to hear
you're feeling poorly, Rose.
Dr. Taylor thought
I might be able to help.
The more, the merrier.
I'm well-accustomed to doctors.
My wife has type 1 diabetes
and hypertension.
But Rose is here today
because of a chronic UTI.
Her internist prescribed her
several rounds of antibiotics,
but none of them have done anything.
So I sent a urine test with cultures.
Mm-hmm.
Multi-resistant fungal infection.
"Fungal" is such
an unpleasant word, isn't it?
A lot of medical words are
Phlegm, discharge.
Rose taught
11th grade English composition
for 32 years.
Words are her thing.
Some are just naturally embarrassing,
like having a fungus.
Well, no need to be
embarrassed here, Rose.
It says it's sensitive to voriconazole
and amphotericin only.
So voriconazole. 200 milligrams. IV.
Um, I had the same thought,
but there's a problem.
- It's on the shortage list.
- For three weeks now.
What about this other medication?
Let us talk it over.
We'll be right back.
Amphotericin B is old-school.
- They call it amphoterrible.
- I know.
And Rose's kidneys are already
compromised because of her diabetes.
Her creatinine is 2.8 to start.
Ampho will knock them out
and put her in dialysis,
or worse, kill her.
It has to be voriconazole.
Let's start calling around
hospitals, pharmacies,
- see if they have any.
- No, I already did.
Everyone I talked to in Chicago was out.
I'm not sure what the next move is,
which is why I dragged you into this.
I mean, what do you do
if you can't get the only drug
that'll treat an infection?
The pain is localized to her back.
It says here her UA is dirty.
Yeah, that's not normal for a urine dip,
but it also doesn't scream
infection either.
- Mm-hmm.
- I checked the shortage list,
and I know that
the contrast dye supply is low.
- It's currently restricted.
- Yes.
But protocol also states
that if a patient needs a CT
Okay, did you ultrasound her
for a kidney stone?
- No.
- Why don't you?
Kidney stones usually present
in pregnant women
- with peritonitis or flank pain.
- Right.
Candace only has low back pain.
Sure. You can still
ultrasound her to check.
I could, but as we both know,
ultrasound is not
very sensitive for a stone.
A CT would give me a much better picture
- of what's actually going on.
- Okay.
So if the ultrasound doesn't
show anything conclusive,
you'll order the CT, yeah?
- I'll do an ultrasound then.
- Right.
And you might want to start her
on empiric antibiotics too.
In case it's pyelonephritis,
you should get ahead of that.
I mean, like, it's perfectly natural
for a teenager to want distance from
From their parents, right?
But I don't know.
Recently, it just seems like
she doesn't want anything
to do with me at all anymore.
That may only be temporary.
And it's healthy for your daughter
to seek out this kind of independence.
You think that I, of all
people, wouldn't know that?
But I don't know, man. It's been a
surprisingly difficult pill
to swallow, you know?
And that kind of dovetails
with this other issue
that I'm having at work, right,
involving being there for
patients in difficult times.
I mean, I'm used to living
in those uncomfortable moments, right?
I mean, it's what we do.
You know what I'm talking about.
You've been doing this a long time.
- Mm-hmm.
- But recently,
when, say, I have to give a patient,
like, a really tough diagnosis, right,
like, tell them
or the people that they love
that they have
a lifelong mental illness
Their lives are over.
Yeah.
And I've been haunted
by these moments, right?
They stick with me.
It's like sometimes
they stare back at me.
Sometimes they cry.
Sometimes they don't know
what to do, nor should they.
But you know what? Maybe I should.
Dr. Greenwell?
Please, go on.
Are you all right?
My chest.
I think I think I might
be having a heart attack.
Dr. Greenwell! Otis!
Dr. Greenwell?
Dr. Greenwell?
- What do we got?
- Otis Greenwell, 52 years old.
Collapsed into a glass coffee table.
EKG was normal.
Multiple lacerations to the forearm.
We applied pressure dressings en route
and gave him an aspirin.
He was having chest pains.
Make sure he gets
a complete cardiac workup.
Will do, Dr. Charles.
I'll be right out here,
Dr. Greenwell, okay?
He's a doctor?
Yeah. My therapist, in fact.
So take good care of him, okay?
Pulse is weak.
He's likely in hemorrhagic
shock from all the blood loss.
Please, am I going to die?
I'm gonna do everything in my power
to make sure that doesn't happen, okay?
All right.
Anyone there? Anyone in there?
Yeah, yeah! Hey, help us!
Hey, Severide?
Severide, is that you?
It's Crockett!
Crockett? Hey, what's going on in there?
What's the situation?
There's three of us in here!
Two of us are okay,
but the train's conductor,
he's badly hurt.
He's pretty shocky.
This passageway is too narrow.
We'll try and widen it
and get a backboard through.
- It might take a while.
- No.
No, listen to me. We can't wait.
I need you to get me
some supplies off the ambo,
and I need you to call Med.
I need them to send some things
you don't have.
Copy that!
Just hold tight, Crockett!
Nathaniel doesn't have that long.
If we're gonna save him, we got
to do it right here, right now.
People, I don't have many details,
but Crockett is down in the tunnel
trying to help those who are injured.
I do know that he is in touch with CFD
and appears to be safe at this time.
And I'll update you as soon
as I hear anything more.
Thank you.
Jeez.
I hope he's okay.
Yeah.
Come on.
Ms. Goodwin, we were
just coming to find you.
- Do you have a second?
- Sure.
My patient, Rose Fremont,
has a serious fungal infection
that needs treating.
And the only drug that can help her,
voriconazole, is unavailable
all throughout Chicago.
Well, could be just
another region-wide shortage.
I'll reach out to our suppliers
out of state.
The army, navy, and national guard
might be resources as well.
Just do what you can for her
in the meantime.
Okay. She's gonna need pressors
to keep her blood pressure up.
Speaking of the army,
I heard about your brother.
Yeah, Jay needed a change.
I think it'll be good for him.
Ah. Well, I know you two are close.
I'll make those calls.
Adia, talk to me.
Trey Bruso, 22. BP 138/80.
Heart rate, 104. Fell off a
ladder while painting a house.
I hate hospitals.
Okay, we won't take that personally,
but we'll still try to get you back up
on that ladder soon, all right?
Okay, everyone.
Let's get ready for a transfer.
Okay, ready?
One, two, three.
No breath sounds on the right side.
We need an X-ray!
I want out of here!
The faster we can get this done,
the faster you can leave,
Trey, all right?
Just relax. Relax.
Stand back.
40% pneumothorax to the right chest.
Let's get a chest tube. 28 french.
Sorry, Ethan.
There's a problem.
I sent the last Pleur-evac
out to the tunnel collapse.
Crockett requested it.
- This is ridiculous.
- Relax, Kai.
Dr. Marcel shouldn't
be putting a chest tube
in someone
under those conditions anyway.
- It's not a sterile environment.
- Oh, really?
You think I should have sent
him a note explaining that?
So now our patient needs a chest tube,
and we can't connect it
to a drainage system.
How is that supposed to work?
The Helmand Province. Remember?
Oh, yeah. I'll hit up central supply.
- Yeah, you want help?
- No, I'm good.
It's like riding a bike.
One of you guys want to tell
me what you're talking about?
Pay attention, Kai.
You might learn something.
Mind if I join you?
Candace, this is Dr. Archer,
Chief of the ED.
He's been consulting on your case.
- How you doing, Candace?
- My back really hurts.
Well, hopefully, that
won't be the case much longer,
so bear with us.
Was I right about the kidney stones?
I'm not seeing any stone,
but I am seeing some hydronephrosis
on her left kidney.
- Ah.
- What does that mean?
Your kidney is not draining effectively,
so it's a little swollen.
I'm concerned that it might be infected,
so it's a good thing that Dr. Asher here
has already started you on antibiotics.
Will it hurt the baby?
The sooner we get ahead
of it, the better.
Give her four of morphine
for the pain and call urology.
Excuse us, Candace.
We don't know for certain
that it's a kidney infection.
If it walks like a kidney infection
and talks like a kidney infection
Hydronephrosis is not
uncommon in pregnant women.
When a uterus gets enlarged,
it can cause urine to back up
and dilate the kidneys.
It doesn't confirm an infection.
I appreciate your determination
to get a definitive diagnosis,
but you are overthinking this one.
You know, I just have this feeling
that I'm never gonna
pass some test of yours.
Oh, God. All right.
Look, I'm getting squeezed
by a lot of shortages,
including contrast dye.
And if the antibiotics don't work
and if her back pain gets worse,
then you can send her for a CT.
I removed the shards,
redressed his wounds.
Did you get his labs back yet?
Yeah, he's not having an MI.
Though his heart rate was
elevated when he came in,
there's no sign
of a cardiac event at all.
I mean, he's in good health,
but he said he's not sleeping.
Huh. Shoot me his chart.
Yeah.
Well, this is awkward.
Oh, come on.
We're both doctors, Otis.
Stuff happens, right?
But let's face it, Dan.
I'm supposed to be taking care of you.
Well, you're gonna have plenty
of opportunity to do that, all right?
- What do you think happened?
- I don't know.
I just I must have passed out.
- Happen before?
- No.
Dr. Hudgins said that you
were having a hard time sleeping.
Yeah. I haven't been
sleeping much recently, no.
What would you say to the idea
that maybe what you had
was a little panic attack?
Well, let's say that
it was a panic attack.
I guess maybe it could
have been the result
of a buildup of stressors.
All right. All right.
I'm wondering what those might be.
I mean, when it happened, I was talking
about the difficulty
that I've been having
giving bad news to patients.
Does that sound right?
I actually don't remember.
Look, I really just want to go home, OK?
Okay.
Except your heart rate is going back up.
I'm I'm sure it'll be fine.
Yeah, yeah. You're all right.
It's not a heart attack, okay?
Just breathe.
Okay.
Oh! Oh, the pain, it's back!
Five of Valium, please.
Look at me. Look at me.
In through the nose,
out through the mouth.
In through the nose.
Okay, secure!
Okay, first bag coming to ya!
All right!
Okay, got it!
Okay, looks good.
Put that over there by Nathaniel.
Okay, will do.
Okay, send the next one!
All right!
Pull!
It's stuck.
It's caught on something.
Pull harder!
- Jack, I need you.
- Yeah, coming.
Give me a hand with this Pleur-evac.
Yeah, got it.
Crockett!
You okay?
I'm stuck.
Oh, no.
Okay, yes. Thank
you for letting me know.
That was CFD.
There's been a secondary
collapse in the subway tunnel.
They lost contact with Dr. Marcel.
Do they know if he's okay?
It's unclear.
They said they're doing everything
they can to tunnel him out now.
Okay.
Dr. Asher, we need you.
What happened?
She wasn't complaining of nausea,
and then she just started vomiting.
Okay, let me see.
101.2.
Is this all from a kidney infection?
Well, let's get her up
to radiology for a CT.
Thank you.
I can move my arm freely
on the other side.
If I could just get the
right angle to pull it out
Hey, Nathaniel?
Nathaniel, can you hear me?
I think he's losing consciousness.
He's gonna stop protecting his airway.
Come on. What can I do?
Throw your weight against me.
Square in the back.
Give it everything you got.
What are you talking about?
You hit me just right.
Pop my shoulder out of its socket.
I think I can reposition myself
to get the leverage I need
to pull my arm free.
Come on, Nathaniel
doesn't have much longer.
- I could break your arm.
- Just do it.
Okay.
- Ready?
- Now.
Aah!
That did it.
Pull my arm free.
Grab my wrist.
I want you to pull my arm
straight out in front of me.
I need to pop my shoulder back
in the socket.
Go, go, go, go! Go, go, go!
Aah!
Oh, I'm good.
I'm good. I'm good.
Crockett, listen, if
we don't get out of here fast,
this whole wall and everything above us
could come crashing down any second.
Nathaniel is the priority.
Come on. I need your help.
- You got your phone on you?
- Yeah.
All right. I need some light.
All right, Nathaniel.
We're gonna get you
fixed up. Okay, buddy?
I want you to take the blood
out of that red bag.
And there should be some tape in there.
I want you to tear me a little piece.
And there's a needle in that bag.
I want you to pull that out
and get that ready for me.
Got it.
All right, this might feel
a little uncomfortable.
Okay, buddy?
There you go.
I know, I know. Easy, easy, easy.
He's lost a lot of blood.
We need to get
his blood pressure back up
before we do anything else.
You got that needle prepped?
Yeah.
We got to sedate him, intubate him.
And then we're gonna hook him up
to that portable ventilator there, okay?
Okay.
I'm gonna get you out of here, okay?
We've got to get that halfway
into the chamber.
There we go.
Anything else I can do?
Yeah, why don't you get us
a little bit more light,
if you can?
You get a collapsed lung to re-expand
by evacuating the excess air
in the chest with a chest tube.
And you hook it
to a water seal drainage system
to keep the air from
coming back through the tube.
That's right, but what if you don't have
a commercial drainage system?
You have to make one. Three bottles.
Bottle number one is
the collection bottle.
All the fluid and air
that exits the chest tube
comes here first.
Now the fluid stays, but
the air is still on the move,
so we have to reroute that air
through this tube here,
into bottle number two, the water seal.
And that water keeps the air
from heading back
- the other way.
- Exactly.
Bottle number three is for suction.
We connect this bottle
to the regulator in the wall,
and it creates
a negative pressure vacuum
that sucks all the air
through all three bottles
but only to the level of water
in the suction bottle.
Makes sense, but kind of primitive.
But it works.
Two of Versed, 100 fentanyl?
Yeah.
Fentanyl is in.
Go ahead. Put it in the tube.
Lidocaine.
Scalpel.
And that's
how you DIY a drainage system.
Okay.
- Let's secure the tube.
- Okay.
So there isn't any voriconazole anywhere
because the FDA cited the manufacturer
for workplace issues.
And until that gets resolved,
there will continue to be
a production delay.
So that's it?
Rose might die because
the manufacturer screwed up?
Look, it infuriates me too.
What can be done for Rose right now?
We can try to mitigate her symptoms.
But unless we treat the infection,
she's going to get worse.
All right.
I'll keep searching on my end.
And if anything comes up,
I'll let you know.
Look, I wouldn't mention this
if we weren't desperate,
but I had a friend in medical school
who was able to get
pharmaceutical-grade drugs.
What do you mean?
For students who wanted
to pull all-nighters.
Usually, it was like
Ritalin or Adderall,
but it seemed like
he had access to everything.
You're talking like
some kind of drug dealer.
It's illegal, yes,
but we're out of options.
How would we even know
the drugs are legit?
He has relationships with pharmacists.
The quality of the medicine
is not an issue.
Vanessa, we could lose our licenses,
maybe even go to jail.
I want to help Rose, I do,
but not that way.
No, we can't.
- The light helps. Thanks.
- Yeah.
Okay, Nathaniel is sedated.
Hand me this tube when I ask for it, OK?
- Yeah.
- All right.
Okay, intubating.
Okay, tube.
Okay, tube is in.
Okay, we're in business.
Okay.
I'm still not hearing enough
breath sounds in the left chest.
We have to drain the blood.
He needs a chest tube.
Can you fetch me that jumpbag,
the one with the Pleur-evac, please?
Yeah.
Candace's CT results.
Retrocecal appendicitis.
Really?
Well, that's not something
you see every day.
No, it's not.
And the fact that her appendix
is angled medially
explains why she only had back pain.
Uh-huh.
Change her antibiotics
to ceftriaxone and Flagyl.
Call the OR and have them open
for a lap appy.
I'll join you,
in case anything goes wrong
with the pregnancy.
Mm-hmm.
My heat.
She's not making any sense.
Pressure is down. MAP's 45.
Her septic shock is getting worse.
Add vasopressin and increase
the Levophed to 20 mics.
My feet
are cold.
Is there nothing else
you can do for her?
Yeah, place a foley and
update me on her urine output.
That's it?
I'm begging you, please!
I'll be right back.
How are you feeling?
A little sheepish.
I think you might be on to something
with this panic attack idea.
I mean, what do you think's going on?
Because at this point,
it's kind of difficult
to ignore the fact
that in both instances,
I was talking about the difficulty
that I've been having
giving patients bad news
when you were triggered.
Yeah.
I read journals all the time
to keep up, stay fresh.
Uh-huh, okay.
I recently read about
sporadic fatal insomnia, SFI.
You heard of it?
You know, I'm familiar
with familial fatal insomnia.
It's a genetic brain disorder, right?
Yes. SFI is a variant.
It's nongenetic and even more rare.
It starts with a mild inability to sleep
that progressively worsens
until it robs you of
your faculties and kills you.
Right, and so,
you're concerned that you might
have this or that you're developing it?
I know it's irrational,
but I I can't help it.
I'm really scared.
Well, I mean, have you
thought about getting tested?
No, I can't do that.
Hey, a simple PET scan
will tell you everything
you need to know.
But that's the problem.
If I test positive, my life is over.
Every last second I have
will be consumed by that.
I won't be able to function.
But, I mean, aren't you kind
of consumed by it already?
I'm so tired.
Well, I mean, of course you are.
Look, have you thought about,
I don't know,
what clarity might bring
to this scenario?
Look, if you test negative,
you get a good night's sleep,
right? That's easy.
But even if you test positive,
which is unlikely,
look, I mean, it'd be difficult,
but wouldn't it also kind of,
I don't know, inform
how you want to spend the rest
of the time you had left?
People you might want to hang out with?
The places you might want to go?
I don't know, it just seems to me
that there's an upside
to clarity both ways.
I'll get the scan.
Voriconazole, the antifungal?
Yeah, thought I'd check anyway.
Thank you.
Will.
Voriconazole. 200-milligrams. Tablets.
I know it's an IV, but the
bioavailability is the same.
Where'd you get them?
It turns out someone did have it.
No.
Will.
These are the real deal from a pharmacy.
The prescription was filled
two months ago.
Check the label. I've already
called and verified it.
And your friend just happened
to have them?
He said that sometimes people
empty out their medicine cabinets,
and they turn over the contents to him.
- That's how he got these.
- That's called diversion.
It's a crime.
Rose will likely die from
this infection. You know that.
Even if you were
to give her these pills,
how are you gonna explain it
in her chart?
I don't know.
I guess we wouldn't put them in?
She needs these pills, Will.
There's only one way to do this.
No, no. You stay here.
Hey, Nancy. Could you give us a moment?
Sure.
Thank you.
Emmanuel, I found some voriconazole.
Oh, thank God.
But I can't give it to Rose.
- I don't understand.
- Yeah.
The pills weren't acquired
through the proper channels.
But I assure you, this is
the antifungal Rose needs.
It will knock out her infection.
It will save her life.
I just can't legally give them to her,
but you can.
It's your decision.
Dr. Taylor and I cannot know about this.
We'll check back in a little while.
You put your blood, sweat, and tears
into a project like this train.
You try to anticipate
every potential catastrophe,
only to be undone by rusty old tracks
and cracked tunnel walls.
So it was the tunnel's fault?
It's not my train's.
Let me guess, you're one of those
"never explain,
never complain" guys, yeah?
Yeah, well, this day
wasn't good for me either.
- What's that?
- Oh, the battery on the vent.
It's dying.
Why are you down here, Crockett?
What do you mean?
A train crashes, and a tunnel collapses,
and you run in.
Why?
I I just did.
You want to know
why I created this train?
To change the world.
Chicago first, but soon,
every other city would see a faster,
more efficient, cost-effective,
environmentally-friendly mode
of transportation.
Jack Dayton has done it again.
A brilliant innovator. A hero.
That's the portrait I try
to paint for the media anyway.
The truth is, I developed this train
to make me another fortune.
Money and ego have been the motivation
behind almost every decision
I've ever made.
Every good deed.
Every good deed has
really been self-serving,
unlike you.
No.
What?
Believe me, Jack, I
I am far from selfless.
Crockett?
Ah, hey.
Okay, so what do you guys say?
Want to get out of here?
My results.
Negative.
Oh.
Oh, good God.
Oh, thank God.
Hopefully, you can
get a little sleep now.
I can't thank you enough, Dan.
Hey, I'm just really happy
it turned out the way it did.
But I think
we should stop seeing
each other professionally,
I'm afraid.
I'm sorry, but this has been
a massive breach
of therapeutic boundaries.
You know what,
I would actually really like
to continue, if it's okay with you.
You want me to stay on
as your therapist after this?
What, are you kidding me?
I mean, all this experience
has done for me today
is humanize you.
We might have hit the fast
forward button a little bit,
but, Otis, do you have any idea
how difficult it is out there
to find a practitioner
who will just, you know,
listen and talk and be present?
All I saw today was the kind of,
I don't know, humanity, right,
that made me really want
to keep working with you,
if you're good with it.
Sure.
Good.
Everyone, gather around, please.
- Everyone?
- Good news.
We've just been informed
that Dr. Marcel is safe,
and he and his patients,
including Jack Dayton,
are en route.
All right, everybody.
Let's get back to work.
So how'd it go?
Uh, good.
You showed Dr. Choi how to
do that thing with the bottles?
Yeah, I did.
In Afghanistan,
we had a whole lot of GSWs
without a whole lot of equipment,
but we did have bottles.
Cool.
Yeah, it's cool.
In any case, he is a good teacher.
Hey, and FYI, Dr. Marcel
is a pretty good teacher too.
Hmm.
Excuse me.
Nice work today, Dr. Asher.
- Thank you.
- Yeah.
Your patient got lucky.
She had a good doctor.
And which one of us is that?
Well, we both know.
Listen, your weekly drug test,
we can dispense with that.
Great.
Pressure is stable and
has been for some time now,
even without the pressors.
We'll have to wait
for your cultures to come back,
but I'd wager
the infection is resolving.
I feel what's the word
I'm looking for?
Relieved?
Sanguine.
Good word. People don't use it enough.
It certainly seems like
she's getting back to normal.
Well, hopefully, if this all continues,
you can go home tomorrow.
We can't thank you enough.
It worked.
Yeah, look.
We did what we had to do,
but no one can ever know about this.
Ever.
They're here!
Nathaniel Perry, 34 years old.
Chest was crushed in a train crash.
Dr. Marcel intubated him in the field
and placed a chest tube.
All right, I got him. All right.
You're going to two.
Mr. Dayton, sorry to meet you
under these circumstances.
Sharon Goodwin, executive
director of patient services.
And I'm Dr. Choi.
Let's get you checked out.
All right, and Crockett said
I'm gonna needed an MRI.
Will do.
- Where is Crockett?
- He's okay, right?
Yeah, he said he had to see someone
and that it couldn't wait.
Pamela?
Pamela, please.
Pamela, please talk
Crockett, are you okay?
Yeah. Where's your mom?
She left for Boston this morning.
I'm sending these things on to her.
I need to tell her something.
Yeah, she saw you called.
She didn't want to talk to you.
I get it.
Could you tell her something for me?
Just tell her
I haven't been entirely honest with her.
Honest with myself, really.
Oh?
Your mom never would
have risked her ability
to perform surgery.
I mean, you said so yourself
when she was on the table.
But I made the decision I wanted anyway.
It was selfish.
I didn't want to lose her.
But I guess I lost her anyway.
I'm sorry.
You take care, Ava.
You, too, Crockett.