ER s08e14 Episode Script
A Simple Twist of Fate (aka Seven Sinners)
E.
R.
Previously on E.
R.
I have a baby with an amphetamine overdose.
- Joyce, you in there? - I'm calling the police.
No.
- I'm trying to help a sick child.
- Mom, he has leukemia.
He may not survive.
If you've got some kind of twisted need to relive this, that's fine.
I'm not gonna do it again.
I made my peace a long time ago.
What the hell happened? She swallowed Rachel's Ecstasy.
- She could still die! - I know, Dad! Please, please, Dad.
I'm sorry! I don't understand why this has happened.
E.
R.
8x14 "A SIMPLE TWIST OF FATE" Dr.
Lewis, you need to get up.
- Dr.
Lewis! - What? You need to get up.
- What time is it? - Almost 7.
Oh, my God, I was just gonna lie down for a second.
- When was that? I need to get home.
Animal attack from the zoo in 15 to 20.
- Oh, no.
I'm not on till noon.
- Weaver needs you now.
Yeah, and I need a hot shower and some mouthwash.
Dr.
Greene is still up in the PICU.
Someone has to cover him.
You happened to be curled up in the lounge.
- Is she extubated? - His daughter? - Yeah.
- They're waiting on a blood gas.
- She triggering the vent? - No.
- Did Neurology read the EEG? - I don't know.
- I said, no! - We're talking bagels and cream cheese.
No one is taking a bribe.
Promotions like this add to the cost of pharmaceuticals.
Marketing expenditures passed on to mostly elderly consumers.
I'm elderly.
- There's no free lunch, Frank.
- This is breakfast.
Yes.
This is Susan Lewis in the ER.
I need to speak with the charge nurse.
They weaned her down to 30 percent, she's off sedation and the PICU fellow ordered a CPAP trial.
Oh, thanks.
Never mind.
I'll take the rack.
You clear the pass-ons and get this borborygmi out of 4.
You wanna ask me to cover all day after staying all night? All night was your choice.
Welcome to management.
- No whining allowed.
- You sleep with your eyelids open.
- Partly open.
- Still kind of freaky.
Not as freaky as watching you eat with your mouth open.
Any strawberry? - Wait.
What are you doing? - Looking for a knife.
- Next to the penlights.
- All right.
You're gonna eat that? Why not? The next time you get a pneumonitis and you have to prescribe Reprotrex or the cheaper, effective generic drug, you're not gonna feel slightly beholden? By a bagel? No.
Are you sure? Okay.
I'm gonna go to Doc Magoo's, get some breakfast, find a toothbrush change my underwear, and then I'll clear your borborygmi.
Fifteen minutes.
If I stick with the underwear I've got on, can we at least keep the food out? It's all right.
It's all right.
You can't titrate a little Versed so she won't remember? Any benzo decreases her ventilatory drive.
Then do it.
But if you allow the sedation to wear off, you have to be ready.
I need to warn you.
Extubation's a leap of faith with little ones.
I can't do a NIF.
PEEP's under two, CO-2 is normal.
- Let's go.
- Okay.
Have the ambu bag ready.
Disconnecting the vent.
And tape is clear.
And tube.
Suction.
All right, come on, Ella.
Big cough.
Big cough.
She's not breathing.
Blow by O-2.
Give her time.
Give her time.
Break open the airway box.
Draw up a milligram of midazolam.
Come on, Ella.
- Positive pressure now.
- No, wait.
That's a happy sound.
We're here.
We're here.
It's all right.
Yeah, we're here.
Is his car still there? Sometimes he skips Marketing, but he won't skip Cost Accounting.
If you wanna wait, I can be there when you do it.
No.
I'm gonna ask him at school.
He'll stay calm in front of his study group.
- You can't ask him, Joyce.
- Right.
I know.
- And you have to leave if he doesn't- - I know.
I know.
Do you wanna come to work with me? - Can I stay here until he leaves? - Of course.
Call me after you talk to him.
Abby.
These groups, they really work? He only lasted two sessions in counseling.
- Joyce- - I know.
I wanna try and help him.
It's worth a try.
You can go back to him if he gets better, or file a complaint and a judge can- He'll do this.
If he knows I'm serious, he'll do this for me.
- Call me.
- Thanks, Abby.
Lock the door.
Abby? You seen Joyce? - Abby, my wife.
You seen her? - What? No.
She didn't come home.
I'm getting worried.
- She didn't call you? - No.
Did you call the police? No.
We had a fight.
She might just be mad at me.
If you hear from her, have her call me? Yeah, sure.
Thanks.
Have a good day.
She's moving extremities? All four.
Fixing and following.
Good color.
Oh, Mark, that's great.
No seizure in the next 48 hours, we should be home free.
What's that for? The breast pump up in OB is missing a collection tube.
- She's eating? - She's about to try.
Thank you for covering.
Don't worry.
Take care of your daughter.
Positive LOC.
Now GCS 13, postictal.
This is the zoo trauma? - Yeah.
He got bit by a monkey.
- It was a sloth.
- What is a sloth? - It's like a monkey.
No, it's not.
They're not anything like primates.
- They're not even in the same order.
- Dr.
Greene? I hear your baby's doing better.
- Off the vent.
- Oh, good.
That's really good news.
So far.
- I didn't file a H-5122 with the chart.
- A what? Mandatory reporting of illegal substance abuse.
Oh, right.
I just wasn't sure.
I thought maybe you'd want to- Yeah, I'll take care of it.
Sometimes it takes a little longer during shift change.
Shift change? When one nurse goes home, another comes on? Oh, right.
I'll go get her.
- Etoposide? - Two-CdA.
- He'll piggyback in the second phase.
- Hey.
His IV has run out, and there's an alarm going off.
It's only a pretreatment solution.
The nurse will change it when they move him.
- Move him? - To the treatment room.
His cells are almost 100 percent leukemic.
He'll need a second chemo induction now.
- And then a bone marrow transplant.
- He's already failed one.
Another one's gonna make him sicker and be more dangerous.
- Chemotherapy alone is gonna save him? - Maybe.
He's gonna get a set of drugs he didn't get before.
- You've decided to experiment on him? - I haven't decided anything.
Look, it's as much luck as science involved at this point.
- You look like you need a rest.
- No.
You're gonna pump that junk back into his veins, I'm gonna stay right here.
I meant to get the ring sized smaller, but I didn't get the chance.
How did you swallow it? He likes me to suck on his fingers.
I see.
Nothing to panic about.
It should pass in two or three days.
- "Pass"? - Two or three days? She'll be fine.
Add some fiber to your diet and let nature take its course.
He's not worried about me.
He's afraid his wife'll notice his wedding ring is missing.
- There's nothing we can do? - Well, I could try an endoscopy.
I don't like the sound of that.
- We stick a tube down your throat- - I gotta get to work.
Honey, I need my ring! Well, I need my job.
I'm on stage in an hour.
I gotta get to work.
And I ain't searching my stool.
Abby's ready for that vag bleed in 1.
- I got Registry to fill in for me.
- You're leaving? I'm on my second dose of Compazine.
I'm still puking.
- Five hundred? - Hey.
How much would you charge to stick a tube down your throat? You two negotiate.
I'll be right back.
Frank, are you sick too? I ain't praying! - How many pads? - Two so far.
Started bleeding yesterday.
Hi, Valerie, I'm Dr.
Lewis.
When was your last period? - Two months ago.
- Do you think you could be pregnant? My parents would freak.
My older sister just had a baby.
Abby, line two.
It's your neighbor.
Just relax.
I need to take a look, all right? - Joyce? - How old is your sister? - Eighteen.
- Okay, wait.
What? Hold on.
Hold on.
What? Okay.
Come here, and I'll give you my key and- Do you have a coat on? - Maybe she's not hungry.
- She hasn't had anything in 12 hours.
Come on.
Come on, Ella.
Come on.
- We could put a little TPN in her line.
- Hey, there.
There.
She's taking it.
Yeah, you're hungry, aren't you? Yeah.
Dr.
Greene, your daughter's on the phone.
I'll call her back.
Where is she? Home.
Katherine stayed over.
- Did they charge her with anything? - Who? The police.
No.
Well, what did they do? You didn't tell them, did you? I wasn't the Attending physician.
Mark, she was in possession of a controlled substance that could've killed our daughter.
She wasn't trying to hurt her.
It was three pills.
I don't think they're gonna waste a lot of time on it.
- Waste time? - You know what I mean.
You're already making excuses for her.
- No, I'm not.
- You're not doing anything, are you? What would you like me to do? You want me to have her arrested? You think she should go to juvenile hall? Would that be better? Do something.
You haven't even called her mother.
- Well, I've been a little busy- - There's a phone! - She's in court all day.
- No.
No, you're avoiding.
Even now you're refusing to deal with a problem you should have handled way before this happened! - Are you blaming me for this? - Oh, damn it! Her stomach's just upset.
Trauma 2.
Have fun.
I'm going home before it comes out both ends.
- Who's working the desk? - Personnel is sending a temp.
I'm already down four nurses.
Abby is coming back, but this is gonna get worse before it gets better.
Anybody who ate those bagels and that cream cheese is gonna blow chunks.
I ate one of those bagels.
I'll add your name to the class-action suit.
Oh, my God! Joyce, I thought you said you were just locked out.
He came back.
He left and then he came back.
Where are your shoes? I just ran.
I hid down the street until he left again.
Okay, let me see.
Can you just let me inside? It's freezing out here.
- We need to go to the hospital.
- I'm okay.
No.
I have to get an x-ray.
- It's not as bad as it looks.
- Yes, it is.
Your cheekbone's broken.
Pulse ox is 82 on 2 liters.
- Oh, no.
Not you too.
- Yeah.
I had the garlic.
No breath sounds on the left.
Chest tube.
Am I dying? - The icicle collapsed your lung.
- Pressure's down to 70.
- God! This is it.
- Squeeze in 2 liters of saline.
I'm gonna use a tube to re-inflate it.
I reached Dr.
Kovac.
Mark's coming down until he gets here.
- No, we can handle this.
- I have to go home.
If I'm working a double, you're not stiffing me after a few hours.
- No, I really have to go home.
- Wait.
Wait! You ate the bagels? - It's a teaching hospital.
- I'd still prefer you to do it.
What's your mom doing in there? I thought he was an orphan.
You should at least be supervising her.
I can see her from here.
John, something's wrong, he's coughing up blood! They gave him a blood thinner.
Hemoptysis is normal.
- This isn't normal.
- Did you hit the lung? No.
I slipped it in the subclavian.
Pulse ox is 95.
Let's bring him to 2 liters.
- Is he thrombocytopenic? - Thirty thousand this morning.
- Pretty low for a central line.
- They transfused him after the treatment.
Please stop debating this and help him! - What do his coags look like? - He got platelets, cryo and FFP.
- He's in pain.
Help him.
- Morphine? Pressure's low already.
I don't wanna bottom him out.
- You can always give him more blood.
- Sure.
Blood in, blood out.
Let's page Dr.
Neiser.
CBC, PT, PTT, portable chest and a blood gas.
And call the blood bank.
Have them prep another 10-pack of platelets.
And an x-ray.
Let's check placement.
How are you doing there, Mick? Are you having any trouble breathing? Mom? Mom, what are you doing? I can't.
Please take care of him.
I'm only here because you asked for my help.
I can't see him in that kind of pain.
Not again.
- What did you expect? - I don't know.
You can't get this kid's hopes up and leave! You're gonna do this? You're gonna drag me back and bail when it gets tough? The kid doesn't think he has to do this alone again! Don't leave him! Thank you.
She was at an all-you-can-eat buffet.
Shortness of breath and wheezing.
Ariel, are you allergic to any food? - Did you give epi? - It got worse as we pulled up.
- Go upstairs.
I got this.
- I saw the board.
You're buried.
I'll close to trauma.
It's bad enough you got my shift.
- It's not a problem.
- Slide her over.
Are you sure that you've never had any asthma or trouble breathing before? Put her on a pulse ox and get Respiratory down here.
- What were you eating? - Shrimp and lobster.
- Shrimp and lobster? - Where do you keep pulse ox cables? - Second drawer.
- Did you eat a lot? Fifty of Benadryl, 125 of Sol Solu-Medrol? Yeah.
IV, now.
And let's get a crash cart ready.
No, really, Mark.
I got this.
Ella's doing great, okay? She's sleeping.
- I need the distraction.
- They're not here.
Well, then try next door.
She's not moving air.
Get her on a nebulizer.
Push 1 cc Where are the pulse ox cables? - Who are you? - Registry.
Outside, third supply cart to the left.
Most of the time, we totally click.
We totally get each other.
- He makes me laugh.
- Okay, sit back.
- He's considerate.
- Okay, that's good.
Other days, he's just a different person.
He becomes a different person.
Chin up.
And then I become a different person.
I know he's all the same man, it's just - Hard to walk away from the good part.
- You have to hold still.
Ninety-five percent of the time, he's my best friend, my husband.
- That's hard to walk away from.
- Well it looks like he answered your ultimatum.
I didn't have a chance to give it.
I think he answered it all the same.
Yeah, well, how long is that gonna take? Look, this isn't just any patient, this is my daughter.
Call another neurologist if you have to, I want that EEG read.
She smiled at me.
That's good, right? She's smiling? Yes.
That's good.
I was thinking about taking one at a party.
They were in my bag.
I forgot about it.
I'm so sorry.
- Nothing I can do can make it right.
- You can leave.
You can pack up your things and leave my house.
- I have to call my mom.
- Then call her.
Dr.
Lewis, I need a facial-lac repair in 2.
Simple or complex? She's gonna need a couple sub-Q, and I'm waiting on a facial series.
Okay.
Send her over to CT and clear this hallway.
Why is there a pregnant woman squatting in the hallway? - Susan? - I need you to see her.
Yeah.
One second.
- Who's running the desk? - That's Bouser, from Accounting.
Of course.
That makes sense.
She's never been allergic to anything.
Shellfish allergies come suddenly.
Especially in large amounts.
This is Dr.
Lewis.
I'll be right back.
- She's still wheezing.
- Dad, I talked to Mom.
And Mom will buy the tickets, you just have to drive me to the airport.
- Slow down.
No one wants you to leave.
- Elizabeth does.
You just gotta give her space for a few days.
- Once everything's okay with- - She told me to leave.
- You talked to her? - Upstairs.
She wants me out.
You caught her at a bad time.
I'll talk to her.
No, it's okay, Dad.
I understand.
She's not my mother.
She cares about Ella, and I hurt her baby.
I don't wanna cause more trouble.
I should just go.
You're not going anywhere, Rachel.
Mom says I should go if Elizabeth doesn't want me.
Your mom's not here and she doesn't- Are you okay? Just go home, and we'll figure this out tonight, okay? - Dad? - Rachel, please, now? Now.
How long has she been overweight? Just recently, she put on 15 pounds in the last couple months or so.
I can send a nutritionist to come speak with you if you'd like.
Yes, please.
I can't seem to stop her from eating.
We'll move her to another room.
We'll monitor her breathing for the next couple hours.
- Thank you.
- You're welcome.
I'll be right back.
Hey, what happened? Oh, I bit my tongue.
You did a really good job.
How's Rachel? - I don't know.
- Let me see.
No.
I just need to keep pressure on it.
Come on.
Stick your tongue out.
It's on the right.
I can't see if you do that.
- Do what? - Stick it out straight.
I did.
What? Well, it's not so bad.
Just keep applying pressure.
- You didn't call for backup? - That's what you are.
Clear the rack.
I'll take the fast tracks.
Dispo the pityriasis in 3.
- Please? - What? I've been flying all night.
I come in on my day off and it's a mess.
- You could ask.
- Flying was your choice and it's not my fault you answered your phone.
Lower GI bleed in 5.
Dr.
Lewis, CT shows a non-displaced zygomatic arch fracture.
- Is she worthy to be seen yet? - Luka's here.
Give it to him.
- Hey.
- Hey.
- You're back.
- Yeah.
This morning.
I was getting worried.
I thought I'd at least get a postcard.
You need to get e-mail.
Didn't take long to get sucked into this insanity.
No.
But it's good to see you, though.
- You too.
- How long you been on? I was supposed to be off an hour ago.
Joyce Westlake.
Her husband beat her up this morning, broke her cheekbone.
Don't let me open them.
Good strength.
Check the lower branches.
Show me your teeth.
Nice and symmetrical.
Okay, blow out your cheeks with air.
Fine.
Cranial nerves two through 11 intact.
But not 12.
It's an isolated dysfunction of the right hypoglossal nerve.
- It's a recurrence.
- You don't know that.
I couldn't say "Solu-Medrol.
I do that all the time, especially if I haven't had my morning latte.
Pedes MVA rolling up.
Air-bag burn.
Okay.
In a second.
- If you're worried, get an MRI.
- Yeah.
Mark, it could be a lot of things.
You're under an enormous amount of stress.
I'll check it out.
You could have inflammatory changes from your tumor vaccine.
- Air bag? - First and second degree.
- BP's 110/70.
- He was in the front seat? - We were in a rush.
- You don't put kids in the front seat! It was a parking lot! - We're good.
Luka's here.
- Good.
Well, I got this one and you can get out from under it.
- Any medical problems? - Hay fever in the summer.
Okay.
Let's start with a lateral C-spine.
- What are you doing? - I'm on a break.
Hello.
We're getting killed here.
I still get a break.
Where is she? - What? - Did you bring her here? - Joyce? - Yes, Joyce! No.
Why? I know she stayed with you last night.
I know you picked her up, so stop lying.
I know you beat the crap out of her.
She swung a bat at my head.
- Here.
Wanna feel? - No, thanks.
- Just tell me what room.
- You're kidding, right? It's none of your business.
I thought you figured that out.
You wanna see her? I'll take you.
She's talking to police.
I'm sure they have questions for you too.
- Abby, can you get me the slit lamp? - Yeah, sure.
I need to check for hyphema.
- Who's that? - The husband.
- Any belly pain? - Soft, non-tender.
Needs a BP.
Titrate four of morphine.
Probably corneal burn.
BP, 120/50.
All right, we need Alcaine, fluorescein and a Wood's lamp.
What exactly is Alcaine? And where do you keep it? Mark? Can you get gentamicin ophthalmic from the pharmacy? Did you get my page? I got a page from Neurology.
Yeah.
I was in Neurology looking at your daughter's EEG.
- You got this? - Yeah.
Coat the facial burns with Neosporin.
Any spikes or sharp waves? No.
Normal K complexes and spindles throughout.
- Good.
Good.
That's a good sign.
- Yeah, for now.
You missed the consult.
I thought you were only gonna be here half an hour.
They got swamped down here.
- Swamped? - Yeah.
- What? - Your daughter's in the PICU, Mark.
- Breathing and showing signs of recovery.
- You run away and leave it all to me! I'm gonna go home, I'm gonna shower, I'm gonna change my clothes, okay? Be careful, because the evil daughter's there, waiting for me.
Just go upstairs and sit with your baby.
You told her to leave.
She asked me what she could do.
- You're serious? - I'm perfectly serious.
- I can't do that.
- Can't do what? I can't turn her away, not now.
What has to happen? Does she have to kill her? - Elizabeth- - No! No! This time, I'm doing something.
She's out! I'm not choosing between my daughters.
You don't have to! I'm choosing for you! What am I telling her by letting you ship her away? That she needs to grow up! That she needs to take responsibility! That what she does has very real consequences for people besides herself! She realizes that.
Do you think she would actually hurt Ella again? Either she's out of the house or I'm not taking that baby home.
Hold on.
Calm down.
Take a breath- - She's my child, Mark! - I know that! She's mine too! Then start acting like it! - Ma'am, we're trying to help.
- You called the cops? - He fractured your face.
- No, he didn't! He didn't even touch me! Where can we find him? - Did you check the university? - Abby, no! That's a big area.
He's not at home.
He hangs out at a bar down the street.
I don't want to press charges.
It's called The Windbreaker, on Fourth and Ashland.
There's obvious signs of abuse.
It's not up to you.
Tell them no! Tell them not to do this! We'll check it out.
Call if he shows up here again.
He was here? - Sit down and let the doctor finish.
- What did he say? We're gonna find you a shelter, someplace where he can't hurt you.
I don't want to go to a shelter! I wanna go home! What if you have a kid with him? Is this what you want for your kids? You want him to beat them? - He wouldn't do that! - Oh, wake up, Joyce! This is it.
This is your chance to get away, right now.
It doesn't matter how wonderful he can be sometimes.
If you go back now, you're telling him it's okay to do this to you and it is not okay.
It's not okay.
Your car's here.
I managed to get a flight to Logan, but I'm on standby.
Can you imagine? I'll call you from the Cape.
I'm sorry.
John, I really am.
Kids, you know they get over stuff.
I bet if you went back Mickey would forget today as quick as he can down a milk shake.
No, you were right.
I became too involved.
I'm thinking maybe I wasn't right.
You see that tree? You and your brother built a fort on that big limb - and you played Tarzan.
- Bobby played Tarzan.
I played Cheetah.
You fell down and you sprained your wrist.
And you never even thought about telling me that he pushed you.
You knew? You two had your secrets.
You stuck together.
I saw no reason to pull you apart.
I didn't spend much time thinking about how your brother's death affected you.
I didn't spend much time on anyone.
Do you have time now? I won't betray another little boy.
- Betray? - You don't wanna give up hope.
You can't.
Hope is all either of you have.
Your brother believed me when I told him he'd get better.
It didn't matter where he was how he felt, what the doctor said.
I told him he'd get better.
He died believing me.
No.
He was pretending for you.
That was another one of our secrets.
I was supposed to not let you be sad.
I was supposed to make you forget to make you happy.
He made me promise to make you happy.
I'm sorry, Mom.
I love you.
Do you hear me? I love you.
Well, if there's no money, it should be fairly- Can you hold on one second? - Yeah? - Campanelli's.
I got your pizza.
Come on up.
If there's no money, it should be fairly straightforward, right? Well, there's a counselor there, isn't there? Well, talk to her tomorrow.
I don't know, I guess you just go and get what you need when you know he's not there.
You know, you did the right thing, Joyce.
Okay.
Can you hold on one second? We- We like this place too.
Good fettuccine.
I'm gonna have to call you back.
Where's the delivery guy? Oh, I got it.
It's on me.
- No, that's okay.
- Where do you want it? Over here? Yeah, that's fine.
We're still planning on inviting you for dinner.
- Brian - Listen, I screwed up.
I have a problem, I need to get some help for it.
But I love my wife.
I just have these strong feelings, you know? And that's not an excuse, and she might not talk to me.
I understand I don't deserve forgiveness, but I just wanna tell her I'm sorry.
County Social Services can get her a letter.
So she's in a group home or something? I can't talk to you about this, Brian.
- I just wanna make sure she's all right.
- She will be.
Tell me where she is.
I promise I won't hurt her.
I think you should leave.
She's my life.
Don't you get that? She's everything to me.
- You can't take her away from me.
- I didn't! - Abby, please.
Where is she? - No.
- Where is she? - All right, listen.
You have to leave now, or I'm gonna call the police.
And I'm pretty sure you're not interested in talking to them again, right? You're right.
I'm sorry.
Good night.
Brian.
Brian! Oh, my God.
Did she recommend a diet? - Did she talk to your parents? - My mom.
Tim is my stepdad.
Well, I know it'll be hard at first.
But if you start eating better, you'll start feeling better.
I know I'm fat.
I don't care.
I'm glad you're comfortable with your body.
That's very important.
But you put on a lot of weight in a short time and that can cause health problems.
And, you know, you'll be going to high school soon.
- You'll be interested in boys.
- I don't like boys.
Well, you say that now, but trust me, in a couple of years, you'll want- No, I won't.
I hate boys.
Why? Why do you hate boys? Do you have problems with boys? With men? I don't want boys to touch me.
Ever.
Ariel, when did your mom marry your stepfather? - Dr.
Lewis, we need you.
- In a second.
Was it within the last year? - Three months ago.
- Dr.
Lewis, it's Abby.
- She was assaulted.
- What? Pupils are 4 millimeters and reactive.
How long were you passed out? - I don't know.
- What happened? My neighbor got pissed because I sent his wife to a battered woman's shelter.
Follow my finger with your eyes.
The guy that came here today? Chest is clear.
He's your neighbor? Yeah.
He wanted to know where we placed Joyce.
Good bowel sounds.
Any belly pain? - Not really.
- And he knows where you live? Obviously.
- Tender at the right costal margin.
- No, my nose.
Oh.
Sorry.
Sorry.
Can I get a gown? Right here.
Okay.
Head and facial CT.
CBC and dip a urine.
- And titrate up to 10 of morphine.
- No, Tylenol.
- Abby, you may have broken your nose.
- Yeah.
I don't want any narcotics.
- At least some Vicodin.
- Just Tylenol.
Six-centimeter contusion, medial aspect of the right thigh.
Did you get kicked? I don't know.
Maybe when I fell.
- Is there a chance you were raped? - No.
No, I don't think so.
Set up a lighted speculum and rape kit.
I was unconscious, I wasn't in a coma.
We just need to be sure.
Did she eat? Just passed out.
Have you? - What? - Eaten.
No.
Go.
I'll take her.
- We need to talk.
- No.
I don't want to discuss it anymore.
Not tonight.
Okay.
Just one more swab.
And then a vaginal aspirate then we're done.
Have you had intercourse in the last 72 hours? No.
No signs of abrasion.
No signs of trauma.
No semen.
I didn't think so.
You can put your feet down.
- So this guy lives on the same floor? - Yeah.
I'd think about moving.
No, I'm not moving.
He's moving.
Well, you definitely have a nasal fracture.
But it's non-displaced, so when the swelling goes down you'll look good as new.
CBC's normal, no blood in the urine.
Could've been a lot worse.
Yeah.
You should be careful about getting into these things.
You know, I was trying to help the girl.
I did help the girl.
I mean, somebody needed to do something.
Something.
Is there someone I can call? - Your mom? - No.
We don't need to admit you.
Is there somewhere you can stay tonight? Yeah, I'll be fine.
You can't go home until they find him.
You can stay with me.
I'm- I'll- I'm just gonna get a hotel or something.
Really, I'll be fine.
And do you have your wallet? - I'll figure something out.
- Abby, stop it.
It's a pullout, but it's comfortable.
It's free and it's safe.
Thank you.
The radiologist cleared the head CT.
- And the facial cuts? - Just the nose.
- Was she? - No, no.
No evidence of anything but getting pummeled in the face.
Did they find him? I don't know.
Triage is cleared.
Can you prep the pass-ons? I still haven't unpacked.
I've lived here five months, I haven't unpacked.
Yeah, bail.
We did catch up.
Yeah, now that you got a professional.
- Jerry? - Dr.
Lewis.
- They let this place go, huh? - Yeah.
What are you doing? - Working.
- Since when? I've been temping since I've come out of retirement.
- Where did you get that? - What? The bagel.
Under the desk.
Somebody threw away perfectly good dip too.
You want some? You should go home, now.
- I don't have a problem with you.
- I have a problem with you.
- I got angry.
It was a mistake.
- You hit women by mistake? I screwed up.
Let's see you hit me, huh? I didn't mean to.
I lost my temper.
Lose your temper with me.
I'm gonna go to the cops now and turn myself in.
- Wait.
Just wait! - Better start swinging back! Hold on! Wait! I was wrong.
I got angry.
She took away my wife! You took away your wife! I know, I know, I know.
But I loved her.
She's everything to me, and I lost her.
I'm sorry! I'm so sorry! I won't mess with Abby again.
I won't even talk to her.
I'll move.
I'll move out of the building.
Please, I'm sorry.
Please.
You touch her again I'll kill you.
R.
Previously on E.
R.
I have a baby with an amphetamine overdose.
- Joyce, you in there? - I'm calling the police.
No.
- I'm trying to help a sick child.
- Mom, he has leukemia.
He may not survive.
If you've got some kind of twisted need to relive this, that's fine.
I'm not gonna do it again.
I made my peace a long time ago.
What the hell happened? She swallowed Rachel's Ecstasy.
- She could still die! - I know, Dad! Please, please, Dad.
I'm sorry! I don't understand why this has happened.
E.
R.
8x14 "A SIMPLE TWIST OF FATE" Dr.
Lewis, you need to get up.
- Dr.
Lewis! - What? You need to get up.
- What time is it? - Almost 7.
Oh, my God, I was just gonna lie down for a second.
- When was that? I need to get home.
Animal attack from the zoo in 15 to 20.
- Oh, no.
I'm not on till noon.
- Weaver needs you now.
Yeah, and I need a hot shower and some mouthwash.
Dr.
Greene is still up in the PICU.
Someone has to cover him.
You happened to be curled up in the lounge.
- Is she extubated? - His daughter? - Yeah.
- They're waiting on a blood gas.
- She triggering the vent? - No.
- Did Neurology read the EEG? - I don't know.
- I said, no! - We're talking bagels and cream cheese.
No one is taking a bribe.
Promotions like this add to the cost of pharmaceuticals.
Marketing expenditures passed on to mostly elderly consumers.
I'm elderly.
- There's no free lunch, Frank.
- This is breakfast.
Yes.
This is Susan Lewis in the ER.
I need to speak with the charge nurse.
They weaned her down to 30 percent, she's off sedation and the PICU fellow ordered a CPAP trial.
Oh, thanks.
Never mind.
I'll take the rack.
You clear the pass-ons and get this borborygmi out of 4.
You wanna ask me to cover all day after staying all night? All night was your choice.
Welcome to management.
- No whining allowed.
- You sleep with your eyelids open.
- Partly open.
- Still kind of freaky.
Not as freaky as watching you eat with your mouth open.
Any strawberry? - Wait.
What are you doing? - Looking for a knife.
- Next to the penlights.
- All right.
You're gonna eat that? Why not? The next time you get a pneumonitis and you have to prescribe Reprotrex or the cheaper, effective generic drug, you're not gonna feel slightly beholden? By a bagel? No.
Are you sure? Okay.
I'm gonna go to Doc Magoo's, get some breakfast, find a toothbrush change my underwear, and then I'll clear your borborygmi.
Fifteen minutes.
If I stick with the underwear I've got on, can we at least keep the food out? It's all right.
It's all right.
You can't titrate a little Versed so she won't remember? Any benzo decreases her ventilatory drive.
Then do it.
But if you allow the sedation to wear off, you have to be ready.
I need to warn you.
Extubation's a leap of faith with little ones.
I can't do a NIF.
PEEP's under two, CO-2 is normal.
- Let's go.
- Okay.
Have the ambu bag ready.
Disconnecting the vent.
And tape is clear.
And tube.
Suction.
All right, come on, Ella.
Big cough.
Big cough.
She's not breathing.
Blow by O-2.
Give her time.
Give her time.
Break open the airway box.
Draw up a milligram of midazolam.
Come on, Ella.
- Positive pressure now.
- No, wait.
That's a happy sound.
We're here.
We're here.
It's all right.
Yeah, we're here.
Is his car still there? Sometimes he skips Marketing, but he won't skip Cost Accounting.
If you wanna wait, I can be there when you do it.
No.
I'm gonna ask him at school.
He'll stay calm in front of his study group.
- You can't ask him, Joyce.
- Right.
I know.
- And you have to leave if he doesn't- - I know.
I know.
Do you wanna come to work with me? - Can I stay here until he leaves? - Of course.
Call me after you talk to him.
Abby.
These groups, they really work? He only lasted two sessions in counseling.
- Joyce- - I know.
I wanna try and help him.
It's worth a try.
You can go back to him if he gets better, or file a complaint and a judge can- He'll do this.
If he knows I'm serious, he'll do this for me.
- Call me.
- Thanks, Abby.
Lock the door.
Abby? You seen Joyce? - Abby, my wife.
You seen her? - What? No.
She didn't come home.
I'm getting worried.
- She didn't call you? - No.
Did you call the police? No.
We had a fight.
She might just be mad at me.
If you hear from her, have her call me? Yeah, sure.
Thanks.
Have a good day.
She's moving extremities? All four.
Fixing and following.
Good color.
Oh, Mark, that's great.
No seizure in the next 48 hours, we should be home free.
What's that for? The breast pump up in OB is missing a collection tube.
- She's eating? - She's about to try.
Thank you for covering.
Don't worry.
Take care of your daughter.
Positive LOC.
Now GCS 13, postictal.
This is the zoo trauma? - Yeah.
He got bit by a monkey.
- It was a sloth.
- What is a sloth? - It's like a monkey.
No, it's not.
They're not anything like primates.
- They're not even in the same order.
- Dr.
Greene? I hear your baby's doing better.
- Off the vent.
- Oh, good.
That's really good news.
So far.
- I didn't file a H-5122 with the chart.
- A what? Mandatory reporting of illegal substance abuse.
Oh, right.
I just wasn't sure.
I thought maybe you'd want to- Yeah, I'll take care of it.
Sometimes it takes a little longer during shift change.
Shift change? When one nurse goes home, another comes on? Oh, right.
I'll go get her.
- Etoposide? - Two-CdA.
- He'll piggyback in the second phase.
- Hey.
His IV has run out, and there's an alarm going off.
It's only a pretreatment solution.
The nurse will change it when they move him.
- Move him? - To the treatment room.
His cells are almost 100 percent leukemic.
He'll need a second chemo induction now.
- And then a bone marrow transplant.
- He's already failed one.
Another one's gonna make him sicker and be more dangerous.
- Chemotherapy alone is gonna save him? - Maybe.
He's gonna get a set of drugs he didn't get before.
- You've decided to experiment on him? - I haven't decided anything.
Look, it's as much luck as science involved at this point.
- You look like you need a rest.
- No.
You're gonna pump that junk back into his veins, I'm gonna stay right here.
I meant to get the ring sized smaller, but I didn't get the chance.
How did you swallow it? He likes me to suck on his fingers.
I see.
Nothing to panic about.
It should pass in two or three days.
- "Pass"? - Two or three days? She'll be fine.
Add some fiber to your diet and let nature take its course.
He's not worried about me.
He's afraid his wife'll notice his wedding ring is missing.
- There's nothing we can do? - Well, I could try an endoscopy.
I don't like the sound of that.
- We stick a tube down your throat- - I gotta get to work.
Honey, I need my ring! Well, I need my job.
I'm on stage in an hour.
I gotta get to work.
And I ain't searching my stool.
Abby's ready for that vag bleed in 1.
- I got Registry to fill in for me.
- You're leaving? I'm on my second dose of Compazine.
I'm still puking.
- Five hundred? - Hey.
How much would you charge to stick a tube down your throat? You two negotiate.
I'll be right back.
Frank, are you sick too? I ain't praying! - How many pads? - Two so far.
Started bleeding yesterday.
Hi, Valerie, I'm Dr.
Lewis.
When was your last period? - Two months ago.
- Do you think you could be pregnant? My parents would freak.
My older sister just had a baby.
Abby, line two.
It's your neighbor.
Just relax.
I need to take a look, all right? - Joyce? - How old is your sister? - Eighteen.
- Okay, wait.
What? Hold on.
Hold on.
What? Okay.
Come here, and I'll give you my key and- Do you have a coat on? - Maybe she's not hungry.
- She hasn't had anything in 12 hours.
Come on.
Come on, Ella.
Come on.
- We could put a little TPN in her line.
- Hey, there.
There.
She's taking it.
Yeah, you're hungry, aren't you? Yeah.
Dr.
Greene, your daughter's on the phone.
I'll call her back.
Where is she? Home.
Katherine stayed over.
- Did they charge her with anything? - Who? The police.
No.
Well, what did they do? You didn't tell them, did you? I wasn't the Attending physician.
Mark, she was in possession of a controlled substance that could've killed our daughter.
She wasn't trying to hurt her.
It was three pills.
I don't think they're gonna waste a lot of time on it.
- Waste time? - You know what I mean.
You're already making excuses for her.
- No, I'm not.
- You're not doing anything, are you? What would you like me to do? You want me to have her arrested? You think she should go to juvenile hall? Would that be better? Do something.
You haven't even called her mother.
- Well, I've been a little busy- - There's a phone! - She's in court all day.
- No.
No, you're avoiding.
Even now you're refusing to deal with a problem you should have handled way before this happened! - Are you blaming me for this? - Oh, damn it! Her stomach's just upset.
Trauma 2.
Have fun.
I'm going home before it comes out both ends.
- Who's working the desk? - Personnel is sending a temp.
I'm already down four nurses.
Abby is coming back, but this is gonna get worse before it gets better.
Anybody who ate those bagels and that cream cheese is gonna blow chunks.
I ate one of those bagels.
I'll add your name to the class-action suit.
Oh, my God! Joyce, I thought you said you were just locked out.
He came back.
He left and then he came back.
Where are your shoes? I just ran.
I hid down the street until he left again.
Okay, let me see.
Can you just let me inside? It's freezing out here.
- We need to go to the hospital.
- I'm okay.
No.
I have to get an x-ray.
- It's not as bad as it looks.
- Yes, it is.
Your cheekbone's broken.
Pulse ox is 82 on 2 liters.
- Oh, no.
Not you too.
- Yeah.
I had the garlic.
No breath sounds on the left.
Chest tube.
Am I dying? - The icicle collapsed your lung.
- Pressure's down to 70.
- God! This is it.
- Squeeze in 2 liters of saline.
I'm gonna use a tube to re-inflate it.
I reached Dr.
Kovac.
Mark's coming down until he gets here.
- No, we can handle this.
- I have to go home.
If I'm working a double, you're not stiffing me after a few hours.
- No, I really have to go home.
- Wait.
Wait! You ate the bagels? - It's a teaching hospital.
- I'd still prefer you to do it.
What's your mom doing in there? I thought he was an orphan.
You should at least be supervising her.
I can see her from here.
John, something's wrong, he's coughing up blood! They gave him a blood thinner.
Hemoptysis is normal.
- This isn't normal.
- Did you hit the lung? No.
I slipped it in the subclavian.
Pulse ox is 95.
Let's bring him to 2 liters.
- Is he thrombocytopenic? - Thirty thousand this morning.
- Pretty low for a central line.
- They transfused him after the treatment.
Please stop debating this and help him! - What do his coags look like? - He got platelets, cryo and FFP.
- He's in pain.
Help him.
- Morphine? Pressure's low already.
I don't wanna bottom him out.
- You can always give him more blood.
- Sure.
Blood in, blood out.
Let's page Dr.
Neiser.
CBC, PT, PTT, portable chest and a blood gas.
And call the blood bank.
Have them prep another 10-pack of platelets.
And an x-ray.
Let's check placement.
How are you doing there, Mick? Are you having any trouble breathing? Mom? Mom, what are you doing? I can't.
Please take care of him.
I'm only here because you asked for my help.
I can't see him in that kind of pain.
Not again.
- What did you expect? - I don't know.
You can't get this kid's hopes up and leave! You're gonna do this? You're gonna drag me back and bail when it gets tough? The kid doesn't think he has to do this alone again! Don't leave him! Thank you.
She was at an all-you-can-eat buffet.
Shortness of breath and wheezing.
Ariel, are you allergic to any food? - Did you give epi? - It got worse as we pulled up.
- Go upstairs.
I got this.
- I saw the board.
You're buried.
I'll close to trauma.
It's bad enough you got my shift.
- It's not a problem.
- Slide her over.
Are you sure that you've never had any asthma or trouble breathing before? Put her on a pulse ox and get Respiratory down here.
- What were you eating? - Shrimp and lobster.
- Shrimp and lobster? - Where do you keep pulse ox cables? - Second drawer.
- Did you eat a lot? Fifty of Benadryl, 125 of Sol Solu-Medrol? Yeah.
IV, now.
And let's get a crash cart ready.
No, really, Mark.
I got this.
Ella's doing great, okay? She's sleeping.
- I need the distraction.
- They're not here.
Well, then try next door.
She's not moving air.
Get her on a nebulizer.
Push 1 cc Where are the pulse ox cables? - Who are you? - Registry.
Outside, third supply cart to the left.
Most of the time, we totally click.
We totally get each other.
- He makes me laugh.
- Okay, sit back.
- He's considerate.
- Okay, that's good.
Other days, he's just a different person.
He becomes a different person.
Chin up.
And then I become a different person.
I know he's all the same man, it's just - Hard to walk away from the good part.
- You have to hold still.
Ninety-five percent of the time, he's my best friend, my husband.
- That's hard to walk away from.
- Well it looks like he answered your ultimatum.
I didn't have a chance to give it.
I think he answered it all the same.
Yeah, well, how long is that gonna take? Look, this isn't just any patient, this is my daughter.
Call another neurologist if you have to, I want that EEG read.
She smiled at me.
That's good, right? She's smiling? Yes.
That's good.
I was thinking about taking one at a party.
They were in my bag.
I forgot about it.
I'm so sorry.
- Nothing I can do can make it right.
- You can leave.
You can pack up your things and leave my house.
- I have to call my mom.
- Then call her.
Dr.
Lewis, I need a facial-lac repair in 2.
Simple or complex? She's gonna need a couple sub-Q, and I'm waiting on a facial series.
Okay.
Send her over to CT and clear this hallway.
Why is there a pregnant woman squatting in the hallway? - Susan? - I need you to see her.
Yeah.
One second.
- Who's running the desk? - That's Bouser, from Accounting.
Of course.
That makes sense.
She's never been allergic to anything.
Shellfish allergies come suddenly.
Especially in large amounts.
This is Dr.
Lewis.
I'll be right back.
- She's still wheezing.
- Dad, I talked to Mom.
And Mom will buy the tickets, you just have to drive me to the airport.
- Slow down.
No one wants you to leave.
- Elizabeth does.
You just gotta give her space for a few days.
- Once everything's okay with- - She told me to leave.
- You talked to her? - Upstairs.
She wants me out.
You caught her at a bad time.
I'll talk to her.
No, it's okay, Dad.
I understand.
She's not my mother.
She cares about Ella, and I hurt her baby.
I don't wanna cause more trouble.
I should just go.
You're not going anywhere, Rachel.
Mom says I should go if Elizabeth doesn't want me.
Your mom's not here and she doesn't- Are you okay? Just go home, and we'll figure this out tonight, okay? - Dad? - Rachel, please, now? Now.
How long has she been overweight? Just recently, she put on 15 pounds in the last couple months or so.
I can send a nutritionist to come speak with you if you'd like.
Yes, please.
I can't seem to stop her from eating.
We'll move her to another room.
We'll monitor her breathing for the next couple hours.
- Thank you.
- You're welcome.
I'll be right back.
Hey, what happened? Oh, I bit my tongue.
You did a really good job.
How's Rachel? - I don't know.
- Let me see.
No.
I just need to keep pressure on it.
Come on.
Stick your tongue out.
It's on the right.
I can't see if you do that.
- Do what? - Stick it out straight.
I did.
What? Well, it's not so bad.
Just keep applying pressure.
- You didn't call for backup? - That's what you are.
Clear the rack.
I'll take the fast tracks.
Dispo the pityriasis in 3.
- Please? - What? I've been flying all night.
I come in on my day off and it's a mess.
- You could ask.
- Flying was your choice and it's not my fault you answered your phone.
Lower GI bleed in 5.
Dr.
Lewis, CT shows a non-displaced zygomatic arch fracture.
- Is she worthy to be seen yet? - Luka's here.
Give it to him.
- Hey.
- Hey.
- You're back.
- Yeah.
This morning.
I was getting worried.
I thought I'd at least get a postcard.
You need to get e-mail.
Didn't take long to get sucked into this insanity.
No.
But it's good to see you, though.
- You too.
- How long you been on? I was supposed to be off an hour ago.
Joyce Westlake.
Her husband beat her up this morning, broke her cheekbone.
Don't let me open them.
Good strength.
Check the lower branches.
Show me your teeth.
Nice and symmetrical.
Okay, blow out your cheeks with air.
Fine.
Cranial nerves two through 11 intact.
But not 12.
It's an isolated dysfunction of the right hypoglossal nerve.
- It's a recurrence.
- You don't know that.
I couldn't say "Solu-Medrol.
I do that all the time, especially if I haven't had my morning latte.
Pedes MVA rolling up.
Air-bag burn.
Okay.
In a second.
- If you're worried, get an MRI.
- Yeah.
Mark, it could be a lot of things.
You're under an enormous amount of stress.
I'll check it out.
You could have inflammatory changes from your tumor vaccine.
- Air bag? - First and second degree.
- BP's 110/70.
- He was in the front seat? - We were in a rush.
- You don't put kids in the front seat! It was a parking lot! - We're good.
Luka's here.
- Good.
Well, I got this one and you can get out from under it.
- Any medical problems? - Hay fever in the summer.
Okay.
Let's start with a lateral C-spine.
- What are you doing? - I'm on a break.
Hello.
We're getting killed here.
I still get a break.
Where is she? - What? - Did you bring her here? - Joyce? - Yes, Joyce! No.
Why? I know she stayed with you last night.
I know you picked her up, so stop lying.
I know you beat the crap out of her.
She swung a bat at my head.
- Here.
Wanna feel? - No, thanks.
- Just tell me what room.
- You're kidding, right? It's none of your business.
I thought you figured that out.
You wanna see her? I'll take you.
She's talking to police.
I'm sure they have questions for you too.
- Abby, can you get me the slit lamp? - Yeah, sure.
I need to check for hyphema.
- Who's that? - The husband.
- Any belly pain? - Soft, non-tender.
Needs a BP.
Titrate four of morphine.
Probably corneal burn.
BP, 120/50.
All right, we need Alcaine, fluorescein and a Wood's lamp.
What exactly is Alcaine? And where do you keep it? Mark? Can you get gentamicin ophthalmic from the pharmacy? Did you get my page? I got a page from Neurology.
Yeah.
I was in Neurology looking at your daughter's EEG.
- You got this? - Yeah.
Coat the facial burns with Neosporin.
Any spikes or sharp waves? No.
Normal K complexes and spindles throughout.
- Good.
Good.
That's a good sign.
- Yeah, for now.
You missed the consult.
I thought you were only gonna be here half an hour.
They got swamped down here.
- Swamped? - Yeah.
- What? - Your daughter's in the PICU, Mark.
- Breathing and showing signs of recovery.
- You run away and leave it all to me! I'm gonna go home, I'm gonna shower, I'm gonna change my clothes, okay? Be careful, because the evil daughter's there, waiting for me.
Just go upstairs and sit with your baby.
You told her to leave.
She asked me what she could do.
- You're serious? - I'm perfectly serious.
- I can't do that.
- Can't do what? I can't turn her away, not now.
What has to happen? Does she have to kill her? - Elizabeth- - No! No! This time, I'm doing something.
She's out! I'm not choosing between my daughters.
You don't have to! I'm choosing for you! What am I telling her by letting you ship her away? That she needs to grow up! That she needs to take responsibility! That what she does has very real consequences for people besides herself! She realizes that.
Do you think she would actually hurt Ella again? Either she's out of the house or I'm not taking that baby home.
Hold on.
Calm down.
Take a breath- - She's my child, Mark! - I know that! She's mine too! Then start acting like it! - Ma'am, we're trying to help.
- You called the cops? - He fractured your face.
- No, he didn't! He didn't even touch me! Where can we find him? - Did you check the university? - Abby, no! That's a big area.
He's not at home.
He hangs out at a bar down the street.
I don't want to press charges.
It's called The Windbreaker, on Fourth and Ashland.
There's obvious signs of abuse.
It's not up to you.
Tell them no! Tell them not to do this! We'll check it out.
Call if he shows up here again.
He was here? - Sit down and let the doctor finish.
- What did he say? We're gonna find you a shelter, someplace where he can't hurt you.
I don't want to go to a shelter! I wanna go home! What if you have a kid with him? Is this what you want for your kids? You want him to beat them? - He wouldn't do that! - Oh, wake up, Joyce! This is it.
This is your chance to get away, right now.
It doesn't matter how wonderful he can be sometimes.
If you go back now, you're telling him it's okay to do this to you and it is not okay.
It's not okay.
Your car's here.
I managed to get a flight to Logan, but I'm on standby.
Can you imagine? I'll call you from the Cape.
I'm sorry.
John, I really am.
Kids, you know they get over stuff.
I bet if you went back Mickey would forget today as quick as he can down a milk shake.
No, you were right.
I became too involved.
I'm thinking maybe I wasn't right.
You see that tree? You and your brother built a fort on that big limb - and you played Tarzan.
- Bobby played Tarzan.
I played Cheetah.
You fell down and you sprained your wrist.
And you never even thought about telling me that he pushed you.
You knew? You two had your secrets.
You stuck together.
I saw no reason to pull you apart.
I didn't spend much time thinking about how your brother's death affected you.
I didn't spend much time on anyone.
Do you have time now? I won't betray another little boy.
- Betray? - You don't wanna give up hope.
You can't.
Hope is all either of you have.
Your brother believed me when I told him he'd get better.
It didn't matter where he was how he felt, what the doctor said.
I told him he'd get better.
He died believing me.
No.
He was pretending for you.
That was another one of our secrets.
I was supposed to not let you be sad.
I was supposed to make you forget to make you happy.
He made me promise to make you happy.
I'm sorry, Mom.
I love you.
Do you hear me? I love you.
Well, if there's no money, it should be fairly- Can you hold on one second? - Yeah? - Campanelli's.
I got your pizza.
Come on up.
If there's no money, it should be fairly straightforward, right? Well, there's a counselor there, isn't there? Well, talk to her tomorrow.
I don't know, I guess you just go and get what you need when you know he's not there.
You know, you did the right thing, Joyce.
Okay.
Can you hold on one second? We- We like this place too.
Good fettuccine.
I'm gonna have to call you back.
Where's the delivery guy? Oh, I got it.
It's on me.
- No, that's okay.
- Where do you want it? Over here? Yeah, that's fine.
We're still planning on inviting you for dinner.
- Brian - Listen, I screwed up.
I have a problem, I need to get some help for it.
But I love my wife.
I just have these strong feelings, you know? And that's not an excuse, and she might not talk to me.
I understand I don't deserve forgiveness, but I just wanna tell her I'm sorry.
County Social Services can get her a letter.
So she's in a group home or something? I can't talk to you about this, Brian.
- I just wanna make sure she's all right.
- She will be.
Tell me where she is.
I promise I won't hurt her.
I think you should leave.
She's my life.
Don't you get that? She's everything to me.
- You can't take her away from me.
- I didn't! - Abby, please.
Where is she? - No.
- Where is she? - All right, listen.
You have to leave now, or I'm gonna call the police.
And I'm pretty sure you're not interested in talking to them again, right? You're right.
I'm sorry.
Good night.
Brian.
Brian! Oh, my God.
Did she recommend a diet? - Did she talk to your parents? - My mom.
Tim is my stepdad.
Well, I know it'll be hard at first.
But if you start eating better, you'll start feeling better.
I know I'm fat.
I don't care.
I'm glad you're comfortable with your body.
That's very important.
But you put on a lot of weight in a short time and that can cause health problems.
And, you know, you'll be going to high school soon.
- You'll be interested in boys.
- I don't like boys.
Well, you say that now, but trust me, in a couple of years, you'll want- No, I won't.
I hate boys.
Why? Why do you hate boys? Do you have problems with boys? With men? I don't want boys to touch me.
Ever.
Ariel, when did your mom marry your stepfather? - Dr.
Lewis, we need you.
- In a second.
Was it within the last year? - Three months ago.
- Dr.
Lewis, it's Abby.
- She was assaulted.
- What? Pupils are 4 millimeters and reactive.
How long were you passed out? - I don't know.
- What happened? My neighbor got pissed because I sent his wife to a battered woman's shelter.
Follow my finger with your eyes.
The guy that came here today? Chest is clear.
He's your neighbor? Yeah.
He wanted to know where we placed Joyce.
Good bowel sounds.
Any belly pain? - Not really.
- And he knows where you live? Obviously.
- Tender at the right costal margin.
- No, my nose.
Oh.
Sorry.
Sorry.
Can I get a gown? Right here.
Okay.
Head and facial CT.
CBC and dip a urine.
- And titrate up to 10 of morphine.
- No, Tylenol.
- Abby, you may have broken your nose.
- Yeah.
I don't want any narcotics.
- At least some Vicodin.
- Just Tylenol.
Six-centimeter contusion, medial aspect of the right thigh.
Did you get kicked? I don't know.
Maybe when I fell.
- Is there a chance you were raped? - No.
No, I don't think so.
Set up a lighted speculum and rape kit.
I was unconscious, I wasn't in a coma.
We just need to be sure.
Did she eat? Just passed out.
Have you? - What? - Eaten.
No.
Go.
I'll take her.
- We need to talk.
- No.
I don't want to discuss it anymore.
Not tonight.
Okay.
Just one more swab.
And then a vaginal aspirate then we're done.
Have you had intercourse in the last 72 hours? No.
No signs of abrasion.
No signs of trauma.
No semen.
I didn't think so.
You can put your feet down.
- So this guy lives on the same floor? - Yeah.
I'd think about moving.
No, I'm not moving.
He's moving.
Well, you definitely have a nasal fracture.
But it's non-displaced, so when the swelling goes down you'll look good as new.
CBC's normal, no blood in the urine.
Could've been a lot worse.
Yeah.
You should be careful about getting into these things.
You know, I was trying to help the girl.
I did help the girl.
I mean, somebody needed to do something.
Something.
Is there someone I can call? - Your mom? - No.
We don't need to admit you.
Is there somewhere you can stay tonight? Yeah, I'll be fine.
You can't go home until they find him.
You can stay with me.
I'm- I'll- I'm just gonna get a hotel or something.
Really, I'll be fine.
And do you have your wallet? - I'll figure something out.
- Abby, stop it.
It's a pullout, but it's comfortable.
It's free and it's safe.
Thank you.
The radiologist cleared the head CT.
- And the facial cuts? - Just the nose.
- Was she? - No, no.
No evidence of anything but getting pummeled in the face.
Did they find him? I don't know.
Triage is cleared.
Can you prep the pass-ons? I still haven't unpacked.
I've lived here five months, I haven't unpacked.
Yeah, bail.
We did catch up.
Yeah, now that you got a professional.
- Jerry? - Dr.
Lewis.
- They let this place go, huh? - Yeah.
What are you doing? - Working.
- Since when? I've been temping since I've come out of retirement.
- Where did you get that? - What? The bagel.
Under the desk.
Somebody threw away perfectly good dip too.
You want some? You should go home, now.
- I don't have a problem with you.
- I have a problem with you.
- I got angry.
It was a mistake.
- You hit women by mistake? I screwed up.
Let's see you hit me, huh? I didn't mean to.
I lost my temper.
Lose your temper with me.
I'm gonna go to the cops now and turn myself in.
- Wait.
Just wait! - Better start swinging back! Hold on! Wait! I was wrong.
I got angry.
She took away my wife! You took away your wife! I know, I know, I know.
But I loved her.
She's everything to me, and I lost her.
I'm sorry! I'm so sorry! I won't mess with Abby again.
I won't even talk to her.
I'll move.
I'll move out of the building.
Please, I'm sorry.
Please.
You touch her again I'll kill you.