Chicago Med (2015) s08e18 Episode Script

1
Told him I needed dialysis.
Left it pretty vague.
It's a good thing you told him, though.
Not just for his sake.
Hey, Grace. Over here.
Word is she's single.
Maybe I could buy you a cup of coffee.
What about a drink instead?
We can help a lot more people
with Jack's vision
and money in our corner.
Dayton says from now on, 2.0
is for paying customers only.
When Jack wants something, he
can be like a dog after a bone.
Yeah, well, that has
been my impression as well.
[LAUGHTER]
Ooh.
Who are the flowers from?
Guess.
Oh, your not-so-secret admirer,
Dr. George Thomas.
Oh, orchids.
- The man's refined.
- No.
The man is persistent.
[LAUGHS] Come on.
Tell me you're not
a little bit flattered.
Well, it's a bit much, don't you think?
I think George has a crush.
Well, I think he needs to take a hint.
He's asked me out for drinks again.
Why won't you go?
He's on the board, Maggie.
You work here every day.
Where else you supposed
to meet somebody?
Well, I just think it's not a good idea
- to mix business with pleasure.
- Fine.
Sure, but when has that
ever worked for anyone?
I mean, take the ED, for example.
You've got Ethan and April.
You've got Will and Natalie.
You've got Will and Hannah.
- You got Will and
- Okay, all right.
Spare me the update
on Dr. Halstead's love life.
- There could be
- Go to work.
- Goodwin and
- Bye.
[LAUGHS] [DOOR SHUTS]
I'm surprised you've got the guts
to show your face this morning,
305 to 146.
Glad to see last night's win
didn't go to your head.
Did you memorize our Scrabble scores?
Do you think it's some kind of record?
Largest spread ever recorded.
Well, someone's extra snarky
this morning.
- What's in that thermos?
- Oh.
Well, there were four shots of espresso.
- It's empty now.
- Whoa. Where's the fire?
My pilot program launches today.
That's right. I totally
forgot about the big day.
The ED gets a technological facelift.
New software, diagnostic tools,
system upgrades.
Be honest. People are not gonna
like all the changes, right?
- They'll be resistant.
- Of course they will be.
At first, but once
they give it a shot
They're gonna see the tech is
gonna help them with their work
and work better and work
for them and not against them.
And you can tell I've had
four shots of espresso
- on an empty stomach.
- Yes.
- Let's get you a muffin.
- Yes, let's.
A blueberry muffin, chai latte.
Okay. Yeah, sure.
- Grace?
- Mm-hmm.
- Grace.
- Mm-hmm. Mm-hmm, yeah.
[BOTH INHALE DEEPLY, EXHALE]
Thanks. Come here.
Hey, look.
You've been helping me do my
job better since you got here.
Today's gonna go great.
Thank you.
I
couldn't help it.
No need to help it.
- That was a close one.
- Thank you so much.
- I appreciate it.
- Have a good day.
Lifesaver.
Hey, got your own
personal valet now, hotshot?
Your son is a lifesaver.
Apparently, my car
was about to be towed,
and he offered to move it for me.
That's the least he could do.
What do you mean?
You've take him under your wing.
You set him up with a sponsor.
You sent that valet gig his way.
You've been a really positive influence.
And now that I've laid it on thick,
can I ask a favor?
Should've seen that coming.
I need an attending
to cover for me next week
at a department meeting,
and you're the only one
around here I trust.
What's going on?
So I'm being evaluated
for the transplant list.
Dr. Cameron feels it's time
seeing as I'm officially
in end stage renal disease.
Dean, I'm sorry.
And the kicker is,
even if I get on the list,
it might not be an easy match.
I've got this high cPRA.
What about Sean?
Isn't he getting tested?
Mm, no, that's not an option.
But he would be
your best possible donor match.
Yeah, Sean needs to focus
on his own health now, not mine.
Sean's coming up
on one year of being sober.
He's in a really good place.
Donating could be a really
positive experience for him.
I'm not taking my son's kidney, Hannah.
- Dean
- Incoming!
- Dr. Archer, you're with me.
- Yeah.
- I'm right there.
- It's your son.
He should be given
the opportunity to help
if he wants to.
I don't mean to be patronizing,
but you'll get it when you have a kid.
Going to T3.
Kurt Leger. 36-year-old male.
Was ejected from his wheelchair.
Fell down a flight of stairs.
Vitals are stable.
My wheel got caught in an uneven tile.
And I went flying.
I'm okay, though, really.
Just knocked the wind out of me.
How long you been in a wheelchair?
- Huh?
- How long
have you been in a wheelchair?
Told us he's got
a T-10 spinal cord injury.
Got bucked off a horse in high school.
Is this a complete injury, Kurt,
or is this paralysis
from the waist down?
- Waist down, yeah.
- Okay.
On my count. One, two, three.
- Oh, God.
- Okay.
Okay.
Okay, breath sounds clear bilaterally.
Okay. Let's take this board out.
Kurt, we're gonna roll you
over for just a moment, okay?
Okay.
All right.
[GROANING]
All right, let's hold off
on clearing C-spine just yet.
Give him 100 of fentanyl.
That'll help take the edge off.
Okay. And we'll be back shortly.
[GROANING]
You were pressing way below T-10.
How could he feel that?
Well, no clue. Could be referred pain.
We'll know more once we see imaging.
Has trauma ever reversed
permanent paralysis?
What, from a complete
spinal cord injury? No.
No, never. No.
[TENSE MUSIC]
♪
Hello.
- Good morning.
- Oh.
- Hey there.
- Hi.
Please sit.
- Sit.
- Okay.
I have news. Big news.
Oh, how exciting.
My coworker, Vanna
She's moving to Florida
to live with her daughter.
Yeah, you remember.
- Yeah.
- Good.
Well, I might buy her house.
Wow.
- Yeah.
- Okay.
It is small, but it's just me.
So it will be perfect.
- And, I mean, that's great.
- Yeah.
And you can afford it,
I mean, obviously.
Well, I will have to use
all of my savings
for the downpayment
and take out a mortgage,
but I can do it.
And Vanna is offering it to me
off market
for a very fair price.
Well, that's so exciting.
You know it's a fair price because
you looked at some comps
in the neighborhood?
- Comps?
- Comparable properties.
Comps, yes. Well, no.
- I haven't yet, but I will.
- No, not yet.
- Yeah.
- And I trust Vanna.
Yeah.
You don't think this is a good idea.
Oh, gosh, I don't mean
to give that impression at all.
- I don't.
- Oh, okay.
I just think, you know,
you have to be
I don't know, always when you
make a big move like this,
you gotta ask the question,
is now the best time to buy?
You know, and if you're
gonna wipe out your savings
for the downpayment, I mean,
maintenance issues will come along.
You might want to do a renovation.
You just gotta make sure
Hey, look, I really
I don't mean to be a downer
about this at all.
- I really don't.
- No, it's okay.
There's a lot to think about.
- I'm still thinking about it.
- Okay.
You want to go somewhere
and talk about it some more?
Get a cup of coffee or something?
I can't. I have errands to run.
And I will see you later, Daniel.
Okay.
Hey, congrats.
Congrats.
The new system automatically
updates room availability
and displays room assignments
on all the monitors.
Maggie, now you won't
have someone asking you
every two minutes, "Where am I going?"
No, that'll still happen.
Okay, everybody.
Let's get back to work.
Thank you very much.
No, no, it won't happen because now
they can just look at the monitors
I understand that they can,
but will they?
These folks are creatures of habit.
Well, it'll become habit over time.
Okay, well tell me more
about these lights.
Are they part of a room triage system?
So no, these are actually noise sensors.
They monitor volume levels
throughout the ED.
When it gets too loud,
they start flashing.
What happens when they do?
Noise police just pops out? Oh.
Well, no.
Hopefully it's a gentle reminder
to anyone in the vicinity
to lower their voice.
- Yeah, I'm
- Research shows
that excessive noise
in the emergency room
increases patients' stress and anxiety,
raises their cortisol levels.
Well, I'm for the reminder to the staff
that they must keep unnecessary
noise at a minimum.
I mean, it's what I do every day.
Which you shouldn't have to.
You got enough on your plate, Maggie.
Adults should be able to self-monitor
with a simple visual cue, right?
I guess, Grace. We'll see.
[KNOCKS AT DOOR]
- Hello, Ms. Palmer.
- It's Alicia.
Hi, Alicia. I'm Dr. Halstead.
I see you've been experiencing
frequent headaches lately.
Yeah, two to three a week
for the last month.
The one I'm currently having
is the longest so far.
Going on 29 hours.
This should all be in my chart.
I gave the nurse a record of my attacks.
Yes, I'm seeing that here.
And a list of conditions and diseases
that include my symptoms.
I'm obviously not a doctor.
I'm not trying
to insult your intelligence.
No offense taken.
I just read that people get misdiagnosed
in the emergency room every year.
Well, I can tell you
a misdiagnosis tends to happen
when a patient's presentation
is atypical.
Yes, that is what the article said.
But here at Med,
we've actually got a new
Well, really new, like, as of today
AI-based diagnostic tool
that helps us make sure
we don't miss anything.
There's a lot more to it,
but the gist is
it creates a differential
for the doctor to compare
against their own.
Differential. That's the list of things
that could be wrong with me, right?
So it's like having a colleague
double-check your work.
A colleague that scans
every medical database
and journal in an instant.
Okay, yeah.
Let's definitely use the robot.
Well, because we're
in the pilot phase still,
I'm gonna need you
to sign a consent form.
I'll grab it and be right back.
- Thanks.
- All right.
I'm sorry I didn't put on the gown.
I know I'm supposed to,
but it would take me forever
at the moment.
I'll cut you some slack.
I'm also kind of hoping
this won't take long.
Ryan has had perfect attendance
all year.
Oh, well as an alumna
of the perfect attendance club,
I will do my best
to get you both out the door.
So, Sarah, you got dizzy
driving to school today?
For, like, a few seconds.
Yeah, I pulled over
to study myself for a moment.
And then I felt fine.
But my worrywart over here
begged me to turn around and come here.
She gets dizzy a lot.
Sometimes she has trouble
catching her breath.
- Hmm.
- I have to park on the street.
I get a little winded sometimes
walking from our apartment to the car.
Every day?
I tried to explain to Ryan it's normal.
Well, your ankles are swollen.
And your breathing still seems
a bit labored, even at rest.
- [PHONE CHIMES]
- Yeah, I had swollen ankles
and I was panting all the time
when I was this big with Ryan too.
Just ask my ex.
Oh, wait. He's nowhere to be found.
Well, these all could be symptoms
of third trimester pregnancy, I agree,
but I'd still like to do
a full workup just to be safe.
I've got an appointment
with by OB on Monday.
I'd really prefer if we
could just check you out now.
Mom, look at this text
you got from Ms. Goto.
It says as long as I get back
before lunch is over,
it won't mess up my record.
So let the doctor
run tests and stuff, please.
Okay, okay.
Yes, run all the tests and stuff.
Hey, I'm just fine.
We'll make sure your baby
sister is feeling good, okay?
Dr. Archer, Kurt Leger's scans are up.
Okay.
Yeah, unstable burst fracture
at T-12 from the fall today.
What?
Well, it isn't a medical miracle
he's got feeling below T-10.
What do you mean?
Well, no evidence of
prior trauma at the vertebrae.
Yeah, this guy's not paralyzed.
Kurt.
Wanted to review your imaging.
To start with,
you don't have an injury at T-10.
I'm guessing this isn't news to you.
Do I need to repeat that?
I didn't think the scans would
What, blow your cover?
Okay, but what's really pressing
I'm not trying
to get disability benefits
or better parking.
- That's not why.
- Sure, sure.
- Of course, yeah.
- I don't want you to think
Hey, it really doesn't matter
what I think.
What does matter: your tumble today
caused an unstable burst fracture
in your T-12 vertebrae,
and that's gonna require surgery to fix.
And without surgery?
There really is not another option.
If your fracture was stable,
I would say you can try a brace.
No, no, I'm not asking
about other options.
If I don't treat this, what will happen?
You're gonna end up
actually needing a wheelchair.
You're gonna be looking at weeks in bed.
Chronic back pain.
Weakness in one or both of your legs.
Numbness.
Even paralysis.
I don't want the surgery.
So I really appreciate you giving
me access to your psychiatric records.
- It's very helpful.
- Of course.
How about I just, you know, give you
my understanding of what I read,
and then you let me know
if I missed anything.
Does that sound okay?
All right, so you were diagnosed
with body integrity identity
disorder eight years ago
but experienced symptoms
from early childhood.
Since I was at least five, yeah.
And for you, BIID presents itself
in the form of a very strong
desire to be paralyzed?
It's all I think about.
It dominates every aspect of my life.
But it seems like
a wheelchair gave you some relief.
Some, but I can still feel my legs.
And for reasons I can't explain,
that's an extremely distressing feeling.
I've had therapists tell me it's due
to repressed childhood trauma,
neurologists who think it's
a glitch in my cerebral cortex.
A psychic told me
it was linked to a past life.
Right.
Yeah, I mean,
I can see that you've tried
a number of different
therapeutic approaches here
You know, kind of behavioral therapy,
antidepressants, muscle relaxants.
Even hypnosis.
Nothing's worked.
I wish I had something
special in my toolkit for you,
but, I mean, frankly,
these are all the therapies
I would recommend myself.
Must be very frustrating for you.
Yeah.
And honestly,
today's the most hopeful I've
felt in a really long time.
I want the tests.
Okay.
- Hey, Grace, you got a sec?
- Hey.
So I don't know if there's,
like, a formal suggestion box
during this pilot phase.
I'm the suggestion box. What's up?
New software.
It included giant cell arteritis
in my patient's differential.
Your patient with the headaches.
- Exactly.
- GCA's pretty rare.
It presents in 5 out of
every 10,000 people, I think.
And testing for it requires
a number of expensive labs.
The patient's insurance
is gonna cover it,
but I don't like
ordering unnecessary tests.
I prefer to rule out horses
before chasing zebras.
Of course, but you
don't have to order the labs.
A doctor can override any
suggestion on the differential.
Right, but before
the doctor can do that,
the differential's
automatically uploaded
to the patient's chart.
Which the patient can view in real time
by logging in to the online portal.
Which my patient did.
And now, she's insisting
I order all these unnecessary labs.
So your suggestion is
to lose automatic upload,
which we can't because when the
patient signs the consent form,
they're guaranteed access
to the full results.
Ah, I see.
Well, you know what?
Better safe than sorry.
- Right?
- Yeah.
Absolutely, and it'll
ease the patient's mind too.
Well, let me know how it turns out.
Hello, Baylin. Remember me, Maggie?
Baylin drove himself to the ED
because he feels like
his heart is pounding.
I'm sorry to hear that.
You want to take a walk with me, okay?
We're going right down here to three.
Thanks, Leah.
[PANTING] The CIA is following me.
I think I saw one of them
in the waiting area.
But I can't be sure.
He's always changing his appearance.
All right, I won't let anyone come
into your room without your permission.
Trini here
is gonna help you get situated.
Hi, Baylin.
Why don't you take a seat on the bed?
I'll grab a gown.
- Trini.
- Yeah?
Baylin's a frequent flier
with schizophrenia
with a complex PTSD,
and psych's backed up.
Got it.
Do you mind keeping him
company for a bit?
- Not at all.
- Thank you.
Hi.
Hi, Sarah. This is Dr. Marcel.
- Hi.
- Hey, Sarah.
Um, I see surgery
on your scrubs, Dr. Marcel,
and it's making me nervous.
Well, I tend to have
that effect on people.
Well, Sarah,
before we go over your results,
we were gonna see if Ryan here
wanted to go to the rec room.
There's all kinds of video
games and snacks down there.
Yeah, that's a great idea.
Why don't you check it out, kiddo?
No, I'm staying with you.
Ryan, this is a conversation
between grown-ups.
I'll be quiet. I promise.
It's just us two.
There's no keeping anything
from him anyway.
Go ahead.
Okay, so I asked Dr. Marcel to consult
because your echocardiogram
revealed you have a condition
called peripartum cardiomyopathy,
or PPCM.
It's often missed,
because as you experienced,
it mimics the symptoms of pregnancy.
So, Ryan, it's really good that
you brought your mom in today.
Great job, buddy.
That's heart disease, isn't it?
It is. Yours is a very rare form
that can occur at the end of pregnancy
or shortly after giving birth.
Now, I reviewed your echo
with Dr. Asher,
and we can treat you with medicine.
Oh, thank goodness.
We will have to admit you overnight.
Wait. To the hospital?
We'll start you on medications
to help your heart function better
and get rid of any fluid
that's causing discomfort.
If I'm just taking medication,
why can't I do that at home?
Well, it's recommended
that you stay in the hospital
for monitoring
and so you can rest,
at least until
the acute symptoms subside.
I can't.
I don't have anyone
to watch Ryan, and
I really can't afford
a hospital stay right now.
I'm saving up to send Ryan
to private school next year.
Speaking of, kiddo,
we gotta get you to school.
Lunch period is gonna be over soon.
Mom, I don't care.
What do you mean you don't care?
This kid has perfect attendance.
And if he keeps it up,
he is gonna get an award
at the end of the year.
Stop it, Mom! I don't care
about the stupid award!
Hey, you don't speak to me like that.
Just get me the prescription
so I can leave.
I really can't recommend that.
I understand.
Please get me the prescriptions.
I know we've had
disagreements in the past
around this topic,
but this is a no-brainer.
This guy wants to be paralyzed.
How can he have decisional capacity?
Well, because like a vast
majority of people with BIID,
he's aware and oriented, right?
He understands the risks of the surgery
as well as the alternatives.
- You know, he's of sound mind.
- Sound mind?
What about the fact that he
flung himself down the stairs?
No evidence
that the fall was intentional.
Come on, man. How could there not be?
Well, according to the paramedics,
there were several witnesses
who confirmed it was an accident.
Not to mention,
no history of self-harm
or reckless behavior.
Actually was able
to get ahold of his shrink
who assured me he never even considered
trying to paralyze himself.
Well, maybe he just never discussed it.
- Dean.
- Yeah?
Even if the fall were intentional,
we still can't force a surgery on him.
No, but a court order could.
But we don't have the grounds
to petition a judge, right?
Because he competent.
I don't like it either, okay?
But he has the right
to refuse the surgery.
Okay, all right.
And once again,
you're keeping my patients
from getting the care they need.
Hey, so what gives?
What are you talking about?
You didn't see
this impromptu board meeting
added to your calendar?
I mean, do you have any idea
what this is about?
I didn't even know it was happening.
Okay, well, it's an impromptu meeting
with the entire board,
plus C-suite, okay?
I mean, that can't be good.
Look, I don't like
being blindsided either,
but don't get all fatalistic.
Yeah, well,
when I talked to Jack about it,
he wouldn't share any details,
and he told me not to worry.
That makes me worry.
Well, you're in fairly regular contact
with his lawyers, aren't you?
Well, see if he has any
significant filings in motion,
and I'll put a call out to George.
Maybe he has some intel.
George?
Yeah, Dr. Thomas,
our newest board member.
Oh, yeah, I didn't realize
that you and George
were getting so chummy.
I'll go find some other
business to stick my nose into.
[DISTANT CHATTER] [MACHINERY BEEPING]
Red light.
[WHIMPERS]
Red light! The CIA's found me!
The signals are moving!
They're gonna be here any minute.
- Let's get back in bed, okay?
- Oh, no.
They flash the red lights
when they got you cornered like a rat.
That's their signal to move in!
Maggie, I could use a hand.
- No, no, no, no.
- Baylin.
Baylin, I need you to calm down.
Breathe. Breathe. I need you to breathe.
These light,
I'm turning them off right now.
- I'm turning them off.
- Yeah, I'm sorry!
- I have to go!
- Baylin.
- Baylin. Baylin.
- They're gonna kill me!
Security, stop him
from leaving right now.
Page Dr. Charles.
Let me go! Let me go!
[SOBBING]
I gotta go, please.
Looks like our old buddy, Baylin,
went off his meds a couple weeks ago.
Good news: he's agreed
to check into the psych ward
for a couple of days
until he gets back on regimen.
Great.
So these are what set him off?
And why were they installed again?
To make patients more comfortable.
The genius of Jack Dayton.
They got to go.
Mm-hmm.
Maggie, I heard what happened.
So you'll understand
why I want the lights removed.
Red was a poor color choice.
I'll reprogram the lights to
something more neutral tonight.
I want them gone, please, Grace.
Not reprogrammed. Just gone.
You agreed that monitoring
noise levels in the ED
is important for patient care.
And I do a damn good job of it.
I'm not suggesting that you're not.
I don't need any assistance.
[KNOCKS AT DOOR]
So good news.
All your labs came back normal.
Your ESR was mildly elevated,
but that's nothing
to be concerned about.
What is ESR? What does it test for?
Erythrocyte sedimentation rate.
It measures inflammatory
activity in the body.
- And mine's elevated?
- Mildly.
And it can be elevated
for a number of reasons.
I mean, something like
stubbing your toe will do it.
What if you have What is it called
- Giant cell
- Arteritis.
Right. Would your ESR be elevated then?
Yes, but much higher than yours.
How much higher?
Off the top of my head, I believe,
typically 50 or above.
- And mine was 31.
- Correct.
And you never see GCA in
a patient with an ESR below 50?
There have been cases, similar ones,
but those patients all had symptoms
of the condition you do not have.
Uh, it's far more likely
you have a headache disorder.
I suspect migraines
or cluster headaches.
I'd like to refer you to a specialist
Whoa, your system says here,
if it is GCA,
it should be treated
right away to prevent
vision loss or a stroke?
It could be weeks
before I see a specialist.
Alicia, the gold standard
for diagnosing GCA
is a temporal artery biopsy.
Neurosurgeon makes an incision
above your temple
and removes a piece
of your blood vessel.
A surgeon?
Yes, we're talking
about an actual procedure here.
But I'd be out for the whole thing.
They put me to sleep, right?
No, it's only used with light sedation
under local anesthetic.
You'd be awake the whole time.
Look, I know headaches
are extremely frustrating
and you want answers, but let's start
with giving you some relief.
I'm gonna put you on triptan.
It's a class of drug used
I'm not gonna feel any relief
until I know definitively
this isn't GCA.
Alicia, it's just you have
so few of the symptoms
You said misdiagnoses happen
when a patient's presentation
is atypical.
I want the biopsy.
Sarah, I really wish
you'd reconsider staying.
Just let me get him to school.
If I have another spell,
I'll come right back.
Oh! [WATER BREAKS]
Wait. Did my water just break?
Let me check.
Yes, it did. Okay, it is time.
- What? But it's so early.
- You're 38 weeks.
Yeah. Ryan was two weeks late.
Every baby comes on their own timeline.
Let's get you up to labor and delivery.
Wait. What about Ryan?
My sister's in Michigan.
It'll take her six hours to get here.
- Mom, I want to stay with you.
- No, you don't.
A delivery room is no place
for an 11-year-old boy.
- You'll be scarred for life.
- If it's okay with Ryan,
I don't mind hanging with him
here at the hospital.
I don't have anywhere to be.
No. No, I can't ask you to do that.
You didn't. I offered.
- Thank you.
- Yeah.
Hey, you listen to Dr. Marcel, okay?
- Okay, ready?
- Yeah.
All right, bud.
Bye.
Come on.
Dr. Archer, hi.
I know it's not my place
But you are giving something up
that you cannot get back.
I understand that.
And if you change your mind
down the road
I'm not gonna change my mind.
Hmm.
When you lose control of your
bladder for the first time,
you'll feel differently.
Not to be disrespectful,
but I went over all of this
with Dr. Charles,
and he was satisfied.
Because you told him what
you knew he needed to hear.
- Excuse me?
- Oh.
I think you knew exactly
what you were doing today.
Dr. Archer,
can I get a word, please?
You think I don't know when I'm
getting played by a patient?
It wasn't a comment on your skill.
Dean, what are you thinking, man?
I need to remind you of all
people that bullying a patient
into a procedure
might get you in real trouble?
Somebody needed
to talk some sense into this
All right, this is
an unprecedented situation.
- No, it's not.
- It absolutely is.
Maybe some more opinions in the mix.
Oh, you want to get another
psychiatrist to weigh in?
- I think it'd be wise.
- Great idea.
It would cover ourselves legally.
Whoa. You're getting loud, Doctors.
Dr. Kwon's on call.
Say hi for me.
All right, lidocaine and
a gram of cefazolin, please.
Thank you.
What's that for again?
It's an antibiotic to prevent
infection post-procedure.
Scalpel. All right, Alicia.
You're gonna feel a little pressure
as I make my incision, okay?
Just breathe.
- How you doing, Alicia?
- Mm.
Feels a little weird, but I'm okay.
All right. Not too much longer, Alicia.
Almost to the vessel.
You're doing great.
Yeah, biopsy's nearly complete.
Dr. Halstead, I
I can't swallow.
Is this from the anesthesia?
No, it wouldn't affect your airway.
Maybe you're just
feeling a little nervous.
- Take a deep breath.
- [WHEEZES]
I can't. My throat is closing in.
- [MACHINERY BEEPING RAPIDLY]
- Sats at 86%.
Epi one milligram IV. 125 solumedrol.
I can't I can't
Alicia, you're having an
allergic reaction to something.
There were no indications
in her chart, right?
None, and she didn't
mention any allergies.
[WHEEZING]
I need you to keep that on for me.
Where's that epi?
It's right here.
Okay, Alicia, hang on.
You're gonna be okay.
You're gonna be okay.
- Hey.
- Hey, I got your text.
- Sarah's baby is breech?
- Mm?
Just scanned her a few minutes ago.
If it were up to me, we'd
proceed with a vaginal delivery
and use pipers to pull the head out.
But let me guess,
Sarah wants to do a C-section
because it's safer for the baby?
But far riskier for Sarah, as you know,
given her heart condition.
I hated to pull you out of the ED,
but I could really use
an extra set of hands in there.
Yeah, of course, I'll
scrub and meet you in the OR.
Great.
I shouldn't have
talked to her like that.
Well, the thing about moms is
they have this funny way of
knowing what's in our hearts,
even when we don't say it
or if we say something we don't mean.
They know better.
Dr. Marcel,
do you think I stress my mom out?
I mean, she's always
doing everything for me.
Maybe that's why she's sick.
No way.
Look, Ryan,
there's not a lot of stuff we can say
with complete certainty in medicine,
but this I can say
with total confidence:
you did nothing
to cause your mom's condition.
Hey, you want to get something
from the gift shop there?
For your mom and baby sister?
My mom would like it
if I wrote her a card
telling her I'm sorry.
Okay, then let's go.
Come on.
So turns out
you're allergic to cefazolin.
It's recorded in your chart now,
but it's still something
for you to be aware of.
Cefazolin. Cefazolin, cefazolin.
Can you tell me how to spell that?
Sure. Let me know when you're ready.
You know what? Never mind.
Maybe I shouldn't research everything.
Clearly it doesn't always
lead to the best decisions.
Hey, absolutely nothing wrong
with wanting to be informed.
You are your own best advocate.
Mm, I think
I think my headache's gone.
The medicine's working.
- Excellent news.
- Yeah.
Well, I'll let you get some rest.
Thank you, Dr. Halstead, for everything.
- Hey.
- What's up?
I heard what happened.
Is your patient okay?
Yeah, she's gonna be fine.
And the biopsy?
Well, pathology won't get
the results for at least a day,
but Dr. Gordon said the vessel
looked totally healthy.
What a waste of time and resources.
If you want to join me,
I'm planning on paying Goodwin a visit.
What do you mean? Why?
To let her know what
a disaster these upgrades are
before they get past the pilot phase.
Mags, come on.
Don't you think that's overkill
involving Goodwin?
Will, patient care has been compromised
- on multiple fronts today.
- Not intentionally.
And Grace, she's still
working out the kinks.
Well, I'm not trying
to sabotage Grace's efforts,
but I'm also not gonna stand by
while Dayton tries to
automate us all out of a job.
[KNOCKS AT DOOR]
Yeah?
Yeah, uh
so Dr. Kwon agrees that
Kurt has decisional capacity.
- Got it.
- Yeah.
And he's signing the paperwork
to leave AMA.
Appreciate the update.
So, uh
I'm tied to a dialysis machine
most nights.
And I'm currently being evaluated
for the transplant list.
- I didn't know you were
- That bad off?
Yeah, me neither.
Yeah, and once
I'm on the transplant list,
I need to be within a certain radius
of the hospital at all times.
But suddenly my life and my plans
are being dictated by my health.
And so, when I see this young guy,
this picture of health,
willingly giving it up,
I made it personal,
which you already probably
knew that I was doing
because you're excellent
at what you do, Dan.
And I shouldn't have implied otherwise.
All right.
Hi.
Oh, hey.
Um
Your assistant let me in.
I hope you don't mind.
No, not at all, and
thanks again for the flowers.
They're lovely
but really quite unnecessary.
- Sure.
- Thank you.
Mm-hmm.
[CLEARS THROAT]
All right.
I-I got your voicemail.
Well, you know
you could've just called me.
You didn't have to make the trip over.
Yeah.
After hearing your message,
I called Jack, and I asked him
what this surprise
board meeting was about.
All right.
Jack has a proposal on the table
that would drastically change
Med's future.
Mm-hmm.
Okay.
First arm out.
Towel.
Here she comes.
- And there she is.
- [SOBBING]
Okay.
All right, you have
a beautiful baby girl, Sarah.
She is so excited to meet her mama.
[MACHINERY FLATLINING]
I can't find a pulse. Her heart stopped.
Pack her abdomen.
I'll start compressions.
Come on, Sarah.
Stay with us.
Charge to 200.
Come on, Sarah.
Come on.
[PENSIVE MUSIC]
♪
Oh, man.
How's Ryan's aunt?
She wanted to stay back in the nursery
with the baby a bit longer.
- How's he doing?
- Yeah.
About what you'd expect.
Oh, poor kid.
His aunt and uncle seem really great.
- Mm-hmm.
- Gets along with his cousins.
Yeah, Ryan and his baby
sister will be loved to pieces.
His aunt made that very clear.
Hey, walk with me.
You know you did
everything you could, right?
Sarah's heart was worse off
than we thought.
Nothing we could've done to change that.
Sad truth.
Only thing that
would've made a difference
is if Sarah had come in earlier
when she first started
experiencing symptoms.
You know, my sister,
Elizabeth Lizzy
She, uh
She was Ryan's age when our mom died.
I didn't know
you lost your mom as a kid.
Lizzy and Matt
That's my brother
They had it the toughest
'cause they really remembered her.
I never got to meet her.
She died in childbirth with me.
- Aortic stenosis.
- Mm.
Undiagnosed.
I'm sorry to hear that.
The doctor said that he thought
she was suffering with symptoms
during her pregnancy
but she just downplayed it.
Yeah, because like Sarah,
she wanted to be the best mom
that she could be.
To her, that meant
putting her kids first
and herself last.
Swallowing any pain or discomfort
so that she wouldn't burden her kids.
And still, to this day,
I am so angry at her for it.
I'm so angry because
I never got to have my mom.
I don't get to remember her.
- It's okay.
- [SOBBING]
It's all right.
It's okay.
Oh, hey, Lil.
Liliana.
- Oh, you're still here.
- Yeah.
I was actually I was kind of
hoping that I'd catch you.
- How's your day?
- Fine.
You've given any more thought
to Vanna's house?
Oh, yes. Maybe not the best idea.
Why? 'Cause of what I said?
You made some good points.
No.
No, I made some self-interested points.
What do you mean self-interested?
You walked in here
this morning all excited
about a beautiful little house
you'd found, right?
Your dream house.
And what I heard was
that maybe you were
planning a future that didn't
You know, that didn't involve me, so
Owning my own home has been
a goal for a long, long time.
And the reason that I feel ready now
to take this leap of faith is
Is really all your fault, Daniel.
Because of you,
I now know I want
to put down roots in Chicago.
Despite its miserable winters.
Remember, I'm from Poland.
- Yeah.
- [CHUCKLES]
[TENDER MUSIC]
♪
Yes, it's Sharon Goodwin.
[INDISTINCT CHATTER]
I'd appreciate it if you
could get back to me tonight,
if at all possible.
Yes, I'll be up late. Thank you.
What's going on?
We're trying to reach
every member of the board
before Jack can get to them first.
He wants to convert Med
into a for-profit hospital.
Turn it over to investors.
- Can he do that?
- Well, he can certainly try.
He wants to put it to a board vote.
I mean, if Jack succeeds,
there goes Med as we know it.
Vital services that don't
generate enough income cut.
We're gonna have to discharge
patients that can't pay.
Yeah, I know. That's why
we're doing everything we can
to make sure he does not succeed.
Look, I need to make this next call.
- Did you need something?
- Oh, no.
- No, it can wait.
- You sure?
- Yeah.
- All right.
Hello? [DOOR SHUTS]
Hey. Thanks for meeting me.
Of course.
Rough day?
Yeah, rough day.
What's going on?
I
I need to tell you something.
Okay.
It's about your dad.
And he can't know that you
learned this from me, but
Look, if it was my parent,
I'd want to know, so
What is it?
[SIGHS]
Hannah, please.
His health is getting worse.