ER s08e18 Episode Script

Orion in the Sky

E.
R.
Previously on E.
R.
Did you sleep well? Yes.
It was great.
I'm afraid it's definitely tumor re-growth.
How much time? If this works, 10 months.
I'm gonna go out and get some Zofran.
No, no, no.
Stay.
Stay.
It'll pass.
E.
R.
8x18 "ORION IN THE SKY" Problem with the office supplies? - I just pronounced Bertha.
- Blue Bertha? I admitted her 10 times for COPD in the last six months.
She must have liked you a lot.
Every time, she swore to me she'd quit smoking.
Every time.
Behind the crack, no rim.
As soon as she was discharged, though, boy, back to two packs a day.
I even saw her light up under the arch once.
Intubated her three times this year, high-dose steroids, home nebulizer.
Dragging her O-2 tank around with her.
- That's an H for you.
- What's the point if you're not gonna take a little responsibility for your health? I call this the "spirit killer.
" - Is it supposed to rain again? - That's an O for you.
I think it's gonna rain again.
We offer them a service.
Whether they take our advice or not is up to them.
She'd still be alive if she'd listened to our advice.
Hard as it was to deal with Blue Bertha, it's still harder to be Blue Bertha.
- Not anymore.
- Dr.
Carter there's a rig rolling in with an MVA and I got a researcher at the Art Institute.
LOC.
- Greg Pratt? Mark Greene.
- How you doing? - What did he do to deserve us? - He just finished nine months at the VA.
- Three months of internship? - Yes, I'll be a Resident in July.
- Here? - Only if the match screws me.
- Nice.
- No.
But I'm ready to jump in.
- Seen it all, one way or another.
- Is that right? - You want us to grab that? - No, you've got your museum lady.
- I'll help you with that crossover later.
- I think I got it.
You're palming it.
The idiot chucked the ball right at my head.
There's a little blood.
You have a tiny perforation.
He popped my eardrum.
We see it all the time.
Give you some drops to help it heal.
- Some "clops"? - Some drops.
Cortisporin suspension.
Okay.
- Thanks.
So what should you be? - What? - Frank's career-aptitude quiz.
- He hasn't cornered me yet.
- What is this? - It's green tea.
It's echinacea.
- Good for the immune system.
- I'll stick to the normal sludge.
You have to get that yourself.
Would you rather pose nude or be bit by a ferret? - Ferret.
- How's he doing? Somewhere between rock star and lion-tamer.
- Did you cheat? - Just a hint of Mick Jagger.
- And a whole lot of Siegfried and Roy? - I have a patient.
Nursing orders, IV's, medications go on that rack.
If you've got both clerk and nursing orders- Start with the clerk rack.
- Frank.
- Pratt.
- Got a first name? - At the VA, they called me "Doctor.
" Well, here we'll call you "Junior.
" Luka, can you take the chest pain in 3 and the kid with the UTI? - I already have three criticals.
- I'll take it.
Oh, no, that's okay.
Carter, grab my rule-out appy.
- And the hunt for the lost condom.
- Sounds like fun.
- Abby, your landlord called.
- My landlord? - This the respiratory distress? - Norma Cruz, 46 years old choking episode, severe multiple sclerosis.
- Abby? - Carter.
- I'm good.
Is this her base line? - Not sure.
The son should be here soon.
All the bay-station calls come in over the MICN.
- Okay.
- Don't touch it, Junior.
Don't call me that.
My point was, it wouldn't hurt us to lighten Dr.
Greene's load.
- Right.
- Yeah, sure.
- Why? What's the problem? - Nothing.
- Can't get a line in.
- Chem panel, UA and a Foley.
- Is she moving air? - Sounds like rhonchi at the bases.
- This is Jeffrey, Mrs.
Cruz's son.
- Hi, I'm Dr.
Greene.
- Is your mother normally this sick? - They said she'd be dead a month ago.
He filled me in on her history.
I can take this.
Is it my birthday or something? It's okay for me to treat my own patient? Sorry.
- Did your mother throw up? - No, we never feed her by mouth.
- Might be obstructed.
- She have a "do not resuscitate" order? Her veins are shot.
I'm never gonna get a good line.
Jeffrey, your mother probably has an aspiration pneumonia.
We can have a surgeon look at her, but she'll need an IV to give her antibiotics.
- I need to wait for Linda.
- Who's Linda? My sister, a lawyer.
She drew up the papers.
- Pressure's dropping, 80 systolic.
- I don't think we have time.
Do you want us to administer drugs to push up her blood pressure? - I can't.
I need to wait.
- You gotta tell me.
Central-line kit now.
Willa Goment.
Egyptologist from the Art Institute.
Syncopal episode at work.
She have any medical conditions you know of? - The curse of the mummy.
- The what? I found her on the floor of Nefertiti's tomb.
Guy in Curtain 1 is hurting.
Can I give him something? - I'll take it.
- Do a quick exam and then call Uro.
- You got it.
- It's a penile fracture.
- Penile fracture? - Up to 100 of fentanyl.
- One, right? - Yeah, it's over there.
I'm all over it.
- So no history of these episodes? - Carter, he's going in the wrong room.
He'll figure it out.
Let me take a look.
You wanna unbuckle your belt and pull your pants down, please? - My pants? What? - It's okay, I'm a doctor.
I'm still waiting for some drops! That's not gonna do it.
The pants, please.
Are you sure this is necessary? Could you lean back a little bit? - Easy there.
- Were you having vigorous sex? What? No, I was hit in the head! Most sprains happen along the shaft, but yours seems to be pretty minor.
Nothing personal.
Dude, I have an earache.
Well, then come down here, then.
Fine.
Don't worry, it's not always as simple as it seems on the other end of the phone.
No, she's right.
Mom told us she wanted to die at home in her own bed.
I should have never have called the ambulance.
It's okay if you don't want to let her go.
But that'll never stop.
I'll always want more.
Dr.
Greene, her sats are down to 86.
Decreased on the right.
Portable chest, page RT.
- Surgery see her? - Dr.
Corday said she'd evaluate - in four hours, depending on the DNR.
- Pressure's down to 70 systolic.
- What's happening? - She reaspirated or collapsed a lung.
I thought you said she was okay now.
Jeffrey, your mother's not gonna be able to breathe much longer on her own.
- Do you want us to help her? - Linda said not to.
Well, she's not here right now.
You have to tell us.
Save her.
- You sure? - Just do it.
Do everything.
Okay, rapid induction.
- Drugs are on board.
- Bag her.
Sats are down to 80, Mark.
Let's go, let's go.
Give me the tube.
My fault.
Sorry.
Abby, I need a stress dose of 125 of Solu-Medrol.
Here.
I'll do it.
All right, give me a straight blade.
Okay, get steroids.
Sensor, intuitor, judger.
- I never thought of myself as judger.
- Yeah, right.
- What? - Check judger, Frank.
Mind your own business.
This is my career.
- Won't work if you're not honest.
- Oh, who's judging now? I've earned it.
- Hey, Mark.
- Hey.
Dr.
Greene, your ex called.
She'll meet you at 1.
- I thought she said noon.
- She's running an hour late.
- What'd Weaver get? - She ain't playing.
Give your best estimate.
"Subgroup P3: Beauty pageant organizer or warden at a women's prison.
" - Carter, where's your intern? - Either Radiology or the cafeteria.
Find him.
- You all right? - Early-onset arthritis.
Coffee? Maybe you should ease up a little.
- I'm fine, Kerry.
- You do triage for awhile if you want or take a half-shift.
Working is good.
You need to make sure you're taking care of yourself.
There's no need to overextend.
We can handle the load.
I just want to keep doing what I've always done.
- You couldn't hold that ET tube.
- It's little spasms in my hand.
Is that from the vincristine? A side effect of the treatment or a progression of the disease.
You pick the poison.
Still, I'd like you to take over Pratt's orientation.
Whatever you want, Kerry.
It might be best if you left critical procedures to the rest of us.
You're pulling me out of the Trauma Room? Anybody else I'd send home.
I trust you to recognize your own limitations.
I take pills for my blood pressure and my water.
Water in your legs or to make you urinate? Hytrin.
It helped me pee for a while, but it's worse now.
- That hurts? - You bet.
- Put the med and back pain together.
- Alpha-1-blocker.
- And if you take too much? - Hypotension, could make you dizzy.
- You had any falls, Mr.
Seidel? - Nope.
Good question, though.
- Who's your primary physician? - Allanson.
Service said he went skiing I should come here.
Hypotensive at 140/90.
Pulse, 96.
Oral temp, 98.
6.
I've had two Foleys since Christmas.
Has Dr.
Allanson ever asked you to use a catheter at home? Last time, I twisted his arm for a blood test.
I still haven't gotten the results.
- What do you want to do, Dr.
Pratt? - Full set of labs.
Urine, culture, Accu-Chek, a post-void residual and a rectal.
- Are you sure? My guy never does those.
- Dr.
Greene, it's 1:00.
Add a PSA.
I'll be back in half an hour.
- Can I get you anything? - No, thanks.
- Milk shake, huh? - I decided to let myself go.
I can't stay long.
I just wanted to stop by and say hi.
- Did you see Rachel? - We had breakfast.
Her favorite.
Waffle House? That'll score you some points.
She couldn't stop crying, Mark.
It's a lot for a teenager to take in.
It's a lot for anyone.
It's really that bad? Yeah.
There are always breakthroughs, right? I mean, look what happened last time.
I'm kind of beyond that.
We agreed Rachel would be with me July and August.
If you want to change that- - No, that sounds like a good plan.
- She could stay with you longer.
I mean, she's gonna want to spend time with you.
As much time as possible.
Thanks.
I'm sorry, Mark.
I'm sorry we had such a rough go.
Maybe if I hadn't switched jobs or been more patient We made choices, Jen.
Both of us.
We weren't so bad together, were we? I wouldn't change a thing.
None of it.
Okay.
So I gotta get to Midway.
Wait.
I updated my will last year, but- Look at it out there.
It's gonna take me hours.
I want to start a college fund.
Well, you'll drop Rachel off in St.
Louis in July.
We can talk then.
- I don't know if I'll be able to make that.
- Yes, you will.
I want to set something aside for her wedding, too.
July, okay? Let's not do this.
Not today.
I don't know if there'll be another time.
She's my daughter.
I want to make sure that she's taken care of.
- She will be.
- Jen- I'll see you in St.
Louis.
- Heads.
Heads up.
- Slow down.
Hey! - Enrique, the new orderly.
- He's gonna kill someone.
He keeps the rooms clear.
- So what did he want? - Who? Your landlord? Oh, yeah.
Brian, he moved back to Idaho a few days ago.
- And he took all his stuff with him.
- So you have your place back? - He offered it to me.
Yeah.
- Good, good.
- I mean, all my stuff's there, so - It'll be nice to sleep in a bed again.
Yeah.
But Thanks for the hospitality.
Except, of course, for that Croatian lamb gruel stuff.
- It's not gruel.
It's called jujenca juha.
- It's a gastrointestinal adventure.
Take your time.
I mean, if you want to make sure that he is gone for good.
- I've mooched off you long enough.
- Dr.
Greene! - Okay, you need to sit still.
- Mr.
Ervin, how is the junk business? - I'm having some trouble with my feet.
- But he refuses to take off his shoes.
- I don't know her.
- Dr.
Chen.
She's very capable.
- She touched my cart.
- Don't touch Al's cart.
- I moved it 2 feet.
- Okay, meet Dr.
Pratt.
- Hello.
- Hey.
What's the trouble? The ghouls put spikes in my sneakers.
The ghouls? The ones from the burned jeep or the ones that roam rooftops? There are new ghouls.
Everywhere.
- Psych consult.
- Screw you, Junior.
Take it easy, Al.
Take off your shoes so we can look, okay? Okay.
Let Dr.
Chen help you.
I'll be back in a minute.
It's not a good idea to openly show disdain for our frequent flyers.
He sees ghouls.
What's wrong with a Psych consult? - A little help? - All right, go back in there.
Try it again.
- Freddy Harrison.
Looks about 30.
- He's 28.
- No, I'll hang with you.
- Grab his old chart and get a history.
Carter said I should get my hands dirty.
Go.
- Go.
- Found down an alley with agonal respiration and pinpoint pupils.
- You shooting up? - We're in rehab.
He's clean.
- Hey, Dr.
Greene, I got this.
- I'm already on it.
One, two, three.
Gave 2 of Narcan down the ET with no response.
- I'll cover this.
- You've listened to Weaver now back off.
CBC, chem panel, tox screen, Foley and a portable chest.
- You're ruining his clothes.
- We're trying to help him.
Okay, step back.
You're in the way.
- Whoa.
Narcan is working.
- You want some Ativan? And some Pavulon.
Check the ET tube.
Whoa, whoa, whoa, Freddy.
- Oh, Freddy, lie back down.
- Freddy, you're okay.
- I thought you was dead.
- I want my wallet.
Give me my wallet.
- We need to take care of you.
- Don't touch me.
I want my wallet.
- Maybe it fell in the parking lot.
- Abby, call Security.
He wants his stuff.
You people, you're crooks.
- You know you are.
- Carter, I need your help.
- You know you stole his things.
- Freddy, come back.
You're bleeding.
- Oh, God! - I'm sorry.
Son of a bitch! - It was an accident.
- Hey, hey, break it up.
- You okay? - Give me a hand here.
- My baby's coming out! - Just try and breathe slowly.
Don't push.
- Oh, God! - Keep breathing.
Keep breathing.
Get the gurney.
CBC, Chem-7.
Get an ultrasound.
- Looks like I missed the fun.
- Chest is clear.
- She break her water? - I don't know.
Set up the SonoSite.
- Why is the floor wet? - Because this window leaks.
- Diffusely tender with guarding.
- Did they sedate that maniac? Didn't have to.
He passed out and smashed his face.
- Pressure's only 80.
- Oh, man.
Okay.
Let's type and cross for four.
And get some O-neg.
It hurts! It hurts! - How far along are you? - What? - When are you due? - I don't know.
- She's having contractions.
- Okay, get a fetal monitor.
- How big? - It looks like about 28 weeks.
Okay, terbutaline,.
25, sub-Q.
And mix the mag.
No evidence of previa.
Call OB.
She may need a crash section if she's abrupting.
Pulse ox, 85.
- No, bag him.
- Midface fractures? I can't see the cords.
You want to give this a shot? Set up the fiberoptic scope and prep the neck for a crike.
She's crowning.
It's coming now.
- Don't push.
Just breathe.
- I can't! I can't stop! Don't push.
Okay.
Bulb suction, clamp.
Call the NICU.
- And draw up.
02 of epi.
- Is that my baby? Come on, breathe, little guy.
- Why isn't he breathing? - He's very sick.
I want to see my baby.
Bag him.
Pulse is 50.
Starting compressions.
My beautiful boy.
What's the Apgar? One for heart rate, zero for color, respirations.
- Let me go see my baby! - Not right now.
- Shane, what kind of drugs you using? - I'm not.
If you want us to help your baby, you have to tell us if you're using heroin.
I don't do that anymore.
- Cocaine? Crack? - No, nothing.
- Damn it, there's blood in the airway! - Baby's pinking up.
Heart rate's 120.
Start working on the umbilical line.
You all right? - No, too much blood.
I can't get this.
- He's bradying down.
- All right, let's do the crike.
- Amp of atropine.
He needs an airway unless you want to give a shot.
Let me just take a quick look, and then you can cut.
- I thought you were right-handed.
- I'm a switch hitter.
I need you to advance the tube when I say so.
- Ready? - Here we go.
- Run of five.
- Hundred of lidocaine.
- Damn it.
- Let's do the crike.
No, here we go.
There, there.
Go.
Advance the tube, Carter.
Go, go, go.
Good breath sounds.
- Sats are coming up.
- That's nice.
- Lucky.
- Very nice.
Let's get a post-intubation film, head and facial CT to follow.
- Five-minute Apgar is six.
- Better.
Dr.
Greene, mom's tox screen.
Shane, we're taking your baby up to the Intensive Care Unit.
- I want to stay with him.
- Take him up.
- No, you're stealing my baby.
- Shane, let us take care of him.
You'll keep him.
You won't bring him back.
I love him! You almost killed him.
- That's not what I wanted.
- Your urine's positive for opiates.
You shoot up.
You've never been to a doctor.
- But I was going to.
- After seven months? Are you too strung-out to know you're pregnant? - Dr.
Greene? - I've been stressed out.
Well, that explains why you've been using cocaine too.
Don't tell me you haven't been drinking.
Your blood-alcohol level is 54.
- I had a beer last night.
- You've been lying to us.
- I want to see my baby! - You want to see him? There he is.
Look.
Premature.
A third of the weight of what he should be.
If he's lucky enough not to have brain damage from the coke he's still gonna suffer from fetal alcohol syndrome- - No! Please, stop it! - Developmental delays.
Next time you see him he's not gonna look any better because he's gonna be suffering from heroin withdrawal.
Just stop it! Congratulations, you're a mother.
- Can you take the baby up? - Yeah.
You a basketball fan? - I saw you playing from my window.
- Try and hit it the first time, Marni.
- Doctors are the worst patients.
- So I hear.
I took my grandson to see his first Bulls game last week.
They're not what they used to be.
He fell asleep at halftime, but I think he enjoyed it.
That's okay.
Their guards fall asleep all the time.
- We'll let that infuse.
- Twenty minutes, I know.
- It's the ER on line two.
- Dr.
Weaver? Someone named Pratt.
Pratt, I'm with a patient right now.
I can't talk.
- What? - He's bradying down.
- I don't know what's happened.
- I'll be right there.
Marni, can you send someone down with the vincristine? - Dr.
Greene.
- Marni.
- We don't do house calls.
- I am not going home.
Excuse me.
Excuse me.
Thanks.
What happened? He barfed on Pratt's shoes and passed out.
- Dr.
Greene, where were you? - We didn't want to call you but he wouldn't calm down.
- Sorry.
- Oh, here you go.
- Don't go too far.
- Thanks.
- What's that for? - Reduce my blood alcohol.
- No luck with the IV.
- Right saphenous.
- What? - It's the only one that's not sclerosed.
- You want to get it, Carter? - No, Pratt's got it.
Accu-Chek's through the roof.
- Did you take your insulin, Al? - There's so much to remember.
- He's diabetic? - It's news to me.
Line's in.
It shouldn't be news to you.
Did you get a good history? I am a glorious history.
- I told you to get his old chart.
- So what was that, like a test? Make sure he flushes all three lumens.
Don't give him an air embolus.
- CBC, Chem-21 and a urine.
- He's good.
Sats are 90, pulse is 110.
Dr.
Greene? Add a hemoglobin, A1 C, serum ketones, blood cultures and 12-lead.
Liter up, good 18 in the right foot.
Add 40 of K in the liter, intubation tray, 8-0 ET tube.
- Why? What's that for? - Sats are dropping.
Come on, Al, breathe.
Carter, get ready to bag him.
- Do the Sellick.
- The what? The Sellick.
Give me your hand.
Okay.
Okay.
When his blood sugar's over 700, sometimes he stops breathing.
Thanks for mentioning that.
Give him 10 of regular, IV push.
Start him on 8 units per hour.
Dr.
Pratt.
Dr.
Greene.
Thanks.
- You could've told me he was diabetic.
- I said to work him up.
I was looking for chronic athlete's foot.
You missed the DKA because you didn't follow instructions.
- It didn't seem necessary.
- That assessment is up to me.
Okay? You do the learning, I'll do the teaching.
- Do I seem like a punk to you? - No.
Then stop trying to treat me like one.
I'm sure that you think that you're ready for anything.
Wait.
Is this the one about the old guy and the young guy? - Because, see, I've heard it all before.
- There's a door there that goes outside.
If you don't like the way I'm doing this, keep walking.
- He's a good doctor.
- He's a burnout if I ever saw one.
- I learned a lot from him.
- If I had my call, I'd stick with you.
- You don't.
- You saw him in there.
I just can't figure out what's going on with this guy.
A tumor.
- What? - He has a brain tumor.
An inoperable GBM that's recurred.
That's what's going on with him.
- That's what the IV's for.
- He's in his second cycle of chemo.
- And he's still working? - Everything okay? - Yeah.
- Yeah, Pratt was just saying how much he's benefiting from Dr.
Greene.
He's a good teacher.
You could start feeding me this information a little earlier.
- Labs back for Seidel.
- Thanks.
His PSA's higher than his Alk Phos.
Six hundred? Did you call his doctor? Left three messages on his service before I got the cell number.
- Son of a bitch.
- What do you think? He knew? He should have.
This guy shouldn't have to find out from doctors he's never met in the ER.
Hey, listen, in med school I was a hotshot.
And I forgot I'm not one here.
Well, not yet at least.
Like I said, no rush.
- Hello? - Hi.
Yeah, is your father there? - This is Dr.
Greene from the County ER.
- Hold on.
Listen, I didn't mean any disrespect earlier.
- Someone told you I'm dying.
- Dr.
Greene, is it? - Yeah.
- Call my office.
I'm not taking any calls.
I understand you' re on vacation.
Your patient's PSA set a record high.
Oh, well, how can I be of help? Well, for starters, when was the last time you examined him? - About two years, I'd say.
- Two years? - Have you made a diagnosis? - In fact, yes.
Metastatic prostate cancer.
Really? I never saw any indication.
Well, the huge irregular mass on his enlarged prostate may have been a clue.
You want me to put him on the phone? Why don't you put down your hot cocoa, and get your ass on a plane to Chicago- He hung up.
- Very persuasive.
- I try.
- Should we tell him? - Let him sleep.
Call Urology for a bed.
I panicked.
Okay? You weren't here, and I didn't know what to do.
- You knew this wasn't what she wanted.
- You're extubating? You should have never intubated her in the first place.
- What about the obstructions? - It's a mild ileus.
I don't care what it is.
I have durable power of attorney.
And we want to take our mother home now.
Get that line out of her.
You may wanna leave that in, in case she needs fluid.
Don't you get it? She wants to die.
You people can't accept that.
It's like a defeat to you.
Do you have the DNR? Okay.
Pull it.
- Just at the bed right around the corner.
- All right.
What's this about? I got called down from Oncology, so the nurse is here with my vincristine.
- You sure you're feeling all right? - Wish people would stop asking me that.
Could you unplug her and let them go? Yeah, sure.
Dr.
Greene, I want my cart.
- What? - They threw my cart outside.
- Ready? - Sure.
I want my cart.
I always have it with me.
It's okay, Al.
I'm right here.
Everything's gonna be all right.
I almost had to call an Oncology staff meeting.
They weren't crazy about my doing this down here.
Please, I want my cart.
Give me my cart! These new needle-less systems are a pain.
Give me my cart.
- You know what? I'm not doing this.
- I can't come back.
- You don't have to.
I'm done.
- Please! - Dr.
Greene - I want my cart.
Al, let me help you find your cart.
Thank you.
Thank you.
Aspergilloma is what people used to superstitiously take as the curse of the mummy.
I'll never hear the end of this at work.
How did I get it? You went to Egypt recently on an excavation, right? Pulmonology will bronch her.
Give her 200 of itra- Itraconazole, BID, will help with the oral steroids.
- I work too much, that's why I'm sick.
- You'll be okay soon.
You know that song, "Don't it always seem to go that you don't know what you got till it's gone? " - Joni Mitchell.
- Story of my life.
I hate that song.
Mark.
I spoke with Oncology.
I told them you'd be up soon.
- You shouldn't have.
- They're holding a room for you.
I'm finished.
I've had enough.
You can go up now, and I'll drive you home.
Elizabeth.
This isn't something that you decide by yourself on the spur of the moment.
This might be the last important decision I get to make.
You haven't given it time to work, Mark.
Please.
I dropped an ET tube today.
I couldn't wrap my thumb around it.
That doesn't mean the chemo's not working.
It's a game, Elizabeth.
I don't wanna play.
Look, it's only the second cycle.
This treatment could prolong your life.
Maybe.
For a couple of months.
Well, then give yourself that time.
Give it to me and Ella.
Give it to Rachel.
Who knows what might happen? We see patients here every day who are told that they should have been dead long ago.
I need to be realistic.
- You mean give up.
- It's not giving up.
It's making a choice.
I'd rather have two good months than twice that chained to meds and needles and IV stands, stuck in a bed sitting next to other clock-watchers, being prodded and small-talked to by doctors and nurses, all of them with that look in their eye like you're already gone.
I don't want to end it like that.
Look, we can look into some new regimens.
We can find some alternative therapies that we haven't heard about.
Mr.
Seidel is awake.
I'll be right there.
Please? There's no alternative.
Just dying the way I've lived.
I'll see you at home.
I love you.
- You ready? - I can do it.
- Not the easiest news to give someone.
- I know the job.
Mr.
Seidel.
My old lady's waiting with my daughter, so can we get this over with? Your presentation is consistent with metastatic cancer of the prostate.
Cancer? Are you sure? Maybe you got it wrong.
Allanson never said anything about cancer.
He may have overlooked it.
He always acted like I was a hypochondriac.
He should have caught it.
Maybe we should call your wife before we explain everything.
Tell me, is it bad? Possibly, it could be.
What? Do I need chemotherapy or an operation or what? I mean, it's not like I'm gonna die, right? I could die? We need to admit you for tests.
The cancer appears to be very advanced.
You need to prepare yourself for the worst.
I know what a shock this is and what must be going through your mind right now.
You can't.
Yeah, I can.
I'll call his family.
- Go in and sit with him.
- What did you say to him? Wasn't anything I learned from being a doctor.
No, no, no, we need to keep that in.
Okay? - I want to go.
- It's wet out there.
It's raining.
- It stopped.
I don't want to be here.
- Me either.
- When can you get him upstairs? - Oh, I'll call the Telemetry Unit.
- Last serum ketones? - Still positive.
- Urine? -200 cc's in the last hour.
I'll take it out.
You know I know how.
Al, it's gonna become harder for you to be able to take care of yourself.
- Do you have any family you can go to? - No.
There's nobody.
- Then let me admit you.
- You know I don't like this place.
I don't belong here.
Whatever's going to happen, I want it to happen outside.
Please.
Okay.
It'll be over soon.
- Right? - Yeah, it will.
How much longer do I have to sit here? - Ms.
Raskin, it's been a long time.
- The service isn't what it used to be.
- What's the trouble? - I have this hangnail, it is very painful.
I have a brain tumor, and it's inoperable.
- What? - I win.
Excuse me, can somebody please see my daughter? - A nurse will be right with you.
- I've been here for over two hours.
- I'm Dr.
Greene.
- Hi, doctor.
- No, it'll hurt, Daddy.
- Oh, what will hurt? Katie's class mythology project.
Why they let kids play with wooden spears, I'll never know.
I like your outfit.
Can I put you up here? - There.
- It hurts.
I know.
I'll be gentle.
It's up under the nail.
She won't even let me near it.
Can I look? - I don't want a shot.
- No, no, no shots.
I promise.
Let's play a game.
- Close your eyes, okay? - Okay.
- What do you see? - The sky.
- What's up there? - Orion's Belt.
- Orion's? - He couldn't beat the scorpion.
- So he jumped into the sea.
- Really? Artemis put him in the sky, where the scorpion never gets him.
I didn't know that.
- There.
That didn't hurt, did it? - Is it over? It's all done.
- Thank you, Katie.
- What did I do? You just became my very last patient.
- Your shift over? - Yeah.
Thank you.
Haleh, can you give that hangnail lady a cast shoe sign her out and tell her to never come back? If you say so.
Dr.
Greene, I set up Seidel for the biopsy, and his family's on the way in.
Okay.
Hey, I just wanted to say, you know, I learned a lot today.
Good.
Come back tomorrow.
How's Pratt doing? A little eager, a little cocky.
He should fit right in.
Think he'd want to take on some extra shifts? Pretty safe bet.
What about you? Me? How many shifts should I put you down for next month? Never let your work become your life, Kerry.
Live a little.
No rest for the weary, Carter.
I've been on since 4 a.
m.
- You leaving early? - Not early enough.
Fisher in the hall's an alcoholic.
Knocked himself out.
Check a head CT and road-test him before you let him go.
- Withdrawal? - Just your usual midweek party.
Chakarova has hives.
Got prednisone, Benadryl.
Feeling better.
Watch her for half an hour.
Send her on her way.
Dispo's written.
- Anybody actually sick? - Just the doctor.
Hey, did you see the guy in 3? Pacio, 56-year-old, chest pain.
Ruled out going to Medicine.
Got aspirin, beta-blockers, heparin and an Ace.
Fell through a plate-glass window.
- Just keep pressure on that dressing.
- Bleeder in the left arm is the worst.
Good night, Dr.
Greene.
- BP, 100/70.
- Bye.
So EKG for Pacio? Flip T's in lateral leads.
X- ray's clear.
Check his troponin and repeat EKG in 10 minutes.
- It stopped raining.
- Yeah.
Clear sky.
I'm out of here.
You on tomorrow? Your ball needs air.
It's not my ball.
You set the tone, Carter.
What? Work on your jump shot.

Previous EpisodeNext Episode