Chicago Med (2015) s08e20 Episode Script
The Winds of Change Are Starting to Blow
1
Richard, was it the first time 2.0
was being used on a patient?
We were able to remove
the patient's tumor.
And we're optimistic for his future.
I'm not taking my son's kidney, Hannah.
Donating could be a really
positive experience for him.
If you turn out to be
a match, I won't say no.
I was wanting you to meet my brother.
So tell me doctor, you deal
with any crazy people today?
Pavel.
I didn't mean to offend.
I was meeting with a headhunter.
I have a bad feeling about the direction
that Jack is taking us.
Jack, he got the votes.
We are now a for-profit hospital.
Hello, Daniel.
Hoping I'd run into you. Walk you out?
Your desk, bottom drawer,
left you a treat.
You didn't have to do that.
We don't get to see
each other during the day.
It's my way of feeling close to you.
[CAR HORN BEEPS]
Ah, the esteemed Dr. Charles,
Chicago's very own Carl Jung.
Pavel, how you doing?
Fine.
Hurry, Liliana. Get in.
Let's not keep him.
He must be very busy.
Just a minute.
- I'm sorry.
- It's OK.
Pavel can be rude.
He was a lawyer back in Poland.
And he has had a hard time finding
a career here in America.
I think he feels
- Left behind.
- Yes.
Yeah, it's hard.
Making jokes is just his frustration.
He has a big heart.
Have a good day, Daniel.
Morning, Sharon.
Hey, Maggie, good morning.
You know that recruiter
that I met with last week?
Well, she may be calling you
for some references.
You're really doing this, leaving Med?
Well, just testing the waters.
And what would it take
to make you stop testing?
You got a time machine?
Take Med back to when
patients came before profits?
All right. I get it.
I'll let you know if someone calls.
Thank you.
I wish you didn't have to
take a day off work for this.
I feel bad.
Testing to see if I can
give you my kidney
kind of trumps parking a few cars.
- Hmm.
- Hey guys.
Big day.
You ready, Sean?
I'm cool.
- He's a nervous wreck.
- Mm.
I'm grateful. [CHUCKLES]
My job as a dad is being there for you.
And you being there for me
is even more trying than I thought.
[PHONE CHIMES]
Oh, thank God.
I'm needed in the ED.
Mm. Too much emotion for you, Dean?
- Yeah, way, way too much.
- Yeah.
Hey, Dr. Asher. Just the usual chai tea?
Yes, please. Thank you, Carly.
Sean.
You sure I can't get you a coffee?
Ah, not today. Just water.
OK.
[SOFT MUSIC]
I think Carly just gave you flirty eyes.
Is there, like, something-something
- brewing between you two?
- Just friends.
Oh.
Because smart, kind, and super
cute are just not your type.
- No, that's my type.
- Mm.
Mine's just somewhere else right now.
♪
What if I'm not a donor match?
Then we'll figure something else out.
Good morning. Good morning.
So are the rumors true?
What rumors?
The rehab clinic going part-time.
The dialysis center
possibly shutting down.
Oh, those rumors.
Well, maybe.
New mandate says that if
a department is losing money,
it could be on the chopping block.
Well, what about the ED? [ALERT BLARES]
I don't know.
Maggie, need some help.
Talk to me.
Name's Jan Dover,
30s, single vehicle crash,
low impact, backed into a light pole.
GCS 15, laceration on her left palm.
Appears slightly jaundiced,
and has some very interesting theories
about the medical industrial complex.
Ma'am, please. It's policy.
What about my autonomy?
Am I not allowed to govern
my own health and wellness?
She was a little rattled at the scene.
I think that's why she didn't fight us
getting into the ambo.
But now that the shock's
worn off, she won't come out.
OK. Let me see what I can do.
Thank you, Cesar.
Hi, Jan.
I'm Maggie.
I'm a nurse here at Chicago Med.
I know what you're going to
ask, and I'm not going inside.
Well, the thing is you're already here.
And your hand, it looks like
it needs stitches.
- Oh, it's fine.
- Well, let's confirm that.
And then we'll send you on your way.
[SCOFFS] They've got you
on the payroll, don't they?
I'm sorry. Who's they?
The pharmaceutical companies.
[SCOFFS] All you nurses are on the take.
I can assure you, I'm not on any take.
No. I've read about it.
And I know that the minute
I walk through that door,
you're going to inject me with a virus.
And I will spend the rest of my life
paying for overpriced medications.
You'll get a cut,
and your pals at big pharma
will make a fortune keeping me alive.
Told you. [AMBULANCE HORN HONKS]
OK.
Jan, I'm not sure where
you got your information.
But if you come inside
with me, maybe we can
No. I'm not going anywhere.
[DRAMATIC MUSIC]
♪
She's very distrustful
of hospitals, paranoid,
maybe even delusional.
And she says her name is Jan Dover.
It sounds like a variation
on Jane Doe, doesn't it?
Exactly. And she's been white knuckling
those handles ever since they got here.
By the way, her hand's been bleeding.
That lac must be deep
and hurt like hell.
Is she angry? Combative?
No, she's just terrified and
thinks we're going to hurt her
and has a ton of internet
research to back it up.
You know, COVID with all the isolation
and loneliness really amplified
the conspiracy theories
in general, made the medical system
in particular an easy target.
Jan, how you doing? I'm Dr. Charles.
A psychiatrist. Here we go.
What do you mean?
Medicine's answer for people
who don't play along
is call them crazy.
Jan, we just met, OK?
The only thing I know about
you is that you're losing
a lot of blood, and we gotta
We gotta take a look at that hand.
And I appreciate that,
but I already told her
that I am not going inside the hospital.
- It is too dangerous.
- How so?
X-rays, gamma rays, infrared radiation.
I mean, we can keep chatting
if you can fix those.
Oh, well, we actually
have a protocol for that.
- You do?
- Yeah. Trust me.
You are not the first person
to come into this hospital
with that set of concerns.
[SIGHS] OK. Fine then.
Great.
Wheelchair, please.
We have a protocol for the
electromagnetic spectrum?
We do now.
By the way, she is very jaundiced.
It could be something serious.
Yeah.
So look, in order to actually
get her into a treatment room,
I'm going to ask you to get
with the X-ray techs, OK?
And here's what I want you
to ask them for.
Tim, how long has your
stomach been bothering you?
A few weeks or so.
It's mostly when I eat.
Yeah? And how does it feel now?
Mild, sharp?
Kind of like indigestion or bloating,
but then then last night it
just it got a little worse.
Seriously, Tim? A little worse?
He woke up from a dead sleep screaming.
- He had tears in his eyes.
- Pam.
[SCOFFS] My wife overshares
when she's nervous.
And my husband downplays
when he's in pain.
Can you tell we've been married forever?
That's all good. OK.
So 1 to 10, how's the pain feel now?
[GROANS] That's like
a 6 or 7 right there.
Nope. Downplaying. That's a 10 face.
I see it every time we have a stair day.
Stair day?
Our resolution for 2023
was to lose weight, get fit.
And one of our workouts is walking
the stairs in our building.
She she makes it sound
like it's a mid-rise.
It's not even close. It's 35 stories.
Well, he never makes it
past the eighth floor.
Meanwhile, I make it
to the top every time,
and I haven't lost a pound.
- Tim here's lost 22.
- 24.
Yeah, I don't know.
It must be my metabolism.
Or it's whatever's going
on with your stomach,
and if that's the case, I want it too.
- [GROANS] You can have it.
- OK, well,
we'll give you something
to take the edge off, OK?
Uh, 25 of fentanyl and a GI cocktail.
Also, order an upright
and flat abdominal X-ray
and a CT abdomen and pelvis.
OK. Just take some deep breaths.
- It'll help with the pain.
- [SIGHS]
[DISTANT RATTLING, TOOLS WHIRRING]
[THUMPING]
♪
George, a minute?
Sharon. Of course, of course.
Just sketch in the aquarium.
I'll be right back.
An aquarium?
I thought we were only
taking over a couple of rooms
for this new VIP build.
Well, demand was much
greater than expected.
So at the 11th hour,
Jack decided to take the entire floor.
But this is the geriatrics unit.
Did he even consider those patients?
Well, the plan is to fold geriatrics
into the orthopedic.
Oh, so that's the plan, huh?
Clearly, word didn't get to you.
Well, clearly.
I'm so sorry, Sharon.
It must have been an oversight.
Since turning for-profit,
there have been
dozens of new voices in the mix.
And it's really gummed up
the lines of communication.
Well, un-gum them.
Because I will not be left out
of the loop in my own hospital.
Well, anything further,
and I will notify you myself.
Good.
How far do we have to go?
Uh, just number three
down here on the right.
[SIGHS] These poor people,
staring at me, yet they have no idea
how dangerous this place is.
All the things they're being exposed to.
You know, I used to be like them
till I discovered the truth.
The truth?
What, um, what exactly
do you mean by that?
Jan, every machine that
could be removed has been,
and the equipment that we couldn't
has been draped with a lead vest
like the one that you're wearing.
And the walls have been insulated
with anti-radiation blankets.
Wow.
- You did this fast.
- Yeah.
Protocol, right?
Here we go.
Fine. OK.
Jan, that's Tracy.
Be right back.
- Well, she's in.
- Yeah.
Hopefully she's comfortable
enough to let us fix her hand,
but we really got to
figure out this jaundice.
How we going to do that?
She's taking every tool
we've got out of play.
Richard, Vickie.
- Dr. Halstead.
- How you been?
Wonderful.
Last week, he was five months
cancer-free.
That's fantastic.
I only wish you could
have treated my clumsiness.
I think I busted my ankle.
Yeah. I can see that. What happened?
Oh, I tripped going down the stairs.
I've been icing it for a week,
but it's not getting
any better. [GROANS]
Vickie made me come in.
I need him in walking shape.
We're going to Machu Picchu next month,
hiking the Inca trail.
We got time back that
I never thought we'd have.
We're trying to make the most of it.
That's wonderful.
We'll get some X-rays, but
I suspect it's just a sprain.
Oh, that's good to hear,
considering last time we were here.
Thank God for OR 2.0.
Yeah, Richard,
you were its first patient.
Your success was a real inspiration.
Oh, shoot, honey,
I left my cell in the car.
- Do you mind grabbing it for me?
- Sure.
I'll be right back.
[GROANING] Oh, God.
Richard, you all right?
I needed her to leave for a minute.
- [GROANING]
- What's going on?
I tripped because I've been weak.
There's a dull pain in my belly,
and I haven't had an appetite.
[STRAINED BREATHING]
The cancer's back. I know it.
Let's not get ahead of ourselves.
We'll run some tests and go from there.
So I assume Vickie doesn't know.
I can't bring myself to tell her.
Since my surgery, we've been
living our best lives.
She's so happy.
I don't want to take that from her.
I understand.
[GROANS]
Free fluid and free air in my abdomen?
What does that mean?
That there's a hole
somewhere in your intestine
- or your stomach.
- From what?
Could be a perforated ulcer.
It might be something
sharp that you swallowed.
Honestly, I won't be sure
until I get in there.
Get in there? You mean surgery?
Yeah. Leak in the GI tract needs
to be addressed immediately.
- But he'll be all right?
- Yes.
It's a routine operation.
There's a waiting room.
We also have a café, if you like.
I don't know. I I want to be close.
Pam, honey, you know what?
Why don't you take a walk?
You love this time of year,
nice weather.
You can get your steps in.
I guess the fresh air
might do me some good.
Quell the nerves. [LAUGHS]
Sure. OK. So we're good here? Yeah?
All right, well, I'll change my scrubs,
and I'll get the techs to bring
you upstairs to pre-op holding.
- OK.
- OK?
Hi.
Sweetie, you need to let go.
Oh, I'm sorry.
Don't worry. We'll keep you updated
throughout the entire operation.
Thank you.
Oh, and another one
Vaccines.
You want to know who they're helping,
just look at the sponsor behind it.
Hey, a lot of people have
problems with vaccines,
you know? It's a complicated issue.
Exactly.
I didn't think you would understand.
Really important for
somebody in my position
to keep an open mind.
Refreshing. [CHUCKLES]
You know, Jan, I'm noticing
some skin discoloration.
Oh, it's just the
fluorescent lights in here.
You know, it could be.
But it also might be jaundice.
You mind if I just take
a tiny bit of blood,
do a couple of very simple blood tests?
Yes, I mind very much.
Got it. Understood.
You were saying?
Oh, HIV. [SCOFFS]
I read a very persuasive
article basically saying
that they intentionally dusted
it over low-income communities
as a form of population control.
- Wow.
- Yeah.
I mean, people wanted to blame
the Reagan administration,
you know, the FBI,
but the research I've done
points to the CIA.
What kind of research? I'm just curious.
I mean, written literature,
podcasters, YouTubers.
But I prefer online forums
because people are always
sharing information.
So, um, I mean, do you have, like a
A favorite forum that you could show me?
Yeah, I don't know.
Look, I will draw my own conclusions.
It's just the more
up-to-the-minute stuff
I have access to, the better.
No big deal.
OK. Um
[CLEARS THROAT] All right.
Look at this thread.
It talks about the scanners
that they use in hospitals.
We're seeing that, yeah.
Mm-hmm. CTs, ultrasounds,
especially MRIs,
and how they inject
dangerous hydrogen protons
- into the body.
- Wow.
Hospitals kill people.
They kill them.
OK. We had a good chat, but
Look, you seem like
a nice guy, but I would, um,
I would really like to go home now.
Got it. Um, let me just quickly
go find somebody to stitch you up.
No, no, no, no. I don't think so.
That's a deep wound, OK?
I mean, we don't close it up,
it's going to keep bleeding.
And what I really don't want to happen
- is that it gets infected.
- No, no.
I'll keep it clean.
You want to risk having your
hand infected? You could lose it.
OK. Fine.
But no scans, no IVs,
just a needle and thread.
And then you let me go.
Deal.
- Back in a flash.
- [SIGHS]
Mags?
- Yeah.
- Find Zack.
- Have him stitch up her hand.
- She's gonna let us treat her?
Just the hand, not the jaundice.
Well, that's a start.
What about her mental state?
You know, conspiracy theories
are not necessarily connected
to any kind of
paranoid personality disorder.
I mean, certainly not in Jan's case.
And she's what? Just gullible?
I'd say more like a combination of
I don't know
Lonely and prone to persuasion.
I'm really starting to think
that something bad
happened to her in a hospital.
That makes sense.
How do we get past that?
Because I'm concerned that her jaundice
- means that her liver's failing.
- Yeah, I mean, look.
She wouldn't let me draw blood,
all right?
Scans are out of the question.
So I guess we're just going
to have to go with, you know,
her medical history.
Well, we don't even have that.
- We don't even have her name.
- It's Jacqueline Warner.
She handed me her phone.
The settings trick that I taught you.
Anyway, it's not going to take Zack
that long to stitch her up,
but she's already asking to leave, so
Don't worry. I'll buy you some time.
- Thank you.
- Got you.
Vickie, Richard.
- Dr. Marcel?
- Nice to see you both.
Yeah, it's nice to see you too.
- Yeah.
- I don't understand.
You're a surgeon.
You said it was just a sprain.
Richard, what's going on?
The cancer's back, isn't it?
I'm afraid so.
CT scan showed multiple
lesions in your liver.
So it metastasized.
It spread from my pancreas.
Yes.
Richard.
You knew something was wrong.
Why didn't you tell me?
I wanted to.
But I I also just
didn't wanna face it.
[SOMBER MUSIC]
These last few months,
the way you laugh at my dumb jokes,
burn my toast on the edges.
I've fallen for you all over again.
You beat cancer once.
- You can beat it again.
- No, honey.
I'm a science guy.
The odds of that happening
Are good.
Richard, OR 2.0 knows your body.
It's been learning and
improving with every surgery
it's done since yours.
Now, don't get me wrong.
This procedure you need now,
high-frequency ablation,
it's a delicate operation.
But 2.0 has all the tools.
But a A third lease on life?
Really?
I believe so.
OK. [CHUCKLES]
Let's do it again.
Good.
- Thank you both.
- Yeah.
Here we go.
Perforated ulcer on the anterior surface
of the first portion of the duodenum.
Got some undigested
food remnants, lavage.
Betcha it's corn and green beans.
[MACHINERY BEEPING]
Close.
Corn and cauliflower.
I was going to say cauliflower.
All right. Uh, suction, please.
Let's move on to the omental patch,
3-0 silk suture.
Whoa!
- What the hell was that?
- That's a tapeworm.
Where the hell did it go?
That's a good question.
Look at that.
Booked the whole day for
one person's pacemaker?
Apparently, Jack has
decided to rent out OR 2.0.
As long as you have the money,
you can reserve it
for as long as you want.
I know this is unorthodox,
but when Jack started
analyzing revenue streams
No, he's selling seats on a rocket ship,
making up rules only his
rich pals can play by.
OK. Right now, I need
a solution for my patient.
Rich is ready for surgery,
and this other guy is still in Colorado.
And my priority is patient care,
and I'm not going to
have an operating room
held hostage by Jack Dayton.
Start your surgery.
Wait. Just hold on.
Jack's already made it clear
that he's no longer subsidizing 2.0.
[SIGHS] We sure Evans can pay?
Are you kidding me?
We're talking about a man's life.
Dr. Halstead, the way I see it,
Mr. Evans's initial surgery
was pro bono,
so we can consider this
a necessary follow-up
and forgive the bill.
Start your surgery, Dr. Marcel.
- Thank you.
- You know, Jack's ideas,
chasing profits for the hospital,
it only widens the gap.
It's not right.
Wow.
I got to let Jack know what's going on.
No, no, no, no.
You let me tell him myself.
We're going to keep this line
of communication direct.
[ELEVATOR BEEPS]
Dr. Charles, Zack's
finished stitching Jan up.
And I've stalled all that I can.
She's antsy, and she wants out of here.
OK, well, I'm starting to see why.
Nothing glaring in Jan's chart,
but it turns out her sister,
Deborah, was seen at East Mercy
right before the pandemic
for a broken arm.
Upon examination, they discover
aggressive pancreatic cancer.
She's dead in a month.
So in Jan's mind, her sister
went into the hospital healthy,
had a bunch of scanning tests,
and came out with a terminal disease?
Exactly.
She has this sudden catastrophic loss,
and she's furious and
looking for someone to blame.
Oh, my God.
Jaundice is a symptom
of pancreatic cancer.
- Isn't it hereditary?
- Yes.
And it was killing her sister
before she even knew she had it.
Same thing could be happening to Jan.
She needs a full workup now.
- What are we going to do?
- OK, look.
I'm going to dive back into
these sites, these forums,
see if I can find something
that we can connect on.
In the meantime, start the discharge,
but slow roll it for me.
OK. Work fast.
[SOFT TENSE MUSIC]
All right, Trini, I'm back.
What do we got?
- Nothing.
- Seriously?
Since we stopped taking
walk-ins without insurance,
numbers are down.
Well, we can't do that. It's illegal.
[SIGHS] I don't know.
I guess we're only taking
true emergencies now.
I know you've been waiting a long time.
And I'm sorry, sir.
They'll be able to help you
at East Mercy.
We turning him away because
he doesn't have insurance?
Yeah.
Excuse me, sir.
I'm Dr. Halstead. What's going on?
Gout's flaring up again.
I'm sorry. I know that's painful.
How about your chest? Any pain?
What? No.
Are you sure? 'Cause if you do,
well, that'd be considered an emergency,
and we'd have to treat you here.
So no chest pain?
I might have a slight
feeling of tightness.
Well, in that case,
let's get you checked out.
OK, what do you feel?
We got grilled cheese, dim sum, pizza.
Any of them. I'm starving.
I had to fast for the blood test,
then no time to eat
before the scans started.
Any idea when the results come in?
Well, they said a couple of days.
Probably going to feel
like weeks though.
Mm-hmm. [WOMAN SCREAMING]
Oh, my God.
Oh, my God. Oh, my God.
- Are you hurt? What
- I I don't know.
I was just walking, and then
all of a sudden my stomach
- [SCREAMS, SOBS]
- OK, all right.
Help me get her to the bench.
What's your name?
- Pam.
- Pam, I'm Dr. Asher.
- That's Sean.
- Thank you.
Is it OK if I feel your belly?
- Yes.
- Yeah? OK.
My my husband's in surgery right now
for a hole in his intestine.
Could I could I have the same thing?
- [SCREAMS] Sorry.
- OK.
It's OK. Squeeze as hard as you like.
[GROANING]
Oh, God.
I'm sorry. I just peed myself.
Oh, no, Pam. That's not urine.
Your uterus is enlarged and firm.
Your water just broke. You're in labor.
What? I'm pregnant?
I'm sorry.
You didn't you didn't know?
Wow, OK, so I imagine
you have a lot of questions.
But right now,
we need to get you inside.
- I'll get a wheelchair.
- Wait. I'm scared.
I need to hold on to someone,
and my husband's in the
I'll step in for him, if you'd like.
Thank you.
OK. I'll go get that wheelchair.
I see.
Oh, lost it. Damn it.
Uh, this a cause-and-effect thing?
Tapeworm lead to the ulcer?
No.
Ulcer's usually from
the H. pylori bacteria
Super common, almost all of us have it.
Tapeworm's from a bad meal.
[CHUCKLES] I'm never eating again.
Gotcha. Ha ha.
Wife's not picking up.
Leave your number. Ask her to text you.
Pull this out slowly.
Tapeworms regenerate.
Don't want this breaking off on me.
Uh, how long do you think it is?
No idea.
But I can't wait to find out.
Need some help in here!
- Move it.
- Where?
- Anywhere but here, Mike.
- What happened?
They took an X-ray in the treatment room
- next door and it set her off.
- I heard them.
They said X-ray.
And then someone yelled, clear.
See, they're admitting
the radiation is bad for you.
And these blankets are not enough.
OK. I'm sorry.
But we got rid of the X-ray machine.
Well, Dr. Charles said I could go,
- so I'm leaving right now.
- Jacqueline
What? How do you know my name?
Oh, I can explain.
No. Forget it. I don't trust any of you.
[SIGHS]
We know about your sister
and her cancer.
Yeah, that the hospitals gave her
with their X-rays
and their CTs and their MRIs.
- Those scans killed her!
- It's not true.
Deborah had cancer before
she went to the hospital.
No.
Her death had nothing to do
with the test. It was genetic.
That's why we need you
to get tested too.
No. You stay away from me.
You have all been lying to me
since I got here.
That's not true.
We've been trying to help you.
- Then let me go!
- Maggie, just a word.
- Be right back.
- I'm done here.
Give me five minutes.
I'll walk you out myself.
Mags?
What are you doing?
We've got to get through to her somehow.
Reinforcing her paranoid fantasies
is not the way to do that.
She may have a terminal
cancer, Dr. Charles.
She needs to get screened.
Well, of course she does.
But it's got to be her decision
to do that.
Well, we know that's never
going to happen, don't we?
Yeah, it's a safe bet this
is why Tim was shedding weight.
Tapeworm was stealing calories.
Tim's wife text you back yet?
No. Still MIA.
I don't get it.
So worried about Tim having surgery.
- Where'd she go?
- One last push!
- [GROANS, SCREAMS]
- Awesome, Pam.
You're almost there. Keep going.
- OK.
- Oh.
[PANTING] Oh, my God.
Full-term?
Ultrasound revealed that the
gestational age is around 37 weeks.
It doesn't make any sense.
I have polycystic ovarian syndrome.
I get a period once, maybe twice a year.
We've tried forever, and nothing.
OK, we can figure out
the hows and whys later, Pam.
Right now, I need you to focus.
Here comes another contraction.
OK. All right. Ready, Pam?
- Push as hard as you can, OK?
- [SCREAMING]
Sean? [EXHALING]
Right. Uh, breathe through it.
Short, short, long.
[LAMAZE BREATHING]
OK. I see the top of the head.
All right, Tim.
Can't imagine there's much more.
Holy smokes.
One more pull. One more.
And ugh!
It's out.
Whew.
He is out. He is out.
[LAUGHS] [BABY CRYING]
It's a boy, Pam.
Oh, my God. This is incredible.
I'm a mom. [LAUGHS]
- Congratulations.
- Thanks.
Here he is.
- There we go.
- [LAUGHS]
Oh, my God. [SOBS]
My husband is Is he still in surgery?
I'll find out for you.
He is not going to believe
what just came out of me.
[BOTH LAUGH]
[BABY CRYING]
2.0, give me a lateral
cross-section of the liver.
Rotating.
[COMPUTER BEEPING]
OK. I've got visuals of the lesions.
2.0, triangulate.
Guidance initiated.
Angle 3 degrees left.
Three degrees.
OK.
Probe has penetrated the first lesion.
Activate radiofrequency.
Activating.
[BEEPING]
Very nice.
First lesions have been ablated.
Six more to go, Richard.
2.0, guide me to the next one.
Calculating.
Calculating.
2.0, guide me to the next lesion.
Calculating. Calculating.
Calculating. Calculating.
Push forward 3 millimeters
to circumvent the common hepatic vein.
All right.
Advancing forward.
That came out of my intestine?
Yeah. All 6 feet, 4 inches of it.
No more YOLO moments for me.
YOLO? You Only Live Once?
Yeah.
Nine months ago, Pam and I
went to Thailand for our 10th.
I was all over those street carts.
Pork, chicken, fish, insects.
I probably picked up that tapeworm
somewhere in that smorgasbord.
Perhaps.
Although, tapeworms only take two months
to reach adult size, so it's possible
that you were infected more recently.
Same thing goes for
the H. pylori bacteria
that caused your ulcer.
Could've have happened
any time, any place.
So the two aren't connected?
Well, not medically.
But tapeworms can go
undetected for years.
So if you hadn't developed an ulcer
which required surgery,
then who knows how long
it would've taken to discover it?
I guess it was my lucky day, then, huh?
- Yeah.
- [LAUGHS]
Actually, yeah.
About your trip to Thailand
Pretty sure you didn't bring
anything back in you,
but I'm very certain that your wife
brought something back in her.
Surprise.
Who is that?
Our son.
What?
We're parents. [LAUGHS]
- And who is that?
- Oh, that's my son.
Parents? Is this really
happening right now?
Yes. It's really happening.
And I guess now we know why
I haven't lost any weight.
But your OB, she said you
couldn't ever get pregnant.
Yes, well, she was wrong.
[SOFT MUSIC]
- Whoa.
- I know.
It's a lot. [LAUGHS]
Um, do you want to hold him, Dad?
- Yeah.
- Yeah? [LAUGHS]
[LAUGHS] Ow.
Here he is.
[LAUGHS] Hey, bud.
[BABY COOS]
[LAUGHTER]
Ugh, I can walk. I hate these things.
I'm sorry.
It's just
It's hospital policy, you know.
Of course. Get me out of here.
You know, I've been thinking
about these conversations
we've had, and it occurred to me
it wasn't that long ago
that doctors actually thought
that cigarettes were good for you.
I mean, we sold them
in hospitals, right?
Point being that the medical
world always has been,
always will be constantly evolving.
I mean, look, I do this
for a living every day.
I'm a doctor. No way I can keep up.
You know what I mean?
How's your, uh, hand?
Feeling any better?
Yeah. A little.
Here. Let me, uh
[VELCRO RIPPING]
- There we go.
- OK.
So listen, um,
I just wanted to say that
the last couple of years
has been really hard
for a lot of people, right?
Loneliness, isolation, loss.
I really miss my sister.
- I bet you do.
- Mm-hmm.
And that's why I was thinking
there might come a time
when you might want to talk to somebody
about her, about her cancer,
about what it was like to lose her.
And I thought of somebody who
you really might respond to.
- A doctor?
- No. Not an MD.
This is an MSW, actually,
trained therapist,
but somebody who really thinks,
like, way outside the box.
Anyway, uh, this is her card,
you know, I mean, just in case, hm?
[SIGHS] OK.
All right, bye.
♪
A referral, Dr. Charles?
That's the best we could do?
Hey, Maggie, she took the card.
I mean, under the circumstances,
that's for me, it's a plus.
And by the way, already
talked to that therapist.
And in case she ever calls,
first order of business,
encourage her to get screened.
So you know, I'll take it.
I'm sorry about earlier.
Maybe I made it a little too personal.
Hardest part of my job
is just constantly checking myself,
make sure I'm not projecting my life
onto the people I'm trying to help.
So I get it.
Yeah. It's not easy.
Yeah, and then, bam, there it was.
You know, just looked at it
right in the eyes, you know?
Wait. Do tapeworms even have eyes?
Eyes, no eyes, you know what I mean.
[MUMBLES]
Mm-kay, well,
afraid I'm going to have to listen
to the rest of the saga later.
I promised Pam that I would
visit her and the baby.
- Mm, OK.
- Sean, you want to come?
Pretty sure after today
that Tim and Pam consider you family.
No. I'll stop by later.
I wanna hit the gift shop,
get something for the baby.
OK.
See you guys later.
I know that look. [BOTH CHUCKLE]
Yeah.
I've been feeling it for a while.
I mean, Hannah's smart,
kind, and super cute.
And seeing her in action today
Yeah. She's a catch. No question.
But, uh,
you know, you're just getting
back on your feet, you know?
I know. Lot of cons.
But the pros?
I feel good with her.
Trust her.
Yeah, I get it.
You know, you're still in recovery.
And so is Hannah, for that matter.
- Did OK?
- Oh, surgery was flawless,
just like the first time.
2.0 took care of all the lesions
and ran additional scans that confirm
the cancer was confined to his liver.
Oh, thank you.
They say third time's a charm,
but I hope we never
have to see you again.
Oh, I totally get it. Yeah.
- How we looking?
- Just lowered his sedation.
OK. Richard, hey.
Time to wake up, buddy.
Richard?
Hey.
[TENSE MUSIC]
Richard, can you hear me?
Last time, he woke right up.
Yeah. It was a long surgery.
He may need a little more time.
Richard.
Not responding to deep, painful stimuli.
[MACHINERY BEEPING]
Need a head CT.
What's happening?
Is something wrong?
Difficulty coming out of anesthesia
could indicate, uh, he's had a stroke.
Oh, my God.
Oh, my God. Richard?
Richard? Open your eyes.
Richard, open your eyes.
Richard, it's time to wake up.
Richard, wake up.
- Oh, Maggie.
- Oh, hey.
The recruiter called,
and I sang your praises.
Thank you.
Tough day?
Oh, it was just the case hit home.
I just wish I could do more, you know?
Yeah, well,
I know exactly what you mean.
- Chin up.
- Yeah.
Ah.
All good with Pam and the baby?
Yup. She is online feverishly
ordering baby bottles
and clothes and diapers.
Yeah. Tim too.
Crib, car seat, and a stroller.
- What a day.
- I know.
I mean, I wonder what's
going to happen next, right?
[SCREAMS]
[BOTH LAUGH]
Yeah, you got me.
I mean, where did you get this?
- The hobby store on Madison.
- Oh, man.
The paramedics got them
for me in-between runs.
- Yeah.
- Yeah.
How long were you
sitting there pretending
to read your chart while
waiting for me to come in?
Since I clocked out.
- Uh-huh.
- [LAUGHS]
Hey, Doris. Seen my father?
Uh, doctors' lounge.
- Thanks.
- Mm-hmm.
No, no, no.
Yeah.
[MUFFLED CHATTER]
[SOFT DRAMATIC MUSIC]
♪
Oh, hey, Pavel. What are you doing?
Dropping off Liliana for her shift.
Oh, did I miss her?
She will be back.
Grabbing me a sandwich from the café.
- Oh.
- Nice photo.
Very impressive.
Used to have my name on the wall.
But that's the past.
[SIGHS]
You know, Pavel, I
I can't imagine
how frustrating it must be
to feel like you've got
to start all over again.
Look, it's none of my business.
But, uh, I do have a buddy,
pretty good buddy, actually,
- who has a small law firm
- No, I don't need your help.
I have a plan, and
I'm not one of your patients.
Pavel.
I'll pick you up in the morning.
My brother. I'm sorry.
What he's going through
is very difficult, you know?
We've got to give him some time.
It'll be OK.
Daniel, you're a very patient man.
Me?
I'm a, um, I'm a lucky man.
Oh.
Pupils were fixed and dilated.
I mean, no gag reflex.
No corneal reflex.
Stroke. No chance of recovery?
Vickie's decided
to discontinue life support.
She's saying goodbye.
[SOMBER MUSIC]
♪
- Dr. Marcel.
- Yeah.
Hey.
How you doing?
I don't know what happened.
2.0 didn't indicate anything was wrong.
No alarms.
Vitals were stable the entire time.
This had to be on me.
I must have done something, you know?
Had to have done something wrong.
I know that's how it feels.
But sometimes, even under
the best of circumstances,
patients don't survive.
And I'm not telling you anything
you don't already know.
It's awful. It is.
But it's the burden we bear.
♪
Richard, was it the first time 2.0
was being used on a patient?
We were able to remove
the patient's tumor.
And we're optimistic for his future.
I'm not taking my son's kidney, Hannah.
Donating could be a really
positive experience for him.
If you turn out to be
a match, I won't say no.
I was wanting you to meet my brother.
So tell me doctor, you deal
with any crazy people today?
Pavel.
I didn't mean to offend.
I was meeting with a headhunter.
I have a bad feeling about the direction
that Jack is taking us.
Jack, he got the votes.
We are now a for-profit hospital.
Hello, Daniel.
Hoping I'd run into you. Walk you out?
Your desk, bottom drawer,
left you a treat.
You didn't have to do that.
We don't get to see
each other during the day.
It's my way of feeling close to you.
[CAR HORN BEEPS]
Ah, the esteemed Dr. Charles,
Chicago's very own Carl Jung.
Pavel, how you doing?
Fine.
Hurry, Liliana. Get in.
Let's not keep him.
He must be very busy.
Just a minute.
- I'm sorry.
- It's OK.
Pavel can be rude.
He was a lawyer back in Poland.
And he has had a hard time finding
a career here in America.
I think he feels
- Left behind.
- Yes.
Yeah, it's hard.
Making jokes is just his frustration.
He has a big heart.
Have a good day, Daniel.
Morning, Sharon.
Hey, Maggie, good morning.
You know that recruiter
that I met with last week?
Well, she may be calling you
for some references.
You're really doing this, leaving Med?
Well, just testing the waters.
And what would it take
to make you stop testing?
You got a time machine?
Take Med back to when
patients came before profits?
All right. I get it.
I'll let you know if someone calls.
Thank you.
I wish you didn't have to
take a day off work for this.
I feel bad.
Testing to see if I can
give you my kidney
kind of trumps parking a few cars.
- Hmm.
- Hey guys.
Big day.
You ready, Sean?
I'm cool.
- He's a nervous wreck.
- Mm.
I'm grateful. [CHUCKLES]
My job as a dad is being there for you.
And you being there for me
is even more trying than I thought.
[PHONE CHIMES]
Oh, thank God.
I'm needed in the ED.
Mm. Too much emotion for you, Dean?
- Yeah, way, way too much.
- Yeah.
Hey, Dr. Asher. Just the usual chai tea?
Yes, please. Thank you, Carly.
Sean.
You sure I can't get you a coffee?
Ah, not today. Just water.
OK.
[SOFT MUSIC]
I think Carly just gave you flirty eyes.
Is there, like, something-something
- brewing between you two?
- Just friends.
Oh.
Because smart, kind, and super
cute are just not your type.
- No, that's my type.
- Mm.
Mine's just somewhere else right now.
♪
What if I'm not a donor match?
Then we'll figure something else out.
Good morning. Good morning.
So are the rumors true?
What rumors?
The rehab clinic going part-time.
The dialysis center
possibly shutting down.
Oh, those rumors.
Well, maybe.
New mandate says that if
a department is losing money,
it could be on the chopping block.
Well, what about the ED? [ALERT BLARES]
I don't know.
Maggie, need some help.
Talk to me.
Name's Jan Dover,
30s, single vehicle crash,
low impact, backed into a light pole.
GCS 15, laceration on her left palm.
Appears slightly jaundiced,
and has some very interesting theories
about the medical industrial complex.
Ma'am, please. It's policy.
What about my autonomy?
Am I not allowed to govern
my own health and wellness?
She was a little rattled at the scene.
I think that's why she didn't fight us
getting into the ambo.
But now that the shock's
worn off, she won't come out.
OK. Let me see what I can do.
Thank you, Cesar.
Hi, Jan.
I'm Maggie.
I'm a nurse here at Chicago Med.
I know what you're going to
ask, and I'm not going inside.
Well, the thing is you're already here.
And your hand, it looks like
it needs stitches.
- Oh, it's fine.
- Well, let's confirm that.
And then we'll send you on your way.
[SCOFFS] They've got you
on the payroll, don't they?
I'm sorry. Who's they?
The pharmaceutical companies.
[SCOFFS] All you nurses are on the take.
I can assure you, I'm not on any take.
No. I've read about it.
And I know that the minute
I walk through that door,
you're going to inject me with a virus.
And I will spend the rest of my life
paying for overpriced medications.
You'll get a cut,
and your pals at big pharma
will make a fortune keeping me alive.
Told you. [AMBULANCE HORN HONKS]
OK.
Jan, I'm not sure where
you got your information.
But if you come inside
with me, maybe we can
No. I'm not going anywhere.
[DRAMATIC MUSIC]
♪
She's very distrustful
of hospitals, paranoid,
maybe even delusional.
And she says her name is Jan Dover.
It sounds like a variation
on Jane Doe, doesn't it?
Exactly. And she's been white knuckling
those handles ever since they got here.
By the way, her hand's been bleeding.
That lac must be deep
and hurt like hell.
Is she angry? Combative?
No, she's just terrified and
thinks we're going to hurt her
and has a ton of internet
research to back it up.
You know, COVID with all the isolation
and loneliness really amplified
the conspiracy theories
in general, made the medical system
in particular an easy target.
Jan, how you doing? I'm Dr. Charles.
A psychiatrist. Here we go.
What do you mean?
Medicine's answer for people
who don't play along
is call them crazy.
Jan, we just met, OK?
The only thing I know about
you is that you're losing
a lot of blood, and we gotta
We gotta take a look at that hand.
And I appreciate that,
but I already told her
that I am not going inside the hospital.
- It is too dangerous.
- How so?
X-rays, gamma rays, infrared radiation.
I mean, we can keep chatting
if you can fix those.
Oh, well, we actually
have a protocol for that.
- You do?
- Yeah. Trust me.
You are not the first person
to come into this hospital
with that set of concerns.
[SIGHS] OK. Fine then.
Great.
Wheelchair, please.
We have a protocol for the
electromagnetic spectrum?
We do now.
By the way, she is very jaundiced.
It could be something serious.
Yeah.
So look, in order to actually
get her into a treatment room,
I'm going to ask you to get
with the X-ray techs, OK?
And here's what I want you
to ask them for.
Tim, how long has your
stomach been bothering you?
A few weeks or so.
It's mostly when I eat.
Yeah? And how does it feel now?
Mild, sharp?
Kind of like indigestion or bloating,
but then then last night it
just it got a little worse.
Seriously, Tim? A little worse?
He woke up from a dead sleep screaming.
- He had tears in his eyes.
- Pam.
[SCOFFS] My wife overshares
when she's nervous.
And my husband downplays
when he's in pain.
Can you tell we've been married forever?
That's all good. OK.
So 1 to 10, how's the pain feel now?
[GROANS] That's like
a 6 or 7 right there.
Nope. Downplaying. That's a 10 face.
I see it every time we have a stair day.
Stair day?
Our resolution for 2023
was to lose weight, get fit.
And one of our workouts is walking
the stairs in our building.
She she makes it sound
like it's a mid-rise.
It's not even close. It's 35 stories.
Well, he never makes it
past the eighth floor.
Meanwhile, I make it
to the top every time,
and I haven't lost a pound.
- Tim here's lost 22.
- 24.
Yeah, I don't know.
It must be my metabolism.
Or it's whatever's going
on with your stomach,
and if that's the case, I want it too.
- [GROANS] You can have it.
- OK, well,
we'll give you something
to take the edge off, OK?
Uh, 25 of fentanyl and a GI cocktail.
Also, order an upright
and flat abdominal X-ray
and a CT abdomen and pelvis.
OK. Just take some deep breaths.
- It'll help with the pain.
- [SIGHS]
[DISTANT RATTLING, TOOLS WHIRRING]
[THUMPING]
♪
George, a minute?
Sharon. Of course, of course.
Just sketch in the aquarium.
I'll be right back.
An aquarium?
I thought we were only
taking over a couple of rooms
for this new VIP build.
Well, demand was much
greater than expected.
So at the 11th hour,
Jack decided to take the entire floor.
But this is the geriatrics unit.
Did he even consider those patients?
Well, the plan is to fold geriatrics
into the orthopedic.
Oh, so that's the plan, huh?
Clearly, word didn't get to you.
Well, clearly.
I'm so sorry, Sharon.
It must have been an oversight.
Since turning for-profit,
there have been
dozens of new voices in the mix.
And it's really gummed up
the lines of communication.
Well, un-gum them.
Because I will not be left out
of the loop in my own hospital.
Well, anything further,
and I will notify you myself.
Good.
How far do we have to go?
Uh, just number three
down here on the right.
[SIGHS] These poor people,
staring at me, yet they have no idea
how dangerous this place is.
All the things they're being exposed to.
You know, I used to be like them
till I discovered the truth.
The truth?
What, um, what exactly
do you mean by that?
Jan, every machine that
could be removed has been,
and the equipment that we couldn't
has been draped with a lead vest
like the one that you're wearing.
And the walls have been insulated
with anti-radiation blankets.
Wow.
- You did this fast.
- Yeah.
Protocol, right?
Here we go.
Fine. OK.
Jan, that's Tracy.
Be right back.
- Well, she's in.
- Yeah.
Hopefully she's comfortable
enough to let us fix her hand,
but we really got to
figure out this jaundice.
How we going to do that?
She's taking every tool
we've got out of play.
Richard, Vickie.
- Dr. Halstead.
- How you been?
Wonderful.
Last week, he was five months
cancer-free.
That's fantastic.
I only wish you could
have treated my clumsiness.
I think I busted my ankle.
Yeah. I can see that. What happened?
Oh, I tripped going down the stairs.
I've been icing it for a week,
but it's not getting
any better. [GROANS]
Vickie made me come in.
I need him in walking shape.
We're going to Machu Picchu next month,
hiking the Inca trail.
We got time back that
I never thought we'd have.
We're trying to make the most of it.
That's wonderful.
We'll get some X-rays, but
I suspect it's just a sprain.
Oh, that's good to hear,
considering last time we were here.
Thank God for OR 2.0.
Yeah, Richard,
you were its first patient.
Your success was a real inspiration.
Oh, shoot, honey,
I left my cell in the car.
- Do you mind grabbing it for me?
- Sure.
I'll be right back.
[GROANING] Oh, God.
Richard, you all right?
I needed her to leave for a minute.
- [GROANING]
- What's going on?
I tripped because I've been weak.
There's a dull pain in my belly,
and I haven't had an appetite.
[STRAINED BREATHING]
The cancer's back. I know it.
Let's not get ahead of ourselves.
We'll run some tests and go from there.
So I assume Vickie doesn't know.
I can't bring myself to tell her.
Since my surgery, we've been
living our best lives.
She's so happy.
I don't want to take that from her.
I understand.
[GROANS]
Free fluid and free air in my abdomen?
What does that mean?
That there's a hole
somewhere in your intestine
- or your stomach.
- From what?
Could be a perforated ulcer.
It might be something
sharp that you swallowed.
Honestly, I won't be sure
until I get in there.
Get in there? You mean surgery?
Yeah. Leak in the GI tract needs
to be addressed immediately.
- But he'll be all right?
- Yes.
It's a routine operation.
There's a waiting room.
We also have a café, if you like.
I don't know. I I want to be close.
Pam, honey, you know what?
Why don't you take a walk?
You love this time of year,
nice weather.
You can get your steps in.
I guess the fresh air
might do me some good.
Quell the nerves. [LAUGHS]
Sure. OK. So we're good here? Yeah?
All right, well, I'll change my scrubs,
and I'll get the techs to bring
you upstairs to pre-op holding.
- OK.
- OK?
Hi.
Sweetie, you need to let go.
Oh, I'm sorry.
Don't worry. We'll keep you updated
throughout the entire operation.
Thank you.
Oh, and another one
Vaccines.
You want to know who they're helping,
just look at the sponsor behind it.
Hey, a lot of people have
problems with vaccines,
you know? It's a complicated issue.
Exactly.
I didn't think you would understand.
Really important for
somebody in my position
to keep an open mind.
Refreshing. [CHUCKLES]
You know, Jan, I'm noticing
some skin discoloration.
Oh, it's just the
fluorescent lights in here.
You know, it could be.
But it also might be jaundice.
You mind if I just take
a tiny bit of blood,
do a couple of very simple blood tests?
Yes, I mind very much.
Got it. Understood.
You were saying?
Oh, HIV. [SCOFFS]
I read a very persuasive
article basically saying
that they intentionally dusted
it over low-income communities
as a form of population control.
- Wow.
- Yeah.
I mean, people wanted to blame
the Reagan administration,
you know, the FBI,
but the research I've done
points to the CIA.
What kind of research? I'm just curious.
I mean, written literature,
podcasters, YouTubers.
But I prefer online forums
because people are always
sharing information.
So, um, I mean, do you have, like a
A favorite forum that you could show me?
Yeah, I don't know.
Look, I will draw my own conclusions.
It's just the more
up-to-the-minute stuff
I have access to, the better.
No big deal.
OK. Um
[CLEARS THROAT] All right.
Look at this thread.
It talks about the scanners
that they use in hospitals.
We're seeing that, yeah.
Mm-hmm. CTs, ultrasounds,
especially MRIs,
and how they inject
dangerous hydrogen protons
- into the body.
- Wow.
Hospitals kill people.
They kill them.
OK. We had a good chat, but
Look, you seem like
a nice guy, but I would, um,
I would really like to go home now.
Got it. Um, let me just quickly
go find somebody to stitch you up.
No, no, no, no. I don't think so.
That's a deep wound, OK?
I mean, we don't close it up,
it's going to keep bleeding.
And what I really don't want to happen
- is that it gets infected.
- No, no.
I'll keep it clean.
You want to risk having your
hand infected? You could lose it.
OK. Fine.
But no scans, no IVs,
just a needle and thread.
And then you let me go.
Deal.
- Back in a flash.
- [SIGHS]
Mags?
- Yeah.
- Find Zack.
- Have him stitch up her hand.
- She's gonna let us treat her?
Just the hand, not the jaundice.
Well, that's a start.
What about her mental state?
You know, conspiracy theories
are not necessarily connected
to any kind of
paranoid personality disorder.
I mean, certainly not in Jan's case.
And she's what? Just gullible?
I'd say more like a combination of
I don't know
Lonely and prone to persuasion.
I'm really starting to think
that something bad
happened to her in a hospital.
That makes sense.
How do we get past that?
Because I'm concerned that her jaundice
- means that her liver's failing.
- Yeah, I mean, look.
She wouldn't let me draw blood,
all right?
Scans are out of the question.
So I guess we're just going
to have to go with, you know,
her medical history.
Well, we don't even have that.
- We don't even have her name.
- It's Jacqueline Warner.
She handed me her phone.
The settings trick that I taught you.
Anyway, it's not going to take Zack
that long to stitch her up,
but she's already asking to leave, so
Don't worry. I'll buy you some time.
- Thank you.
- Got you.
Vickie, Richard.
- Dr. Marcel?
- Nice to see you both.
Yeah, it's nice to see you too.
- Yeah.
- I don't understand.
You're a surgeon.
You said it was just a sprain.
Richard, what's going on?
The cancer's back, isn't it?
I'm afraid so.
CT scan showed multiple
lesions in your liver.
So it metastasized.
It spread from my pancreas.
Yes.
Richard.
You knew something was wrong.
Why didn't you tell me?
I wanted to.
But I I also just
didn't wanna face it.
[SOMBER MUSIC]
These last few months,
the way you laugh at my dumb jokes,
burn my toast on the edges.
I've fallen for you all over again.
You beat cancer once.
- You can beat it again.
- No, honey.
I'm a science guy.
The odds of that happening
Are good.
Richard, OR 2.0 knows your body.
It's been learning and
improving with every surgery
it's done since yours.
Now, don't get me wrong.
This procedure you need now,
high-frequency ablation,
it's a delicate operation.
But 2.0 has all the tools.
But a A third lease on life?
Really?
I believe so.
OK. [CHUCKLES]
Let's do it again.
Good.
- Thank you both.
- Yeah.
Here we go.
Perforated ulcer on the anterior surface
of the first portion of the duodenum.
Got some undigested
food remnants, lavage.
Betcha it's corn and green beans.
[MACHINERY BEEPING]
Close.
Corn and cauliflower.
I was going to say cauliflower.
All right. Uh, suction, please.
Let's move on to the omental patch,
3-0 silk suture.
Whoa!
- What the hell was that?
- That's a tapeworm.
Where the hell did it go?
That's a good question.
Look at that.
Booked the whole day for
one person's pacemaker?
Apparently, Jack has
decided to rent out OR 2.0.
As long as you have the money,
you can reserve it
for as long as you want.
I know this is unorthodox,
but when Jack started
analyzing revenue streams
No, he's selling seats on a rocket ship,
making up rules only his
rich pals can play by.
OK. Right now, I need
a solution for my patient.
Rich is ready for surgery,
and this other guy is still in Colorado.
And my priority is patient care,
and I'm not going to
have an operating room
held hostage by Jack Dayton.
Start your surgery.
Wait. Just hold on.
Jack's already made it clear
that he's no longer subsidizing 2.0.
[SIGHS] We sure Evans can pay?
Are you kidding me?
We're talking about a man's life.
Dr. Halstead, the way I see it,
Mr. Evans's initial surgery
was pro bono,
so we can consider this
a necessary follow-up
and forgive the bill.
Start your surgery, Dr. Marcel.
- Thank you.
- You know, Jack's ideas,
chasing profits for the hospital,
it only widens the gap.
It's not right.
Wow.
I got to let Jack know what's going on.
No, no, no, no.
You let me tell him myself.
We're going to keep this line
of communication direct.
[ELEVATOR BEEPS]
Dr. Charles, Zack's
finished stitching Jan up.
And I've stalled all that I can.
She's antsy, and she wants out of here.
OK, well, I'm starting to see why.
Nothing glaring in Jan's chart,
but it turns out her sister,
Deborah, was seen at East Mercy
right before the pandemic
for a broken arm.
Upon examination, they discover
aggressive pancreatic cancer.
She's dead in a month.
So in Jan's mind, her sister
went into the hospital healthy,
had a bunch of scanning tests,
and came out with a terminal disease?
Exactly.
She has this sudden catastrophic loss,
and she's furious and
looking for someone to blame.
Oh, my God.
Jaundice is a symptom
of pancreatic cancer.
- Isn't it hereditary?
- Yes.
And it was killing her sister
before she even knew she had it.
Same thing could be happening to Jan.
She needs a full workup now.
- What are we going to do?
- OK, look.
I'm going to dive back into
these sites, these forums,
see if I can find something
that we can connect on.
In the meantime, start the discharge,
but slow roll it for me.
OK. Work fast.
[SOFT TENSE MUSIC]
All right, Trini, I'm back.
What do we got?
- Nothing.
- Seriously?
Since we stopped taking
walk-ins without insurance,
numbers are down.
Well, we can't do that. It's illegal.
[SIGHS] I don't know.
I guess we're only taking
true emergencies now.
I know you've been waiting a long time.
And I'm sorry, sir.
They'll be able to help you
at East Mercy.
We turning him away because
he doesn't have insurance?
Yeah.
Excuse me, sir.
I'm Dr. Halstead. What's going on?
Gout's flaring up again.
I'm sorry. I know that's painful.
How about your chest? Any pain?
What? No.
Are you sure? 'Cause if you do,
well, that'd be considered an emergency,
and we'd have to treat you here.
So no chest pain?
I might have a slight
feeling of tightness.
Well, in that case,
let's get you checked out.
OK, what do you feel?
We got grilled cheese, dim sum, pizza.
Any of them. I'm starving.
I had to fast for the blood test,
then no time to eat
before the scans started.
Any idea when the results come in?
Well, they said a couple of days.
Probably going to feel
like weeks though.
Mm-hmm. [WOMAN SCREAMING]
Oh, my God.
Oh, my God. Oh, my God.
- Are you hurt? What
- I I don't know.
I was just walking, and then
all of a sudden my stomach
- [SCREAMS, SOBS]
- OK, all right.
Help me get her to the bench.
What's your name?
- Pam.
- Pam, I'm Dr. Asher.
- That's Sean.
- Thank you.
Is it OK if I feel your belly?
- Yes.
- Yeah? OK.
My my husband's in surgery right now
for a hole in his intestine.
Could I could I have the same thing?
- [SCREAMS] Sorry.
- OK.
It's OK. Squeeze as hard as you like.
[GROANING]
Oh, God.
I'm sorry. I just peed myself.
Oh, no, Pam. That's not urine.
Your uterus is enlarged and firm.
Your water just broke. You're in labor.
What? I'm pregnant?
I'm sorry.
You didn't you didn't know?
Wow, OK, so I imagine
you have a lot of questions.
But right now,
we need to get you inside.
- I'll get a wheelchair.
- Wait. I'm scared.
I need to hold on to someone,
and my husband's in the
I'll step in for him, if you'd like.
Thank you.
OK. I'll go get that wheelchair.
I see.
Oh, lost it. Damn it.
Uh, this a cause-and-effect thing?
Tapeworm lead to the ulcer?
No.
Ulcer's usually from
the H. pylori bacteria
Super common, almost all of us have it.
Tapeworm's from a bad meal.
[CHUCKLES] I'm never eating again.
Gotcha. Ha ha.
Wife's not picking up.
Leave your number. Ask her to text you.
Pull this out slowly.
Tapeworms regenerate.
Don't want this breaking off on me.
Uh, how long do you think it is?
No idea.
But I can't wait to find out.
Need some help in here!
- Move it.
- Where?
- Anywhere but here, Mike.
- What happened?
They took an X-ray in the treatment room
- next door and it set her off.
- I heard them.
They said X-ray.
And then someone yelled, clear.
See, they're admitting
the radiation is bad for you.
And these blankets are not enough.
OK. I'm sorry.
But we got rid of the X-ray machine.
Well, Dr. Charles said I could go,
- so I'm leaving right now.
- Jacqueline
What? How do you know my name?
Oh, I can explain.
No. Forget it. I don't trust any of you.
[SIGHS]
We know about your sister
and her cancer.
Yeah, that the hospitals gave her
with their X-rays
and their CTs and their MRIs.
- Those scans killed her!
- It's not true.
Deborah had cancer before
she went to the hospital.
No.
Her death had nothing to do
with the test. It was genetic.
That's why we need you
to get tested too.
No. You stay away from me.
You have all been lying to me
since I got here.
That's not true.
We've been trying to help you.
- Then let me go!
- Maggie, just a word.
- Be right back.
- I'm done here.
Give me five minutes.
I'll walk you out myself.
Mags?
What are you doing?
We've got to get through to her somehow.
Reinforcing her paranoid fantasies
is not the way to do that.
She may have a terminal
cancer, Dr. Charles.
She needs to get screened.
Well, of course she does.
But it's got to be her decision
to do that.
Well, we know that's never
going to happen, don't we?
Yeah, it's a safe bet this
is why Tim was shedding weight.
Tapeworm was stealing calories.
Tim's wife text you back yet?
No. Still MIA.
I don't get it.
So worried about Tim having surgery.
- Where'd she go?
- One last push!
- [GROANS, SCREAMS]
- Awesome, Pam.
You're almost there. Keep going.
- OK.
- Oh.
[PANTING] Oh, my God.
Full-term?
Ultrasound revealed that the
gestational age is around 37 weeks.
It doesn't make any sense.
I have polycystic ovarian syndrome.
I get a period once, maybe twice a year.
We've tried forever, and nothing.
OK, we can figure out
the hows and whys later, Pam.
Right now, I need you to focus.
Here comes another contraction.
OK. All right. Ready, Pam?
- Push as hard as you can, OK?
- [SCREAMING]
Sean? [EXHALING]
Right. Uh, breathe through it.
Short, short, long.
[LAMAZE BREATHING]
OK. I see the top of the head.
All right, Tim.
Can't imagine there's much more.
Holy smokes.
One more pull. One more.
And ugh!
It's out.
Whew.
He is out. He is out.
[LAUGHS] [BABY CRYING]
It's a boy, Pam.
Oh, my God. This is incredible.
I'm a mom. [LAUGHS]
- Congratulations.
- Thanks.
Here he is.
- There we go.
- [LAUGHS]
Oh, my God. [SOBS]
My husband is Is he still in surgery?
I'll find out for you.
He is not going to believe
what just came out of me.
[BOTH LAUGH]
[BABY CRYING]
2.0, give me a lateral
cross-section of the liver.
Rotating.
[COMPUTER BEEPING]
OK. I've got visuals of the lesions.
2.0, triangulate.
Guidance initiated.
Angle 3 degrees left.
Three degrees.
OK.
Probe has penetrated the first lesion.
Activate radiofrequency.
Activating.
[BEEPING]
Very nice.
First lesions have been ablated.
Six more to go, Richard.
2.0, guide me to the next one.
Calculating.
Calculating.
2.0, guide me to the next lesion.
Calculating. Calculating.
Calculating. Calculating.
Push forward 3 millimeters
to circumvent the common hepatic vein.
All right.
Advancing forward.
That came out of my intestine?
Yeah. All 6 feet, 4 inches of it.
No more YOLO moments for me.
YOLO? You Only Live Once?
Yeah.
Nine months ago, Pam and I
went to Thailand for our 10th.
I was all over those street carts.
Pork, chicken, fish, insects.
I probably picked up that tapeworm
somewhere in that smorgasbord.
Perhaps.
Although, tapeworms only take two months
to reach adult size, so it's possible
that you were infected more recently.
Same thing goes for
the H. pylori bacteria
that caused your ulcer.
Could've have happened
any time, any place.
So the two aren't connected?
Well, not medically.
But tapeworms can go
undetected for years.
So if you hadn't developed an ulcer
which required surgery,
then who knows how long
it would've taken to discover it?
I guess it was my lucky day, then, huh?
- Yeah.
- [LAUGHS]
Actually, yeah.
About your trip to Thailand
Pretty sure you didn't bring
anything back in you,
but I'm very certain that your wife
brought something back in her.
Surprise.
Who is that?
Our son.
What?
We're parents. [LAUGHS]
- And who is that?
- Oh, that's my son.
Parents? Is this really
happening right now?
Yes. It's really happening.
And I guess now we know why
I haven't lost any weight.
But your OB, she said you
couldn't ever get pregnant.
Yes, well, she was wrong.
[SOFT MUSIC]
- Whoa.
- I know.
It's a lot. [LAUGHS]
Um, do you want to hold him, Dad?
- Yeah.
- Yeah? [LAUGHS]
[LAUGHS] Ow.
Here he is.
[LAUGHS] Hey, bud.
[BABY COOS]
[LAUGHTER]
Ugh, I can walk. I hate these things.
I'm sorry.
It's just
It's hospital policy, you know.
Of course. Get me out of here.
You know, I've been thinking
about these conversations
we've had, and it occurred to me
it wasn't that long ago
that doctors actually thought
that cigarettes were good for you.
I mean, we sold them
in hospitals, right?
Point being that the medical
world always has been,
always will be constantly evolving.
I mean, look, I do this
for a living every day.
I'm a doctor. No way I can keep up.
You know what I mean?
How's your, uh, hand?
Feeling any better?
Yeah. A little.
Here. Let me, uh
[VELCRO RIPPING]
- There we go.
- OK.
So listen, um,
I just wanted to say that
the last couple of years
has been really hard
for a lot of people, right?
Loneliness, isolation, loss.
I really miss my sister.
- I bet you do.
- Mm-hmm.
And that's why I was thinking
there might come a time
when you might want to talk to somebody
about her, about her cancer,
about what it was like to lose her.
And I thought of somebody who
you really might respond to.
- A doctor?
- No. Not an MD.
This is an MSW, actually,
trained therapist,
but somebody who really thinks,
like, way outside the box.
Anyway, uh, this is her card,
you know, I mean, just in case, hm?
[SIGHS] OK.
All right, bye.
♪
A referral, Dr. Charles?
That's the best we could do?
Hey, Maggie, she took the card.
I mean, under the circumstances,
that's for me, it's a plus.
And by the way, already
talked to that therapist.
And in case she ever calls,
first order of business,
encourage her to get screened.
So you know, I'll take it.
I'm sorry about earlier.
Maybe I made it a little too personal.
Hardest part of my job
is just constantly checking myself,
make sure I'm not projecting my life
onto the people I'm trying to help.
So I get it.
Yeah. It's not easy.
Yeah, and then, bam, there it was.
You know, just looked at it
right in the eyes, you know?
Wait. Do tapeworms even have eyes?
Eyes, no eyes, you know what I mean.
[MUMBLES]
Mm-kay, well,
afraid I'm going to have to listen
to the rest of the saga later.
I promised Pam that I would
visit her and the baby.
- Mm, OK.
- Sean, you want to come?
Pretty sure after today
that Tim and Pam consider you family.
No. I'll stop by later.
I wanna hit the gift shop,
get something for the baby.
OK.
See you guys later.
I know that look. [BOTH CHUCKLE]
Yeah.
I've been feeling it for a while.
I mean, Hannah's smart,
kind, and super cute.
And seeing her in action today
Yeah. She's a catch. No question.
But, uh,
you know, you're just getting
back on your feet, you know?
I know. Lot of cons.
But the pros?
I feel good with her.
Trust her.
Yeah, I get it.
You know, you're still in recovery.
And so is Hannah, for that matter.
- Did OK?
- Oh, surgery was flawless,
just like the first time.
2.0 took care of all the lesions
and ran additional scans that confirm
the cancer was confined to his liver.
Oh, thank you.
They say third time's a charm,
but I hope we never
have to see you again.
Oh, I totally get it. Yeah.
- How we looking?
- Just lowered his sedation.
OK. Richard, hey.
Time to wake up, buddy.
Richard?
Hey.
[TENSE MUSIC]
Richard, can you hear me?
Last time, he woke right up.
Yeah. It was a long surgery.
He may need a little more time.
Richard.
Not responding to deep, painful stimuli.
[MACHINERY BEEPING]
Need a head CT.
What's happening?
Is something wrong?
Difficulty coming out of anesthesia
could indicate, uh, he's had a stroke.
Oh, my God.
Oh, my God. Richard?
Richard? Open your eyes.
Richard, open your eyes.
Richard, it's time to wake up.
Richard, wake up.
- Oh, Maggie.
- Oh, hey.
The recruiter called,
and I sang your praises.
Thank you.
Tough day?
Oh, it was just the case hit home.
I just wish I could do more, you know?
Yeah, well,
I know exactly what you mean.
- Chin up.
- Yeah.
Ah.
All good with Pam and the baby?
Yup. She is online feverishly
ordering baby bottles
and clothes and diapers.
Yeah. Tim too.
Crib, car seat, and a stroller.
- What a day.
- I know.
I mean, I wonder what's
going to happen next, right?
[SCREAMS]
[BOTH LAUGH]
Yeah, you got me.
I mean, where did you get this?
- The hobby store on Madison.
- Oh, man.
The paramedics got them
for me in-between runs.
- Yeah.
- Yeah.
How long were you
sitting there pretending
to read your chart while
waiting for me to come in?
Since I clocked out.
- Uh-huh.
- [LAUGHS]
Hey, Doris. Seen my father?
Uh, doctors' lounge.
- Thanks.
- Mm-hmm.
No, no, no.
Yeah.
[MUFFLED CHATTER]
[SOFT DRAMATIC MUSIC]
♪
Oh, hey, Pavel. What are you doing?
Dropping off Liliana for her shift.
Oh, did I miss her?
She will be back.
Grabbing me a sandwich from the café.
- Oh.
- Nice photo.
Very impressive.
Used to have my name on the wall.
But that's the past.
[SIGHS]
You know, Pavel, I
I can't imagine
how frustrating it must be
to feel like you've got
to start all over again.
Look, it's none of my business.
But, uh, I do have a buddy,
pretty good buddy, actually,
- who has a small law firm
- No, I don't need your help.
I have a plan, and
I'm not one of your patients.
Pavel.
I'll pick you up in the morning.
My brother. I'm sorry.
What he's going through
is very difficult, you know?
We've got to give him some time.
It'll be OK.
Daniel, you're a very patient man.
Me?
I'm a, um, I'm a lucky man.
Oh.
Pupils were fixed and dilated.
I mean, no gag reflex.
No corneal reflex.
Stroke. No chance of recovery?
Vickie's decided
to discontinue life support.
She's saying goodbye.
[SOMBER MUSIC]
♪
- Dr. Marcel.
- Yeah.
Hey.
How you doing?
I don't know what happened.
2.0 didn't indicate anything was wrong.
No alarms.
Vitals were stable the entire time.
This had to be on me.
I must have done something, you know?
Had to have done something wrong.
I know that's how it feels.
But sometimes, even under
the best of circumstances,
patients don't survive.
And I'm not telling you anything
you don't already know.
It's awful. It is.
But it's the burden we bear.
♪