Chicago Med (2015) s09e04 Episode Script

1
Colleagues date all the time.
It's not a big deal.
Yeah, but it is to me.
There's no rush.
It's fun sneaking around.
I didn't know you were a Chicago boy.
Born and raised.
Just been away a lot of years.
Must be nice, being home.
[DRAMATIC MUSIC]
Public shaming is a way
to get companies' attention
and move them to act.
It's not our lane.
We don't get involved with insurance.
I'm not sure that's the kind of impact
I'm trying to make.
Whoa, heads up, coming through!
Good job, Haley, you're doing great.
[HALEY SCREAMING IN PAIN]
You're doing great, Haley!
Baby one is almost out!
Get ready to give me everything you can,
and push as hard as you can, okay?
- What do you need from me?
- Twins, four weeks early.
Neo's on their way down, but
I need eyes on baby number two.
- Got it.
- Okay, ready?
Here it comes. Give me one big push.
- There you go! There you go!
- [SCREAMING]
Almost out! He's out!
- [BABY CRYING]
- A quick breather.
Baby two is head down on its way,
baby three right behind it.
- Baby three?
- Baby three?
No, no, no, no, twins. Not triplets.
One down, definitely two to go.
Haley, when was your last ultrasound?
Uh, I had one my first trimester,
another in my second,
and I was on my way
to see my doctor next week.
Well, you would have
gotten a big surprise.
Triplets? Twins.
Two cribs, two car seats.
I have seven brothers and sisters.
- Trust me, the more the merrier.
- [LAUGHS NERVOUSLY]
Okay, you ready for round two?
- Come on, baby.
- Yeah.
Okay, deep inhale.
Exhale!
Push!
- Coming through.
- Whoops. Sheesh.
Home sweet home, huh?
There he is.
Welcome back, Dean. We missed you.
Yeah.
I appreciate the low-key welcome.
I was a little worried people would
make a big deal about it.
What, like with a
"congrats on the new kidney" banner?
[CHUCKLES] No.
We just delivered surprise triplets.
Kind of stole your thunder.
- My lucky day.
- [CHUCKLES]
So look, the whole
kidney thing, dialysis,
and the house calls and the Sean stuff.
You were a saint,
even when I tried my hardest
to push you away, so thanks.
Wow, look at you, practicing gratitude.
- Something wrong with that?
- No, I like it.
It's just not normally your style.
Oh, really?
Mm-hmm.
That guy's
scoping you out at six o'clock.
Wyatt from pharma.
Talked a few times.
Seems like a nice guy.
Those weren't his babies
you delivered, were they?
- [CHUCKLING] Hey.
- Hey.
There he is. Welcome back, Dean.
What do we got, LJ?
High-speed motor vehicle crash.
Car hit some black ice,
skidded off the road.
Victim's Mark May, GCS 8,
and hypotensive.
Gave him a unit of
whole blood on the flight.
Okay. Here we go.
Thanks, guys. We got it from here.
Got a rail coming down.
- You want to hop on the chest?
- Yeah, you got it.
Hello, hello.
BP 102/96.
Breath sounds bilaterally.
Crockett, it's almost showtime.
- Got to make a decision.
- Thought we made it.
You host, I handle the menu.
- Oh, Lord.
- Pelvis feels loose.
- Ultrasound coming in.
- Mm-hmm.
I'm thinking barbecue now.
[SUSPENSEFUL MUSIC]
Fast looks good.
He's not bleeding into his belly.
He's bleeding from somewhere.
BP just dropped 95/60.
Hang another unit of blood
and trigger the MTP.
Jimmy, that's you.
Mike, let's get some X-rays.
- Chest and pelvis, please.
- Yep.
So, uh, 11th-hour menu change?
- Seriously now?
- It's the middle of winter.
T-bones and filets just sound
better than catfish and cod.
Clear. [MACHINE BEEPS]
Good.
Resetting for pelvis.
Clear.
Chest is good, but his pelvis is busted.
Open-book fracture,
probably bleeding into it.
All right, let's put them in a binder
to close down the pelvis until
I can get in there and pack it.
- That's still you, Jimmy.
- Yep.
Nice and easy, guys. I got his head.
Log roll on my count. One, two, three.
Easy, easy, easy.
Maggie, what do you think? Surf or turf?
Uh-uh. Don't put me
in the middle of this.
Easy on your end.
To me.
- I got his head. Go.
- You got it.
- Got it.
- Yep. Put him down.
I'll call the OR and let
them know that you're coming.
Yep.
I'm telling you.
Barbecue's the way to go.
Okay, well, we'll figure it out later.
Dr. Archer, good morning.
I'm Zola Ahmad,
your new senior resident.
I'm not stalking you.
I just wanted to introduce
myself first thing.
Yeah?
You mean before I'm caught up
on your renegade antics
of the last few weeks?
Yeah, kind of. Too late?
Yeah, too late, too late.
[SIGHS] Look, I may have
crossed a few lines
and stepped on a few toes, but
you know what? There is no but.
The renegade is out of my system.
I am no longer going to be a headache.
Well, you know what, Dr. Ahmad?
You caught me on a good day.
I'm gonna give you
the benefit of the doubt.
Tabula rasa. Clean slate.
- Mm.
- Don't dirty it up.
Look at this.
D-E-N-N-I-S. Dennis.
Okay, that's your name,
but I'm not sure where
you're going with this.
I've been Denny's, Dentist,
Ennis, everything but Dennis.
- Denny's?
- Until today.
[LAUGHS]
Maybe 'cause everyone now knows
I'm the big boss's boyfriend.
You're ridiculous.
Ah, what you meant to say is "charming."
- Mm.
- Or was it "handsome"?
Go with me here.
[NOTIFICATION CHIMES]
"Charmingly handsome."
I like that.
Sharon. What is it?
My grandson, Isaiah,
is being brought into the ED
by ambulance.
[DRAMATIC MUSIC]
[BABY CRYING]
Lungs are clear.
BP's 110/76. Heart rate's 115.
That's that's good, right?
He's he's breathing okay?
His heart's fine?
Bert, let's step to the hallway.
Give the doctor some space to work.
- It happened so fast.
- Yes, yes.
Well, we're gonna straighten it all out.
Bert, what happened? [BABY CRYING]
I fell on Isaiah.
♪
[EKG BEEPING STEADILY]
He fell asleep.
Does that mean he's okay,
or did he just cry himself
into exhaustion?
Shh. I don't know, honey.
Let's wait and see what the tests say.
Dr. Ripley has ordered a skeleton survey
to check for fractures
and a rapid MRI
in case of a head injury.
[APPREHENSIVE MUSIC]
And Dad just fell on him?
They were playing.
Your father's legs got tangled up.
He couldn't really explain the details.
How is he? Dad?
Dr. Ripley is examining him now.
Hey.
Yeah.
It's okay. It's okay, baby.
Mama's here.
It's okay.
[WHISPERING] This is
the bravest face I've got.
[BREATH CATCHES]
♪
Yeah, I saw you
checking me out just now.
Earlier this morning too.
Hmm. Yeah, I think that was
you checking me out.
Huh.
Not the first time, I might add.
I guess we should
get dinner tonight then.
Right? Settle the whole
who's-been-checking-out-who
once and for all? Hmm?
Yeah, that sounds fun.
I'll, um, give you my number.
Until later then.
Mm-hmm.
What was all that?
Wyatt just asked me out.
Wow, face-to-face.
That's confident. Boyfriend material.
Mm.
- Or boy toy.
- Easy.
Let's not get carried away.
I don't know.
There's research that
shows your brain knows
the kind of relationship it wants
as soon as you meet someone.
So what do we think of the new resident?
- Who? Zola?
- Yeah.
I like her. She's fun.
You're not a fan?
Cautious optimism, emphasis on cautious.
Mm. Shocker.
You didn't warm up to me
for a few months,
but look at us now.
- Bosom buddies.
- What's good, guys?
- Hey.
- Sean.
I thought you weren't supposed
to be at the valet stand
until next week.
Well, that was the plan
until this morning.
I came in to turn in my uniform.
What happened?
I got a new gig.
Recovery coach at a rehab center.
- Oh.
- Wow.
Way to go. Proud of you, son.
- Congratulations.
- Thanks. Thanks, Dad.
It's been a long road,
but it's all beginning
to fall into place.
All right, well,
I'm gonna go give notice.
[SOFT MUSIC]
- How about that?
- [SIGHS]
No evidence he hit his head
or lost consciousness,
but his left knee is swollen and loose.
X-ray's negative. It's not a fracture.
- A ligament injury?
- That's my guess.
Ordered an MRI, techs will
be by in a bit to take him.
All right. Thank you, Dr. Ripley.
Of course.
[APPREHENSIVE MUSIC]
How's Isaiah?
Well, he's getting X-rays
and a rapid MRI.
Tara's with him.
The doctor said two-year-olds
fall all the time,
that they're built
for bumps and bruises.
But I fell on him, Sharon.
It's not the same thing.
It was an accident, Bert.
Doesn't change where we are right now.
Any vomiting, Floyd? Diarrhea?
No, but I'm bloated
morning, noon, and night.
Nauseous most of the time too.
- Appetite?
- Zero.
I know it don't look like it,
but this spare tire's lost
a lot of tread.
[CHUCKLING]
How would you describe
this pain in your abdomen?
Dull, sharp?
Um, mushy?
Is that a thing?
In here, we call
it "diffuse tenderness,"
but I like your way much better.
So this mush, when did it start?
Uh, best recollection,
two, three weeks ago.
It was after visiting Memphis
but before rolling into St. Louis.
Oh, you're on the road.
Where are you headed?
Eh, don't know. I'm wandering.
[BOTH CHUCKLE]
Uh, I lost my job a few months ago,
and I'm just using my severance
to zigzag the US of A.
Where'd you get this scar, Floyd?
- Prior surgery?
- A week after I was born.
It's been so long, I can barely
remember what it's called.
A misrotation?
Malrotation.
Bingo, that's it.
Yeah, came out my mama with
my insides all over the place.
Doctors had to put it back
in the right spot.
You think that's why
my gut's a mess now?
I don't think so,
but I also don't have any theories,
so I wanna run some tests
and go from there.
CBC, CMP, LFTs, and a KUB.
Yes, Doctor.
Uh, that's a lot of initials.
And hospitals like to charge
by the letter.
Well, we'll get an estimate on the cost
and see how much
your insurance will approve.
I'm already in my pocket
just visiting the ED.
If insurance ain't gonna pony up
for the rest of the tab,
I'm just gonna have to keep
grinning and bearing it.
Well, you came here for help, Floyd.
That's what you're gonna get.
Thank you, Doctor.
Dr. Archer, incoming,
going to treatment six.
Jordan Moore III, 32,
got lightheaded and fell down a
flight of stairs at his office.
Initial GCS 13, now 15.
Witness said he was out
about 30 seconds.
Been lethargic since we got here.
All right. On my count. Ready?
And one, two, three.
All right, got him.
- Take it easy with this guy.
- All right, Jordan.
I'm Dr. Archer. This is Nurse Doris.
Do you know where you are?
[SOFTLY] Oh, man, I'm going.
All right. I'll take that as a no.
[TENSE MUSIC]
All right.
Lungs are clear.
Okay, Jordan, you are
in the ED, Chicago Med.
You fell down some stairs, buddy.
My dad. My dad.
We'll call him, hon.
- Okay, belly's good.
Let's take a look at that arm.
Mm-hmm.
Jordan, I'm gonna open your shirt, okay?
Well, damn.
Anterior dislocation
of the left shoulder,
CBC, CMP, cardiac labs.
Mike, give me the iPad.
Give me a 12-lead EKG and a panscan.
All right, Jordan, we are
gonna start doing some
What's happening to me now?
Please help. I don't wanna die.
All right, all right, all right.
♪
Dr. Ahmad.
Floyd's HMO isn't gonna cover
the labs that you ordered,
so he's passing on the tests.
[SCOFFS] I expected as much.
I've never been pleasantly surprised
by an insurance company.
Me neither, which is why I reached out
to his primary care physician
to get him seen there.
Oh, good call.
His HMO should cover that 100%.
Yeah, but unfortunately,
his PCP's in Kentucky,
and their next available isn't
until the first of the month.
Insurance companies the only
thing that they're good at
- is getting in the way.
- Amen.
But we have to work with them.
Do we, though?
Three weekends now, I've traded
drunk underage college kids
who have registered under fake IDs,
made-up names, made-up addresses.
Admin sends the bills. What happens?
It bounces back,
and the hospital eats the cost.
Exactly.
So what if we register Floyd
under self-pay
with a different name and a different
- no.
- No.
- We can't do that.
- Uh-uh.
- What am I saying?
- It's fraud.
It's called fraud.
I know. Yeah, I know.
Can you just forget I said that?
Mm-hmm. Sure.
It just sucks that
all we can do for Floyd
is make him an appointment with his PCP.
All right.
I'll sign off on his discharge.
Hold on. Let me think on it for a bit.
Maybe there's
something more that we can do
that won't cost Floyd a small fortune.
Yeah, sure.
[SOFT DRAMATIC MUSIC]
Jordan.
I'm Dr. Archer.
Yeah, I, um
I remember.
Well, vaguely.
Thanks for bringing me back.
I thought that was the big one.
No, no, no. Your heart's fine.
Your cardiac tests were normal.
Your troponins were a bit elevated,
so your heart was under some stress,
but nowhere near the level
of a heart attack.
Yeah. Yeah, this time.
Next time, though.
Men in my family just drop dead
out of the blue.
Both my father and his father
died of heart attacks when they
were the same age I am now.
- No warning at all.
- Well, I'm sorry to hear that.
I certainly can understand your concern.
But I assure you,
it was no heart attack.
Then why'd I collapse?
It's most likely from
a transient abnormal heart rhythm.
It's not uncommon.
They're often harmless. They're blips.
No.
This wasn't a blip.
I know what I felt.
It's the family curse,
and now it's my turn.
Damn it.
[EKG BEEPING]
I eat right. I don't smoke.
I don't drink. I exercise like a maniac!
[EKG BEEPING QUICKER]
I see a GP, a cardiologist!
I am on top of my health,
and yet here I am!
Okay, okay, okay. Breathe.
Breathe, Jordan. Come on, breathe.
[BREATHING HEAVILY]
Hearts don't just skip a beat
at random in my family.
All right? They give out.
Well, on occasion,
and I'm not saying this is you,
but sometimes transient abnormal rhythms
are caused by cardiac miswiring.
Yeah, so I can repeat the EKG
and get an echo,
and we can go from there.
I'll try anything.
I just want answers.
I'm terrified.
All right. All right.
[SOFT SUSPENSEFUL MUSIC]
♪
- Hey, Marcel.
- Hey.
Hey, I'll see you guys tomorrow.
How'd surgery go for our MVC?
Smooth sailing.
Packed his pelvis, got the bleeding
under control, embolized in angio.
Ortho has to go back in
to reduce and fixate
the pelvis, but a couple
of months, some rehab,
he'll be good to go.
Oh, that's great.
And knowing that he's on the
mend means we can settle up.
Barbecue versus Cajun fish fry.
- Cajun fish feast.
- [CHUCKLES]
I'm not an amateur.
And I'm not just a helicopter pilot.
- Grill master extraordinaire.
- If you do say so yourself.
- So we dug in here?
- Yep. How you wanna handle it?
- Best of three?
- Uh, no.
- No, one and done.
- Let's go.
Rock paper, scissors, shoot.
[GROANS SOFTLY] And barbecue it is.
Lucky break.
Oh, please, dude, I'm a surgeon too.
I know the first instinct
is to throw scissors.
Oh, hey, Maggie, you got a sec?
Only if you walk with me.
Look, I just received
my general surgery credentials
here at Med.
Mm-hmm.
Also applied for my trauma
surgery fellowship in July.
- Nice. Good luck.
- Thanks.
You know, in the meantime,
I'll be around the ED more often,
so if I can ever help out, hit me up.
Will do. Are you flying anywhere today?
No, shift just ended.
Treatment 7.
Scrubs are in the locker room.
Welcome to the team, Dr. Johnson.
Okay, no problem.
And that's scheduled for tomorrow.
Ah, great. Caught you.
All of Isaiah's tests were negative.
No fractures, no head injury.
Then he's not hurt?
- He's fine.
- Oh, thank goodness.
[LAUGHS]
[SOFT MUSIC]
Whew. [CHUCKLES]
[SIGHS]
Excuse me, Ms. Goodwin.
Dr. Washington. Thank you.
♪
So, ladies, Wyatt just texted me.
- Oh, no.
- Mm-mm.
Uh, that's, uh
- yeah, that's his
- Oh!
- Penis?
- Yeah.
Yeah, no, I was expecting
"Made reservations for 7:00."
Instead, bam, full frontal.
Mm-mm.
- Your first D-pic?
- Uh, yeah.
- [CHUCKLES]
- Yeah.
Why, you've gotten one before?
- One? I'm to at least five.
- Oh, I've got
What? Okay.
Well, then, so, what was he thinking?
He sends this to me
and I'll just start swooning?
I think some men are still cavemen.
Is that portrait mode?
Hmm.
[SOFT SUSPENSEFUL MUSIC]
Ooh. You see that?
Underneath the shaft,
next to the frenulum?
Some kind of lesion?
Syphilis?
It's hard to tell. It could be.
Disease is on the rise because
of penicillin shortages.
- [GROANS]
- Flashing his junk like that?
Gotta assume that he's sexually active.
Means he could be spreading it.
Oh, he's gotta get checked out.
Yeah.
That means that I actually
have to respond to this
and get him to take it seriously.
What what do I type?
Just keep it clinical.
I don't know.
I think you have to speak his language,
make sure that
he really gets the message.
- May I?
- Mm, yeah.
Unfortunately, I'm fluent in alpha male.
♪
"Nice pic."
[LAUGHS]
"Meet me in the ED. I want"
"I want to see that thing in person."
Oh. Good luck with that.
[SPUTTERS]
Hi. Dropping off from Odyssey Labs.
Odyssey?
You sure you're in the right place?
Doris, I got it. Thank you very much.
Are you looking for me, Maggie Lockwood?
Yes.
- Where do I sign?
- Right here.
Thank you.
Now, please get out of here quickly.
Floyd's now got a low-grade fever.
Says that his bloating
and nausea has gotten worse,
and there are no tests
this hospital can run
anywhere near his price range.
That's okay.
I took care of his blood work.
Lab results? How did you get these?
I outsourced Floyd's tests
to the lab contracted
to his insurance company.
Everything's covered by his
HMO and nothing out of pocket,
leaving Med out of the loop. Shady!
But no fraud or lying.
So?
His EOS is a little high.
That's it? Elevated EOS?
That could be from anything.
Simple allergy all the way to cancer.
And the only way to
narrow it down is more tests.
A CT to start.
We're right back where we started.
♪
I just I can't let him
just walk out of here.
I need to make this right somehow.
Yeah.
- [MACHINES BEEPING RAPIDLY]
- [GROANING] You see something?
- Oh, it's bad, isn't it?
- No.
Try and keep still, Jordan.
[GROANING] Oh, God!
[MACHINE BEEPING RAPIDLY]
Oh, this is it.
Oh, this is it.
- My chest is getting tight.
- All right, come on, Jordan.
Just deep breaths.
Deep breaths, come on.
I can't breathe!
I can't breathe!
Two of Versed.
All right, we're gonna give
you something to calm you down.
In the meantime, I want you to
breathe with me, Jordan, okay?
Four seconds in, come on.
- [INHALES RAGGEDLY]
- Okay, four seconds out.
[EXHALING]
- [ALARM BEEPING]
- Jordan? Ah, he's coding.
- Damn it, no pulse.
- Need a hand?
All right, yeah. Bag him, okay?
Crash cart! Yeah, yeah, a V-fib.
Start compressions.
All right, charge to 200.
[TENSE MUSIC]
All right, clear.
Still no pulse.
All right, again. 200. Milligram of epi.
Clear.
No.
All right, again. 200. Milligram of epi.
Clear.
Pulse is back. ROSC.
All right, let's replay.
♪
Ultrasound's a little fuzzy.
He was clearly moving around a lot.
But overall, heart looks good.
Yeah, wall motion is normal.
Then why the arrest?
[SIGHS] I'm wondering that myself.
He still tachycardic?
Yeah, heart rate's in the 130s.
Given it just hit 190, I'll take it.
Hey, I was thinking, uh,
your patient going from
panic attack to full arrest
in the blink of an eye could mean
there's a heart signaling
or conduction issue.
Yeah, those are at the top of my list.
I'll run some more tests.
Uh, appreciate the help.
Yeah.
Dr. Archer?
CT's waiting for you on line three.
Got Floyd's CT.
[SOFTLY] Wait, how?
Tech ran it off book. We cut a deal.
What kind of a deal?
The kind that gets things
done without red tape.
No fraud, no lying, promise.
Come on, fire it up.
Calcification and inflammation
on the abdominal wall.
Seriously, nothing else?
A normal scan is a good thing.
Yeah, of course.
But just doesn't explain any
of his symptoms is all.
We've been sneaking around all day,
and we haven't gotten anywhere.
Well
All right, uh, I just
got a call from radiology.
Seems a CT tech
didn't close down his window
when his shift ended,
and he left up images of a patient
who's not listed on the log.
You can't go to C
without bloodwork first,
and yet, not one test
run through our lab
Well, actually, that was me.
Oh, that's wonderful.
So what she has is catching?
Dr. Archer, I can explain.
My patient, Floyd,
he's got a really crappy HMO.
His preventative care was
literally preventing his care.
I've seen that movie before.
It doesn't have a happy ending.
Yeah, well, at this rate,
neither does your career.
You've already
flamed out of two hospitals,
and you're doing your best
to flame out of a third.
I hear you. I overstepped.
Okay, and we get it.
We won't dig the hole any deeper, okay?
[SOFT TENSE MUSIC]
- Archer.
- [SIGHS]
What was that about?
What was that about? Uh
it was about Dr. Ahmad trying
to make a good first impression.
You know, I missed everything
about this place
during my recovery
except idiot residents.
And there he goes.
Goodbye, Dr. Gratitude.
All right, can we get somebody
to take this thing down, please?
I know you're still
feeling crummy, Floyd.
But all your test results were negative,
so it makes me think
you're just fighting a bug
you picked up on the road.
Gonna just let it run its course then.
I wish I could have been more help.
Oh, you tried.
Confirmation with
your primary care physician.
What's another three weeks, right?
[CHUCKLES] Thanks, Doctor.
Dr. Archer looking for me?
[CHUCKLES] No.
I think he's going out of his way
to avoid both of us for now.
[CHUCKLES]
Sorry about today.
I shouldn't have led off
by using an outside lab
for Floyd's bloodwork.
I set a bad precedent.
It was inspiring,
but I made my own choices.
[NOTEPAD TAPPING]
Mind If I pry?
Oh, you're wondering why, aren't you?
I'm actually wondering who.
From the start, you were willing to
commit insurance fraud for Floyd.
A leap like that makes me think
treating him was really
about someone else.
Shirleen Watkins.
Hmm. Is she a relative?
Not blood, but definitely family.
I was a surprise baby.
The next closest sibling
to me was nine years older.
I was in grade school. They were adults.
My parents were great,
but they were just old.
You know, almost 60
and working full-time.
I was alone a lot.
Shirleen was our neighbor.
She was 24, super cool.
[SOFT DRAMATIC MUSIC]
But my junior year of high school,
- she came down with something.
- Mm.
We thought it was just a cold.
I was already interested in medicine,
so I told her to see a doctor.
She had just started a new job.
Insurance hadn't kicked in,
so she put it off.
By the time her insurance was active,
the runaround was so ridiculous.
Weeks were wasted before
she was able to make an appointment,
- and by then, it was too late.
- What was it?
Lung cancer.
Oh.
She died six weeks later.
If not for the insurance BS,
then maybe she'd still be around.
I'm sorry, Zola.
I was 16.
It still burns.
[SOMBER MUSIC]
♪
- [BABY WHIMPERING]
- Oh, careful.
We don't want anybody else
to get any more X-rays today.
Oh, but the tickle monster
has been unleashed,
and he loves little boys named Michael!
That's Isaiah, Dad.
Knock, knock. Hope I'm not interrupting.
Hey, Isaiah. How you doing, buddy?
[CHUCKLES]
Uh, so Bert, your MRI
shows a tear in your ACL.
We got two options for you
rest and rehab,
or surgery to reconstruct it.
But you can't do that
until the swelling goes down,
so you don't have a decision
to make now.
Okay. Thanks, Doc.
Meantime, ortho will be down in a few
to fit you with a knee immobilizer,
just to give you some added stability.
Immobilizer? Is it big?
- I need to be able to drive.
- [STAMMERS]
It's bulky,
but it's your left leg, Bert.
You use your right with the pedals.
You'll be able to drive.
Oh, yeah. My right leg. [CHUCKLES]
[CHUCKLING] Your father, without fail,
left is right, push is pull.
Thank goodness we have revolving doors.
Well, I got to imagine you had enough
of the ED for one day.
I'll get the discharge paperwork going.
Nice meeting you all.
See you later, buddy. [BERT CHUCKLES]
- Thank you, Dr. Ripley.
- Yeah.
Now, now, where were we?
Oh, yes, I remember, tickle monster!
[LAUGHS]
Psst. [TAPS TABLE]
Well, here I am.
All of me.
[WHISPERS] This way.
Oh.
I can't believe it.
I get to play doctor with a real doctor.
Oh, not so fast.
The doctor will be with you in a moment.
What?
All right.
Hi.
I'm Dr. Ripley.
I hear you have a lesion on your penis.
[TENSE MUSIC]
Floyd!
[FLOYD RETCHING]
Here you go.
He went for deep dish pizza
right after being discharged.
Shortly after, he started
vomiting and couldn't stop.
Fever jumped to 102.
Abdominal pains also got worse.
Oh, it hurts so bad right here,
and the pain started jumping up
to my shoulder.
[GROANS] Don't press so hard!
Sorry, Floyd. I gotta get a good look.
His gallbladder is inflamed
with pericystic fluid.
With the fever, it could
be acute cholecystitis.
- It needs to come out.
- I'll call surgery. Brandon!
No. Page Crockett.
Likely have to be open because
of his malrotation scarring
- from when he was a baby.
- All right.
You got it, Doctor.
- I can't afford an operation.
- It's an emergency now, Floyd.
Everything's covered by your HMO.
So your father's gonna be out
of commission
for a while with his knee.
I know some nurses who might
want a part-time nanny.
Oh, that's okay. I actually started
putting feelers out last week.
Really?
I think that Isaiah is
getting to be too much for Dad.
Last few weeks, he's been off.
He's forgetting things
and misplacing stuff.
The last few weeks? Or forever?
I know he's quirky,
but it's getting worse.
He keeps repeating himself too.
Tara, your father has
always been a broken record.
I mean, how many times has
he told the story
about meeting Michael Jordan in the DMV?
So you think it's just Dad being Dad?
If the shoe fits.
[PENSIVE MUSIC]
You keep me in the loop
with that knee, okay?
You got it.
♪
Love you.
Everything's fine.
Okay.
Is it syphilis?
No, actinic keratosis.
Oh, thank God.
Wait, is that still an STI?
No, it's a patch of rough scaly skin
caused by UV exposure.
Based on the pic you sent me,
pretty clear you like
to bask in the sun.
Yeah, I guess
I should have worn sunscreen.
Should have left it in your pants.
Well, then we wouldn't have
this great origin story
about how we met.
For real, you think that
we're gonna still date?
Yeah, it's a clean bill of health.
Something to celebrate.
Hard pass.
I can't speak for all women,
but for me, getting blasted
with a closeup of your business
is a giant red flag.
- Oh.
- Bye, Wyatt.
Prepare for takeoff.
Seeing big brother and going in!
[MAKING BLASTING SOUNDS] [KIDS GIGGLING]
[IMITATING AIRCRAFT NOISES]
Difficulty in the air! Oh, no!
He's coming down for a crash landing!
[CHILD LAUGHING]
[IMITATING AIRCRAFT NOISES]
So I didn't have a heart attack.
I went into cardiac arrest.
- And they're different?
- Yes.
So a heart attack is when blood
flow to the heart is blocked
and is starved of oxygen.
Cardiac arrest is when the
heart suddenly stops beating.
Your arrest was caused by
a rare type of arrhythmia called CPVT,
catecholaminergic polymorphic
ventricular tachycardia.
Heart starts beating so fast,
it essentially shorts out.
It's genetic.
- It's genetic?
- Yeah.
So that means my father
and grandfather had it too.
It's very likely.
It would have been easily
missed in your grandfather.
That era was the dark ages
for cardiac care.
So an autopsy, would have
looked like a heart attack.
As far as your father is concerned,
your family history now established
So the family curse
is a strain of bad DNA
getting passed down?
Well, stress exacerbates the condition,
and there's no shortage
of things to stress about
when you're in your 30s, right?
So it stands to reason
that CPVT presented itself
to you, your father,
and your grandfather
around the same age.
Is there a cure?
No, but it can be controlled
with beta blockers
and an internal defibrillator.
[SOFT MUSIC]
How long have internal
defibrillators been around?
Almost 45 years.
[CHUCKLES]
So if the doctors
would have figured this out,
my father could have had one.
And probably my grandfather.
Dr. Archer, if you hadn't
cared enough to keep digging,
I'm pretty sure I wouldn't have
been around much longer.
I'm very grateful.
♪
Should have been thinking
gallbladder from the start,
especially when Floyd said that
he dropped a bunch of weight.
There was no vomiting,
pain was limited, no jaundice.
Plus, the CT didn't see any gallstones.
Hey, hindsight's 20/20.
We're getting Floyd fixed up.
That's all that matters.
Well, if it's my last case at Med,
at least I'll be leaving on a high note.
Hey, Dean's no choirboy.
And he's definitely
not a fan of bureaucracy.
He gets it.
So you think all's well that ends well?
I won't get fired?
Whatever happens, you're a good doctor.
Appreciate that.
Gallbladder coming out.
[EKG BEEPING STEADILY]
Lat.
[TENSE MUSIC]
Abdominal wall feels really inflamed.
Yeah, I saw that on CT,
a lot of calcification.
No, I don't think that's the case.
Feels like something else.
Stomach is adhered to
the abdominal wall.
Scissors?
Thank you.
♪
Ooh.
What are you seeing?
Not sure. Hemostat.
Ooh.
It looks like some kind of bristle.
Oh, my God, I think
I know where that came from.
♪
Nice going, distracting
that boy so he could get an IV.
The brother was a lot heavier
than you thought, though, huh?
Like an anvil.
I might have to learn some magic tricks.
Easier on the upper body.
It's good thinking.
Check this out.
I have no clue what
I'm looking at here, man.
Oh, well, that is a
nylon bristle I just fished out
of the abdominal wall
of Zola and Maggie's patient,
Floyd, just like
the kind on barbecue brushes.
Oh, man, Floyd was
in Memphis a few weeks ago.
Shortly thereafter is when
his pain set in.
- A lot of barbecue in that town.
- Oh, yeah.
The bristle could have
fallen from a brush,
ended up in the meat,
and eroded through his stomach,
and migrated to his abdominal wall.
Sounds about right.
Magic bristle theory? Really?
Oh, it's not as farfetched
as you would think.
Zola found a bunch of documented cases.
One patient even died.
They found a bristle during autopsy.
Okay. Guess we're hosting a fish fry.
- Feast, Johnson.
- Feast.
- Feast.
- When is the shindig?
Saturday.
What, are you coming?
I don't know. I was thinking about it.
[PENSIVE MUSIC]
Okay.
What's up? Why wouldn't Maggie be there?
She's going through a divorce.
♪
I heard everything went well in the OR.
Your patient take a turn?
Nope.
Just hiding out, I guess.
Hmm.
The CT scan.
What'd you trade with the tech
to get him to run it?
My Ventra card.
His commute's on me for a while.
ICU lounge, 20 minutes.
♪
I wish I could have seen Wyatt's face
- when Mitch walked in.
- Oh, this is fascinating.
I just clicked a link to an article
detailing how there's
still Neanderthal DNA
floating around the population.
Variants are associated
with a variety of traits:
neurological, immunological,
and get this
dermatological,
where they've been linked
to the development
of sun-induced keratosis.
Shut up.
- [LAUGHING] So Zola was right.
- Oh, my God.
Some guys really are still cavemen.
That's hilarious.
And utterly depressing,
because now there's actual science
that states that dating is not for me.
Well, I bet the numbers are
still on your side, though.
Yeah, Google estimates
40,000 single men in Chicago
in your demographic.
So you've gotta click
with at least one of them.
Mm?
Yeah.
Maybe.
♪
Get back to you.
- Hey.
- Hey, nice surprise.
So how was your grandson
and the ex-husband?
Oh, they're both fine.
Catastrophe averted.
And I'm sorry about that
deer-in-the-headlights stare
I gave you this afternoon.
It was just so much happening.
I didn't have the bandwidth
for worlds colliding.
Of course not.
It wasn't the time or the place.
And I'm the one who
should be apologizing.
Even though it's not
a shortcut to anywhere,
I sometimes cut through the ED
hoping to run into you.
And today, it was because
I wanted to be supportive,
but I really didn't know how.
You see, it's that kind of honesty
that's gonna really
make me fall for you.
I'm done for the day.
You wanna grab dinner?
[SIGHS] Wish I could.
I still got a few things
I gotta finish up with.
- Okay.
- But we still on for Friday?
- Oh, I can't wait.
- Aw.
- [CHUCKLES]
- Mwah.
[CHUCKLES]
- See you.
- All right.
[LAUGHS]
Dr. Archer, I am so sorry
I know, I know. Yes, you're sorry.
You're sorry.
All right, you got caught up
in the moment.
It'll never happen again.
We're way past apologies, Dr. Ahmad.
[SOFT DRAMATIC MUSIC]
♪
Primer for you for class.
- Class?
- Mm-hmm.
Medical ethics course.
Eight hours every weekend for ten weeks.
I signed you up. You start Saturday.
If I were you, I'd take notes.
So I'm not fired?
Not today.
That's something to be grateful for.
♪
Ma!
Tara, what are you doing here?
- Where is Isaiah?
- Michael's watching him.
I need to show you something now.
I know you said
everything's fine with Dad,
but I was looking through
footage on the nanny cam
in Isaiah's room, and I saw this.
Take a look.
He goes to leave the room,
but he opens the closet door.
And he's just standing there.
He doesn't know where he is.
[SOMBER MUSIC]
♪
Something's wrong with Dad.
Damn.
♪