Chicago Med (2015) s09e05 Episode Script
I Make A Promise, I Will Never Leave You
1
Ben and I are getting a divorce.
I really just wanna move on.
I'll be around the ED more
often if I can ever help out.
Are you flying anywhere today?
- No, shift just ended.
- Treatment seven.
Welcome to the team, Dr. Johnson.
Something's wrong with Dad.
He's forgetting things.
It's getting worse.
He doesn't know where he is.
Damn.
You've already flamed
out of two hospitals,
and you're doing your best
to flame out of a third?
So I'm not fired?
Medical ethics course.
If I were you, I'd take notes.
[DRAMATIC MUSIC]
Wow.
How does that make you feel?
I'm not sure.
It is what it is.
- Good morning, Peter.
- Morning, Maggie. Dr. Ahmad.
Do we have a notary in house?
I have some papers to sign.
Yeah, Edward.
I'll send him down
at the end of the day.
You need some help?
- Are you a doctor?
- I am. What happened?
I don't know. I've never
seen this man before.
He was wandering a
couple blocks from here.
He kept saying, "Help Betty."
He's really cold.
Okay, let's get him inside.
Betty.
[APPREHENSIVE MUSIC]
Dr. Sorensen.
No, I'm Dr. Ripley.
Nancy, he's hypothermic.
I need blankets and warm IV bags.
On it. You're going to five.
Okay.
Help Betty.
Betty?
Hey, Daniel.
- Morning.
- Good morning.
When was the last time you saw Bert?
Not for a while.
I mean, come to think of it,
I did call him a couple weeks ago,
and he was in a hurry.
Said he'd call me back, and
I'm now realizing he never did.
Yeah, and is that
something you've noticed
- his memory?
- Not really.
I mean, that could happen to any of us.
I mean, I do that stuff all the time.
Why? Are you worried about him?
I don't know, but Tara is.
And he was here.
He fell when he was watching Isaiah.
He fell?
Yeah, nothing serious,
but he did twist his knee.
He just seemed a little confused,
and I wouldn't be concerned,
but Bert does have a
family history of dementia.
We should probably have him checked out.
To get Bert to see a doctor
for anything is an ordeal.
- You know that.
- Right, tell me about it.
But he's coming here today
for a follow-up on his knee.
Oh, well, why don't I just, you know,
spontaneously stop
by, have a little chat?
That would be great.
Thank you.
[KNOCKING ON DOOR]
Hi, Alex.
- Hi.
- I'm Dr. Ahmad.
Emily. My husband, Mark.
So I see that your heart rate is fast.
I don't feel it.
But his watch says it's at 140.
It's probably nothing, but
that's why we brought him in.
Well, your watch isn't lying, 140.
Rest of your vitals are good.
Is there anything bothering you?
No, I feel fine.
Normally, he eats like a horse,
but the last couple of days,
he's hardly had anything.
I just wasn't hungry.
[MACHINE BEEPING QUICKLY]
Lungs sound good.
Lymph nodes aren't swollen.
Any tenderness?
Mm-mm.
What about here?
[WINCES]
Yeah, a little bit.
What does that mean?
I'm not sure, but I'd like
to order a CT to find out.
♪
- Okay.
- I'll put the order in.
I'll be back to check on you soon.
- Thank you.
- Yeah.
Thank you.
- Loren?
- Maggie.
Kaitlin Neeley, 28, septic shock.
Leukocytosis and hypotensive.
BP 80/43, temp 103.5.
She was pregnant.
Water broke at 15 weeks pre-viability.
That was two weeks ago.
It's not there. It's not there.
No, don't say it.
- No, no.
- Honey, everything's okay.
We're at the hospital.
They're gonna take care of you.
They were driving here, but she
got so sick, they had to pull over.
Rural clinic didn't have the
capabilities to care for her,
- so they called me.
- Okay.
Can I help?
No, unfortunately, this is OB.
- Hannah.
- Yeah.
Kaitlin Neeley, 15 weeks, water broke.
White blood count is high.
This is her husband, Eric.
All right, Maggie, start a second IV.
- You got it, Doc.
- Did they perform a D&E?
No, the doctor said they had to wait
for her to pass the remains on her own.
Okay, CBC, CMP, lactate,
and blood cultures.
- [SCREAMING]
- Oh, honey!
Honey!
I need to start your wife
on antibiotics immediately.
Do you know if she's allergic to any?
- She isn't.
- Okay.
Triple up ampicillin,
clindamycin, gentamicin.
Copy that.
Your wife is very sick,
but we're gonna take good care of her.
[DRAMATIC MUSIC]
♪
She's been carrying fetal
remains for two weeks.
Oh, my God. And she couldn't get a D&E?
No, her doctor wouldn't do it.
Why?
How's our patient?
Better.
Temp's come up to 95.
How is his cognition?
Sir.
Can you tell us your name?
Jimmy.
Did you hurt yourself?
- Maybe hit your head?
- No.
Betty.
Who's Betty?
My sister.
No ID, but he had this
Post-it in his pocket.
It's a telephone number.
What happened to Betty? Where is she?
Home. She got sick.
Get Dr. Sorensen.
Is is that her doctor or your doctor?
Dr. Sorensen.
Does he work at this hospital?
- Yes, here.
- Okay.
Okay, see if you can
find this Dr. Sorensen
and try that number.
[SUSPENSEFUL MUSIC]
[SIGHS]
We're gonna take good
care of you, Jimmy.
Okay?
Oh, thank you.
♪
Dr. Charles?
I've got an elderly patient,
severely hypothermic.
No visible injuries, um,
but he's pretty out of it.
No ID other than a phone number.
I'm thinking he's got
dementia or maybe wandered away
- from a care facility.
- Oh.
You wanna give me your take?
Sure.
His name's Jimmy.
Shoot me his chart.
Give me a couple minutes.
Yeah.
Hi, Alex. Mr. and Mrs. Foster.
This is Dr. Marcel.
He's one of our surgeons.
I've asked him to consult.
Surgeon? Why?
Well, Radiology said that
Alex's CT was equivocal,
meaning it was inconclusive.
But what it did show is
a possible appendicitis.
And from my experience, with
Alex's elevated heart rate
and loss of appetite,
I believe that is, indeed, the case.
So I'd like to operate.
Wait, so you're not
sure it's appendicitis?
No.
Why do I have to have an operation?
Because if it is appendicitis
and your appendix bursts,
that would put you at risk
of an infection in the belly,
and that could be life-threatening.
Oh.
But we can avoid that
with a minimally invasive
laparoscopic surgery done with a camera
through several small incisions
what we call a Band-Aid surgery.
I agree with Dr. Marcel.
A laparoscopic appendectomy
is the best course of action.
Most likely, he'd be
done in half an hour.
Mom? Dad?
Yeah, okay.
Okay.
- All right.
- Thank you.
I'll see you after.
- All right.
- Thank you.
Thank you.
- You okay?
- It'll be fine. Mm-hmm.
Is she doing any better?
About the same.
You know, I don't have
any more flights today,
so I think I'll stick
around, if you don't mind.
Mm.
Maybe I can give Eric
some moral support.
That's a good idea.
Are you gonna do that operation?
I recommend we try to
induce instead of a D&E.
Surgery can be much
riskier if she's septic.
Tell me what happened.
Kaitlin's water broke.
Everybody said the fetus
couldn't survive at 15 weeks,
but it was still alive,
so doctors were afraid to do the D&E.
She didn't wanna get arrested.
[APPREHENSIVE MUSIC]
Where we live, that could happen.
They sent us home.
Kaitlin got sicker and sicker.
And I kept calling,
and they kept telling me
it wasn't a life-threatening emergency.
Finally, I just gave up
and started driving here.
Kaitlin's from Chicago.
When we got married, we
moved to my family's farm,
where I grew up.
We were so excited when
Kaitlin finally got pregnant.
She's been so worried she's
not gonna be able to again.
Eric, I'm gonna do the best that I can.
But I don't know.
I don't know.
♪
Okay, staple line looks good.
No bleeding.
[TENSE MUSIC]
Nice and easy.
Appendix is in the bag.
Gently wiggle the bag circularly,
and then pull it up and out.
Hold on.
This feels unusual.
Go ahead and send that for a
stat frozen section, please.
♪
Definitely some cognitive impairment,
though I'm not quite sure why.
Tox screen's negative,
no sign of head trauma.
The childlike affect, it's
not what you normally see
with Alzheimer's or vascular dementia,
though you can't rule it out.
I'm thinking some kind
of intellectual deficit.
So I'm thinking we should get a head CT.
Definitely.
We have no more information on the guy?
You reach out to CPD?
Yeah, there's no missing persons
matching his description, and
no one's come looking for him.
He can't stop talking about
his sister, Betty, right,
how he is just very concerned about her.
She's sick. She needs our help.
Yeah, but given his mental state,
is that even a real person?
You know, maybe it's
someone from his childhood
- or a show he saw on TV.
- Yeah.
I tried the number he had again
still no answer.
- I left another message.
- Okay.
Let's say that is actually
Betty's number, right?
Maybe she's not answering
because she can't
because she is, in fact, incapacitated.
How about we ask CPD
to run a reverse trace?
That way, at least,
we'll get an address.
Okay.
[SUSPENSEFUL MUSIC]
[ALARM BEEPS] [DEVICE CHIRPS]
Dr. Archer, incoming.
You're going to trauma four.
Damon Adams, 28,
shortness of breath, diaphoretic.
BP 130/90, heart rate 125. Sats 89.
- Need help.
- It's right there.
Sean.
He lives at the center where I work.
I've been counseling him.
All right, wait here.
All right, on my count. Ready?
We good? One, two, three.
[GRUNTS]
All right, Damon, I'm Dr. Archer.
What's going on?
- Real sick.
- Yeah?
When did this start?
- A couple days ago.
- [COUGHING]
- I can't catch my breath.
- Well, we can help you.
Come on, let's get him up here.
Lift him up. Start him on 100% O2.
AP chest stat.
I need a CBC, BNP, and an ABG.
♪
- X-ray.
- Clear.
Pulmonary edema.
Fluid in the lungs.
Call Cardiology for a stat echo.
Yeah, got it.
Okay.
Better?
You okay if I share
some things with Sean?
All right, I'll check back soon.
So [SIGHS]
Your friend's in pretty bad shape.
Pulmonary edema suggests
that he's in heart failure.
We shouldn't be seeing
that in somebody so young.
Oh, man.
You say that he's living
at the rehab center.
- Is he an addict?
- Recovering,
but I'm pretty sure he's
clean. We talk a lot.
He's really been working the program.
It's possible whatever's going on
with his heart might
have something to do
with IV drug use.
Well, you'll be able to help him, right?
I'll do what I can, but
you need to understand,
Sean, his condition is serious.
Well, if anybody can
help him, you can, Dad.
I know you can.
♪
Is Alex all right?
- Yes.
- He handled the surgery like a champ.
And it's a good thing
you brought him in.
His appendix really needed to come out.
Yeah, the pathology report showed
a contained appendiceal cancer.
- Cancer?
- Cancer?
Wait, he's only 15.
No need to worry.
It was small, just one
centimeter, and we got it all.
Good thing he was wearing that watch.
Oh.
Wow.
And we don't need to
talk to an oncologist?
Well, when you come
back for a follow-up,
we could talk about that.
But the treatment is to remove
the appendix, and we did that.
Mm, okay.
- When can we see Alex?
- Now.
Dr. Ahmad will take you to recovery.
- Thank you.
- Thank you.
You got it.
No, no, no, no, I'm just here
to have my knee looked at.
When was the last time
you had a physical, Bert?
I don't know.
They did some scans when I was here.
That is not a physical.
You're already here.
The doctor will make it quick.
Daniel will come in and say hello.
You owe it to your
children and your grandson
to look after your health.
All right. All right.
Thank you.
I'm seeing pericardial effusion.
That means that there's
a buildup of fluid
in the sac around the
heart, and that puts pressure
on the heart so that it
doesn't pump effectively.
Would you please let me
know when the attending
- has looked at this?
- You got it.
Okay.
So I'm not sure what's going on.
So I'm gonna start you on antibiotics,
in case it's a bacterial infection.
We're gonna treat the
pericardial effusion
with steroids and anti-inflammatories.
Sats are at 83,
and blood pressure's dropping.
[HYPERVENTILATING]
Dad?
[TENSE MUSIC]
Okay, I think we need to put you
on a machine that breathes for you.
- Okay.
- All right?
In order to do that, we
need to put you to sleep.
Is that all right?
All right.
Call respiratory.
All right, 20 of
etomidate and 100 of sux.
On its way.
♪
Okay, I'm in.
Bag him.
All right, this will let his body rest,
and hopefully, it'll help push
the fluid out of his lungs.
Thanks, Dad.
Put a foley in, and let's start him
on 125 milligrams of Solumedrol
and 10 milligrams of Lasix.
We won't see any changes for
a while, so I'll check back.
- Dr. Archer.
- Yeah?
- Have you got a minute?
- Yeah.
My ex-husband, Bert, is here
for a follow-up on a knee injury.
He hasn't had a physical in ages,
and he has finally agreed to get one.
Would you mind giving
him a quick look-see?
- Just the basics.
- No problem.
He's in two.
Oh, and um, Dr. Charles,
he might stop by.
He and Bert are old friends.
- Okay.
- Thank you.
Sure.
Hey, Nancy?
- Is Jimmy's CT back?
- Not yet.
Uh, how's CPD doing
on that reverse trace?
They have an address.
They're sending a car over now.
I hope they find a contact.
Jimmy started running a fever
and his chest is congested.
I put him on antibiotics
in case of pneumonia.
Listen, I don't know
if this means anything,
but I did, in the archives, find
a Dr. Sorensen who worked here.
Great, can we can we get in touch?
Unfortunately, no.
He died 50 years ago.
♪
Well, he's not gonna be any help.
How long is this gonna take?
Longer if you don't keep still.
I heard I had an old pal
in here, making trouble.
Sharon twisted my arm.
How we doing? Where are you guys at?
I took his vitals, got blood.
Treated me like a pincushion.
I have a proposal for you.
What do you say I take
over before this old crank
bites your head off?
I will absolutely take
you up on your offer.
[CHUCKLES]
Okay.
Let us see what we have here.
Uh, look up for me, buddy.
So you know we've got
Celtics-Bulls tomorrow night, right?
Right.
I was actually thinking about
putting down a little action.
- You? Action?
- Why not?
Celtics heavily favored,
all right, but I'm just
I'm really feeling the upset.
If I take the Bulls, I get 6-to-1 odds.
Hmm.
Yeah?
Okay, now follow with
your eyes, not your head.
Here you go.
So if I put down 20 bucks,
that would get me,
when it's 6 to 1 odds,
that would get me
Uh, 110?
120, isn't it?
I think it's 120, yeah.
Oh, yeah, yeah, yeah, yeah, 120.
[CHUCKLES]
Not bad, huh?
No. No, not bad.
Mm.
You know, we haven't
been to Al's for a while.
You wanna grab some lunch on Friday?
You got it.
Okay.
[CHUCKLES]
[APPREHENSIVE MUSIC]
Hey, Alex. Can you hear me?
Can you open your eyes for me?
Can you squeeze my hand for me?
Can you do that?
Is something wrong?
No, his body is just
taking longer than expected
to clear the muscle
relaxant that we gave him,
which was part of the anesthetic.
Is that a problem?
No, we can give Alex a
medication that will help
reverse the muscle relaxant
and help him come back to us
a little bit faster.
- We do this all the time.
- Okay.
Let's give him 0.2 of Exsomadex.
On its way.
This should act fast.
[GROANING SOFTLY]
- [BEEPING]
- Sinus tachycardia.
BP 80/50.
Oh, what's happening to him?
Let's get him upright.
He's having an anaphylactoid reaction,
which is like an allergic reaction.
Oh, God!
Epi 0.3 milligrams IM.
On its way.
You said you do this all the time.
We do.
BP now 72/45.
Solumedrol 125, diphenhydramine 50,
Famotidine 20.
Oh, my God. My baby.
Oh, my baby.
[TENSE MUSIC]
Okay, BP's coming up.
87/55.
93/60.
Oh.
He's gonna be okay.
Really, he's gonna be fine.
But why?
Why did this happen?
♪
Dr. Asher, we need you in here.
Her BP keeps dropping.
Okay, up her Levophed to 20.
[ALARM BEEPING]
Oh, God! Oh, God!
Brisk VB.
♪
- She's not dilating.
- What does that mean?
It means that the medication
we used to induce labor
isn't working fast enough.
BP's still low.
Transfuse 2 of red and 2 of plasma.
Call for 6 and 6.
We need to operate now.
You said it was risky
while she was septic.
We can't wait. Call the OR.
Let them know we're coming
up for an emergent D&E.
♪
Don't let her die.
Please don't let her die.
♪
Can I ask you for a
little favor? All right?
Just because your blood
pressure is a little high,
do you mind hanging around
till I get your blood work back?
Just for my own peace of mind.
Go to the café. Have
a nice cup of coffee.
It won't be long.
I'll text you one way or the other.
Okay.
Looking forward to Friday.
Friday?
Lunch. Lunch at Al's.
- 1:00.
- Right.
Right. Lunch at Al's.
1:00. See you, Dan.
- See you, pal.
- [CHUCKLES]
[TENSE MUSIC]
♪
Give me suction.
Marty, how's she looking?
BP's better than pre-op, 100/60.
Good.
Good, good, good, good.
Uterus feels clear.
Marty, how much IVF did she get?
2 liters of NS, 2 PRBC, 2 of plasma.
Urine output is at 300 CC
Dr. Asher.
She's hemorrhaging!
BP 70/30, heart rate 150.
Start the MTP and give her 1 gram TXA,
0.2 milligrams methergine
IM now and 1,000 misoprostol.
- Should we open?
- No, get me a Bakri balloon.
Retractor.
♪
Inflating.
The bleeding's slowing.
BP coming up.
♪
How's he doing?
Not great.
He feels helpless.
Is she gonna be able to keep her uterus?
I don't know.
Right now, it's all
about saving her life.
Yeah.
So you have kids?
One.
She's grown.
My ex and I, we tried to adopt,
but it didn't work out.
What about you?
No.
No, I, um
I was married young
before I went into the service.
And after I got back from deployment,
we both agreed that
there was nothing there.
It's all so hard.
And to have this?
[APPREHENSIVE MUSIC]
♪
Dr. Ripley.
Yeah.
Jimmy's CT.
It doesn't look like
Alzheimer's, does it?
No.
No, brain's not globally atrophied.
It looks like a lot of
scarring in the frontal area.
Yeah.
So traumatic brain injury?
♪
In a manner of speaking.
I read about this in medical school.
Dr. Charles.
Hey.
So what do you think?
I think that we could be
looking at some issues.
So he's gonna need a thorough workup.
It's a good idea.
Convincing him is not gonna be easy.
Help me out with that?
Actually, I made up a
little excuse about his labs
in order to keep him here.
Tell him together after I get him back?
Text me.
Thanks.
- How's the kid?
- He's fine.
It was scary.
Yeah.
I think the hospital
should pull Exsomadex.
Whoa. Why?
The anaphylactic reaction happened
after we administered it.
Temporal connection
doesn't mean anything.
That kid's on 15 other medications.
They could have a delayed effect.
More likely, it was the
antibiotic or the anesthetic.
I considered that, so I pulled ADR data.
There have been several similar
reactions to Exsomadex here.
Get this the manufacturer
report claims 1 out of 2,500.
Med data shows 1 out of 200.
That's 10 times what
the manufacturer claims.
Well, you might have a case,
but this data is retrospective.
It's not any kind of clinical study.
So pull Exsomadex until we have one.
Hold on. It's a popular medication.
I've used it and never had a problem.
It doesn't mean that you won't.
Crockett, that boy almost died today.
All right.
I'll, uh
I'll bring this up at the
drug and formulary meeting.
Best I can do for now.
In the meantime, make
sure that the nurses
submit an adverse drug
reaction report, okay?
Thank you.
To begin the transorbital lobotomy,
the orbitoclast is inserted
under the left eyelid
and up against the
top of the eye socket.
The neurosurgeon drives the point
through the orbital plate
into the frontal lobe
to a depth of 5 centimeters.
He then swings the handle far laterally.
He now drives the instrument
another 2 centimeters
♪
Here's Jimmy's CT.
I think we can rule out Alzheimer's.
Identical scarring on
oh, my God.
He had a lobotomy?
Yeah.
They haven't done those
for, like, 60 years.
I mean, he must have been a kid.
They did the procedure
on difficult patients.
Jimmy was probably a discipline problem,
hard to control.
So Dr. Sorensen stuck
a skewer into his brain
and took care of that.
Awful.
♪
Dad said he's getting more
oxygen now, so that's good.
Hey. This is Dr. Collins.
- She started our center.
- Oh, Margo. Please.
I think I've seen you
around the hospital.
Yeah, I recently got privileges.
I'm sorry I couldn't get here earlier.
Several new residents were checking in.
So how is Damon doing?
Well, he's sedated.
He's on a ventilator.
Dad's been taking
really good care of him.
I'm sure he has.
Well, we're by no
means out of the woods.
Can I see his chart?
Sure.
Endocarditis.
We're hoping the
antibiotics knock it out.
Listen, if you need to get back,
I can call you if there's a change.
Uh, no, I'd like to
stay, see how he does.
Is it all right if I sit with him?
- Of course.
- Thank you.
Hey, just so you know,
your son, he's been a real godsend.
That's nice to hear.
It's so helpful to have
people around our residents
who understand their challenges.
Kaitlin?
Kaitlin, can you hear me?
Hi.
I got good news.
We were able to save your uterus.
So if you decide to conceive again,
you should be able to.
Honey, did you hear?
No.
No, I can't.
I can't do it again.
Please. I'm sorry.
It's okay. It's okay.
Nobody would help.
I know.
They made me feel like I didn't matter.
[SOLEMN MUSIC]
I was thinking,
if you agree,
maybe we should move.
But your home, the farm.
I can't go back there.
How could I?
Oh, God, Kaitlin,
I don't think I could stand to
see you suffer like that again.
I know how much you
wanted a family, so
if you decide you want us to try again,
you don't have to be afraid.
We'll leave you two alone.
♪
[SIGHS] Well, it's good to know
there's some good guys in the world.
Yeah.
How is she?
♪
They're not gonna pull Exsomadex.
They're submitting the data to the FDA,
and they'll, uh, follow
their recommendations.
That could take forever.
We need to pull it
now. I'll talk to them.
Hold on. I made the case.
- It's been decided.
- I can still try.
Drop it, Zola.
It's not how things work here.
Of course.
♪
[KNOCKING]
You feeling better, Jimmy?
Uh-huh.
What about Betty?
Dr. Ripley, CPD is here.
I'll be back in a minute.
- Dr. Ripley?
- Hi.
We did a well-being check on the address
associated with that number.
We found an elderly woman deceased.
Medical examiner is investigating,
but it looks like natural causes.
I took this off the credenza.
That's my patient.
And that's the woman we found.
I talked to a neighbor who said
they were brother and sister.
And she was her brother's caregiver.
Sorry I don't have better news.
She must have collapsed,
and Jimmy went looking for help.
Better call social work.
He's not going home.
I thought you'd be more
comfortable waiting in here.
I haven't been in your
office for a long time.
Very nice.
Please. Can I get you anything?
- Nah.
- [KNOCKING ON DOOR]
- Come on in.
- Daniel.
Go ahead.
Tell her what great shape I'm in.
Well, I mean, by and large, you are.
There you go.
Yeah, I noticed a
a minor balance issue.
I hurt my knee. What do you expect?
And some short-term memory issues.
Memory?
What do you mean?
Well, you're forgetting things, Bert.
Well, who doesn't forget things?
What's this about?
Really just about your
your friends and your family
being a little bit concerned.
That's all.
Concerned.
We'd like you to take
some more tests, Bert.
What tests?
Oh, to see if I'm all
there, compos mentis.
Is that what you're talking about?
Well, I mean, if there is an issue
and trust me, big if
don't you wanna know?
I mean, I certainly would.
There isn't.
Well, just in case, let's make an
appointment with the neurologist.
Oh, yeah.
I get it.
This is a setup.
It was a setup from the beginning.
Look, I apologize, Bert,
but I knew you wouldn't
come here on your own.
And Tara has been so worried.
Uh-uh. Don't put this on Tara.
This is this is you. [LAUGHS]
Yeah, y-you're trying to put me away.
You wanna put me away so
you can get your hands on
- on my on my pension!
- Oh, Bert!
And and you're in it with her.
The two of you are
cooking up this nonsense
so you can get my money!
Couple of crooks!
Bert.
Bert.
How long have we been friends for, huh?
- 40 years?
- 40 years, but not anymore.
A-and what was that power I gave you?
That law power?
Power of attorney.
Well, you don't have it anymore.
You ought to be ashamed!
Bert!
[DRAMATIC MUSIC]
♪
Dr. Ahmad, they discharged Alex.
Great.
Yeah, like you said, no big deal.
I'm sorry for what happened.
No. Please, it wasn't your fault.
And Alex is doing fine.
You caught his cancer.
My God.
We are so grateful
to you and Dr. Marcel.
We can't even begin to thank you enough.
Thank you, guys. Good luck.
- Thank you.
- Thanks.
Thank you.
[ALARM BLARING]
No pulse.
He's fibrillating.
I'll get on his chest.
Milligram of epi.
Charge to 200.
Charging.
Clear.
[SOLEMN MUSIC]
Still no pulse.
Epi's in.
Again, charge to 200.
Charging.
Clear.
[SUSTAINED TONE]
Huh, nothing.
He's asystole.
♪
No.
No.
Damn it.
[SIGHS]
Time of death, 1703.
♪
All right, Jimmy, let's get
you into this wheelchair.
That's it.
Now, you see that nice woman?
She's gonna take you to a new home.
Did you help Betty?
Some very good people went to help her.
Where I'm going, is Betty there?
No, she isn't.
I-I want Betty.
I'm sorry, Jimmy.
She can't be there.
But she'd want you to go,
and she'd want you to be happy.
I I want Betty.
Yeah.
Yeah, I know.
I'm sorry, Jimmy.
♪
Here.
That's Betty
and me.
Yeah.
I love Betty.
♪
It's gonna be all right, Jimmy.
I'll come see you, okay?
And we'll talk about Betty then.
I was cold.
Now I'm warm.
Thank you.
You're welcome.
Hi, Jimmy.
I'm Madeline.
Hi, Madeline.
♪
That's a a tough one, huh?
I just keep wondering
what his life might have been if,
you know
If they hadn't given up on him?
Yeah.
You know, I've been meaning to ask you,
were you ever able to
reconnect with your mom?
No.
I heard she's been in and out of rehab,
in and out of custody.
Well,
I'm sorry to hear that.
And I'm also
I'm just so sorry if I
turned out to be yet another person
that made you feel
abandoned in this life.
You know, I just I
genuinely regret that.
And I I hope you'll
accept my apology.
♪
It's real.
I'm sorry.
Yeah.
Thank you for not saying,
"Now you can move on,"
or something ridiculous like that.
I mean, I was tempted.
Me too.
♪
[LAUGHS]
I'm not ready.
Hmm?
Why?
Why?
Until there's an autopsy,
there's no way to know for sure.
But whatever that infection was,
it just weakened his heart
until we couldn't save him.
Because he used drugs?
Well, we might have a better
idea after the autopsy.
But it's possible.
Street drugs, dirty needles.
Oh, man.
Sean,
I'm sorry I couldn't save him.
You did everything you could.
In my world, you see a lot of loss.
And no matter how hard you try,
sometimes it's just never enough.
I can guess how Sean is feeling.
He came to the center full of hope,
wanting to make a difference.
I'll talk to him.
♪
Bert?
I'll, uh, get tested, just to
just to get you off my back.
Okay.
Satisfied?
♪
Oh.
- Hey.
- Hey.
You, uh, pulling another shift?
Yeah.
I thought I was the only
one into self-flagellation.
No, I'm pretty good at it too.
♪
Rough day?
Yeah.
You?
Yeah.
♪
Get some rest.
You too.
♪
[DRAMATIC MUSIC]
♪
[WOLF HOWLS]
Ben and I are getting a divorce.
I really just wanna move on.
I'll be around the ED more
often if I can ever help out.
Are you flying anywhere today?
- No, shift just ended.
- Treatment seven.
Welcome to the team, Dr. Johnson.
Something's wrong with Dad.
He's forgetting things.
It's getting worse.
He doesn't know where he is.
Damn.
You've already flamed
out of two hospitals,
and you're doing your best
to flame out of a third?
So I'm not fired?
Medical ethics course.
If I were you, I'd take notes.
[DRAMATIC MUSIC]
Wow.
How does that make you feel?
I'm not sure.
It is what it is.
- Good morning, Peter.
- Morning, Maggie. Dr. Ahmad.
Do we have a notary in house?
I have some papers to sign.
Yeah, Edward.
I'll send him down
at the end of the day.
You need some help?
- Are you a doctor?
- I am. What happened?
I don't know. I've never
seen this man before.
He was wandering a
couple blocks from here.
He kept saying, "Help Betty."
He's really cold.
Okay, let's get him inside.
Betty.
[APPREHENSIVE MUSIC]
Dr. Sorensen.
No, I'm Dr. Ripley.
Nancy, he's hypothermic.
I need blankets and warm IV bags.
On it. You're going to five.
Okay.
Help Betty.
Betty?
Hey, Daniel.
- Morning.
- Good morning.
When was the last time you saw Bert?
Not for a while.
I mean, come to think of it,
I did call him a couple weeks ago,
and he was in a hurry.
Said he'd call me back, and
I'm now realizing he never did.
Yeah, and is that
something you've noticed
- his memory?
- Not really.
I mean, that could happen to any of us.
I mean, I do that stuff all the time.
Why? Are you worried about him?
I don't know, but Tara is.
And he was here.
He fell when he was watching Isaiah.
He fell?
Yeah, nothing serious,
but he did twist his knee.
He just seemed a little confused,
and I wouldn't be concerned,
but Bert does have a
family history of dementia.
We should probably have him checked out.
To get Bert to see a doctor
for anything is an ordeal.
- You know that.
- Right, tell me about it.
But he's coming here today
for a follow-up on his knee.
Oh, well, why don't I just, you know,
spontaneously stop
by, have a little chat?
That would be great.
Thank you.
[KNOCKING ON DOOR]
Hi, Alex.
- Hi.
- I'm Dr. Ahmad.
Emily. My husband, Mark.
So I see that your heart rate is fast.
I don't feel it.
But his watch says it's at 140.
It's probably nothing, but
that's why we brought him in.
Well, your watch isn't lying, 140.
Rest of your vitals are good.
Is there anything bothering you?
No, I feel fine.
Normally, he eats like a horse,
but the last couple of days,
he's hardly had anything.
I just wasn't hungry.
[MACHINE BEEPING QUICKLY]
Lungs sound good.
Lymph nodes aren't swollen.
Any tenderness?
Mm-mm.
What about here?
[WINCES]
Yeah, a little bit.
What does that mean?
I'm not sure, but I'd like
to order a CT to find out.
♪
- Okay.
- I'll put the order in.
I'll be back to check on you soon.
- Thank you.
- Yeah.
Thank you.
- Loren?
- Maggie.
Kaitlin Neeley, 28, septic shock.
Leukocytosis and hypotensive.
BP 80/43, temp 103.5.
She was pregnant.
Water broke at 15 weeks pre-viability.
That was two weeks ago.
It's not there. It's not there.
No, don't say it.
- No, no.
- Honey, everything's okay.
We're at the hospital.
They're gonna take care of you.
They were driving here, but she
got so sick, they had to pull over.
Rural clinic didn't have the
capabilities to care for her,
- so they called me.
- Okay.
Can I help?
No, unfortunately, this is OB.
- Hannah.
- Yeah.
Kaitlin Neeley, 15 weeks, water broke.
White blood count is high.
This is her husband, Eric.
All right, Maggie, start a second IV.
- You got it, Doc.
- Did they perform a D&E?
No, the doctor said they had to wait
for her to pass the remains on her own.
Okay, CBC, CMP, lactate,
and blood cultures.
- [SCREAMING]
- Oh, honey!
Honey!
I need to start your wife
on antibiotics immediately.
Do you know if she's allergic to any?
- She isn't.
- Okay.
Triple up ampicillin,
clindamycin, gentamicin.
Copy that.
Your wife is very sick,
but we're gonna take good care of her.
[DRAMATIC MUSIC]
♪
She's been carrying fetal
remains for two weeks.
Oh, my God. And she couldn't get a D&E?
No, her doctor wouldn't do it.
Why?
How's our patient?
Better.
Temp's come up to 95.
How is his cognition?
Sir.
Can you tell us your name?
Jimmy.
Did you hurt yourself?
- Maybe hit your head?
- No.
Betty.
Who's Betty?
My sister.
No ID, but he had this
Post-it in his pocket.
It's a telephone number.
What happened to Betty? Where is she?
Home. She got sick.
Get Dr. Sorensen.
Is is that her doctor or your doctor?
Dr. Sorensen.
Does he work at this hospital?
- Yes, here.
- Okay.
Okay, see if you can
find this Dr. Sorensen
and try that number.
[SUSPENSEFUL MUSIC]
[SIGHS]
We're gonna take good
care of you, Jimmy.
Okay?
Oh, thank you.
♪
Dr. Charles?
I've got an elderly patient,
severely hypothermic.
No visible injuries, um,
but he's pretty out of it.
No ID other than a phone number.
I'm thinking he's got
dementia or maybe wandered away
- from a care facility.
- Oh.
You wanna give me your take?
Sure.
His name's Jimmy.
Shoot me his chart.
Give me a couple minutes.
Yeah.
Hi, Alex. Mr. and Mrs. Foster.
This is Dr. Marcel.
He's one of our surgeons.
I've asked him to consult.
Surgeon? Why?
Well, Radiology said that
Alex's CT was equivocal,
meaning it was inconclusive.
But what it did show is
a possible appendicitis.
And from my experience, with
Alex's elevated heart rate
and loss of appetite,
I believe that is, indeed, the case.
So I'd like to operate.
Wait, so you're not
sure it's appendicitis?
No.
Why do I have to have an operation?
Because if it is appendicitis
and your appendix bursts,
that would put you at risk
of an infection in the belly,
and that could be life-threatening.
Oh.
But we can avoid that
with a minimally invasive
laparoscopic surgery done with a camera
through several small incisions
what we call a Band-Aid surgery.
I agree with Dr. Marcel.
A laparoscopic appendectomy
is the best course of action.
Most likely, he'd be
done in half an hour.
Mom? Dad?
Yeah, okay.
Okay.
- All right.
- Thank you.
I'll see you after.
- All right.
- Thank you.
Thank you.
- You okay?
- It'll be fine. Mm-hmm.
Is she doing any better?
About the same.
You know, I don't have
any more flights today,
so I think I'll stick
around, if you don't mind.
Mm.
Maybe I can give Eric
some moral support.
That's a good idea.
Are you gonna do that operation?
I recommend we try to
induce instead of a D&E.
Surgery can be much
riskier if she's septic.
Tell me what happened.
Kaitlin's water broke.
Everybody said the fetus
couldn't survive at 15 weeks,
but it was still alive,
so doctors were afraid to do the D&E.
She didn't wanna get arrested.
[APPREHENSIVE MUSIC]
Where we live, that could happen.
They sent us home.
Kaitlin got sicker and sicker.
And I kept calling,
and they kept telling me
it wasn't a life-threatening emergency.
Finally, I just gave up
and started driving here.
Kaitlin's from Chicago.
When we got married, we
moved to my family's farm,
where I grew up.
We were so excited when
Kaitlin finally got pregnant.
She's been so worried she's
not gonna be able to again.
Eric, I'm gonna do the best that I can.
But I don't know.
I don't know.
♪
Okay, staple line looks good.
No bleeding.
[TENSE MUSIC]
Nice and easy.
Appendix is in the bag.
Gently wiggle the bag circularly,
and then pull it up and out.
Hold on.
This feels unusual.
Go ahead and send that for a
stat frozen section, please.
♪
Definitely some cognitive impairment,
though I'm not quite sure why.
Tox screen's negative,
no sign of head trauma.
The childlike affect, it's
not what you normally see
with Alzheimer's or vascular dementia,
though you can't rule it out.
I'm thinking some kind
of intellectual deficit.
So I'm thinking we should get a head CT.
Definitely.
We have no more information on the guy?
You reach out to CPD?
Yeah, there's no missing persons
matching his description, and
no one's come looking for him.
He can't stop talking about
his sister, Betty, right,
how he is just very concerned about her.
She's sick. She needs our help.
Yeah, but given his mental state,
is that even a real person?
You know, maybe it's
someone from his childhood
- or a show he saw on TV.
- Yeah.
I tried the number he had again
still no answer.
- I left another message.
- Okay.
Let's say that is actually
Betty's number, right?
Maybe she's not answering
because she can't
because she is, in fact, incapacitated.
How about we ask CPD
to run a reverse trace?
That way, at least,
we'll get an address.
Okay.
[SUSPENSEFUL MUSIC]
[ALARM BEEPS] [DEVICE CHIRPS]
Dr. Archer, incoming.
You're going to trauma four.
Damon Adams, 28,
shortness of breath, diaphoretic.
BP 130/90, heart rate 125. Sats 89.
- Need help.
- It's right there.
Sean.
He lives at the center where I work.
I've been counseling him.
All right, wait here.
All right, on my count. Ready?
We good? One, two, three.
[GRUNTS]
All right, Damon, I'm Dr. Archer.
What's going on?
- Real sick.
- Yeah?
When did this start?
- A couple days ago.
- [COUGHING]
- I can't catch my breath.
- Well, we can help you.
Come on, let's get him up here.
Lift him up. Start him on 100% O2.
AP chest stat.
I need a CBC, BNP, and an ABG.
♪
- X-ray.
- Clear.
Pulmonary edema.
Fluid in the lungs.
Call Cardiology for a stat echo.
Yeah, got it.
Okay.
Better?
You okay if I share
some things with Sean?
All right, I'll check back soon.
So [SIGHS]
Your friend's in pretty bad shape.
Pulmonary edema suggests
that he's in heart failure.
We shouldn't be seeing
that in somebody so young.
Oh, man.
You say that he's living
at the rehab center.
- Is he an addict?
- Recovering,
but I'm pretty sure he's
clean. We talk a lot.
He's really been working the program.
It's possible whatever's going on
with his heart might
have something to do
with IV drug use.
Well, you'll be able to help him, right?
I'll do what I can, but
you need to understand,
Sean, his condition is serious.
Well, if anybody can
help him, you can, Dad.
I know you can.
♪
Is Alex all right?
- Yes.
- He handled the surgery like a champ.
And it's a good thing
you brought him in.
His appendix really needed to come out.
Yeah, the pathology report showed
a contained appendiceal cancer.
- Cancer?
- Cancer?
Wait, he's only 15.
No need to worry.
It was small, just one
centimeter, and we got it all.
Good thing he was wearing that watch.
Oh.
Wow.
And we don't need to
talk to an oncologist?
Well, when you come
back for a follow-up,
we could talk about that.
But the treatment is to remove
the appendix, and we did that.
Mm, okay.
- When can we see Alex?
- Now.
Dr. Ahmad will take you to recovery.
- Thank you.
- Thank you.
You got it.
No, no, no, no, I'm just here
to have my knee looked at.
When was the last time
you had a physical, Bert?
I don't know.
They did some scans when I was here.
That is not a physical.
You're already here.
The doctor will make it quick.
Daniel will come in and say hello.
You owe it to your
children and your grandson
to look after your health.
All right. All right.
Thank you.
I'm seeing pericardial effusion.
That means that there's
a buildup of fluid
in the sac around the
heart, and that puts pressure
on the heart so that it
doesn't pump effectively.
Would you please let me
know when the attending
- has looked at this?
- You got it.
Okay.
So I'm not sure what's going on.
So I'm gonna start you on antibiotics,
in case it's a bacterial infection.
We're gonna treat the
pericardial effusion
with steroids and anti-inflammatories.
Sats are at 83,
and blood pressure's dropping.
[HYPERVENTILATING]
Dad?
[TENSE MUSIC]
Okay, I think we need to put you
on a machine that breathes for you.
- Okay.
- All right?
In order to do that, we
need to put you to sleep.
Is that all right?
All right.
Call respiratory.
All right, 20 of
etomidate and 100 of sux.
On its way.
♪
Okay, I'm in.
Bag him.
All right, this will let his body rest,
and hopefully, it'll help push
the fluid out of his lungs.
Thanks, Dad.
Put a foley in, and let's start him
on 125 milligrams of Solumedrol
and 10 milligrams of Lasix.
We won't see any changes for
a while, so I'll check back.
- Dr. Archer.
- Yeah?
- Have you got a minute?
- Yeah.
My ex-husband, Bert, is here
for a follow-up on a knee injury.
He hasn't had a physical in ages,
and he has finally agreed to get one.
Would you mind giving
him a quick look-see?
- Just the basics.
- No problem.
He's in two.
Oh, and um, Dr. Charles,
he might stop by.
He and Bert are old friends.
- Okay.
- Thank you.
Sure.
Hey, Nancy?
- Is Jimmy's CT back?
- Not yet.
Uh, how's CPD doing
on that reverse trace?
They have an address.
They're sending a car over now.
I hope they find a contact.
Jimmy started running a fever
and his chest is congested.
I put him on antibiotics
in case of pneumonia.
Listen, I don't know
if this means anything,
but I did, in the archives, find
a Dr. Sorensen who worked here.
Great, can we can we get in touch?
Unfortunately, no.
He died 50 years ago.
♪
Well, he's not gonna be any help.
How long is this gonna take?
Longer if you don't keep still.
I heard I had an old pal
in here, making trouble.
Sharon twisted my arm.
How we doing? Where are you guys at?
I took his vitals, got blood.
Treated me like a pincushion.
I have a proposal for you.
What do you say I take
over before this old crank
bites your head off?
I will absolutely take
you up on your offer.
[CHUCKLES]
Okay.
Let us see what we have here.
Uh, look up for me, buddy.
So you know we've got
Celtics-Bulls tomorrow night, right?
Right.
I was actually thinking about
putting down a little action.
- You? Action?
- Why not?
Celtics heavily favored,
all right, but I'm just
I'm really feeling the upset.
If I take the Bulls, I get 6-to-1 odds.
Hmm.
Yeah?
Okay, now follow with
your eyes, not your head.
Here you go.
So if I put down 20 bucks,
that would get me,
when it's 6 to 1 odds,
that would get me
Uh, 110?
120, isn't it?
I think it's 120, yeah.
Oh, yeah, yeah, yeah, yeah, 120.
[CHUCKLES]
Not bad, huh?
No. No, not bad.
Mm.
You know, we haven't
been to Al's for a while.
You wanna grab some lunch on Friday?
You got it.
Okay.
[CHUCKLES]
[APPREHENSIVE MUSIC]
Hey, Alex. Can you hear me?
Can you open your eyes for me?
Can you squeeze my hand for me?
Can you do that?
Is something wrong?
No, his body is just
taking longer than expected
to clear the muscle
relaxant that we gave him,
which was part of the anesthetic.
Is that a problem?
No, we can give Alex a
medication that will help
reverse the muscle relaxant
and help him come back to us
a little bit faster.
- We do this all the time.
- Okay.
Let's give him 0.2 of Exsomadex.
On its way.
This should act fast.
[GROANING SOFTLY]
- [BEEPING]
- Sinus tachycardia.
BP 80/50.
Oh, what's happening to him?
Let's get him upright.
He's having an anaphylactoid reaction,
which is like an allergic reaction.
Oh, God!
Epi 0.3 milligrams IM.
On its way.
You said you do this all the time.
We do.
BP now 72/45.
Solumedrol 125, diphenhydramine 50,
Famotidine 20.
Oh, my God. My baby.
Oh, my baby.
[TENSE MUSIC]
Okay, BP's coming up.
87/55.
93/60.
Oh.
He's gonna be okay.
Really, he's gonna be fine.
But why?
Why did this happen?
♪
Dr. Asher, we need you in here.
Her BP keeps dropping.
Okay, up her Levophed to 20.
[ALARM BEEPING]
Oh, God! Oh, God!
Brisk VB.
♪
- She's not dilating.
- What does that mean?
It means that the medication
we used to induce labor
isn't working fast enough.
BP's still low.
Transfuse 2 of red and 2 of plasma.
Call for 6 and 6.
We need to operate now.
You said it was risky
while she was septic.
We can't wait. Call the OR.
Let them know we're coming
up for an emergent D&E.
♪
Don't let her die.
Please don't let her die.
♪
Can I ask you for a
little favor? All right?
Just because your blood
pressure is a little high,
do you mind hanging around
till I get your blood work back?
Just for my own peace of mind.
Go to the café. Have
a nice cup of coffee.
It won't be long.
I'll text you one way or the other.
Okay.
Looking forward to Friday.
Friday?
Lunch. Lunch at Al's.
- 1:00.
- Right.
Right. Lunch at Al's.
1:00. See you, Dan.
- See you, pal.
- [CHUCKLES]
[TENSE MUSIC]
♪
Give me suction.
Marty, how's she looking?
BP's better than pre-op, 100/60.
Good.
Good, good, good, good.
Uterus feels clear.
Marty, how much IVF did she get?
2 liters of NS, 2 PRBC, 2 of plasma.
Urine output is at 300 CC
Dr. Asher.
She's hemorrhaging!
BP 70/30, heart rate 150.
Start the MTP and give her 1 gram TXA,
0.2 milligrams methergine
IM now and 1,000 misoprostol.
- Should we open?
- No, get me a Bakri balloon.
Retractor.
♪
Inflating.
The bleeding's slowing.
BP coming up.
♪
How's he doing?
Not great.
He feels helpless.
Is she gonna be able to keep her uterus?
I don't know.
Right now, it's all
about saving her life.
Yeah.
So you have kids?
One.
She's grown.
My ex and I, we tried to adopt,
but it didn't work out.
What about you?
No.
No, I, um
I was married young
before I went into the service.
And after I got back from deployment,
we both agreed that
there was nothing there.
It's all so hard.
And to have this?
[APPREHENSIVE MUSIC]
♪
Dr. Ripley.
Yeah.
Jimmy's CT.
It doesn't look like
Alzheimer's, does it?
No.
No, brain's not globally atrophied.
It looks like a lot of
scarring in the frontal area.
Yeah.
So traumatic brain injury?
♪
In a manner of speaking.
I read about this in medical school.
Dr. Charles.
Hey.
So what do you think?
I think that we could be
looking at some issues.
So he's gonna need a thorough workup.
It's a good idea.
Convincing him is not gonna be easy.
Help me out with that?
Actually, I made up a
little excuse about his labs
in order to keep him here.
Tell him together after I get him back?
Text me.
Thanks.
- How's the kid?
- He's fine.
It was scary.
Yeah.
I think the hospital
should pull Exsomadex.
Whoa. Why?
The anaphylactic reaction happened
after we administered it.
Temporal connection
doesn't mean anything.
That kid's on 15 other medications.
They could have a delayed effect.
More likely, it was the
antibiotic or the anesthetic.
I considered that, so I pulled ADR data.
There have been several similar
reactions to Exsomadex here.
Get this the manufacturer
report claims 1 out of 2,500.
Med data shows 1 out of 200.
That's 10 times what
the manufacturer claims.
Well, you might have a case,
but this data is retrospective.
It's not any kind of clinical study.
So pull Exsomadex until we have one.
Hold on. It's a popular medication.
I've used it and never had a problem.
It doesn't mean that you won't.
Crockett, that boy almost died today.
All right.
I'll, uh
I'll bring this up at the
drug and formulary meeting.
Best I can do for now.
In the meantime, make
sure that the nurses
submit an adverse drug
reaction report, okay?
Thank you.
To begin the transorbital lobotomy,
the orbitoclast is inserted
under the left eyelid
and up against the
top of the eye socket.
The neurosurgeon drives the point
through the orbital plate
into the frontal lobe
to a depth of 5 centimeters.
He then swings the handle far laterally.
He now drives the instrument
another 2 centimeters
♪
Here's Jimmy's CT.
I think we can rule out Alzheimer's.
Identical scarring on
oh, my God.
He had a lobotomy?
Yeah.
They haven't done those
for, like, 60 years.
I mean, he must have been a kid.
They did the procedure
on difficult patients.
Jimmy was probably a discipline problem,
hard to control.
So Dr. Sorensen stuck
a skewer into his brain
and took care of that.
Awful.
♪
Dad said he's getting more
oxygen now, so that's good.
Hey. This is Dr. Collins.
- She started our center.
- Oh, Margo. Please.
I think I've seen you
around the hospital.
Yeah, I recently got privileges.
I'm sorry I couldn't get here earlier.
Several new residents were checking in.
So how is Damon doing?
Well, he's sedated.
He's on a ventilator.
Dad's been taking
really good care of him.
I'm sure he has.
Well, we're by no
means out of the woods.
Can I see his chart?
Sure.
Endocarditis.
We're hoping the
antibiotics knock it out.
Listen, if you need to get back,
I can call you if there's a change.
Uh, no, I'd like to
stay, see how he does.
Is it all right if I sit with him?
- Of course.
- Thank you.
Hey, just so you know,
your son, he's been a real godsend.
That's nice to hear.
It's so helpful to have
people around our residents
who understand their challenges.
Kaitlin?
Kaitlin, can you hear me?
Hi.
I got good news.
We were able to save your uterus.
So if you decide to conceive again,
you should be able to.
Honey, did you hear?
No.
No, I can't.
I can't do it again.
Please. I'm sorry.
It's okay. It's okay.
Nobody would help.
I know.
They made me feel like I didn't matter.
[SOLEMN MUSIC]
I was thinking,
if you agree,
maybe we should move.
But your home, the farm.
I can't go back there.
How could I?
Oh, God, Kaitlin,
I don't think I could stand to
see you suffer like that again.
I know how much you
wanted a family, so
if you decide you want us to try again,
you don't have to be afraid.
We'll leave you two alone.
♪
[SIGHS] Well, it's good to know
there's some good guys in the world.
Yeah.
How is she?
♪
They're not gonna pull Exsomadex.
They're submitting the data to the FDA,
and they'll, uh, follow
their recommendations.
That could take forever.
We need to pull it
now. I'll talk to them.
Hold on. I made the case.
- It's been decided.
- I can still try.
Drop it, Zola.
It's not how things work here.
Of course.
♪
[KNOCKING]
You feeling better, Jimmy?
Uh-huh.
What about Betty?
Dr. Ripley, CPD is here.
I'll be back in a minute.
- Dr. Ripley?
- Hi.
We did a well-being check on the address
associated with that number.
We found an elderly woman deceased.
Medical examiner is investigating,
but it looks like natural causes.
I took this off the credenza.
That's my patient.
And that's the woman we found.
I talked to a neighbor who said
they were brother and sister.
And she was her brother's caregiver.
Sorry I don't have better news.
She must have collapsed,
and Jimmy went looking for help.
Better call social work.
He's not going home.
I thought you'd be more
comfortable waiting in here.
I haven't been in your
office for a long time.
Very nice.
Please. Can I get you anything?
- Nah.
- [KNOCKING ON DOOR]
- Come on in.
- Daniel.
Go ahead.
Tell her what great shape I'm in.
Well, I mean, by and large, you are.
There you go.
Yeah, I noticed a
a minor balance issue.
I hurt my knee. What do you expect?
And some short-term memory issues.
Memory?
What do you mean?
Well, you're forgetting things, Bert.
Well, who doesn't forget things?
What's this about?
Really just about your
your friends and your family
being a little bit concerned.
That's all.
Concerned.
We'd like you to take
some more tests, Bert.
What tests?
Oh, to see if I'm all
there, compos mentis.
Is that what you're talking about?
Well, I mean, if there is an issue
and trust me, big if
don't you wanna know?
I mean, I certainly would.
There isn't.
Well, just in case, let's make an
appointment with the neurologist.
Oh, yeah.
I get it.
This is a setup.
It was a setup from the beginning.
Look, I apologize, Bert,
but I knew you wouldn't
come here on your own.
And Tara has been so worried.
Uh-uh. Don't put this on Tara.
This is this is you. [LAUGHS]
Yeah, y-you're trying to put me away.
You wanna put me away so
you can get your hands on
- on my on my pension!
- Oh, Bert!
And and you're in it with her.
The two of you are
cooking up this nonsense
so you can get my money!
Couple of crooks!
Bert.
Bert.
How long have we been friends for, huh?
- 40 years?
- 40 years, but not anymore.
A-and what was that power I gave you?
That law power?
Power of attorney.
Well, you don't have it anymore.
You ought to be ashamed!
Bert!
[DRAMATIC MUSIC]
♪
Dr. Ahmad, they discharged Alex.
Great.
Yeah, like you said, no big deal.
I'm sorry for what happened.
No. Please, it wasn't your fault.
And Alex is doing fine.
You caught his cancer.
My God.
We are so grateful
to you and Dr. Marcel.
We can't even begin to thank you enough.
Thank you, guys. Good luck.
- Thank you.
- Thanks.
Thank you.
[ALARM BLARING]
No pulse.
He's fibrillating.
I'll get on his chest.
Milligram of epi.
Charge to 200.
Charging.
Clear.
[SOLEMN MUSIC]
Still no pulse.
Epi's in.
Again, charge to 200.
Charging.
Clear.
[SUSTAINED TONE]
Huh, nothing.
He's asystole.
♪
No.
No.
Damn it.
[SIGHS]
Time of death, 1703.
♪
All right, Jimmy, let's get
you into this wheelchair.
That's it.
Now, you see that nice woman?
She's gonna take you to a new home.
Did you help Betty?
Some very good people went to help her.
Where I'm going, is Betty there?
No, she isn't.
I-I want Betty.
I'm sorry, Jimmy.
She can't be there.
But she'd want you to go,
and she'd want you to be happy.
I I want Betty.
Yeah.
Yeah, I know.
I'm sorry, Jimmy.
♪
Here.
That's Betty
and me.
Yeah.
I love Betty.
♪
It's gonna be all right, Jimmy.
I'll come see you, okay?
And we'll talk about Betty then.
I was cold.
Now I'm warm.
Thank you.
You're welcome.
Hi, Jimmy.
I'm Madeline.
Hi, Madeline.
♪
That's a a tough one, huh?
I just keep wondering
what his life might have been if,
you know
If they hadn't given up on him?
Yeah.
You know, I've been meaning to ask you,
were you ever able to
reconnect with your mom?
No.
I heard she's been in and out of rehab,
in and out of custody.
Well,
I'm sorry to hear that.
And I'm also
I'm just so sorry if I
turned out to be yet another person
that made you feel
abandoned in this life.
You know, I just I
genuinely regret that.
And I I hope you'll
accept my apology.
♪
It's real.
I'm sorry.
Yeah.
Thank you for not saying,
"Now you can move on,"
or something ridiculous like that.
I mean, I was tempted.
Me too.
♪
[LAUGHS]
I'm not ready.
Hmm?
Why?
Why?
Until there's an autopsy,
there's no way to know for sure.
But whatever that infection was,
it just weakened his heart
until we couldn't save him.
Because he used drugs?
Well, we might have a better
idea after the autopsy.
But it's possible.
Street drugs, dirty needles.
Oh, man.
Sean,
I'm sorry I couldn't save him.
You did everything you could.
In my world, you see a lot of loss.
And no matter how hard you try,
sometimes it's just never enough.
I can guess how Sean is feeling.
He came to the center full of hope,
wanting to make a difference.
I'll talk to him.
♪
Bert?
I'll, uh, get tested, just to
just to get you off my back.
Okay.
Satisfied?
♪
Oh.
- Hey.
- Hey.
You, uh, pulling another shift?
Yeah.
I thought I was the only
one into self-flagellation.
No, I'm pretty good at it too.
♪
Rough day?
Yeah.
You?
Yeah.
♪
Get some rest.
You too.
♪
[DRAMATIC MUSIC]
♪
[WOLF HOWLS]