ER s09e17 Episode Script
The Advocate (aka Side Effects)
Previously on E.
R.
I'm fine.
I've scheduled a meeting with Dr.
Meyers.
It's mandatory.
That was my great-grandmother's.
Youre going to propose? That's it? You bought out this whole place just for that? I found a sore on his penis.
I think it's syphilis.
Any way we can keep it out of my medical record? No! That is not the point! You might save 2.
4 up front but you're gonna lose 20,000 primary care visits a year- - Thank you, Dr.
Weaver.
- For a potential loss of over $10 million.
We have to make tough choices.
You're shortsighted now! Is there a motion to vote? - Excuse me.
I'm not finished.
- I think we understand the issue.
- Lack of primary care leaves thousands- - And your argument.
These are human beings, not statistics.
And we are abandoning an entire community- We get it.
Thank you.
Now is there a motion to vote in open session? - Mr.
Chairman- - Motion.
Second.
All right.
All those in favor of closing the Erie Street Clinic.
Those opposed to the closing.
The nays have it.
Fifteen-minute recess.
Nice work, Kerry.
- Is it always this close? - You have the gift of persuasion.
Well, pugnacity is more like it.
And an understanding of what motivates people.
- That's the secret to a good politician.
- I'm out of my league there.
Nonsense.
It wouldn't surprise me if you were Surgeon General someday.
Kristy.
Meet the future Surgeon General and savior of the Erie Street Clinic.
- Hello, doctor.
- He's kidding.
- He never kids.
- Kerry, you have another minute? Sure.
Parks and Recs has been pushed to 11:00.
And Bamberger called about the gay-marriage amendment.
Tell him I'm sympathetic but it will never pass, and I'm not gonna torpedo the bill.
Maybe we should get you on that one.
Might actually stand a chance.
What do you mean? Youre a problem-solver, Kerry.
A pragmatist.
I can't tell you how much I appreciate that.
Thank you.
That's why I hate to implore you for another personal favor.
But, well I frankly don't know what else to do.
You were very considerate in treating my off-the-record condition.
Did the lesion not heal? No, it did.
But I'm in a relationship with someone, someone that works for me.
I'm single.
Were in love.
But workplace affairs are Well, I don't need the attention.
And she's symptomatic.
I was hoping you could provide treatment with the same level of discretion.
Send her to any free clinic.
Theyre all confidential.
It's a simple shot of penicillin, right? Treatment without generating a medical record is malpractice.
But you've done it before.
And I shouldn't have.
Okay.
Okay.
I think I understand.
I'm sorry.
I mean, you know, I could lose my license.
Don't be sorry.
Youre a woman of principle.
How can I not respect that? Forget I asked.
And congratulations again.
- You did some real good today, Kerry.
- Thank you.
Of course, there are no guarantees for next year's budget at your hospital.
What? There's an afternoon vote on eliminating emergency services.
At County General? You mean closing the ER.
I need you, Kerry.
Is your jalopy still in the shop? - It's a Jeep.
- Oh, a Jeep.
Jalopy.
- You hardly touched your breakfast.
- I don't like to eat much before a shift.
All that blood and guts, you know? Don't remind me.
I had a feeling there was some agenda this morning, you've been very mysterious.
I just wanted to check in, see how you were.
And I wanted to give this back to you for the time being.
- She said no? - I didn't ask.
- Did something happen? - No.
It just felt kind of rushed.
- What did she do? - Nothing.
Doesn't even know.
I don't think she knows.
Maybe she knows.
I don't know.
- I'm sorry, John.
- I thought you'd be relieved.
That youre unhappy? I got the impression that you never really cared for her.
I've spent so many years trying to get you to do what I think is best for you.
Youre passed having me badger you about your choices.
This is yours.
Give it, or don't, to whomever you choose.
- Why? - Well, I'm thinking emergency medicine.
- Here? - Better than Iraq.
Hey, that is not it.
Don't you still owe four years? I can roll the time to after my residency.
Afraid to fight, all right.
- Hey, any time, any place, old man.
- I can smell fear a mile away.
Answer the phone, Frank.
The holiday's called "St.
Patrick's Day, not "St.
Patrick's Week.
You got something against the Irish? The giant shamrock in Triage started drinking 72 hours ago.
- Excuse me.
I'm looking for Dr.
Weaver.
- Frank.
She'll be back in a few minutes.
Have a seat over there.
They always ask me.
Do I look like customer service? - He's cute.
- He's a zygote.
- Anymore blind dates? - Never again.
But were going to Las Vegas tonight.
- Who's we? - Me and Chen.
And 50 other County employees.
So how's it going with you? I have a rule-out MI waiting on his second troponin.
No, I meant in general.
- Any news? - No.
Did you need that? Oh, I thought it was a different patient.
- So how are you and Carter? - Good, I guess.
Kind of.
He's been acting a little weird.
It's been rough for both of you lately.
I think were getting back to normal.
Dr.
Lewis, he's seizing again.
Another four of lorazepam, and load a gram of Dilantin.
Abby, clear a CT on this one.
- Blown pupil? - Subconj hemorrhage.
- No ID? - Too young for a license.
No purse.
- This the assault? - LOC in Union Station.
- Probably a street kid.
- With those boots? - Expensive jacket too.
- Maybe she shoplifts.
- She come in with that girl? - No.
Different run.
- Chest is clear.
Belly's soft.
- Dr.
Kovac? - Isolated head and facial trauma.
- What happened? - Let's get a C-spine, chest and pelvis.
- Dr.
Kovac? - You got this? - Yeah.
Trauma panel, urine ICON, dip a UA.
- Sorry.
I forgot.
- Three times.
Three missed appointments.
Yeah.
I have a bad memory.
Your department required psychotherapy.
I don't wanna be a heavy.
- I wanna help.
- Prepare for disappointment.
I have extended hours tonight.
I'm free from 7 to 8.
Can you make that? - I really don't see the point.
- You don't have to see it.
Just show up.
Just show up.
That's all I've been doing.
Showing up.
Time goes by faster at work.
Shift work.
Treat and street a few lost souls.
Youre with them when they are most vulnerable.
- Is that bile? - That's 17 Jell-O shots.
When they're naked, weak, hurt you touch them look at their bodies see them more closely than their families, their lovers.
But it's mechanical, you know, temporary.
You fix them up, or you watch them die.
Either way, it ends, and you move on.
No next time, no strings.
No real connection.
Maybe that's why I stay.
- You waiting on an incoming? - What? - Did you sign out for an incoming? - Coffee.
Cigarette break? You want some? - What? - Coffee? No, thanks.
- Not turning into a health nut on me.
- No.
Waiting for an old lady that fell off her treadmill.
Okay.
Do you remember what happened? Can I call your parents? I don't live at home.
Where do you live? Molly, I can't help you unless you talk to me.
They call it a boot camp for kids who can't get along with their parents.
So they discipline you? Does this look like discipline? A camp counselor did this to you? Yeah.
I heard they raped a girl.
Okay.
Haleh, perhaps Molly should be speaking with a police officer.
I'm sure your mother would like to know that you' re safe.
Who do you think sent me there in the first place? - Any family? - She said she has a husband, Charles.
- What else did I say about him? - That he's useless.
Exactly.
Forget him.
It's a stolen card.
How am I supposed to know her mother's maiden name? Why are you boarding four ICU players and eight med-surg admissions? Susan's driving.
Talk to her.
Dr.
Weaver? Keith Mitchell.
I have an appointment.
We don't make appointments in the ER.
Report your complaint to the Triage nurse.
I believe special arrangements were made by Alderman Bright? Jonathan has nothing but wonderful things to say about you.
How long have you been in his office? I started junior year, spring quarter, so about two years.
Now I get grad-school credit and on-the-job training.
He's a great mentor.
Very generous with his time.
This goes in the buttocks.
I'm surprised that you waited so long to be treated.
I didn't notice the sore.
Jonathan did.
- When? - Two nights ago.
I was so embarrassed.
I just hoped I didn't give it to him.
- He didn't have it? - No.
I was pretty crazy in my college days.
We' re monogamous now.
I have to say, he was really cool about it.
Most people wouldn't be so understanding.
All done.
We all have our past, right? I told you not to work out so much.
So I can sit and watch the soaps all day? Any other symptoms, Mrs.
Sanbery? Yes.
My hair's falling out.
But I blame that on him.
- She's just kidding.
- The hell I am! - Did you check the fingernails? - Yeah.
I'm getting to that.
- What? - These marks, these lines.
- What marks? - These are Mees' lines.
- What kind of work did you do? - Supervisor at a wood-processing plant.
- Did they use arsenic? - Tested us for it all the time.
Can't be it.
Okay.
Let's get Mrs.
Sanbery's blood and urine reports from OSHA.
- I will be right back.
- Take him with you.
Ruthie, just relax, please.
Wonders of marital bliss.
Who's worse? Her for being such a pain, or him for being so pathetic.
It cuts both ways, I guess.
My bike-girl trauma may have a diminished foot pulse.
Check Doppler.
I'll be there in a minute.
Mrs.
Banks.
- Yes? - I'm Dr.
Corday.
I'm the surgeon treating your daughter.
- She'll need surgery? - No, no.
I'm surprised the camp actually called you.
Why wouldn't they? Well, they assaulted your daughter.
Is that what she told you? She ran off on the second day.
- They didn't touch her.
- Somebody did.
With Molly there's all kinds of explanations.
- What makes you certain it's not the camp? - Because she says it is.
Trashing my house with a baseball bat.
Shoplifting, drinking, drug use, unwanted pregnancy.
Do I need to go on? I need to call my office.
Maybe you can talk to her when you' re finished.
I haven't been able to talk to her in three years.
They actually threw you across the room? In a bar fight, not a tossing.
Big difference.
Congratulations, Kerry.
Whatever you' re doing down at City Hall seems to be working.
- Well, it was a close vote.
- But without a single cut.
- What? - The hospital budget.
We were vulnerable to a 20-percent cut, it sailed through less than an hour ago.
They say he drove out the snakes.
- Who? - St.
Patrick.
Well, I'd like to see you and Robert in my office at 5.
- Is there a problem? - Just a little administrative housekeeping.
We should burn through it quickly.
Dr.
Weaver, Dr.
Lewis needs you.
- What kid? - That kid.
He was looking for you, waiting in Chairs.
Paramedic brought him in.
Stand by with an epi drip.
- Hey, Kerry.
Do you know this kid? - What happened? Passed out across the street.
Tight wheezes and hives.
Barely any breath sounds.
You don't happen to know if he has any food allergies, do you? - No, I don't.
- He was looking for you.
Sats are dropping, 93.
Pulse, 120.
Cords are too edematous.
Prep a crike tray.
Fiber-optic with a 7-0 tube.
- Okay, one more look.
- Wasting time.
- You need to let the drugs work.
- He needs intubation.
- You do know him? - He could be allergic to anything an insect bite, or have a carcinoid.
He's got an ID from City Hall.
Okay, do a jaw thrust and keep a good seal when you bag him.
You know, I did get some papers from Health and Human Services this morning.
Maybe he dropped them off.
Okay, suction and light source on high.
Let's go.
This is an emergency.
You tell him that one of his staffers is in the ER with a severe allergic reaction.
Tell him to call me as soon as he can.
You were right.
He does work at City Hall.
- Alderman Bright's office? - Yeah.
How did you know? Well, there's no insect bite, but there's a chancre on his penis.
- Kerry? - That's a bit of a leap, don't you think? The alderman left here with untreated syphilis.
- We don't know that it was untreated.
- Now one of his staffers comes in- We don't know if the alderman is in the habit of sexual harassment, much less gay.
The kid is in anaphylactic shock.
Either it's a food allergy or a drug.
- My guess is penicillin.
- Not necessarily.
It could be idiopathic histamine release or vasculitis.
He's triggering the vent.
- Any spontaneous eye opening? - Not yet.
Call Immunology for skin testing.
Have them include penicillin.
Get me as soon as he wakes up.
- What's his Fl-O2? - Fifty percent.
Sounds like upper-airway secretions.
I think he's just a little wheezy.
Why don't you get a suction catheter.
He may have a mucous plug we need to clear out.
- He's satting at 98 percent- - I wanna optimize his oxygenation.
Get it.
Keith? Keith? Can you hear me? Keith? Keith, there's a tube in your throat to help you breathe.
You had a severe allergic reaction, probably to the penicillin.
But everything is okay now, all right? We'll take out the tube soon.
You'll be able to speak.
And the other doctors will have some questions for you.
They've examined you.
So they know you have syphilis.
And they'll be able to determine an allergy to penicillin.
But Jonathan cannot have sent you here to me.
You know what that means.
We have to protect him.
We can't give anyone reason to speculate or they might even target Jonathan as the source of the infection.
Listen carefully, Keith.
People have been known to borrow prescriptions from friends without ever seeing a doctor.
They think they know what they have and how to treat it so they take care of it on their own.
Do you understand? Good.
Dr.
Carter, dealership called.
You need brake pads.
It'll be ready at 5.
- Can you get rabies from fish? - No.
- You' re sure? - I'm pretty sure.
What do you make of this? Pike bit me when I was getting it off the line.
Looks infected.
That's it? Call me if you start growing gills.
Doctor, OSHA results.
The arsenic levels in Mrs.
Sanbery's urine for the past three years have been undetectable.
- And today's results? - Over 200 mics per liter.
Maybe she got down about being home.
- Suicide attempt? - I don't know.
Happens to some retirees.
Either that or her husband's trying to kill her.
Well, find out if she's been depressed.
Take it from there.
- What's that? - What? On your back.
It's the patch.
For birth control? No, for smoking.
- You quit smoking? - Four days ago, yes.
Thanks for noticing.
Thanks for sharing.
Last week, I had to bring a throat-cancer patient outside so she could smoke through her trach hole.
- And I decided this has gotta stop.
- Really? There's some bronchospasm.
Add a unit dose of Atrovent to his next treatment.
I think he's waking up.
- Should I call Lewis? - He's her patient.
- Get her out! Get her out of here! - Lie back! You'll hurt yourself.
I don't wanna see her! I told you not to call her! Get out! - You need to talk to her.
- About locking me up again? - About getting me raped? - How about Haldol? She never listens to me! She doesn't care about me! You said we were going camping, you lying slut! - Okay.
Two of Ativan.
- Make it four.
I could use a good buzz! Now, you listen to me! - I want you to settle down right now! - Get her out of here.
I'll ask your mother to leave if you stop struggling.
I put you in that program because I care about you.
- Liar! - Okay.
Okay, hard restraints! - Oh, God - Liar! - Where's the Ativan? - Liar! Liar! From the time she was 2, she's been acting like this.
I thought she would get over it.
Okay.
Come in here.
- And keep pressure on that.
- I know.
They shocked four times for V-fib.
Hold compressions.
Asystole.
Hate crime.
Forget it.
Gray matter and brainstem failure.
- Call it.
- Time of death: 1343.
Some jerk shot him because he wouldn't get off the bus.
Said it was only for Americans.
Morales is en route with the shooter.
Okay, Keith, we have a breathing treatment for you to work on.
Okay.
Here you go.
Deep breaths in and out.
Pulse ox: 99.
Good.
You had an allergic reaction to something.
Is there anything you've eaten that you know you' re allergic to? - Any new medications? - Penicillin.
Why are you taking penicillin? Syphilis.
My ex-girlfriend told me she had an outbreak and I'd better take care of it.
- Did you know you' re allergic to it? - No.
Did the doctor who gave it to you ask? I didn't see the doctor.
My ex told me they gave it to her.
I had a friend who had some leftover from a strep throat.
We' re still waiting for a Russian translator.
When they cry, the eardrum turns red, and you can't rule out an infection.
Kovac, Eye Trauma Girl's losing visual acuity.
She may need decompression.
I'll be right there.
Dr.
Kovac, I was wondering if you'd write a letter of recommendation for my file.
I can't do that.
- What? - Sorry.
Did you give him the message? Luka, wait.
Corday needs some help.
Hold on.
Tell him that I really need to talk to him.
It's important.
Well, you have him call me back.
- You' re blowing off your therapy? - No.
- We had an agreement.
- I never agreed to it.
Well, you came back here, didn't you? I told you it was mandatory, didn't I? - Excuse me.
Luka, I- - Hey, I don't need to see a shrink.
- What's wrong? - His BP's down to 80.
- Might have vagalled with the ABG.
- My stomach Get his head down and squeeze in two liters.
Belly's rigid.
- Where's his last chest film? - Why does it hurt? Tachy at 120.
- Oh, God! Free air under the diaphragm.
- What does that mean? You have a perforation in your stomach or intestine.
- From the penicillin? - No.
Hang a 100 gent, 500 of Flagyl.
- Pressure's down to 60.
- Keith? Keith? How you doing? Keith! How hard were you bagging him? The cords were swollen shut.
Don't hyperventilate.
- Kerry, don't blame this on her.
- Get Corday in here.
Twenty of famotidine, IV piggyback.
Small perforations can heal spontaneously.
Now, Abby.
O-2, 15 liters by mask.
Set up for a central line.
Get some Betadine.
- I can't see.
Why can't I see? - Hold still.
Dr.
Corday, Dr.
Weaver needs a consult.
Retrobulbar hematoma, compressing the optic nerve.
Am I going blind? Please tell me what's wrong.
Blood's collecting behind your eye.
We'll have to drain it.
- How? - A tiny incision.
- Dr.
Corday? - Give me a minute.
- You' re gonna cut my eye? - Just the skin at the side.
No, please.
I don't want you guys to do this.
If we wait, we risk blindness.
Please don't.
I really don't want you to cut my eye.
- Molly, we have no choice.
- Mom? Mom? - One percent with epi.
- I'm here.
They believe what you tell them.
They have to trust you.
You 're the doctor.
You know best.
But I don't.
I guess.
And lie.
Say the same things to different people over and over again until I can hardly make the words come out of my mouth anymore.
It's really hard not to be disgusted.
With yourself, with the system, everyone you work with.
Even with the people you are supposed to help.
Hold on.
Dr.
Corday, we have a gastric rupture.
- Can you suture? - Yeah.
I got it.
- How many fingers? - Two.
- Infuser's primed.
- I'm in.
Hook me up.
- He has a history of peptic ulcer disease? - Over-inflation from bag-mask ventilation.
Could've had an underlying lesion.
Fluid's in.
Pressure's not coming up.
Dopamine at 10 mics.
Tell the O.
R.
Why was he being bagged? Anaphylaxis.
- Gram of cefoxitin.
Cover anaerobes.
- No.
He's allergic to penicillin.
- Any family? - Not that I could see.
Kerry? - Sinus tach on monitor.
- Kerry? - What? - Any family? - I don't know.
Ask Frank.
- He's had steroids? - So how long am I in the hospital? - A few days.
You can go home as long as there's no rebleeding.
Home.
Yeah, right.
My mom would rather I go blind.
She was just here holding your hand.
Yeah, holding my hand for 10 minutes doesn't fix 10 years.
Ten years of what? Of hating me.
- She hates me.
- That's not what I saw.
Whatever.
I hate her too.
What I saw was a scared little girl crying for her mother.
And her mother came.
She'd never let me come home.
- Ask her.
- I can't.
Getting beat up on the street is better? Would you? What? Ask her? - The field's dry.
He's septic.
- Dopamine's up to 20 mics.
- How much blood loss? - Insignificant.
- What's the last crit? - Thirty-six.
Run of six.
100 of lidocaine, starting a drip at two per minute.
He needs crystalloid.
Squeeze in two units of saline and hang Levophed.
- V-tach! - Crash cart! Charge to 200.
- No pulse.
Start compressions.
- Amp of epi.
- We' re charged.
- Clear.
Clear.
No change.
Charge to 300.
Epi's on board.
- Charged again.
- Clear.
Clear.
V- fib.
Damn it.
Three-sixty.
He's a kid.
He should respond.
Vasopressin, 40 units IV.
Mix up a Pronestyl drip.
He was probably gonna blow up the bus.
Blood in the belly.
He's tachy at 120.
Damn terrorists everywhere you look.
He was Sikh.
They' re committed to nonviolence.
Why's he wearing a towel on his head? Maybe he got out of the shower, where you should be.
Blunt trauma.
Still hypotensive after a chest tube and two units.
Looks like an intra-abdominal bleed.
Probable splenic lac with fractured ribs.
Fluid in Morrison's.
Call the O.
R.
- Pressure's down, 50 systolic.
- Let's put him in Trendelenburg.
And squeeze in two units of 0-neg.
Let's go.
I'll take him up myself.
- Dr.
Romano.
- Grab the drug box.
Dr.
Romano, your arm.
Damn it! I'm fine.
Let's just- Let's go.
Let's roll.
It's all my own fault.
I should've never married him.
You get one shot, maybe, at being truly happy.
I had it with Henry Booth when I was 20, and I blew it.
Okay.
Well, I'm gonna come up and check on you after your chelation therapy.
- Till death do they part, huh? - Maybe they deserve each other.
- Do you wanna get dinner tonight? - I can't.
Not tonight.
- Abby, I need to pee.
- I'll be right there, Pablo.
- I don't think I can hold it that long.
- I'm coming! - I was hoping that we could get together.
- I can't.
I have a thing.
What thing? I'm meeting someone.
- Who? - My AA sponsor.
When did this happen? I just decided maybe it was time to say hello.
Hey, Gallant, where's Mrs.
Banks? - Who? - You took care of her facial lac.
- She's not in sutures? - Nope.
Listen, I'm thinking of applying for the match in emergency medicine.
Bad idea.
The letter wasn't for my rotation.
- It was for my residency application.
- I know.
What? What? He bit the balloon! - You think he aspirated? - He looks cyanotic.
Bag him and get a pulse ox.
Foreign body.
- Tough to ventilate.
- It's blocking his airway.
- Pedes intubation tray and a McGill.
- Pulse ox is 81.
I'm good at what I do.
I have certain skills, certain abilities.
They came naturally to me.
- Perfect fit.
- Can you see anything? It's not about seeing.
Others would struggle to get through the day, and I wanted more.
I might have something.
More urgency, more purpose.
Sats are coming up.
Medicine was exciting, powerful alive.
Today, we saved a teenager's sight.
I saved a child's life.
I didn't feel it.
Didn't feel anything.
- Was he stopping at the ER? - They said he was coming straight up.
- Sorry.
I hope I didn't keep you waiting.
- For what? I got tied up with a parathyroidectomy.
Is Robert here? - Our 5:00.
- Right.
Just give me a minute.
- What happened? - Been trying to reach you.
- I was stuck at an EPA site.
- I've been calling and paging.
- Calm down.
- This is why we have records and notes.
This is why we take a history before we administer drugs.
- Privately, please.
- You know that he died? Keith died.
Went into anaphylactic shock, and his airway closed.
Alderman, what brings you here? I'm checking on a staff member.
Congratulations on the budget.
First year they haven't tried to close us.
Dr.
Weaver did an excellent job of articulating your needs.
She's our own little articulator.
Where are you going? - Don't we have this meeting? - Give me a second.
- You okay? - More trouble with the arm? Not worse than getting it severed in the first place.
- I'm glad to hear it.
Stay well.
- Yeah.
You too.
His airway closed, but they had to bag him anyway which caused his stomach to over-inflate and tear.
In here.
But they intubated him anyway, and that over-inflated his stomach.
Slow down.
Slow down.
I thought he was getting a shot of penicillin.
He got one! That's what caused the anaphylaxis! - Things like this happen in medicine.
- My God! What did I do? I didn't ask him if he was allergic.
We always ask.
We always have a chart.
The chart reminds us we' re treating the patient correctly.
Yes, you could've asked.
It wouldn't have prevented it.
I could've given him something else, or better yet, nothing.
I told him it would be a shot of penicillin even before I approached you.
He didn't tell me he was allergic.
He didn't know.
This would've happened, anyway, however he got treated.
They' re waiting for you in the conference.
Anspaugh needs to scrub in.
Have them start without me.
All right.
There's already no record of the shot.
It's too late for that.
We can tell the truth.
- No one else knows? - Not yet.
- Keith didn't say anything about me? - For God's sake.
- Oh, my God.
He's dead.
- I know.
I know.
- He's dead.
- It hurts me more than you know.
That's crap.
You let that poor kid believe he gave you the syphilis.
Don't tell me I don't care! I care.
I care.
But I do need to know what people know.
Self-servingly, yes, I have to protect myself.
But I also have to protect you and this hospital and other county programs- What about protecting your staff? What about protecting your lover? Kerry, this is not your fault.
You understand? It's not your fault.
But if you confess to something like it was people will treat you like it was.
And then everybody loses.
Did he say anything about me? Don't worry.
He lied for you.
He loved you.
They' re starting.
And I killed him trying to hide that for you.
You won't wanna be late for that meeting.
But I will need you later for a press conference.
He was one of my staff.
Goodbye, Jonathan.
Congratulations, Kerry.
Hold on.
I never let rehab compromise my work schedule.
We both know administration is not your strong suit.
- Should I come back later? - No, Kerry.
This involves you.
How long you been planning this? I've asked Robert to consider sharing the chief of staff position with you.
I'd rather cut off my good arm.
I'm sorry you feel that way.
I thought this solution served everyone.
Well, you were wrong.
It's a gift, Robert.
I suggest you take it.
Take it right up the ass.
Fine.
Congratulations, Kerry.
You've just become chief of staff.
Good cap refill.
No disruption of the vasculature.
No.
There wouldn't be with a mechanism of injury.
What's next? I could cut it while slicing a bagel and not realize it till I pass out from blood loss.
- Robert.
- Maybe I could set the damn thing on fire.
You need to be patient.
Yes.
So everyone keeps telling me.
Although none of us actually believe I'm even going to partially recover.
Do we? You believe in the laws of karma, Elizabeth? Eastern philosophy, the influence of past actions on your future life.
I know what it is.
So I can be a jerk.
So what? I've always been honest.
Brutally honest.
Bruised some egos, hurt some feelings.
Maybe provoked a few tears.
But honesty's a hell of a lot more than most people can claim.
I don't deserve this.
Hey, what time's your thing? She's probably waiting for me right now.
Did you get your car fixed? Yeah.
One of these days, I'm gonna get one that works.
So You know, right? - Know what? - That night at the restaurant I had a ring.
You knew that, right? I figured if you wanted to talk about it, you would've.
I didn't go through with it because in that moment it just felt It didn't feel right.
And I don't know why.
And I wish I did know why.
I think the fact that I didn't do it means that maybe something isn't working.
I get it.
It's okay.
I gotta go.
You get it? That's good.
Maybe you can explain it to me because I don't get it.
I know I show up for work, and you act like a completely changed person.
And I think that's great if that's real.
The patch, the sponsor- - Real? - For real, for you.
Or is this gonna get thrown out next time something happens? - If you' re trying to prove something to- - What? - Like some kind of quick fix.
- I didn't do it for you! I woke up sick of myself, okay.
And if you' re sick of me and just all of it, I don't blame you.
I'm not sick of you.
How do you hear that? All I do is disappoint you.
I feel like all I'll ever do is disappoint you.
- I've said this before.
- Stop.
Stop! Stop with this fatalistic, black-cloud, nothing-good-is-ever-gonna-happen routine.
- It's not a routine.
- Hey! What do I have to say? What do I have to do to get through to you? - She needs a stable environment.
- She's the one that's unstable! - Yeah.
I wonder why.
- Luka.
- She's your daughter.
- I've got this now.
- Do you even give a damn? - Thank you.
Does he think that this is the first time I've ever had to make this kind of decision with Molly? I wish to God it was, but it's not.
What if she wants to come home? Now she's scared.
She got hurt.
But what happens when we get there, and it starts all over again? - You'll try harder.
- I have! A thousand times.
Maybe I am a bad mother, but I can't do it anymore.
Enjoy her when she's this age.
She's not old enough to hate you.
I was- I was trying to calm the baby.
You know, with the glove, the balloon.
Don't worry about it.
Yeah, but he could've died.
Yeah.
But he didn't.
You're one of the best medical students that's come through here in a long time.
The place will be lucky to have you.
A letter from me wouldn't mean much.
They only tolerate me know I can burn through a shift.
Tomorrow, I'll get up and do it again.
- Have you thought about taking time off? - Yeah.
Yeah.
Maybe moving home.
I don't know.
There's a cartoon I once saw in a magazine.
A little man is sitting in a room with two doors.
One door says, " Do not enter.
" And the other door says, " Do not exit.
" So he just sits there holding his hat.
We only have 15 minutes left.
Did you wanna keep talking? Or do you wanna get to it? One dispo, two admits, and I am out of here.
Are you ready? Yeah.
But I wasn't gonna change.
- Hey, this way I go straight to the casino.
- You can sing backup for Tony Orlando.
- Who? - Never mind.
- I'll meet you outside.
- Okay, I'll get a cab.
Excuse me, miss.
Can you tell me how to get to the cafeteria? I'm sorry.
I don't work here.
All of us at City Hall are saddened by the loss of Keith Mitchell.
He was a bright and vibrant young man who had a promising future in public service.
He devoted himself to bring dignity and opportunity to the underserved members of our community.
Even though his death was sudden, unexpected and heartbreaking his spirit will live on through his contributions to social programs and through the thousands of lives he touched.
Our thoughts and prayers go out to Keith's family to his many friends and to all those affected by this unavoidable tragedy.
R.
I'm fine.
I've scheduled a meeting with Dr.
Meyers.
It's mandatory.
That was my great-grandmother's.
Youre going to propose? That's it? You bought out this whole place just for that? I found a sore on his penis.
I think it's syphilis.
Any way we can keep it out of my medical record? No! That is not the point! You might save 2.
4 up front but you're gonna lose 20,000 primary care visits a year- - Thank you, Dr.
Weaver.
- For a potential loss of over $10 million.
We have to make tough choices.
You're shortsighted now! Is there a motion to vote? - Excuse me.
I'm not finished.
- I think we understand the issue.
- Lack of primary care leaves thousands- - And your argument.
These are human beings, not statistics.
And we are abandoning an entire community- We get it.
Thank you.
Now is there a motion to vote in open session? - Mr.
Chairman- - Motion.
Second.
All right.
All those in favor of closing the Erie Street Clinic.
Those opposed to the closing.
The nays have it.
Fifteen-minute recess.
Nice work, Kerry.
- Is it always this close? - You have the gift of persuasion.
Well, pugnacity is more like it.
And an understanding of what motivates people.
- That's the secret to a good politician.
- I'm out of my league there.
Nonsense.
It wouldn't surprise me if you were Surgeon General someday.
Kristy.
Meet the future Surgeon General and savior of the Erie Street Clinic.
- Hello, doctor.
- He's kidding.
- He never kids.
- Kerry, you have another minute? Sure.
Parks and Recs has been pushed to 11:00.
And Bamberger called about the gay-marriage amendment.
Tell him I'm sympathetic but it will never pass, and I'm not gonna torpedo the bill.
Maybe we should get you on that one.
Might actually stand a chance.
What do you mean? Youre a problem-solver, Kerry.
A pragmatist.
I can't tell you how much I appreciate that.
Thank you.
That's why I hate to implore you for another personal favor.
But, well I frankly don't know what else to do.
You were very considerate in treating my off-the-record condition.
Did the lesion not heal? No, it did.
But I'm in a relationship with someone, someone that works for me.
I'm single.
Were in love.
But workplace affairs are Well, I don't need the attention.
And she's symptomatic.
I was hoping you could provide treatment with the same level of discretion.
Send her to any free clinic.
Theyre all confidential.
It's a simple shot of penicillin, right? Treatment without generating a medical record is malpractice.
But you've done it before.
And I shouldn't have.
Okay.
Okay.
I think I understand.
I'm sorry.
I mean, you know, I could lose my license.
Don't be sorry.
Youre a woman of principle.
How can I not respect that? Forget I asked.
And congratulations again.
- You did some real good today, Kerry.
- Thank you.
Of course, there are no guarantees for next year's budget at your hospital.
What? There's an afternoon vote on eliminating emergency services.
At County General? You mean closing the ER.
I need you, Kerry.
Is your jalopy still in the shop? - It's a Jeep.
- Oh, a Jeep.
Jalopy.
- You hardly touched your breakfast.
- I don't like to eat much before a shift.
All that blood and guts, you know? Don't remind me.
I had a feeling there was some agenda this morning, you've been very mysterious.
I just wanted to check in, see how you were.
And I wanted to give this back to you for the time being.
- She said no? - I didn't ask.
- Did something happen? - No.
It just felt kind of rushed.
- What did she do? - Nothing.
Doesn't even know.
I don't think she knows.
Maybe she knows.
I don't know.
- I'm sorry, John.
- I thought you'd be relieved.
That youre unhappy? I got the impression that you never really cared for her.
I've spent so many years trying to get you to do what I think is best for you.
Youre passed having me badger you about your choices.
This is yours.
Give it, or don't, to whomever you choose.
- Why? - Well, I'm thinking emergency medicine.
- Here? - Better than Iraq.
Hey, that is not it.
Don't you still owe four years? I can roll the time to after my residency.
Afraid to fight, all right.
- Hey, any time, any place, old man.
- I can smell fear a mile away.
Answer the phone, Frank.
The holiday's called "St.
Patrick's Day, not "St.
Patrick's Week.
You got something against the Irish? The giant shamrock in Triage started drinking 72 hours ago.
- Excuse me.
I'm looking for Dr.
Weaver.
- Frank.
She'll be back in a few minutes.
Have a seat over there.
They always ask me.
Do I look like customer service? - He's cute.
- He's a zygote.
- Anymore blind dates? - Never again.
But were going to Las Vegas tonight.
- Who's we? - Me and Chen.
And 50 other County employees.
So how's it going with you? I have a rule-out MI waiting on his second troponin.
No, I meant in general.
- Any news? - No.
Did you need that? Oh, I thought it was a different patient.
- So how are you and Carter? - Good, I guess.
Kind of.
He's been acting a little weird.
It's been rough for both of you lately.
I think were getting back to normal.
Dr.
Lewis, he's seizing again.
Another four of lorazepam, and load a gram of Dilantin.
Abby, clear a CT on this one.
- Blown pupil? - Subconj hemorrhage.
- No ID? - Too young for a license.
No purse.
- This the assault? - LOC in Union Station.
- Probably a street kid.
- With those boots? - Expensive jacket too.
- Maybe she shoplifts.
- She come in with that girl? - No.
Different run.
- Chest is clear.
Belly's soft.
- Dr.
Kovac? - Isolated head and facial trauma.
- What happened? - Let's get a C-spine, chest and pelvis.
- Dr.
Kovac? - You got this? - Yeah.
Trauma panel, urine ICON, dip a UA.
- Sorry.
I forgot.
- Three times.
Three missed appointments.
Yeah.
I have a bad memory.
Your department required psychotherapy.
I don't wanna be a heavy.
- I wanna help.
- Prepare for disappointment.
I have extended hours tonight.
I'm free from 7 to 8.
Can you make that? - I really don't see the point.
- You don't have to see it.
Just show up.
Just show up.
That's all I've been doing.
Showing up.
Time goes by faster at work.
Shift work.
Treat and street a few lost souls.
Youre with them when they are most vulnerable.
- Is that bile? - That's 17 Jell-O shots.
When they're naked, weak, hurt you touch them look at their bodies see them more closely than their families, their lovers.
But it's mechanical, you know, temporary.
You fix them up, or you watch them die.
Either way, it ends, and you move on.
No next time, no strings.
No real connection.
Maybe that's why I stay.
- You waiting on an incoming? - What? - Did you sign out for an incoming? - Coffee.
Cigarette break? You want some? - What? - Coffee? No, thanks.
- Not turning into a health nut on me.
- No.
Waiting for an old lady that fell off her treadmill.
Okay.
Do you remember what happened? Can I call your parents? I don't live at home.
Where do you live? Molly, I can't help you unless you talk to me.
They call it a boot camp for kids who can't get along with their parents.
So they discipline you? Does this look like discipline? A camp counselor did this to you? Yeah.
I heard they raped a girl.
Okay.
Haleh, perhaps Molly should be speaking with a police officer.
I'm sure your mother would like to know that you' re safe.
Who do you think sent me there in the first place? - Any family? - She said she has a husband, Charles.
- What else did I say about him? - That he's useless.
Exactly.
Forget him.
It's a stolen card.
How am I supposed to know her mother's maiden name? Why are you boarding four ICU players and eight med-surg admissions? Susan's driving.
Talk to her.
Dr.
Weaver? Keith Mitchell.
I have an appointment.
We don't make appointments in the ER.
Report your complaint to the Triage nurse.
I believe special arrangements were made by Alderman Bright? Jonathan has nothing but wonderful things to say about you.
How long have you been in his office? I started junior year, spring quarter, so about two years.
Now I get grad-school credit and on-the-job training.
He's a great mentor.
Very generous with his time.
This goes in the buttocks.
I'm surprised that you waited so long to be treated.
I didn't notice the sore.
Jonathan did.
- When? - Two nights ago.
I was so embarrassed.
I just hoped I didn't give it to him.
- He didn't have it? - No.
I was pretty crazy in my college days.
We' re monogamous now.
I have to say, he was really cool about it.
Most people wouldn't be so understanding.
All done.
We all have our past, right? I told you not to work out so much.
So I can sit and watch the soaps all day? Any other symptoms, Mrs.
Sanbery? Yes.
My hair's falling out.
But I blame that on him.
- She's just kidding.
- The hell I am! - Did you check the fingernails? - Yeah.
I'm getting to that.
- What? - These marks, these lines.
- What marks? - These are Mees' lines.
- What kind of work did you do? - Supervisor at a wood-processing plant.
- Did they use arsenic? - Tested us for it all the time.
Can't be it.
Okay.
Let's get Mrs.
Sanbery's blood and urine reports from OSHA.
- I will be right back.
- Take him with you.
Ruthie, just relax, please.
Wonders of marital bliss.
Who's worse? Her for being such a pain, or him for being so pathetic.
It cuts both ways, I guess.
My bike-girl trauma may have a diminished foot pulse.
Check Doppler.
I'll be there in a minute.
Mrs.
Banks.
- Yes? - I'm Dr.
Corday.
I'm the surgeon treating your daughter.
- She'll need surgery? - No, no.
I'm surprised the camp actually called you.
Why wouldn't they? Well, they assaulted your daughter.
Is that what she told you? She ran off on the second day.
- They didn't touch her.
- Somebody did.
With Molly there's all kinds of explanations.
- What makes you certain it's not the camp? - Because she says it is.
Trashing my house with a baseball bat.
Shoplifting, drinking, drug use, unwanted pregnancy.
Do I need to go on? I need to call my office.
Maybe you can talk to her when you' re finished.
I haven't been able to talk to her in three years.
They actually threw you across the room? In a bar fight, not a tossing.
Big difference.
Congratulations, Kerry.
Whatever you' re doing down at City Hall seems to be working.
- Well, it was a close vote.
- But without a single cut.
- What? - The hospital budget.
We were vulnerable to a 20-percent cut, it sailed through less than an hour ago.
They say he drove out the snakes.
- Who? - St.
Patrick.
Well, I'd like to see you and Robert in my office at 5.
- Is there a problem? - Just a little administrative housekeeping.
We should burn through it quickly.
Dr.
Weaver, Dr.
Lewis needs you.
- What kid? - That kid.
He was looking for you, waiting in Chairs.
Paramedic brought him in.
Stand by with an epi drip.
- Hey, Kerry.
Do you know this kid? - What happened? Passed out across the street.
Tight wheezes and hives.
Barely any breath sounds.
You don't happen to know if he has any food allergies, do you? - No, I don't.
- He was looking for you.
Sats are dropping, 93.
Pulse, 120.
Cords are too edematous.
Prep a crike tray.
Fiber-optic with a 7-0 tube.
- Okay, one more look.
- Wasting time.
- You need to let the drugs work.
- He needs intubation.
- You do know him? - He could be allergic to anything an insect bite, or have a carcinoid.
He's got an ID from City Hall.
Okay, do a jaw thrust and keep a good seal when you bag him.
You know, I did get some papers from Health and Human Services this morning.
Maybe he dropped them off.
Okay, suction and light source on high.
Let's go.
This is an emergency.
You tell him that one of his staffers is in the ER with a severe allergic reaction.
Tell him to call me as soon as he can.
You were right.
He does work at City Hall.
- Alderman Bright's office? - Yeah.
How did you know? Well, there's no insect bite, but there's a chancre on his penis.
- Kerry? - That's a bit of a leap, don't you think? The alderman left here with untreated syphilis.
- We don't know that it was untreated.
- Now one of his staffers comes in- We don't know if the alderman is in the habit of sexual harassment, much less gay.
The kid is in anaphylactic shock.
Either it's a food allergy or a drug.
- My guess is penicillin.
- Not necessarily.
It could be idiopathic histamine release or vasculitis.
He's triggering the vent.
- Any spontaneous eye opening? - Not yet.
Call Immunology for skin testing.
Have them include penicillin.
Get me as soon as he wakes up.
- What's his Fl-O2? - Fifty percent.
Sounds like upper-airway secretions.
I think he's just a little wheezy.
Why don't you get a suction catheter.
He may have a mucous plug we need to clear out.
- He's satting at 98 percent- - I wanna optimize his oxygenation.
Get it.
Keith? Keith? Can you hear me? Keith? Keith, there's a tube in your throat to help you breathe.
You had a severe allergic reaction, probably to the penicillin.
But everything is okay now, all right? We'll take out the tube soon.
You'll be able to speak.
And the other doctors will have some questions for you.
They've examined you.
So they know you have syphilis.
And they'll be able to determine an allergy to penicillin.
But Jonathan cannot have sent you here to me.
You know what that means.
We have to protect him.
We can't give anyone reason to speculate or they might even target Jonathan as the source of the infection.
Listen carefully, Keith.
People have been known to borrow prescriptions from friends without ever seeing a doctor.
They think they know what they have and how to treat it so they take care of it on their own.
Do you understand? Good.
Dr.
Carter, dealership called.
You need brake pads.
It'll be ready at 5.
- Can you get rabies from fish? - No.
- You' re sure? - I'm pretty sure.
What do you make of this? Pike bit me when I was getting it off the line.
Looks infected.
That's it? Call me if you start growing gills.
Doctor, OSHA results.
The arsenic levels in Mrs.
Sanbery's urine for the past three years have been undetectable.
- And today's results? - Over 200 mics per liter.
Maybe she got down about being home.
- Suicide attempt? - I don't know.
Happens to some retirees.
Either that or her husband's trying to kill her.
Well, find out if she's been depressed.
Take it from there.
- What's that? - What? On your back.
It's the patch.
For birth control? No, for smoking.
- You quit smoking? - Four days ago, yes.
Thanks for noticing.
Thanks for sharing.
Last week, I had to bring a throat-cancer patient outside so she could smoke through her trach hole.
- And I decided this has gotta stop.
- Really? There's some bronchospasm.
Add a unit dose of Atrovent to his next treatment.
I think he's waking up.
- Should I call Lewis? - He's her patient.
- Get her out! Get her out of here! - Lie back! You'll hurt yourself.
I don't wanna see her! I told you not to call her! Get out! - You need to talk to her.
- About locking me up again? - About getting me raped? - How about Haldol? She never listens to me! She doesn't care about me! You said we were going camping, you lying slut! - Okay.
Two of Ativan.
- Make it four.
I could use a good buzz! Now, you listen to me! - I want you to settle down right now! - Get her out of here.
I'll ask your mother to leave if you stop struggling.
I put you in that program because I care about you.
- Liar! - Okay.
Okay, hard restraints! - Oh, God - Liar! - Where's the Ativan? - Liar! Liar! From the time she was 2, she's been acting like this.
I thought she would get over it.
Okay.
Come in here.
- And keep pressure on that.
- I know.
They shocked four times for V-fib.
Hold compressions.
Asystole.
Hate crime.
Forget it.
Gray matter and brainstem failure.
- Call it.
- Time of death: 1343.
Some jerk shot him because he wouldn't get off the bus.
Said it was only for Americans.
Morales is en route with the shooter.
Okay, Keith, we have a breathing treatment for you to work on.
Okay.
Here you go.
Deep breaths in and out.
Pulse ox: 99.
Good.
You had an allergic reaction to something.
Is there anything you've eaten that you know you' re allergic to? - Any new medications? - Penicillin.
Why are you taking penicillin? Syphilis.
My ex-girlfriend told me she had an outbreak and I'd better take care of it.
- Did you know you' re allergic to it? - No.
Did the doctor who gave it to you ask? I didn't see the doctor.
My ex told me they gave it to her.
I had a friend who had some leftover from a strep throat.
We' re still waiting for a Russian translator.
When they cry, the eardrum turns red, and you can't rule out an infection.
Kovac, Eye Trauma Girl's losing visual acuity.
She may need decompression.
I'll be right there.
Dr.
Kovac, I was wondering if you'd write a letter of recommendation for my file.
I can't do that.
- What? - Sorry.
Did you give him the message? Luka, wait.
Corday needs some help.
Hold on.
Tell him that I really need to talk to him.
It's important.
Well, you have him call me back.
- You' re blowing off your therapy? - No.
- We had an agreement.
- I never agreed to it.
Well, you came back here, didn't you? I told you it was mandatory, didn't I? - Excuse me.
Luka, I- - Hey, I don't need to see a shrink.
- What's wrong? - His BP's down to 80.
- Might have vagalled with the ABG.
- My stomach Get his head down and squeeze in two liters.
Belly's rigid.
- Where's his last chest film? - Why does it hurt? Tachy at 120.
- Oh, God! Free air under the diaphragm.
- What does that mean? You have a perforation in your stomach or intestine.
- From the penicillin? - No.
Hang a 100 gent, 500 of Flagyl.
- Pressure's down to 60.
- Keith? Keith? How you doing? Keith! How hard were you bagging him? The cords were swollen shut.
Don't hyperventilate.
- Kerry, don't blame this on her.
- Get Corday in here.
Twenty of famotidine, IV piggyback.
Small perforations can heal spontaneously.
Now, Abby.
O-2, 15 liters by mask.
Set up for a central line.
Get some Betadine.
- I can't see.
Why can't I see? - Hold still.
Dr.
Corday, Dr.
Weaver needs a consult.
Retrobulbar hematoma, compressing the optic nerve.
Am I going blind? Please tell me what's wrong.
Blood's collecting behind your eye.
We'll have to drain it.
- How? - A tiny incision.
- Dr.
Corday? - Give me a minute.
- You' re gonna cut my eye? - Just the skin at the side.
No, please.
I don't want you guys to do this.
If we wait, we risk blindness.
Please don't.
I really don't want you to cut my eye.
- Molly, we have no choice.
- Mom? Mom? - One percent with epi.
- I'm here.
They believe what you tell them.
They have to trust you.
You 're the doctor.
You know best.
But I don't.
I guess.
And lie.
Say the same things to different people over and over again until I can hardly make the words come out of my mouth anymore.
It's really hard not to be disgusted.
With yourself, with the system, everyone you work with.
Even with the people you are supposed to help.
Hold on.
Dr.
Corday, we have a gastric rupture.
- Can you suture? - Yeah.
I got it.
- How many fingers? - Two.
- Infuser's primed.
- I'm in.
Hook me up.
- He has a history of peptic ulcer disease? - Over-inflation from bag-mask ventilation.
Could've had an underlying lesion.
Fluid's in.
Pressure's not coming up.
Dopamine at 10 mics.
Tell the O.
R.
Why was he being bagged? Anaphylaxis.
- Gram of cefoxitin.
Cover anaerobes.
- No.
He's allergic to penicillin.
- Any family? - Not that I could see.
Kerry? - Sinus tach on monitor.
- Kerry? - What? - Any family? - I don't know.
Ask Frank.
- He's had steroids? - So how long am I in the hospital? - A few days.
You can go home as long as there's no rebleeding.
Home.
Yeah, right.
My mom would rather I go blind.
She was just here holding your hand.
Yeah, holding my hand for 10 minutes doesn't fix 10 years.
Ten years of what? Of hating me.
- She hates me.
- That's not what I saw.
Whatever.
I hate her too.
What I saw was a scared little girl crying for her mother.
And her mother came.
She'd never let me come home.
- Ask her.
- I can't.
Getting beat up on the street is better? Would you? What? Ask her? - The field's dry.
He's septic.
- Dopamine's up to 20 mics.
- How much blood loss? - Insignificant.
- What's the last crit? - Thirty-six.
Run of six.
100 of lidocaine, starting a drip at two per minute.
He needs crystalloid.
Squeeze in two units of saline and hang Levophed.
- V-tach! - Crash cart! Charge to 200.
- No pulse.
Start compressions.
- Amp of epi.
- We' re charged.
- Clear.
Clear.
No change.
Charge to 300.
Epi's on board.
- Charged again.
- Clear.
Clear.
V- fib.
Damn it.
Three-sixty.
He's a kid.
He should respond.
Vasopressin, 40 units IV.
Mix up a Pronestyl drip.
He was probably gonna blow up the bus.
Blood in the belly.
He's tachy at 120.
Damn terrorists everywhere you look.
He was Sikh.
They' re committed to nonviolence.
Why's he wearing a towel on his head? Maybe he got out of the shower, where you should be.
Blunt trauma.
Still hypotensive after a chest tube and two units.
Looks like an intra-abdominal bleed.
Probable splenic lac with fractured ribs.
Fluid in Morrison's.
Call the O.
R.
- Pressure's down, 50 systolic.
- Let's put him in Trendelenburg.
And squeeze in two units of 0-neg.
Let's go.
I'll take him up myself.
- Dr.
Romano.
- Grab the drug box.
Dr.
Romano, your arm.
Damn it! I'm fine.
Let's just- Let's go.
Let's roll.
It's all my own fault.
I should've never married him.
You get one shot, maybe, at being truly happy.
I had it with Henry Booth when I was 20, and I blew it.
Okay.
Well, I'm gonna come up and check on you after your chelation therapy.
- Till death do they part, huh? - Maybe they deserve each other.
- Do you wanna get dinner tonight? - I can't.
Not tonight.
- Abby, I need to pee.
- I'll be right there, Pablo.
- I don't think I can hold it that long.
- I'm coming! - I was hoping that we could get together.
- I can't.
I have a thing.
What thing? I'm meeting someone.
- Who? - My AA sponsor.
When did this happen? I just decided maybe it was time to say hello.
Hey, Gallant, where's Mrs.
Banks? - Who? - You took care of her facial lac.
- She's not in sutures? - Nope.
Listen, I'm thinking of applying for the match in emergency medicine.
Bad idea.
The letter wasn't for my rotation.
- It was for my residency application.
- I know.
What? What? He bit the balloon! - You think he aspirated? - He looks cyanotic.
Bag him and get a pulse ox.
Foreign body.
- Tough to ventilate.
- It's blocking his airway.
- Pedes intubation tray and a McGill.
- Pulse ox is 81.
I'm good at what I do.
I have certain skills, certain abilities.
They came naturally to me.
- Perfect fit.
- Can you see anything? It's not about seeing.
Others would struggle to get through the day, and I wanted more.
I might have something.
More urgency, more purpose.
Sats are coming up.
Medicine was exciting, powerful alive.
Today, we saved a teenager's sight.
I saved a child's life.
I didn't feel it.
Didn't feel anything.
- Was he stopping at the ER? - They said he was coming straight up.
- Sorry.
I hope I didn't keep you waiting.
- For what? I got tied up with a parathyroidectomy.
Is Robert here? - Our 5:00.
- Right.
Just give me a minute.
- What happened? - Been trying to reach you.
- I was stuck at an EPA site.
- I've been calling and paging.
- Calm down.
- This is why we have records and notes.
This is why we take a history before we administer drugs.
- Privately, please.
- You know that he died? Keith died.
Went into anaphylactic shock, and his airway closed.
Alderman, what brings you here? I'm checking on a staff member.
Congratulations on the budget.
First year they haven't tried to close us.
Dr.
Weaver did an excellent job of articulating your needs.
She's our own little articulator.
Where are you going? - Don't we have this meeting? - Give me a second.
- You okay? - More trouble with the arm? Not worse than getting it severed in the first place.
- I'm glad to hear it.
Stay well.
- Yeah.
You too.
His airway closed, but they had to bag him anyway which caused his stomach to over-inflate and tear.
In here.
But they intubated him anyway, and that over-inflated his stomach.
Slow down.
Slow down.
I thought he was getting a shot of penicillin.
He got one! That's what caused the anaphylaxis! - Things like this happen in medicine.
- My God! What did I do? I didn't ask him if he was allergic.
We always ask.
We always have a chart.
The chart reminds us we' re treating the patient correctly.
Yes, you could've asked.
It wouldn't have prevented it.
I could've given him something else, or better yet, nothing.
I told him it would be a shot of penicillin even before I approached you.
He didn't tell me he was allergic.
He didn't know.
This would've happened, anyway, however he got treated.
They' re waiting for you in the conference.
Anspaugh needs to scrub in.
Have them start without me.
All right.
There's already no record of the shot.
It's too late for that.
We can tell the truth.
- No one else knows? - Not yet.
- Keith didn't say anything about me? - For God's sake.
- Oh, my God.
He's dead.
- I know.
I know.
- He's dead.
- It hurts me more than you know.
That's crap.
You let that poor kid believe he gave you the syphilis.
Don't tell me I don't care! I care.
I care.
But I do need to know what people know.
Self-servingly, yes, I have to protect myself.
But I also have to protect you and this hospital and other county programs- What about protecting your staff? What about protecting your lover? Kerry, this is not your fault.
You understand? It's not your fault.
But if you confess to something like it was people will treat you like it was.
And then everybody loses.
Did he say anything about me? Don't worry.
He lied for you.
He loved you.
They' re starting.
And I killed him trying to hide that for you.
You won't wanna be late for that meeting.
But I will need you later for a press conference.
He was one of my staff.
Goodbye, Jonathan.
Congratulations, Kerry.
Hold on.
I never let rehab compromise my work schedule.
We both know administration is not your strong suit.
- Should I come back later? - No, Kerry.
This involves you.
How long you been planning this? I've asked Robert to consider sharing the chief of staff position with you.
I'd rather cut off my good arm.
I'm sorry you feel that way.
I thought this solution served everyone.
Well, you were wrong.
It's a gift, Robert.
I suggest you take it.
Take it right up the ass.
Fine.
Congratulations, Kerry.
You've just become chief of staff.
Good cap refill.
No disruption of the vasculature.
No.
There wouldn't be with a mechanism of injury.
What's next? I could cut it while slicing a bagel and not realize it till I pass out from blood loss.
- Robert.
- Maybe I could set the damn thing on fire.
You need to be patient.
Yes.
So everyone keeps telling me.
Although none of us actually believe I'm even going to partially recover.
Do we? You believe in the laws of karma, Elizabeth? Eastern philosophy, the influence of past actions on your future life.
I know what it is.
So I can be a jerk.
So what? I've always been honest.
Brutally honest.
Bruised some egos, hurt some feelings.
Maybe provoked a few tears.
But honesty's a hell of a lot more than most people can claim.
I don't deserve this.
Hey, what time's your thing? She's probably waiting for me right now.
Did you get your car fixed? Yeah.
One of these days, I'm gonna get one that works.
So You know, right? - Know what? - That night at the restaurant I had a ring.
You knew that, right? I figured if you wanted to talk about it, you would've.
I didn't go through with it because in that moment it just felt It didn't feel right.
And I don't know why.
And I wish I did know why.
I think the fact that I didn't do it means that maybe something isn't working.
I get it.
It's okay.
I gotta go.
You get it? That's good.
Maybe you can explain it to me because I don't get it.
I know I show up for work, and you act like a completely changed person.
And I think that's great if that's real.
The patch, the sponsor- - Real? - For real, for you.
Or is this gonna get thrown out next time something happens? - If you' re trying to prove something to- - What? - Like some kind of quick fix.
- I didn't do it for you! I woke up sick of myself, okay.
And if you' re sick of me and just all of it, I don't blame you.
I'm not sick of you.
How do you hear that? All I do is disappoint you.
I feel like all I'll ever do is disappoint you.
- I've said this before.
- Stop.
Stop! Stop with this fatalistic, black-cloud, nothing-good-is-ever-gonna-happen routine.
- It's not a routine.
- Hey! What do I have to say? What do I have to do to get through to you? - She needs a stable environment.
- She's the one that's unstable! - Yeah.
I wonder why.
- Luka.
- She's your daughter.
- I've got this now.
- Do you even give a damn? - Thank you.
Does he think that this is the first time I've ever had to make this kind of decision with Molly? I wish to God it was, but it's not.
What if she wants to come home? Now she's scared.
She got hurt.
But what happens when we get there, and it starts all over again? - You'll try harder.
- I have! A thousand times.
Maybe I am a bad mother, but I can't do it anymore.
Enjoy her when she's this age.
She's not old enough to hate you.
I was- I was trying to calm the baby.
You know, with the glove, the balloon.
Don't worry about it.
Yeah, but he could've died.
Yeah.
But he didn't.
You're one of the best medical students that's come through here in a long time.
The place will be lucky to have you.
A letter from me wouldn't mean much.
They only tolerate me know I can burn through a shift.
Tomorrow, I'll get up and do it again.
- Have you thought about taking time off? - Yeah.
Yeah.
Maybe moving home.
I don't know.
There's a cartoon I once saw in a magazine.
A little man is sitting in a room with two doors.
One door says, " Do not enter.
" And the other door says, " Do not exit.
" So he just sits there holding his hat.
We only have 15 minutes left.
Did you wanna keep talking? Or do you wanna get to it? One dispo, two admits, and I am out of here.
Are you ready? Yeah.
But I wasn't gonna change.
- Hey, this way I go straight to the casino.
- You can sing backup for Tony Orlando.
- Who? - Never mind.
- I'll meet you outside.
- Okay, I'll get a cab.
Excuse me, miss.
Can you tell me how to get to the cafeteria? I'm sorry.
I don't work here.
All of us at City Hall are saddened by the loss of Keith Mitchell.
He was a bright and vibrant young man who had a promising future in public service.
He devoted himself to bring dignity and opportunity to the underserved members of our community.
Even though his death was sudden, unexpected and heartbreaking his spirit will live on through his contributions to social programs and through the thousands of lives he touched.
Our thoughts and prayers go out to Keith's family to his many friends and to all those affected by this unavoidable tragedy.