Chicago Med (2015) s10e02 Episode Script

1
[SIRENS WAILING]
Today could become every day.
I'm here for a reason,
and it's not to keep the status quo.
I've run this ED just
fine before you came here.
Are you worried
Goodwin's lost confidence
in your ability to lead alone?
- You really care about her.
- Yeah, I do.
What are you gonna do when
Jackson-Monroe closes next week?
I don't know.
Beg someone to let me
finish my residency?
Sully and his boys followed
Pawel to a bar in Lincoln Park.
Cops don't care about small-time stuff.
A witness just came forward
who puts you at the scene.
An arrest is not out of the question.
Now, Jimmy, this might tickle a bit,
so I need you to promise
not to giggle, OK?
- OK.
- OK.
Figured it must have fallen
on the floor when I didn't
see it under the pillow.
And got it.
Look at that.
Yes.
I think the tooth fairy better
give you a bonus for this one.
[SOFT DRAMATIC MUSIC]
♪
Good morning.
Good morning.
Oh, that's nice.
I thought you were going home.
Mm-mm.
Someone needed to be on call.
What happened to Gephardt?
Caroline was let go.
As was Mia,
Sammy the day before.
♪
Wow.
Goodwin's really
racking up the body count.
Yeah, at this point,
I'll just be happy to see
reinforcements arrive.
Well, that's assuming
you survive the cut.
The worst is over, from what I hear.
Hmm.
We should do something to celebrate.
Hmm, as long as it involves
climbing into my own bed
tonight, I'm up for anything.
Well, then maybe we
should get a head start.
♪
[LAUGHS]
♪
- [PHONE BUZZES]
- [GROANS]
- [CHUCKLES]
- [GROANS]
[SIGHS]
What is it?
Goodwin.
She wants to see me in her office.
♪
[INDISTINCT CHATTER]
Hank, I'm so sorry.
- This is so brutal.
- I know.
I mean, how long have we been
working with Vicki and Hank?
They're all like family.
I feel like my insides
are being ripped out.
Yes, absolutely. Me too.
But I was talking about how
short-staffed we're gonna be.
Couldn't Ms. Goodwin have waited
until after the Jackson-Monroe
people got onboarded?
You're unbelievable.
Mm, sometimes it is important
to make room for new blood.
He looks awfully familiar, doesn't he?
Yes, because he was here, helping out
with the mass casualty
from the ferry last week.
No, no, that's not it. Mm-mm.
- Mm.
- Morning, Maggie, Doris.
Good morning, Dr. Frost.
- For you.
- What's this?
It's a little thank-you for getting
- my residency transferred.
- Oh.
I know you put in a good word
with the powers that be, so
Well, don't make me regret it.
- [CHUCKLES]
- You have a patient in 6.
Parents think that he has a broken rib.
All right, let's see what we got.
Mm-hmm.
All right,
does this hurt when I touch it?
- [GROANS] A little.
- Little bit?
- Mm-hmm.
- All right.
I got elbowed pretty good
going up for a header
in the box the other day.
Yeah, well, I'm gonna have
a word with your coach
about how hard they're
letting you guys practice.
Please, I don't want
any more special treatment.
I missed all of last season
'cause of the surgery.
The Ewing's sarcoma they removed.
Max had a graft done on his femur.
They took some bone from my forearm.
But good thing I don't
need that for soccer.
[CHUCKLES]
Well, I can see
from your chart here, Max,
that the cancer is in remission.
Yeah, he licked it.
Yeah, my son's a fighter.
I can tell.
What position do you play?
Center mid.
This guy Aidan took my number
10 jersey while I was out.
- Uh-oh.
- But that's cool.
I'm gonna win it back before
regionals next month.
Kid's got a one-track mind.
Well, let's see what Mike
here can show us, all right?
Joe, Gina, please.
X-ray. [DEVICE BEEPS]
[DRAMATIC MUSIC]
Well, Max, I'm not seeing
any rib fractures here,
but sometimes we just can't
catch those on a plain X-ray.
So if it's OK with you all,
I'd like to do a CT scan
for a closer look.
Yeah, sure. Yeah, we got time.
- I'll check back in a bit.
- Thanks.
♪
- Hey, Maggie?
- Yeah?
Can we get this young man a chest C
as soon as we can, please?
Roger that.
And loop in oncology
to take a look as well.
Yeah.
♪
[DOOR SLAMS]
♪
Dr. Ripley.
I'm sure you're wondering
why I've summoned you here this morning.
Please have a seat.
It's come to the hospital's attention
that a new witness has come forward
placing you at the scene
of Pawel Wapniarski's
aggravated battery.
I've already talked
to the police about it.
Well, now we'd like
for you to speak with us.
We've scheduled a committee hearing
later today so you could
tell your side of the story.
Here is the official notice.
♪
You thought you were being fired.
It did cross my mind.
Well, I assure you, Dr. Ripley,
that the outcome of this hearing
could have a far more damaging
effect on your career
than simply being laid off.
If the committee is not
satisfied with your account,
you could very well be suspended,
your license to practice medicine
in jeopardy of being revoked.
For being suspected of roughing up
a known scam artist?
For being suspected
of retaliating against someone
who sued you for malpractice.
Look, I suggest you take
the rest of the morning off
to think about what you're going to say.
♪
Hey, uh, Mitch just got
summoned to see Goodwin.
OK.
He's not getting fired, is he?
Well, why are you asking me?
Because you're the chief of the ED.
Cochief now, apparently.
And no, I don't know
anything about that.
I mean, it's not like Goodwin is
keeping me in the loop lately.
[SIGHS] You've navigated
choppier waters than this, Dean.
I have faith you'll manage.
Fresh pot of coffee
if you're interested.
I already had one this morning, thanks.
I was wondering if you
had time to look over
the memo I emailed last night.
The one that arrived at 10:43?
Can't say I did.
I compiled some data regarding
our door-to-doctor times
and other throughput metrics,
and I took the liberty of drawing up
a proposal on how we might divvy up
the management of operations.
It goes into considerable detail
[CHUCKLING] Oh, I know.
Crashed my hard drive,
the file was so big.
It's understandable
that you're resistant to change, Dean,
but it's only going to hinder
your ability moving forward.
No, actually, I'm fine with change.
I even came up with an idea
on that very front myself.
I have one that fits on a Post-it note.
- Oh?
- Mm-hmm.
We each take half the ED.
I handle trauma.
You run emergency medicine.
It's a clean division of labor, right,
so you staying in your lane,
me staying in mine.
I'm not sure that's going to work.
Ah, sure, it will.
Just give it a chance.
- Hey.
- Yeah.
Naomi's intaking a patient out there,
and she needs one of you to supervise.
What brought the patient in?
Fell off an obstacle course,
banged up her ankle.
Guess that's me. See? Simple.
Well, I'm afraid, Cadet Herrera,
that your ankle is, in fact,
fractured and dislocated.
Good news is, I can reduce
and splint it for you.
Thank you, sir.
But what is most concerning
for me is why you fell.
Student Doctor Howard tells me that you
reported that you fainted?
- Yes, sir.
- Yeah?
Has this ever happen to you before?
No, sir.
All right, can you
lean forward for me, please?
Take a deep breath.
Did you get an EKG yet?
Sinus rhythm, normal rate,
but she's got PVCs.
O2 sats at 93, trending down.
Cadet Herrera passed her yearly physical
just last month with flying colors.
I'd feel a lot better
if there was something
in your history to explain the dizziness
and shortness of breath.
Now, you attend Illinois West,
is that correct?
Yes, sir.
IW had a rep as
a party school back in my day.
Any chance you might be
nursing a hangover?
No, sir. I don't use alcohol.
How about other recreational drugs?
The ROTC unit under my command
is routinely drug tested,
including just this morning.
If Cadet Herrera had been using,
she'd have already lost her scholarship.
OK, well, I'm glad we can rule that out.
All right, let's grab
a CBC, CMP, BNP, and a UA.
And I'll be back in a little
bit to take care of that ankle.
Thank you, sir.
Wait, so that's your plan,
to say nothing?
It's the Physician Wellness Committee.
It's not like I'm facing
a congressional subpoena.
Is this Sully's idea, you stonewalling?
No, I haven't I haven't
spoken with him about this.
Mitch, that's
Hannah, he has enough on his plate
with the cancer, his new baby.
OK, you really think that if Sully knew
that you could lose your license
that he'd let you take the fall for him?
[PHONE BUZZES]
OK, if I'm gonna do this,
I will need to speak with him first.
OK, look, I'm needed downstairs.
But
if Sully's as good
of a friend as you say he is,
he will understand.
Kendall. I'm Dr. Asher.
I understand you suffered
a bit of a spill.
She fell down a flight of stairs
in our apartment building.
Seems like her wrist
took the worst of it.
- OK, may I?
- Mm.
OK.
My baby, is she gonna be OK?
I noticed a spot of blood
in my underwear.
The fetal monitor is showing
a healthy heartbeat,
so that's a positive sign.
But I would love to do an ultrasound
just to make sure, OK?
OK? Of course it's OK.
Why wouldn't I want an ultrasound?
You should be aware
we suffered a miscarriage
a couple years ago,
later even than this.
May I ask what happened?
I lost the baby.
What more do you want me to say?
We don't really like to talk about it.
I understand.
OK. [SIGHS]
So how far along are you?
About 21 weeks?
All right.
I know you gave her a bit of a jostle,
but I am not seeing
any placental eruption.
Wait, something's wrong
with the placenta?
No, no, no, no, no. The opposite.
This is good news.
Honey, it's OK.
- [LAUGHING] Baby's OK.
- You know what?
Why don't we get that wrist X-rayed
and make sure everything's OK there too?
OK, I'll be right back.
♪
Hey, listen.
Sorry for my wife.
That's totally not like her.
I mean, she got in a big fight
with her sister
just before the accident,
so she was all worked up.
No need to apologize.
I'm sure she had quite the scare.
Well, she seems a bit confused still.
Is it possible she hit her head?
You know, we can check on that as well.
- Thank you, Doctor.
- Mm-hmm.
♪
"Trim the fat, Sharon," the board says,
like I'm some kind of butcher.
This is the hardest week
I've ever had here.
No one's holding you to blame.
Well, the doorjamb on my
office tells a different story.
♪
It'll be OK.
I'll catch up with you later.
♪
Oh, hey.
Did I hear correctly that, like,
all of a sudden, Ripley's being called
in front of
the Wellness Committee today?
You know, maybe we should
discuss this in private.
♪
I'm telling you, I am becoming
genuinely concerned that Mitch might be
getting railroaded, really.
Well, you know what concerns me, Daniel?
Someone that I consider
a close personal friend
failed to notify me that
the hospital may have hired
a doctor that he knows has a history
of violent and erratic behavior.
Sharon, he's a patient of mine.
You know I can't talk about that stuff.
All I'm saying is that
you could have found a way
to warn me about some of his red flags
without overstepping
any ethical boundaries.
You know what? You're right.
I could have, and I apologize.
But if you're curious
about why I've been defending
this guy, Sharon, it's 'cause
I think I failed him back then.
I just can't shake the feeling
that this Mitch
simply isn't capable of doing
what he's being accused of.
I truly hope not.
♪
But listen,
I need you to recuse yourself
from this hearing,
all things considered.
Honestly, I'm relieved.
♪
Hey, Dan? Hi, sorry to interrupt.
I have a patient who came in
behaving erratically.
I thought it might have been
due to a fall that she took,
but imaging came back negative,
so I pulled her medical records.
And she's been prescribed
an antipsychotic
for the past 15 years.
Do you think it could have
stopped working?
♪
- Excuse me, Dr. Archer.
- Yeah.
I have a patient in T5
with severe GI distress.
- Is it a trauma?
- No.
It's not my bailiwick anymore.
She's your man.
[RETCHING]
Is it possible he ate something?
I don't think so.
- [GROANS]
- Nothing I can point to.
We had breakfast at the
Cracker Barrel on the way in
to pick up a new F-250
Tyler bought for us.
[GROANS] Sorry, Mom.
You didn't even get to enjoy
the new-car smell.
Oh, please.
Can you believe this boy?
He almost single-handedly
saved the family farm.
Thought we were gonna have to sell,
but then Tyler figured out a way
to increase the yields
on our sunflowers.
What happened here, Tyler?
Oh, I sliced up my hand picking
without gloves, stupidly,
a few days back.
Looks like you may have
burned it as well.
Oh, no.
Here it comes again.
[RETCHING]
I can't remember
when I've seen him this sick.
Ms. Howard, any thoughts?
Uh, likely viral gastroenteritis.
So what now?
We should get a CBC,
CMP, lipase, and a UA
and maybe start him on Zofran and saline
to get him feeling better.
Very good. Go put those orders in.
I need a hand in here!
She can't breathe!
[TENSE MUSIC]
Sats are down to 84.
Speak to me. Can you speak to me?
Cadet Herrera?
All right, we need to intubate.
Push 20 of etomidate, 50 of roc.
♪
I-I don't know if this is gonna work.
Why? What is it?
♪
- [SIGHS]
- Hey.
Lynne told me you're here
for a PET scan?
Just getting my results
from the last one.
I was gonna come bother you,
but I figured you were
busy saving lives
or whatever it is you do.
Mr. Sullivan, we're ready for you now.
[SIGHS, GROANS]
Hey, uh, how about we grab lunch after?
Lunch?
Hmm, like cucumber sandwiches
and a glass of Chablis?
[LAUGHS]
Yeah, or just street tacos, whatever.
Why does this sound serious?
[DRAMATIC MUSIC]
I'll be out here when you're done.
[SIGHS]
♪
So what are you saying?
Our son is terminal?
The sarcoma, unfortunately,
has metastasized
throughout his body
most concerningly,
Max's spine and lymph nodes.
What kind of timeline
are we talking about here?
I hate to hazard these kinds of guesses.
Please, Doc, just
just shoot straight with us.
Given this rate of progress,
Max has two, maybe three months.
[GROANS]
- [SOBBING] No!
- [GROANS]
Oh.
There must be something you
can do to give us more time.
We could go in and debulk
the most aggressive tumor in the spine.
That might buy Max six months or so.
A-and you can do that today?
Yes.
But I have to warn you,
even if successful,
your son's quality of life post-surgery
will be extremely compromised.
Max would be confined to a wheelchair,
unable to play soccer or even walk.
[SOMBER MUSIC]
♪
I mean, falling down the stairs,
it must have been terrifying.
Did you trip over something or
Yeah, I was late for work.
Did we not discuss this already?
Did we? I'm sorry.
I definitely need another cup of coffee.
Says here you're on risperidone and
- Uh-huh.
- Right.
Can I ask what that was prescribed for?
I was diagnosed with schizophrenia.
Back when she was in college,
way before we even met.
I know, it seems inconceivable
to me, the very idea.
I don't think I know anyone
more sane than my wife.
Hmm, well, it sounds like
it's been working well for you.
And how's your mood been in general?
I mean, obviously, pregnancy
can be a bit of an adventure.
How so?
Do I understand correctly that you got
into a heated argument with your sister
right before the accident?
What? No, I hadn't.
Did I get that wrong?
I mentioned earlier to Dr. Asher
I heard you screaming
on the phone at someone, honey,
from the other room.
- Screaming?
- Yeah, something like,
"Stop talking to me like that."
I just assumed it was your sister.
Oh, yeah, I rem yeah, I remember now.
I-I got a call from work,
and it was an emergency,
and that's why I ran off when I did.
♪
Do me a favor, would you?
Add a risperidone level
to Kendall's blood work.
What, you think she stopped taking it?
Not necessarily.
But look, a lot more research
needs to happen,
but there is some data out there
linking it to increased risk
of miscarriage.
Risk is low in the first place,
but I don't know.
I guess there could be a scenario
where she might have blamed it
for their earlier loss.
OK, but so you know,
it's been known to take the lab
a few hours for that test.
Anything you can do to buy some time
while we wait to get it back?
I can recommend
she be admitted overnight
for toco monitoring
to make sure the baby's OK.
Excellent idea.
[RETCHING]
We pushed the Zofran?
4 milligrams, yes.
BP's softer than I was hoping for.
Tell me, Diedre,
do you keep any chickens
or ducks on your farm?
We got a brood of hens for the eggs.
Why?
Avian flu.
I was thinking the exact same thing
as soon as they said they were farmers.
Why didn't you say something earlier?
Assertiveness and confidence
two critical qualities
for a doctor, Naomi,
especially for a woman.
If it doesn't come naturally,
keep practicing in the mirror
till it does.
- Prep nasal swab, H5N1.
- OK.
Thank you, Dr. Lenox.
I-I'll work on that.
Student Doctor Howard,
where are we at
with this patient's labs?
Pretty unremarkable, to be honest.
No drugs in the urine or the blood.
Higher-than-normal levels of B3 and D,
but that can be explained by the
amount of time she spends outdoors.
And her BNP levels aren't
indicative of heart failure.
Something's just not adding up.
Her tongue swelling up
suggests an extreme
anaphylactic response
to something, though, right?
Yeah, the question is, to what?
Push 0.3 milligrams epi IM,
125 milligrams SOLU-MEDROL IV,
and 50 of Benadryl.
And let's grab an echo
so we can rule out
any underlying cardiac issues.
OK.
Just remember,
all of this takes precedence
over some projectile vomiting,
regardless of what Dr. Lenox may say.
Oof.
The sarcoma's back?
I don't believe this.
Regionals are supposed to
start in a couple of weeks, Dad. I
I know it's not
what you were hoping to hear.
But hey, we you know,
spoke with the doctors, and
And they tell us that
with one more simple surgery,
they're confident
you'll finally be cancer-free.
And there's a good chance you might even
be ready for spring season.
♪
I apologize for pulling you
away like this,
OK, and I-I know
how difficult it must be
to communicate these things
to your child.
But I-I guess I'm confused.
None of that was what
we discussed earlier
the prognosis, the timeline.
Doc, I know.
Hey, we just decided,
after all he's been through,
we couldn't tell him he was terminal.
I get that. I do.
But you are overstating
his chance for recovery.
Doc, we just want to keep his hopes up.
His hopes or yours?
♪
This surgery is going
to constrain him physically
for the remainder of his life.
Max should know all the facts
before consenting.
He deserves to know the truth.
We appreciate your concern, Dr. Frost,
but this isn't something we're
really looking to discuss.
But you are grossly
misleading your child.
Our child,
not yours.
This is our decision to make.
♪
And we're gonna need you
to refrain from discussing
any of this with him.
♪
[INDISTINCT CHATTER]
[SOFT DRAMATIC MUSIC]
♪
Hey, Dan, Kendall's labs came back.
No evidence
of risperidone in her system.
- Nothing?
- Mm-mm.
Could have weaned herself off
when she found out she was pregnant.
How long might it take until
she shows signs of an episode?
Honestly, I think that we're looking
at some early signs now.
Is it possible that an episode
could have led her
to falling down the stairs?
Sure.
Is there any way we can hold her
so she doesn't harm herself or the baby?
Not taking her meds is
clearly a conscious decision,
right, not against the law.
I mean, unfortunately,
she hasn't said anything,
done anything presumptive enough yet
for me to issue a hold.
Yet.
I thought you two should know
Kendall is leaving AMA.
[SIGHS]
♪
I am doing what needs
to be done to protect my baby.
Done. End of story.
I completely understand
that it is tempting
to attribute the cause
of your miscarriage
to the meds you were taking.
Not to mention, there are other meds
we could try with safer profiles
- right n
- I'm fine, OK?
In fact, I'm not sure I need
to be on the medication at all.
I implore you,
please don't take this risk.
Have I signed everything I need to sign?
Just a couple more forms.
I can't find my phone.
Could you please go grab it for me?
- Yes.
- And I will finish this up.
Thank you.
Bryce, I need to level with you.
I'm becoming very concerned
that your wife could already
be well on her way to putting
herself and your child at risk.
Dr. Charles, I think
you are overreacting.
She hasn't had an episode in
all the time you've known her?
That's a wonderful thing.
If and when Kendall starts
to experience symptoms again,
things could get
very challenging very quickly.
How so?
That argument that you
overheard this morning,
do you think that there's a possibility
that she might not actually
have been on the phone with anybody?
Then who was she talking to?
I'm just curious
if you can think of any detail
that might lead you to believe that
she was talking
to somebody who wasn't there.
I don't I don't know.
I don't know. Maybe.
If we were to check
her call history right now,
we'd know for sure.
♪
Oh, good, you found it.
Come on. Let's get out of here.
♪
Listen.
I'm sure it's gonna be OK.
Bryce, good luck to you, really.
♪
[SIGHS]
You're considering
bypassing the parents?
I'm fairly certain I'm well within
my rights as a patient advocate.
In a vacuum, maybe.
But in this circumstance,
the parents expressly requested
that you not communicate the drawbacks
of the surgery to their child.
Doctor? [WHISTLES]
Thank you.
Personally, I prefer my
residents have as much autonomy
as possible and make
decisions for themselves,
as long as they're not
stepping over any bright lines.
I mean, but, you know,
what do I know? [CHUCKLES]
Well, great. Thanks, Dr. Archer.
Mm-hmm.
What happened to us
staying in our lanes?
I'm sorry? What?
Dr. Frost's patient is pretty clearly
under the purview of emergency medicine.
Really?
Because I thought the boy
came in initially with injured ribs.
But hey, if you prefer a more
"spirit of the law" interpretation,
I'm OK with that.
[CHUCKLES]
From what this committee
can glean, Dr. Ripley,
it appears the victim
of the alleged assault,
a Mr. Pawel Wapniarski,
recently sued you successfully
for malpractice.
That was settled out of court.
Nonetheless,
there's an appearance of motive
or at least a conflict of interest.
Add in the fact that you had
left the hospital
the day in question,
depriving you of an alibi,
plus a witness who places you at or near
the felony itself, and
♪
Reputationally,
this hospital can't afford
to have our doctors be seen
as carrying vendettas for retribution.
So we need to ask you,
Dr. Ripley, directly,
were you or were you not
responsible for what happened?
♪
I have no comment.
♪
Dr. Ripley, you do understand
that if you don't
cooperate with this committee,
you could face indefinite suspension?
♪
I do.
♪
Hey.
I thought we agreed
you were gonna come clean.
I changed my mind.
You changed your mind, great.
Just like that, 'cause now
now you've been suspended.
What happened?
Did Sully tell you not to say anything?
Uh, no.
He told me his cancer was terminal.
What?
[DRAMATIC MUSIC]
Yeah, his latest PET scan confirmed it.
♪
He might only have a few weeks left.
Mitch, I am so sorry.
How was I supposed to tell him
that I was being forced
to snitch on him, that
he was gonna have to spend
the remaining days of his life
caught up in arraignments
and bail hearings,
away from Lynne and his kid?
♪
Look, none of this changes the fact,
though, Mitch, that your career
is on the line.
Stop. Stop, OK?
None of it matters anymore.
But you not practicing medicine
- doesn't change what's
- I won't put him through that.
♪
Any improvement?
Her ABGs are really acidotic.
Looks like she'll need dialysis.
Her kidneys are failing?
Not yet, but they're
trending in that direction.
Dr. Archer, I know this might
seem completely irrelevant,
but Dr. Lenox has a patient in T5.
- His name's Tyler
- All right, Dr. Lenox
is perfectly capable of taking
care of her own patients.
At least, I hope so.
No, I-I agree, sir,
but in this case, anyway,
her patient is showing some fairly
inconsistent symptoms himself.
I mean, at one point, we thought
he might have bird flu, but
All right, you care
to tell me what any of that
has to do with Cadet Herrera here?
Tyler's kidneys are also failing.
Maybe you and Dr. Lenox
should compare notes.
♪
Yeah, I don't know. I'm not seeing it.
I mean, yes, they both have
a metabolic acidosis,
but that's not that uncommon.
Well, did your patient
present with anything
- that is uncommon?
- Her tongue, right?
Her tongue?
Yeah, it swelled up
pretty quickly after intake.
Sores, lesions suggests that she
must have ingested something.
- Huh.
- Yeah, your patient's
not demonstrating any of that, right?
No.
What about the cut on his hand?
The cut?
Tyler cut himself harvesting sunflowers.
But you mentioned it looked
like he'd been burned,
the way it scarred up.
Could just be a reaction
to something he was growing.
You said he was a-a farmer, right?
- Mm-hmm.
- Yeah, sunflowers and hemp.
My patient's B3 levels
were high when she came in,
and her commanding officer
said something about her
being tested for drugs this morning.
Maybe she was trying to rig the test?
Mm.
Tyler's mother mentioned
that they were up here
buying a new pickup.
They came into some money recently.
I'm I'm sorry.
What are we talking about?
♪
On your farm, Tyler,
are you growing pot?
My boy wouldn't do anything like that.
All right, there's a young
woman who may die over there
unless we get
an honest answer out of you.
Tyler, is this what's going on?
♪
I started growing marijuana
on the back acreage, yeah.
But only to keep the farm going, Mama.
Tyler.
Have you been using any pesticides?
Yeah, a little, but only
to increase the yield.
BOTH: Paraquat.
Any chance you may have
sold any on the IW campus?
♪
All right, we need to up
the firepower on Herrera.
Let's do a quick bedside UA to confirm.
- Mix 10 milliliters urine
- Chemo, maybe.
With 1 gram of sodium bicarbonate
- Cyclophosphamide.
- And 1 of sodium dithionate.
Plus, amp up the immunosuppressants.
- OK.
- OK?
Got it.
♪
Why did my parents lie to me?
Why did they lie?
You know, if I had to take a guess,
it's because they were motivated
by their love for you, Max,
and their desire
to spend as much time
with you as possible.
♪
And if I were them, I might
be doing the same exact thing.
What's going on here?
Max, are you OK?
No, I'm not OK.
Pops, you promised me
I was gonna play soccer again.
What did you just do?
I told you that as a pediatrician,
I am obligated to advocate
for my patients.
Can I speak with you outside, please?
♪
- [GRUNTS]
- Dad!
Ron, Derek, get over here.
Don't you ever talk to my son again!
- Are you OK?
- Come on.
I'm fine.
- Take this man into custody.
- No, no, no!
No, no. Hey, hey, hey, hey!
Leave him be.
- All right, we're fine here.
- Honey.
♪
[DEVICE BEEPS]
- Dr. Asher?
- Yeah.
Ambo's wheeling in peds versus auto,
22 weeks pregnant.
You're going to trauma 1.
♪
Head trauma, patient unresponsive,
GCS 3, BP 202 over 95, heart rate 52.
Kendall?
She was lucid for a moment, but
she crumped, so we intubated her.
- OK.
- Kendall, I'm right here.
Sir, I'm gonna need you
to stay right there, please.
- Right there.
- OK, on my count.
One, two, three.
- Thank you, Courtney.
- Yep.
Thank you, Matt.
♪
OK, pupil's blown.
It's gotta be an epidural hematoma.
If we don't release the pressure,
her brain can herniate. Mags, call CT.
Get someone from neurosurgery
down here stat.
- You got it.
- It all happened so fast.
One second, we're walking home
from the market,
and the next, she's screaming
at I don't know who,
insisting they're trying to get her.
And then she just
bolted out into traffic.
OK, we're gonna do what we can, Bryce.
All right, both scanners
have patients on the table.
CT2 can see you in 10 minutes.
Neurosurg can meet you in the OR in 20.
What? She doesn't have time for that.
No, we need to alleviate
the pressure now.
OK, get me an IO kit.
We're gonna place a 15-millimeter
interosseous needle
to aspirate the blood.
Is she gonna be OK?
When's the last time
you did one of those?
I watched one
when I was a medical student.
- Med
- We don't have any
better options, Mags. Time is brain.
- Scalpel.
- Mm-hmm.
♪
What is that, a drill?
- What are you doing with that?
- Sir.
[DRILL WHIRRING]
♪
Syringe.
♪
15 mls for now.
BP's normalizing.
Fetal heart tones are holding strong.
OK, this is a temporary fix
until we get mom to the OR.
Let's get this patient to CT.
I checked Kendall's call history.
You were right.
She wasn't talking to anyone,
at least not on the phone.
I don't know why
I was so afraid to look.
Mr. Lange, the good news is,
Kendall's been stabilized for now
and your baby's still viable.
However, your wife sustained
significant head trauma.
She's not out of the woods yet.
The next 24 to 48 hours will be crucial.
[DRAMATIC MUSIC]
I suspected she was
showing signs of distress.
What was I supposed to do?
She wanted a baby.
She wanted a baby badly.
Bryce, it's the trickiest part, right?
I mean, it's so confusing.
Of course we want
to respect our loved one's
sense of autonomy, right?
And the vast majority of the time,
you're able to do that.
But sometimes, sometimes
we gotta we gotta step in
and protect people from themselves.
♪
We're gonna need to keep you overnight
until the pesticides
are flushed completely.
But your body is responding well so far.
And overall, we feel that
you're past the worst of it.
Thank you.
Do we have any idea how she was
exposed to the paraquat?
Well, unfortunately,
we're swimming in toxins these days.
Cadet Herrera probably just accidentally
ingested something.
Well, I'm gonna call back into the base,
give them a progress report.
Way to keep battling, Herrera.
Maybe lay off the weed
moving forward, Cadet.
Pretty impressive catch there, sir,
though I still can't figure out,
how did you know
that she'd been smoking weed?
Her elevated B3 levels.
Pounding niacin is a time-honored hack
for dodging drug tests.
How would you know?
Well, contrary to how it might appear,
I was young once too.
Well, perhaps Dr. Lenox used to
cut loose back in the day as well.
I don't even want to think
[DOOR CLICKS OPEN]
Look, and again,
I don't want to press charges
against the guy.
I completely understand
where he was coming from,
though I still contend
I was doing the right thing.
Yeah, of course you do.
But just for my edification,
what made you think
you had the authority
to circumvent Max's parents like that?
You can blame me.
I OK'd it.
Dr. Frost was acting within his rights
as a pediatric EM resident.
I concur.
At least we know he can take a punch.
Yeah, well, I guess it beats
having another doctor
who's throwing them.
Now we need to decide
how to deal with the father.
Just so we're all on the same page,
we're transferring Max
up to surgery now.
They're still going through with it?
Far as I can tell, the kid's OK with it.
No, no, no. That can't be right.
Jonathan, don't.
I'd like to speak with Max, please.
No.
That's not gonna be possible.
Mom, Dad,
please, let Dr. Frost in.
I want to speak to him too.
Thank you.
[SIGHS] In private, guys.
Sorry about that.
It's OK.
Look, I don't know if they
explained this to you fully,
but you don't have
to go through with this
just because it's what
your parents want.
When I was first diagnosed,
my uncle actually had me write down
everything I still wanted
to accomplish in my life.
I think it was to keep my
spirits up, you know, 'cause
'cause of the fight with cancer.
But anyway, that that list
got really long, and
I mean, now it looks like
I'm not gonna be able
to accomplish much of any of it.
The only thing I know for sure
I can accomplish
in the life that I have left
is to make my parents happy.
♪
I can still do that.
It's gonna have to be enough.
♪
Well, then I think you're
making the right decision.
♪
Uh, I may have been hasty earlier
when I suggested
we split up the ED 50-50.
It's too big a risk.
Patient care suffers if it
falls in the gap, you know?
That's the point I was
attempting to make earlier.
But I suppose I should be grateful
it only took you one shift
to reach the same conclusion.
Anyway, I-I printed up
the memo that you sent.
Some real interesting ideas here.
And of course, I have notes.
[TENSE MUSIC]
Hey, uh, I'm looking
for Detective Girardi.
To what may I tell him this pertains?
Yeah, he questioned me earlier
about the Wapniarski assault.
I'm
I'm here to turn myself in.
Take a number. Have a seat.
Excuse me?
♪
[DOORBELL RINGS]
♪
What the hell did you just do?
♪