ER s10e07 Episode Script

E.
R.
Previously on E.
R.
Morris, you bailing? Let him walk.
- How do you put it on? - Donning and doffing are more complex I want my damn arm, all right? I've waited long enough! Stay away from my patients.
From now on I'll present to another Attending.
- He's diabetic.
- I didn't know he had diabetes.
He's a kid.
You're an adult.
You're supposed to be a doctor.
- That patient brought you flowers? - And a book.
He's a Civil War buff.
I've been reading to him.
He's losing his sight.
You're going to his house? He has no one.
He's going blind.
No one should end up like that.
E.
R.
10x07 "DEATH AND TAXES" You ran out of milk.
- What day is it? - Twenty-sixth.
What do you want, front page or sports? Do you ever realize that a month's gone by without your noticing? Fed's raised rates again.
And it wasn't bad - but it wasn't great either? - Half a point.
I should have bought.
Yes, hello.
This is she.
Oh, yeah.
Okay.
Yeah.
See you there.
Okay, thanks.
Bye.
- Work? - No, my accountant reminding me of our appointment with the IRS today.
I'm getting audited, which blows - considering I file 1040EZ.
- You don't do long form? Well, I'm single.
I don't own anything.
I don't have any dependents.
You want some? - What? - Kids, instant tax write off.
- Yeah, but - Come on, baby, let's do it, huh? We like each other, right? The sex is pretty good.
What are the odds we're gonna find someone better, huh? Whose stupid idea was this? Weaver says it's space efficient.
Yeah, take a bucket of acetone to erase.
- Need a hand with that? - You trying to be funny? - Nope, just trying to be helpful.
- Don't bother, boy scout.
I finished your eval.
May wanna practice these words: "paper or plastic?" Oh, and speaking of negative evaluations, sign this.
- What's this? - Documentation of chronic tardiness failure to attend required conferences.
- I'm pulling six shifts a week- - And yelling at an X-ray tech.
He gave me a lateral C-spine without T-1.
The repeat took over three hours.
That's unacceptable and beside the point.
Sign it.
- This goes up to Human Resources? - Nope.
Stays with me until I have a fat enough file to pull the trigger.
- Oh, now you're gonna fire me.
- Keep giving me ammo.
- Oh, hey! - Electrical malfunction.
- Only on women? - It happens.
I'm telling you, it's not chickenpox.
Hey, teen mom.
News flash.
This is not day care, okay? Eighty-six the love child and stop tying up the phone lines.
Yeah, listen, I'm a nurse, and I'm telling- Fine.
Whatever.
Next time you put a marker on your face, do it before school so I can get a sitter.
- That means I can stay here? - Until I can find one.
Now go to the lounge and do something normal, like homework.
- Hey.
- Hey.
Don't even.
- What's that about? - Overprotective mother.
- You still on surgical rotation? - No.
I start my ER rotation today.
- Welcome home.
- Got the whole family here! Low-speed MVA, rear-ended, no PSI.
Superficial face lac on Mom, sore wrist on the girl and Dad's only complaint is about his car.
- Six grand in body work, easy.
- What about the baby? Found on the floor, no apparent injuries.
- No car seat? - Cries when he's in it.
- So Katie here goes and unhooks him.
- We're all okay here.
Is this totally necessary? The shock of the accident can often mask injuries.
Most important factors when triaging children involved in an MVA? - Restraint use.
- Glasgow coma scale.
Evaluate consciousness and spontaneous movement.
In this case, the baby's a 15.
Good, Neela.
What? - You know this stuff.
- Hey, Abby, guy over here needs a Foley.
Oh, wait, I'm sorry, you're playing doctor today? Never mind.
I'll find a nurse who's not kidding herself.
Here's one.
Mom, right? Good news and bad news.
The bad news is, my enlarged prostate guy needs a tube up his urethra.
Good news, he gets to have you in his pants.
I have to take my lunch hour today.
I'm being audited.
- Didn't know we paid you enough.
- You don't.
- My meeting's at noon, downtown, so- - All right! That is- - What are you doing? - What are you doing? - Cut it out! - What are you doing? He just grabbed my ass.
Here, take this to church and have it exorcised.
Keep walking, right up to the nursing director's office.
When you get there, there'll be a pink slip waiting.
Good.
Give me plenty of time to file my sexual harassment lawsuit.
You mind? Yes, I do.
You can have it back at the end of the day - if you learn to behave! - Give me my damn hand back! Dove? - That the soap you use? - Oh, yeah.
It works, works, works for you.
You know, they say that smell is a more powerful sense than sight.
It has a stronger impact on memory.
It's true.
Given the choice, I'd- I'd choose sight.
Could do without smelling dog poop again.
Or- Or stepping in it.
Can I get a Vacutainer with a red top? Housebreaking not going so well? - I can do that for you if you want.
- No, I got it.
No, it's fine.
- Oh, and thanks.
- For what? The dog.
He laughs at all my jokes and licks my feet.
I think I'm in love.
If your dig.
levels are in the therapeutic range you can stop dragging yourself down here.
Oh, great.
Yeah, just see your primary physician every three months.
Okay, and we are done.
Listen, I make a mean tri-tip.
- Seriously, I'm quite- Quite the chef.
- Really? Yeah.
Would-? You know, would you like to have dinner tonight? I'll throw in a good bottle of wine if it would close the deal.
Sure.
What time? - Eight.
- All right, I'll see you then.
- Doctor who does her own blood draws? - Only on friends.
Listen, sorry about earlier, but I got a rule against ass-grabbing.
It's a good rule.
What did you do with it anyway? I put it where it ought to be, under lock and key.
- Here.
I don't need the receipt.
- No, I do.
I'm going long form next year.
- Hey.
What the hell are you doing here? - Working.
- I thought you quit.
- Oh, my dad wouldn't let me.
Said he pull my money if I didn't see this thing through.
- This "thing" meaning medicine? - Yeah.
Want some? It's 10:00 in the morning, man.
- Hey, you been smoking weed? - You know, my roommate tokes.
Can't help it if the smell sticks.
Katie, knock it off.
Sorry about the mess, doc.
We're med students actually, and it's fine, really.
He likes you.
Colin usually cries with strangers.
- When's he not crying? - Seems like a happy enough guy.
Head sheet, ibuprofen, and Dad's good to go.
Oh, he's not either of their fathers.
- He's my boyfriend.
- Who's next? Seven-year-old, no medical history, ecchymosis of left hand.
Full range of motion, neurovascularly intact.
X- rays are clear.
NSAIDs for pain, R.
I.
C.
E.
and home? Good.
Neela? Twenty-one-year-old female, cleared the neck clinically, exam normal.
Irrigated the wound, approximated edges with Dermabond.
- Excellent.
Abby? - Full-term ten-month-old male alert and interactive.
He doesn't seem to be on- - Start with the vitals.
- Afebrile, pulse 118, resps 24.
No hematoma or stepoff.
Lungs are clear, abdomen soft moves all extremities.
Since he wasn't restrained, think baby gram and head CT.
- A full body X-ray? - He might need a screening film - since he can't tell us what hurts.
- He would with irritability and guarding.
Trust your exam, Abby.
No unnecessary X-rays, no CT.
He already got a portable.
Finish the discharge paperwork and send him home.
Dr.
Kovac, I have a UTI in 2.
Maybe you're like me, better with babies than with school.
Got in a fight, stuck with a shank made out of a fork.
- Jimmy, I need to see your eyes.
- Can I help? Stab wound above the scapula.
Tell me what you do.
- ABC's, IV, O2, monitor and pulse ox.
- That and introduce yourself.
Hi.
I'm Neela Rasgotra.
I'm going to listen to your lungs now.
Okay, head's atraumatic, TM's fine.
They handcuff in juvenile hall? He's 18, with the big boys at Joliet for aggravated assault, B and E.
Five to 10 but probably get a few more now.
Clear, no increased work of breathing.
Which means the knife wound hasn't affected your lungs.
Okay, portable chest with a lateral neck and a set of hematocrits.
Dr.
Chen, there's a call from China holding on line one for you.
Wonder what time it is over there.
Do me a favor.
Can you tell my parents the cat's fine and I'll call later.
It's not your folks.
It's the embassy.
Get him set up for suturing.
"B and E," that's "breaking and entering.
" What did you break into? My stepfather's house.
He locked me out.
You still here? - Who's asking? - I'm a nurse.
I saw you earlier.
Oh, I wish I could say the same.
Have you seen a cabbie anywhere around here? I called for one about an hour ago.
No.
I can call another one for you.
- You okay? - Me? Oh, yeah, yeah.
Blind, getting blinder every day.
- Life is good.
- Sam.
- I'll call you another cab.
- Got your backup babysitter on line one.
She's glad you called, she's got pinkeye, wonders can you get her antibiotics? Fifty pounds of pressure in addition to being waterproof.
Which makes it perfect for shucking clams.
- What happened to your other gizmo? - It's being punished.
- Enough fun and games.
Where is it? - You got a stay of execution.
- Your audit's been pushed an hour.
- Nothing like postponing the inevitable.
- Hey, my hand.
Cough it up.
- At the end of the day if you don't try anything with that one.
Need I remind you that I'm in charge? You'll have to convince me first.
- Hey, Alex.
- What's a prolapsed rectum? Shouldn't you be reading, like, Harry Potter or something? - You menstruating? - Hey, look a popped-out eyeball! Something wrong? My parents were in a car accident.
- I'm sorry.
- Happened in some province north of Suzhou.
I'm not exactly sure where.
- Can you get somebody to cover for me? - Of course.
Are you okay? Not really.
I have to pack and get my emergency visa.
I don't even know if my passport's still good.
Do you know any details? Only that there are no trauma centers in China.
Something happen? Her parents got hurt in China.
MVA.
Hey, Jing-Mei.
What's going on? Your folks okay? I won't know until I get there.
- Is there anything I can do? - No, I don't think so.
Okay.
Come here.
Don't worry, it's gonna be okay.
I gotta go.
Jensen's at a conference, Stewart's on nights Chen's on emergency leave.
It leaves us short one Attending.
Ankle sprain, med refill, kid with cough.
I'll pick up her slack.
She also had a dislocated shoulder.
I'll give reductions to Residents with two paws and half a brain.
Elbow contusion, fight-bite lac.
Beat it.
What pleasure could you possibly get out of humiliating people? - Fun.
You ought to try it sometime.
- What did I miss? Your calling, as a hoodlum.
Here, prison stabbing ought to be right up your alley.
If it's any consolation, we all suffer at his hand.
What do you got? Franny Meyers, 34 years old, brought in by paramedics with chest pain and palpitations for an hour.
No cardiac history, no risk factors.
I'm Dr.
Lewis.
Can you tell me what happened? Nothing, I felt a little dizzy at work and somebody called 911.
- I'm fine now.
- Orthostatics are good.
I got an EKG - which was normal.
- Any medications? - Nope.
- Are you having trouble sleeping? - No.
- Do you drink soda, coffee? - Never.
- Really? That's amazing.
I skipped breakfast, that's all.
Listen, I have got to go pick up my little girl from preschool.
No, you're not going anywhere soon.
Someone with chest pain and heart palpitations we keep them overnight for observation.
My husband can't do everything.
He works too.
Find a bed on Telemetry and send out for troponins? Yeah.
Have Cards do a stress test.
I have three kids, work a full-time job, every day is a stress test.
This is nothing.
Probably you're right, but we need to follow your labs and monitor your heart.
Yeah.
You seem to be doing well.
One-on-one.
I'm not so hot in a group.
You know, it gets better.
It always does.
- Wanna get something to eat tonight? - Oh, I have a date, sort of.
- Chuck? - No.
We should spend either all our time together or none at all and I'm kind of leaning towards none at all.
- So it's a date with someone new? - Someone old, actually.
Did that guy's head get cracked by a bat or something? - Sledgehammer.
- Really? No, he slipped in the shower, bumped his head.
He's gonna be fine.
Aren't you supposed to be in the lounge? Yeah, but mostly away from you.
I don't know what my mom's problem is.
I've been in DKA like a thousand times this year.
- Wasn't your fault.
- I better take you back.
Belly pain prior to vomiting and diarrhea, no fever, no history of stones - urine dip negative.
- Might be the seafood lo mein.
- I'm thinking appy.
- CBC results? I didn't order a CBC.
Dr.
Kovac? You didn't check the white-cell count on a possible appendicitis? I told him not to bother.
No guarding, no rebound, no fever.
CBC is the standard test used in the diagnosis- For almost everything, but it's useless for anything else except leukemia - which he doesn't have.
It's a primary indication of infection and I have absolutely no intention of proceeding without it.
Fine, then it was 16,000.
- You told me you didn't order the test.
- I forgot to put the results on the chart.
I still think it's an unconvincing case for appy.
Exactly my point.
Order a CT with triple contrast to be certain.
Yes, ma'am.
If you're on a mission to subvert protocol, you should clear it through Administration first.
How do you stand it down here? Everybody's more agreeable in Surgery.
- Gee, why do you suppose that is? - Okay, here's a time-waster.
Transport from Geldin, stable The community hospital on the east side? Known as a glorified Doc In The Box.
Who's expendable? You are.
Since you're neither fish nor fowl you're useless on a mindless transport.
Robert.
Dr.
Corday, you forgot to sign for the factor eight.
Eureka.
Our affirmative-action hero and our sultry hand thief.
Go with God, but more importantly, just go.
- My kid's here.
I don't have a sitter.
- That's my problem, how? The nurses can take care of him in the lounge until you get back, right, Chuny? - Sure, no problem.
- That's settled.
Ebony and Ivory can go into the sunset and the rest of us can get work done - without being stared at.
- Come on, honey.
- I don't think his mom loved him.
- You on hold? Yeah, why? Mrs.
Meyers wants to leave AMA.
Yes, yes, I have an appointment for today that I'd like to reschedule.
Mrs.
Meyers, you need to see a doctor before you go.
I can't find my shoes.
Somebody stole my shoes.
- They're right there.
- I don't know what I was thinking.
Who's gonna make dinner? Who's gonna feed the dogs? - Slow down.
- Who's gonna wash the clothes? All right.
- She barely has a pulse.
- Someone grab a crash cart! I'm okay.
I'm okay.
- Have you been in prison long? - Few months.
Busted me right after my girlfriend got me this.
Her name's Lila.
She's pretty too.
- Stitches can come out in 10 days.
- How's he doing? Has some bony tenderness, just on his way to Radiology now.
Otherwise, completely intact.
Then we need to make a switch.
Hang on, let me uncuff him.
- Let's go.
- Easy, man.
Dr.
Pratt.
- Get her out of here! - Jimmy, it's all right.
- Just get her out! - Okay.
Okay.
Go.
Go.
Guys give me a couple of minutes, all right? Please.
- Want to tell me what happened? - I'm not a fag, all right? Okay.
But you're bleeding pretty bad.
Did they rape you? Don't come close, okay? I'm cool.
This is serious.
- I said, just leave me alone.
- Okay, so you're refusing treatment.
Just know that you're AMA and going back to the big house in about an hour.
Now, you let me do the exam, you buy yourself at least a day here.
- One more time, hard as you can.
- Anybody seen Sam's weird little kid? - I can't find him anywhere.
- Nope.
- Still SVT.
- Am I having a heart attack? I don't think so, but your heart is beating fast.
No T waves, narrow QRS.
Has anything like this happened before? - No, I don't think so.
- EKG tech's on his way.
- Supraventricular tachycardia? Yes, vagal maneuvers didn't work.
- Adenosine? - Six milligrams.
Mrs.
Meyers, we're giving you medicine to try and to convert your heart back to a normal rhythm.
When we do, we'll be better able to find out why this is happening.
I'll administer it.
Nice assessment.
Thanks.
- You never compliment me like that.
- Like what? "Nice assessment.
" - I do.
- No, you don't.
- I don't? - No.
I give you my time, which is the highest form of a compliment.
Out of the way.
Out of the way.
Shoo.
What's the weirdest thing you've taken out of someone's body? Prednisone for five days and Benadryl for itching, okay, Mr.
McPhee? - Like a real long tapeworm? - Worse.
Can you get a knee immobilizer for the LOL in 3? - Yes, doctor.
- A gerbil? Look, Alex, I really need to work now.
Go back to the lounge, okay? Chuny, the rule-out appy guy's eating? Mr.
Persky? He's on his second tray.
Okay, Mr.
Persky, time to go home.
Let me sign these discharge papers- What about the CT Corday wanted? He's past the common age for appy, he's not getting any sicker - and he's got an appetite.
- You said it was appendicitis.
Not if you can stomach that much food.
But there was progression of pain, there was tenderness.
- Could be an unusual presentation.
- Sure, once in a million cases.
Kovac, Radiology wants you upstairs.
Your tibia-fracture lady is agitated.
Mr.
Persky, if you experience vomiting, fever or worsening belly pain, come back.
Otherwise, have a nice day.
Where are you going now? - X-ray.
- Can I come? No.
The lounge, go.
Hey, Chuny, need you to get me an Attending for a rape exam.
We use the same kit for men and women, right? I'll do it when I get back from Radiology.
No, thanks.
A guy can get raped? - Doctor, got a minute? - I got 10 patients of my own and six med students I'm avoiding, does it look like it? - I need you to do a rape kit.
- Wasn't on the board.
Had a knife wound, he didn't tell us.
He? The prisoner you gave me earlier.
He has some rectal bleeding.
Well, you go ahead, I'll sign off on it.
Per Legal, an Attending should do all rape exams.
- It'll be our little secret.
- Hey, wait a minute.
Wait.
You're all over me for protocol, and now you want me to do a procedure- All of a sudden you're Mr.
By-the-Book? This is not a stretch for you.
Just do it, break the rules.
You're good at it.
- Coffee break, imagine that.
- You from County? - Yes, sir.
- Twelve-year-old with acute myeloid leukemia spiked a fever to 102.
It's probably just a cold, but since she's neutropenic she needs admission somewhere till her culture's negative.
- You don't have a Pedes floor? - Budget cuts.
Chest X-ray's clear, UA's negative, got two grams of Ceftaz.
- Her parents here? - Yep, brought her over from Ann Arbor for a concert, celebrate her successful bone-marrow transplant.
Girl started feeling sick so they drove her to the nearest hospital, which was us.
I thought you said she just had a cold.
I'm Dr.
Gallant, from County.
- She didn't look like this earlier.
- Michelle, can you hear me? Last vitals were two hours ago.
They said she was sleeping.
- Oxygen mask.
- She was satting at 100 percent.
Can't get a good pulse ox through this much nail polish.
- No, a Pedes mask.
- We don't have them.
She should be on a monitor.
Mix some ox and gent and hang another liter.
She was stable.
Now she's septic.
We need Valium.
- Here, catch.
- Will someone tell us what's going on? She might have a blood infection and chemo weakened her ability to fight it.
Sats only 81.
- Okay, help me get her onto the gurney.
- Gallant.
I need to explain the risks of transport.
Gallant, I need to talk to you.
There's chances of worsening her condition in transport.
Now, doctor.
I need to speak with you.
She's not stable.
You need to stay here or tube her before we go.
She has a strong pulse, we have her on O2.
We scoop and run.
- It's 20 minutes till she stops breathing.
- County is 15, tops.
Look, if I can't get her tubed, there's no backup here, none.
Okay, let's go.
We're going code three.
- What does that mean? - Your daughter's sick we need to get her to a trauma center.
Can we ride with her? - No room.
We're headed to County.
- Gallant, consent.
Sign here.
Your heart rate's back to normal, which means the adenosine worked.
- Did you get in touch with your husband? - Yeah.
He's picking up the kids.
- That's one less thing for you to do.
- Yeah.
You should try to get some rest.
I can't.
- I lied.
I don't sleep much at all.
- Really? Do you think that's weird? I don't even know anymore.
I think I think with three kids it's pretty hard to do without some help.
You have any help? A nanny? No.
No, I mean, for energy.
Are you taking anything or drinking anything to give you a little lift? Because, Franny, if you are taking something it could be doing serious damage to your heart.
Another mom I know gives it to me.
It's the only way that we can get things done.
Please don't tell my husband.
Okay.
I'll be right back.
An hour and counting.
Do you think the IRS flagged me - because I worked in two states? - Soccer mom uses crystal meth.
- What? - You heard me.
- Did she just tell you out of the blue? - No, I asked.
- Someone help us! We were just here.
- What happened? He fell asleep and now he won't wake up.
- They came with an MVA this morning.
- They were discharged.
- Any vomiting? - No, no, but he's not right.
You must have missed something.
- Pupils are equal and sluggish.
- He's hypertensive, 110/82.
- Miller two and a 4-0 ET tube.
- What's going on? - Sir, we're trying to find out.
- Let's get a gram of mannitol.
- Did he get a CT? - No.
- Cricoid.
- Heart rate's 69.
Tube.
No CT after an MVA? He just flew out of the car seat.
Okay.
I I'm in.
Did you check for a cranial hematoma for a stepoff? - Yes.
I checked all of that.
He was fine.
- Mannitol's running.
- What's wrong? - He might've had some head trauma.
It can cause bleeding in the brain.
I'm sorry it wasn't caught earlier.
Let's get him a CT.
Unrestrained and no CT? Are you kidding, Abby? Hey.
What did the CT show? Parietal skull fracture with subdural hematoma.
Neurosurg has got him up in the OR now.
- How could I miss an intracranial bleed? - It happens.
- He seemed like a healthy baby to me.
- You had an Attending.
If I can't trust my clinical skills, I should go home because the book stuff is not going that great either.
When I get back, we'll pull the charts and the film and we'll just go over it step-by-step and see what went wrong.
- It's how you learn.
- Need some help in here! - Didn't they tell you she was septic? - Claimed they didn't know.
- Went apneic in the rig.
- Lost pulse when we pulled up.
She's in PEA.
Milligram of epi, atropine.
What about your audit? Third atropine's in.
Weak femoral pulse with compressions.
The trip over did not help.
She wasn't coding.
She had a good pulse.
Dopa's up to 20, don't have a pressure.
They had no Pedes RTs, no equipment.
- It was dangerous to leave her.
- Yeah, they're a bunch of idiots.
Why didn't you tube her? Stop compressions.
Still PEA.
- She was breathing on her own.
- Dr.
Lewis, got your geriatric boyfriend - on the phone.
It's important.
- I'll call back.
Resume compressions.
- Come on, Michelle.
- More epi.
Where are the parents? - Coming from Geldin.
- Can they get here? - I think they're from Michigan.
- She's fixed and dilated.
They better figure it out fast.
Dr.
Morris, your pancreatitis is a case of menstrual cramps.
So perhaps in the future, before you call Surgery read Chapter 1 of Harrison's.
Right.
Can you make sure Amanda Knight gets 600 of ibuprofen? - Yes, doctor.
- I consulted on that man earlier.
Why isn't he in bed? - He just signed in.
- Mr.
Persky's back? - Who let him go in the first place? - Dr.
Kovac let him go.
- Without the CT I ordered? - Mr.
Persky, what happened? - He's febrile.
- Oh, God.
It hurt for a while there, but it's much better now.
- Think he perfed? - Yes.
Mr.
Persky when the appendix bursts, it releases pressure, which abates the pain.
Unfortunately, it releases fecal matter into the belly requiring us to operate on you.
- Like under anesthesia? - Yes.
My mother died that way.
No anesthesia.
- During your surgery? - Yes.
Going under is what killed her.
Right.
Okay, well, let's take Mr.
Persky upstairs and prep him - for surgery.
I'll be right there.
- Where are you going? I'm gonna find Dr.
Kovac.
Stop compressions.
Asystole.
Resuming compressions.
- Should we try transcutaneous pacing? - How long has she been down? - Forty-two minutes.
- Okay, Gallant.
Gallant.
Time of death, 15:37.
There's only so much responsibility you can take.
You didn't give her cancer.
So how come that doesn't make me feel any better? Those the parents? Yeah.
- Gallant? - I'll tell them.
Is it all right if I come in? Sorry it's taking so long.
Dr.
Pratt's been tied up.
But then I suppose you don't mind the delay.
- Will you report what happened? - I never said anything did.
Because maybe you could be transferred to another facility someplace safer for you.
There's no shame in this.
No one's going to think less of you for it, not me, not your girlfriend.
I don't have one anymore.
I'm the girl now.
- Jimmy - Can you leave me alone? No! It's gonna hurt my baby! Eloise, you have a broken leg.
You need to settle down.
- No! No! - Give me five of Haldol.
No! It's gonna hurt my baby! Please! No! No! No! I don't- I don't want my baby- I don't want my baby to do drugs.
- Did you kill her? - No.
Send her up to Ortho and make sure they cast her before she wakes up.
Sorry you had to see that.
- Did you get scared? - Are you kidding? It was cool.
So, what does this thing do, make you glow in the dark? Yeah, only after 1000 X-rays.
Want one? Can I have one of my head? Is it okay? Long as your department gets charged for it.
Okay.
Lay still, hold your breath.
I understand you overrode my order for an abdominal CT on the appy patient.
- Yes.
- Well, he's since managed to perforate his appendix and is upstairs waiting for surgery.
Instead of a quick laproscopic procedure, I'll perform an open laparotomy - with antiseptic washout.
- That's too bad.
Your actions have made his life and mine much harder.
- You know he wants epidural anesthesia? - What do you want me to say? Neither a CBC or a CT would have been definitive.
- Sometimes the best test is time.
- You're serious? He was given discharge instructions and came back as directed.
- The system worked.
- Oh, for you, maybe but he'll have a riskier surgery and I'll miss dinner with my daughter.
Score one for your bloody mission.
Can you see Morris' crouper so we can discharge her? - Yeah, in a minute.
- I need consent for conscious sedation - for Carolyn Kinaire.
- Okay, hang on.
- Dr.
Lewis.
- You have to present to Kovac or Romano.
I have to call the IRS and beg not to be imprisoned.
Kovac is not here and Romano's the reason why I need this.
- What did he do now? - Male rape victim who needs an exam and Napoleon's not too comfortable with the prospect.
- Homophobe.
Fine, I'll do it.
- You're the best.
- Ready to go over this? - Yeah, I've denied my bladder this long.
The Helen Keller of County.
You missed a skull fracture today.
You'll be back to code browns in no time.
Hang on a second.
Hey.
You.
- What is it, Dr.
Lewis? I'm a busy man.
- You're one less patient busy.
- I'm taking the rape case.
- Excuse me? - Don't know if it's a gay thing, or what- - What are you talking about? Pratt feels- He's a rabid dog who should be shot before he infects the other staff.
As for my abilities, I finish what I start.
Okay? Okay.
Bang.
- Hey, Frank.
- Back from your little joyride? - You seen my kid around? - Yeah, I saw him stalking Kovac earlier.
- Did the IRS call? - Yes, said something about penalties back taxes, you owing them for their lost time - and that Hollander guy called again.
- Did he leave a number? Nope, just canceled dinner.
- I spoke with Mrs.
Meyers.
- Who? Meth mom.
She's agreed to seek counseling.
- Social Services will follow up.
- They don't wanna see her? I told them she's obviously devoted to her family, takes good care of them.
Be harder when she dies of a drug-induced heart attack.
Well, I'm sure this scared her, enough to get the message, I'd think.
- Okay, go with your gut.
- Are you sure? Because it's a bit of a weakness on my part, not reading people well.
Never occurred to me that a working wife and mother would be a meth user.
People are capable of anything when put under the right stressors.
Need help visualizing the fissure.
- Okay.
- You want to swab for sperm too? No, we have enough.
Help me take this off.
The bleeding's stopped.
The tear will heal on its own.
- Is he good to go? - Back to the daddy tank as soon as his discharge papers are signed.
Excuse me, Dr.
Romano, may I speak with you privately? You're already my favorite.
You want people to talk? - His lab workup.
- Why you showing it to me? Dr.
Pratt's on his way into a trauma.
Some test results have come back.
You're HIV-positive with a CD4 count of less than 200.
That means you have AIDS.
Did you hear what I just said? Yeah, thanks.
At least now I know it's not gonna be forever.
- That the guy who got punked out? - Shut up.
He's had a bad day.
- Okay, this all looks well documented.
- Gee, thanks.
Baby had a normal exam and the mechanism was borderline.
I would've scanned the head, but Kovac might not.
It's a judgment call.
- That's why I ordered a baby gram.
- When you read an X-ray - are you using the ABCD mnemonic? - Airway, Bones, Cardiac, Diaphragm.
Wait, this is the wrong film.
No, it's Colin Tranh, and I still don't see it.
Is it more superior? - Do you have the head CT? - Yeah.
Okay, here's the fracture.
And I still don't see it.
It's not there.
Get a social worker and find that boyfriend now.
- Trauma 1 's empty.
Come on.
- Dr.
Lewis, GSW to the head.
Went into V-fib two minutes out.
Robbery, homicide, both? Self-inflicted.
No time to transfer.
Charge to 200.
- Why isn't he intubated? - Because he's a DNR.
- That's what I told him.
- Suicide is against the law.
If he flinched, he only injured his cortex.
Okay, let's do this.
8-0 tube.
Come on, give me those.
- Dr.
Lewis? - Stand by with epi.
Still V-fib, 360.
Clear.
Amp of epi.
- He used a gun.
- Charge to 360.
- Stop it.
- Clear.
Stop it! I'm saving him.
Hundred of lidocaine.
- She knows him.
- Just leave him.
It's what he wanted.
- Is the baby out of surgery? - Yeah.
I spoke to the doctor.
- It went well.
Where's his mother? - At work.
I called.
- So he's going to be okay, right? - Yes, he will.
- This is Mr.
Sung.
He's a social worker.
- How you doing? Fine.
What's this all about? - You mentioned that Colin cries a lot.
- Yeah.
So? - Was he crying when you got home? - Why? It appears his skull was fractured after he left.
- What? - He didn't have a fracture when he was here earlier.
- Are you saying I hit him? - I don't know what you did.
Did you slam his head against the wall? Or the floor? The crib railing? - I don't have to listen to this.
- I'll take it from here.
Come with me.
I didn't hit that kid.
I didn't do anything.
Excuse me.
You're nuts.
Lady, you don't know what you're talking about! I didn't hit that stupid kid.
Hey! Alex, this room is for families who need privacy.
- Come on.
- Super power punch.
- Quit knocking me off.
- Plus, it's time to go.
- But I'm winning.
- Alex, it's late and I'm tired.
Come on.
Fine.
- See you.
- See you.
- Did you make a new friend today? - Guess so.
Cool.
Hey, would it be okay if we invite him over for Thanksgiving dinner? - He doesn't really have any family.
- Sure.
Okay.
Oh, wait, I forgot something.
- You finish your homework? - Yeah, but look.
It's my head.
Dr.
Kovac did it for me.
- He X-rayed your skull? - Yeah.
Night.
- Hi.
- You're going home then? Yeah, my family's here to pick me up.
Listen, I just want to thank you for everything, okay? Hey.
Do you guys want me to make spaghetti tonight for dinner? Neela, labs are back on my lupus patient.
How do you calculate creatinine clearance? Weight in kilos times 140, minus age, divided by 72, times creatinine.
Thanks.
Have a good night.
Abby, would you be interested in studying together some time? - Sorry? - I'm good at the academic stuff.
But you're good with everything else.
Maybe we could help each other.
Okay.
- Hey, Dr.
Lewis.
- What is it? The LOL in 2 is complaining of nausea.
Give her 10 of Compazine and make sure she gets a dinner tray.
- Pretty rough day today, huh? - Yeah.
- Did you hear from Jing-Mei? - She got on a plane.
Did you send in a blood draw, check a dig.
level? - Yeah.
- The tube you sent was hemolyzed.
They need another draw.
What do I tell them? Tell them he left AMA.
- Time's up.
Where's my hand? - In the women's bathroom in the tampon machine.
Get it yourself.