Chicago Med (2015) s10e18 Episode Script

1
My mother died of prion disease
when she was 45 years old.
My father took his own life
three hours later.
Why'd you share this with me?
I knew you wouldn't pity me.
When it comes to surgery,
you have to think three steps ahead.
She is one of the best
and brightest I've seen.
And that's a testament
to your mentorship.
I've been accepted into Gaffney's
cardiothoracic residency program.
Something I've been working
on for the last year or so,
doing IVF.
I wanted to give you this.
25 grand?
It would be a tragedy
if you never got to be a mom.
[DRAMATIC MUSIC]
[LAUGHS]
Look at her go.
And, of course,
the younger one gets the doll.
Sharing is caring.
- Am I right?
- Mm-hmm.
I used to hate it
when you would take my things.
Oh, I know.
Hey, what is up with you?
You've been smiling like
a schoolgirl all morning.
What do you mean?
Did you and Mitch hook up again?
- What?
- I mean, I wouldn't blame you.
He's beautiful.
I did not hook up with Mitch again.
Though, I think we do need
to have a conversation.
About what?
I Kind of told him I loved him
when he was stuck in the well.
- Oh, my God, Hannah.
- I meant it.
I meant it, though.
You know, I got caught up in the moment.
I thought he was gonna die, Lizzy.
It's like a soap opera with you two.
It's [SIGHS]
- It's not.
- [GROANS]
You all right?
Yeah. No, it's nothing.
Been having this wicked
indigestion lately.
Lately?
Well, how long has that been?
- I don't know, about a week.
- OK.
Well, let's get you into Gaffney
No.
Get a little looksie, just in case.
It's nothing. Please, Hannah, no.
I am not taking no for an answer.
I'm sorry, Dr. Charles.
I know that cardiac workups
aren't your normal domain,
but we're a bit shorthanded
at the moment.
Yep, yep, yep, yep.
49-year-old male
collapsed in a stairwell.
Lenox says she'll be in to do an echo
as soon as she's out
of her budget meeting.
Oh, and evidently, the wife
is a bit of a character.
Treatment 3.
[LAUGHS]
I'm not actually sure
what happened exactly.
I just know that it was
getting hard to breathe,
and then my heart started beating fast.
- Like palpitations?
- Yeah.
Ever had those before?
I used to get them every now and then,
but it's been quite a while.
So the paramedics said that
they found you in a stairwell.
He kind of just collapsed in my arms.
Yeah, thankfully, Cynthia was with me.
Uh-huh.
Cynthia is your wife?
Ex-wife, actually.
We were attending our class reunion.
That's where we met, Northwestern.
I did a summer session there
myself during undergrad.
It's a great school. I'm Dr. Lenox.
I've been looking over
your chart, Mr. Parker,
and it seems your enzymes
came back negative,
so I think we can rule out
a heart attack.
There was a tiny irregularity
in your EKG, however,
but that could just be
the result of overexertion.
They tell me you were in University Hall
- when it happened?
- Mm-hmm.
Were you trying to climb
the clock tower?
I'm not sure you can actually
reach it from the stairs.
[CHUCKLES]
No, I wasn't taking the stairs.
So why were you in the stairwell?
Uh, Cynthia and I just reconnected
a little over a month ago.
After five years apart.
Actually, more like nine, babe.
Nine? No, that's not right.
I got the canceled
alimony checks to prove it.
[CHUCKLING]
Are we still talking about the stairs?
Oh, my God, we were having sex.
[SOFT DRAMATIC MUSIC]
Might that explain the overexertion?
It might.
Let's do an echocardiogram
to take a closer look.
You see what you do to me, baby?
You literally make my heart race.
- [LAUGHS]
- Get over here.
♪
You know what?
It is time for my midmorning coffee.
Cynthia, would you like to join me
while Dr. Lenox finishes examining Ron?
♪
Don't do anything I wouldn't do.
Oh, I know. Oh, God, it is crowded.
OK, you wait here, and I will
go check on a room, OK?
- Ooh, ooh.
- Oh, oh.
Sorry.
Hi, Mitch.
Lizzy, good to see you.
Likewise.
Uh, I thought you were off
today everything OK?
Yeah, just getting
my sister checked out.
You're you're running again?
- Yeah.
- That's great.
Yeah, I guess.
I'm still trying to get
my wind up though.
Yeah, it's the last time.
Last time I'm running with this maniac.
Hey, hi. Sorry.
I'd give a proper hello
cardiac event, I'm pretty sure.
- Sorry.
- Mm-hmm.
- [LAUGHS]
- [PANTING]
I've I've been meaning
to talk to you.
Yeah, me, too.
Maybe once you get your sister settled
and I change into some scrubs?
- Yeah.
- OK.
Help! Please!
- He's barely breathing.
- It's our son.
Anybody, please!
Let me take him inside, OK? OK?
- OK.
- I got him.
Right this way. Come on.
Hey, we need a nurse
and a tech, and call RT.
- Gotcha, Trauma 1.
- OK.
Let's put him on a monitor.
[TENSE MUSIC]
Mommy, I can't see.
- It's all blurry.
- It's OK.
- Mommy's right here.
- Ma'am? Ma'am? Excuse me.
What happened?
We were at our old farmhouse
we're renovating out in Kankakee,
and Miles was playing in the hayloft.
He was fine until
we started driving back,
but he said he felt dizzy
and that his stomach hurt,
so we headed straight here.
Sudden lethargy
and difficulty breathing.
Toxidrome.
OK, he must have gotten into something.
Organophosphate, maybe?
Do they grow crops there?
Uh, we don't know for sure.
Maybe an anticholinergic?
Could he have gotten into
any medications
antihistamines, antidepressants?
It can't be that either.
I mean, he's drooling.
Look at all the saliva.
- BP 74 over 48.
- OK.
We need to intubate.
Give me a 5.0 cuff to ET tube
and a Mac 2 scope.
Draw up 5 of etomidate
and 17 of rocuronium.
Let's think about it, all right?
Lethargic, hypotensive,
drooling, dilated pupils.
And out at a barn.
♪
OK, I'm not seeing anything over here.
What are you looking for?
No.
Hey.
♪
[TOGETHER] Snakebite.
♪
Good morning.
Hey.
What's what's with the box?
It's my last day in the ED, remember?
I start up in cardiothoracic next week.
Yeah, that's right.
I'm inviting everyone
to Molly's after work
to celebrate.
Oh, yeah. Thanks, no.
Big send-offs aren't really my thing.
However, I do have the
perfect parting gift for you,
a patient all to yourself.
Is anyone gonna bring me
an extra pillow?
My neck is killing me!
- What's the catch?
- There's no catch.
Murph comes in every few months
with some mysterious ailment.
You'll love him
maybe not today but eventually.
OK. Good to know.
Thank you.
I'll get changed and get right on it.
OK.
You know, if you would have
told me a year ago
that I would all of a sudden
find my ex-husband
attractive again, I would have said
you need your head examined.
And yet here I am back again
with a schoolgirl crush.
Do you know he's taking me
to Norway tomorrow
to see the northern lights
for my birthday?
- Lucky you.
- [LAUGHS]
Yeah.
[SIGHS]
PayDay, huh? That is a classic.
It's funny. I loved to use these back
I love to use
I love to use these
I used to love these back in the day.
They helped me get through
my senior thesis.
I don't know why I find myself
craving them again.
Maybe that's like a I don't know
a theme for you right now,
rekindling old loves?
Hmm? What?
The candy bar, your ex-husband.
And since when is nostalgia a crime?
Could you excuse me a quick second?
I'll be right back.
Hey, what do you think?
Well, with Ron, I'm not entirely sure.
His symptoms suggested
congestive heart failure,
but his echo looks pretty good.
So I'm gonna talk to Dr. Hayes,
see what he thinks.
And maybe you want
to debrief the ex-wife.
I'm not sure she approves
of my bedside manner.
Yeah. My pleasure.
Thanks.
We're administering what's known
as a polyvalent antivenom.
It's called CroFab.
It'd cover the handful
of venomous snakes
endemic to the area.
There's four, actually
the copperhead,
cottonmouth, timber rattlesnake,
and eastern massasauga.
Someone from the Home
sent it to us.
- Home Team?
- What we call our followers.
We were live streaming
when it all happened,
so we've been getting nonstop messages.
Yeah, I'd stay out
of the comment section
when it pertains to medicine.
No, our people haven't
steered us wrong yet.
We started doing home improvements
on social media 11 months ago.
Our channel just took off
with their help.
That's great. I just
I would rather focus
on your son right now
and not the Home Team.
Are you accusing us of
not caring about our child?
Absolutely not.
Honestly, we'll take
all the help we can get.
We'll just keep our fingers crossed now
that the antivenom can do its job
and bring Miles' swelling down.
We'll check back soon.
[TENSE MUSIC]
Lizzy, you remember Dean.
- Hi.
- Hey.
Hey.
Sorry, finally found a window.
- Oh.
- Is, uh is this a bad time?
It's OK if it is.
- Oh, um
- Oh, no.
I've got
You two should talk already.
Dean here can get me started, right?
Yeah, I think I can manage it.
Good.
- After you.
- Sure.
Mm.
I know I've given you
some mixed signals lately,
first breaking up with you
and then telling you
- that I love you too
- Hannah,
you don't have to explain yourself.
I'm not gonna hold you to something
you said when I was
on the verge of dying.
Oh, Mitch, that's not
Hey, hey, it's all right.
I've been doing a lot
of thinking lately,
and, um,
you were right,
what you said about me when we broke up,
about my anger issues,
about me not knowing
how to be in a healthy relationship,
all of it.
I said a lot of that when I was angry.
And you had every right to be.
[SIGHS]
[SOFT DRAMATIC MUSIC]
♪
I threw away a winning
lottery ticket with you,
and I'm gonna have to live
with that the rest of my life.
♪
I just hope, at the very least,
you'll be able to forgive me.
♪
Your heart rate sounds normal, Murph.
Well, it was beating
like crazy this morning,
- when my arm started hurting.
- OK.
So what other symptoms
have you been experiencing?
Well, last night, my stomach
started hurting so bad,
it was like I couldn't see.
And then this morning,
the pain went into my chest.
And now it feels like
it's more in my neck.
Well, like I said,
sharp pain on and off.
And my hand gets tingly.
You think maybe it's a stroke?
No.
You think I'm crazy, don't you?
Nope, I do not.
Look, we can just slip past all of this,
and you can just slide me some meds,
and I can just get
a decent night's sleep.
Dr. Archer is he is stingy
with the good stuff.
I'm sorry, but I can't do that, Murph.
Why do I waste my time?
What I am going to do
is try to figure out
what's causing your pain.
So I'll run some tests and see
what we can come up with, OK?
You're probably just
trying to cover your ass
so I give you a good review.
Hey.
So how did it go?
You didn't take him back, did you?
No, of course not.
Weirdly, it seems like
Mitch is actually
- actually changing.
- Oh.
- Hmm.
- What?
In my experience, people's changes
tend not to last.
Eventually, everybody goes back
to being who they are.
Well, I don't know about that, Dean.
[SIGHS]
Oh, my God, look at that.
That is your baby girl.
- It's a girl?
- You get a girl.
[LAUGHS]
I'm no obstetrician, but I'm pretty sure
- those are her feet.
- Yep.
She'll start kicking about now
and making facial expressions.
You know, I wonder if she's learned
- how to roll her eyes yet.
- OK.
Let's hear that little heartbeat.
[OMINOUS MUSIC]
♪
- Something wrong?
- Let me see that.
- Yeah.
- [CLEARS THROAT]
♪
Why don't I hear a heartbeat?
♪
Lizzy, I'm so sorry.
There is no heartbeat.
♪
[CRIES] What? No.
[SOBBING]
Well, you were right, guy's a conundrum.
How'd he get short of breath
and syncopize
with a good ejection fraction
and normal valves?
My thought, exactly.
Maybe it was an arrhythmia?
Let's keep him on the monitor,
slow him down with metoprolol,
- and repeat his EKG.
- OK.
Thank you, Dr. Hayes.
You know, usually, you'd want
to consult with a cardiologist
for symptoms like these
not that I'm complaining.
You know I always love these
little meetings of our minds.
Speaking of meetings, are you going
to the leadership conference
in Myrtle Beach next month?
I don't know, those things
aren't really my cup of tea.
Oh, they're not meant
to be your cup of tea.
They're meant to be
your frozen margarita
with a salted rim and a mezcal float.
Oh, you mean a boondoggle?
Mm, I like to think of it
as some well-needed R&R
- to recharge the batteries.
- Mm-hmm.
Come on. It's a free weekend in the sun.
Relax by the pool, get a massage,
maybe let your hair down.
You seem to have me
confused with someone
- who's able to do that.
- Do what?
Uh, let your hair down. That's not me.
I'm not that kind of person.
Oh, I think you're wrong.
You're being very presumptuous.
Oh, um,
I didn't mean any offense.
It's probably best
if we keep our interactions
focused solely on work moving forward.
Yeah, message received.
I should know more about
your patient within the hour.
I just keep playing it all
over and over in my mind.
Should I not have been walking
around in the cold today?
- Did that somehow harm the baby?
- No.
No, Lizzy, listen to me. Listen to me.
You cannot blame yourself, OK?
[SIGHS]
Sometimes these things, they just
they happen.
And based on the measurements,
been about a week
since the baby had a heartbeat.
A whole week?
How could I not have felt that?
Hey, I know that this is hard.
OK?
But the fact that you got
pregnant the first time
means that you can do it again.
I'm not so sure anymore.
After all I've been through,
the IVF rounds, I just
Stop that, Lizzy. You will be a mother.
I truly believe that.
[SOFT DRAMATIC MUSIC]
[SIGHS] All right.
So what happens now?
Well, we'll need to perform
a D&E to remove the fetus,
which I know it can sound kind of scary,
but it's very safe, very standard.
And you will be doing it, right?
Lizzy, no. I'm sorry.
It's against hospital policy
for doctors to operate
on family members.
What? No, no.
Hannah, please.
I need to know someone I trust is there.
[TENSE MUSIC]
♪
How's your sister?
She asked if I could do her D&E.
Mm, yeah.
It's gonna be hard to get by Legal.
I know. I already told her.
Let me talk to Kalmick.
Lizzy may have to sign a waiver,
but we'll figure it out.
♪
Hey, guys, I could use some extra eyes.
- My patient, Murphy Costello
- Oh, Murph.
Oh, what's his problem today?
Trying to score
some pain meds off of you?
Well, I initially thought
a herniated disk,
but his MRI came back clear.
- You sent him for an MRI?
- Yeah. Why?
Well, Accounting's
gonna have a conniption,
but, hey, it's not my money.
What about nerve impingement?
- Did you do a Neer's test?
- Yes.
And a Hawkins-Kennedy and a Jobe,
and those were negative as well.
OK, well, maybe it's just
all in his head again, like last time.
Um, do you think you maybe
want to, like, hot potato him over
- to Dr. Charles 'cause he's
- No, no, no.
There's got to be something I'm missing.
It's my last day.
I want to go out with a win.
Fair enough.
You wanted to know when
the fifth vial of CroFab
had been administered?
Yeah.
The antivenom's still not taking.
BP's still softer than we hoped for.
Darla, let's double it up.
Give him another five vials please.
Whoa, that seems like a lot
for a little kid.
The dose is actually
for the amount of venom
coursing through his body, not his size.
And what if it weren't one of
those four snakes that bit him?
Well, in that case,
we'll have a much steeper hill to climb.
I'll go call Animal Control
and see if they've spotted any
other venomous species in that area.
We'll be back with you
in a minute, all right?
You heard that, Home Team.
Just to update you, Miles is
doing worse than we thought.
We really need everyone's
strength and prayers right now.
Excuse me.
What are you doing?
We're just giving our followers
an update on Miles' condition.
Your followers?
Does this seem like an appropriate time
or place to be doing that?
Look, I know what
this must look like, but look
No, what it looks like
is you are exploiting
your son's life-threatening
condition to get more views.
No, no, that's not our intention at all.
You are aware that you're the reason
he is in this position, OK?
Because you were not watching him
when you were supposed
to be watching him.
He's your son, OK?
You're supposed to be there for
him to protect him, all right?
So the least you can do right now
is put the phone away and
be present with him here.
Dr. Frost.
[TENSE MUSIC]
Perhaps you should go clear your head
for a minute, give these parents
some time alone with their kid.
Yeah.
♪
But what's it called, WPW?
Wolff-Parkinson-White syndrome, yes.
It's a heart rhythm
disorder characterized
by an extra electrical pathway
in the heart,
a congenital defect.
You've essentially had it all your life.
That's what's been causing
the intermittent tachycardia
over the years.
It just didn't reveal itself until now.
OK, so what happens now?
Well, correcting the arrhythmia
is pretty straightforward.
We'll send a catheter
up through your veins
and ablate the extra electrical pathway.
So what's the recovery time
on this, usually?
About a week or two.
Well, so if we wanted
to travel tomorrow
I'd recommend against that.
Well, I can just postpone this
until we get back from Norway.
Ron, don't be stupid.
It's your birthday, babe.
It's a big one.
This trip can't be rescheduled.
Look, there's gotta be
some kind of Band-Aid
you could put on it, get me
through the next few weeks,
- right?
- Oh, my God.
You've lost your mind.
We could prescribe an anti-arrhythmia
medication temporarily.
And so has this one.
What is wrong with all of you?
I'm surrounded by morons!
What's gotten into you?
God, I need somebody here
who knows something.
Dr. Charles, can you get in there?
I my idiot my
my
he needs a shrink, and so
might every single one of them.
OK. OK.
♪
What are you all looking at?
♪
Cynthia.
Ron wanted me to find you
and tell you that he's decided
to go ahead with the surgery.
And Dr. Hayes is taking him
upstairs right now.
OK, well, my little fet
my my little effect
had the desired show
effect, then.
[SIGHS] You know what I mean.
I hope you don't mind me observing
that that's not the first time
that that's happened today.
Well, it's been a stressful few hours,
and I'm turning 50 in a couple of days,
so it's probably just a senior moment.
Maybe.
But, you know, in my line of work,
when those senior moments
are accompanied by
fine motor skill issues
and sudden flashes
of irritability, disinhibition,
I get concerned.
And something tells me that,
I don't know,
maybe you're starting to get
a little concerned yourself.
You know the best part
about reconnecting with an old love?
Tell me.
It's the way they look at you,
as if you haven't changed.
I am familiar with that phenomenon.
I mean, Ron was never
the most observant partner
to begin with, but it's really sweet.
He's so smitten, he doesn't see.
You know, if you want,
we could just run some tests,
you know, while they're working on him.
[SOFT DRAMATIC MUSIC]
[SIGHS]
OK.
You know,
for a second there,
I was really, really looking
forward to this birthday.
Murph, please,
I just need 20 minutes. That's all.
Enough. You're not listening to me.
Fix what's wrong, and let me go
let me just let me go home.
Just give me 20 minutes, OK?
20 minutes.
[SIGHS]
Why hasn't Murph been discharged?
He came in hours ago.
I've been trying to make a diagnosis,
but it's been elusive.
My most recent hypothesis was that
it might be an unusual presentation
for pronator teres syndrome,
but the pain's not localized enough.
I
I confess, I'm stumped.
I appreciate your thoroughness,
but we need to open up that bed.
So if you can't figure it out
and it's not emergent, move on.
Got it. Oh, speaking of moving on
I know. It's your last day.
I'm sorry, but I'm not available
to come to Molly's tonight.
Um, that's OK.
I know you're busy.
Listen, whatever Murph
came in here to complain about,
he's gotten it off his chest,
so don't beat your head against
the wall. Just cut him loose.
He's gotta get something off his chest.
- I just said that.
- Thank you, Dr. Lenox.
I need to do an ultrasound.
Hey, Renee?
- Is Trey around?
- He he left.
He was a little worked up and
said he didn't want to talk.
About that, uh, we wanted to apologize
for what transpired earlier.
You guys are going through
a tough time right now,
and, well, anyway,
I think what Dr. Frost
- and I are trying to say is
- I had
I had no right to lecture you like that,
and I apologize.
No, you were right.
This social media thing was
supposed to be something fun
for our family to do together,
but now I'm afraid that
I let it become our identity.
Swelling hasn't subsided yet, has it?
No, not like we would
want to see right now.
But we are nowhere near giving up hope.
We're actually in consultation
with a transfusion specialist,
and we might be able to try an
experimental plasma exchange.
I got it!
- Whoa! Hey!
- Whoa!
I got it. I got it.
What did you do?
I killed that son of a bitch.
That's what I did.
What?
Your words kept ringing
in my head, Dr. Frost,
my boy lying there
suffering and helpless,
and here I am on my phone,
instead of doing something about it.
Uh-huh.
So I went back to that barn,
and I tore it apart
until I found this bastard
up in the hayloft.
I picked up a shovel,
gave it a good whack,
knocked him out cold.
You brought a live snake into the ED?
OK, this is good.
Um, you know, we can get
Animal Control to ID it now,
- so
- OK.
Yeah, here, look.
- Careful.
- I am.
[OMINOUS MUSIC]
No, no, no, no, no, no.
Are you sure you brought it in?
Uh, yes. Yes, I am.
OK, I felt it in the bag
when I walked in,
and security was giving me
a hard time with my ID,
so I put it down, and
Oh, my God. Trey, tell me you didn't.
Oh, damn.
- Oh, damn.
- OK, don't panic.
It's OK. Just
Hey, at least we know
it's in the hospital.
♪
I checked the waiting room,
the trauma rooms, nothing.
And you didn't tell anyone else, right?
Well, not yet. Why?
Ironically, the protocol
for a snake being on the loose
in the hospital is to not tell
anyone a snake is on the loose.
What kind of sadist writes
these protocol manuals?
We have to project an air of calmness.
Security and maintenance
and every other spare body
is searching high and low,
and Animal Control is on the way.
Hey, hey.
So I spoke with the dad.
He said it was red with
black and yellow bands.
That sounds like a coral snake,
which is an elapid, not a pit viper,
and that would explain
why the polyvalent antivenom
didn't work, because
they're not normally found
in this part of the country.
[SOFT DRAMATIC MUSIC]
I'm not even gonna ask
why you know that.
I'll call the zoo, see if they can
send over some antivenom.
I'll notify security.
Keep me posted.
Uh, I'll
OK.
That's just about everything.
Well, you heard the boss.
Let's wrap it up and dial her down.
Hey, thanks for talking
Kalmick into letting me
take the lead on this one.
It meant a lot to Lizzy
and to me.
Don't mention it.
He's actually really understanding
once you've signed all the releases.
Hold on.
What is it?
[VITALS MONITORS BEEPING]
That's strange.
She's still bleeding.
[TENSE MUSIC]
♪
Her uterus is boggy.
It's not contracting down at all.
She's starting to hemorrhage.
Give her 250 micrograms Hemabate, IM.
Do you need a balloon catheter?
No, that won't work quickly enough.
We need to open her up.
♪
- Oh, hey.
- [GASPS]
Ah.
Hi. Yeah, sorry, yeah.
Sorry, didn't mean to scare you.
No, no, no.
I was actually just
about to come find you.
Mr. Parker's ablation went swimmingly.
We can notify the ex-wife.
- Oh, great.
- Yeah.
Um, I wanted to get your take on a scan.
Yeah.
There appears to be a pattern of atrophy
on the frontal and temporal lobes.
It's a tad asymmetrical,
so I would favor
frontotemporal dementia over Alzheimer's
if I was doing a differential.
Why? Whose image is that?
Cynthia's.
That would explain the disinhibition.
Among other things.
You suspect behavioral-variant FTD?
I do.
And she doesn't want Ron to know.
Well, a terminal diagnosis like that
is hard enough to contextualize
for yourself
without dumping it on
someone you care about.
Dumping?
That's an interesting choice of words.
The knowledge of a terminal diagnosis
is like its own disease, Daniel.
Once someone knows, they're infected
with all of the pain that comes with it,
and that pain can be worse
for those that have
to watch their loved ones
suffer than it even is
for the patient themself.
So Cynthia is protecting Ron
by not telling him.
She's shielding him
from a slow-moving tragedy.
Oh.
It sounds like you've had
some experience in this area
similar cases is what I mean.
Doesn't every doctor?
You know, I'm just saying,
Cynthia has a point.
That's all.
OK, what are you looking for again?
The anterior scalene muscle.
If my theory is correct,
that's where the bulk
- of the problem lies.
- Wait.
You're injecting me with what?
A mix of a numbing agent, Marcaine,
and a steroid that will help
reduce any inflammation.
Yeah. Did I mention I hate needles?
Relax, Murph.
This will only pinch a bit.
Just, please, look at the monitor.
[GASPS] What the hell?
Thank you.
Oh!
How do you feel?
I feel
Nothing
[SIGHS]
In a good way.
- Yeah.
- Wait.
What what did you say this was again?
Because I couldn't concentrate before.
It's called thoracic outlet syndrome.
It's when the nerve or blood vessel
gets compressed between
the space in the first rib
and your collarbone.
In your case, both are being squeezed,
which is why your symptoms
were so varied.
But that injection should ease your pain
temporarily, until you can
have more definitive treatment.
But I'll refer you to
a specialist moving forward.
It's been,
like, forever
since I haven't had any pain.
I mean, I've seen so many doctors.
I I had given up hope.
I'm sorry for being such a jerk.
That's OK. It's totally understandable.
You are a saint
and a genius,
and I am so grateful to you, Dr. Howard.
Thank you. Thank you.
Thank you.
What's the matter, Murph?
Your pain's not back, is it?
[GASPS]
[SCREAMING]
Snake!
Are you OK?
So there's a snake in the ED.
Nice.
Oh, but you're not supposed
to say that part out loud.
Can someone get an ETA
on Animal Control?
- I can do that, yep.
- OK.
[SOFT DRAMATIC MUSIC]
Tissue looks awfully gray.
- Is it necrotic?
- Partially.
Well, that explains the bleeding.
What do you want to do now?
Sounds like the uterus should come out.
No.
We do a wedge resection.
We lose the necrotic pieces
and salvage the rest,
keep her ability to have a baby.
Get me a Bovie.
Well, is it even salvageable?
In theory, it could work.
The necrosis is localized enough.
BP's moving in the wrong direction.
Then hang another couple of units.
We need to get this bleeding
under control.
OK, I'll try a uterine
artery ligation
0 Vicryl suture.
All right.
The bleeding's not slowing. I can't see.
Suction.
The sutures keep tearing through.
The tissue's too soft.
I need to try the other side.
[MACHINE BEEPS LOUDLY]
Pressure's getting harder
to stabilize, guys.
If I were you, I would think
about cutting and running.
Yeah, well, you're not her, Marty.
Just do your damn job.
We might need to resect more.
[BEEPING]
It's your call, Doctor.
What do you want to do?
[BEEPING]
We keep going.
I can make this work.
[BEEPING]
What's up, dude?
You had us really worried there, bud.
Yeah. How are you feeling?
Are you hungry?
Do they have any ice cream?
[LAUGHTER]
We just might be able to
find you something, buddy.
The hospital is gonna want
to keep Miles overnight,
but we're confident
he'll make a full recovery.
Thank you both for everything.
- Of course.
- You're welcome.
Ooh!
I like playing with this bunny.
- Hey, Home Team.
- Yeah.
Look who we have here.
- Say, "What's up, Home Team?"
- What's up?
Yeah.
See?
People like that don't change.
They're just not capable of it.
[SOFT DRAMATIC MUSIC]
♪
Wait. Degenerating?
What do you mean?
My cognition,
my balance, everything, me.
It's all going away.
What are you trying to say?
You've got dementia?
Sorry.
I was just coming in
to do a post-op eval.
I will come back later.
Here are your things.
Do you know anything about this MRI?
Not really my specialty.
No, I told you this is
something I was talking
to Dr. Charles about.
I wasn't even gonna say anything to you.
What? Why?
Because I was afraid.
I don't know how long I'm gonna
be this version of myself,
and I totally understand
if you don't want
to be with me anymore.
I can't believe you.
[SIGHS]
I just can't believe you think
you can get rid of me that easy.
Babe, these last few weeks
have been some
of the happiest of my life.
♪
I'm not gonna give that up.
♪
All right.
Listen, I wasn't gonna do this
till Norway, but
I'll give you some privacy.
No, no, no, no.
Stay, Dr. Lenox.
I need a witness.
[CRYING]
Will you marry me, Cynthia Maude Parker,
again?
Come on. Say yes.
Babe, I'm so scared.
Yeah, me, too.
But look, no matter what,
we're gonna get through this
together, OK?
- OK.
- Yeah.
Hey, Doris, have you seen
Your box?
You mean the one you left in the middle
of the nurses' station?
I put it in the doctor's lounge,
where it should have been
in the first place.
Thank you.
[EXHALES]
Wait. Ooh, wait.
Surprise!
So you all didn't forget.
No.
Congratulations, Dr. Howard.
Whoo!
[APPLAUSE]
Naomi, you brought a high degree
of positivity and
intelligence to the ED,
and you will be missed.
Oh.
Aw.
OK, OK.
Can we cut the cake, please?
Thank you.
OK.
Well, I'm gonna go finish my rounds.
Doris, great cake.
Nicholas, one second.
I was giving our earlier
conversation some thought,
and
Myrtle Beach might be
a welcome diversion.
Oh.
Though I should warn you
I prefer my margaritas
on the rocks, no salt.
Well, that's OK.
I can probably be salty
enough for both of us.
I look forward to seeing you poolside.
♪
I know this residency with Dr. Hayes
is like a dream come true,
but I'm actually
really gonna miss the ED.
We see people when
they're at their lowest,
and sometimes well, sometimes
we're able to turn things
around for them.
And we do an awful lot
of good down here.
- Yeah, I like to think so.
- Yeah.
And, well, the people aren't half bad.
Is it just me, or does this
taste like toothpaste?
Well, Doris made it, so who knows?
I think it's actually pretty thoughtful.
It's actually inedible.
Uh-oh.
You all right?
I don't know. You tell me.
Well, what's going on?
I'm sorry.
Dr. Charles, I don't mean to
take you away from the party,
all right? I'm fine.
I'm not asking for help right now.
- Thank you.
- OK, sure.
What is this?
Did Ripley put you up to this?
What? No.
Put me up to what?
Nothing, all right? Whatever.
I don't need you shrinking me
right now, OK?
I'm good.
Well, that's good because
I don't shrink colleagues.
I do check in with my friends
every now and then
when they're having a bad day.
But if they get all huffy with me,
I tend to leave it alone.
Good night.
[SIGHS]
Hey.
Hey.
Oh, hey.
How did everything go?
It went, um
Well, you see, there were
There were some
unforeseen complications.
And
Um
After we performed the D&E,
you started to bleed profusely,
and when we opened you up to
locate the source of the bleed,
we found that your uterus was necrotic.
♪
[GASPS]
Necrotic?
There was a lot of dead tissue.
We tried to resect
what we could to save it,
but, ultimately, we needed to
perform a total hysterectomy.
♪
You took my uterus without my consent?
We had no choice.
You'd have died otherwise.
Becoming a mother
was the most important thing
in the world to me,
the only thing I ever wanted,
and now that is gone,
Dean, because of you.
No, Lizzy, Lizzy, Lizzy.
I made the decision
for the hysterectomy.
I made that decision.
What?
[CRYING]
- I couldn't lose you.
- How could you?
I couldn't lose you.
Hey.
I couldn't lose you.
[CRYING]
I couldn't lose you.
[CRYING] Oh.