ER s10e21 Episode Script

E.
R.
Previously on E.
R.
No, I work at a burger joint.
Caught myself by putting my hands on the grill.
You're too young to have high blood pressure, E.
- This is my dad.
- Hi.
The longer you stay, the harder it's gonna be on him when you leave.
Well, maybe I won't leave this time.
She left the money to me.
She left the house to me.
She trusted me to make the right decisions.
I doubt she'd agree that's what you're doing now.
Pleasure meeting you.
I look forward to getting the wedding announcement.
E.
R.
10x21 "MIDNIGHT" - What else did we get? - Another book from Elizabeth Corday.
Elizabeth.
Who's that? Surgeon.
British.
- The American Way of Birth.
- Don't let Dr.
Ford catch you reading that.
Oh, yeah? Why not? Because it argues that the shift from home births and midwives to hospital births and C-sections is the result of American OBs' greed.
- All right, what do you think? - I'll read it today.
No, about the paint.
Maybe something with more blue.
Maybe? You know, Americans are way too neurotic and technology-reliant.
I mean, with all your money and equipment your infant mortality rate is still terrible.
Oh, you'd rather be back in Kivu, giving birth on a concrete floor? You're, like, 34th or something, behind Guam.
I like the second one.
Too much gray.
Well, why don't we ask George? - George? - You don't like George? - Oh, please.
- I like George.
It's the name of first president of the United States, the quiet Beatle.
- Current occupant of the White House.
- Well, no name is perfect.
Hey, George.
It's Dad.
Listen, would you rather be born on the filthy dirt floor of a primitive mud hut in Central Africa, or-? I do not live in a mud hut.
Or in a modern hospital surrounded by the finest doctors and equipment in the world? Kick once for America, twice for the mud hut.
- I resent your characterization- - He's deciding.
- He's not deciding.
- He's deciding.
- You know what, he's sleeping.
- No.
- I'm back.
- Hey, you get there in time? Yeah.
It's a nice-looking school.
It's kind of heavy-duty security, though.
They have a drug shootout there recently or something? What the hell is this? Honey, you knew what that was when I met you at 15.
Where did he get it? He saw it with my stuff, and he wanted to know what it was.
So you gave it to him? - He knows not to take it to school.
- A condom? Hey, look.
Come on, I'm sorry, all right? It's no big deal.
I shouldn't have had the thing in my damn pocket.
Picked up a few, just in case.
- You're not on the pill right now, right? - Me? A boy can dream, can't he? You look good, baby.
I missed you.
- What are you doing? - What you like.
It's still what you like, isn't it? No.
I gotta go finish laundry.
Hey, can you hang with Alex tonight? I got something I gotta do.
A date? Yeah, sure.
I can't believe we graduate tomorrow.
Neither can future patients.
Today, ill-prepared students.
Tomorrow, doctors with the fate of countless helpless victims in incapable hands.
They ought to make them wear caution signs.
" Danger: New Doc" in big letters on your coats.
Thanks for the pep talk.
Happy to lend encouragement to the newbies.
- Jerk.
- Bastard.
How long will it take me to get to O' Hare at midnight? - Midnight? - My family's arriving from London.
- I had to get the cheapest flight.
- How many are coming? - Nineteen.
- How many? Really.
Eighteen if my uncle's hip is still dodgy.
Your families coming? Father and mother, Dad's new wife, Mom's new boy- - Abby, any family jetting in? - No.
We're not that close.
We're more like survivors of a particularly brutal carjacking than a family.
Hello, ladies.
Let's get a move on.
It's your last chance to learn something before you start screwing up your malpractice premiums.
- Wanker.
- Turd.
Dick.
- Is Alex coming with us? - No.
It'd be fine with me if he did.
- Just you and me.
- Where do you wanna go? Just hang out.
I miss you.
Eighty-five-year-old male, combative and uncooperative wandering around naked at board and care.
Give me my watch back, you bastards! - Thinks we took his watch.
- I want it back, you son of a bitch! It's on his wrist.
- You want restraints? - Not yet.
CBC, chem panel, UA and chest x-ray.
Somebody call the cops.
And let's see if we can find a reason for his deterioration.
Hey, back so soon? - Lucky me, huh? - Abby, you free? What, everybody just decide to not file anything for two months? Frank, my man! Thank God you're back.
You start blubbering, I swear I'm gonna smack you.
- Back to work already? - Wife threw me out of the house.
I think I was getting on her nerves.
She was definitely getting on mine.
- John? - Yeah.
- God, how long have I been asleep? - About an hour.
- Here, drink this.
- No, thanks.
- No, really, I don't want it.
- Come on, come on, come on.
- You been doing your kick counts? - What? No.
The baby squirms like mad all the time.
You've been reading too many books.
I'll count, okay? Just go do something useful.
Unpack a box, paint, do something.
- Go, go.
- Okay, okay.
Remember that kid with high blood pressure? - Nope.
- Burnt his hands on a grill? His belly CT came back.
No pheo, no coarc, no renal artery stenosis.
Nothing indicates cause for high blood pressure.
- So? - He has primary hypertension.
What? That big kid who flips burgers? - What'd you tell him on discharge? - To lose weight, get some exercise.
Gave him a scrip for hydrochlorothiazide.
And referred him to Family Medicine Clinic.
- Voilà.
You're a miracle worker.
- Look at his cardiac echo.
- Left ventricular hypertrophy.
- You call the clinic? - He hasn't made an appointment.
- Call and remind him.
He has end-organ damage.
He could have CHF or arrhythmia.
Neela, he's a kid, okay? That would take decades.
Call him, tell him to get his butt to the clinic sometime before he's 30.
No fever, no pneumonia, no UTI.
- Something metabolic? - Pulse ox is 98.
Sodium's okay.
Sugar's normal.
No anion gap.
- Mr.
Ferguson, you have to stay in bed.
- I have to go feed the cat.
We'll make sure the cat's taken care of, but you have to stay in bed.
- What else? - Could be toxic ingestion but there's no toxidrome.
I think it's just a worsening of his dementia.
Five hundred cc saline bolus and D5 half at 100 an hour? Yep.
You graduate tomorrow? - Eight short years later, yeah.
- You got your boards results yet? - No.
- Dr.
Kovac, you got a minute? They gonna let you graduate? I can walk, but I don't get my diploma until I pass.
- You haven't passed your boards yet? - I took them last week.
Wow, I had to take mine, like, six months before my graduation.
Morris, what do you need? Hey, Malik.
Can you hang 500 saline for the old guy in Exam 3? - You got it.
- Dr.
Corday is a surgeon.
She'd be on the sixth floor.
I went there first.
They told me to come here.
- Yeah? Well, they were wrong.
- Rachel? - Jerry, how've you been? - Oh, my God.
Look at you.
- You're all grown up.
- Frank, you remember Rachel, right? Rachel Greene.
Dr.
Greene's daughter.
No bleeding, right, and no contractions? Nothing hurts? Hey, slow down, honey.
You're scaring me.
Did your membranes rupture? Could've happened in the shower.
I saw Dr.
Ford yesterday, and the membranes are fine.
Hey, you can't park here.
- It's okay.
I'm a doctor.
- Good for you.
You gotta move it.
It's a tow-away zone! Thank you.
When he does come in would you get him to call me back, please? Thanks.
Bloody hell.
" Bloody hell " already? It's not even lunchtime.
I'm trying to find a hypertensive No answer at home.
Hasn't turned up for work, either.
Organ damage in a hypertensive teenager? Is that even possible? - Anybody know whose patient that is? - Mine.
Malik.
Larry Godiva's taking another afternoon stroll.
Thank you.
One of you Samantha Taggart? - You a process server? - No.
Then that's me.
Better eat them quick.
They gonna start melting soon.
- Ice cream? - Anybody want a sundae? Somebody sent you ice cream? Yeah, she's here right now.
With a boy, yeah.
BJ.
Right, okay.
All right, thanks, bye.
- I called your mother.
- How is she? She's surprised you're here.
BJ, could you give us a few minutes, please? Cafeteria's on the first floor.
Could you get me some fries, Diet Coke? Cool.
- You good? - Yeah, fine, thanks.
So your mother tells me that you're not living at home anymore.
- Moved in with a friend from school.
- Living with her family? No, got our own place.
How's Ella? Can't wait to see her- Excuse me, Elizabeth.
Can I borrow you for a moment? Yeah.
I'll be right back.
I've got a bad mesenteric occlusion.
May need the O.
R.
Fine, sure.
I got those Itzhak Perlman tickets for Sunday.
- Shaw's first? - Right, yeah, yeah.
- Where'd you say the patient was? - Angiography suite.
I'll be right there.
I'm sorry, Rachel.
I have to get back to work.
Who was that? - Colleague, Dr.
Lawson.
- Handsome.
- So we can stay with you, right? - How long for? Couple of days.
I wanted to check out U of I, maybe Northwestern.
You know you're always welcome.
- Separate bedrooms, of course.
- Of course.
I was 15 when we met.
I was scooping ice cream at the mall little apron, white hat, whole bit.
- Anything left? - Help yourself.
Hey, you just had bypass surgery, like, seven weeks ago.
A treat now and then is not gonna kill anybody.
In your case, that little truism might not be completely accurate.
Steve and his buddies would come after work.
He was working construction then.
He was all tan, sweaty, little cowboy boots.
- How old was he? - Twenty-three.
- And you were 15? - Yep.
Disgraceful, huh? He'd come to my school and pick me up in this old Mustang GT O he was always fixing up.
We'd go out driving or go play "X-Men" in the arcade.
Lots of times, we'd just park somewhere and steam up the windows.
And your parents had nothing to say about this? They had plenty to say, but I didn't listen.
- So, what happened? - Alex happened.
When was the last time you were sure you felt the baby move? In the bath, this morning.
- No bleeding, no cramping? - No.
A little buzz here.
And again, a little buzz.
You sure you had that positioned over the head? Yes.
The amniotic-fluid index? If she's got poly- John, sit down.
Take Kem's hand.
I've been looking for over five minutes.
There's no heartbeat.
There's no gross body movement.
There's no response to acoustic stimulation.
I'm sorry.
John.
Kem.
I'm so sorry.
The baby died.
It could have been an infection, a cord accident erythroblastosis, preeclampsia.
We may never know.
I'm gonna admit you so we can get started on induction.
An induction? We should get this baby out as fast as possible.
I have to go through labor? I'm sorry.
I'll go order the epidural and get started on your paperwork.
Vicki? - Blood pressure was fine.
- Yeah.
- Rh-positive, she's afebrile.
- We're gonna do an autopsy after the delivery and see what we can find.
I'll ripen the cervix with misoprostol.
We'll start Pitocin about four hours after.
- How long will that take? - Twelve to 24 hours.
Sometimes it's longer for first-time moms.
LV wall thickness is 18.
- Is this Burger Boy again? - No one's answering the phone.
Seventeen-year-olds do not have trouble with high blood pressure.
Left ventricular hypertrophy in teens can lead to heart failure.
- And sudden death from cardiac arrhythmia.
- You're a cardiologist now? - I looked it up on the internet.
- Everything on the internet is true.
I wanna go by his house and see if he's there.
He lives 10 minutes away.
I can take a BP cuff, some IV supplies and oxygen.
Don't forget a thoracotomy tray in case he needs a heart transplant.
Where does he live? Morgan Taylor Homes? Bring an armored personnel carrier and a squad of Rangers.
- You can't go in there.
- I'm taking my lunch.
- I'll be back in 30 minutes.
- Hey, Mother Teresa.
I get off at 6.
I'll take you.
But you owe me vindaloo after.
Who's got the geriatric flasher? - Ferguson has dementia.
- Had him in self-restraints.
- Keeps getting loose.
- Use the Posey vest.
I don't wanna see his "wee Willy Wonka" wagging around here anymore.
- I'll go make sure he's okay.
- Nail him to the bed if you have to.
Hey, Kovac, Security's on the line.
They say your car alarm's going off in the garage.
It's driving them crazy.
So you like Indian food? I love Indian food: chicken tikka, masala, naan.
I love it.
When you open your match letter, maybe I can take you out to celebrate.
- Might not be anything to celebrate.
- You're gonna do great.
You're smart cute.
You work your ass off.
Got nothing to worry about.
Not like Lockhart.
Some residency program's gonna get a shock when they find she hasn't passed boards.
- I need to go and see a patient.
- So are we on? Sure, maybe.
Your TV control is here, on-button, volume, channels.
It's gonna feel a little tight.
This is the call button, straight to nurses' station.
If you need anything- - All set.
- You thirsty? I'll get you some ice chips.
Hey.
You know, your alarm's a little sensitive.
You might wanna raise the motion-detection threshold a bit.
It's a nice ride.
- What'd it set you back? - What do you want? The sports package.
Should hold up pretty good on resale.
I really screwed this thing up with my family.
But I'm gonna make it right this time.
And I need time to make it right.
Let Sam see how much I've changed.
Time to be a father to my son.
We belong together, Sam, Alex and I.
And Sam knows that.
You paid that kid $ 10 to watch your car? I want there to be wheels on there when we get back.
Thanks for doing this.
He's here, we yell at him to get to the clinic.
If not, just leave a note, and that's it, okay? - Lifts are over there, I think.
- Trust me, the elevators don't work.
- Thirty-nine, right? - Yeah.
- So much wire mesh.
- So they don't throw things on folks below.
- Like trash? - Like bricks.
Nobody's home.
Got the note? Come on, would you? I'm starving.
- Elgin? - Great.
It's Neela from the hospital.
I just get a little winded climbing the stairs.
It's no big deal.
- You remember Dr.
Pratt, right? - What's up, man? You been taking your hydrochlorothiazide? Why not? Because you told me if I exercised a little, I'll feel better.
I said you could stop taking it in six months if you exercised and lost weight.
- Is that dinner? Cheeseburgers.
- Yeah.
My mother's working tonight.
I have to pick up the kids from Ms.
Johnson at 7.
Can someone look after the kids so you can come to the hospital for more tests? - I'm feeling okay.
- Take your pills.
Come in next week for a blood pressure check, okay? - All right.
Thanks, doc.
- You got it.
He needs an EKG and a chest x-ray.
He needs to pick up his family and get them fed.
You found him.
You told him what he needs.
Unless you plan on adopting the kid, let's get something to eat.
- What time is your graduation ceremony? - Noon.
- You're not gonna go? - I'm off.
Thanks, but no.
It's boring.
It's boring, and I'm not even sure I'm gonna go myself.
To your own graduation? Yes.
It seems pointless considering the fact that I might not actually get to practice medicine, so I would rather no one come.
- Abby, got a minute? - Yeah.
But thanks.
- Anything new on Henry? - No, no, thank you.
Abby, did you get confirmation of your match list yet? Couple of weeks ago, yeah.
Well, with your clinical skills, I'm sure you'll do very well.
Off the record, I can tell you that we ranked you in our top 20.
If County's top of your list, you're guaranteed to match here.
I thought we weren't supposed to talk about that.
No.
No, of course not.
You found out I failed my boards.
Well, I took them again last week.
The hypothetical concern would be that if you don't pass again and you match with a program, whatever that program might be you would be ineligible to begin your internship.
And the program would be short an intern.
Programs can still delete applicants from their match lists until Friday.
That way, the applicant would match with his or her second choice.
And if he or she didn't pass their boards, the second-choice program would be the hospital short a body.
Well, I guess if that happened If that happened, the applicant that was deleted would lodge a complaint with the National Board indicating he or she'd been approached by the chief of staff in violation of clearly stated rules governing how matches are conducted.
Hey.
Where to? I'm starving.
I'm gonna have to take a rain check.
- Everything all right? - Yeah, yeah, fine.
I'm just just tired.
This have something to do with Steve? Because I keep telling him he's gotta find another place to crash.
I just think it's maybe confusing for Alex.
Alex isn't confused.
It's not that simple.
Can I give you a lift? No, that's okay.
Hey, it's morning in Kinshasa.
You want me to call your family? Kem, do you want me to call your family? You sure? - What's that? - Have you told anybody? No.
No.
Been here with you.
I don't want anyone to know.
Okay - You didn't restock.
- No, I didn't.
- Just restock when you use something.
- I will, when I actually use it.
You need anything? Do you? I don't want anyone to know, okay? Ella's asleep? Guy named Dave called.
Wanted to know if you were still up for a movie Saturday night.
He has a daughter, the same school as Ella.
Guy at the hospital, tall British guy.
- You dating him too? - How are you liking school? - Don't worry.
I'm going to college.
- Do I look worried? My mom's worried.
Rachel, why are you here? I just wanna look at a couple of colleges.
I need a prescription for Plan B.
The morning-after pill? Why didn't you go to your mother? Five centimeters, 100 percent effaced.
You're moving along.
- How much longer? - Hard to say.
Hours still.
My legs are completely numb.
We can turn the epidural down.
I'll come back and check on your progress.
I'm gonna go get a cup of coffee or something.
You'll be okay for a couple of minutes? One more big push.
That's it.
Push.
Push.
That's it.
Good.
Long night, huh? - Yeah.
- Your first? - Yeah.
- I got three already.
All girls.
This one gonna be a girl too.
Even our cat's a girl.
You know what time it is? - Yeah.
It's almost midnight.
- Midnight.
I am dying for a cigarette.
But you gotta go all the way down halfway across the building to get to one of them smoking areas.
So I'll probably see you around the hallway later on, huh? - Good luck.
- You too.
Didn't mention anything about the ice cream.
Was a big hit.
- God, you're beautiful, Sam.
- Yeah, this is me at my finest.
No, really.
- You're all grown up.
- You're drunk.
A little bit.
Hey, did you go to the hospital and say something to Luka? Sam, I want another chance.
Well, I don't want you going to the hospital, okay? I gotta get up early.
Come on.
Steve.
Do you remember those cottonwood trees down by the river we used to go to? Used to lay under those trees for hours, just drinking Schnapps and rum-and-Cokes with no ice.
Making love, Dave Matthews coming from my car stereo.
Listen, Steve.
Please.
Sammy, I love you, sweetie.
I love you, Sammy.
Please, Steve.
Please, Steve, what? Let me- Let me by, please.
- I can't feel anything.
- Head's almost out.
One, two, three, four, five, six- - Bear down.
Hard as you can.
- Shoulder's out.
- I got it.
I got it.
- It's almost over.
He's out.
He's out.
It's over.
True knot.
Clamp.
Your baby twisted and squirmed in such a way that he tied a knot in his umbilical cord.
Send 5 cc's of cord blood to the lab for Rh factor.
There's nothing you could have done to prevent this.
Not genetic.
It's not an infection.
It was just bad luck.
- Would you like to see him? - No.
No.
Are you sure? John? It's okay, son.
It's okay.
- Stillborn? - Yeah, true knot in the cord.
- How terrible.
- I can't even imagine.
- I'll try and get up there after rounds.
- Those poor people.
- Seven months old? - Almost eight.
Yeah, tough break.
What? I was being sincere.
This is the admit area where we keep track of all of the patients we have in the ER.
That's Jerry.
He makes this whole place work, and he's very big.
That's Frank, works with Jerry.
Had a massive heart attack and shouldn't be eating that doughnut.
And this is the ER staff.
- Staff, this is my family.
- Nice to meet you.
Okay, well, lovely to see you all.
Down this way are the trauma and exam rooms where we save the lives of unfortunate souls who end up here.
On a busy shift, we'll see over 120 patients, sometimes as many as 200.
Back there is the Suture Room, where we attend to minor skin wounds.
That's a naked patient.
Let's step through this way.
- Is that too tight? - No, it's fine.
Would you like a lock? To keep? Good morning.
You look radiant.
Liar.
I was up half the night.
Doing what, one might wonder? I was hoping you could do me a very large favor.
Will there be a very large reward? I need you to write me up a scrip for Reglan Yasmin and two packets of Plan B.
John? I'm off in a few minutes.
I asked them to get a room for you downstairs.
I wanna watch Kem for the rest of the day.
Just make sure there's no bleeding.
Has she held the baby yet? I've been doing this for over 20 years.
There's nothing more difficult than what you've been through.
But if Kem doesn't say goodbye to her child she will regret it for the rest of her life.
And a three-month supply of oral contraceptives.
- Birth control pills? - You'll still need to use condoms.
- Who's Dr.
Lawson? - He's a friend.
Why didn't you do it? When your mother discovers these in your dresser drawer, I'd rather she didn't know they came from me.
Lawson.
Was he that British guy from yesterday? Your gynecologist back home can write you a refill for the Yasmin when it runs out.
Do you like him more than the guy from Ella's school? Rachel.
They're both nice, you know, but it's just an occasional meal.
It's a movie.
You know, I have Ella.
I'm very busy with my work.
It's okay.
Dad would've wanted you to be happy.
Do you miss him? Yeah.
Yeah, I do.
Me too.
I appreciate you both coming.
But you should go home.
I don't want you to miss your graduation.
That is today, right? I was gonna miss it anyway.
They didn't have any bagels, but the coffee was fresh.
I was just saying, Dad, how much I appreciate you guys all being here but I think that we're okay.
And I think you guys can go.
Okay.
You know, if you- I know.
You too, Dad.
You can go.
Oh, thanks.
I think I'll stay.
Lester, have you seen Abby? Abby.
Have you seen her? No.
Kem? They want us to move to another room soon.
And they're gonna take the baby when we go.
Would you like to hold him? Campbell, Edward Barrington the third.
Ann Marie Barstow.
Corazon, Linda Benitez.
Bennings, Jonathan Bett.
Hey.
- What did I miss? - Molly Ivins gave a kick-ass speech.
- Who? - They haven't gotten to Abby yet.
I thought you were on bed rest.
Please, I'm already a week late.
I am desperate to get this kid out.
Lily Yay Lin Chang.
Lee Son Chow.
Robert David Betterman.
- I can't breathe.
- Wet crackles to the apex.
He's in pulmonary edema.
Hey, I know you.
Pratt's patient? Pratt, think this one's yours.
- Pulse ox is 78.
- He needs Lasix.
What's going on? - 17-year-old with pulmonary edema.
- Elgin? - We need a nitro spray.
- Had two in the field.
- Want an intubation tray? - What? No.
- Just got a little hypertension.
- He has a little congestive heart failure.
Start a nitro drip at 40 mics and 25 sublingual captopril.
- Sats dropping to low 80s.
- Page Cardiology.
We need a stat echo down here now.
Never seen a kid this young in heart failure before.
- I don't see Abby, do you? - No, said she probably wouldn't come.
To her own graduation? Lester Rodney Kertzenstein.
Andrashi Lapoor.
Abigail Marjorie Lockhart.
Congratulations.
Robin Jay Nancy.
Neela Rasgotra.
- Neela! - Neela! When your brother died the thing I hated the most were other people's platitudes.
There are no words.
You don't know where you'll find the strength, but somehow you do.
You can have another child.
It was an accident.
A tragic unforeseeable accident.
The whole thing was an accident.
No, it wasn't.
You love each other.
Everybody can see that.
I don't know that she'll want to have another baby with me.
Sure she will.
Just give it some time.
Abby? - Congratulations.
- Thanks.
Hey, this is so great.
Good for you.
We're gonna get something to eat.
Wanna join us? - No, I'm tired.
But thanks.
- Okay.
And thank you guys for coming.
- See you at work.
- Okay.
I'll be back.
Hey, Mom, it's Abby.
No, no, everything's fine.
We just haven't talked in a while, so Yeah, it's good to hear your voice too.
Hey, Mom? Guess what.
I graduated today.
Really.
Can you believe it? Kem.
They're gonna come down and take us to our new room soon.
And when they come, they're gonna take the baby and we're never gonna see him again.
I don't know what the right thing is to say.
I don't know what the right thing to do is.
It was an accident.
It was nothing that you did wrong.
It was nothing that we did wrong.
It just happened.
I love you, and I want to spend the rest of my life with you.
But we have to say goodbye to our son now.
I have to help you to do that, and I don't know how to do that.
Please, help me.
Please.
Yeah? - He's beautiful.
- Oh, my God.
I love you so much.
I love you so much.