ER s11e03 Episode Script
Try Carter
E.
R.
Previously on E.
R.
I don't know if I want to be a doctor.
I'll have a job soon and I'll send money.
What job? Where? Give me a position, a job, any kind of job, just until I get myself refocused.
I'm sorry.
I can't- Can't really help you.
I've been having trouble sleeping.
E.
R.
11x03 "TRY CARTER" EMERGENCY - What are you doing? - Couldn't sleep.
Thought I'd get a jump on the day.
- How's the night shift going? - Ugly.
It's been quiet for the last hour or so.
Well, that won't last.
Sunburns, blown-off fingers, potluck food poisoning.
- Nothing like the ER on the Fourth of July.
- Sound like you're looking forward to it.
Mix alcohol, gunpowder and the great outdoors you're in for a good time.
You talk to Kem? Yeah.
A couple days ago.
The time change makes it hard, so we e-mail.
- She doing okay? - Yeah.
You know.
These things take time.
How about you? I'm here, aren't I? So much for quiet.
See you inside.
the greater Chicago area for our nation's birthday today.
So celebrations planned all over the city will have great weather and good turnouts.
Perfect conditions for the many fireworks displays we expect to see tonight.
Oh, we' re out of milk.
joining the folks out in Lisle to look in on the annual Eyes to the Skies Festival.
We 're gonna catch the hot-air balloon Do you need me to give you a ride anywhere? No, thanks.
- You' re sure? I don't mind.
- I'm okay.
You should watch this.
There's a woman on next who fought a lion that was trying to steal her baby.
No.
I have to go to work.
If you want, I can take another run at Weaver.
Maybe something's opened up at the hospital.
I don't wanna work in the hospital.
I've got a couple of job interviews today.
You do? What are they? Good morning, we're back.
I don't wanna jinx anything.
Hey, Bobby.
What do you have for us? Okay.
Well, I'll just see you when I get back from work.
I can pick up groceries today if you'd like.
That would be great.
Thank you.
I'll need to borrow some money.
Just until I get my first paycheck.
Forty-two-year-old female.
She came in with shortness of breath.
Harris can go home with a knee immobilizer.
Hey, Frank.
That's a very nice touch.
You look Very - Gay? - Patriotic.
Granger and Granger, waiting on streps.
Find me if positive.
- Good morning.
- Good morning.
- Hennessey in the suture room.
- Two-layer repair.
Neosporin, after-care instructions, and send her out the door.
You're on fire, dude.
- How many Red Bulls you have today? - Hey, Morris.
- Take care of Delacourt? - Back strain.
- Don't forget femoral and pedal pulses.
- I never do.
- Why is it important to check leg pulses? - Arterial embolus? - Penny, to you.
- Peripheral vascular disease.
Close but no cigar.
More studying, less time at the salon.
Next contestant? Back pain can be the presenting symptom in abdominal aortic dissection.
- In abdominal aortic dissection.
- Can I get some fries with that? I guess it's true what they say.
Those who can't do, teach.
But what is he teaching them? Caught him injecting lido with epi in a toe.
- Oh, I'm not kidding.
- No chest pain.
Hey, Morris? Wait up.
And she's still hypoxic and tachypneic.
EKG's normal, no cough, nothing showed up on the x-ray.
So should I order a spiral CT? You think I should.
Yeah, I should order the CT to rule out PE.
Right.
Of course.
I knew that.
I knew that.
Spiral CT for chest pains - All right.
What else we got? - Mr.
Wallace.
Day three, postop, hernia repair.
We call Surgery.
They like to know when patients come.
This is Dr.
Pratt.
He's one of our Residents.
You present to him, he presents to me.
Dr.
Pratt, instruct our med students on the initial management of chest pain? All chest pain consistent with ACS gets O2, IV aspirin, beta-blocker and nitro.
- Well, what if the EKG is normal? - I repeat.
O2, IV aspirin, beta-blocker and nitro.
All right.
Fall to outstretched arm, earache, belly pain and vomiting.
Go, go.
Make me proud.
First one to kill a patient buys me lunch.
- I didn't expect you back so soon.
- A guy can only play so much Xbox.
- How's the head? - Hard as a rock.
- Yeah? No headaches? No dizziness? - No, man.
I'm cool.
I wouldn't miss this for the world.
July's my favorite.
New interns, new med students.
I know more than any of the newbies this time of year.
That's not necessarily a good thing.
Hey, how's Deb? I think she's good.
Yeah? You talk to her? Carter! Pratt! Twenty-four-year-old male.
Stabbing victim.
I ain't no victim.
The other guy's the victim.
Do I look like a victim? - Settle down.
- You settle down.
- And let me the hell up.
- You could be seriously injured here.
- I've been shot before.
-118/78.
Pulse, 86.
- Mild tenderness.
- I'm bulletproof! -94 on two liters.
- I got bulletproof.
- You sure? - Yes.
Trauma panel, HemoCue, type for two.
Let's start with an upright chest.
- Last patient.
Couldn't get rid of him.
- You're leaving me Mr.
Body Fluids? - Sorry.
- Hey.
- You going home to crash? - Yeah.
- You wanna get together later? - Maybe.
Alex has a soccer game.
Steve talked him into signing up.
He never stuck around to see any games.
- I'll call you.
- Okay.
Dr.
Carter, what's the special of the day? a blood alcohol of 500 and a foot drop.
Neurology won't take him until Neurosurg cleared.
They won't come until he sobers.
- MRl to rule out cord compression? - They're gridlocked.
What am I supposed to do? Babysit.
Hang your banana bag.
And I would hunt around for a mop and a bucket.
All right.
Forty bucks I get that guy upstairs in 20 minutes.
You're on, hotshot.
Starting now.
All right.
- MRI Department.
- Hello, this is Dr.
Barnett from the ER.
Yeah, I have a patient who needs an L-spine with gadolinium today.
Well, when then? Look, I need to take a look at your MRl schedule.
I gotta get a patient in there pronto.
It's a holiday.
They're booked solid.
Maybe.
Yo, Lockhart.
I need to borrow your students.
- They're not my students.
- That's good.
Come on, kiddies.
It's teaching time.
We heard you had a good one up here in the ICU for my students.
Patient named Robinson.
Thanks.
So he's scheduled for an MRl on his knee? Yeah, but that's the least of his problems.
Guy needs a workup before surgery will take him for the replacement.
- It's a scheduling nightmare.
- I'm sure it is.
Pay up, Uncle Cracker.
- Six and 30 makes 10.
May I help you? - Can I get a job application? Need to speak to the manager.
- Is he here? - Unfortunately.
Yale, University of Chicago Med School, interesting.
This is all very impressive, but what's the extent of your barista experience? - Excuse me? - Starbucks, Diedrich's Coffee Bean & Tea Leaf.
- I've never actually worked in a café.
- I see.
But I'm used to working in a very busy hospital.
So I'm sure I can handle a few coffee orders.
Really? How do you prepare a venti, triple skinny, no-foam caramel macchiato? That intern, Abby, do you know if she's seeing anybody? Just me.
It's a casual sexual relationship, but we're always looking for a third.
Abby, what if the UA's normal on a 2-year-old with fever? Viral syndrome.
Have them follow up with their PMD.
What if the kid vomited Tylenol he got in triage? Give a rectal dose and explain that fever won't hurt him.
And what would you do if a med student asked you out? Call for a Psych consult.
Twenty-four-year-old cyclist collided with another.
- Hold up.
- No LOC, GCS, 15, vitals stable.
- Complains of knee pain.
- What is this? Bike versus bike.
Abdomen soft, pelvis stable.
- Don't move your neck.
- What? Don't do that.
Funky Monks.
Chili Peppers tribute band, right? We were until our lead singer found Jesus.
That's a bummer.
Thinking about putting a band together.
Abrasions and ecchymosis to the hip, Dr.
Bon Jovi.
You on any medications? - I don't take medicines.
- I need to make a statement.
That's the other guy.
That idiot rode right in front of me! - I didn't see you, man.
- Because he was riding like a maniac! - Hey! - I got this guy.
- Gee, thanks.
- Road rash over left chest, arm and face.
- Complains of shoulder pain.
- I ride 200 hundred miles a week.
Irrigate the abrasions and apply Neosporin.
Were you wearing that helmet? Of course.
When can I see a cop? He ruined my bike! You did a little more damage to him than he did to your bike.
It's a $6000 Serotta Legend.
You paid six grand for a bike? Hey, Mr.
Zeller, please.
No, I need this to examine you.
Oh, my God.
I'm fine! I keep telling you that! - How are you doing, Mr.
Hanson? - It don't even hurt! - There's blood in Morrison's.
- Bull! - Do know what Morrison's is? - Do you? Chest is clear.
Don't think it crossed the diaphragm.
Hemoglobin is 13.
2.
Give him a gram of cefotetan just in case he nicked the bowel.
You heard the man.
Give me some medicine.
- Let me get the hell up out of here.
- You're not going anywhere.
- You need surgery.
- For what? He didn't shoot me.
Ain't no bullets there.
Don't know what y'all looking for.
- Bleeding in your belly.
- Punctured intestines.
- You can get an infection and die.
- Forget that.
I need to call my brother to get out of here.
I know you're tough, but what part of "you could die" don't you understand? I ain't dying.
I'm walking.
- Man, get me a damn phone! - Dr.
Pratt? Get me a phone, man! Let the fool go.
He deserves to die.
Yeah.
If that's what you want.
- Yeah, I don't care.
- You're not the Attending.
Since my name's on the chart, we should call Psych.
He's not crazy, he's stupid.
Okay, hey, whatever.
I'll call them down for an idiot consult.
Look, he's not drunk, he's not on drugs and if he leaves AMA and goes home and dies you better believe his family's gonna sue us.
All right.
I'll call his brother.
Maybe a family member can talk sense into him.
Mr.
Zeller? Sir? Can-? Mr.
Zeller.
Mr.
- Hey, I've been here for four hours.
Still haven't had a doctor check my foot.
- You seem to be walking on it all right.
- That's not the point.
Well, you see all these patients? Chances are we're not gonna get to you until most of them go home.
So why don't you find a magazine and make yourself comfortable? How's he doing? Crepitus bilaterally, decreased range of motion.
- How's the other guy? - Obnoxious.
So how many miles do you ride a week? Lots.
Lots and lots of riding.
I ride here.
I ride there.
I'm like the wind.
Hey, man! I told you that they hurt.
What's the matter? - Sorry.
I'm just checking your reflexes.
- There's nothing wrong with my reflexes.
I got good ref- Cat-like reflexes.
I'm like a cat.
Really? Which is it? A cat or the wind? Like a cat in the wind.
I got nine lives, and I always land on my feet.
Hey.
Did you order a head CT? Low-speed mechanism.
Didn't indicate.
He wasn't wearing a helmet and seems altered.
It's just a mild concussion.
We'll observe him for a bit, okay? - Where's the drunk with the foot? - MRl.
- I thought they were booked.
- I pulled a few strings.
- Pull more and get this guy one.
- What's his problem? He collided with another cyclist.
His neuro's non-focal, responds to commands.
- He seems altered to me.
- Did he get knocked out? - He just said he didn't hit his head.
- Carter! Forty-five-year-old, GSW to the head following a liquor store holdup.
- Is this the perp? - No.
He got away.
- This guy's the hero.
- Derek tried to help the store owner.
- You the wife? - Girlfriend.
Okay.
BP, 100/60, tachy to 115.
- Abby, you wanna run this? - Sure.
Dr.
Barnett, get that head CT just to be safe.
- Lungs are clear.
- Doll eyes.
- What's that mean? - BP, 108/80.
Sinus tach, 110.
- Can I get an otoscope? - Who are you? Dubenko, surgical Attending.
I'm covering trauma today.
- His limbs are flaccid.
- CSF in the ears.
Somebody tell me what's happening.
Doing everything we can.
His injuries are severe.
Derek's tough.
- He's a fighter.
- No corneal reflexes.
He's not breathing over the vent.
It's been 40 minutes.
No.
No.
No.
He's tough.
He's- I'm sorry, ma'am.
Every indication suggests your boyfriend has no brain activity.
That's it? There's nothing else we can do for him.
I'm very sorry.
Do you think that you can help us get in touch with his family? I'm the closest thing he has to a family.
Screen him.
CBC, chem panel, ABG, type and Rh cultures, UA, HIV, Hep B and C.
- I forget anything? - VDRL, RPR.
I'm very sorry.
If you have time to sit, you have time to treat patients.
Start him on dopamine if his diastolic's- Unless he signs a consent form for drug testing, we can't do that.
No.
That's not the same as consent.
Really? Same to you.
Calling your mom? Bike courier's boss wants us to drug-test him.
- So did you? - There's no need.
And his head CT was negative, thank you very much.
Mr.
Tunny, do you remember your doctor's name? Yeah, it was him.
Do you know where you are? No place I wanna be.
What are the first chords of the Chili Pepper's "Californication"? - A minor, F major seventh, A minor.
- Thank you.
- That means nothing to me.
- You're just gonna have to trust me.
Trust you to what? The guy still seems altered.
Drug screen for opiates, benzos or even cannabis would give us an answer.
- Then we don't have to keep looking.
- Won't change our observe management.
Tox screens can stay positive for days.
- Could lose his job for smoking last week.
- It's confidential.
Not if it becomes a workers' comp case.
Then it's on his record.
What is he? Your dealer? Maybe we should tox screen you.
- Hey, Sam? - Yeah? - You have a UA for Tunny in there? - Yeah.
- Add a tox screen.
- Sure.
Thank you.
Is your supervisor here? - That would be me.
- I'd like to apply for a job.
- You've worked in one of our stores? - No.
But I like the clothes.
Really? That looks more like Old Navy.
- Have you ever worked retail? - No.
But I'm a quick study.
Unfortunately, I'm looking for experienced help right now.
I can work a cash register and I'm a people person.
I worked at my parents' restaurant for years.
I really need people with a strong fashion sense and personal-style statement.
Why don't you leave your name and number and I'll get back to you.
- What are you doing? - I like them to be the same length.
- Hey, Malik, where's the fire? - Exam 3.
- What happened? - Somebody set off a stink bomb.
Let's hope there's no asthmatics around.
- Come here.
Is that the Colles' fracture? - Yep.
The wrist has to be flexed for proper alignment.
The wrist has to be flexed for proper alignment.
- What do I do now? - You cut it off and you start again.
What do I tell her? We're gonna leave that for And then we're gonna put on a fiberglass cast.
Okay, dear? - This hurt? - No.
We'll knock you out put a little incision by your bellybutton, take a look.
- That's it? - Hold on, Mr.
Hanson.
You hear that? My man says he can fix me up, have me out of here tomorrow.
Gonna do exploratory laparoscopy on a penetrating trauma? - Yep.
- No, he's not.
You guys don't know what the hell y'all doing.
- Piece of cake.
- What if there's a liver lac? - I'll buzz it with cautery.
- What if it's too big? If it were large, he'd have clinical evidence of intra-abdominal hemorrhage.
You better ask to see a specialist you wanna get out of here without dying.
- What if the knife nicked the colon? - I'll run the bowel.
- Nobody can do that with a scope.
- I can.
Welcome to the world of modern medicine.
Let's go.
So long, suckers.
Well, don't look at me.
I didn't hire him.
Okay, Mrs.
Isley, all your blood tests came back normal.
Yes.
Well, I'd like to see a specialist.
Ray.
How about clearing in a few of these beds? What? I'm taking them through like fast-food orders.
- It's the back door that's plugging up.
- You got rid of that drunk pretty quick.
Let me see some more of that.
Sam, I need McCarthy out of here.
And why hasn't Tunny been discharged? We're still waiting on his tox screen.
- I didn't order a tox screen.
- Abby did.
- What are you doing? - Chest pain.
- How old are you? - Seventeen.
Dr.
Pratt said all chest pain gets O2, IV aspirin, beta-blocker and nitro.
- What physical activity have you done? - Nothing.
I was just watching TV.
What about yesterday? - I worked out a little.
- Weightlifting? - Bench press.
- I almost did 200.
Where's Dr.
Pratt? Comfortable? I prevented one of your students from giving nitroglycerin to a - I didn't tell him to do that.
- You have to be specific with these kids.
Sorry.
- You all right? - Just a headache.
- You said you weren't having those.
- Only when I'm working here.
- Okay, go home.
- Oh, come on.
Come on.
No harm, no foul.
I'll keep an eye on him.
You have been dragging your ass all day.
- I've had time-consuming cases.
- Maybe you came back too soon.
So go home.
Get yourself in shape before you fix anybody else.
Can't afford to send me home.
I'm worth two doctors and three interns.
Not today you're not.
Go home.
I'll find somebody else to cover your shift.
Hey.
The biker's blood work came back.
HIV-positive.
No good for organ donation.
That's too bad.
Frank, call Kovac.
I need him to come and finish the rest of Pratt's shift.
Sure.
Make me the holiday hatchet man.
- Do you have any plans for this evening? - Takeout.
And the Cubs/White Sox game.
I was thinking about going to a meeting then getting something to eat.
- Interested? My treat.
- You're buying? Did you order a tox screen on my patient? Which one? You know which one.
Tunny.
The altered bike courier.
You can't order tests on my patients behind my back.
Urinalysis was negative for opiates, benzos, PCP cannabis, cocaine, amphetamines, name it.
- Okay.
So now we know.
- No.
We know this is the second time you've been wrong about my patients today.
And you know what? It's the last.
You treat your cases and I'll treat mine.
- You believe this guy? - Hey if you have a problem with a Resident's workup - take it up with the Attending.
- It's easier just to fix it.
That's what the nurses do.
You're gonna have to work with this guy for four years.
Dr.
Carter? I suggest that you figure out a way of getting along with him.
This is Douglas James.
He's a friend of Derek and me.
- Hi.
- Hi.
Douglas is waiting for a liver.
And him and Derek have the same blood type.
Right.
I'm sorry.
We screened Derek and we found that he is non-eligible as a donor.
- Because of his HIV? - Yes.
I'm HIV-positive too.
I've been taking interferon for hepatitis C but they've given me three months without a transplant.
Well, direct donations are not encouraged.
I'm HIV-positive.
You really think anyone's ever gonna give me a liver? - I'll be back to discharge you.
- Can you get serum organic acids lactate and a VDG? - On Mulhoney? - Throw in a free T4 - and TSH while you're at it.
- Are you kidding? - Did I miss something? - No.
The kid's got a second-degree burn on two fingers - he doesn't need this.
- You only do unnecessary tests on my patients when Abby asks.
- I thought you were working together.
- He's my patient.
- I'm the only one who can write orders- - Hey, Luka.
- What are you doing here? - Carter needed me to cover for Pratt.
Why didn't you say no? - Labs are back on Tunny.
- Thanks.
- Did you get any sleep? - A little.
Jane Doe, 23, found down in the park by some kids.
Breathing's labored.
Sats, 92.
Pulse, 111.
Systolic, 93.
Ma'am, wake up.
Inspiratory stridor.
Aeration is terrible.
Sub-Q epi and get her in a trauma room.
Howard? Could be an allergic reaction.
Was there any food on scene? You see any bee stings? Hurry up, Howard.
Okay, okay.
- Sub-Q epi's in.
- Finally.
- Any medic alert bracelet? Asthma inhaler? - Didn't see any.
Periorbital petechiae.
Luka? Ecchymosis on the neck.
Well, what's that mean? It means someone tried to strangle her.
God bless America.
Kerry.
- Elizabeth.
- I've been calling you all day.
Yeah.
I've been in meetings and I've got another one three minutes ago.
Call my office, tell them I said to fit you in tomorrow.
I need to talk about Dr.
Dubenko today.
- How's he working out? - He's not, to be quite frank.
- I haven't received any complaints.
- Consider this your first.
No one even bothered to tell me you'd hired him.
That's what search committees do.
You should've attended more meetings.
Kerry.
I missed one meeting.
What did you do? Hire the only candidate I didn't endorse? Why are you taking this so personally, Elizabeth? I've got to go.
I'm sure the two of you can work this out.
Oh, hey, Dr? - Dubenko.
- Right.
Sorry.
John Carter.
- You remember the GSW this morning? - Yeah, brain-dead biker.
His girlfriend says he wanted to be an organ donor.
- Great.
- But he's HIV-positive.
Well, no can do.
Well, his buddy needs a liver ASAP and he's the same tissue type.
It's against the law to harvest organs from an HIV-positive patient.
- You know that.
- The recipient is HIV-positive.
It doesn't matter.
UNOS won't approve and no surgeon's gonna operate.
What's that smell? - Stink bomb.
Frank! - Got it! They warned me about this place.
They weren't kidding.
- Dr.
Corday.
- Carter.
Maybe you can help me.
I need help with a patient.
I believe Dr.
Dubenko is covering- I don't think that he wanted to.
And what is it? Too mundane for our new superstar? - I think it may be too illegal.
- Oh, so he's cowardly and cocky.
He's the perfect complement to Weaver's treachery and ambition.
I'm sorry, Carter.
But I have to deal with him, so do you.
Good luck.
Stridor seems to be improving.
Keep an eye on her pulse ox.
Come and get me if she de-sats.
- I'll notify the police.
- What happened to her? Hey, Luka.
- Hey.
- Alex, what are you doing here? You're supposed to be with Steven and Monique at the soccer game.
- I gotta find someone to cover me.
- Don't bother it's probably gonna suck anyway.
I can take him.
I'm off in 20.
I was filling in for Pratt.
You can pick him up at my place after work.
Hey, are you busy? I need your expertise.
- Have Alex meet me in the lounge.
- Thanks.
JOB HUNTERS You worked at a restaurant from the time you were 6 until 16? - It was a family restaurant.
- What kind? Indian.
I never want to work in a restaurant again.
- I don't even like eating in them.
- You haven't worked since then? - I've been in school.
- Studying? Medicine.
Oh, wow.
I'll be honest.
We don't get many doctors looking for jobs.
So you placed very high on your placement test but you haven't got a lot of experience in any other service industry.
No retail, no sales.
- Secretarial? - No.
- Bookkeeping? - Not really.
Horticulture? Mechanics? Electrical? Perhaps we'd have better luck if you told us what you can do.
Let's see.
I can crack open your chest re-inflate your lung and squeeze your heart back to life.
Okay.
Dubenko was right to pass.
Why are you pushing so hard for this? Because we're this guy's last hope.
Because I couldn't save his friend.
Because some good should come out of this.
And what if they sue? Who? His buddy wants the liver.
He's not gonna live long without it.
The hospital could fire me.
The guy's gonna die without the liver, he's never gonna get another.
- They could pull my license.
- Unlikely.
- Acting in the patient's best interest.
- Or jail.
There's already legislation allowing this.
- It's waiting for the governor's signature.
- It'll still violate regulations.
I know.
But it is ridiculous to let a perfectly good organ go to waste.
The liver's not gonna affect the recipient the recipient's got the virus.
He's got a good heart, good lungs low viral load- How's Weaver gonna react? Well, she- Yeah, she might have a little issue with this.
She'll have a bloody conniption fit.
Which in itself is almost worth the risk.
Screw it.
Screw it.
Prep him.
I'll mobilize the team.
Sneaking tests on other doctors' patients? - Ray? - You totally boned me.
- I felt like an idiot.
- Sorry.
- Well, you were right.
- Really? Check out the serum salicylates.
- I'll let you know next time.
- Don't do it next time.
- Where's he going? - To the O.
R.
Corday agreed to do the surgery.
- You talked her into it? - No.
Well, maybe a little.
So you never responded to my offer.
- I'll take a rain check on dinner.
- What about the meeting? - Do you still go to meetings? - I'll go if you go.
- I'm good.
- Yeah? I see how hard you're throwing yourself into the job, Carter.
- It's a hard job.
- So is sobriety.
And so is losing a child.
- Hey, where's Dr.
Kovac? - I don't know.
- What's wrong? - I think Jane Doe's having trouble breath- Call Respiratory Therapy.
- I need to talk to you.
- Talk to your patient.
And you might want to add an amp of bicarb to his IV.
- You need to alkalinize his urine.
- What? He's got a toxic aspirin level.
Hey.
Hey.
What are you doing here? Oh, pediatrician visit.
Somebody was being checked for Pyloric stenosis.
Hey, Cosmo.
- How's he doing? - Oh, good.
Just reflux.
Oh, hi, Frank.
Hi.
- So, wow, you look great.
- Oh, thanks.
How's it going? Twelve new med students.
How do you think? Is Chuny or Haleh around? Yeah, Chuny's around.
Why? You need a nurse? I need somebody to watch him.
I could do it.
Well, are you sure? Because he can be really cranky.
Yeah.
No, yeah, of course.
Okay.
Well, you'll need this because he spits up.
That's what he does basically: spit, poop, eat, sleep, repeat.
Yeah, just like his daddy.
How is Chuck taking to fatherhood? You mean motherhood? The guy's more maternal than I am.
Thanks.
I'll be back.
Okay.
She'll be right back.
The IV's blown.
I need to start another line.
Okay, seven P's.
Preparation, pre-oxygenation pre-treatment, paralysis and sedation, protecting the airway passing the tube, proof of placement, post-intubation management.
Okay, preparation suction.
Good.
Yankauer's ready.
Pre-oxygenation, O2 100 percent non-rebreather.
half centimeter from the end.
- You got this, Howard? - Yep.
Six-five is ready if cords are tight.
Laryngoscope bulb is good.
- I can't believe how big he is.
- Oh, he should be.
He doesn't stop eating.
Where have you been? I was parked.
I had to pee and everybody wanted to see him.
What's wrong with you people? You've never seen a baby? Can you give him room? No one's wearing masks.
- Relax.
- There's germs everywhere, babe.
It's good for his immunity.
I called for a consult and I don't think I should have.
- What patient? - Which of you is Carter? I'm Dr.
Carter.
- You know what otitis media looks like? - I do.
Then teach it to your students.
So they don't call me for a ENT consult every time a kid comes with an earache.
She's closing up.
You're not gonna get any sized tube in if you don't move.
- Find Kovac? - Couldn't find him.
Sats are down to 79.
CO2 monitor's ready, purple.
Paralysis and sedation, 82.
5 of sux and 17 of etomidate.
- Heart rate's 66.
- What are you doing? - Checking the doses.
- You've done that.
She's gonna end up cricked if you don't move.
Oh, God.
Now look what you've done.
You ruined everything.
Howard, get it together.
You can do this.
- She messed it all up.
- She's bradying down.
Suction, oxygen, laryngoscope- All right, give her the meds and have a 7.
0 ready to go.
I got this.
She's my patient.
- Pulse ox, 72.
- Suction.
Suction! - Sux is in.
- Tube.
- It was on the floor.
- Give it to me! Bradycardic, 55.
- The cords are so tight.
- Fifty-four, 52.
All right.
Have epi and ready.
Howard, stand by with a 6.
5.
I always check four times.
I'm in.
Good color change.
Heart rate's coming up.
Sats, 88.
Call for an x-ray.
See if CT's ready to take her.
Pupils are non-reactive.
Were they non-reactive before? - I don't remember.
I'll check the chart.
- Howard.
- Nice pass! He's good.
- Thanks.
Come on.
Come on.
There we go.
- Shoot! - There we go.
Shoot.
- Tough break.
- Yeah.
- You played a good game.
- My team blows.
Every team has good and bad days.
The most important thing is to try your best.
- Want to grab a pizza on the way home? - Sure.
I can help you practice someday if you want to kick around.
- No, thanks.
- I don't mind.
I played football in school.
I mean, soccer.
I was pretty good.
- We could go to the park near my place.
- Look, Luka I'm glad we're friends.
But I've got a dad.
And he's coming back.
- What happened? - Abby saved Kovac's patient.
- Delayed laryngeal edema.
- And a freaking intern.
- Have you seen Howard? - Nope.
- Hey, Abby? - Just a minute.
- Could you show me how to use the slit-? - Not now.
You need something? Think you could get me her phone number? What's going on, Howard? Just needed some air.
- Sometimes it's olfactory overload.
- I was talking about the trauma.
You were looping in there.
Checking things three or four times, repeating your actions.
I like to be thorough.
Come on.
What is it? Sometimes I get nervous.
It didn't seem like nervous to me.
Do you have OCD? I've got to get back to work.
Yo, doc.
The freak in the cape just put his hand through the window to Exam 2.
All right.
Set him up for sutures in Curtain 1.
I gave Mr.
Ogilvie too much oral contrast.
- Can I ask you a question? - No.
My patient has a 2-inch head lac.
Should I use 3.
0 Prolene or 4.
0 to suture? Doesn't anyone knock anymore? Chuck? What are you doing? Oh, it's a supplemental nursing device.
What? You've never seen a father breastfeed his kid? - Can't say that I have.
- I tell you, these things are amazing.
It allows the father to bond the same way the mother does if you can get past sore nipples.
- You want to give it a shot? - No.
My patient has a head lac.
Should I use 3.
0 Prolene or 4.
0 to suture? Hey, Rockheart.
- What did you call me? - Lockhart.
- Are you heading home? - That's what most of us do - at the end of our shift.
- Yeah.
Well, I'm sort of in between places right now.
Listen, I'm sorry we got off on the wrong foot.
- Can I buy you dinner? Make it up to you? - No, thanks.
You were right.
It was altered from an aspirin overdose.
The more he popped, you know, the more his knee hurt.
- He was popping them like M&M's.
- You might want to suggest endoscopy.
He probably ate out his stomach lining.
- How well do you know Howard? - Not very.
Why? - He doesn't seem a little strange to you? - How so? Maybe a little obsessive or compulsive.
- He froze in a trauma today.
- You've been in thousands of codes he's probably seen six.
Cut the guy some slack.
You don't think I should mention it to an Attending? What are you? The hall monitor? - Brauts? - I like to live dangerously.
Come on, you got to wolf down a few dogs on the Fourth.
It's tradition.
Didn't she used to work in the hospital? Neela? Hello, and welcome to Jumbo Mart.
Can I help you? - What are you doing? - Working.
Here? We have a special on our cupcakes.
Buy two, get one free.
- Oh, sweet.
- When you said you were looking I thought you meant at another hospital or a clinic maybe.
- Well, I didn't have much luck.
- You only looked for one day.
This is the only job I can get because I'm a loser.
You are not a loser.
At least you're close to the hospital.
- Which is as close as I'm ever gonna get.
- That's not true.
Yes, it is.
I blew it.
I blew everything.
I've got no job, no apartment, no money.
I mean, look at me.
I'm not even American.
Oh, you are going down, you little freak.
- You suck.
- You're worse at this than at soccer.
Bite me, you Slav bastard.
Alex.
What did you just say? - What? - What did you say? - Nothing.
- I heard you.
- You heard him.
What did he say? - I didn't hear.
Might have been the game.
Yeah.
I'm pretty sure you heard the game, Mom.
Yeah, well, I don't want to hear that kind of talk out of you or you.
How was the game? - We lost.
- Yeah, but he played well.
Still lost.
Well, maybe next time.
- Come on, grab your stuff.
- After this game.
Alex, please, now.
Or else I'm gonna fall asleep right here on this couch.
You can stay here for tonight.
Plenty of room.
Actually, you can stay as long as you like.
Well, that's something that me and Alex would have to talk about first.
Talk about what? Talk about you getting your butt in gear.
Kramer can go home.
Balmore's waiting for a transfer to the jail ward.
Henderson needs a monitored bed or the morgue if he doesn't get admitted soon.
- Where is Ray? - Try the roof.
- What's he doing? - I think he lives there.
He lives in the call room.
He just cooks on the roof.
What are you doing? Just chilling.
Looks like you're all moved in up here.
Yeah.
Well, the rent's right.
And, hey, you can't beat the view.
While you've been up here on your little cookout your patient has been circling the drain.
He needs dopamine and a trip to the ICU.
He's a DNR.
His daughter's bringing the paperwork from Milwaukee.
Want a beer? No.
Thank you.
I can throw on a dog.
No, I'm good.
I heard about your son.
I'm sorry.
Thank you.
That's got to be hard.
Sometimes.
You aren't living in the hospital, are you? Why? Would that be a problem? Might be a problem for Dr.
Weaver.
She has the place sprayed for interns.
Hey, dude.
Check it out.
Happy Fourth of July.
Yeah, you too.
R.
Previously on E.
R.
I don't know if I want to be a doctor.
I'll have a job soon and I'll send money.
What job? Where? Give me a position, a job, any kind of job, just until I get myself refocused.
I'm sorry.
I can't- Can't really help you.
I've been having trouble sleeping.
E.
R.
11x03 "TRY CARTER" EMERGENCY - What are you doing? - Couldn't sleep.
Thought I'd get a jump on the day.
- How's the night shift going? - Ugly.
It's been quiet for the last hour or so.
Well, that won't last.
Sunburns, blown-off fingers, potluck food poisoning.
- Nothing like the ER on the Fourth of July.
- Sound like you're looking forward to it.
Mix alcohol, gunpowder and the great outdoors you're in for a good time.
You talk to Kem? Yeah.
A couple days ago.
The time change makes it hard, so we e-mail.
- She doing okay? - Yeah.
You know.
These things take time.
How about you? I'm here, aren't I? So much for quiet.
See you inside.
the greater Chicago area for our nation's birthday today.
So celebrations planned all over the city will have great weather and good turnouts.
Perfect conditions for the many fireworks displays we expect to see tonight.
Oh, we' re out of milk.
joining the folks out in Lisle to look in on the annual Eyes to the Skies Festival.
We 're gonna catch the hot-air balloon Do you need me to give you a ride anywhere? No, thanks.
- You' re sure? I don't mind.
- I'm okay.
You should watch this.
There's a woman on next who fought a lion that was trying to steal her baby.
No.
I have to go to work.
If you want, I can take another run at Weaver.
Maybe something's opened up at the hospital.
I don't wanna work in the hospital.
I've got a couple of job interviews today.
You do? What are they? Good morning, we're back.
I don't wanna jinx anything.
Hey, Bobby.
What do you have for us? Okay.
Well, I'll just see you when I get back from work.
I can pick up groceries today if you'd like.
That would be great.
Thank you.
I'll need to borrow some money.
Just until I get my first paycheck.
Forty-two-year-old female.
She came in with shortness of breath.
Harris can go home with a knee immobilizer.
Hey, Frank.
That's a very nice touch.
You look Very - Gay? - Patriotic.
Granger and Granger, waiting on streps.
Find me if positive.
- Good morning.
- Good morning.
- Hennessey in the suture room.
- Two-layer repair.
Neosporin, after-care instructions, and send her out the door.
You're on fire, dude.
- How many Red Bulls you have today? - Hey, Morris.
- Take care of Delacourt? - Back strain.
- Don't forget femoral and pedal pulses.
- I never do.
- Why is it important to check leg pulses? - Arterial embolus? - Penny, to you.
- Peripheral vascular disease.
Close but no cigar.
More studying, less time at the salon.
Next contestant? Back pain can be the presenting symptom in abdominal aortic dissection.
- In abdominal aortic dissection.
- Can I get some fries with that? I guess it's true what they say.
Those who can't do, teach.
But what is he teaching them? Caught him injecting lido with epi in a toe.
- Oh, I'm not kidding.
- No chest pain.
Hey, Morris? Wait up.
And she's still hypoxic and tachypneic.
EKG's normal, no cough, nothing showed up on the x-ray.
So should I order a spiral CT? You think I should.
Yeah, I should order the CT to rule out PE.
Right.
Of course.
I knew that.
I knew that.
Spiral CT for chest pains - All right.
What else we got? - Mr.
Wallace.
Day three, postop, hernia repair.
We call Surgery.
They like to know when patients come.
This is Dr.
Pratt.
He's one of our Residents.
You present to him, he presents to me.
Dr.
Pratt, instruct our med students on the initial management of chest pain? All chest pain consistent with ACS gets O2, IV aspirin, beta-blocker and nitro.
- Well, what if the EKG is normal? - I repeat.
O2, IV aspirin, beta-blocker and nitro.
All right.
Fall to outstretched arm, earache, belly pain and vomiting.
Go, go.
Make me proud.
First one to kill a patient buys me lunch.
- I didn't expect you back so soon.
- A guy can only play so much Xbox.
- How's the head? - Hard as a rock.
- Yeah? No headaches? No dizziness? - No, man.
I'm cool.
I wouldn't miss this for the world.
July's my favorite.
New interns, new med students.
I know more than any of the newbies this time of year.
That's not necessarily a good thing.
Hey, how's Deb? I think she's good.
Yeah? You talk to her? Carter! Pratt! Twenty-four-year-old male.
Stabbing victim.
I ain't no victim.
The other guy's the victim.
Do I look like a victim? - Settle down.
- You settle down.
- And let me the hell up.
- You could be seriously injured here.
- I've been shot before.
-118/78.
Pulse, 86.
- Mild tenderness.
- I'm bulletproof! -94 on two liters.
- I got bulletproof.
- You sure? - Yes.
Trauma panel, HemoCue, type for two.
Let's start with an upright chest.
- Last patient.
Couldn't get rid of him.
- You're leaving me Mr.
Body Fluids? - Sorry.
- Hey.
- You going home to crash? - Yeah.
- You wanna get together later? - Maybe.
Alex has a soccer game.
Steve talked him into signing up.
He never stuck around to see any games.
- I'll call you.
- Okay.
Dr.
Carter, what's the special of the day? a blood alcohol of 500 and a foot drop.
Neurology won't take him until Neurosurg cleared.
They won't come until he sobers.
- MRl to rule out cord compression? - They're gridlocked.
What am I supposed to do? Babysit.
Hang your banana bag.
And I would hunt around for a mop and a bucket.
All right.
Forty bucks I get that guy upstairs in 20 minutes.
You're on, hotshot.
Starting now.
All right.
- MRI Department.
- Hello, this is Dr.
Barnett from the ER.
Yeah, I have a patient who needs an L-spine with gadolinium today.
Well, when then? Look, I need to take a look at your MRl schedule.
I gotta get a patient in there pronto.
It's a holiday.
They're booked solid.
Maybe.
Yo, Lockhart.
I need to borrow your students.
- They're not my students.
- That's good.
Come on, kiddies.
It's teaching time.
We heard you had a good one up here in the ICU for my students.
Patient named Robinson.
Thanks.
So he's scheduled for an MRl on his knee? Yeah, but that's the least of his problems.
Guy needs a workup before surgery will take him for the replacement.
- It's a scheduling nightmare.
- I'm sure it is.
Pay up, Uncle Cracker.
- Six and 30 makes 10.
May I help you? - Can I get a job application? Need to speak to the manager.
- Is he here? - Unfortunately.
Yale, University of Chicago Med School, interesting.
This is all very impressive, but what's the extent of your barista experience? - Excuse me? - Starbucks, Diedrich's Coffee Bean & Tea Leaf.
- I've never actually worked in a café.
- I see.
But I'm used to working in a very busy hospital.
So I'm sure I can handle a few coffee orders.
Really? How do you prepare a venti, triple skinny, no-foam caramel macchiato? That intern, Abby, do you know if she's seeing anybody? Just me.
It's a casual sexual relationship, but we're always looking for a third.
Abby, what if the UA's normal on a 2-year-old with fever? Viral syndrome.
Have them follow up with their PMD.
What if the kid vomited Tylenol he got in triage? Give a rectal dose and explain that fever won't hurt him.
And what would you do if a med student asked you out? Call for a Psych consult.
Twenty-four-year-old cyclist collided with another.
- Hold up.
- No LOC, GCS, 15, vitals stable.
- Complains of knee pain.
- What is this? Bike versus bike.
Abdomen soft, pelvis stable.
- Don't move your neck.
- What? Don't do that.
Funky Monks.
Chili Peppers tribute band, right? We were until our lead singer found Jesus.
That's a bummer.
Thinking about putting a band together.
Abrasions and ecchymosis to the hip, Dr.
Bon Jovi.
You on any medications? - I don't take medicines.
- I need to make a statement.
That's the other guy.
That idiot rode right in front of me! - I didn't see you, man.
- Because he was riding like a maniac! - Hey! - I got this guy.
- Gee, thanks.
- Road rash over left chest, arm and face.
- Complains of shoulder pain.
- I ride 200 hundred miles a week.
Irrigate the abrasions and apply Neosporin.
Were you wearing that helmet? Of course.
When can I see a cop? He ruined my bike! You did a little more damage to him than he did to your bike.
It's a $6000 Serotta Legend.
You paid six grand for a bike? Hey, Mr.
Zeller, please.
No, I need this to examine you.
Oh, my God.
I'm fine! I keep telling you that! - How are you doing, Mr.
Hanson? - It don't even hurt! - There's blood in Morrison's.
- Bull! - Do know what Morrison's is? - Do you? Chest is clear.
Don't think it crossed the diaphragm.
Hemoglobin is 13.
2.
Give him a gram of cefotetan just in case he nicked the bowel.
You heard the man.
Give me some medicine.
- Let me get the hell up out of here.
- You're not going anywhere.
- You need surgery.
- For what? He didn't shoot me.
Ain't no bullets there.
Don't know what y'all looking for.
- Bleeding in your belly.
- Punctured intestines.
- You can get an infection and die.
- Forget that.
I need to call my brother to get out of here.
I know you're tough, but what part of "you could die" don't you understand? I ain't dying.
I'm walking.
- Man, get me a damn phone! - Dr.
Pratt? Get me a phone, man! Let the fool go.
He deserves to die.
Yeah.
If that's what you want.
- Yeah, I don't care.
- You're not the Attending.
Since my name's on the chart, we should call Psych.
He's not crazy, he's stupid.
Okay, hey, whatever.
I'll call them down for an idiot consult.
Look, he's not drunk, he's not on drugs and if he leaves AMA and goes home and dies you better believe his family's gonna sue us.
All right.
I'll call his brother.
Maybe a family member can talk sense into him.
Mr.
Zeller? Sir? Can-? Mr.
Zeller.
Mr.
- Hey, I've been here for four hours.
Still haven't had a doctor check my foot.
- You seem to be walking on it all right.
- That's not the point.
Well, you see all these patients? Chances are we're not gonna get to you until most of them go home.
So why don't you find a magazine and make yourself comfortable? How's he doing? Crepitus bilaterally, decreased range of motion.
- How's the other guy? - Obnoxious.
So how many miles do you ride a week? Lots.
Lots and lots of riding.
I ride here.
I ride there.
I'm like the wind.
Hey, man! I told you that they hurt.
What's the matter? - Sorry.
I'm just checking your reflexes.
- There's nothing wrong with my reflexes.
I got good ref- Cat-like reflexes.
I'm like a cat.
Really? Which is it? A cat or the wind? Like a cat in the wind.
I got nine lives, and I always land on my feet.
Hey.
Did you order a head CT? Low-speed mechanism.
Didn't indicate.
He wasn't wearing a helmet and seems altered.
It's just a mild concussion.
We'll observe him for a bit, okay? - Where's the drunk with the foot? - MRl.
- I thought they were booked.
- I pulled a few strings.
- Pull more and get this guy one.
- What's his problem? He collided with another cyclist.
His neuro's non-focal, responds to commands.
- He seems altered to me.
- Did he get knocked out? - He just said he didn't hit his head.
- Carter! Forty-five-year-old, GSW to the head following a liquor store holdup.
- Is this the perp? - No.
He got away.
- This guy's the hero.
- Derek tried to help the store owner.
- You the wife? - Girlfriend.
Okay.
BP, 100/60, tachy to 115.
- Abby, you wanna run this? - Sure.
Dr.
Barnett, get that head CT just to be safe.
- Lungs are clear.
- Doll eyes.
- What's that mean? - BP, 108/80.
Sinus tach, 110.
- Can I get an otoscope? - Who are you? Dubenko, surgical Attending.
I'm covering trauma today.
- His limbs are flaccid.
- CSF in the ears.
Somebody tell me what's happening.
Doing everything we can.
His injuries are severe.
Derek's tough.
- He's a fighter.
- No corneal reflexes.
He's not breathing over the vent.
It's been 40 minutes.
No.
No.
No.
He's tough.
He's- I'm sorry, ma'am.
Every indication suggests your boyfriend has no brain activity.
That's it? There's nothing else we can do for him.
I'm very sorry.
Do you think that you can help us get in touch with his family? I'm the closest thing he has to a family.
Screen him.
CBC, chem panel, ABG, type and Rh cultures, UA, HIV, Hep B and C.
- I forget anything? - VDRL, RPR.
I'm very sorry.
If you have time to sit, you have time to treat patients.
Start him on dopamine if his diastolic's- Unless he signs a consent form for drug testing, we can't do that.
No.
That's not the same as consent.
Really? Same to you.
Calling your mom? Bike courier's boss wants us to drug-test him.
- So did you? - There's no need.
And his head CT was negative, thank you very much.
Mr.
Tunny, do you remember your doctor's name? Yeah, it was him.
Do you know where you are? No place I wanna be.
What are the first chords of the Chili Pepper's "Californication"? - A minor, F major seventh, A minor.
- Thank you.
- That means nothing to me.
- You're just gonna have to trust me.
Trust you to what? The guy still seems altered.
Drug screen for opiates, benzos or even cannabis would give us an answer.
- Then we don't have to keep looking.
- Won't change our observe management.
Tox screens can stay positive for days.
- Could lose his job for smoking last week.
- It's confidential.
Not if it becomes a workers' comp case.
Then it's on his record.
What is he? Your dealer? Maybe we should tox screen you.
- Hey, Sam? - Yeah? - You have a UA for Tunny in there? - Yeah.
- Add a tox screen.
- Sure.
Thank you.
Is your supervisor here? - That would be me.
- I'd like to apply for a job.
- You've worked in one of our stores? - No.
But I like the clothes.
Really? That looks more like Old Navy.
- Have you ever worked retail? - No.
But I'm a quick study.
Unfortunately, I'm looking for experienced help right now.
I can work a cash register and I'm a people person.
I worked at my parents' restaurant for years.
I really need people with a strong fashion sense and personal-style statement.
Why don't you leave your name and number and I'll get back to you.
- What are you doing? - I like them to be the same length.
- Hey, Malik, where's the fire? - Exam 3.
- What happened? - Somebody set off a stink bomb.
Let's hope there's no asthmatics around.
- Come here.
Is that the Colles' fracture? - Yep.
The wrist has to be flexed for proper alignment.
The wrist has to be flexed for proper alignment.
- What do I do now? - You cut it off and you start again.
What do I tell her? We're gonna leave that for And then we're gonna put on a fiberglass cast.
Okay, dear? - This hurt? - No.
We'll knock you out put a little incision by your bellybutton, take a look.
- That's it? - Hold on, Mr.
Hanson.
You hear that? My man says he can fix me up, have me out of here tomorrow.
Gonna do exploratory laparoscopy on a penetrating trauma? - Yep.
- No, he's not.
You guys don't know what the hell y'all doing.
- Piece of cake.
- What if there's a liver lac? - I'll buzz it with cautery.
- What if it's too big? If it were large, he'd have clinical evidence of intra-abdominal hemorrhage.
You better ask to see a specialist you wanna get out of here without dying.
- What if the knife nicked the colon? - I'll run the bowel.
- Nobody can do that with a scope.
- I can.
Welcome to the world of modern medicine.
Let's go.
So long, suckers.
Well, don't look at me.
I didn't hire him.
Okay, Mrs.
Isley, all your blood tests came back normal.
Yes.
Well, I'd like to see a specialist.
Ray.
How about clearing in a few of these beds? What? I'm taking them through like fast-food orders.
- It's the back door that's plugging up.
- You got rid of that drunk pretty quick.
Let me see some more of that.
Sam, I need McCarthy out of here.
And why hasn't Tunny been discharged? We're still waiting on his tox screen.
- I didn't order a tox screen.
- Abby did.
- What are you doing? - Chest pain.
- How old are you? - Seventeen.
Dr.
Pratt said all chest pain gets O2, IV aspirin, beta-blocker and nitro.
- What physical activity have you done? - Nothing.
I was just watching TV.
What about yesterday? - I worked out a little.
- Weightlifting? - Bench press.
- I almost did 200.
Where's Dr.
Pratt? Comfortable? I prevented one of your students from giving nitroglycerin to a - I didn't tell him to do that.
- You have to be specific with these kids.
Sorry.
- You all right? - Just a headache.
- You said you weren't having those.
- Only when I'm working here.
- Okay, go home.
- Oh, come on.
Come on.
No harm, no foul.
I'll keep an eye on him.
You have been dragging your ass all day.
- I've had time-consuming cases.
- Maybe you came back too soon.
So go home.
Get yourself in shape before you fix anybody else.
Can't afford to send me home.
I'm worth two doctors and three interns.
Not today you're not.
Go home.
I'll find somebody else to cover your shift.
Hey.
The biker's blood work came back.
HIV-positive.
No good for organ donation.
That's too bad.
Frank, call Kovac.
I need him to come and finish the rest of Pratt's shift.
Sure.
Make me the holiday hatchet man.
- Do you have any plans for this evening? - Takeout.
And the Cubs/White Sox game.
I was thinking about going to a meeting then getting something to eat.
- Interested? My treat.
- You're buying? Did you order a tox screen on my patient? Which one? You know which one.
Tunny.
The altered bike courier.
You can't order tests on my patients behind my back.
Urinalysis was negative for opiates, benzos, PCP cannabis, cocaine, amphetamines, name it.
- Okay.
So now we know.
- No.
We know this is the second time you've been wrong about my patients today.
And you know what? It's the last.
You treat your cases and I'll treat mine.
- You believe this guy? - Hey if you have a problem with a Resident's workup - take it up with the Attending.
- It's easier just to fix it.
That's what the nurses do.
You're gonna have to work with this guy for four years.
Dr.
Carter? I suggest that you figure out a way of getting along with him.
This is Douglas James.
He's a friend of Derek and me.
- Hi.
- Hi.
Douglas is waiting for a liver.
And him and Derek have the same blood type.
Right.
I'm sorry.
We screened Derek and we found that he is non-eligible as a donor.
- Because of his HIV? - Yes.
I'm HIV-positive too.
I've been taking interferon for hepatitis C but they've given me three months without a transplant.
Well, direct donations are not encouraged.
I'm HIV-positive.
You really think anyone's ever gonna give me a liver? - I'll be back to discharge you.
- Can you get serum organic acids lactate and a VDG? - On Mulhoney? - Throw in a free T4 - and TSH while you're at it.
- Are you kidding? - Did I miss something? - No.
The kid's got a second-degree burn on two fingers - he doesn't need this.
- You only do unnecessary tests on my patients when Abby asks.
- I thought you were working together.
- He's my patient.
- I'm the only one who can write orders- - Hey, Luka.
- What are you doing here? - Carter needed me to cover for Pratt.
Why didn't you say no? - Labs are back on Tunny.
- Thanks.
- Did you get any sleep? - A little.
Jane Doe, 23, found down in the park by some kids.
Breathing's labored.
Sats, 92.
Pulse, 111.
Systolic, 93.
Ma'am, wake up.
Inspiratory stridor.
Aeration is terrible.
Sub-Q epi and get her in a trauma room.
Howard? Could be an allergic reaction.
Was there any food on scene? You see any bee stings? Hurry up, Howard.
Okay, okay.
- Sub-Q epi's in.
- Finally.
- Any medic alert bracelet? Asthma inhaler? - Didn't see any.
Periorbital petechiae.
Luka? Ecchymosis on the neck.
Well, what's that mean? It means someone tried to strangle her.
God bless America.
Kerry.
- Elizabeth.
- I've been calling you all day.
Yeah.
I've been in meetings and I've got another one three minutes ago.
Call my office, tell them I said to fit you in tomorrow.
I need to talk about Dr.
Dubenko today.
- How's he working out? - He's not, to be quite frank.
- I haven't received any complaints.
- Consider this your first.
No one even bothered to tell me you'd hired him.
That's what search committees do.
You should've attended more meetings.
Kerry.
I missed one meeting.
What did you do? Hire the only candidate I didn't endorse? Why are you taking this so personally, Elizabeth? I've got to go.
I'm sure the two of you can work this out.
Oh, hey, Dr? - Dubenko.
- Right.
Sorry.
John Carter.
- You remember the GSW this morning? - Yeah, brain-dead biker.
His girlfriend says he wanted to be an organ donor.
- Great.
- But he's HIV-positive.
Well, no can do.
Well, his buddy needs a liver ASAP and he's the same tissue type.
It's against the law to harvest organs from an HIV-positive patient.
- You know that.
- The recipient is HIV-positive.
It doesn't matter.
UNOS won't approve and no surgeon's gonna operate.
What's that smell? - Stink bomb.
Frank! - Got it! They warned me about this place.
They weren't kidding.
- Dr.
Corday.
- Carter.
Maybe you can help me.
I need help with a patient.
I believe Dr.
Dubenko is covering- I don't think that he wanted to.
And what is it? Too mundane for our new superstar? - I think it may be too illegal.
- Oh, so he's cowardly and cocky.
He's the perfect complement to Weaver's treachery and ambition.
I'm sorry, Carter.
But I have to deal with him, so do you.
Good luck.
Stridor seems to be improving.
Keep an eye on her pulse ox.
Come and get me if she de-sats.
- I'll notify the police.
- What happened to her? Hey, Luka.
- Hey.
- Alex, what are you doing here? You're supposed to be with Steven and Monique at the soccer game.
- I gotta find someone to cover me.
- Don't bother it's probably gonna suck anyway.
I can take him.
I'm off in 20.
I was filling in for Pratt.
You can pick him up at my place after work.
Hey, are you busy? I need your expertise.
- Have Alex meet me in the lounge.
- Thanks.
JOB HUNTERS You worked at a restaurant from the time you were 6 until 16? - It was a family restaurant.
- What kind? Indian.
I never want to work in a restaurant again.
- I don't even like eating in them.
- You haven't worked since then? - I've been in school.
- Studying? Medicine.
Oh, wow.
I'll be honest.
We don't get many doctors looking for jobs.
So you placed very high on your placement test but you haven't got a lot of experience in any other service industry.
No retail, no sales.
- Secretarial? - No.
- Bookkeeping? - Not really.
Horticulture? Mechanics? Electrical? Perhaps we'd have better luck if you told us what you can do.
Let's see.
I can crack open your chest re-inflate your lung and squeeze your heart back to life.
Okay.
Dubenko was right to pass.
Why are you pushing so hard for this? Because we're this guy's last hope.
Because I couldn't save his friend.
Because some good should come out of this.
And what if they sue? Who? His buddy wants the liver.
He's not gonna live long without it.
The hospital could fire me.
The guy's gonna die without the liver, he's never gonna get another.
- They could pull my license.
- Unlikely.
- Acting in the patient's best interest.
- Or jail.
There's already legislation allowing this.
- It's waiting for the governor's signature.
- It'll still violate regulations.
I know.
But it is ridiculous to let a perfectly good organ go to waste.
The liver's not gonna affect the recipient the recipient's got the virus.
He's got a good heart, good lungs low viral load- How's Weaver gonna react? Well, she- Yeah, she might have a little issue with this.
She'll have a bloody conniption fit.
Which in itself is almost worth the risk.
Screw it.
Screw it.
Prep him.
I'll mobilize the team.
Sneaking tests on other doctors' patients? - Ray? - You totally boned me.
- I felt like an idiot.
- Sorry.
- Well, you were right.
- Really? Check out the serum salicylates.
- I'll let you know next time.
- Don't do it next time.
- Where's he going? - To the O.
R.
Corday agreed to do the surgery.
- You talked her into it? - No.
Well, maybe a little.
So you never responded to my offer.
- I'll take a rain check on dinner.
- What about the meeting? - Do you still go to meetings? - I'll go if you go.
- I'm good.
- Yeah? I see how hard you're throwing yourself into the job, Carter.
- It's a hard job.
- So is sobriety.
And so is losing a child.
- Hey, where's Dr.
Kovac? - I don't know.
- What's wrong? - I think Jane Doe's having trouble breath- Call Respiratory Therapy.
- I need to talk to you.
- Talk to your patient.
And you might want to add an amp of bicarb to his IV.
- You need to alkalinize his urine.
- What? He's got a toxic aspirin level.
Hey.
Hey.
What are you doing here? Oh, pediatrician visit.
Somebody was being checked for Pyloric stenosis.
Hey, Cosmo.
- How's he doing? - Oh, good.
Just reflux.
Oh, hi, Frank.
Hi.
- So, wow, you look great.
- Oh, thanks.
How's it going? Twelve new med students.
How do you think? Is Chuny or Haleh around? Yeah, Chuny's around.
Why? You need a nurse? I need somebody to watch him.
I could do it.
Well, are you sure? Because he can be really cranky.
Yeah.
No, yeah, of course.
Okay.
Well, you'll need this because he spits up.
That's what he does basically: spit, poop, eat, sleep, repeat.
Yeah, just like his daddy.
How is Chuck taking to fatherhood? You mean motherhood? The guy's more maternal than I am.
Thanks.
I'll be back.
Okay.
She'll be right back.
The IV's blown.
I need to start another line.
Okay, seven P's.
Preparation, pre-oxygenation pre-treatment, paralysis and sedation, protecting the airway passing the tube, proof of placement, post-intubation management.
Okay, preparation suction.
Good.
Yankauer's ready.
Pre-oxygenation, O2 100 percent non-rebreather.
half centimeter from the end.
- You got this, Howard? - Yep.
Six-five is ready if cords are tight.
Laryngoscope bulb is good.
- I can't believe how big he is.
- Oh, he should be.
He doesn't stop eating.
Where have you been? I was parked.
I had to pee and everybody wanted to see him.
What's wrong with you people? You've never seen a baby? Can you give him room? No one's wearing masks.
- Relax.
- There's germs everywhere, babe.
It's good for his immunity.
I called for a consult and I don't think I should have.
- What patient? - Which of you is Carter? I'm Dr.
Carter.
- You know what otitis media looks like? - I do.
Then teach it to your students.
So they don't call me for a ENT consult every time a kid comes with an earache.
She's closing up.
You're not gonna get any sized tube in if you don't move.
- Find Kovac? - Couldn't find him.
Sats are down to 79.
CO2 monitor's ready, purple.
Paralysis and sedation, 82.
5 of sux and 17 of etomidate.
- Heart rate's 66.
- What are you doing? - Checking the doses.
- You've done that.
She's gonna end up cricked if you don't move.
Oh, God.
Now look what you've done.
You ruined everything.
Howard, get it together.
You can do this.
- She messed it all up.
- She's bradying down.
Suction, oxygen, laryngoscope- All right, give her the meds and have a 7.
0 ready to go.
I got this.
She's my patient.
- Pulse ox, 72.
- Suction.
Suction! - Sux is in.
- Tube.
- It was on the floor.
- Give it to me! Bradycardic, 55.
- The cords are so tight.
- Fifty-four, 52.
All right.
Have epi and ready.
Howard, stand by with a 6.
5.
I always check four times.
I'm in.
Good color change.
Heart rate's coming up.
Sats, 88.
Call for an x-ray.
See if CT's ready to take her.
Pupils are non-reactive.
Were they non-reactive before? - I don't remember.
I'll check the chart.
- Howard.
- Nice pass! He's good.
- Thanks.
Come on.
Come on.
There we go.
- Shoot! - There we go.
Shoot.
- Tough break.
- Yeah.
- You played a good game.
- My team blows.
Every team has good and bad days.
The most important thing is to try your best.
- Want to grab a pizza on the way home? - Sure.
I can help you practice someday if you want to kick around.
- No, thanks.
- I don't mind.
I played football in school.
I mean, soccer.
I was pretty good.
- We could go to the park near my place.
- Look, Luka I'm glad we're friends.
But I've got a dad.
And he's coming back.
- What happened? - Abby saved Kovac's patient.
- Delayed laryngeal edema.
- And a freaking intern.
- Have you seen Howard? - Nope.
- Hey, Abby? - Just a minute.
- Could you show me how to use the slit-? - Not now.
You need something? Think you could get me her phone number? What's going on, Howard? Just needed some air.
- Sometimes it's olfactory overload.
- I was talking about the trauma.
You were looping in there.
Checking things three or four times, repeating your actions.
I like to be thorough.
Come on.
What is it? Sometimes I get nervous.
It didn't seem like nervous to me.
Do you have OCD? I've got to get back to work.
Yo, doc.
The freak in the cape just put his hand through the window to Exam 2.
All right.
Set him up for sutures in Curtain 1.
I gave Mr.
Ogilvie too much oral contrast.
- Can I ask you a question? - No.
My patient has a 2-inch head lac.
Should I use 3.
0 Prolene or 4.
0 to suture? Doesn't anyone knock anymore? Chuck? What are you doing? Oh, it's a supplemental nursing device.
What? You've never seen a father breastfeed his kid? - Can't say that I have.
- I tell you, these things are amazing.
It allows the father to bond the same way the mother does if you can get past sore nipples.
- You want to give it a shot? - No.
My patient has a head lac.
Should I use 3.
0 Prolene or 4.
0 to suture? Hey, Rockheart.
- What did you call me? - Lockhart.
- Are you heading home? - That's what most of us do - at the end of our shift.
- Yeah.
Well, I'm sort of in between places right now.
Listen, I'm sorry we got off on the wrong foot.
- Can I buy you dinner? Make it up to you? - No, thanks.
You were right.
It was altered from an aspirin overdose.
The more he popped, you know, the more his knee hurt.
- He was popping them like M&M's.
- You might want to suggest endoscopy.
He probably ate out his stomach lining.
- How well do you know Howard? - Not very.
Why? - He doesn't seem a little strange to you? - How so? Maybe a little obsessive or compulsive.
- He froze in a trauma today.
- You've been in thousands of codes he's probably seen six.
Cut the guy some slack.
You don't think I should mention it to an Attending? What are you? The hall monitor? - Brauts? - I like to live dangerously.
Come on, you got to wolf down a few dogs on the Fourth.
It's tradition.
Didn't she used to work in the hospital? Neela? Hello, and welcome to Jumbo Mart.
Can I help you? - What are you doing? - Working.
Here? We have a special on our cupcakes.
Buy two, get one free.
- Oh, sweet.
- When you said you were looking I thought you meant at another hospital or a clinic maybe.
- Well, I didn't have much luck.
- You only looked for one day.
This is the only job I can get because I'm a loser.
You are not a loser.
At least you're close to the hospital.
- Which is as close as I'm ever gonna get.
- That's not true.
Yes, it is.
I blew it.
I blew everything.
I've got no job, no apartment, no money.
I mean, look at me.
I'm not even American.
Oh, you are going down, you little freak.
- You suck.
- You're worse at this than at soccer.
Bite me, you Slav bastard.
Alex.
What did you just say? - What? - What did you say? - Nothing.
- I heard you.
- You heard him.
What did he say? - I didn't hear.
Might have been the game.
Yeah.
I'm pretty sure you heard the game, Mom.
Yeah, well, I don't want to hear that kind of talk out of you or you.
How was the game? - We lost.
- Yeah, but he played well.
Still lost.
Well, maybe next time.
- Come on, grab your stuff.
- After this game.
Alex, please, now.
Or else I'm gonna fall asleep right here on this couch.
You can stay here for tonight.
Plenty of room.
Actually, you can stay as long as you like.
Well, that's something that me and Alex would have to talk about first.
Talk about what? Talk about you getting your butt in gear.
Kramer can go home.
Balmore's waiting for a transfer to the jail ward.
Henderson needs a monitored bed or the morgue if he doesn't get admitted soon.
- Where is Ray? - Try the roof.
- What's he doing? - I think he lives there.
He lives in the call room.
He just cooks on the roof.
What are you doing? Just chilling.
Looks like you're all moved in up here.
Yeah.
Well, the rent's right.
And, hey, you can't beat the view.
While you've been up here on your little cookout your patient has been circling the drain.
He needs dopamine and a trip to the ICU.
He's a DNR.
His daughter's bringing the paperwork from Milwaukee.
Want a beer? No.
Thank you.
I can throw on a dog.
No, I'm good.
I heard about your son.
I'm sorry.
Thank you.
That's got to be hard.
Sometimes.
You aren't living in the hospital, are you? Why? Would that be a problem? Might be a problem for Dr.
Weaver.
She has the place sprayed for interns.
Hey, dude.
Check it out.
Happy Fourth of July.
Yeah, you too.