ER s11e04 Episode Script
Fear
E.
R.
Previously on E.
R.
Who are you? Dubenko, surgical Attending.
I'm covering trauma.
What did you do? Hire the only candidate I didn't endorse? Maybe something's opened up at the hospital.
I don't wanna work in the hospital.
Welcome to Jumbo Mart.
Can I help you? - What are you doing? - Working.
You can stay here for tonight.
Actually, you can stay as long as you like.
Sometimes I get nervous.
It didn't seem like nervous to me.
Do you have OCD? It's against the law to harvest organs from an HIV-positive patient.
The recipient is HIV-positive.
It doesn't matter.
UNOS won't approve and no surgeon's gonna operate.
But it is ridiculous to let a perfectly good organ go to waste.
Prep him.
I'll mobilize the team.
E.
R.
11x04 "FEAR" - Go away! - Let me in! - Open this damn door! - Why can't you leave us alone? Mama, what's wrong? Just leave us in peace! I'll kill all of you! The kids too! Just let us alone.
Oh, God.
Oh, God.
Oh, God.
Is that what you want? You want me to kill the kids? - Mama, please.
- It's gonna be okay.
We just gotta go.
Come on.
Open it or I'll kill them one by one, and make you watch.
Go where he can't find you.
Open this damn door! Come on.
Come on.
Saige! Mama! The transplant wasn't a total success.
I still have to meet with the Medical Executive Committee.
Yeah.
Makes me nervous too.
Mommy, in the picture? Look, John, I'll have to go.
I'll call you when I hear something, all right? Yeah.
Okay, bye.
Sorry, sweetheart.
What were you saying? Is this Daddy? Yeah.
You know that.
Who are they? That's your nana and your grandpa.
Are they dead too? I've been to the science museum like 10,000 times.
Why can't I just stay home? This way maybe you'll learn something instead of zoning out all day in front of that Xbox.
You can learn from that too.
Luka taught me how to rob all 15 stores in Vice City.
- Looks cool on his plasma.
- You like it over there at Luka's? Like the neighborhood and everything? Guess so.
- You like him too, right? - Yeah, why? Just wondering.
Well, then how would you feel about maybe moving in with him? - You serious? - He offered.
You want to? I don't know.
We never really lived with anyone before.
We lived with Dad.
Can I put our TV in my room then? - Maybe we should think about it more.
- Yeah.
Sir, please don't read that paper until you've paid for it.
- Just this, please.
- Sure, $1.
19.
One-one-nine.
I'll be right with you.
- Is there a problem? - I got it.
I'll get it the next time.
I think Howard has a touch of OCD.
Is that even possible, to have a touch of OCD? Three-ten, please.
- Busy over there today? - I wouldn't know.
I thought you'd gotten out of your mandatory ride-along.
It doesn't matter that windowless vehicles make me sick.
That's why they call it mandatory.
How's it going here? Eight-forty-two, please.
Great.
I get 10 percent off all my purchases.
- Abby, we gotta roll.
- See you later.
Bye.
- I talked her into doing it.
- Your hand never touched a scalpel.
Look, we're just trying to determine Dr.
Corday's understanding of the law- - That's about to change.
- Find the current law regarding HIV-positive organ transplant.
The donor was originally my patient.
I'm just trying to ask for an opportunity to speak in her behalf.
Attendance is limited to department heads.
Last I checked, you weren't one.
Bring it on.
Dr.
Pratt is on the clock, and ready to rock.
Which reminds me, I'm concerned we have doctors using work as therapy for post-traumatic stress.
- He's fine.
- I'm not talking about him.
Look, I got your request for extra shifts and it seems to me you're glossing over some of your susceptibilities.
- Hold the elevator.
- Too late.
Sorry.
I'm sorry to bring up your history of substance abuse but the fact is, you're still an addict.
You've been through an emotional roller coaster.
And I know what it's like.
Why push it? Why tempt fate? God knows you don't need the money.
There's no problem, Kerry.
Good.
Because I'm not in the business of safeguarding doctors' licenses.
- Not twice anyway.
- So no extra shifts? Go to the movies.
Take trips.
Do something other than hang around this hellhole.
- Kerry.
- What? I tried to make an appointment.
Your assistant's being snarky.
Let me guess.
You want to extend your maternity leave.
I was wondering if you found a permanent replacement for the chief of Emergency Medicine? - Someone you want to recommend? - Yeah, me.
- Told her you're busy.
- I offered you the position - and you turned me down.
- That was pre-baby.
- Post-baby that bad? - I like kids better when they're not sucking the life force out of me.
Chuck doesn't mind staying at home as long as we can make up the lost income.
A grand more per week with a two-year commitment.
Deal.
When do I start? We need six months' worth of variant x-ray interpretation unscheduled returns and a pneumonia pathway compliance by day's end.
Oh, and the toilets in the ER are backed up.
Good luck finding maintenance.
About time.
Getting crazy out here.
- How young are the kids? - Four and five.
Three-story fall from a window ledge.
- Miracle they're breathing and talking.
- What happened? Some domestic disturbance.
Mom's pretty worked up.
Please, God, please.
He tried to kill my babies.
- Who did, ma'am? - My husband.
Looks like an angulated fracture.
Spontaneous resps.
Get her on O2, and start a line.
I need a leg splint.
Hi.
Hello.
Can you tell me your name? - Kali.
- Okay, Kali.
- He had a gun.
- Any idea where he is now? Oh, God, why did you let this happen? Oh, God.
Can you wiggle your toes? Great.
That is perfect.
Are you an angel? Vascular's intact.
A what? An angel? Gonna take me to heaven? Will somebody please answer my question? Are we talking urticaria? We're not sure.
Insect bites, lymphadenopathy, erythema nodosum.
- It's possible.
- Which one is possible? All of the above.
Come on, guys.
Were the bumps firm? Were they non-tender? - Were they freely moveable? - They're just bumps.
All right.
Hold on, hold on, hold on.
First of all, read up on derm.
Secondly, learn to describe lesions systematically so your superiors don't look at you like you're complete dumbasses.
How are you doing, Mr.
Hayslip.
I'm Dr.
Pratt.
- You mind if I take a look? - That's what I'm here for.
Good.
Alrighty.
So what are they? Let me run some tests and we'll find out, okay? In the meantime, take a more thorough history and get his labs cooking.
Jing-Mei, hey.
Hey.
- What are you doing here? - Ortho's slammed.
Borrowed a cast cutter, figured I'd do it myself.
I know you're limber, but you're not that limber.
Come on, let me help you.
Thanks.
Anytime.
- It happened so fast.
- BP's 106/60 after morphine.
- Pushing another two.
- I got it.
The way he came right at us, and then my babies were down here- Ma'am, we're taking your kids to County Emergency.
Up we go.
- Meet us there.
- Do you have family or friends - that can drive you? - What if he comes back? - The police are here.
- No, we gotta stay together.
- Sorry, it's against policy.
- My children need me.
- Let her in.
- What? - Let her in.
Hey, Pam? - What? Will you take the brother? This way your sister won't be alone, okay? Thanks.
You're just supposed to be along for the ride, remember? You feeling that at all? So no John Hancocks? Your cast.
Nobody signed it.
I could have asked the night nurse, I guess.
You know, I haven't left the house in weeks.
The only reason why I'm here is because I decided to hitch a ride with my dad's transport ambulance.
He's got pneumonia again.
For the third time.
And phlebitis and a UTl.
Admitted him this morning.
You could have just called me.
I could have picked you up.
I think it's gonna be a while before I get into a car with you again.
Don't forget your range-of-motion exercises to build up your gastroc.
You ever think about him? Who? Elgin.
A 5-year-old, displaced tibia fracture after falling from a third-story window attempting to escape an abusive father.
- GCS fifteen, vitals stable after six of MS.
- Distal neurovascular status? - Intact.
- The mom? Yes, big red taxi thanks to Abby.
Brother and sister in the next rig.
We're gonna do everything we can for them.
I promise.
Tenderness at the olecranon and distal radius.
Multiple fractures.
Her name's Kali, after the Hindu goddess.
- Any LOC? - Not according to bystanders.
- Switching teams on us now, Lockhart? - It's pretty, you know? CBC, lytes, type and cross for two.
Lateral C-spine, chest, pelvis, left elbow, wrist and femur.
- Put CT on hold for head and abdomen.
- Very good, Howard.
- But it means "destruction.
" - Dumar, go.
He only used to hurt me.
Why'd he have to hurt my babies? We need Social Services here right away.
Let's get Mom to the family room.
Sure.
Ma'am, you want to come with me, please? It's okay.
Good breath sounds, good sats.
I'll check on number two.
- They catch the bastard that did this yet? - No.
Okay, we're out of here.
Old man found down, Lincoln Park.
Tracheal midline, no JVD.
- I'm scared.
- I know.
- Abby, come on.
- I'm right here.
Don't worry.
- I'm gonna catch you on the next run.
- Set up for that neck film.
You don't have 12 hours, you're not gonna get credit.
- Right or left side? - No hemotympanum.
Little sister's stable for now.
TKO saline after 500 cc's.
- Are you coming or not? - Someone get me a lead apron.
There was no next of kin.
And you know that because the hospital's policy of due diligence was exercised? The organ had to be procured quickly for the operation to be successful.
There wasn't time for a 24-hour family search.
Was the rest of the surgical team aware they were performing an illegal procedure? I'm sure they assumed that consent and UNOS approval were in place.
Did they know both patients were HIV-positive? Universal precautions are taken in surgery regardless of a patient's HIV status.
Look, this was a unique situation requiring decisive action.
That now exposes us to huge civil liabilities.
Only if negligence or malice are proven, which is clearly not the case.
- The recipient is thriving.
- It's against the law, Elizabeth.
At the moment, yes.
But the bill changing all of that is sitting on the governor's desk as we speak.
Unsigned.
So a liver that would have been destroyed was transplanted into a man who wouldn't have qualified for one a day or two earlier than the law allows.
Where's the harm in that? - I saved a patient's life.
- Actually, our patient died.
This other fellow just happened to benefit from it.
You breached hospital policy, state and federal law.
Any of which is grounds for dismissal, and/or loss of your license should we report this to the state board.
Sorry.
Got stuck in a hemorrhagic Meckel's diverticulectomy.
- Why is he here? - He's on the Medical Ethics Committee.
If you had followed protocol and presented to them, you would know that.
What's the next step, then? We'll make a decision.
You'll be notified as soon as we reach one.
Right.
Damn, these veins are tiny.
You're gonna have to settle down or it's gonna hurt even more.
- Mama - C-spine is clear.
- Sats, 97.
Need some help? - I've done it before.
- Yeah.
Bet you were pretty good at it too.
- Parietal abrasion.
No step off.
- What do we have? - I thought they paged Dubenko.
- Well, you got me.
- Mama Four-year-old with chest contusion.
Rib fractures.
Eight, nine, 10 on the left, but the lung is up.
- Sisters, right? - Yeah.
- Let's check for tamponade.
- As soon as Sam sticks the kid.
Sorry.
I got a flash but no return.
- Try the other side.
- We need another nurse? - No.
- Where's my mama? Hey, Tamira, do you like the Wiggles? Which one is your favorite? Anthony? Murray.
He plays guitar.
DTRs two plus and equal.
Good answer.
I like Jeff because he's always sleeping.
Got it.
- Thanks.
- Good bowel sounds.
No guarding.
- How do you know about the Wiggles? - I try to keep up with kids' TV.
Gives you something to talk to them about.
- You're kidding me, right? - Okay, she's stable for CT.
I hate the bloody Wiggles.
Kali, you have big beautiful brown eyes, and they are both equal and reactive.
No murmur, rub or gallop.
- How's it going in here? - Pretty severe pelvic fracture.
- Call Ortho? - Yes.
In the meantime, use sheet traction.
Pocket Doppler to Dr.
Corday.
How'd it go upstairs? I'm not sure.
I'll know in a couple of hours.
Thanks for asking.
I can't imagine they'll give you anything more than a slap on the wrist.
- Good pedal pulses.
- Foley's in.
Dip it for blood.
Angel? Angel? Abby, I think she's talking to you.
Oh, hi.
- You're still here, right? - Yeah.
We're all still here.
- She'll need a second IV.
- I can start a central line.
- Dr.
Pratt? - What? We have the chest x-rays for Mr.
Hayslip.
- Who? - The guy with the bumps.
He has a huge left hilar mass.
- Okay, go.
I got Abby.
- Yeah, but she's playing paramedic.
Yeah.
Well, I got Howard too.
Howie.
- How's the urine? - Negative.
But I should try with a reagent strip from another bottle.
- I only dipped it twice.
- Why? Once is sufficient.
Dr.
Corday, we need you in here.
- What happened? - Sats dropped to 79.
Probably a pulmonary contusion.
Tamira? Tamira, can you hear me? - She's barely moving air.
- Get an ambu-bag and intubation tray.
- Should we get the mom in here? - I'm not planning on her dying, are you? Is the universe punishing me for being a bad mom? There are charts here that haven't been picked up in six hours.
Good help is hard to find.
Like if you order a no-foam latte, there should be no foam.
Yeah, Neela burned my bagel earlier.
- You finish those QA reports? - Not yet.
Yeah, I thought you'd be a little rusty.
Where's Dr.
Corday? - In Trauma.
- Okay.
Tell her to find me when she's out.
It's important.
Oh, and St.
Joe's is closing its ER next week for renovations.
- Plan on doubling your intake down here.
- Congratulations on your promotion.
- What's this? - That is my time-off request demand for a 5-percent pay increase and my letter of resignation if neither condition is met.
Welcome to management.
- How are you doing, Kali? - I'm not hungry.
- Tachy at 130.
- Okay, we got a big pelvic bleed.
Let's hang some O-neg.
Let's get a pressure bag on that saline.
- Where are they? - No, I don't want to.
- Okay, Kali, you need to relax.
- No, tell me what's happening to my kids.
- We're doing everything we can for them.
- Mommy, no.
You're hurting her! What are you doing to her? - No, no, Nichelle.
- Abby.
Oh, my God! What are they doing? - Come on, Abby.
- Listen to me, okay? Why aren't they helping? Why aren't they helping my kids? They are.
They are.
Okay? Okay, come on.
Let's go.
Let's let the doctors do their work, okay? Okay.
Okay.
- It's non-productive.
- Any hemoptysis? Cough's chronic, but getting worse.
Yeah, after two packs a day for 25 years, no kidding.
Should I cancel the derm consult? The guy's got stage-four lung cancer with 100 skin mets.
What do you think? - You have a primary-care doctor? - No.
- Mr.
Hayslip.
- Let me guess.
More tests? - Actually, that won't be necessary.
- Good.
Give me a nice little cream for my rash, and I'm out of here.
It's not a rash.
Look, I don't know how to say this so I'm just gonna come right out and say it.
- You've got advanced lung cancer.
- What? Which has metastasized to your skin.
These are little cancers? You need to see Oncology.
They'll have the results of your biopsy and can recommend a course of chemotherapy.
I'm sorry.
Stay with the patient.
He'll need somebody to hold his hand.
- Heart pressure's up.
Repeat the bolus.
- All right, I'll take that.
- You, chart.
Chuny, hang the blood.
- On it.
- You running this trauma now? - Guy's sweating bullets.
All right, first hematocrit is 34.
- Dr.
Corday? - One room over.
- Circumferential traction.
- Yeah.
Pelvic and femur fracture with retroperitoneal bleeding.
TPOD's better.
You should get it from Central.
And mobilize angio.
- Didn't know we stocked the TPOD.
- That must be new.
Let's give her 10 liters O2 by mask.
- I'll call Central.
- Yeah, you do that.
Is my sister gonna die? Saige, right? Well, we're doing everything that we can to make sure that that doesn't happen.
Wanna up the FiO2.
Howard, can you please take him out? - That's a social worker's job.
- They're not here right now.
- Type-specific's ready? - So get a nurse to talk to him.
I'm a little busy right now.
- I'd rather talk to him.
- Who, him? Go.
I asked for blood.
I wanna repeat the crit I want a unit of FFP.
I wanna know where the damn social worker is.
Covering two hospitals by herself till midnight.
That's my excuse for being late.
What's yours for being an ass? - Where's the HemoCue? - Foot of the bed.
- Fourteen centimeters at the lip.
- Can you see well enough? Most time we can't get one surgeon down here - how did we manage two? - Getting harder to bag.
Yeah.
Rib sliced up the spleen.
The large amount of fluid in the sub-diaphragmatic space is obvious.
Consent for an ex-lap and a splenectomy.
- Sats are dropping.
- Tachy at 140.
No breath sounds.
She has a tension pneumo.
The first chest x-ray was clear.
Okay, open a 20 French and a Thora-Seal.
- Toss in an 18-gauge angiocath.
- Dr.
Corday? Sometimes endotracheal intubation with positive airway pressure exacerbates an imperceptible pneumo.
Okay, sats are up.
I was about to perform a needle thoracostomy.
You can place the chest tube.
O.
R.
can take her as soon as that's in.
Who should I put down as the Attending? - Dubenko.
- Corday.
- It will help to talk about what happened.
- No.
I can't.
Is there anyone we can call for you? I just need to pray for my children to live.
Pray for some peace in my heart and my mind.
Pray for him to die.
He's an evil man.
Oh, he's an evil man.
But he gave me my children.
Now he's gonna take them away.
Need me to answer some questions for you? You wanna watch some TV? Is my mom gonna be okay? Well, it's pretty hard for her right now.
She's worried and upset.
I'm sure you are too.
But hopefully your sisters'll get better real soon.
They'll be back at home getting on your nerves in no time.
Hey, you see those guys right there? They're gonna do everything that they can to keep your family safe from your father.
I'm sorry.
Oh, man.
- Scrubs are in the first supply closet.
- Thanks.
Come on.
It's okay.
Don't worry about it.
How's it going? Not so good.
We can't find this guy.
There's some indication he left the state a year or so ago.
- If he came back, no one saw.
- Neighbors didn't help? Woman next door was passed out drunk, never heard a thing.
People on the other side, they weren't home.
Well, she's still very upset and a little scattered.
Yeah, I would be too if I saw my kid fall three floors.
But I would want to catch the guy who did it to them.
- Hi.
Wendall Meade, Social Services.
- Detective Maskins.
Ma'am let me say how sorry I am that this happened.
- Who are you? - Nichelle this detective needs to ask you about your husband.
Do you have any idea where he's staying? Where he might go? The time.
What's the time? Twelve-fifteen.
He likes to drink.
Get drunk soon as he could every day.
Did he have a favorite bar? - She's a survivor, this one.
- Let's hope.
Look, I've been wanting to congratulate you on the transplant work you did with the HIV patients.
Groundbreaking stuff.
- I wasn't trying to break any ground.
- Right.
Well, in a more perfect world, you'd be given an award for it.
Weaver is waiting on you.
She says it's important.
Anyways, I think what you did was great.
Dr.
Dubenko, TPOD's ready in Trauma One.
I'll send another surgeon down.
The sheet traction method you used is a little archaic.
This gives a better hug around the hips and upper thighs.
Sorry.
- What about Weaver? - Tell her to wait.
Excuse me.
She's asking for you.
- What's going on? - Slowly pull the handle straight out.
Kali? - I wasn't a bad girl.
- No, of course you weren't.
- How's her pressure? - Down to 65.
Crit's dropping, even with the transfusion.
So much for Dubenko and his contraptions.
- I don't wanna go there.
- Barely has a pulse.
I wanna go to heaven.
Just hang on, okay, Kali? "Secure the compression by wrapping the strings around the protruding hooks.
" - Tachy at 150.
No radial pulse.
- Intubation and central line kit.
No room for a femoral with the TPOD.
- Go subclavian.
- On a 5-year-old? We're gonna put a tube down your throat so you can breathe.
You won't be able to talk anymore.
Prep the upper chest.
Let's go.
Kali? I want to go with you, angel.
Five-and-a-half ET tube.
Get the crash cart in here.
BP's down to 56 systolic.
- Howard? - Come on, come on.
Show me the subclavian.
- I'm trying.
I can't get it in there.
- Damn it.
I can't see anything.
Howard, you think you can move? - Howard, swing it around.
- Two, and squeeze.
Check your urine output.
Where's that blood? Two units, crossed and matched.
- Abby, you ready? - Right there, John.
- Yes.
- Hold it steady.
One, two, three, squeeze.
One, two, three, squeeze.
- Got a flash.
Guide wire.
- Okay.
Kali Richardson, medical record number 331928.
Transfer another 20 per kilo, round of 400.
A- positive unit number KB-579111? - Good to go.
- Cordis introducer.
Hang it.
Three bolus of 400, 1200 total.
Okay.
- I'm in.
- One, two, three, squeeze.
- Pressure's dropping, 50.
- One, two, three, squeeze.
- Mix some dopamine.
- Okay, 200 into 250- Will you please shut up?! Squeeze.
One, two, three, squeeze.
One, two, three, squeeze.
The youngest one made it to surgery without arresting.
They've started the ex-lap.
Still working on her sister in Trauma 1.
You okay? I just called Alex.
It took everything I had not to cry.
He accused me of being on my period.
Then maybe I am too.
I almost called him myself.
You two decide yet? - About moving in? - Don't.
You'll kill the romance.
They're on their best behavior and before you know it, they're farting in the kitchen.
We talked about it.
We probably need to talk about it some more.
Just so you know I'm not jealous, I'm not crazy, and I won't be farting in the kitchen, okay? Can't get her pressure above 60.
Must be a posterior bleed.
Third unit's in.
- Check the fourth unit.
- Howard, help Abby.
Give FFP after the fourth.
Up the dopamine to 10.
Okay.
Kali Richardson, 331928.
- Nine-two-eight or 938? - Two-eight.
- Show me.
- Nine-two-eight.
Oh, okay, good.
- Bradying down.
Give me atropine.
- Get the ultrasound.
Make sure we don't miss an intra-abdominal bleed.
- T as in Tom? - T as in Tom.
Next.
Start compressions.
Once more, slowly.
You may have transposed something.
- Hang the damn blood.
- Okay.
It matches.
It matches.
- We're in V-fib.
- Charge to 15.
- I just didn't want her to have a reaction.
- And clear.
All right, young man.
Now, if you have to go again, just let me know, okay? - Okay.
- Feel better? - Yeah.
- All right, now let's go find your mom.
You coming? I was scared.
Of course you were.
I should have done something to stop it.
Look, you're just a kid.
I'm the oldest.
You're 9.
Your father, he's a grown man.
There's only so much you could do.
He was never there.
Who? My father.
Clear.
- Still fib.
- Should have rechecked the blood.
- Second bolus of lidocaine's on board.
- Seventy again.
Should we send hemolysis labs in case it was a transfusion reaction? - That the mother? - Yeah.
Clear.
- Seventh unit's in.
- Are you sure this is a good idea? Nichelle, you need to open your eyes.
You need to be with your daughter now.
Another run of epi.
Let's go 70 again.
Oh, God.
Clear.
- Asystole.
- Could be fine, V-fib.
- Kali? - Again.
- Baby.
- Be careful.
Don't get shocked.
It's all right.
Go ahead.
Kali Baby? My baby No! No, no, no! Kali! Kali! Kal- I was hoping to have seen you earlier.
Yeah, I got caught up in that trauma.
So I have good news.
Though certain members of the committee lobbied for your dismissal I was able to craft a proposal that I think will benefit all of us.
Really? How would you feel about accepting a non-tenure-track position as clinical instructor here at County? So after giving seven years of my service to this hospital I lose my tenure over a single patient.
Elizabeth, you broke the law.
What did you think was gonna happen? I don't know.
That I might be appreciated for saving a life.
That - That friends might have fought for me.
- I did fight for you.
I had to beg, borrow and steal just to keep them from giving your name to the state board.
What the hell.
Let them pull my license.
Let them make it ugly.
I'll go public.
I'll tell anyone who cares to listen this hospital was willing to let a man die because a bloody bill was signed on a Tuesday rather than a Monday.
We did something extraordinary here, Kerry.
You're right.
We did.
But that's not our purpose.
We can barely service the community's basic medical needs as it is.
And that's it? Just stay open, get through each day? Isn't that enough? Howard.
You shouldn't have stopped me.
Howard, you need help.
There are medications for this, therapies.
I'm fine.
I don't think you're fine.
I saw you double-check and triple-check every lab form and blood unit - that went into that.
- Probably AB/O incompatibility.
No, listen to me.
The transfusion was fine.
Nobody did anything wrong.
Howard, we didn't kill her.
Her father did.
- You're not gonna get better- - I'll go into Derm or Radiology- - You're not being rational.
- I'm being thorough! Why is that such a problem for you people? - What was that all about? - Howard has OCD.
Please don't tell me I just lost a doctor.
She would have started kindergarten this year.
You all right? I'm hanging in there.
How about you? Personally or professionally? First-year resident.
It's probably one and the same at this point.
Today was hard.
I can't imagine what it must feel like to lose a child.
Yeah.
Yeah.
Hey.
Big brother just told me he hadn't seen Dad in a while.
It might be because he died a year ago.
Any candidates that did match for an internship? - He seemed reasonable to me.
- Only four in the entire country? A friend is taking a year off after school to live with wolves.
- I can see if she's still in town.
- I'm sure if you talked to him - he would change his mind.
- And one in the Dominican Republic.
Can I do a phone interview? I did talk to Howard but he kept locking and unlocking his doors.
There's a doc in Neurology.
Says he's looking to start over.
- In Milwaukee? Can I get an interview? - He's close to 60, but he's still spry.
- Yes, thank you.
Thank you so much.
- You're welcome.
- Did you hear? - What? Tamira died in the O.
R.
Police went to Dad's favorite bar and confirmed he died last year.
Shot to death in some holdup.
After that, kid says she couldn't eat, couldn't sleep.
After years of abuse, she probably didn't know what to do with herself.
- Any psychiatric history? - No, but records show that her clinic had her on Valium three times a day.
- On it 6 months till she ran out of money.
- How long ago was that? - Last week.
- So she was hooked.
- We're talking benzo withdrawal.
- If she quit cold turkey could be psychosis, delusional thinking, hallucinations.
Did the oldest kid say what really went on? No, and you can forget about him talking to the cops.
Hey, Lockhart, EMS coordinator called for you.
Sounded pretty pissed about your ride-along.
Sorry.
- Hey, Chuny, how's she doing? - Better.
- I gave her 10 of Valium, PO.
- Psychosis should start resolving.
Maybe now she can tell us what really happened.
Only if she knows.
Dr.
Guzman.
SÃ, buenas noches to you too.
No? Wonderful.
Estoy Dr.
Susan Lewis at the County Hospital in Chicago.
How do you say "we have an opening" in Spanish? No clue, but I think that resident you wanted to interview is here.
Hi, how are you? Hi.
Nichelle, do you think you can tell us what happened? No.
I don't know.
Can you tell us where your husband is? Raymond? He's dead.
Can you tell us how he died? In a robbery.
You said he was trying to break into your apartment.
You remember telling us that? Mama, what's wrong? - You said he was trying to kill you.
- No, God, the door! He shot the door! - Mama, let go! - Get up! We- Come on.
We just gotta leave! Mama, stop it, please! Go away! Mama, what's wrong? But he wasn't there, Nichelle.
What happened to Kali and Tamira? - We just gotta- We just gotta leave! - Mama, stop it! - Please.
- No, we just gotta find- Find a place where he can't find you! Where you'll be safe! How did they get over to that window? It's the- It's the only way! Hurry! - Hurry! - Mama, don't, please! - You'll be safe! - Mama, don't! - Stop it, please! - Saige! Saige! How did they fall? - Mama! - Saige! - Mama! - You'll be safe! - Go! No, go! - No! - Go! Saige, come on! - Mama! Go! Go! Go! Mama, stop! Just quit it! Saige! Go! Go! Saige! Mama, stop! Saige! Saige! I made them go out the- I'm sorry.
I'm sorry, Dr.
Carter Dr.
Corday was looking for you.
Says she got her answer.
Sir, I'm afraid that's the only cheese we have.
This isn't cheese.
It's orange crap.
- Are you almost off? - Five, 50 and 5 make 10.
Thank you.
Can we go get a drink or something to eat-? I still have another hour yet.
I work longer days than I did when I was an intern.
I did learn something new.
How to clean the hot-dog machine.
Now, there's a skill I can take wherever I go.
One large coffee and a first-year resident, please.
- Sorry? - Howard quit.
- He did? - Yeah, are you interested? Neela's going through this adolescent rebellion/premature-midlife-crisis thing.
Look, I've called the NRMP.
I have scraped the bottom of the barrel.
I have seen or spoken with more freaks than Dr.
Phil.
I am desperate, no offense, for anyone even remotely competent and/or sane.
I don't know.
I mean, I'm working now so You're right.
You just keep ringing up those pork rinds and making Icees.
Hey, who labeled these jalapeños? They say "mild" but I'm burning my damn tongue off! Dr.
Lewis? When do you need me to start? Elizabeth? Hi, John.
So did you talk to Weaver? - Yes.
- What did she say? Well, she said that there was a place for me here.
A lesser place, but a place nonetheless.
- I'm sorry.
- Don't be.
I didn't take it.
I've decided to leave.
There's not enough of a future for me here.
Let me talk to Weaver again.
- We can go to the courts.
- No, it's all right.
It's all right.
This whole transplant situation the new staff, my 4-year-old daughter it's all helped me see things more clearly.
Mark's gone.
So many of my friends are gone.
There's- There's no reason to stay.
Not for me.
Not for Ella.
I suppose I've known that for a long time now, but it's It's just hard to move on, isn't it? Yeah.
It's hard to close that chapter.
Several.
Where are you gonna go? - Home, I think, for a bit.
- Back to England? Would you apologize to everyone for me? Aren't you gonna come by and see everybody before you go? I'm not much for goodbyes.
They make me cry, truth be told.
If you want me to tell anybody anything Tell them it's been lovely.
R.
Previously on E.
R.
Who are you? Dubenko, surgical Attending.
I'm covering trauma.
What did you do? Hire the only candidate I didn't endorse? Maybe something's opened up at the hospital.
I don't wanna work in the hospital.
Welcome to Jumbo Mart.
Can I help you? - What are you doing? - Working.
You can stay here for tonight.
Actually, you can stay as long as you like.
Sometimes I get nervous.
It didn't seem like nervous to me.
Do you have OCD? It's against the law to harvest organs from an HIV-positive patient.
The recipient is HIV-positive.
It doesn't matter.
UNOS won't approve and no surgeon's gonna operate.
But it is ridiculous to let a perfectly good organ go to waste.
Prep him.
I'll mobilize the team.
E.
R.
11x04 "FEAR" - Go away! - Let me in! - Open this damn door! - Why can't you leave us alone? Mama, what's wrong? Just leave us in peace! I'll kill all of you! The kids too! Just let us alone.
Oh, God.
Oh, God.
Oh, God.
Is that what you want? You want me to kill the kids? - Mama, please.
- It's gonna be okay.
We just gotta go.
Come on.
Open it or I'll kill them one by one, and make you watch.
Go where he can't find you.
Open this damn door! Come on.
Come on.
Saige! Mama! The transplant wasn't a total success.
I still have to meet with the Medical Executive Committee.
Yeah.
Makes me nervous too.
Mommy, in the picture? Look, John, I'll have to go.
I'll call you when I hear something, all right? Yeah.
Okay, bye.
Sorry, sweetheart.
What were you saying? Is this Daddy? Yeah.
You know that.
Who are they? That's your nana and your grandpa.
Are they dead too? I've been to the science museum like 10,000 times.
Why can't I just stay home? This way maybe you'll learn something instead of zoning out all day in front of that Xbox.
You can learn from that too.
Luka taught me how to rob all 15 stores in Vice City.
- Looks cool on his plasma.
- You like it over there at Luka's? Like the neighborhood and everything? Guess so.
- You like him too, right? - Yeah, why? Just wondering.
Well, then how would you feel about maybe moving in with him? - You serious? - He offered.
You want to? I don't know.
We never really lived with anyone before.
We lived with Dad.
Can I put our TV in my room then? - Maybe we should think about it more.
- Yeah.
Sir, please don't read that paper until you've paid for it.
- Just this, please.
- Sure, $1.
19.
One-one-nine.
I'll be right with you.
- Is there a problem? - I got it.
I'll get it the next time.
I think Howard has a touch of OCD.
Is that even possible, to have a touch of OCD? Three-ten, please.
- Busy over there today? - I wouldn't know.
I thought you'd gotten out of your mandatory ride-along.
It doesn't matter that windowless vehicles make me sick.
That's why they call it mandatory.
How's it going here? Eight-forty-two, please.
Great.
I get 10 percent off all my purchases.
- Abby, we gotta roll.
- See you later.
Bye.
- I talked her into doing it.
- Your hand never touched a scalpel.
Look, we're just trying to determine Dr.
Corday's understanding of the law- - That's about to change.
- Find the current law regarding HIV-positive organ transplant.
The donor was originally my patient.
I'm just trying to ask for an opportunity to speak in her behalf.
Attendance is limited to department heads.
Last I checked, you weren't one.
Bring it on.
Dr.
Pratt is on the clock, and ready to rock.
Which reminds me, I'm concerned we have doctors using work as therapy for post-traumatic stress.
- He's fine.
- I'm not talking about him.
Look, I got your request for extra shifts and it seems to me you're glossing over some of your susceptibilities.
- Hold the elevator.
- Too late.
Sorry.
I'm sorry to bring up your history of substance abuse but the fact is, you're still an addict.
You've been through an emotional roller coaster.
And I know what it's like.
Why push it? Why tempt fate? God knows you don't need the money.
There's no problem, Kerry.
Good.
Because I'm not in the business of safeguarding doctors' licenses.
- Not twice anyway.
- So no extra shifts? Go to the movies.
Take trips.
Do something other than hang around this hellhole.
- Kerry.
- What? I tried to make an appointment.
Your assistant's being snarky.
Let me guess.
You want to extend your maternity leave.
I was wondering if you found a permanent replacement for the chief of Emergency Medicine? - Someone you want to recommend? - Yeah, me.
- Told her you're busy.
- I offered you the position - and you turned me down.
- That was pre-baby.
- Post-baby that bad? - I like kids better when they're not sucking the life force out of me.
Chuck doesn't mind staying at home as long as we can make up the lost income.
A grand more per week with a two-year commitment.
Deal.
When do I start? We need six months' worth of variant x-ray interpretation unscheduled returns and a pneumonia pathway compliance by day's end.
Oh, and the toilets in the ER are backed up.
Good luck finding maintenance.
About time.
Getting crazy out here.
- How young are the kids? - Four and five.
Three-story fall from a window ledge.
- Miracle they're breathing and talking.
- What happened? Some domestic disturbance.
Mom's pretty worked up.
Please, God, please.
He tried to kill my babies.
- Who did, ma'am? - My husband.
Looks like an angulated fracture.
Spontaneous resps.
Get her on O2, and start a line.
I need a leg splint.
Hi.
Hello.
Can you tell me your name? - Kali.
- Okay, Kali.
- He had a gun.
- Any idea where he is now? Oh, God, why did you let this happen? Oh, God.
Can you wiggle your toes? Great.
That is perfect.
Are you an angel? Vascular's intact.
A what? An angel? Gonna take me to heaven? Will somebody please answer my question? Are we talking urticaria? We're not sure.
Insect bites, lymphadenopathy, erythema nodosum.
- It's possible.
- Which one is possible? All of the above.
Come on, guys.
Were the bumps firm? Were they non-tender? - Were they freely moveable? - They're just bumps.
All right.
Hold on, hold on, hold on.
First of all, read up on derm.
Secondly, learn to describe lesions systematically so your superiors don't look at you like you're complete dumbasses.
How are you doing, Mr.
Hayslip.
I'm Dr.
Pratt.
- You mind if I take a look? - That's what I'm here for.
Good.
Alrighty.
So what are they? Let me run some tests and we'll find out, okay? In the meantime, take a more thorough history and get his labs cooking.
Jing-Mei, hey.
Hey.
- What are you doing here? - Ortho's slammed.
Borrowed a cast cutter, figured I'd do it myself.
I know you're limber, but you're not that limber.
Come on, let me help you.
Thanks.
Anytime.
- It happened so fast.
- BP's 106/60 after morphine.
- Pushing another two.
- I got it.
The way he came right at us, and then my babies were down here- Ma'am, we're taking your kids to County Emergency.
Up we go.
- Meet us there.
- Do you have family or friends - that can drive you? - What if he comes back? - The police are here.
- No, we gotta stay together.
- Sorry, it's against policy.
- My children need me.
- Let her in.
- What? - Let her in.
Hey, Pam? - What? Will you take the brother? This way your sister won't be alone, okay? Thanks.
You're just supposed to be along for the ride, remember? You feeling that at all? So no John Hancocks? Your cast.
Nobody signed it.
I could have asked the night nurse, I guess.
You know, I haven't left the house in weeks.
The only reason why I'm here is because I decided to hitch a ride with my dad's transport ambulance.
He's got pneumonia again.
For the third time.
And phlebitis and a UTl.
Admitted him this morning.
You could have just called me.
I could have picked you up.
I think it's gonna be a while before I get into a car with you again.
Don't forget your range-of-motion exercises to build up your gastroc.
You ever think about him? Who? Elgin.
A 5-year-old, displaced tibia fracture after falling from a third-story window attempting to escape an abusive father.
- GCS fifteen, vitals stable after six of MS.
- Distal neurovascular status? - Intact.
- The mom? Yes, big red taxi thanks to Abby.
Brother and sister in the next rig.
We're gonna do everything we can for them.
I promise.
Tenderness at the olecranon and distal radius.
Multiple fractures.
Her name's Kali, after the Hindu goddess.
- Any LOC? - Not according to bystanders.
- Switching teams on us now, Lockhart? - It's pretty, you know? CBC, lytes, type and cross for two.
Lateral C-spine, chest, pelvis, left elbow, wrist and femur.
- Put CT on hold for head and abdomen.
- Very good, Howard.
- But it means "destruction.
" - Dumar, go.
He only used to hurt me.
Why'd he have to hurt my babies? We need Social Services here right away.
Let's get Mom to the family room.
Sure.
Ma'am, you want to come with me, please? It's okay.
Good breath sounds, good sats.
I'll check on number two.
- They catch the bastard that did this yet? - No.
Okay, we're out of here.
Old man found down, Lincoln Park.
Tracheal midline, no JVD.
- I'm scared.
- I know.
- Abby, come on.
- I'm right here.
Don't worry.
- I'm gonna catch you on the next run.
- Set up for that neck film.
You don't have 12 hours, you're not gonna get credit.
- Right or left side? - No hemotympanum.
Little sister's stable for now.
TKO saline after 500 cc's.
- Are you coming or not? - Someone get me a lead apron.
There was no next of kin.
And you know that because the hospital's policy of due diligence was exercised? The organ had to be procured quickly for the operation to be successful.
There wasn't time for a 24-hour family search.
Was the rest of the surgical team aware they were performing an illegal procedure? I'm sure they assumed that consent and UNOS approval were in place.
Did they know both patients were HIV-positive? Universal precautions are taken in surgery regardless of a patient's HIV status.
Look, this was a unique situation requiring decisive action.
That now exposes us to huge civil liabilities.
Only if negligence or malice are proven, which is clearly not the case.
- The recipient is thriving.
- It's against the law, Elizabeth.
At the moment, yes.
But the bill changing all of that is sitting on the governor's desk as we speak.
Unsigned.
So a liver that would have been destroyed was transplanted into a man who wouldn't have qualified for one a day or two earlier than the law allows.
Where's the harm in that? - I saved a patient's life.
- Actually, our patient died.
This other fellow just happened to benefit from it.
You breached hospital policy, state and federal law.
Any of which is grounds for dismissal, and/or loss of your license should we report this to the state board.
Sorry.
Got stuck in a hemorrhagic Meckel's diverticulectomy.
- Why is he here? - He's on the Medical Ethics Committee.
If you had followed protocol and presented to them, you would know that.
What's the next step, then? We'll make a decision.
You'll be notified as soon as we reach one.
Right.
Damn, these veins are tiny.
You're gonna have to settle down or it's gonna hurt even more.
- Mama - C-spine is clear.
- Sats, 97.
Need some help? - I've done it before.
- Yeah.
Bet you were pretty good at it too.
- Parietal abrasion.
No step off.
- What do we have? - I thought they paged Dubenko.
- Well, you got me.
- Mama Four-year-old with chest contusion.
Rib fractures.
Eight, nine, 10 on the left, but the lung is up.
- Sisters, right? - Yeah.
- Let's check for tamponade.
- As soon as Sam sticks the kid.
Sorry.
I got a flash but no return.
- Try the other side.
- We need another nurse? - No.
- Where's my mama? Hey, Tamira, do you like the Wiggles? Which one is your favorite? Anthony? Murray.
He plays guitar.
DTRs two plus and equal.
Good answer.
I like Jeff because he's always sleeping.
Got it.
- Thanks.
- Good bowel sounds.
No guarding.
- How do you know about the Wiggles? - I try to keep up with kids' TV.
Gives you something to talk to them about.
- You're kidding me, right? - Okay, she's stable for CT.
I hate the bloody Wiggles.
Kali, you have big beautiful brown eyes, and they are both equal and reactive.
No murmur, rub or gallop.
- How's it going in here? - Pretty severe pelvic fracture.
- Call Ortho? - Yes.
In the meantime, use sheet traction.
Pocket Doppler to Dr.
Corday.
How'd it go upstairs? I'm not sure.
I'll know in a couple of hours.
Thanks for asking.
I can't imagine they'll give you anything more than a slap on the wrist.
- Good pedal pulses.
- Foley's in.
Dip it for blood.
Angel? Angel? Abby, I think she's talking to you.
Oh, hi.
- You're still here, right? - Yeah.
We're all still here.
- She'll need a second IV.
- I can start a central line.
- Dr.
Pratt? - What? We have the chest x-rays for Mr.
Hayslip.
- Who? - The guy with the bumps.
He has a huge left hilar mass.
- Okay, go.
I got Abby.
- Yeah, but she's playing paramedic.
Yeah.
Well, I got Howard too.
Howie.
- How's the urine? - Negative.
But I should try with a reagent strip from another bottle.
- I only dipped it twice.
- Why? Once is sufficient.
Dr.
Corday, we need you in here.
- What happened? - Sats dropped to 79.
Probably a pulmonary contusion.
Tamira? Tamira, can you hear me? - She's barely moving air.
- Get an ambu-bag and intubation tray.
- Should we get the mom in here? - I'm not planning on her dying, are you? Is the universe punishing me for being a bad mom? There are charts here that haven't been picked up in six hours.
Good help is hard to find.
Like if you order a no-foam latte, there should be no foam.
Yeah, Neela burned my bagel earlier.
- You finish those QA reports? - Not yet.
Yeah, I thought you'd be a little rusty.
Where's Dr.
Corday? - In Trauma.
- Okay.
Tell her to find me when she's out.
It's important.
Oh, and St.
Joe's is closing its ER next week for renovations.
- Plan on doubling your intake down here.
- Congratulations on your promotion.
- What's this? - That is my time-off request demand for a 5-percent pay increase and my letter of resignation if neither condition is met.
Welcome to management.
- How are you doing, Kali? - I'm not hungry.
- Tachy at 130.
- Okay, we got a big pelvic bleed.
Let's hang some O-neg.
Let's get a pressure bag on that saline.
- Where are they? - No, I don't want to.
- Okay, Kali, you need to relax.
- No, tell me what's happening to my kids.
- We're doing everything we can for them.
- Mommy, no.
You're hurting her! What are you doing to her? - No, no, Nichelle.
- Abby.
Oh, my God! What are they doing? - Come on, Abby.
- Listen to me, okay? Why aren't they helping? Why aren't they helping my kids? They are.
They are.
Okay? Okay, come on.
Let's go.
Let's let the doctors do their work, okay? Okay.
Okay.
- It's non-productive.
- Any hemoptysis? Cough's chronic, but getting worse.
Yeah, after two packs a day for 25 years, no kidding.
Should I cancel the derm consult? The guy's got stage-four lung cancer with 100 skin mets.
What do you think? - You have a primary-care doctor? - No.
- Mr.
Hayslip.
- Let me guess.
More tests? - Actually, that won't be necessary.
- Good.
Give me a nice little cream for my rash, and I'm out of here.
It's not a rash.
Look, I don't know how to say this so I'm just gonna come right out and say it.
- You've got advanced lung cancer.
- What? Which has metastasized to your skin.
These are little cancers? You need to see Oncology.
They'll have the results of your biopsy and can recommend a course of chemotherapy.
I'm sorry.
Stay with the patient.
He'll need somebody to hold his hand.
- Heart pressure's up.
Repeat the bolus.
- All right, I'll take that.
- You, chart.
Chuny, hang the blood.
- On it.
- You running this trauma now? - Guy's sweating bullets.
All right, first hematocrit is 34.
- Dr.
Corday? - One room over.
- Circumferential traction.
- Yeah.
Pelvic and femur fracture with retroperitoneal bleeding.
TPOD's better.
You should get it from Central.
And mobilize angio.
- Didn't know we stocked the TPOD.
- That must be new.
Let's give her 10 liters O2 by mask.
- I'll call Central.
- Yeah, you do that.
Is my sister gonna die? Saige, right? Well, we're doing everything that we can to make sure that that doesn't happen.
Wanna up the FiO2.
Howard, can you please take him out? - That's a social worker's job.
- They're not here right now.
- Type-specific's ready? - So get a nurse to talk to him.
I'm a little busy right now.
- I'd rather talk to him.
- Who, him? Go.
I asked for blood.
I wanna repeat the crit I want a unit of FFP.
I wanna know where the damn social worker is.
Covering two hospitals by herself till midnight.
That's my excuse for being late.
What's yours for being an ass? - Where's the HemoCue? - Foot of the bed.
- Fourteen centimeters at the lip.
- Can you see well enough? Most time we can't get one surgeon down here - how did we manage two? - Getting harder to bag.
Yeah.
Rib sliced up the spleen.
The large amount of fluid in the sub-diaphragmatic space is obvious.
Consent for an ex-lap and a splenectomy.
- Sats are dropping.
- Tachy at 140.
No breath sounds.
She has a tension pneumo.
The first chest x-ray was clear.
Okay, open a 20 French and a Thora-Seal.
- Toss in an 18-gauge angiocath.
- Dr.
Corday? Sometimes endotracheal intubation with positive airway pressure exacerbates an imperceptible pneumo.
Okay, sats are up.
I was about to perform a needle thoracostomy.
You can place the chest tube.
O.
R.
can take her as soon as that's in.
Who should I put down as the Attending? - Dubenko.
- Corday.
- It will help to talk about what happened.
- No.
I can't.
Is there anyone we can call for you? I just need to pray for my children to live.
Pray for some peace in my heart and my mind.
Pray for him to die.
He's an evil man.
Oh, he's an evil man.
But he gave me my children.
Now he's gonna take them away.
Need me to answer some questions for you? You wanna watch some TV? Is my mom gonna be okay? Well, it's pretty hard for her right now.
She's worried and upset.
I'm sure you are too.
But hopefully your sisters'll get better real soon.
They'll be back at home getting on your nerves in no time.
Hey, you see those guys right there? They're gonna do everything that they can to keep your family safe from your father.
I'm sorry.
Oh, man.
- Scrubs are in the first supply closet.
- Thanks.
Come on.
It's okay.
Don't worry about it.
How's it going? Not so good.
We can't find this guy.
There's some indication he left the state a year or so ago.
- If he came back, no one saw.
- Neighbors didn't help? Woman next door was passed out drunk, never heard a thing.
People on the other side, they weren't home.
Well, she's still very upset and a little scattered.
Yeah, I would be too if I saw my kid fall three floors.
But I would want to catch the guy who did it to them.
- Hi.
Wendall Meade, Social Services.
- Detective Maskins.
Ma'am let me say how sorry I am that this happened.
- Who are you? - Nichelle this detective needs to ask you about your husband.
Do you have any idea where he's staying? Where he might go? The time.
What's the time? Twelve-fifteen.
He likes to drink.
Get drunk soon as he could every day.
Did he have a favorite bar? - She's a survivor, this one.
- Let's hope.
Look, I've been wanting to congratulate you on the transplant work you did with the HIV patients.
Groundbreaking stuff.
- I wasn't trying to break any ground.
- Right.
Well, in a more perfect world, you'd be given an award for it.
Weaver is waiting on you.
She says it's important.
Anyways, I think what you did was great.
Dr.
Dubenko, TPOD's ready in Trauma One.
I'll send another surgeon down.
The sheet traction method you used is a little archaic.
This gives a better hug around the hips and upper thighs.
Sorry.
- What about Weaver? - Tell her to wait.
Excuse me.
She's asking for you.
- What's going on? - Slowly pull the handle straight out.
Kali? - I wasn't a bad girl.
- No, of course you weren't.
- How's her pressure? - Down to 65.
Crit's dropping, even with the transfusion.
So much for Dubenko and his contraptions.
- I don't wanna go there.
- Barely has a pulse.
I wanna go to heaven.
Just hang on, okay, Kali? "Secure the compression by wrapping the strings around the protruding hooks.
" - Tachy at 150.
No radial pulse.
- Intubation and central line kit.
No room for a femoral with the TPOD.
- Go subclavian.
- On a 5-year-old? We're gonna put a tube down your throat so you can breathe.
You won't be able to talk anymore.
Prep the upper chest.
Let's go.
Kali? I want to go with you, angel.
Five-and-a-half ET tube.
Get the crash cart in here.
BP's down to 56 systolic.
- Howard? - Come on, come on.
Show me the subclavian.
- I'm trying.
I can't get it in there.
- Damn it.
I can't see anything.
Howard, you think you can move? - Howard, swing it around.
- Two, and squeeze.
Check your urine output.
Where's that blood? Two units, crossed and matched.
- Abby, you ready? - Right there, John.
- Yes.
- Hold it steady.
One, two, three, squeeze.
One, two, three, squeeze.
- Got a flash.
Guide wire.
- Okay.
Kali Richardson, medical record number 331928.
Transfer another 20 per kilo, round of 400.
A- positive unit number KB-579111? - Good to go.
- Cordis introducer.
Hang it.
Three bolus of 400, 1200 total.
Okay.
- I'm in.
- One, two, three, squeeze.
- Pressure's dropping, 50.
- One, two, three, squeeze.
- Mix some dopamine.
- Okay, 200 into 250- Will you please shut up?! Squeeze.
One, two, three, squeeze.
One, two, three, squeeze.
The youngest one made it to surgery without arresting.
They've started the ex-lap.
Still working on her sister in Trauma 1.
You okay? I just called Alex.
It took everything I had not to cry.
He accused me of being on my period.
Then maybe I am too.
I almost called him myself.
You two decide yet? - About moving in? - Don't.
You'll kill the romance.
They're on their best behavior and before you know it, they're farting in the kitchen.
We talked about it.
We probably need to talk about it some more.
Just so you know I'm not jealous, I'm not crazy, and I won't be farting in the kitchen, okay? Can't get her pressure above 60.
Must be a posterior bleed.
Third unit's in.
- Check the fourth unit.
- Howard, help Abby.
Give FFP after the fourth.
Up the dopamine to 10.
Okay.
Kali Richardson, 331928.
- Nine-two-eight or 938? - Two-eight.
- Show me.
- Nine-two-eight.
Oh, okay, good.
- Bradying down.
Give me atropine.
- Get the ultrasound.
Make sure we don't miss an intra-abdominal bleed.
- T as in Tom? - T as in Tom.
Next.
Start compressions.
Once more, slowly.
You may have transposed something.
- Hang the damn blood.
- Okay.
It matches.
It matches.
- We're in V-fib.
- Charge to 15.
- I just didn't want her to have a reaction.
- And clear.
All right, young man.
Now, if you have to go again, just let me know, okay? - Okay.
- Feel better? - Yeah.
- All right, now let's go find your mom.
You coming? I was scared.
Of course you were.
I should have done something to stop it.
Look, you're just a kid.
I'm the oldest.
You're 9.
Your father, he's a grown man.
There's only so much you could do.
He was never there.
Who? My father.
Clear.
- Still fib.
- Should have rechecked the blood.
- Second bolus of lidocaine's on board.
- Seventy again.
Should we send hemolysis labs in case it was a transfusion reaction? - That the mother? - Yeah.
Clear.
- Seventh unit's in.
- Are you sure this is a good idea? Nichelle, you need to open your eyes.
You need to be with your daughter now.
Another run of epi.
Let's go 70 again.
Oh, God.
Clear.
- Asystole.
- Could be fine, V-fib.
- Kali? - Again.
- Baby.
- Be careful.
Don't get shocked.
It's all right.
Go ahead.
Kali Baby? My baby No! No, no, no! Kali! Kali! Kal- I was hoping to have seen you earlier.
Yeah, I got caught up in that trauma.
So I have good news.
Though certain members of the committee lobbied for your dismissal I was able to craft a proposal that I think will benefit all of us.
Really? How would you feel about accepting a non-tenure-track position as clinical instructor here at County? So after giving seven years of my service to this hospital I lose my tenure over a single patient.
Elizabeth, you broke the law.
What did you think was gonna happen? I don't know.
That I might be appreciated for saving a life.
That - That friends might have fought for me.
- I did fight for you.
I had to beg, borrow and steal just to keep them from giving your name to the state board.
What the hell.
Let them pull my license.
Let them make it ugly.
I'll go public.
I'll tell anyone who cares to listen this hospital was willing to let a man die because a bloody bill was signed on a Tuesday rather than a Monday.
We did something extraordinary here, Kerry.
You're right.
We did.
But that's not our purpose.
We can barely service the community's basic medical needs as it is.
And that's it? Just stay open, get through each day? Isn't that enough? Howard.
You shouldn't have stopped me.
Howard, you need help.
There are medications for this, therapies.
I'm fine.
I don't think you're fine.
I saw you double-check and triple-check every lab form and blood unit - that went into that.
- Probably AB/O incompatibility.
No, listen to me.
The transfusion was fine.
Nobody did anything wrong.
Howard, we didn't kill her.
Her father did.
- You're not gonna get better- - I'll go into Derm or Radiology- - You're not being rational.
- I'm being thorough! Why is that such a problem for you people? - What was that all about? - Howard has OCD.
Please don't tell me I just lost a doctor.
She would have started kindergarten this year.
You all right? I'm hanging in there.
How about you? Personally or professionally? First-year resident.
It's probably one and the same at this point.
Today was hard.
I can't imagine what it must feel like to lose a child.
Yeah.
Yeah.
Hey.
Big brother just told me he hadn't seen Dad in a while.
It might be because he died a year ago.
Any candidates that did match for an internship? - He seemed reasonable to me.
- Only four in the entire country? A friend is taking a year off after school to live with wolves.
- I can see if she's still in town.
- I'm sure if you talked to him - he would change his mind.
- And one in the Dominican Republic.
Can I do a phone interview? I did talk to Howard but he kept locking and unlocking his doors.
There's a doc in Neurology.
Says he's looking to start over.
- In Milwaukee? Can I get an interview? - He's close to 60, but he's still spry.
- Yes, thank you.
Thank you so much.
- You're welcome.
- Did you hear? - What? Tamira died in the O.
R.
Police went to Dad's favorite bar and confirmed he died last year.
Shot to death in some holdup.
After that, kid says she couldn't eat, couldn't sleep.
After years of abuse, she probably didn't know what to do with herself.
- Any psychiatric history? - No, but records show that her clinic had her on Valium three times a day.
- On it 6 months till she ran out of money.
- How long ago was that? - Last week.
- So she was hooked.
- We're talking benzo withdrawal.
- If she quit cold turkey could be psychosis, delusional thinking, hallucinations.
Did the oldest kid say what really went on? No, and you can forget about him talking to the cops.
Hey, Lockhart, EMS coordinator called for you.
Sounded pretty pissed about your ride-along.
Sorry.
- Hey, Chuny, how's she doing? - Better.
- I gave her 10 of Valium, PO.
- Psychosis should start resolving.
Maybe now she can tell us what really happened.
Only if she knows.
Dr.
Guzman.
SÃ, buenas noches to you too.
No? Wonderful.
Estoy Dr.
Susan Lewis at the County Hospital in Chicago.
How do you say "we have an opening" in Spanish? No clue, but I think that resident you wanted to interview is here.
Hi, how are you? Hi.
Nichelle, do you think you can tell us what happened? No.
I don't know.
Can you tell us where your husband is? Raymond? He's dead.
Can you tell us how he died? In a robbery.
You said he was trying to break into your apartment.
You remember telling us that? Mama, what's wrong? - You said he was trying to kill you.
- No, God, the door! He shot the door! - Mama, let go! - Get up! We- Come on.
We just gotta leave! Mama, stop it, please! Go away! Mama, what's wrong? But he wasn't there, Nichelle.
What happened to Kali and Tamira? - We just gotta- We just gotta leave! - Mama, stop it! - Please.
- No, we just gotta find- Find a place where he can't find you! Where you'll be safe! How did they get over to that window? It's the- It's the only way! Hurry! - Hurry! - Mama, don't, please! - You'll be safe! - Mama, don't! - Stop it, please! - Saige! Saige! How did they fall? - Mama! - Saige! - Mama! - You'll be safe! - Go! No, go! - No! - Go! Saige, come on! - Mama! Go! Go! Go! Mama, stop! Just quit it! Saige! Go! Go! Saige! Mama, stop! Saige! Saige! I made them go out the- I'm sorry.
I'm sorry, Dr.
Carter Dr.
Corday was looking for you.
Says she got her answer.
Sir, I'm afraid that's the only cheese we have.
This isn't cheese.
It's orange crap.
- Are you almost off? - Five, 50 and 5 make 10.
Thank you.
Can we go get a drink or something to eat-? I still have another hour yet.
I work longer days than I did when I was an intern.
I did learn something new.
How to clean the hot-dog machine.
Now, there's a skill I can take wherever I go.
One large coffee and a first-year resident, please.
- Sorry? - Howard quit.
- He did? - Yeah, are you interested? Neela's going through this adolescent rebellion/premature-midlife-crisis thing.
Look, I've called the NRMP.
I have scraped the bottom of the barrel.
I have seen or spoken with more freaks than Dr.
Phil.
I am desperate, no offense, for anyone even remotely competent and/or sane.
I don't know.
I mean, I'm working now so You're right.
You just keep ringing up those pork rinds and making Icees.
Hey, who labeled these jalapeños? They say "mild" but I'm burning my damn tongue off! Dr.
Lewis? When do you need me to start? Elizabeth? Hi, John.
So did you talk to Weaver? - Yes.
- What did she say? Well, she said that there was a place for me here.
A lesser place, but a place nonetheless.
- I'm sorry.
- Don't be.
I didn't take it.
I've decided to leave.
There's not enough of a future for me here.
Let me talk to Weaver again.
- We can go to the courts.
- No, it's all right.
It's all right.
This whole transplant situation the new staff, my 4-year-old daughter it's all helped me see things more clearly.
Mark's gone.
So many of my friends are gone.
There's- There's no reason to stay.
Not for me.
Not for Ella.
I suppose I've known that for a long time now, but it's It's just hard to move on, isn't it? Yeah.
It's hard to close that chapter.
Several.
Where are you gonna go? - Home, I think, for a bit.
- Back to England? Would you apologize to everyone for me? Aren't you gonna come by and see everybody before you go? I'm not much for goodbyes.
They make me cry, truth be told.
If you want me to tell anybody anything Tell them it's been lovely.