ER s11e08 Episode Script
A Shot in the Dark
E.
R.
Previously on E.
R.
Look, Luka I'm glad we're friends.
But I've got a dad.
- Fingernails, tattoo, the hair? - It's the whole package.
Okay.
I'll talk to my band mates and see if I can't pull it back a little.
- You off? - Yeah.
If you wait for a second I'll - walk out with you.
- Okay.
Damn it! Son of a bitch! - He should be in a nursing home.
- I'd never do that to him.
You can stay here for tonight.
Plenty of room.
Actually, you can stay as long as you like.
E.
R.
11x08 "SHOT IN THE DARK" - Hey.
- Hey.
How was your night? - The usual.
- Anything good? Guy got his arm caught in a sausage-making machine.
Nice.
I'm not on till 9.
I can drop Alex off at school, but can you pick him up at 3? Sure, after I get some sleep.
Morning.
Mom, I need 10 bucks for the class field trip to Millennium Park.
- Okay.
- They've got a giant silver sculpture shaped like a bean.
If I don't get the money in I have to stay behind to do homework with the fifth graders.
Okay, okay.
What? You've never seen a kid pee before? This is gonna bounce.
- That's a lot of zeroes.
- Tuition was expensive.
No wonder you're sleeping on Abby's sofa.
You know you can defer paying your loans until after residency? Not this one.
This is for my father.
- What? Your dad's leaning on you? - It's for my brother's university tuition.
My parents put me through school, now it's my turn- They can't wait until you're making real money? Is there something you need, Ray? How would you like to work Christmas for me? I'm already working New Year's.
Look, you do Christmas and I'll take your New Year's Eve.
You'd work New Year's Eve? It's important to have us all together on Christmas.
I'll take Ramadan for you.
I'm not Muslim, I'm Sikh.
Great.
I'll cover whenever you wanna take a Sikh day.
- This is unbelievable.
- What? Weaver's got a boyfriend? Only 39 percent of the staff has had a flu shot this year.
I don't want massive absenteeism in January.
- I had mine.
- I'll get one today.
- How about you, Ray? - Tomorrow.
My band's to play at Delilah's tonight.
Can't have a sore arm.
Sore arm? How about 100 percent compliance by next week? You've had lame excuses for the past two months.
- What are you talking about? - First, you had a cold.
- Oh, yeah, then you were sleep-deprived.
- Police officer shot.
ETA, two minutes.
- Where's the wound? - I couldn't understand.
- All right, clear Trauma 1.
- Neela, Ray, Chuny, you're with me.
Mary, get some extra security down here to handle the press.
- Do me a favor, give me a flu shot.
- What? Yeah.
Get me when I'm not expecting it.
Just stick me quick, I got a thing about needles.
- Paramedics probably have two IVs.
- You can go femoral if we need it.
Eddie Escobar, caught one in the neck.
- Lost lots of blood.
- This the throw-and-go? - We were 10 blocks away.
- You're at County General.
- Should've called paramedics.
- We'd still be waiting.
- C-collar.
- Board's ready.
One, two, three.
We're gonna give oxygen through your nose.
- Thank you.
- Pulse is thready.
- Take my keys, Gary.
- It's okay, Eddie.
- Try not to move.
- Someone needs to feed my dogs.
- Have intubation tray ready.
- There's a filing cabinet in the bedroom with all my papers.
Forget about that.
It's gonna be okay.
Tell him.
Trauma panel, type and cross, six units, call X-ray, get a portable neck-and-chest.
I threw up all over Amy's collage.
It was so embarrassing.
Oh, that's okay.
We see, like, a hundred puking kids a day.
Really? - Mom's here.
This is Dr.
Lockhart.
- Hi.
- School nurse called my office.
- They sent her in for vomiting and fever.
- She okay? - Well, it seems like it's just a flu.
Are you okay, honey? - I should take her to our doctor.
- She's here now- - I see how busy you are.
- It's not that.
It's- Do you want to go see Dr.
Ben? It's probably just the stomach flu.
Let us run tests.
We'll give her fluid.
She'll be good as new.
- How long is that gonna take? - About an hour.
- Can we move her to a real room? - I'll work on it.
Sam, this girl needs a line and Tigan.
You have to ask Malik.
Excuse me! Excuse me.
- Sub-Q air.
Otherwise okay.
- Come on.
Excuse me.
Two units O-neg.
Looks like the bullet missed your spinal cord and trachea.
- That's good, buddy.
- Excuse me.
- That's good news.
- Sats aren't so hot.
- He needs plastic.
- Yeah.
I'm all over it.
We're gonna stick a tube down your throat to give you more oxygen.
Whatever you say, doc.
- You'll go to sleep first.
- Twenty of etomidate, 100 of sux? - Everyone else okay? - We're all good, Eddie.
- You get the perp? - Couple of double taps to the chest.
- He went down.
- Go for it, Ray.
- What happened? - Convenience store holdup.
Chased the guy into an apartment building, called for backup.
Scumbag starts shooting out the window.
- All right.
There's too much blood.
- Pulse ox only 72.
Okay.
Pull out and bag him up.
You want me to do it? No, no, no.
I got it.
Give me a straight blade.
- You cut yourself? - No, that's- It's nothing.
- We should take care of it.
- No, really, it's okay.
One more shot, Ray.
- Ray? - Just give me some cricoid pressure.
I could get this.
- I still can't see the cords.
- Okay, that's it.
- You want me to try? - How about you try? - Crike tray.
- Yeah? Yeah.
Betadine, 11 blade.
No.
Sam, third drawer of the crash cart.
Get the trach light.
- The what? - Are you going fiberoptic? - Not exactly.
- Got it.
- Where's the scope? - It's a blind procedure.
- Who's in charge of this ER? - That would be me.
You can stay here, sir, but you have to be quiet.
Okay.
Bend the tip to 90 degrees.
Turn the lights off.
Passing the midline, lift the jaw forward.
Sats are dropping.
Shouldn't we prep the neck? Through the cords, you'll see a pre-tracheal glow.
- He needs a crike.
- That's the glow.
Won't see it if you're in the esophagus.
Okay, that's it.
Bag him.
Turn the lights on.
- Very slick.
- How about a subclavian? Okay, good breath sounds.
Number six gloves, Dr.
Barnett? Seven-and-a-half.
Sterile drape and a finer needle, please.
- I have Mallory.
- This is Eddie's fiancée.
- Okay.
- Oh, my God, Eddie.
I'm Dr.
Lewis.
He's doing okay.
- He was shot? - Once, in the neck.
He's sedated with medication, but you can sit with him, hold his hand.
I was playing around with my nephew.
We were wrestling.
Looks like he kicked your butt.
Is the rib sore? - Right there, yeah.
- Okay, Mr.
Sakabu.
I think it's nothing but a bruise.
What about my shoulder? - Any pain when I press? - It's more on the inside.
It's probably just a strain.
I'll have the nurse bring your discharge instructions.
Hey, hey.
I didn't know you were in today.
The stupid alarm didn't go off.
- Rough night, huh? - Yeah.
You okay? Okay.
I got a quick one for you, ready for discharge.
Give me a couple of minutes, okay? Good news.
Labs are fine, white count's not elevated.
- So we can go? - Mom.
Mom.
Are you all right, honey? - What's wrong? - It hurts now.
- Where does it hurt? - Right here.
Here? Does it hurt more when I take my hand away? I'm gonna get you some medicine for that pain, okay? I need to run some more tests.
Start with four of MS.
Thanks.
I thought she'd be better by now.
What starts out looking like flu ends up to be something else.
- Like what? - Appendicitis.
You said it wasn't serious.
It may not be.
I'd like a surgeon to take- - You think she needs an operation? - It's a possibility.
Oh, God.
No.
No, she's not having surgery.
Not here.
- It's a very simple operation.
- I need to talk to my husband.
There's time.
I need to do another blood test- You can't do surgery without my permission, right? Right.
One step at a time, okay? You call your husband.
I'll get things started.
- Hey, Ray.
Is Carter in there? - Just Lewis.
- How's the cop? - Stable.
What's in your hand? - A chart.
- Okay.
The other hand? A pen.
I didn't say I'd do it.
- Hey, anybody seen Dr.
Chen? - Sorry.
Do you have any plans for New Year's Eve? - You're not really my type.
- Funny.
My band's got a party gig.
- Can you take the p.
m.
for me? - On New Year's Eve? Well, look at it this way, you won't have to go to a square dance by yourself.
Or with a date, or whatever.
You give my med-student lecture for me in January.
- Deal.
- Suspect's been wounded and apprehended.
Do we have ETA? No, I'm sorry.
They haven't called that in yet.
- We'll be with the family.
- Okay.
Ten-year-old girl.
Fever, vomiting, right lower quadrant tenderness.
- Rule out appy.
- Yeah.
CT or ultrasound? It depends.
What the hell was that? What? Jing-Mei? Oh, sorry.
Coffee was brewing.
You okay to work? Yeah, sure.
What do you got? Thirty-five-year-old, strain and sprain - chest and shoulder contusion.
- Okay.
- You don't wanna see the patient? - No.
I trust you.
How's your dad doing? Okay.
I mean, I've got a nurse for him And then from 11 to 7, it's just me.
- So you're not getting much sleep.
- Hey, Dr.
Chen.
Carter's got a baby in status.
Needs you for that suspect in that shooting.
- How soon? - Right now.
Gunshots to the chest and abdomen.
- Vitals? - No pulse in the field.
- Son of a bitch.
- How long down? Cops had to secure the building.
- How long did that take? - Made us wait 45 minutes.
It takes 20 minutes to bleed out.
If there'd been a shooter, she'd be full of holes.
- Two of O-neg on the infuser.
- On my count- - Hold on.
He's cuffed.
- Who's got the key? - Not me.
You got the keys? - I'll check with Hogan.
- Quickly.
- Start on the paramedic gurney.
Betadine, 32 French.
Thoracotomy's all yours, Neela.
- You gonna assist? - You'll be fine.
- Sterile gloves and 10 blade.
- First unit's up.
I need to lift up his arms.
Where's the key? - We're working on it.
- Get the bolt cutters.
- Take it easy.
- I got it.
- Can the officers wait outside? - Suspect's in custody, uncuffed.
- We're waiting here.
- Don't think he's gonna jump off the bed.
Hook up the Thora-Seal.
Give her room to work.
Think he's got a chance? Why do you think they're letting me crack his chest? - That thing's got to wait outside.
- That thing is a service animal.
A service animal with fleas.
Actually, fleas have a natural aversion to minis.
- Abby, Dilantin level's back- - Carter, this is Mrs.
Gellin - and her guide horse, Ruby.
- Who should be outside.
We let Seeing Eye dogs in here.
Our floors are gonna be covered with crap.
- She's housebroken.
- What if she spooks? Oh, we've been on the L, airplanes, elevators - She can stay.
- Thank you.
See you later, Ruby.
Dr.
Carter, Officer Escobar's son's here.
Okay.
We're- We're still working on his dad.
The kid's anxious to see him.
- Let me- Let me go check for you.
- Thanks.
- No, too close to the skull.
- Can you stop the bleeding? - Direct pressure.
- Got it.
Call Angio.
Maybe we can balloon the proximal carotid.
They just picked up his son at school.
- Arlo's here? - How old is your son? Fifteen.
I'm not his mother.
Arlo's from Eddie's first marriage.
- Fine.
Throw down a fresh drape.
- I'll be next door.
- CVC's in.
Need a repeat chest.
- Hey, Arlo.
It's not as bad as it looks.
- It's okay.
You can come on up here.
- What is she doing here? I want her out.
Excuse me, ma'am- - Who let her in? - This the ex-wife? - You shouldn't be here.
- Mom.
Mom.
- Get out! - Can you just shut up? Okay, everybody shut up.
Officer, you and Mallory need to step outside.
- I don't wanna leave him.
- Everyone gets to see him - just one at a time.
- Come on.
We're gonna start x-rays on your father.
You can say hello quickly.
- Dad, it's Arlo.
I'm here.
- He can't talk with the tube in his mouth.
You're gonna be all right.
- Ray, take them to the family room.
- Me? - You're tough, Dad.
- All right, honey, that's enough.
Dr.
Barnett will answer any questions.
Okay.
Right this way, guys.
- Sam, check a second HemoCue.
- I think it's next door.
Thanks.
- You got a rhythm? - Unit five and six are up.
Hold compressions.
- Asystole.
- How's his volume? - Heart's filling well.
- Too many holes.
We could try high-dose epi.
Penetrating trauma with no pulse in the field.
Okay.
- He's dead? - Yeah.
You just saved the taxpayers a million bucks in trial fees and prison costs.
- What happened to your wrist? - Oh, I don't know.
Neela, you wanna help Officer McWayne out here? - I was gonna find family for this patient.
- Get him started in the suture room.
Sorry about the misunderstanding.
Some people are freaked out by little animals.
I'm gonna clean your cut out.
I have a cousin who gets nervous around Chihuahuas.
- Is she wearing sneakers? - It keeps her from slipping on the floor.
My husband wants her transferred to Mercy.
- Surgery's on their way to check her out.
- We wanna move her.
You're gonna have to find a surgeon at Mercy to accept her before I can okay a transfer.
Hey, back off, Ruby.
- Doctor, can you come to the phone? - Yes.
One minute.
I'll be right back.
Re-prep the wound and tie up the horse.
It's my husband.
He's driving back from Detroit.
- Hi.
This is Dr.
Lockhart.
- Are you the doctor? - Yes, I am.
- You better be damn sure - you know what you're doing.
- Mr.
Trager- - If you do anything- - Mr.
Trager, I understand.
We will.
Yes, your wife is working on that right now.
We would never do that, sir.
Got paged about a patient transfer? Wendall Meade, Social Services.
Thank God you're here.
Why don't you get here soon, and we won't make any decisions with- Nice talking to you too.
Little pin prick and some burning.
Sorry.
Must be a pain having to waste all that time trying to save a scumbag's life.
- He jacked a mini-mart, doc.
- Looks like a 14-year-old.
Feels like a foreign body.
Something hard.
Is it possible you were shot? I don't think so.
I remember I scraped my wrist when I fell.
- How about there? - That's a loop of bowel.
I left messages for three surgeons at Mercy.
- They'll call back.
- How long can we wait? Eight to 10 hours.
- I can't find the appendix.
- What does that mean? Usually if it's enlarged, it's easy to find.
- She may not have appendicitis? - It's not a perfect test.
She could still have the disease even if the ultrasound is normal.
Can't you people give me a straight answer? I would say, based on her fever and tenderness, that it is appendicitis.
She said it was stomach flu, then changed her mind.
Now you can't find her appendix? Transfer center from Mercy wants to talk to the Attending.
- Finally.
- Hang a gram of cefotetan.
Do you think I need an operation? - Do I need it soon? - Yep.
Can I have it here? Well, you could but your parents want you to have it at a different hospital.
- Won't that take a while? - Not too long.
It'll be okay.
Why can't I decide? Because when you're a kid, your parents get to decide what's best.
The only way to stop the bleeding is by blowing up a balloon in his artery.
This x-ray is gonna guide us to the right spot.
- How does he get blood to his brain? - Dr.
Lewis.
- Hold on.
- That's a good question, Arlo.
Two carotid arteries supply the brain.
Right and left, okay? If one gets blocked, Mother Nature has a backup plan.
It is called the Circle of Willis.
It's a detour.
But it allows the blood from the right to get over to the left-hand side.
- I understand.
- So he can recover.
Well, priority number one is to stop the bleeding.
- If you're not wearing lead, leave.
- I'll come get you when we're done.
- Thanks, Dr.
Barnett.
- Ray's fine.
Okay, Ray.
- Sam, Dr.
Kovac called.
- Did you take a message? Sounds like your kid got suspended from school again.
- I may need to leave.
- In a minute.
- Dr.
Lewis.
- Have them step outside.
I removed a foreign body from Officer McWayne's arm.
- What's that? - Feels like a plastic BB.
Could be what shot your patient.
- That couldn't sever a carotid artery.
- You sure? Officer Escobar was shot with this metal slug - from a sub-Q, right upper a trapezius.
- Looks like a 9 mm.
- Is that what the suspect used? - I don't think so.
Nine-millimeter semi-automatic, standard issue.
That's what we carry.
I can pick him up.
It's not a problem.
Stay at work.
- Well, what is it about? - No.
The school didn't tell me anything.
- They didn't tell you? What did he do? - They just said to come in for a meeting.
- Well, is he okay? - Yeah, yeah.
He's fine.
All right.
Call me as soon as you get back.
- I will.
- Okay, thanks.
- Tetanus shot for Officer McWayne.
- Being interviewed about friendly-fire.
- Is it for sure now? - They found a pellet gun at the scene.
- So he didn't shoot the cop then.
- Guess not.
Arlo, you should be in the family room.
Is that the guy who shot my dad? He was the suspect they were pursuing.
- Can I go in there? - Probably not a good idea.
- I wanna see him.
- Arlo.
- He's a kid.
- You don't have to do this- - Was he on drugs? - I can't say.
- Did he have a police record? - I don't know.
Why would he do that? Why would he shoot my dad? Arlo, we're not exactly sure who shot your dad.
He may have been accidentally shot by a police officer.
- What? But I thought- - This guy was only carrying a BB gun.
They won't know for sure until the ballistics tests are completed.
Oh, man.
One of his own guys.
Arlo, can we talk to you? - Which one of you did it? - We don't know anything yet.
Why don't we go and sit down? - We're sorry.
- It's not your fault.
Comes with the job.
There, balloon is up and the vessel is occluded.
- Can we have his family in? - Not just yet.
- Entrance wound is dry as a bone.
- Nice.
He's not waking up.
He's still comatose with a flaccid paralysis and an up-going toe.
So much for collateral flow.
- But you can repair the carotid? - Oh, it'd likely do more harm than good.
It's not a procedure that I'm comfortable with.
- But if the wife consents- - His fiancée.
- Not her call then.
- We have an ex-wife.
- Is there a blood relative? - Yeah, a son, but he's 15.
- Could he be a mature minor? - A what? It's when a kid's mature enough to make medical decisions.
- Could be.
- Okay, I'll talk to him.
Get Wendall in on this.
And find me if you need me.
- Okay.
- Dr.
Dubenko, I need you right now.
Keep his crit above 30.
PO-2, 90.
Ten-year-old, appy, systolic's 60.
- Is she septic? - Antibiotics are on board.
- We're running in a liter.
- Who saw her from Surgery? - The family wants her transferred.
- That isn't happening.
Dr.
Hong at Mercy accepted her.
- Pressure's up to 70 with 500.
- They're sending an ambulance.
I'm sorry, ma'am.
Your daughter is very sick.
She needs surgery now.
Do we have consent? - No.
She said we could wait.
- In most cases, we could.
This is unusual.
The infection spread to her blood quickly.
Mrs.
Trager, we need consent for surgery.
- My husband will be here.
I need to wait.
- We don't have time.
It's life-threatening.
- Okay.
We'll double-doctor it.
- What? What? Two physicians' signatures can override your consent.
Sign it.
Sign it.
Let's go.
- This is not what we agreed on.
- I'm sorry.
- You done this before? - No one gets in trouble - acting for the patient.
- Tell that to Dr.
Corday.
- Treating your dad- - Sorry, I was tied up.
Everyone, this is Wendall Meade.
- Hi, Arlo.
- Can he stay? If it's okay with Arlo.
Yeah? Okay, so the two treatment options: We can use a catheter to plug up the artery with coils.
Like with a balloon? Yeah.
That would give him a 15 percent chance of getting better 85 percent chance of still staying in a coma.
Or we could do surgery to reconnect the artery.
If we do that that would give him a 30 percent chance of improving.
- That's a little better.
- Yeah, well, it's risky.
Usually with surgery, half the time the patient deteriorates or dies.
The surgery sounds too risky.
Do you understand the choices, Arlo? They both kind of suck.
- Can you explain them back to me? - What? - I need to make sure he understands.
- I'll make sure he does.
Arlo? Well, if we play it safe there's a small chance he gets better.
If we do the surgery there's a bigger chance he'll improve, but an even bigger risk he'll get sicker.
That's right.
It's your call.
What are you talking about? We've decided Arlo's mature.
He can make the decision.
- By himself? He can't handle this.
- Yes, I can.
- No, you can't.
You're 15.
- He's my dad.
In cases like this, the decision has to be made by a blood relative.
It's the law.
How can this be right? Between you and me, it's not the end of the world.
The board has a zero-tolerance approach to what they consider pornographic.
What? He brought this to school.
He was showing it to the other kids.
That may not be appropriate.
They have lots of cool electronic gadgets in here.
I don't think they were looking at the gadgets.
- Is that your name on the mailing label? - Yeah.
And you're Alex's stepfather? Not exactly.
I see.
But you take an active role in the child-rearing? Yeah, I pick him up from school.
You know, we do sports.
- I took him fishing.
- That's great.
You know, Alex and his mom we've been all living together, and it's really going well.
And how long has that been the arrangement? About a week.
Ray, do you have a minute? Hey.
Hot chocolate? It's my treat.
I'm really sorry about my mom.
- She's just looking out for you, okay? - By freaking out? My dad's lucky she won't even talk to him anymore.
Are you okay with what we talked about? About your dad? Last year for the ninth-grade prom - there was this girl Sarah.
- Yeah.
I was too afraid to ask her.
But my dad told me that you got to take chances or you miss out.
She was going with this guy from the baseball team.
And two weeks later, she asked me to go to a concert on the pier.
Sounds like your dad's a pretty cool guy.
He'd want the surgery.
- Then that's what we'll do.
- But my mom's gonna freak out.
It's your decision.
And I'll back you up.
You will? Sure thing.
Abdominal pain and near-syncope from hypotension.
He was here this morning.
Dr.
Pratt's patient.
Marina, find Pratt, and grab the ultrasound.
I thought it was a bruise.
- When did you get dizzy? - A few hours ago.
- Why didn't you come back? - Doctor said it wasn't serious.
Pressure's only 80 palp.
Trendelenburg, liter of saline, CBC, type and cross for force.
- Sir, where does it hurt? - Sonosite.
- What's up? - You sent home an unstable patient.
Damn, he lacerated a spleen.
Call Surgery.
Dr.
Pratt - I signed off on this.
- He was rolling with his nephew.
- You didn't mention belly pain.
- He didn't have any.
Did you even check a crit? - It would have been normal.
- His shoulder was hurting? - There was no point- - Blood irritates the diaphragm and gives you pain.
You missed it.
You forgot about Kerr's sign.
No, we missed it because you were too tired to see the patient.
- So, what did the principal say? - You're busy, we'll talk at home.
Why can't you tell me now? I don't want to talk about it over the phone.
- All right.
Okay, when I get home.
- Okay.
Arlo's consenting for surgery.
It's taken care of.
- You called it in? - Vascular's ready for him.
- Okay.
- I'll start the pre-op list.
I have to go pump before I explode.
Carolyn made it to the O.
R.
- Who? - Appendix girl.
Great.
You were busy today.
Declared a 15-year-old a mature minor - overrode parental consent on an appy.
- And took a kid from an abusive parent.
It's the triple crown of social work.
- When are you off? - Another hour.
Wanna get some dinner? Thanks, I have plans already.
- Not with anyone, if you're wondering.
- Not a problem.
You can come along, but I have to warn you, it's pretty physical.
- Oh, yeah? - Dr.
Carter Neuro's admitting my CVA in 4.
Thanks.
Abby, that's two to sign out.
- It's 7:05.
- I've been here five minutes too long.
Stroke patient, tele-admit and the cop Dubenko's sending to surgery.
- You've still got three on the board.
- I know.
They're all discharged.
- Hey, Ray, you forgot something.
- Abby, what? Your flu shot.
You're welcome.
Pressure's good, 122/76.
You feeling better, Mr.
Sakabu? Yes.
Thank you very much.
Okay if the nephew comes back? Yeah, sure.
We might be able to get more history.
- Are you on any medication? - No.
Any allergies? How could this happen? Well, it's a very unusual presentation.
You need enough force to break a rib that cuts into the spleen.
My nephew's a pretty tough kid.
He'd have to be to cause something like this.
My uncle gonna be okay? Hey, have you seen Susan? - She signed out.
- Oh, great.
- No, just page her again for me, please.
- What do you need? Can't believe Ray dumped this on me.
I'm supposed to take care of this cop's kid.
What's going on? - He signed out to you? Why'd he do that? - I was in his exit path to the door.
Dr.
Lockhart, this is Keith Trager.
- Daughter has appendicitis.
- Right.
Hi.
We spoke on the phone- - Where is she? - Her condition worsened.
- We had to take her.
- You were to transfer her.
- I know.
There wasn't time for that, sir.
- Take me to her now.
- One second.
- There's a problem with Arlo? Ray said it was all settled, but he's very upset.
- I know the case.
Want me to take it? - Can you? - Thank you.
Yeah, I'm coming.
- Excuse me.
Arlo? - Where's Ray? - He had to leave.
- When's he coming back? - He left for the night.
- He left? - I'm sure I can help.
He promised that he would help me talk to my mom.
I can do that.
Bowel grasper and stapler.
Pressure is 122/76.
Prep the extraction bag.
Peanut swab with Betadine for the stump.
- Oh, my God.
- Got it.
They're doing it through the scope, which means a smaller scar, shorter recovery.
So she's okay? It's not a complicated procedure.
Everything's fine, Keith.
Who is that operating? That's the chief of surgery.
- He's the best.
- Up on the cautery.
Dr.
Dubenko, the parents are here.
Oh, she's doing great.
We caught it before it burst.
- What's that? - Pulse ox probe slipped off.
Everything's fine.
You know, I brought my dad here for back surgery.
He never left.
Well, that's not gonna happen.
He died on the table.
Some junior doc botched the job.
I'm sorry to hear that.
I hate this hospital.
- Where's the other doc? - He isn't available- He took off.
So, Arlo, have you decided on which treatment you would like us to pursue? I want him to have the operation.
It's too risky, honey.
- It's what he'd want.
- Isn't it better to have him around sick - than to lose him? - Does he have to be here? - He's your father's best friend.
- I feel bad too.
I don't know why we're still talking.
Ray said it's my decision.
- What, you don't want my opinion? - No.
Tell her.
Legally, Arlo has the right- - He's too young to handle it.
- I'm not! - Don't talk to your mother like that! - Maybe if I reviewed the risks- No.
I understood it the first time.
Dad would wanna go for it.
I know that's how he always talked.
He liked to take chances.
That's what probably got him shot.
We're not gonna make any progress- I want him to have the operation.
If you approve this surgery how are you going to feel if he dies? - He's not gonna die.
- He could die.
Are you ready to live with that? I'm trying to protect you.
I know you think you're all grown up.
Are you ready to accept responsibility for your father's death? - Hello.
- Hey, Marie.
- It's Dr.
Chen.
How's he doing? - Well.
Okay.
Well, go ahead and push another two of Ativan.
Yeah.
Listen, any chance you can work late tonight? - Probably.
- Yeah, we're getting slammed.
And I don't think I'm gonna be able to get home till 2 a.
m.
Well, all right.
That would be great.
Thank you.
- Yeah, thank you so much.
- No problem.
Okay, bye.
- Hey.
- Hey.
- Sorry about Uncle Sumo's spleen.
- Yeah, well, we caught it in time.
Who knew his nephew was the size of a Hummer? Didn't mean to snap at you earlier.
No.
No.
I was the Attending.
I should have seen him.
So who's the potassium for? My dad.
- You gotta go easy on that stuff.
- Of course.
Forty a day for his diarrhea.
This should last me a few weeks.
- Hey.
- Hey.
- It's a big wall.
- Yep, I'm in training.
For what? Taking down PCPers? Triathlon.
- Hey, Wendy.
- Hey, Brett.
- This is John.
- Hi.
- First time? - No.
I did this once when I was a kid.
All right, thanks.
Take good care of him.
See you at the top.
Let's go to the beginner wall.
Is this how this thing is supposed to go? Sure, if you want to hang upside-down by your balls.
What's going on? The family have decided not to have the surgery.
The family? We've been together for three years.
- Don't I get a say in any of this? - Hello, this is Dr.
Rasgotra in the ER.
We are canceling the carotid surgery on patient Escobar.
Yes, I can hold.
- Hey, John.
- Hi.
So you two are dating? No, we're just friends.
Well, that's how it starts.
We went out for a year or two.
- Oh, yeah? Great.
- Thought we might even get married.
One day she tells me she wants to start seeing other people.
Why do they say that? You know, if you want to break up, you should just do it.
Is the rope supposed to be this loose? - Better? - Yeah, thanks.
- Hey.
- Hey.
- Did you get back to sleep? - No, not really.
Sorry.
Okay, where's Alex? Up in his room.
Want a beer? Do I need one? He brought this to school.
That's it? That's such crap.
Where'd he get it? You subscribe? - I like the articles.
- Oh, please.
So listen, anyway a friend of his had the magazine in the bathroom in the stall at school You know, the kid was Are you kidding me? Oh, my God.
Do you think that Alex is? I thought it would be at least a year or two until I had to deal with this.
Well, I guess I need to talk to him.
Yep.
So I'm here twice a week, anytime you want to join me.
- That'd be great.
- Brett could give you another lesson.
He's quite a teacher.
- See you next time.
- Bye.
I got an outfit just like that at home, but I didn't want to show off.
So are you hungry? No.
No, not really.
You got to eat dinner.
I'm just gonna grab something at home.
Come on, you've been a good sport.
My treat.
- Okay.
- Okay.
So, what are you in the mood for? I don't know.
Indian? No? Chinese? - Sushi? - Had it for lunch.
What about deep-dish pizza? I could go for pizza.
- I know a good pizza place on Monroe.
- Yeah, too many carbs.
Right.
Hey, I have an idea.
Okay, close your eyes, pick a page and point.
That's where we go.
- What if it's a doughnut shop? - Are you in this or not? - There? - Not there.
- There? - Right there.
- And the winner is - Uncle Vito's Mongolian Barbecue.
What's that? It's Italian.
It's Asian.
It's maybe Southern.
- All right, close your eyes and do it again.
- No, no.
You made the rules.
Mongolian barbecue? But it's in Downers Grove.
We don't want to go that far.
Are you in this or not? All right.
I hope they have tofu.
Officer McWayne.
They're moving him up to the ICU.
Okay.
Thank you.
Arlo! - Arlo! - It's okay.
- Where is he going? - Probably just getting a snack.
- He seems really upset.
- It'll pass.
Well, maybe I should go talk to him.
No, he's too emotional.
You can't talk to him when he gets this way.
I hope he doesn't feel like he was forced into this.
You don't want to think about it some more - discuss it after he calms down? - It won't help.
He's not being realistic.
That's why we had to make the decision.
He's too confused.
I heard him express a strong opinion more than once.
You and I both know it was the wrong choice.
He was hoping for something that's never going to happen.
He loves his father, but I'm the one who has to set the limits.
Anyway, thanks for everything you did.
I'm not sure I helped.
Well, when you let us work it out together you did the right thing.
Yeah.
Hey.
Can I come in? Didn't know you liked The Goon.
They didn't have Hellboy.
So look about today at school Mr.
Elmore is such a loser.
Yeah.
What happened with that kid in the bathroom all right, I just wanted to make sure you didn't have any questions.
About what? You know, about what he was doing.
Spanking the monkey? Yeah.
What about it? Well, it's- It's normal but, you know, it's not the kind of thing you should do at school.
You think I'm stupid? No.
At your age, it can be a confusing time.
If you ever want to, you can always talk to me about these things.
Okay.
Okay.
Good night.
- I heard there was an after-hours club.
- Cool.
- Have you seen Kristy? - Yeah, she's pulling around the side.
Hey, you're late.
- We went on at 9.
- How could you just leave like that? I'll meet you in the car.
- I'm sorry, what? - You abandoned that kid.
I signed out my patients when my shift was ov- - You should have signed out to me.
- You were busy.
You thought it was easy.
It got complicated.
How did it get complicated? The kid wanted his dad to have surgery.
- How long you discuss it, two minutes? - He understood.
His dad's not having the surgery.
- Why not? - Because you weren't there.
His mom gave him a hard time about it, and he gave in.
- Did you at least talk to him? - Yes.
Well, all he needed was a little hand-holding, Neela.
- I mean, God, is that so hard for you? - Don't turn it around, make it about me.
- You promised to help.
- No, I told him- You know, it's not my job or anyone else's to keep your promises.
- My shift was over.
- He was counting on you.
- I had a gig.
- Screw your gig! Medicine isn't a day job! This coming from a girl who was selling hot dogs three months ago.
I was off at 7.
Abby was off at 7.
But we were still there taking care of our patients.
We'd never leave the hospital if we had to stick around to tuck in every patient! I'm not talking about every patient, I'm talking about one kid.
It was the most important decision of his life.
He trusted you, and you left.
R.
Previously on E.
R.
Look, Luka I'm glad we're friends.
But I've got a dad.
- Fingernails, tattoo, the hair? - It's the whole package.
Okay.
I'll talk to my band mates and see if I can't pull it back a little.
- You off? - Yeah.
If you wait for a second I'll - walk out with you.
- Okay.
Damn it! Son of a bitch! - He should be in a nursing home.
- I'd never do that to him.
You can stay here for tonight.
Plenty of room.
Actually, you can stay as long as you like.
E.
R.
11x08 "SHOT IN THE DARK" - Hey.
- Hey.
How was your night? - The usual.
- Anything good? Guy got his arm caught in a sausage-making machine.
Nice.
I'm not on till 9.
I can drop Alex off at school, but can you pick him up at 3? Sure, after I get some sleep.
Morning.
Mom, I need 10 bucks for the class field trip to Millennium Park.
- Okay.
- They've got a giant silver sculpture shaped like a bean.
If I don't get the money in I have to stay behind to do homework with the fifth graders.
Okay, okay.
What? You've never seen a kid pee before? This is gonna bounce.
- That's a lot of zeroes.
- Tuition was expensive.
No wonder you're sleeping on Abby's sofa.
You know you can defer paying your loans until after residency? Not this one.
This is for my father.
- What? Your dad's leaning on you? - It's for my brother's university tuition.
My parents put me through school, now it's my turn- They can't wait until you're making real money? Is there something you need, Ray? How would you like to work Christmas for me? I'm already working New Year's.
Look, you do Christmas and I'll take your New Year's Eve.
You'd work New Year's Eve? It's important to have us all together on Christmas.
I'll take Ramadan for you.
I'm not Muslim, I'm Sikh.
Great.
I'll cover whenever you wanna take a Sikh day.
- This is unbelievable.
- What? Weaver's got a boyfriend? Only 39 percent of the staff has had a flu shot this year.
I don't want massive absenteeism in January.
- I had mine.
- I'll get one today.
- How about you, Ray? - Tomorrow.
My band's to play at Delilah's tonight.
Can't have a sore arm.
Sore arm? How about 100 percent compliance by next week? You've had lame excuses for the past two months.
- What are you talking about? - First, you had a cold.
- Oh, yeah, then you were sleep-deprived.
- Police officer shot.
ETA, two minutes.
- Where's the wound? - I couldn't understand.
- All right, clear Trauma 1.
- Neela, Ray, Chuny, you're with me.
Mary, get some extra security down here to handle the press.
- Do me a favor, give me a flu shot.
- What? Yeah.
Get me when I'm not expecting it.
Just stick me quick, I got a thing about needles.
- Paramedics probably have two IVs.
- You can go femoral if we need it.
Eddie Escobar, caught one in the neck.
- Lost lots of blood.
- This the throw-and-go? - We were 10 blocks away.
- You're at County General.
- Should've called paramedics.
- We'd still be waiting.
- C-collar.
- Board's ready.
One, two, three.
We're gonna give oxygen through your nose.
- Thank you.
- Pulse is thready.
- Take my keys, Gary.
- It's okay, Eddie.
- Try not to move.
- Someone needs to feed my dogs.
- Have intubation tray ready.
- There's a filing cabinet in the bedroom with all my papers.
Forget about that.
It's gonna be okay.
Tell him.
Trauma panel, type and cross, six units, call X-ray, get a portable neck-and-chest.
I threw up all over Amy's collage.
It was so embarrassing.
Oh, that's okay.
We see, like, a hundred puking kids a day.
Really? - Mom's here.
This is Dr.
Lockhart.
- Hi.
- School nurse called my office.
- They sent her in for vomiting and fever.
- She okay? - Well, it seems like it's just a flu.
Are you okay, honey? - I should take her to our doctor.
- She's here now- - I see how busy you are.
- It's not that.
It's- Do you want to go see Dr.
Ben? It's probably just the stomach flu.
Let us run tests.
We'll give her fluid.
She'll be good as new.
- How long is that gonna take? - About an hour.
- Can we move her to a real room? - I'll work on it.
Sam, this girl needs a line and Tigan.
You have to ask Malik.
Excuse me! Excuse me.
- Sub-Q air.
Otherwise okay.
- Come on.
Excuse me.
Two units O-neg.
Looks like the bullet missed your spinal cord and trachea.
- That's good, buddy.
- Excuse me.
- That's good news.
- Sats aren't so hot.
- He needs plastic.
- Yeah.
I'm all over it.
We're gonna stick a tube down your throat to give you more oxygen.
Whatever you say, doc.
- You'll go to sleep first.
- Twenty of etomidate, 100 of sux? - Everyone else okay? - We're all good, Eddie.
- You get the perp? - Couple of double taps to the chest.
- He went down.
- Go for it, Ray.
- What happened? - Convenience store holdup.
Chased the guy into an apartment building, called for backup.
Scumbag starts shooting out the window.
- All right.
There's too much blood.
- Pulse ox only 72.
Okay.
Pull out and bag him up.
You want me to do it? No, no, no.
I got it.
Give me a straight blade.
- You cut yourself? - No, that's- It's nothing.
- We should take care of it.
- No, really, it's okay.
One more shot, Ray.
- Ray? - Just give me some cricoid pressure.
I could get this.
- I still can't see the cords.
- Okay, that's it.
- You want me to try? - How about you try? - Crike tray.
- Yeah? Yeah.
Betadine, 11 blade.
No.
Sam, third drawer of the crash cart.
Get the trach light.
- The what? - Are you going fiberoptic? - Not exactly.
- Got it.
- Where's the scope? - It's a blind procedure.
- Who's in charge of this ER? - That would be me.
You can stay here, sir, but you have to be quiet.
Okay.
Bend the tip to 90 degrees.
Turn the lights off.
Passing the midline, lift the jaw forward.
Sats are dropping.
Shouldn't we prep the neck? Through the cords, you'll see a pre-tracheal glow.
- He needs a crike.
- That's the glow.
Won't see it if you're in the esophagus.
Okay, that's it.
Bag him.
Turn the lights on.
- Very slick.
- How about a subclavian? Okay, good breath sounds.
Number six gloves, Dr.
Barnett? Seven-and-a-half.
Sterile drape and a finer needle, please.
- I have Mallory.
- This is Eddie's fiancée.
- Okay.
- Oh, my God, Eddie.
I'm Dr.
Lewis.
He's doing okay.
- He was shot? - Once, in the neck.
He's sedated with medication, but you can sit with him, hold his hand.
I was playing around with my nephew.
We were wrestling.
Looks like he kicked your butt.
Is the rib sore? - Right there, yeah.
- Okay, Mr.
Sakabu.
I think it's nothing but a bruise.
What about my shoulder? - Any pain when I press? - It's more on the inside.
It's probably just a strain.
I'll have the nurse bring your discharge instructions.
Hey, hey.
I didn't know you were in today.
The stupid alarm didn't go off.
- Rough night, huh? - Yeah.
You okay? Okay.
I got a quick one for you, ready for discharge.
Give me a couple of minutes, okay? Good news.
Labs are fine, white count's not elevated.
- So we can go? - Mom.
Mom.
Are you all right, honey? - What's wrong? - It hurts now.
- Where does it hurt? - Right here.
Here? Does it hurt more when I take my hand away? I'm gonna get you some medicine for that pain, okay? I need to run some more tests.
Start with four of MS.
Thanks.
I thought she'd be better by now.
What starts out looking like flu ends up to be something else.
- Like what? - Appendicitis.
You said it wasn't serious.
It may not be.
I'd like a surgeon to take- - You think she needs an operation? - It's a possibility.
Oh, God.
No.
No, she's not having surgery.
Not here.
- It's a very simple operation.
- I need to talk to my husband.
There's time.
I need to do another blood test- You can't do surgery without my permission, right? Right.
One step at a time, okay? You call your husband.
I'll get things started.
- Hey, Ray.
Is Carter in there? - Just Lewis.
- How's the cop? - Stable.
What's in your hand? - A chart.
- Okay.
The other hand? A pen.
I didn't say I'd do it.
- Hey, anybody seen Dr.
Chen? - Sorry.
Do you have any plans for New Year's Eve? - You're not really my type.
- Funny.
My band's got a party gig.
- Can you take the p.
m.
for me? - On New Year's Eve? Well, look at it this way, you won't have to go to a square dance by yourself.
Or with a date, or whatever.
You give my med-student lecture for me in January.
- Deal.
- Suspect's been wounded and apprehended.
Do we have ETA? No, I'm sorry.
They haven't called that in yet.
- We'll be with the family.
- Okay.
Ten-year-old girl.
Fever, vomiting, right lower quadrant tenderness.
- Rule out appy.
- Yeah.
CT or ultrasound? It depends.
What the hell was that? What? Jing-Mei? Oh, sorry.
Coffee was brewing.
You okay to work? Yeah, sure.
What do you got? Thirty-five-year-old, strain and sprain - chest and shoulder contusion.
- Okay.
- You don't wanna see the patient? - No.
I trust you.
How's your dad doing? Okay.
I mean, I've got a nurse for him And then from 11 to 7, it's just me.
- So you're not getting much sleep.
- Hey, Dr.
Chen.
Carter's got a baby in status.
Needs you for that suspect in that shooting.
- How soon? - Right now.
Gunshots to the chest and abdomen.
- Vitals? - No pulse in the field.
- Son of a bitch.
- How long down? Cops had to secure the building.
- How long did that take? - Made us wait 45 minutes.
It takes 20 minutes to bleed out.
If there'd been a shooter, she'd be full of holes.
- Two of O-neg on the infuser.
- On my count- - Hold on.
He's cuffed.
- Who's got the key? - Not me.
You got the keys? - I'll check with Hogan.
- Quickly.
- Start on the paramedic gurney.
Betadine, 32 French.
Thoracotomy's all yours, Neela.
- You gonna assist? - You'll be fine.
- Sterile gloves and 10 blade.
- First unit's up.
I need to lift up his arms.
Where's the key? - We're working on it.
- Get the bolt cutters.
- Take it easy.
- I got it.
- Can the officers wait outside? - Suspect's in custody, uncuffed.
- We're waiting here.
- Don't think he's gonna jump off the bed.
Hook up the Thora-Seal.
Give her room to work.
Think he's got a chance? Why do you think they're letting me crack his chest? - That thing's got to wait outside.
- That thing is a service animal.
A service animal with fleas.
Actually, fleas have a natural aversion to minis.
- Abby, Dilantin level's back- - Carter, this is Mrs.
Gellin - and her guide horse, Ruby.
- Who should be outside.
We let Seeing Eye dogs in here.
Our floors are gonna be covered with crap.
- She's housebroken.
- What if she spooks? Oh, we've been on the L, airplanes, elevators - She can stay.
- Thank you.
See you later, Ruby.
Dr.
Carter, Officer Escobar's son's here.
Okay.
We're- We're still working on his dad.
The kid's anxious to see him.
- Let me- Let me go check for you.
- Thanks.
- No, too close to the skull.
- Can you stop the bleeding? - Direct pressure.
- Got it.
Call Angio.
Maybe we can balloon the proximal carotid.
They just picked up his son at school.
- Arlo's here? - How old is your son? Fifteen.
I'm not his mother.
Arlo's from Eddie's first marriage.
- Fine.
Throw down a fresh drape.
- I'll be next door.
- CVC's in.
Need a repeat chest.
- Hey, Arlo.
It's not as bad as it looks.
- It's okay.
You can come on up here.
- What is she doing here? I want her out.
Excuse me, ma'am- - Who let her in? - This the ex-wife? - You shouldn't be here.
- Mom.
Mom.
- Get out! - Can you just shut up? Okay, everybody shut up.
Officer, you and Mallory need to step outside.
- I don't wanna leave him.
- Everyone gets to see him - just one at a time.
- Come on.
We're gonna start x-rays on your father.
You can say hello quickly.
- Dad, it's Arlo.
I'm here.
- He can't talk with the tube in his mouth.
You're gonna be all right.
- Ray, take them to the family room.
- Me? - You're tough, Dad.
- All right, honey, that's enough.
Dr.
Barnett will answer any questions.
Okay.
Right this way, guys.
- Sam, check a second HemoCue.
- I think it's next door.
Thanks.
- You got a rhythm? - Unit five and six are up.
Hold compressions.
- Asystole.
- How's his volume? - Heart's filling well.
- Too many holes.
We could try high-dose epi.
Penetrating trauma with no pulse in the field.
Okay.
- He's dead? - Yeah.
You just saved the taxpayers a million bucks in trial fees and prison costs.
- What happened to your wrist? - Oh, I don't know.
Neela, you wanna help Officer McWayne out here? - I was gonna find family for this patient.
- Get him started in the suture room.
Sorry about the misunderstanding.
Some people are freaked out by little animals.
I'm gonna clean your cut out.
I have a cousin who gets nervous around Chihuahuas.
- Is she wearing sneakers? - It keeps her from slipping on the floor.
My husband wants her transferred to Mercy.
- Surgery's on their way to check her out.
- We wanna move her.
You're gonna have to find a surgeon at Mercy to accept her before I can okay a transfer.
Hey, back off, Ruby.
- Doctor, can you come to the phone? - Yes.
One minute.
I'll be right back.
Re-prep the wound and tie up the horse.
It's my husband.
He's driving back from Detroit.
- Hi.
This is Dr.
Lockhart.
- Are you the doctor? - Yes, I am.
- You better be damn sure - you know what you're doing.
- Mr.
Trager- - If you do anything- - Mr.
Trager, I understand.
We will.
Yes, your wife is working on that right now.
We would never do that, sir.
Got paged about a patient transfer? Wendall Meade, Social Services.
Thank God you're here.
Why don't you get here soon, and we won't make any decisions with- Nice talking to you too.
Little pin prick and some burning.
Sorry.
Must be a pain having to waste all that time trying to save a scumbag's life.
- He jacked a mini-mart, doc.
- Looks like a 14-year-old.
Feels like a foreign body.
Something hard.
Is it possible you were shot? I don't think so.
I remember I scraped my wrist when I fell.
- How about there? - That's a loop of bowel.
I left messages for three surgeons at Mercy.
- They'll call back.
- How long can we wait? Eight to 10 hours.
- I can't find the appendix.
- What does that mean? Usually if it's enlarged, it's easy to find.
- She may not have appendicitis? - It's not a perfect test.
She could still have the disease even if the ultrasound is normal.
Can't you people give me a straight answer? I would say, based on her fever and tenderness, that it is appendicitis.
She said it was stomach flu, then changed her mind.
Now you can't find her appendix? Transfer center from Mercy wants to talk to the Attending.
- Finally.
- Hang a gram of cefotetan.
Do you think I need an operation? - Do I need it soon? - Yep.
Can I have it here? Well, you could but your parents want you to have it at a different hospital.
- Won't that take a while? - Not too long.
It'll be okay.
Why can't I decide? Because when you're a kid, your parents get to decide what's best.
The only way to stop the bleeding is by blowing up a balloon in his artery.
This x-ray is gonna guide us to the right spot.
- How does he get blood to his brain? - Dr.
Lewis.
- Hold on.
- That's a good question, Arlo.
Two carotid arteries supply the brain.
Right and left, okay? If one gets blocked, Mother Nature has a backup plan.
It is called the Circle of Willis.
It's a detour.
But it allows the blood from the right to get over to the left-hand side.
- I understand.
- So he can recover.
Well, priority number one is to stop the bleeding.
- If you're not wearing lead, leave.
- I'll come get you when we're done.
- Thanks, Dr.
Barnett.
- Ray's fine.
Okay, Ray.
- Sam, Dr.
Kovac called.
- Did you take a message? Sounds like your kid got suspended from school again.
- I may need to leave.
- In a minute.
- Dr.
Lewis.
- Have them step outside.
I removed a foreign body from Officer McWayne's arm.
- What's that? - Feels like a plastic BB.
Could be what shot your patient.
- That couldn't sever a carotid artery.
- You sure? Officer Escobar was shot with this metal slug - from a sub-Q, right upper a trapezius.
- Looks like a 9 mm.
- Is that what the suspect used? - I don't think so.
Nine-millimeter semi-automatic, standard issue.
That's what we carry.
I can pick him up.
It's not a problem.
Stay at work.
- Well, what is it about? - No.
The school didn't tell me anything.
- They didn't tell you? What did he do? - They just said to come in for a meeting.
- Well, is he okay? - Yeah, yeah.
He's fine.
All right.
Call me as soon as you get back.
- I will.
- Okay, thanks.
- Tetanus shot for Officer McWayne.
- Being interviewed about friendly-fire.
- Is it for sure now? - They found a pellet gun at the scene.
- So he didn't shoot the cop then.
- Guess not.
Arlo, you should be in the family room.
Is that the guy who shot my dad? He was the suspect they were pursuing.
- Can I go in there? - Probably not a good idea.
- I wanna see him.
- Arlo.
- He's a kid.
- You don't have to do this- - Was he on drugs? - I can't say.
- Did he have a police record? - I don't know.
Why would he do that? Why would he shoot my dad? Arlo, we're not exactly sure who shot your dad.
He may have been accidentally shot by a police officer.
- What? But I thought- - This guy was only carrying a BB gun.
They won't know for sure until the ballistics tests are completed.
Oh, man.
One of his own guys.
Arlo, can we talk to you? - Which one of you did it? - We don't know anything yet.
Why don't we go and sit down? - We're sorry.
- It's not your fault.
Comes with the job.
There, balloon is up and the vessel is occluded.
- Can we have his family in? - Not just yet.
- Entrance wound is dry as a bone.
- Nice.
He's not waking up.
He's still comatose with a flaccid paralysis and an up-going toe.
So much for collateral flow.
- But you can repair the carotid? - Oh, it'd likely do more harm than good.
It's not a procedure that I'm comfortable with.
- But if the wife consents- - His fiancée.
- Not her call then.
- We have an ex-wife.
- Is there a blood relative? - Yeah, a son, but he's 15.
- Could he be a mature minor? - A what? It's when a kid's mature enough to make medical decisions.
- Could be.
- Okay, I'll talk to him.
Get Wendall in on this.
And find me if you need me.
- Okay.
- Dr.
Dubenko, I need you right now.
Keep his crit above 30.
PO-2, 90.
Ten-year-old, appy, systolic's 60.
- Is she septic? - Antibiotics are on board.
- We're running in a liter.
- Who saw her from Surgery? - The family wants her transferred.
- That isn't happening.
Dr.
Hong at Mercy accepted her.
- Pressure's up to 70 with 500.
- They're sending an ambulance.
I'm sorry, ma'am.
Your daughter is very sick.
She needs surgery now.
Do we have consent? - No.
She said we could wait.
- In most cases, we could.
This is unusual.
The infection spread to her blood quickly.
Mrs.
Trager, we need consent for surgery.
- My husband will be here.
I need to wait.
- We don't have time.
It's life-threatening.
- Okay.
We'll double-doctor it.
- What? What? Two physicians' signatures can override your consent.
Sign it.
Sign it.
Let's go.
- This is not what we agreed on.
- I'm sorry.
- You done this before? - No one gets in trouble - acting for the patient.
- Tell that to Dr.
Corday.
- Treating your dad- - Sorry, I was tied up.
Everyone, this is Wendall Meade.
- Hi, Arlo.
- Can he stay? If it's okay with Arlo.
Yeah? Okay, so the two treatment options: We can use a catheter to plug up the artery with coils.
Like with a balloon? Yeah.
That would give him a 15 percent chance of getting better 85 percent chance of still staying in a coma.
Or we could do surgery to reconnect the artery.
If we do that that would give him a 30 percent chance of improving.
- That's a little better.
- Yeah, well, it's risky.
Usually with surgery, half the time the patient deteriorates or dies.
The surgery sounds too risky.
Do you understand the choices, Arlo? They both kind of suck.
- Can you explain them back to me? - What? - I need to make sure he understands.
- I'll make sure he does.
Arlo? Well, if we play it safe there's a small chance he gets better.
If we do the surgery there's a bigger chance he'll improve, but an even bigger risk he'll get sicker.
That's right.
It's your call.
What are you talking about? We've decided Arlo's mature.
He can make the decision.
- By himself? He can't handle this.
- Yes, I can.
- No, you can't.
You're 15.
- He's my dad.
In cases like this, the decision has to be made by a blood relative.
It's the law.
How can this be right? Between you and me, it's not the end of the world.
The board has a zero-tolerance approach to what they consider pornographic.
What? He brought this to school.
He was showing it to the other kids.
That may not be appropriate.
They have lots of cool electronic gadgets in here.
I don't think they were looking at the gadgets.
- Is that your name on the mailing label? - Yeah.
And you're Alex's stepfather? Not exactly.
I see.
But you take an active role in the child-rearing? Yeah, I pick him up from school.
You know, we do sports.
- I took him fishing.
- That's great.
You know, Alex and his mom we've been all living together, and it's really going well.
And how long has that been the arrangement? About a week.
Ray, do you have a minute? Hey.
Hot chocolate? It's my treat.
I'm really sorry about my mom.
- She's just looking out for you, okay? - By freaking out? My dad's lucky she won't even talk to him anymore.
Are you okay with what we talked about? About your dad? Last year for the ninth-grade prom - there was this girl Sarah.
- Yeah.
I was too afraid to ask her.
But my dad told me that you got to take chances or you miss out.
She was going with this guy from the baseball team.
And two weeks later, she asked me to go to a concert on the pier.
Sounds like your dad's a pretty cool guy.
He'd want the surgery.
- Then that's what we'll do.
- But my mom's gonna freak out.
It's your decision.
And I'll back you up.
You will? Sure thing.
Abdominal pain and near-syncope from hypotension.
He was here this morning.
Dr.
Pratt's patient.
Marina, find Pratt, and grab the ultrasound.
I thought it was a bruise.
- When did you get dizzy? - A few hours ago.
- Why didn't you come back? - Doctor said it wasn't serious.
Pressure's only 80 palp.
Trendelenburg, liter of saline, CBC, type and cross for force.
- Sir, where does it hurt? - Sonosite.
- What's up? - You sent home an unstable patient.
Damn, he lacerated a spleen.
Call Surgery.
Dr.
Pratt - I signed off on this.
- He was rolling with his nephew.
- You didn't mention belly pain.
- He didn't have any.
Did you even check a crit? - It would have been normal.
- His shoulder was hurting? - There was no point- - Blood irritates the diaphragm and gives you pain.
You missed it.
You forgot about Kerr's sign.
No, we missed it because you were too tired to see the patient.
- So, what did the principal say? - You're busy, we'll talk at home.
Why can't you tell me now? I don't want to talk about it over the phone.
- All right.
Okay, when I get home.
- Okay.
Arlo's consenting for surgery.
It's taken care of.
- You called it in? - Vascular's ready for him.
- Okay.
- I'll start the pre-op list.
I have to go pump before I explode.
Carolyn made it to the O.
R.
- Who? - Appendix girl.
Great.
You were busy today.
Declared a 15-year-old a mature minor - overrode parental consent on an appy.
- And took a kid from an abusive parent.
It's the triple crown of social work.
- When are you off? - Another hour.
Wanna get some dinner? Thanks, I have plans already.
- Not with anyone, if you're wondering.
- Not a problem.
You can come along, but I have to warn you, it's pretty physical.
- Oh, yeah? - Dr.
Carter Neuro's admitting my CVA in 4.
Thanks.
Abby, that's two to sign out.
- It's 7:05.
- I've been here five minutes too long.
Stroke patient, tele-admit and the cop Dubenko's sending to surgery.
- You've still got three on the board.
- I know.
They're all discharged.
- Hey, Ray, you forgot something.
- Abby, what? Your flu shot.
You're welcome.
Pressure's good, 122/76.
You feeling better, Mr.
Sakabu? Yes.
Thank you very much.
Okay if the nephew comes back? Yeah, sure.
We might be able to get more history.
- Are you on any medication? - No.
Any allergies? How could this happen? Well, it's a very unusual presentation.
You need enough force to break a rib that cuts into the spleen.
My nephew's a pretty tough kid.
He'd have to be to cause something like this.
My uncle gonna be okay? Hey, have you seen Susan? - She signed out.
- Oh, great.
- No, just page her again for me, please.
- What do you need? Can't believe Ray dumped this on me.
I'm supposed to take care of this cop's kid.
What's going on? - He signed out to you? Why'd he do that? - I was in his exit path to the door.
Dr.
Lockhart, this is Keith Trager.
- Daughter has appendicitis.
- Right.
Hi.
We spoke on the phone- - Where is she? - Her condition worsened.
- We had to take her.
- You were to transfer her.
- I know.
There wasn't time for that, sir.
- Take me to her now.
- One second.
- There's a problem with Arlo? Ray said it was all settled, but he's very upset.
- I know the case.
Want me to take it? - Can you? - Thank you.
Yeah, I'm coming.
- Excuse me.
Arlo? - Where's Ray? - He had to leave.
- When's he coming back? - He left for the night.
- He left? - I'm sure I can help.
He promised that he would help me talk to my mom.
I can do that.
Bowel grasper and stapler.
Pressure is 122/76.
Prep the extraction bag.
Peanut swab with Betadine for the stump.
- Oh, my God.
- Got it.
They're doing it through the scope, which means a smaller scar, shorter recovery.
So she's okay? It's not a complicated procedure.
Everything's fine, Keith.
Who is that operating? That's the chief of surgery.
- He's the best.
- Up on the cautery.
Dr.
Dubenko, the parents are here.
Oh, she's doing great.
We caught it before it burst.
- What's that? - Pulse ox probe slipped off.
Everything's fine.
You know, I brought my dad here for back surgery.
He never left.
Well, that's not gonna happen.
He died on the table.
Some junior doc botched the job.
I'm sorry to hear that.
I hate this hospital.
- Where's the other doc? - He isn't available- He took off.
So, Arlo, have you decided on which treatment you would like us to pursue? I want him to have the operation.
It's too risky, honey.
- It's what he'd want.
- Isn't it better to have him around sick - than to lose him? - Does he have to be here? - He's your father's best friend.
- I feel bad too.
I don't know why we're still talking.
Ray said it's my decision.
- What, you don't want my opinion? - No.
Tell her.
Legally, Arlo has the right- - He's too young to handle it.
- I'm not! - Don't talk to your mother like that! - Maybe if I reviewed the risks- No.
I understood it the first time.
Dad would wanna go for it.
I know that's how he always talked.
He liked to take chances.
That's what probably got him shot.
We're not gonna make any progress- I want him to have the operation.
If you approve this surgery how are you going to feel if he dies? - He's not gonna die.
- He could die.
Are you ready to live with that? I'm trying to protect you.
I know you think you're all grown up.
Are you ready to accept responsibility for your father's death? - Hello.
- Hey, Marie.
- It's Dr.
Chen.
How's he doing? - Well.
Okay.
Well, go ahead and push another two of Ativan.
Yeah.
Listen, any chance you can work late tonight? - Probably.
- Yeah, we're getting slammed.
And I don't think I'm gonna be able to get home till 2 a.
m.
Well, all right.
That would be great.
Thank you.
- Yeah, thank you so much.
- No problem.
Okay, bye.
- Hey.
- Hey.
- Sorry about Uncle Sumo's spleen.
- Yeah, well, we caught it in time.
Who knew his nephew was the size of a Hummer? Didn't mean to snap at you earlier.
No.
No.
I was the Attending.
I should have seen him.
So who's the potassium for? My dad.
- You gotta go easy on that stuff.
- Of course.
Forty a day for his diarrhea.
This should last me a few weeks.
- Hey.
- Hey.
- It's a big wall.
- Yep, I'm in training.
For what? Taking down PCPers? Triathlon.
- Hey, Wendy.
- Hey, Brett.
- This is John.
- Hi.
- First time? - No.
I did this once when I was a kid.
All right, thanks.
Take good care of him.
See you at the top.
Let's go to the beginner wall.
Is this how this thing is supposed to go? Sure, if you want to hang upside-down by your balls.
What's going on? The family have decided not to have the surgery.
The family? We've been together for three years.
- Don't I get a say in any of this? - Hello, this is Dr.
Rasgotra in the ER.
We are canceling the carotid surgery on patient Escobar.
Yes, I can hold.
- Hey, John.
- Hi.
So you two are dating? No, we're just friends.
Well, that's how it starts.
We went out for a year or two.
- Oh, yeah? Great.
- Thought we might even get married.
One day she tells me she wants to start seeing other people.
Why do they say that? You know, if you want to break up, you should just do it.
Is the rope supposed to be this loose? - Better? - Yeah, thanks.
- Hey.
- Hey.
- Did you get back to sleep? - No, not really.
Sorry.
Okay, where's Alex? Up in his room.
Want a beer? Do I need one? He brought this to school.
That's it? That's such crap.
Where'd he get it? You subscribe? - I like the articles.
- Oh, please.
So listen, anyway a friend of his had the magazine in the bathroom in the stall at school You know, the kid was Are you kidding me? Oh, my God.
Do you think that Alex is? I thought it would be at least a year or two until I had to deal with this.
Well, I guess I need to talk to him.
Yep.
So I'm here twice a week, anytime you want to join me.
- That'd be great.
- Brett could give you another lesson.
He's quite a teacher.
- See you next time.
- Bye.
I got an outfit just like that at home, but I didn't want to show off.
So are you hungry? No.
No, not really.
You got to eat dinner.
I'm just gonna grab something at home.
Come on, you've been a good sport.
My treat.
- Okay.
- Okay.
So, what are you in the mood for? I don't know.
Indian? No? Chinese? - Sushi? - Had it for lunch.
What about deep-dish pizza? I could go for pizza.
- I know a good pizza place on Monroe.
- Yeah, too many carbs.
Right.
Hey, I have an idea.
Okay, close your eyes, pick a page and point.
That's where we go.
- What if it's a doughnut shop? - Are you in this or not? - There? - Not there.
- There? - Right there.
- And the winner is - Uncle Vito's Mongolian Barbecue.
What's that? It's Italian.
It's Asian.
It's maybe Southern.
- All right, close your eyes and do it again.
- No, no.
You made the rules.
Mongolian barbecue? But it's in Downers Grove.
We don't want to go that far.
Are you in this or not? All right.
I hope they have tofu.
Officer McWayne.
They're moving him up to the ICU.
Okay.
Thank you.
Arlo! - Arlo! - It's okay.
- Where is he going? - Probably just getting a snack.
- He seems really upset.
- It'll pass.
Well, maybe I should go talk to him.
No, he's too emotional.
You can't talk to him when he gets this way.
I hope he doesn't feel like he was forced into this.
You don't want to think about it some more - discuss it after he calms down? - It won't help.
He's not being realistic.
That's why we had to make the decision.
He's too confused.
I heard him express a strong opinion more than once.
You and I both know it was the wrong choice.
He was hoping for something that's never going to happen.
He loves his father, but I'm the one who has to set the limits.
Anyway, thanks for everything you did.
I'm not sure I helped.
Well, when you let us work it out together you did the right thing.
Yeah.
Hey.
Can I come in? Didn't know you liked The Goon.
They didn't have Hellboy.
So look about today at school Mr.
Elmore is such a loser.
Yeah.
What happened with that kid in the bathroom all right, I just wanted to make sure you didn't have any questions.
About what? You know, about what he was doing.
Spanking the monkey? Yeah.
What about it? Well, it's- It's normal but, you know, it's not the kind of thing you should do at school.
You think I'm stupid? No.
At your age, it can be a confusing time.
If you ever want to, you can always talk to me about these things.
Okay.
Okay.
Good night.
- I heard there was an after-hours club.
- Cool.
- Have you seen Kristy? - Yeah, she's pulling around the side.
Hey, you're late.
- We went on at 9.
- How could you just leave like that? I'll meet you in the car.
- I'm sorry, what? - You abandoned that kid.
I signed out my patients when my shift was ov- - You should have signed out to me.
- You were busy.
You thought it was easy.
It got complicated.
How did it get complicated? The kid wanted his dad to have surgery.
- How long you discuss it, two minutes? - He understood.
His dad's not having the surgery.
- Why not? - Because you weren't there.
His mom gave him a hard time about it, and he gave in.
- Did you at least talk to him? - Yes.
Well, all he needed was a little hand-holding, Neela.
- I mean, God, is that so hard for you? - Don't turn it around, make it about me.
- You promised to help.
- No, I told him- You know, it's not my job or anyone else's to keep your promises.
- My shift was over.
- He was counting on you.
- I had a gig.
- Screw your gig! Medicine isn't a day job! This coming from a girl who was selling hot dogs three months ago.
I was off at 7.
Abby was off at 7.
But we were still there taking care of our patients.
We'd never leave the hospital if we had to stick around to tuck in every patient! I'm not talking about every patient, I'm talking about one kid.
It was the most important decision of his life.
He trusted you, and you left.