ER s11e11 Episode Script
Only Connect
E.
R.
Previously on E.
R.
I take full responsibility for what happened with Sanders.
It won't happen again.
You gotta help.
I think he's dying.
Hey! That man's just been told his cancer has spread.
- Don't you think he has a reason to cry? - Yes.
Fix my brother, bitch, before I blow your head off! I'm telling you to trust yourself enough to comfort.
- I said, let's go.
- You don't have to do this.
Lay down.
E.
R.
11x11 "ONLY CONNECT" I'm Renée Montagne.
Today is Monday and this is Morning Edition from NPR News.
He's too young and he shouldn't listen to that music.
I didn't know you already said no.
I'm trying to teach him the value of a dollar.
You give him everything.
It was only 50 bucks.
For a concert ticket for a 10-year-old? No.
I don't think you should be worried about money.
Look, Luka, I appreciate your generosity but I'm not gonna let you pay for everything.
You don't have to pay half the rent and the bills every month.
I managed to support me and Alex for 10 years.
I can handle it.
You know what? This isn't about money.
You're worried about losing your independence or something.
And about my role in Alex's life.
What, you're worried about losing control over him or what? - You know, you always do this.
- Do what? Telling me what I'm really mad about.
Most of the time you don't know what you're really mad about.
Sam, this isn't our stop.
Hey.
Sleep okay? Yeah.
Better than the night before? You wanna eat anything before you smoke? No.
But thanks.
I can make French toast.
- Aren't you on your way out? - I have time.
Want anything to drink? I bought groceries.
We've got milk, juice.
No, thanks.
Were you vacuuming last night? - Sorry.
Did I keep you up? - No, I just No.
That was very nice of you.
Your shift starts at 2, right? You ready to go back? Well, I can't keep hanging around here.
I gotta get going again.
Everyone's been asking how you are.
- So you're sure you're okay? - What I really need is a little space.
- Okay.
- I'm sorry.
I just- You're right.
I should find a place.
I'll start looking.
- You don't have to rush.
- No, really.
I'll see you at work.
They're not closing the ER, are they? The county health system ran out of money.
They say that so the government will bail us out.
- They're not meeting on the match.
- No.
The applications aren't in.
That's why it's not the match.
- It's an Attendings meeting.
- But they usually meet upstairs.
Enough with the paranoia, people.
Let's get back to work.
- What's going on? - Attending meeting.
- Why? Why here? Why now? - I don't know.
- Maybe they're cutting a Resident.
- No.
You think that's what this is? I don't know.
But whatever it is, it can't be good.
- What color are you painting the room? - Lime green.
- Why? - Because it's my favorite color.
Okay, the Attendings note.
It's not enough just to co-sign the chart.
You have to write your own history, medical assessment and plan.
- On every patient? - It's the only way we get paid.
Sorry.
Very long shift.
Yawning's contagious.
Cosmo's teething.
I was up all night.
I'm exhausted.
We're down two nurses.
Anything else? If we don't get our patient-satisfaction scores up we can't start pursuing HMO contracts.
- Okay, who's low? - Ray, Neela, Morris.
- Abby's the only one with a decent score.
- Even Pratt's on the low end.
Pratt's okay with the patients.
It's the other doctors he has a problem with.
Need the room for a brachial artery laceration, 10 minutes out.
And Neela brings up the rear with a score of 2.
21.
If we wanna make our patients happier, we need to teach our residents to connect with them better.
- What are you, the Croatian Dr.
Phil? - They can't communicate with each other.
Have you seen Neela and Pratt work together? Ray and Morris? We can teach them to make eye contact, introduce themselves.
Act like human beings in front of the patients.
That would change their personality structure which would be great if we could make their parents love them more.
Med schools churn out scientists.
It's up to us to turn them into physicians.
Try it.
They can't do any worse.
I'm gonna get coffee.
I'm going home.
- How long you been waiting? - About six hours.
Six hours? A little longer, my friend, and you're looking at a big cash settlement.
- Here.
Take one of my cards.
- Out of my way! - Give one to your buddy.
- Out of my way.
My first job was working in an orange juice factory.
- Amy, could you sit down, please? - But I got canned.
Couldn't concentrate.
I'd rather stand.
The seats are too small for her.
Oh, shut up, Cullum.
I'll get you in soon, okay? Pratt, knee contusions, slipped at work, can't bear weight.
I've got a hot Ml so it's gonna have to wait.
I didn't say it can't wait.
I said "can't bear weight," as in stand up.
I'll get to it when I get to it.
Plan to help Residents communicate, you might wanna start with Pratt.
Tell me the truth.
How many Vicodin will it take for you to go away? I'll write it down.
I'm doomed.
Morris! Relax and come talk to me when you're done.
- Hi.
- Hi.
- Going home? - Yeah.
I'm gonna go home, sleep off my shift, come back in 12 hours and pick you up.
- Oh, really? - Puccini's can take us at 9:00.
For me, it'll be breakfast.
For you, it'll be whatever you want.
Fantastic.
I'm craving a pound of pasta and some oily garlic bread.
- She's carbo-loading for a marathon.
- Enjoy your honeymoon.
- I'm gonna be fighting with Sam.
- Okay.
Have fun with that.
Dr.
Kovac, can you get gastritis after 16 ibuprofen? Why's your patient taking that much medicine? Is he depressed? I was just about to check.
- There you go.
- Neela.
Amy Packer, an obese 15-year-old with a forehead lac.
What happened? Brother hit her over the head with a lamp.
Hi, Amy.
This is Dr.
Rasgotra.
- Hi.
- Hi.
This is Cullum.
- I can't get up.
- Oh, here.
Let me help you.
Here.
She's too fat to get up.
Oh, my goodness.
That was quite the fall, young lady.
- Oh, thank you.
- Okay.
Can you believe it? There you go.
All this ice and not a speck of salt to be seen.
I think the hospital is negligent and responsible for your injury.
Oh, no.
I don't have an injury.
Well, gonna feel okay probably for the first 24 hours.
And then the pain develops.
You could be looking at long-term disability from for example, lumbar myofascial strain or disc herniation syndrome with radiculopathy.
It's just a bruise.
I think an MRl is indicated definitely.
- Are you a doctor? - No.
Attorney.
Herb Spivak, attorney at law.
My card.
Dr.
Lewis, OIG, line 2.
Claiming we transferred an unstable patient.
- You're a doctor, huh? - Yeah.
Let me tell you something.
You never know when you're gonna need more protection.
These hospital bigwigs will let you hang out to dry if you ever get sued.
If you solicit any more patients in my bay, I will have you forcibly removed.
How about a free pen? Follow my finger.
- Amy.
- Thank you.
Hi, I'm Dr.
Kovac.
- Neela, present to me when you're done.
- Oh, okay.
- Am I in some sort of trouble? - No, no.
Just keep going.
- It's Mr.
Meacham, right? - The one and only.
Tell me about your pain.
Did you have an injury? - I was moving boxes at work.
- Where do you work? I used to work as a lumberjack.
But I couldn't hack it, so they gave me the ax.
Is it worse when you walk? - Can I help with something, Dr.
Kovac? - Just observing.
- You have pain in any of the joints? - No.
Can you get a postural vitals for me in Exam 2? Getting slammed.
I'm setting Neela up for suturing, I got a Foley an NG, two IVs to start, and a five-page patient-transfer summary.
I got your tray.
Amy, I talked to your mom.
She's on her way.
Oh, my foster mom.
He's her real son.
- How long have you been with them? - Since last March.
Sorry.
That was lidocaine to numb up your cut.
Die! I hope he's referring to his game.
Cullum needs his meds adjusted.
That's why he has tantrums.
- Die, die, die.
- Is that what happened? - He lost his temper? - Kind of.
- What meds is he on? - Adderall and Depakote for ADHD and ODD.
I'll be back to sew you up.
Does it seem like every 10-year-old boy you see nowadays has ADHD? ADHD, a Game Boy and an iPod.
Foster kid, head injury, unsupervised home - We should call Social Work.
- I think Wendall's on.
- Look, I know how to do an H & P.
- Excuse me, Dr.
Kovac.
Hold on.
How long did you let him talk before interrupting him? - Twenty, 30 seconds.
- Four.
- What color were his eyes? - I don't know.
We weren't on a date.
Didn't make eye contact.
Listen to his heart? - The guy had a twisted knee.
- Doesn't matter.
Listen to his heart to show you care and that you're paying attention to detail.
- I don't have time.
- It takes one minute.
Makes a difference between your patient feeling taken care of and feeling ignored.
We got patients that have been waiting over nine hours.
Believe me, they already feel ignored.
- You ready to present? - I think I need to redo my exam.
Listen, it's about connecting better.
If your patients trust you, she'll heal faster.
- That's what all the studies say, okay? - Okay.
I find it really distracting working with somebody so good-looking.
Who? Dr.
Kovac? Oh, come on.
Don't pretend he's not hot.
I don't know, you just get used to it.
- Yeah.
But he's gorgeous.
- Who's gorgeous? Got a John Doe.
Looks about 16.
Multiple GSWs to the chest.
- Any vitals in the field? - Nothing.
Luka.
Tier one, no BP.
Never had a rhythm.
Fixed and dilated.
- You wanna call it? - Let's see.
Should we get some O-neg? - Am I missing something? - No.
Let's stick with saline for now.
I thought asystole in the field meant zero percent survival.
Sam, start compressions.
- You want labs too? - No.
Just check a crit.
- Oh, this is like some sort of practice.
- Apparently.
Oh, can I do a chest tube? No.
Neela's gonna do a saphenous cutdown.
- She is? - I am? Okay, let's prep and drape the ankle.
Okay.
Now make your incision from the anterior tibia to the medial malleolus.
You a doctor? I think I'm having an aneurysm.
Sir, please wait back inside for a doctor to get to you.
- Pratt, you got a sec? - I could be having a stroke! - Probably a headache.
- They might cut a resident? I'm gonna sue you if I end up paralyzed.
- Why are you following me? - I'm not.
- Gentlemen, please! - I'm serious.
- My attorney's office is right there.
- Did a doctor screw you up? Come visit the Mobile Law Office of Herb W.
Spivak.
He's had two rounds of epi and atropine.
Holding compressions.
- One more tie on the distal segment.
- Okay.
Asystole.
How much longer? Until the third liter's in.
Sam, resume compressions.
Now, get your femoral pulse.
- Can't quite get one.
- It's because he bled out.
Third liter's in.
No pulse.
Okay, that's it.
Time of death, 9:52.
- Thanks for showing me.
- Yeah.
Write up your note.
I'll co-sign.
Any identifying marks? Brand-new sneakers, blue.
Wonder what he was thinking when he put those on this morning? - What? - Had it been just us you would've pronounced him dead.
- He was hypovolemic.
- He never had a pulse.
There was a chance he might respond to a fluid bolus.
If you were really serious, you would have ordered the O-neg.
Someday they might find themselves with no rapid infuser or a central-line kit.
If they know how to do a cutdown, they could save a life.
I can't afford to waste time on teaching cases when there's real work to do.
This is what we do.
We train doctors.
Sometimes that means running through codes so residents learn procedures.
- I mean, it's a teaching hospital.
- Yeah! It's also a real hospital with patients who didn't get antibiotics because I was in here doing compressions.
So you did some extra compressions.
What are you really mad about? Are you in all seriousness telling me for the second time today that I am not mad about what I'm really mad about? I have no idea what you just said.
Forget it.
Nine hundred dollars for a studio in Andersonville.
- What happened? Abby kick you out? - No.
- Yes.
- When's she coming in? Shift starts at 2.
You know, I've missed her.
What? I have.
I just got a two-bedroom sublet on North and Oakley for just 1000 a month.
Wicker Park.
But my roommate just flaked out on me.
Back in rehab, huh? You wouldn't happen to be interested in? You mean you and me? - Five hundred's better than a grand.
- Thanks.
I'll think about it.
Morris.
Hey, isn't that our local shyster? - Damn.
- No, no, no.
Allow me.
Go for it, Archie.
Hi, I'm looking for a Dr.
Ras-goostra.
Rasgotra? That's me.
Hi.
I'm Kitty Peyser.
I'm Amy's foster mom.
Is she okay? She's fine.
She's just needs some stitches and a tetanus shot.
I heard they got in a fight.
Cullum's not bad.
He needs his meds.
Perhaps you'd like to talk to our social worker? No, I just wanna see my daughter.
I should tell you, I had to notify Social Work.
- They'll probably be contacting DCFS.
- What? - When children come in with suspicious- - No, no, no, come on.
Hey, kids fight.
- It's a standard situation.
- There is no situation.
Mrs.
Peyser Look, don't do this to us.
We love Amy.
They'll take her away.
- Amy, I'm here.
- Hi.
Multiple GSWs.
Gang shootout on the corner of 51st and King.
- Tachy at 138.
BP, 85 palp.
- I'll take the airway.
- What do you got? - Three gunshots to the abdomen.
Run it, Pratt.
No breath sounds on the left.
Morris, chest tube.
Jane, subclavian.
Ray, stop staring at the monitor and concentrate.
- I've never done a subclavian.
- Hey! It's time to buck up.
Central-line kit.
Did you get rid of Herb yet? No.
He says he has a client at the hospital revising her will.
He is wily, that one.
- Stay in the midline, Ray.
- I got it.
Does he need atropine or epi? No.
He needs oxygen.
The tube's not in.
- Oh, great.
- You have to see it go through the cords.
- Give me the blade.
- Let me try again.
Maybe next time.
Tube.
- Pratt, why don't you try teaching? - Oh, okay.
You did it wrong.
Watch me.
Call Surgery.
This guy needs an ex-lap.
And I'm in.
See? It's just that simple.
- Thank you, Greg.
- Anytime, Ray.
Am I gonna have a scar? Just a little line.
We'll take you to Darlene's salon tomorrow.
- We'll get you bangs.
- That'd be nice.
Keep the wound dry till the stitches come out.
So no baths and no swimming.
I should go check on Cullum.
Mary, can you take Mrs.
Peyser to the family room? - Sure.
- Don't worry, Amy.
Everything's gonna be fine.
So Neosporin twice a day and come back if it's red, painful or draining fluid.
Does your cut hurt? - What's wrong? - I know what's gonna happen.
Once you call in Social Work- - Amy, don't get ahead of yourself.
- I can't leave.
They need me.
I give Cullum his pills every morning, and I get him ready for school.
That's a lot of responsibility for a girl your age.
It's the only home where I haven't been beaten up or ignored.
Kitty loves me.
She needs me.
My whole life, I've never felt that before.
- Sam.
- Yeah? Did you already call Social Work on Amy Packer? Yeah.
Wendall will be down soon.
What is that? It's still caffeine.
Call Wendall back and tell her not to bother? - Why? - I was too quick.
I should have waited.
She's a foster kid.
We always call Social Work.
- What are you doing? - Stabbing me to death.
I think he's dehydrated.
Do I look like a pincushion to you? He's my patient.
Why are you torturing my patient? Jane said Dr.
Kovac told her you needed some help today.
Sats, 79.
Barely any pulse.
Let me do it.
You can practice later on a dummy.
- I can't get the tube into the space.
- Use a twisting motion.
- Systolic's only 60.
Cycle the DynaMap.
- Your incision big enough? - I don't know.
- Morris.
- You've done a chest tube before, right? - P.
E.
A.
Lost the pulse.
- Give me the tube.
Out of the way.
- No, I got it.
- You need to manage your team.
- I don't know how to explain any better.
- Bradying down to 50.
- Amp of epi.
- You criticize and make them nervous.
- What do you think you're doing to me? Kid doesn't have time for them to learn.
- Hello.
We can hear you.
- We're standing right here.
He's pulseless.
Check it again.
- Good carotid.
- Tension pneumo.
- It's a common cause of P.
E.
A.
- His sats are rising.
So do you mind if I ask our Residents to roll him up to the O.
R.
? Or do you think that that would hurt their feelings? What was that all about? That was an intubation, a chest tube and a central-line in under 15 minutes.
The point is not to do it all yourself.
Because you all had a group hug this morning do I have to listen to this touchy-feely crap all day? - Yeah.
- I'm not an intern, okay? So stop acting like one.
You have people under you.
You're responsible for teaching them.
So are you gonna build their confidence or destroy it? Well, if the choice is between building up self-esteem and saving my patient I'm gonna have to go with my patient every time.
I don't know, they were unsupervised.
The mother seems overwhelmed, the brother has problems.
This is her fifth home.
It's not a perfect family, but she says it's the best she's ever had.
I haven't spoken to their caseworker.
Safest thing is pull her from the home.
She's happy there.
No guarantee things will be better anywhere else.
You guys talking about that foster kid? They're happy together.
The family seems to be working.
If the mom agrees to parenting classes, I'll consider re-evaluating- Neela, some landlord for you on line two.
I'll take it in Admit.
She'll do whatever you need.
I tell you, I find hospital conditions absolutely woeful.
- Are you overworked and underpaid? - I'm a nurse.
- You can't be back here.
Get out.
- You can't kick me out.
I'm a patient.
- What? - That's right.
Very bad sore throat.
- Sore throat? - I signed in.
Yeah.
I know you guys are backed up, so don't worry, I'll wait.
Just take all the time you need.
I'm gonna fetch me a lozenge.
Haldol and hard restraints? We could treat him like a psych patient with delusions of being a lawyer.
- Abby? - Abby.
- Hi.
- Hi.
- Are you okay? - Yeah, I'm okay.
- Good to see you.
- You too.
- Oh, my God, Abby.
Did you get my card? - Yeah.
Thank you.
I prayed for you.
No windows at all? Shared bathroom? Is that even legal here? - Abby finally kicked her out? - Well, how much a month? It's ugly out there.
You usually do early shifts, right? So you can go for gigs with your band? Yeah.
And if you stick to your late shifts and overnights- Weeks could go by, we might never see each other.
Months even.
Welcome, roomie.
God, I'm gonna regret this.
Excuse me, please.
Excuse me.
I need to see my grandson.
- What's his name? - Michael.
Michael Barnes.
- His friends said he got shot.
- I don't see the name.
He's 16.
He was wearing jeans, a gray T-shirt and sneakers.
- Blue sneakers? - Yes.
Yes.
You saw him? A patient came in earlier matching that description.
- Is he okay? - If you'd like to take a seat - I can get the Attending for you.
- Wait a minute.
Has something happened? - Ma'am- - Is he dead? - I can't give any more information until- - Is he okay? Why can't you tell me? - Ma'am, please calm down.
- Where is he? I need to see him.
- If you'd like to take a seat- - Where's my grandson? - We can't confirm anything until- - His name is Michael Barnes.
Michael? We can't confirm anything until the body's been ID'd.
What? Oh, God.
I'm sorry.
I didn't mean to- Just let me go and get the Attending.
I'm- Ma'am, if you'd just like to take a seat, and I'm sure the Attending can- Oh, Michael.
God.
- Where's the grandmother now? - Crying it out in the family room.
I guess Neela needs to work a little on her death notification.
A little? Grandma's traumatized.
I can't believe we didn't have to sedate her.
You can't teach basic people-skills.
You know how to relate to people or not.
- Croissant? - I'll go talk to her.
You realize you're just encouraging him.
Just because he's a shark doesn't mean we can't eat his pastries.
Hey, who's on call for general surgery tonight? - Sung.
- Okay.
I have to track down an abdominal series from Radiology.
And I have a puking lady that had a dystonic reaction to phenothiazines.
- Zofran? - Yeah, right.
- So how are you doing? - Good.
- Really? - Never better.
- Really? - Yes, yes, yes.
I processed feelings of anger, shame and guilt in an emotionally safe environment.
I've addressed the urge to use alcohol.
And I've consulted both a shaman and a guru, so I'm all good.
That was Wendall, our social worker.
She's getting information from your foster mom.
- She's not gonna take me away? - No.
Your foster mom's gonna take some classes.
You and Cullum will start an after-school program so you can go home together.
- Oh, thank you.
- You're welcome.
Thank you, thank you.
Mary, can you take Amy up to the seventh floor, please? - Sure.
- They'll be waiting for you.
- So you convinced Social Work, huh? - It seems so.
- Good job.
- I took your advice.
I tried to connect.
Didn't do such a good job with the grandmother though.
You and Dr.
Lewis must think I'm a complete idiot.
No, no.
You're just inexperienced.
Hey, hey, hey, come here.
First, you bring them into the family room for a death notification.
Sit down.
Somewhere away from the patients and the staff.
- She just got so hysterical.
- Make sure they are sitting down.
Don't be evasive and don't use euphemisms.
- Use the word "dead" and the word "is.
" - I know all this.
Give them a tissue.
Look them in the eye and make a connection.
Then just say, "I'm very sorry.
" - It's okay.
- I suck.
No, you don't suck.
You're still learning.
I can't believe this.
I'm in a wedding next weekend.
- One percent lido with epi, 6-0 Vicryl.
- God, I'm gonna ruin all the photographs.
They won't look at you, they'll be looking at the bride.
- You owe me one.
- What? No, I don't.
Yeah, you do.
I put down the NG on Mrs.
Leerburger.
I didn't ask you to do that.
- Dr.
Kovac did.
- What? He said you were a little overextended today, unlike the rest of us.
Abby, will you excuse me? I have to go yell at someone.
Have fun.
Okay, Miss Tobel, in the future, try not to pluck your eyebrows in a moving car.
Okay, numb and prep the wound.
I'll be right back.
Get away from me! I know what you want! - You wanna make me suffer! - Security! - Lockhart, you're back.
Welcome back.
- Thank you.
I called John Manning at the International Society for Traumatic Stress Studies We're looking for our son.
We've been waiting for an hour.
- His name is Tevin.
Tevin Burrough.
- Hold on.
I'll check.
We've been here an hour.
Where you going? Get back, bitch! - effective in the treatment of traumatic disorders.
You focus on the most vivid image, emotion or sensation in traumatic memory, simultaneously focusing on an external impulse.
I printed out a bunch of the studies for you.
You can take a look at them.
- We can talk about them tomorrow.
- Okay, thank you.
Good.
Okay.
Abby, eyebrow lac's ready.
You were gonna show me how to do a running subcuticular.
Right.
- Are you okay? - Yes.
Yeah, I'm fine.
This won't leave a mark, will it? Dr.
Lockhart is using a special technique to minimize scarring.
Abby? I'm sorry.
I can't do this right now.
- What? - Sorry.
- Joe, what happened? - He threatened to sue me.
He's parked in front of a hydrant.
- What's with the motor home? - I'm getting rid of it.
- Susan.
- Yeah? I think maybe I came back too soon.
- Are you okay? - I don't know.
I'm not in the right frame of mind to do this.
- Take all the time you need.
- Ray's staying late to cover.
No, it's okay.
Don't worry about it.
I'll call you later.
Sorry.
Sorry.
- You all right? - Yeah, I'm fine.
God.
You'll catch the next one.
Thank you.
Spivak, get out here now.
- Hello, doctor.
- Oh, come on.
We fixed you up.
- Jerry.
- The guy has really great coffee.
Sorry.
Dr.
Lewis.
Are you ready to discuss this morning's fall? - Did you sign Mr.
Fayen in to CT? - Yeah.
I had to go up to CT to push morphine instead of doing it here.
- Just trying to help.
- No.
You're being passive-aggressive.
- Why are you so mad? - Because - I'm used to having control over my life.
- Sam.
- What? - Do you know where Neela is? You're the Attending on Amy Packer, the foster kid? - Yeah.
- This is Mari Hinojosa from DCFS.
I have bad news.
- I think that's everything.
- Thank you.
- "Desensitization reprocessing"? - Yeah.
It's some crazy stuff Dubenko gave me.
- Want me to give it a try? - No.
I think it's dead.
Procrastinating.
Didn't miss it at all.
Work, over the holidays.
I must've made an impression on you.
You didn't notice I was gone for a week.
No, I remember.
You're the guy with the beard.
Yeah.
- Where did you go? - Yellowstone.
The most beautiful place on earth.
You ever been? I didn't realize it until I was smack in the middle of the geysers but the whole thing is actually one gigantic active volcano.
- Did you know that? - No, I did not.
It could blow at any second.
It's actually 30,000 years overdue.
And what would happen if it did? It would wipe out most of the western U.
S.
Cover the rest of the country in ash.
Wreak havoc on the global climate.
- Is that all? - We'd be gone in an instant, just like that.
That's how fragile life is.
You know that.
You work in the ER.
Yeah.
The human life span is so short anyways.
It's almost irrelevant.
Are you high? There's your train.
- See you later.
- Thank you.
Bye.
Between the paramedics and the doctors here, we worked on him for 45 minutes - but his injuries were too severe.
- His mother died when he was 5.
Your son did well in surgery.
They were able to control the bleeding in his liver.
- Since then, it's just been the two of us.
- He wasn't in pain, and he didn't suffer.
I knew something like this was gonna happen.
His heart and his brain were spared.
He'll probably do just fine.
- He was talking about going to college.
- I'm very sorry.
He's gonna be groggy, but he might be able to hear what you're saying.
Take as much time as you need to say goodbye.
This isn't my grandson.
This isn't my son.
Oh, God.
Hello? Hi.
No.
No, they can't refuse to admit her.
She's got post-op adhesions.
- The surgeon's gonna rip our heads off - Haleh.
Haleh.
Listen.
Listen.
Okay.
Just push four of morphine, and I'll be there in a minute, okay? - Fine.
Bye.
- How the hell did this happen? - I'm not sure yet- - Were they mislabeled? - I don't know.
- Did they look the same? - Was there a computer glitch? - I don't know.
All I know is that there were two John Doe's both 16, gunshot wounds, gang-related.
Both treated in Trauma 1 a few hours apart.
Susan, I just do not understand how this happened.
There was a massive communication failure.
Well, it's your job to make sure that people communicate.
- I take full responsibility for it.
- We screwed up.
We didn't know there were two John Does.
We didn't speak to each other or check the board.
Who was in which trauma? Neela, Sam and I worked on a kid with a saphenous cutdown.
Morris, Ray, Pratt and I had the other.
There was no overlap between the traumas? I was in both.
- Who's that? - Med student.
- I put a name alert on the board.
- Why didn't you say anything? No one listens to me.
No one even remembers I was in the room.
- You look like you could use a vacation.
- No.
I got this great time-share down in Boca Grande that I let friends use.
- Friends? - You know, friends that refer friends.
It's got a great house and this beautiful boat and a pair of Jet Skis.
Spivak? Security.
Come on, give me a break, will you? - You're back.
- Yep.
- Thought your shift was over.
- No, not till 10.
- So you were just taking a break? - I guess so.
- Up on the El tracks? - Yeah.
- I love it up there.
- Me too.
Never know who you might run into.
We just put them through hell.
What will you say? I'll tell the truth.
Families of dead patients don't remember much.
The only thing they remember is if it seemed like you cared.
If you were honest and direct with them.
Did Dr.
Lewis tell you to keep me away from them? Yeah.
- I wanna go in with you.
- Okay.
It's unconstitutional.
Thank you.
Do not cross this line, or I will have you arrested.
- I don't see any line.
- You know what I mean.
- You can't come back here.
- This is a public institution.
- It doesn't matter.
- Well, you're violating my civil rights.
- I never got to see a doctor.
- So sue me.
Your office is being towed, by the way.
Hold it, hold it, hold it.
Come on! Come on! Have some pity! - So much for Herb.
- Whatever.
You know he'll be back.
Amy? What's going on? - Who are you? - I'm her doctor.
- I'm bringing her to the Haley Home.
- She lied to me.
- Go talk to your social worker.
- I don't understand.
Stop.
I have two more kids to pick up.
Don't make my job any harder.
- Amy, wait.
- She told me I could go home.
- Thirty days? - You can have visitors after two weeks.
- I need to talk to you.
- Cold turkey, just like that? Well, they give you medication to help ease the withdrawal.
Think about it, okay? How could you pull Amy out of her home behind my back? It wasn't behind your back.
We got new information.
- We had a plan.
- Her caseworker was out of town- - Why didn't you tell me? - If you would stop interrupting- - You're supposed to consult the doctor- - Kovac signed off.
- Hey.
- I'm hating doctors right now.
Neela's mad, Ray practically accused me of elder abuse.
Morris laughed when this kid kicked me in the shin.
- I was gonna ask if you were ready.
- That's all you have to say? You know, we come from different perspectives sometimes and sometimes we disagree.
But whatever happened, you were right.
- Why didn't you tell me about Amy? - I was going to.
- When? - When I had time.
Thought it might be better if you found out after your shift.
I'm an adult.
I don't need you to protect me.
I wasn't trying to.
You made a good decision based on information you had.
- But there was a pattern of incidents.
- Like what? - Like April 16th, scald injury to shoulder.
- Sounds pretty minor to me.
- July 14th, bite inflicted by brother.
- Who we know has behavioral issues.
October 20th, clavicular fracture after a fall.
November 30th, 14-centimeter leg lac after tripping on stairs.
Her history wasn't consistent with her injuries.
Okay.
- Each one is not a big deal, but together- - I got it.
I thought it was a done deal, told Amy everything would work out.
- I got her hopes up.
- Well, in the end - we're doing the right thing for her.
- So why not just tell me that? I was worried that finding out would make you lose your confidence.
And I didn't want that to happen, so If I was trying to protect you, I'm sorry, okay? You know, I didn't always used to be a mobile lawyer.
I used to have big money.
Big, big money.
I lost my shirt on niftypets.
com.
- Can I get something for the pain? - Sure.
Soon as we finish this paperwork required by our lawyer - to guard against frivolous lawsuits.
- I ain't signing nothing.
This document gives us permission to treat you.
This second one specifies whether you have an advance directive or living will.
- Are you serious? - If your heart stops do you want us to use measures to resuscitate you? Just put me out of my misery.
- Hi.
- Hey.
I'm leaving for the day.
I'm waiting on a transfer patient so I'll walk out with you.
- Listen, I'm sorry about this morning.
- No.
I'm sorry.
I've been camping on your couch for six months.
Yeah.
But I didn't mean to be a jerk about it.
No.
I needed a good kick in the ass, and I found a place with Ray, actually.
So I'll be leaving at the end of the week.
Well, take your time.
There's no rush.
And by the way, are you nuts? Yes.
Yes, I am.
- So random question.
- Yes? Do you ever get crushes on people you work with? - What do you mean? - You know.
- Crushes on people you work with.
- Yeah, I guess.
Sometimes.
Why? I don't know.
- What? - What? - Are you leaving for the night? - Yeah.
- Good night, guys.
- Good night.
- Night.
- Night.
- See you at home.
- Okay.
You know, you're really good at teaching other people how to communicate.
Thanks.
We should try it ourselves sometime.
Yeah.
My English, you know? Still working on it.
Now you're gonna pull the Croatian card? That is low.
- You were right about one thing.
- Oh, only one thing? Fifty bucks was too much for a concert ticket.
R.
Previously on E.
R.
I take full responsibility for what happened with Sanders.
It won't happen again.
You gotta help.
I think he's dying.
Hey! That man's just been told his cancer has spread.
- Don't you think he has a reason to cry? - Yes.
Fix my brother, bitch, before I blow your head off! I'm telling you to trust yourself enough to comfort.
- I said, let's go.
- You don't have to do this.
Lay down.
E.
R.
11x11 "ONLY CONNECT" I'm Renée Montagne.
Today is Monday and this is Morning Edition from NPR News.
He's too young and he shouldn't listen to that music.
I didn't know you already said no.
I'm trying to teach him the value of a dollar.
You give him everything.
It was only 50 bucks.
For a concert ticket for a 10-year-old? No.
I don't think you should be worried about money.
Look, Luka, I appreciate your generosity but I'm not gonna let you pay for everything.
You don't have to pay half the rent and the bills every month.
I managed to support me and Alex for 10 years.
I can handle it.
You know what? This isn't about money.
You're worried about losing your independence or something.
And about my role in Alex's life.
What, you're worried about losing control over him or what? - You know, you always do this.
- Do what? Telling me what I'm really mad about.
Most of the time you don't know what you're really mad about.
Sam, this isn't our stop.
Hey.
Sleep okay? Yeah.
Better than the night before? You wanna eat anything before you smoke? No.
But thanks.
I can make French toast.
- Aren't you on your way out? - I have time.
Want anything to drink? I bought groceries.
We've got milk, juice.
No, thanks.
Were you vacuuming last night? - Sorry.
Did I keep you up? - No, I just No.
That was very nice of you.
Your shift starts at 2, right? You ready to go back? Well, I can't keep hanging around here.
I gotta get going again.
Everyone's been asking how you are.
- So you're sure you're okay? - What I really need is a little space.
- Okay.
- I'm sorry.
I just- You're right.
I should find a place.
I'll start looking.
- You don't have to rush.
- No, really.
I'll see you at work.
They're not closing the ER, are they? The county health system ran out of money.
They say that so the government will bail us out.
- They're not meeting on the match.
- No.
The applications aren't in.
That's why it's not the match.
- It's an Attendings meeting.
- But they usually meet upstairs.
Enough with the paranoia, people.
Let's get back to work.
- What's going on? - Attending meeting.
- Why? Why here? Why now? - I don't know.
- Maybe they're cutting a Resident.
- No.
You think that's what this is? I don't know.
But whatever it is, it can't be good.
- What color are you painting the room? - Lime green.
- Why? - Because it's my favorite color.
Okay, the Attendings note.
It's not enough just to co-sign the chart.
You have to write your own history, medical assessment and plan.
- On every patient? - It's the only way we get paid.
Sorry.
Very long shift.
Yawning's contagious.
Cosmo's teething.
I was up all night.
I'm exhausted.
We're down two nurses.
Anything else? If we don't get our patient-satisfaction scores up we can't start pursuing HMO contracts.
- Okay, who's low? - Ray, Neela, Morris.
- Abby's the only one with a decent score.
- Even Pratt's on the low end.
Pratt's okay with the patients.
It's the other doctors he has a problem with.
Need the room for a brachial artery laceration, 10 minutes out.
And Neela brings up the rear with a score of 2.
21.
If we wanna make our patients happier, we need to teach our residents to connect with them better.
- What are you, the Croatian Dr.
Phil? - They can't communicate with each other.
Have you seen Neela and Pratt work together? Ray and Morris? We can teach them to make eye contact, introduce themselves.
Act like human beings in front of the patients.
That would change their personality structure which would be great if we could make their parents love them more.
Med schools churn out scientists.
It's up to us to turn them into physicians.
Try it.
They can't do any worse.
I'm gonna get coffee.
I'm going home.
- How long you been waiting? - About six hours.
Six hours? A little longer, my friend, and you're looking at a big cash settlement.
- Here.
Take one of my cards.
- Out of my way! - Give one to your buddy.
- Out of my way.
My first job was working in an orange juice factory.
- Amy, could you sit down, please? - But I got canned.
Couldn't concentrate.
I'd rather stand.
The seats are too small for her.
Oh, shut up, Cullum.
I'll get you in soon, okay? Pratt, knee contusions, slipped at work, can't bear weight.
I've got a hot Ml so it's gonna have to wait.
I didn't say it can't wait.
I said "can't bear weight," as in stand up.
I'll get to it when I get to it.
Plan to help Residents communicate, you might wanna start with Pratt.
Tell me the truth.
How many Vicodin will it take for you to go away? I'll write it down.
I'm doomed.
Morris! Relax and come talk to me when you're done.
- Hi.
- Hi.
- Going home? - Yeah.
I'm gonna go home, sleep off my shift, come back in 12 hours and pick you up.
- Oh, really? - Puccini's can take us at 9:00.
For me, it'll be breakfast.
For you, it'll be whatever you want.
Fantastic.
I'm craving a pound of pasta and some oily garlic bread.
- She's carbo-loading for a marathon.
- Enjoy your honeymoon.
- I'm gonna be fighting with Sam.
- Okay.
Have fun with that.
Dr.
Kovac, can you get gastritis after 16 ibuprofen? Why's your patient taking that much medicine? Is he depressed? I was just about to check.
- There you go.
- Neela.
Amy Packer, an obese 15-year-old with a forehead lac.
What happened? Brother hit her over the head with a lamp.
Hi, Amy.
This is Dr.
Rasgotra.
- Hi.
- Hi.
This is Cullum.
- I can't get up.
- Oh, here.
Let me help you.
Here.
She's too fat to get up.
Oh, my goodness.
That was quite the fall, young lady.
- Oh, thank you.
- Okay.
Can you believe it? There you go.
All this ice and not a speck of salt to be seen.
I think the hospital is negligent and responsible for your injury.
Oh, no.
I don't have an injury.
Well, gonna feel okay probably for the first 24 hours.
And then the pain develops.
You could be looking at long-term disability from for example, lumbar myofascial strain or disc herniation syndrome with radiculopathy.
It's just a bruise.
I think an MRl is indicated definitely.
- Are you a doctor? - No.
Attorney.
Herb Spivak, attorney at law.
My card.
Dr.
Lewis, OIG, line 2.
Claiming we transferred an unstable patient.
- You're a doctor, huh? - Yeah.
Let me tell you something.
You never know when you're gonna need more protection.
These hospital bigwigs will let you hang out to dry if you ever get sued.
If you solicit any more patients in my bay, I will have you forcibly removed.
How about a free pen? Follow my finger.
- Amy.
- Thank you.
Hi, I'm Dr.
Kovac.
- Neela, present to me when you're done.
- Oh, okay.
- Am I in some sort of trouble? - No, no.
Just keep going.
- It's Mr.
Meacham, right? - The one and only.
Tell me about your pain.
Did you have an injury? - I was moving boxes at work.
- Where do you work? I used to work as a lumberjack.
But I couldn't hack it, so they gave me the ax.
Is it worse when you walk? - Can I help with something, Dr.
Kovac? - Just observing.
- You have pain in any of the joints? - No.
Can you get a postural vitals for me in Exam 2? Getting slammed.
I'm setting Neela up for suturing, I got a Foley an NG, two IVs to start, and a five-page patient-transfer summary.
I got your tray.
Amy, I talked to your mom.
She's on her way.
Oh, my foster mom.
He's her real son.
- How long have you been with them? - Since last March.
Sorry.
That was lidocaine to numb up your cut.
Die! I hope he's referring to his game.
Cullum needs his meds adjusted.
That's why he has tantrums.
- Die, die, die.
- Is that what happened? - He lost his temper? - Kind of.
- What meds is he on? - Adderall and Depakote for ADHD and ODD.
I'll be back to sew you up.
Does it seem like every 10-year-old boy you see nowadays has ADHD? ADHD, a Game Boy and an iPod.
Foster kid, head injury, unsupervised home - We should call Social Work.
- I think Wendall's on.
- Look, I know how to do an H & P.
- Excuse me, Dr.
Kovac.
Hold on.
How long did you let him talk before interrupting him? - Twenty, 30 seconds.
- Four.
- What color were his eyes? - I don't know.
We weren't on a date.
Didn't make eye contact.
Listen to his heart? - The guy had a twisted knee.
- Doesn't matter.
Listen to his heart to show you care and that you're paying attention to detail.
- I don't have time.
- It takes one minute.
Makes a difference between your patient feeling taken care of and feeling ignored.
We got patients that have been waiting over nine hours.
Believe me, they already feel ignored.
- You ready to present? - I think I need to redo my exam.
Listen, it's about connecting better.
If your patients trust you, she'll heal faster.
- That's what all the studies say, okay? - Okay.
I find it really distracting working with somebody so good-looking.
Who? Dr.
Kovac? Oh, come on.
Don't pretend he's not hot.
I don't know, you just get used to it.
- Yeah.
But he's gorgeous.
- Who's gorgeous? Got a John Doe.
Looks about 16.
Multiple GSWs to the chest.
- Any vitals in the field? - Nothing.
Luka.
Tier one, no BP.
Never had a rhythm.
Fixed and dilated.
- You wanna call it? - Let's see.
Should we get some O-neg? - Am I missing something? - No.
Let's stick with saline for now.
I thought asystole in the field meant zero percent survival.
Sam, start compressions.
- You want labs too? - No.
Just check a crit.
- Oh, this is like some sort of practice.
- Apparently.
Oh, can I do a chest tube? No.
Neela's gonna do a saphenous cutdown.
- She is? - I am? Okay, let's prep and drape the ankle.
Okay.
Now make your incision from the anterior tibia to the medial malleolus.
You a doctor? I think I'm having an aneurysm.
Sir, please wait back inside for a doctor to get to you.
- Pratt, you got a sec? - I could be having a stroke! - Probably a headache.
- They might cut a resident? I'm gonna sue you if I end up paralyzed.
- Why are you following me? - I'm not.
- Gentlemen, please! - I'm serious.
- My attorney's office is right there.
- Did a doctor screw you up? Come visit the Mobile Law Office of Herb W.
Spivak.
He's had two rounds of epi and atropine.
Holding compressions.
- One more tie on the distal segment.
- Okay.
Asystole.
How much longer? Until the third liter's in.
Sam, resume compressions.
Now, get your femoral pulse.
- Can't quite get one.
- It's because he bled out.
Third liter's in.
No pulse.
Okay, that's it.
Time of death, 9:52.
- Thanks for showing me.
- Yeah.
Write up your note.
I'll co-sign.
Any identifying marks? Brand-new sneakers, blue.
Wonder what he was thinking when he put those on this morning? - What? - Had it been just us you would've pronounced him dead.
- He was hypovolemic.
- He never had a pulse.
There was a chance he might respond to a fluid bolus.
If you were really serious, you would have ordered the O-neg.
Someday they might find themselves with no rapid infuser or a central-line kit.
If they know how to do a cutdown, they could save a life.
I can't afford to waste time on teaching cases when there's real work to do.
This is what we do.
We train doctors.
Sometimes that means running through codes so residents learn procedures.
- I mean, it's a teaching hospital.
- Yeah! It's also a real hospital with patients who didn't get antibiotics because I was in here doing compressions.
So you did some extra compressions.
What are you really mad about? Are you in all seriousness telling me for the second time today that I am not mad about what I'm really mad about? I have no idea what you just said.
Forget it.
Nine hundred dollars for a studio in Andersonville.
- What happened? Abby kick you out? - No.
- Yes.
- When's she coming in? Shift starts at 2.
You know, I've missed her.
What? I have.
I just got a two-bedroom sublet on North and Oakley for just 1000 a month.
Wicker Park.
But my roommate just flaked out on me.
Back in rehab, huh? You wouldn't happen to be interested in? You mean you and me? - Five hundred's better than a grand.
- Thanks.
I'll think about it.
Morris.
Hey, isn't that our local shyster? - Damn.
- No, no, no.
Allow me.
Go for it, Archie.
Hi, I'm looking for a Dr.
Ras-goostra.
Rasgotra? That's me.
Hi.
I'm Kitty Peyser.
I'm Amy's foster mom.
Is she okay? She's fine.
She's just needs some stitches and a tetanus shot.
I heard they got in a fight.
Cullum's not bad.
He needs his meds.
Perhaps you'd like to talk to our social worker? No, I just wanna see my daughter.
I should tell you, I had to notify Social Work.
- They'll probably be contacting DCFS.
- What? - When children come in with suspicious- - No, no, no, come on.
Hey, kids fight.
- It's a standard situation.
- There is no situation.
Mrs.
Peyser Look, don't do this to us.
We love Amy.
They'll take her away.
- Amy, I'm here.
- Hi.
Multiple GSWs.
Gang shootout on the corner of 51st and King.
- Tachy at 138.
BP, 85 palp.
- I'll take the airway.
- What do you got? - Three gunshots to the abdomen.
Run it, Pratt.
No breath sounds on the left.
Morris, chest tube.
Jane, subclavian.
Ray, stop staring at the monitor and concentrate.
- I've never done a subclavian.
- Hey! It's time to buck up.
Central-line kit.
Did you get rid of Herb yet? No.
He says he has a client at the hospital revising her will.
He is wily, that one.
- Stay in the midline, Ray.
- I got it.
Does he need atropine or epi? No.
He needs oxygen.
The tube's not in.
- Oh, great.
- You have to see it go through the cords.
- Give me the blade.
- Let me try again.
Maybe next time.
Tube.
- Pratt, why don't you try teaching? - Oh, okay.
You did it wrong.
Watch me.
Call Surgery.
This guy needs an ex-lap.
And I'm in.
See? It's just that simple.
- Thank you, Greg.
- Anytime, Ray.
Am I gonna have a scar? Just a little line.
We'll take you to Darlene's salon tomorrow.
- We'll get you bangs.
- That'd be nice.
Keep the wound dry till the stitches come out.
So no baths and no swimming.
I should go check on Cullum.
Mary, can you take Mrs.
Peyser to the family room? - Sure.
- Don't worry, Amy.
Everything's gonna be fine.
So Neosporin twice a day and come back if it's red, painful or draining fluid.
Does your cut hurt? - What's wrong? - I know what's gonna happen.
Once you call in Social Work- - Amy, don't get ahead of yourself.
- I can't leave.
They need me.
I give Cullum his pills every morning, and I get him ready for school.
That's a lot of responsibility for a girl your age.
It's the only home where I haven't been beaten up or ignored.
Kitty loves me.
She needs me.
My whole life, I've never felt that before.
- Sam.
- Yeah? Did you already call Social Work on Amy Packer? Yeah.
Wendall will be down soon.
What is that? It's still caffeine.
Call Wendall back and tell her not to bother? - Why? - I was too quick.
I should have waited.
She's a foster kid.
We always call Social Work.
- What are you doing? - Stabbing me to death.
I think he's dehydrated.
Do I look like a pincushion to you? He's my patient.
Why are you torturing my patient? Jane said Dr.
Kovac told her you needed some help today.
Sats, 79.
Barely any pulse.
Let me do it.
You can practice later on a dummy.
- I can't get the tube into the space.
- Use a twisting motion.
- Systolic's only 60.
Cycle the DynaMap.
- Your incision big enough? - I don't know.
- Morris.
- You've done a chest tube before, right? - P.
E.
A.
Lost the pulse.
- Give me the tube.
Out of the way.
- No, I got it.
- You need to manage your team.
- I don't know how to explain any better.
- Bradying down to 50.
- Amp of epi.
- You criticize and make them nervous.
- What do you think you're doing to me? Kid doesn't have time for them to learn.
- Hello.
We can hear you.
- We're standing right here.
He's pulseless.
Check it again.
- Good carotid.
- Tension pneumo.
- It's a common cause of P.
E.
A.
- His sats are rising.
So do you mind if I ask our Residents to roll him up to the O.
R.
? Or do you think that that would hurt their feelings? What was that all about? That was an intubation, a chest tube and a central-line in under 15 minutes.
The point is not to do it all yourself.
Because you all had a group hug this morning do I have to listen to this touchy-feely crap all day? - Yeah.
- I'm not an intern, okay? So stop acting like one.
You have people under you.
You're responsible for teaching them.
So are you gonna build their confidence or destroy it? Well, if the choice is between building up self-esteem and saving my patient I'm gonna have to go with my patient every time.
I don't know, they were unsupervised.
The mother seems overwhelmed, the brother has problems.
This is her fifth home.
It's not a perfect family, but she says it's the best she's ever had.
I haven't spoken to their caseworker.
Safest thing is pull her from the home.
She's happy there.
No guarantee things will be better anywhere else.
You guys talking about that foster kid? They're happy together.
The family seems to be working.
If the mom agrees to parenting classes, I'll consider re-evaluating- Neela, some landlord for you on line two.
I'll take it in Admit.
She'll do whatever you need.
I tell you, I find hospital conditions absolutely woeful.
- Are you overworked and underpaid? - I'm a nurse.
- You can't be back here.
Get out.
- You can't kick me out.
I'm a patient.
- What? - That's right.
Very bad sore throat.
- Sore throat? - I signed in.
Yeah.
I know you guys are backed up, so don't worry, I'll wait.
Just take all the time you need.
I'm gonna fetch me a lozenge.
Haldol and hard restraints? We could treat him like a psych patient with delusions of being a lawyer.
- Abby? - Abby.
- Hi.
- Hi.
- Are you okay? - Yeah, I'm okay.
- Good to see you.
- You too.
- Oh, my God, Abby.
Did you get my card? - Yeah.
Thank you.
I prayed for you.
No windows at all? Shared bathroom? Is that even legal here? - Abby finally kicked her out? - Well, how much a month? It's ugly out there.
You usually do early shifts, right? So you can go for gigs with your band? Yeah.
And if you stick to your late shifts and overnights- Weeks could go by, we might never see each other.
Months even.
Welcome, roomie.
God, I'm gonna regret this.
Excuse me, please.
Excuse me.
I need to see my grandson.
- What's his name? - Michael.
Michael Barnes.
- His friends said he got shot.
- I don't see the name.
He's 16.
He was wearing jeans, a gray T-shirt and sneakers.
- Blue sneakers? - Yes.
Yes.
You saw him? A patient came in earlier matching that description.
- Is he okay? - If you'd like to take a seat - I can get the Attending for you.
- Wait a minute.
Has something happened? - Ma'am- - Is he dead? - I can't give any more information until- - Is he okay? Why can't you tell me? - Ma'am, please calm down.
- Where is he? I need to see him.
- If you'd like to take a seat- - Where's my grandson? - We can't confirm anything until- - His name is Michael Barnes.
Michael? We can't confirm anything until the body's been ID'd.
What? Oh, God.
I'm sorry.
I didn't mean to- Just let me go and get the Attending.
I'm- Ma'am, if you'd just like to take a seat, and I'm sure the Attending can- Oh, Michael.
God.
- Where's the grandmother now? - Crying it out in the family room.
I guess Neela needs to work a little on her death notification.
A little? Grandma's traumatized.
I can't believe we didn't have to sedate her.
You can't teach basic people-skills.
You know how to relate to people or not.
- Croissant? - I'll go talk to her.
You realize you're just encouraging him.
Just because he's a shark doesn't mean we can't eat his pastries.
Hey, who's on call for general surgery tonight? - Sung.
- Okay.
I have to track down an abdominal series from Radiology.
And I have a puking lady that had a dystonic reaction to phenothiazines.
- Zofran? - Yeah, right.
- So how are you doing? - Good.
- Really? - Never better.
- Really? - Yes, yes, yes.
I processed feelings of anger, shame and guilt in an emotionally safe environment.
I've addressed the urge to use alcohol.
And I've consulted both a shaman and a guru, so I'm all good.
That was Wendall, our social worker.
She's getting information from your foster mom.
- She's not gonna take me away? - No.
Your foster mom's gonna take some classes.
You and Cullum will start an after-school program so you can go home together.
- Oh, thank you.
- You're welcome.
Thank you, thank you.
Mary, can you take Amy up to the seventh floor, please? - Sure.
- They'll be waiting for you.
- So you convinced Social Work, huh? - It seems so.
- Good job.
- I took your advice.
I tried to connect.
Didn't do such a good job with the grandmother though.
You and Dr.
Lewis must think I'm a complete idiot.
No, no.
You're just inexperienced.
Hey, hey, hey, come here.
First, you bring them into the family room for a death notification.
Sit down.
Somewhere away from the patients and the staff.
- She just got so hysterical.
- Make sure they are sitting down.
Don't be evasive and don't use euphemisms.
- Use the word "dead" and the word "is.
" - I know all this.
Give them a tissue.
Look them in the eye and make a connection.
Then just say, "I'm very sorry.
" - It's okay.
- I suck.
No, you don't suck.
You're still learning.
I can't believe this.
I'm in a wedding next weekend.
- One percent lido with epi, 6-0 Vicryl.
- God, I'm gonna ruin all the photographs.
They won't look at you, they'll be looking at the bride.
- You owe me one.
- What? No, I don't.
Yeah, you do.
I put down the NG on Mrs.
Leerburger.
I didn't ask you to do that.
- Dr.
Kovac did.
- What? He said you were a little overextended today, unlike the rest of us.
Abby, will you excuse me? I have to go yell at someone.
Have fun.
Okay, Miss Tobel, in the future, try not to pluck your eyebrows in a moving car.
Okay, numb and prep the wound.
I'll be right back.
Get away from me! I know what you want! - You wanna make me suffer! - Security! - Lockhart, you're back.
Welcome back.
- Thank you.
I called John Manning at the International Society for Traumatic Stress Studies We're looking for our son.
We've been waiting for an hour.
- His name is Tevin.
Tevin Burrough.
- Hold on.
I'll check.
We've been here an hour.
Where you going? Get back, bitch! - effective in the treatment of traumatic disorders.
You focus on the most vivid image, emotion or sensation in traumatic memory, simultaneously focusing on an external impulse.
I printed out a bunch of the studies for you.
You can take a look at them.
- We can talk about them tomorrow.
- Okay, thank you.
Good.
Okay.
Abby, eyebrow lac's ready.
You were gonna show me how to do a running subcuticular.
Right.
- Are you okay? - Yes.
Yeah, I'm fine.
This won't leave a mark, will it? Dr.
Lockhart is using a special technique to minimize scarring.
Abby? I'm sorry.
I can't do this right now.
- What? - Sorry.
- Joe, what happened? - He threatened to sue me.
He's parked in front of a hydrant.
- What's with the motor home? - I'm getting rid of it.
- Susan.
- Yeah? I think maybe I came back too soon.
- Are you okay? - I don't know.
I'm not in the right frame of mind to do this.
- Take all the time you need.
- Ray's staying late to cover.
No, it's okay.
Don't worry about it.
I'll call you later.
Sorry.
Sorry.
- You all right? - Yeah, I'm fine.
God.
You'll catch the next one.
Thank you.
Spivak, get out here now.
- Hello, doctor.
- Oh, come on.
We fixed you up.
- Jerry.
- The guy has really great coffee.
Sorry.
Dr.
Lewis.
Are you ready to discuss this morning's fall? - Did you sign Mr.
Fayen in to CT? - Yeah.
I had to go up to CT to push morphine instead of doing it here.
- Just trying to help.
- No.
You're being passive-aggressive.
- Why are you so mad? - Because - I'm used to having control over my life.
- Sam.
- What? - Do you know where Neela is? You're the Attending on Amy Packer, the foster kid? - Yeah.
- This is Mari Hinojosa from DCFS.
I have bad news.
- I think that's everything.
- Thank you.
- "Desensitization reprocessing"? - Yeah.
It's some crazy stuff Dubenko gave me.
- Want me to give it a try? - No.
I think it's dead.
Procrastinating.
Didn't miss it at all.
Work, over the holidays.
I must've made an impression on you.
You didn't notice I was gone for a week.
No, I remember.
You're the guy with the beard.
Yeah.
- Where did you go? - Yellowstone.
The most beautiful place on earth.
You ever been? I didn't realize it until I was smack in the middle of the geysers but the whole thing is actually one gigantic active volcano.
- Did you know that? - No, I did not.
It could blow at any second.
It's actually 30,000 years overdue.
And what would happen if it did? It would wipe out most of the western U.
S.
Cover the rest of the country in ash.
Wreak havoc on the global climate.
- Is that all? - We'd be gone in an instant, just like that.
That's how fragile life is.
You know that.
You work in the ER.
Yeah.
The human life span is so short anyways.
It's almost irrelevant.
Are you high? There's your train.
- See you later.
- Thank you.
Bye.
Between the paramedics and the doctors here, we worked on him for 45 minutes - but his injuries were too severe.
- His mother died when he was 5.
Your son did well in surgery.
They were able to control the bleeding in his liver.
- Since then, it's just been the two of us.
- He wasn't in pain, and he didn't suffer.
I knew something like this was gonna happen.
His heart and his brain were spared.
He'll probably do just fine.
- He was talking about going to college.
- I'm very sorry.
He's gonna be groggy, but he might be able to hear what you're saying.
Take as much time as you need to say goodbye.
This isn't my grandson.
This isn't my son.
Oh, God.
Hello? Hi.
No.
No, they can't refuse to admit her.
She's got post-op adhesions.
- The surgeon's gonna rip our heads off - Haleh.
Haleh.
Listen.
Listen.
Okay.
Just push four of morphine, and I'll be there in a minute, okay? - Fine.
Bye.
- How the hell did this happen? - I'm not sure yet- - Were they mislabeled? - I don't know.
- Did they look the same? - Was there a computer glitch? - I don't know.
All I know is that there were two John Doe's both 16, gunshot wounds, gang-related.
Both treated in Trauma 1 a few hours apart.
Susan, I just do not understand how this happened.
There was a massive communication failure.
Well, it's your job to make sure that people communicate.
- I take full responsibility for it.
- We screwed up.
We didn't know there were two John Does.
We didn't speak to each other or check the board.
Who was in which trauma? Neela, Sam and I worked on a kid with a saphenous cutdown.
Morris, Ray, Pratt and I had the other.
There was no overlap between the traumas? I was in both.
- Who's that? - Med student.
- I put a name alert on the board.
- Why didn't you say anything? No one listens to me.
No one even remembers I was in the room.
- You look like you could use a vacation.
- No.
I got this great time-share down in Boca Grande that I let friends use.
- Friends? - You know, friends that refer friends.
It's got a great house and this beautiful boat and a pair of Jet Skis.
Spivak? Security.
Come on, give me a break, will you? - You're back.
- Yep.
- Thought your shift was over.
- No, not till 10.
- So you were just taking a break? - I guess so.
- Up on the El tracks? - Yeah.
- I love it up there.
- Me too.
Never know who you might run into.
We just put them through hell.
What will you say? I'll tell the truth.
Families of dead patients don't remember much.
The only thing they remember is if it seemed like you cared.
If you were honest and direct with them.
Did Dr.
Lewis tell you to keep me away from them? Yeah.
- I wanna go in with you.
- Okay.
It's unconstitutional.
Thank you.
Do not cross this line, or I will have you arrested.
- I don't see any line.
- You know what I mean.
- You can't come back here.
- This is a public institution.
- It doesn't matter.
- Well, you're violating my civil rights.
- I never got to see a doctor.
- So sue me.
Your office is being towed, by the way.
Hold it, hold it, hold it.
Come on! Come on! Have some pity! - So much for Herb.
- Whatever.
You know he'll be back.
Amy? What's going on? - Who are you? - I'm her doctor.
- I'm bringing her to the Haley Home.
- She lied to me.
- Go talk to your social worker.
- I don't understand.
Stop.
I have two more kids to pick up.
Don't make my job any harder.
- Amy, wait.
- She told me I could go home.
- Thirty days? - You can have visitors after two weeks.
- I need to talk to you.
- Cold turkey, just like that? Well, they give you medication to help ease the withdrawal.
Think about it, okay? How could you pull Amy out of her home behind my back? It wasn't behind your back.
We got new information.
- We had a plan.
- Her caseworker was out of town- - Why didn't you tell me? - If you would stop interrupting- - You're supposed to consult the doctor- - Kovac signed off.
- Hey.
- I'm hating doctors right now.
Neela's mad, Ray practically accused me of elder abuse.
Morris laughed when this kid kicked me in the shin.
- I was gonna ask if you were ready.
- That's all you have to say? You know, we come from different perspectives sometimes and sometimes we disagree.
But whatever happened, you were right.
- Why didn't you tell me about Amy? - I was going to.
- When? - When I had time.
Thought it might be better if you found out after your shift.
I'm an adult.
I don't need you to protect me.
I wasn't trying to.
You made a good decision based on information you had.
- But there was a pattern of incidents.
- Like what? - Like April 16th, scald injury to shoulder.
- Sounds pretty minor to me.
- July 14th, bite inflicted by brother.
- Who we know has behavioral issues.
October 20th, clavicular fracture after a fall.
November 30th, 14-centimeter leg lac after tripping on stairs.
Her history wasn't consistent with her injuries.
Okay.
- Each one is not a big deal, but together- - I got it.
I thought it was a done deal, told Amy everything would work out.
- I got her hopes up.
- Well, in the end - we're doing the right thing for her.
- So why not just tell me that? I was worried that finding out would make you lose your confidence.
And I didn't want that to happen, so If I was trying to protect you, I'm sorry, okay? You know, I didn't always used to be a mobile lawyer.
I used to have big money.
Big, big money.
I lost my shirt on niftypets.
com.
- Can I get something for the pain? - Sure.
Soon as we finish this paperwork required by our lawyer - to guard against frivolous lawsuits.
- I ain't signing nothing.
This document gives us permission to treat you.
This second one specifies whether you have an advance directive or living will.
- Are you serious? - If your heart stops do you want us to use measures to resuscitate you? Just put me out of my misery.
- Hi.
- Hey.
I'm leaving for the day.
I'm waiting on a transfer patient so I'll walk out with you.
- Listen, I'm sorry about this morning.
- No.
I'm sorry.
I've been camping on your couch for six months.
Yeah.
But I didn't mean to be a jerk about it.
No.
I needed a good kick in the ass, and I found a place with Ray, actually.
So I'll be leaving at the end of the week.
Well, take your time.
There's no rush.
And by the way, are you nuts? Yes.
Yes, I am.
- So random question.
- Yes? Do you ever get crushes on people you work with? - What do you mean? - You know.
- Crushes on people you work with.
- Yeah, I guess.
Sometimes.
Why? I don't know.
- What? - What? - Are you leaving for the night? - Yeah.
- Good night, guys.
- Good night.
- Night.
- Night.
- See you at home.
- Okay.
You know, you're really good at teaching other people how to communicate.
Thanks.
We should try it ourselves sometime.
Yeah.
My English, you know? Still working on it.
Now you're gonna pull the Croatian card? That is low.
- You were right about one thing.
- Oh, only one thing? Fifty bucks was too much for a concert ticket.