ER s11e15 Episode Script

URGENCIAS Previously on E.
R.
Okay.
- Dr.
Lockhart.
Mr.
Scanlon.
- Kerry.
I'm mixing up some Ancef.
I'm just gathering up supplies Dubenko's working him hard and my place is closer to the hospital.
So sleeping over is a convenience.
Not into research, don't care about publishing.
You'll be out looking for a job in a couple years.
You'll look back and wish you'd stepped up.
- How do you stand it? - What? The responsibility.
E.
R.
11x15 "ALONE IN A CROWD" - Slow down, buddy.
- Sorry, ma'am.
Wait for me! Did he just call me "ma'am"? - Yeah.
- Because technically, I'm a "miss.
" Maybe you project maturity.
Meaning I look old? No, you look beautiful.
You look beautiful and not a day over 16.
Seriously, if you didn't know me, would you think that I had a fifth grader? No, no.
I could see you with a toddler.
Oh, God.
Sleep deprivation, diapers, teething.
Been there, done that.
Is that something you think you might want again? Kids? You? I don't know.
I can't really imagine myself with an infant again.
- Lucas, take it for five minutes.
- I hate you.
Then Christopher can have it for five minutes.
Callie! Callie! - I got it! - Will somebody-? Will you take that? - Yes.
Hello? - He won't let me have it! - You get it for five - Hi.
- and then Christopher for five.
- Mom.
Mom.
- What? - Can I go to Stacy's house? No.
One of you- - Take the dog out.
- She said no.
- She can be such a bitch.
- Here's your father.
Come on.
Come on.
- We gotta go.
- My dad's here.
I gotta go.
Bye.
Here we go.
Here we go.
Take your coat.
Okay? You got? You got? - Here, Mom.
- You got your trumpet? All right.
Don't try and sweet-talk your dad, okay? The answer is no.
Please close the door! Thank you! Have fun! - Hello? - Hey, it's Pam.
Hi, Pam.
Can I call you right back? Five minutes? - Okay.
Great.
Thanks so much.
Bye.
- Bye.
You know, I'm- I'm really feeling okay now.
- I- I just got a little dizzy.
- Pulse ox, 99 on 2 liters! - I just got a little dizzy is all.
- Got another call.
Lower Wacker, MVC.
- Lucky us.
- I think I'm gonna be okay so if you could just take me back home.
I really appreciate your coming and everything you've- Sir? Sir? Hi, I'm Dr.
Kovac.
- Hello.
- What happened? I- I don't know.
I got a little dizzy.
- I had too much coffee or- - Aphasia and hemiparesis.
Or maybe some kind of anxiety attack.
- I- I- - A little young for CVA.
Is she hypertensive? - My dad actually had high blood pressure.
- Last BP, 128 over 76.
- I don't.
- What's open? - Trauma 1.
- Ma'am, can you tell us your name? Yes.
Ellie.
- Sorry? - My name is Ellie Shore.
What did she say? See you later, Ray! - You heading in? - Yeah.
All right, all right.
Okay.
Wait up, guys.
I'll give you a ride.
I'm working tonight anyway.
We were trying for opposite shifts.
I had to make a switch.
We have a gig on Saturday.
I'm sorry.
Is it okay with you if the guys stay here? Cool.
Hi.
You- You play anything? The viola.
That's kind of bright in my eyes.
- There's nothing wrong.
- Pupils, equal and reactive.
- Nobody is listening to me.
Am I slurring? - Normal sinus on the monitor.
- Is something wrong with my tongue? - Facial droop.
It does feel kind of numb.
- Maybe I'm not talking loud enough.
- She's not hypoglycemic.
- Normal rhythm, no murmur.
- Excuse me! Where am I? Ma'am, you're at a county hospital.
We're gonna take care of you.
- County? Great.
- Can you squeeze my hand? Yeah.
Look, I don't know what that paramedic guy told you, but I'm fine.
- Good grip.
- So you can just stop doing all this and just let me up and call me a cab - and I'll be on my way.
- Now squeeze with your right.
What did you just do? - As hard as you can, squeeze.
- I ca- Anything? I ca- Was that my arm? - I didn't feel it or anything.
- Absent DTRs on the right.
What's wrong with my arm? - What's wrong with my arm? - Positive Babinski.
Oh, God! Where's my leg? My foot! Why can't I feel my-? - Miss! What are you-? Wait! - Call Neuro and let's get a CT.
What are you-? Those are my pants.
Miss, please? Not my underwear! I'm not- Try to- - I'm not staying! - Just try to relax, okay? Ma'am, I'm gonna put a catheter into your bladder.
There might be some discomfort as it passes, okay? You do this every day off? Usually it's a 10K.
Oh, so you're cutting me some slack, right? Just keeping it fun.
You need to stop? No, I got another mile in me.
How about a water break? - Want some? - No, I'm good.
You know it's been three months? Oh, yeah? Since what? What do you want to do for dinner tonight? I don't know.
I don't feel much like going out.
You? Not really.
Race to the fountain? Winner cooks, loser cleans? You're on.
Ready, set- - Hey.
- What? - Happy three-month anniversary.
- Hey! Dr.
Pratt, my MVC couple is ready to go home.
Husband's got a broken foot.
Wife's eye is patched.
Their car's totaled.
Get them a taxi voucher.
- Where do I turn in my PPD results? - Employee Health.
Dr.
Pratt, do you have any dating tips for someone on a med student's budget? Yeah, don't bother.
No, it's incredibly flattering.
That'd be great.
I'll let you know who'll be attending.
Okay.
Thank you very much.
Good news? We're being honored at the Trauma Foundation dinner.
Nice.
Yeah, they're looking for an outstanding senior resident to accept.
So why tell me? Pratt, don't fish for compliments.
It doesn't become you.
Eight p.
m.
on the 16th.
Seven-minute PowerPoint presentation with slides and video.
- Cozying up with management again? - Not in this lifetime.
A bunch of us are meeting later to celebrate Weaver going on vacation.
- If third years are buying, I'm in.
- Well drinks only.
Figure it'll help shore up support for my chief-resident bid.
Neela, what do you say? - Well, it beats going home.
- Is something wrong with home? Come on.
We laugh, we bond.
We do a little team building with our ducklings here.
- Sure.
- All right.
Party on.
What? The big kids aren't invited? It's like my lips are moving, but nothing's coming out.
- I don't feel sick.
I don't feel anything.
- No carotid bruits.
- I feel something.
- Platelets are good.
- PT, PTT's normal.
- What do you think it is? - This is bad.
- Onset of symptoms is too quick - for a tumor.
Aneurysm or AVM? - I'm healthy.
I have three kids.
I'm 35.
- Could be a hypercoagulable state.
- The kids.
Oh, my God.
- The kids! - CT's backed up.
Neuro's on the way.
- We have a name on her yet? - Excuse me.
- Ellie.
- I've gotta- - Close your eyes for a second.
- Wait a minute.
I have to tell you something.
Somebody's got to pick up my kids.
- Orbicularis oculi deficit.
- Call my husband and have him do it.
- Think it's embolic? - More than likely - to the proximal MCA.
- Okay? Please? I think she wants to write something.
Go ahead and let her try.
So TPA could reverse it.
If there's no bleed and we're within three hours.
But no one knows how long she's been down.
Ellie, can you hear me? Yes, yes, yes.
I can hear you.
His name is Dan.
- This is his number.
- You had a stroke.
- Tell him he needs to take the kids.
- It's impossible to express language.
So while you might be able to understand us we definitely won't be able to understand you.
That's not what I wrote.
- What did you do? - Neuro's not coming without a CT.
That's not what I wrote! We're trying to figure out what type of stroke you had - so that we can treat it.
- I had a stroke? See if you can track down any family members.
That's impossible.
Old people get strokes.
I mean, whatever this is it's just temporary.
It has to be.
- Hey.
- Hi, what's up? I'm just down on a surgical consult.
Did I, by any chance, leave a watch at your place? Yeah, it's in my locker.
Abby, do you still need that cath UA on Mrs.
Russell? No.
Clean catch.
Negative dip.
I brought in some lunch if maybe you'd wanna - meet up in the break room.
- Actually I was thinking that maybe we shouldn't be quite so together here.
- I thought everybody knows.
- I didn't tell anybody.
Except maybe one person.
You? - No.
- So, good.
Your sofa getting much action these days? - What? - Living with Ray is- How can I put it? Loud, messy and a bit crowded.
- I told you to take time moving out.
- It wasn't any better at your place.
Who's next? Six-year-old with wrist pain.
Is there a Clayton Davis? Over here.
- You Clayton? - I'm Tucker, his big brother.
He's got a bump on his head.
Show her.
This hurts too.
How did all this happen, Clayton? He fell off the kitchen counter.
- And who are you? - She's our sister, Bridget.
Whole family's here, huh? My dad went to get some coffee.
I can take Clayton in for now.
But before he can be treated, your father has to sign forms.
- I'll go find him.
- Okay.
So, young man, what were you doing on top of the kitchen counter? Reaching for a bowl.
We were hungry.
Let me find out where to go.
Hi.
My neighbor was brought here earlier.
I have her kids with me.
Her name is Ellie Shore.
Okay, okay.
If by some chance this is a stroke it's minor.
It has to be.
I can think.
I can hear.
- I can feel.
- CT's ready for her.
- Put on a monitor.
Suction the secretion.
- Am I drooling? Yeah, I am.
I'm drooling.
- This'll make you more comfortable.
- She's smiling.
Maybe that means it's not so bad.
She's a nurse.
Maybe she doesn't know.
Okay, Ellie, I'm gonna look in your mouth.
All right? She's a doctor.
She's not smiling as much.
Maybe she's just more serious.
- No gag reflex.
- Maybe not.
- Muscles are weak on the right.
- Now this one.
He is gorgeous.
- What is he? Six-four, 6'5"? - Tube her to be safe? Ellie, we're gonna have to put a tube in your throat to protect your airway.
Can they come in? - Okay, just for a minute.
- Ellie, your kids are here.
They are? She can hear you better if you stand there.
- Why? - Because your mom is having trouble moving the right side of her body.
Hi, guys! Don't be scared, okay? Is that why her face looks funny? - Is she dying? - No.
- No, she's not.
- Honey, Mommy's not dying.
- She's gonna be fine.
- When did you see her last? Right after school.
She was fine.
You should take them outside.
- Why is she doing that? - Well, we just- We need to help her breathing.
She'll be fine.
Come on.
Let the doctors take care of your mom.
- Let's go.
Come on.
- Mommy.
- Push the etomidate and sux.
- You're going to sleep now.
When you wake up, you'll be breathing with a ventilator.
Oh, God.
Am I dead? Is this it? Is this death? No, something's wrong.
I can't open my eyes.
I can't move.
Somebody help me.
There's no evidence of hemorrhage, so it's probably a clot.
It's too late for TPA? It can cause brain bleed if it's done after three hours.
If her kids saw her a few hours ago had a rig ride ER assessment It's too close to take a chance.
Well, what are our other options? Well, hope that collateral flow can develop.
Get her into physical therapy.
With a major stroke like this, her chances of a meaningful recovery aren't good.
The only other option is the MERCI.
The what? It's a catheter-retrieval system.
It takes you into the brain through an artery and allows you to corkscrew the clot out.
And it reverses the stroke completely? It's not without risks.
Oh, God! Oh, God! I'm blind! I can't breathe! Help me! Please, someone! Please, someone! - Do something, please! - On my count.
- Someone! Can't anybody hear me? - One, two, three.
Help me.
Please, God.
Help me! Hey, can I ask you a question? Yeah.
Did you ever ask Luka about his kids? One time, I think.
Yeah.
Why? I don't know.
Sometimes I think- Is she crying? Heart rate's up to 130.
BP's 170 over 92.
- We have to get her to the ER.
- What's going on? - When did we tube her? - About 10 minutes ago.
Ellie, it's all right.
We're gonna help you.
The etomidate wore off before the sux.
She's conscious but paralyzed.
- Okay, coming through! - What's the story? - Non-violent demonstration got violent.
- Protestors went nuts downtown.
That kid the cop beat up last week.
This one got tear gas to the face.
I was just picking up my grandma's medicine at the pharmacy.
Crush injury, second-degree burns, multiple minor lacs coming in behind.
Mob torched cars, broke a lot of glass? Good vitals after four of morphine.
I feel pretty bad.
Could I get some more? Yeah.
As soon as we make sure you're actually hurting, dude.
Did he just withhold pain meds? I think it's safe to remove him from our shortlist.
Too late.
He's officially applied.
- What about Nichol? - Talks too much.
- Pattengill? - I don't know.
Skilled but aloof.
We're in trouble.
The pickings for next year's chief resident are slim.
- We're gonna have to look elsewhere.
- What about Pratt? Susan, he's the best we've got.
With some serious caveats.
Med students and interns already go to him with their questions.
Doesn't make him a leader.
- Oh, God! Oh, God! - Need some help here.
She's tachycardic and hypertensive.
- Sedative wore off before the paralytic.
- Help! Get her to curtain two.
- What-? What are they saying? - She's panicking.
- Help! Help me.
- I don't want to snow her too much.
- We need to follow serial neural exams.
- Help me.
Why-? Help me! Why isn't anybody doing anything? - I swear to God, I'm losing it! - Fent's on board.
- I swear to God, I'm losing it! - Ellie, it's okay.
What you are feeling is a normal side effect.
We gave you a narcotic called fentanyl that'll help ease your discomfort.
It'll make you dizzy at first, but it'll help calm you.
- Okay? - What is that stuff? When the medication wears off, you'll be able to open your eyes again.
Because it is good.
Really good.
Dr.
Lockhart, a moment of your time? It's okay.
We got this.
Neuro checks q.
10 minutes.
Do you remember our abdominal wound yesterday? - Guess what we found during surgery.
- Liver lac? - Guess again.
- Spleen? Condom full of cocaine, lodged in the jejunum.
Knife nicked the bag, releasing coke into the peritoneum.
- Explains the sympathetic overdrive.
- Totally fantastic case.
If you write it up today there's a chance to get it into next month's issues.
If Trauma doesn't bite - Annals of Emergency Medicine.
- You want me to? Us.
I'll help you.
It'll only take a couple hours.
I'm- I'm working.
I'll talk to your superior.
They're prepping my thyroidectomy.
Gotta go.
- I'm sorry, but- - What intern doesn't want to publish? - Of course, I want to get published- - Then it'd be idiotic to pass this up.
- Right.
- Okay.
My office at 7.
Your distal radius and ulna are fine.
What's that mean? I don't think his wrist is broken.
You still hungry, Clayton? We never ate.
We were making dinner when he fell.
So you were both helping out, were you? How very grown-up.
Hey, this is my dad.
- Hey.
- Hey, how's he doing? How's he doing? His neuro exam is normal.
Looks like a mild concussion.
He'll need observation at home over the next 24 hours.
The wrist is probably just sprained but we'll get an x-ray just to be sure.
Well, whatever you need to do.
Have you been drinking, Mr.
Davis? I had a beer.
I'll arrange for the children to get food trays while we're waiting on Radiology.
- Thanks.
- Okay.
Dr.
Pratt, I have a case involving a 6-year-old with a sprained wrist.
- Father appears to have been drinking.
- Present to Morris.
- I'd rather present to you.
- I've got six med students in my face every time I turn around.
I'm not the only third year on the floor.
Left side still works.
Sort of.
That's a good sign.
Try to write again.
Come on.
Move.
Do it.
Come on.
Move.
- Twitch, jerk, anything.
- Your heart rate's down.
Fentanyl must agree with you.
Damn it! - You okay in there? - The tube in my throat hurts.
I can't pee by myself.
Can't walk.
Yeah, you got some gorgeous kids.
- Is she talking to me? - I cannot believe you've had three.
- You look great.
- Okay, you've seen my stretch mark.
- You're not talking to me.
- They're in our family room right now.
- They're hanging in there, okay? - Can't they wait here? I mean, who's- Who's watching? Have they eaten? Has their father come yet? Dear God, what is that? Y es.
Pretty stinky, huh? Welcome to my world.
I'll be right back.
Hey, Mrs.
Lacy.
How are you doing? Okay, let's put this up.
Watch your leg.
And let's get you out of this thing, okay? There you go.
Must have been 500 people there.
Add police presence, throw a bottle.
All of a sudden there's looting going on.
Not me.
What are the odds I'd have gotten hit, you know? Eyes are pretty irritated.
Can you follow my finger? That tear gas is some nasty stuff.
Did you get a TV out of the deal? I told you, I was just walking by.
All right? Extraocular movements intact.
Running errands for granny during a riot.
- No septal hematoma.
- You don't believe me? Put it this way, dude.
We've heard it all before.
Right, Chuny? Heart rate's down to 90 after a liter.
All right.
Keep him in PO.
D5, half of We're gonna do a CAT scan to define your injury.
Then we'll send you to OR for repair.
Okay, thanks.
That guy's full of crap.
Don't sweat it.
I couldn't spot the con artists until my second year.
I don't know the rest.
Heart rate's still up.
Did you give her more fent yet? - Oh, yeah.
More of that.
- Not yet.
Twenty-five mics? - Yeah.
- No wedding ring.
Husband on his way.
Can't do anything without consent.
Sexy accent too.
Wonder where he's from.
Neighbor tracked him down.
He's on his way.
- Feeling any better, Ellie? - What big strong hands you have.
It's pathetic.
This guy touches me, and my heart races.
- What am I, 14? - BP, 127 over 77.
Actually, it's pounding now.
- Okay, this isn't so good.
- Heart rate's 240.
- What's happening? - Looks like SVT.
Get the crash cart.
She's hemodynamically stable.
Try meds.
Six of adenosine.
- I'm getting dizzy.
It's hard to breathe.
- Is it related to her stroke? No.
If her atrium doesn't beat properly, there can be pooling of blood.
- She threw a clot, it went to her brain? - Yeah.
I can't take this.
Adenosine pushed at 18:57.
Ellie, this is gonna slow your heart down.
You may feel discomfort.
But only for a few seconds, okay? Oh, God! - What's happening? - Are you her husband? - Yes.
- Back on SVT.
Right now she's in an abnormal heart rhythm.
We're trying to fix it.
We believe something similar may have happened before.
It would've allowed a clot to form, move to her brain - causing the stroke.
- She had a stroke? I need the rhythm strip.
- Double the dosage? - Wait.
It's atrial flutter.
Two-to-one block.
Adenosine won't convert that.
- Twenty milligrams Diltiazem? - Slow IV push.
Can you tell me what's happening? Ellie, I'm so sorry.
I know this was painful but this drug allowed us to figure out your heart problem.
Now we can give you the proper medication.
This one won't hurt, okay? - Is she awake? - We can't be sure.
But she has had spontaneous eye movement.
Sinus rhythm at 76.
It's okay.
You can come closer.
Honey? - Ellie, can you hear me? - You're here.
Sir? No, don't cry.
No, no.
There's a procedure we want to try called clot extraction.
- Dan? - A catheter is inserted into the groin - and threaded up in the brain.
- The clot's identified - then a retrieval system pulls it out.
- How you doing? - If it works, the stroke can be reversed.
- If it doesn't? There are certain risks involved.
Infection and complications - that may lead to coma or death.
- Your heart's back to normal.
- So she's not in a coma now? - No, no.
The stroke affected the language center of her brain.
So she can see and hear, but she cannot communicate.
Do you want us to go ahead with the procedure? - Say yes.
- What happens if we don't do it? Well, her heart condition is treated, but she won't improve neurologically.
- But she won't die.
- No, Dan.
Listen to what he's saying.
This other thing might fix me.
- How long can she live like this? - I can't live this way.
Indefinitely.
I don't know what to do.
You do.
Remember when we talked about your cousin? The one in the wreck? I said I'd rather die than live that way? - She's not a vegetable, right? - This is worse, Dan! I'm aware! I don't get to be brain-dead! - We can't do this without your consent.
- What about my consent? I consent, damn it! I consent! I consent! - Is that what's best? - Dan, have some balls.
- If you love me, don't leave me like this.
- There's a chance she'll come out.
Please, this once, hear me.
Oh, my God.
Ellie? Ellie? Give consent, please.
Okay.
Mr.
Davis? - Sir? - Yeah? Clayton's on his way back from X-ray.
You'll be glad to know there doesn't appear to be a fracture.
That's good.
What I'd like to do is splint Clayton's wrist and have you bring him back in a week to get rechecked.
Oh, all right.
- Where are the children? - I had to take Bridget to the bathroom.
So we about done here? Yes.
I've already written Clayton's discharge orders.
Did you drive? - You might want to bring the car around.
- No, we took the el.
I can give you a taxi voucher if you'd like.
Yeah, taxi! Sure.
Excuse me.
I'll be right back.
- Morris? - What up? Six-year-old, negative x-ray, point tenderness at the scaphoid splinted, RICE, follow-up in a week.
Say no more.
There seems to be a strange family dynamic.
What? You talking physical or sexual abuse? Neither.
I'm not sure, actually.
What I do know is that the father has had a beer.
Breaking news: Having a brew isn't a crime.
We got a board full of real patients, Neela.
- Ever been up to Neuroradiology before? - Nope.
- Medford seems like a solid doc.
- I hear he's the best.
I hear he's screwing a med student.
Excuse me.
Which suite for Dr.
Medford? - Room A.
Down the hall on your right.
- Thank you.
- Ellie Shore.
- Doctor's on his way.
Ellie, we have to go back downstairs now, okay? - Wait.
You're leaving? - Dr.
Medford's team - is gonna take good care of you.
- But I - I don't know these people.
- Ellie? - They're strangers.
- I'm Dr.
Medford.
We're going to clean the top of your leg at the site where the catheter will pass.
And I'm Martha.
I'll be shaving part of your pubic hair.
Fantastic.
- Hi.
- Oh, there you are.
Come on in.
I pulled the chart.
Good.
Do you like burgers? I thought we could do this over food.
- You mean now? - Yeah.
- Yeah.
Here.
Put this on.
- Well - There's a good place down the street.
- I'm not actually that hungry.
That looks good on you.
Okay? Shall we? Okay.
- We any closer? - I'd say- - Another couple of hours? - Yeah.
Well we can start with the first course, skip to the last finish with the main.
Or we could just order.
- Chicago.
The number for Tiny's Pizza.
- Okay, now, that's spooky.
What do you think? Large pepperoni and mushroom? I think I love you.
I would like to place an order for delivery, please.
Brat.
- Any nerve damage? - Nope.
Wound's been copiously irrigated, Ancef on board Plastics and OMF both consulted, waiting on an OR to open up.
- Good deal.
- This is Irene, Kevin's grandmother.
She's a diabetic.
She needed her insulin this afternoon.
My grandson's a good boy.
Why you got to accuse him of stealing TVs? - Excuse me? - He's not a thief.
He goes to college.
- I was kidding, Pratt.
- No, man, you weren't kidding.
Whatever, dude.
I'm sorry if you took offense.
Morris, get in here.
- Yeah? - What the hell was that all about? He was part of a mob that was gassed by the cops after breaking into a bunch of storefronts.
You accused that kid of looting? It ain't a stretch.
Guys come in all the time with stories about sick grannies.
Half the time, it's bogus.
You can't make assumptions about every black kid here.
- This coming from you, huh? - Yes, this coming from me! Now I want you to go and apologize to those people - like you mean it.
- What? Just do it.
Well done.
Yeah, well, guy's an idiot.
Anyway.
Hey, Pratt.
Carter and Kovac think you should apply - for the chief-residency position.
- What about you? If I see more of what I just saw, I could be persuaded.
Are you interested? Thank you.
But no.
She had what's called an embolic stroke.
It's something that can happen to anyone.
- Even kids? - Usually not kids.
She's in Neuroradiology now.
So she, like, stays this way forever? Maybe, but she could also recover.
Be just fine again.
Can you fix her or not? We're gonna try.
But for now, just- Just be here for each other.
Send her your love and good thoughts, okay? I called my mom a bitch today.
I'm sure she knows you didn't mean that.
- Is she all by herself? - No, no.
I'm gonna actually go now and check on her.
Okay? Lucas was 8 pounds, 4 ounces.
Christopher, 9 pounds, 1 ounce.
This is good.
Stay focused.
Stay alert, and I'll stay connected.
Gonna be a little burning at the top of your leg.
- How's she doing? - Putting guide ports in the femoral artery.
- Erin, 9 pounds, 11 ounces.
- Nineteen-gauge single-wall needle.
Haven't been the same since.
Wonder if they can do a tummy tuck while they're at it.
Thought you might want to see a familiar face.
Hey.
Okay, so I was thinking I would start by maybe gathering some data - on body stuffing- - Two mineral waters - and a couple of burgers? Medium okay? - Sure.
Sure.
Yeah, two medium burgers and we'll share a basket of fries.
You got it.
Thank you.
- Are- Are you from here originally? - Pardon me? I don't know.
I detected a hint of Minnesotan in your accent.
Yes.
Yeah, I mostly grew up in Saint Paul but I've lived all over the place.
Anyway, in terms of the paper- Introduction, case summary, discussion.
That's all there is to it.
Do you-? Do you like foreign films? Something's in me.
Actually in my brain right now.
Feels funny.
Kind of hollow.
Ellie, we're gonna take some pictures of arteries in your brain.
Okay? - Lonely.
- Catheter is in the internal carotid.
- Let's go for it.
- Injecting the dye.
Should be a defect in the MCA.
God, I'm bored.
- That the occlusion? - M-one.
- Proximal middle cerebral artery.
- Yeah, completely blocked by the clot.
- Maybe I'm tired of talking to myself.
- Ellie, the clot's where we thought it was.
- It prevents flow to the brain - Maybe just let go.
- controlling language, motor function.
- Maybe just let go.
- So, what time do you wanna get up? - Six.
How about 5, and we work in a run? You're relentless.
Just committed.
- Good night.
- Good night.
- Shut up.
- I'm serious.
Morris is applying for chief resident.
He is an unethical, talentless dolt surrounded by sycophants.
Well, maybe he should forget resident and run for president.
- Pratt should get the job.
- Need any coffee? Mr.
Davis? Where are your children? I didn't see them outside.
Mr.
Davis, wait.
You're supposed to be with your kids.
Clayton's got a concussion.
He needs to be monitored.
- Hey, wait up, man.
- You need to stay with Clayton tonight.
I ain't got no kids.
The oldest one gave me 7 bucks and told me to pretend.
- That's all.
- Pretend what? That they was mine.
Memories.
Blended.
Folding like water.
Lake.
That smell.
Sun block? Jasmine.
Happy.
All of us.
Wet.
Kids.
Noisy.
Messy.
Love.
You.
There are only two available social workers tonight for six hospitals? Well, can you try a 911 page then? Please.
Neela Rasgotra, County Hospital ER.
Thank you.
If the kid had the smarts to hire someone as his dad he's gonna be responsible monitoring the concussion.
Yeah, but why would he lie about his father? Maybe his real folks aren't such prizes.
Maybe he didn't want them to know.
He filled out the form.
Think the address is correct? - It's a real street.
Crappy neighborhood.
- Phone's disconnected.
Twenty-two-years old, multiple GSWs to the abdomen.
BP, 90 palp.
Pulse ox, 97 on 10 liters.
- What's open? - Trauma One.
- Dr.
Lewis? - Ask Pratt.
- Dr.
Pratt.
- Yeah? Attendings are unavailable.
I need to leave.
An emergency.
- Do I have permission to go? - What kind of emergency? Well, I had a patient earlier, an entire family and I'm very concerned about them.
There are no available social workers.
And all I have is an address on Duluth.
Well, we're pretty well caught up here.
So go.
But take Ray with you.
Duluth's a rough neighborhood.
Hello? Oh, hi.
- Wait.
What time is it there? - Who is it? I can barely hear you.
Oh, you just got that? Yeah, I thought you could use some ceftriaxone.
Not much.
Just working.
Where are you going? - See you at work.
- John? Are you there? Hey, can I call you right back? - Look, I'm sorry.
- Who was it? It was stupid, it was rude and I'm sorry.
Can we go back inside? Is this a diversion for you until she comes back to the States? - It's freezing here.
- Go back inside.
Hey.
I had a baby with her.
What am I supposed to do? Cut her out of my life because I'm with you? Are you with me? Can we just please go back inside? Don't- Come on, don't walk away.
Okay.
So that's it? One phone call and you're gone, huh? One phone call? You were in bed with me.
You could've mentioned that between "hi" and the weather.
We spend every night together.
We enjoy each other's company.
We have fun.
All right.
I know what you want me to say and- And I can't say it, okay? I'm sorry.
Well, at least you're honest.
- Look, it doesn't mean that we- - Yeah, it does.
Wendall.
Fluoro on.
Torquing clockwise.
- Injecting.
- Cross your fingers.
One, two, three - Ten cc's in.
- four.
- Think you got it? - Pulling back.
- Got it.
- Beautiful.
Fully re-canulized.
No fragments in the distal branches.
Wide open.
Wake up, Ellie.
Good tidal volume.
Can we get her off the vent? I'm not sure.
If we extubate, it may be better to do it in the ER just to be safe.
Yeah.
- Who is it? - Tucker, it's Dr.
Rasgotra from the hospital.
Hey, buddy.
Your folks around? Get up, you guys.
Get up.
Come on.
Get up.
They're gonna take us now.
- What for? - Tucker.
Wake up, Clayton.
Remember? I told you they'd split us up if they found out.
- Get your coats on.
- Tucker, where are your parents? There's just my mom.
In there.
Hello? Ms.
Davis? Oh, God.
She got sick.
A week ago.
- Hey.
- Hey.
Pull up a stool, guys.
- How come no one's here yet? - Come on.
I'm someone.
Come on, senior residents don't bite.
Not this one anyway.
Barkeep, we got some thirsty students here.
- I'll have a beer.
- Me too.
Light.
- Me three.
- Vodka, neat.
I like the way you think, Jane.
What? No interns? Doctors Barnett and Rasgotra had some patient follow-up thing.
- Where's Abby? - Right here.
- Oh, hey.
Hi.
Sit down.
- Hi.
Where have you been? I feel like I haven't seen you all shift.
Around.
Morris, what's this all about? In a word, mentoring.
Is Dr.
Pratt coming? He better be.
He's splitting the bill.
all night as they close up to seven.
Gordon inbounds to Hinkley.
Hinkley brings it up across the half court Ellie? I want you to take a deep breath, okay? Tidal volume's 1200 with an excellent NIF.
You ready? Yeah.
Okay, I'm gonna pull this tube out now.
Deep breath in.
And out.
Don't worry.
That'll stop.
Okay.
Okay, let's sit her up.
Want to try and say something? Thank you.
Hey.