ER s11e20 Episode Script
You Are Here
E.
R.
Previously on E.
R.
- Church? - Yeah.
My niece is getting baptized.
- I have to hold her.
- Oh, you're the godfather.
You know, tenure means financial security.
Tenured Attendings need the ability to carry their own weight.
You mean, bring in grant money.
We would be interested in covering the construction costs.
The entire thing? - I had a gig.
- Screw your gig! Medicine isn't a day job! The Chief Resident in a busy, urban ER - We're not giving it to him though, right? - Considering it.
You out of your mind? PREGNANCY TEST E.
R.
11x20 "YOU ARE HERE" Hi.
- Hey.
- What you doing down there? I don't know.
Get back up here.
Oh, man.
I can't.
I want to, I do, but I gotta jam.
What, you got gigs during the day? Different gig.
I'm a doctor.
Oh, yeah, right.
No, really, I am.
I work at County.
And I'm looking at a 12-hour shift that starts in 29 minutes.
- So - You want some? Better than coffee.
Still, I gotta pass.
Oh, because you're a doctor? Pretty much, yeah.
That's one sucky day job you got.
- That's what I'm talking about.
- Yeah? - What you know about that? - Shut up and listen.
Ready to go to school, to get an education? - Show me something.
- Okay! Hey, yo, who you bringing to that party tonight? What party? You serious? - Darnell's 30th, man.
- Oh, man.
Let me guess, you too busy.
Hey, I wouldn't be out here at 7 whupping your ass if I wasn't.
- You ain't been back in a while, man.
- Hey, like you said, I'm a busy man.
Okay, Doc Ain't-Got-Time-For-My-Friends.
I make this shot you dragging your ass to that party.
- Right, like that's gonna happen.
- Okay.
Come on, show me something.
It's crunch time.
Don't be a bum out there.
Show me something.
Crunch time, baby.
- Game over.
- Hey, Sam? - Yeah? - Out of shaving gel.
Bo- Bottom drawer on the right.
Alex, move it! Carpool's here! - You find it? - Still looking.
PREGNANCY TEST It's all the way in the back.
- What? - The shaving gel.
You almost done in here then? Yeah.
Go ahead if you need to.
No, I can wait.
Mike - She in? - Let me check.
Make sure these QA files get to Anspaugh ASAP and I need five copies of this budget collated.
Call Surgery.
Tell them I'm still waiting for their M-and-M data and I'm not happy about it.
Yes, ma'am.
Oh, this coffee tastes like crap.
Doesn't anyone change filters around here? Sorry, new assistant.
Good help, you know? Hard to find.
So the formal announcement will come out later today but I wanted to tell you the news myself.
You've been awarded tenure.
Seriously? Yep.
Congratulations.
Wow, that's great! I just- I wasn't expecting it until next year or something.
Nonsense.
You've earned it.
Well, thank you, Kerry.
That means a lot to me.
Sure.
I still have some other notifications to make today so if you could keep this on a need-to-know basis After all, you got 30 years to gloat about it, right? What? You don't like that station? No, it's fine.
You feel okay today? Yeah.
Why? Well, you- You were in the bathroom a long time.
No more than usual.
So was it positive or negative? Negative.
- Were you gonna say anything? - I was worried.
I checked.
I was wrong.
What is there to say? - What, you'd rather I was pregnant? - I'd rather you didn't keep secrets.
- Yeah, that's funny coming from you.
- What's that supposed to mean? You've seen all of my dirty laundry.
I barely know a thing about you.
- That's not true.
- You don't talk, Luka.
- About what? - About anything.
How am I to know you're honest when you don't talk? About what? I'm not the one who lied - about a test.
- I didn't lie.
- Yeah, fine.
You omitted.
- You don't? What, what? What do I omit? Your past.
Your family.
I should check the traffic.
He's the author of a wonderful new book titled Growing Up Single.
Neela, cat-litter ingestion, uncontrollable drooling.
- Drooling? - Either that or a butt abscess - on a 300-pounder.
Your choice.
- Drooler.
- The labs are back on Mr.
Busto.
- All right, hang 500 of Levaquin.
Eugene Bradley's here complaining about pain again.
Here without a parent.
Morris, see what this kid's deal is.
Bet it's the same as last month: "My pills don't work.
" Last week: "I lost the bottle.
" There's: "When pain's this bad, I gotta have my IV.
" Can't blame him.
His disease has made him narcotic-dependent.
- A.
K.
A.
addict.
- No, there's a difference.
And we take complaints here seriously, so go.
Isn't it Abby's turn to treat this? - Abby's at some family thing with Jake.
- Looks like it's your turn.
TMJ's going out on NSAIDS, Gram's stain's negative on effusion.
Home and ortho follow-up.
Gonna start calling you "the closer," man.
All right.
Hey, kid over there.
Sickle cell.
Bit of pain, without his mother.
Get his story.
Call the Heme Clinic, give a heads up.
- If it's non-emergent, send him home.
- Sure.
Anyone ever tell you you got a cruel streak? - Have you seen Lewis? - No, she's hiding out.
But congrats by the way.
Associate Professor of Emergency Medicine.
Nice ring to it.
- How did you? - Oh, it's Who's "CoryB123"? Just someone on my IM Buddy List.
- A celebration is in order.
- Yeah.
Well, it's not exactly official yet, "JerrBear99.
" So keep it quiet, off the Internet.
Good news needs to be shared.
My mom's at work, but she told me to come.
It's a good pulse.
Minimal swelling.
It doesn't look that bad.
Unfortunately, we can't treat you without her consent.
I brought a note from her.
Hey, unless it's an emergency, we need the real deal, man.
Look, it hurts really bad this time.
Real bad.
You know? - What are you taking for it? - Morphine.
But most of the time, the pills are just a waste.
And my mom says I probably need an IV.
Okay.
Well, I'll tell you what I'm gonna do.
I'm gonna get you a couple of taxi vouchers.
You're gonna go home, take your pills, and stay off your feet.
If you're in pain when your mom gets home, have her bring you back.
Then I'm gonna have to wait again.
You just ask for Dr.
Barnett.
Bring you right in, okay? You getting organized on us? These two shelves, free samples.
Those cabinets, alphabetized.
Benzos and narcotics here and actually locked up.
If only I could do this with my kitchen.
- What's going on? - Nothing.
- Has Kerry found you yet? - No, I haven't seen her.
Why? They're making the tenure announcements today.
And you're not the only one getting it.
What? - When did this happen? - Just now.
No.
I mean, when did you apply? Are you surprised? No, of course you'd get tenure.
You're great.
I thought you said you were gonna wait a couple years.
Yeah, well, they kind of encouraged me to apply early.
Really? They didn't encourage me to apply at all.
Well, she's probably been trying to find you all morning.
Well, I've been in here busting my ass.
Yeah, because you're dedicated to reorganizing the drugs.
Or is it because you're avoiding Morris? Complaining of nausea, vomiting, diarrhea, pain.
It's the flu.
All right, I'll tell him.
Give the patellar fracture a shot of Toradol.
I can't stand hearing her whine.
Isn't Toradol contraindicated since she's going to the OR? - If you're busy, I can find Dr.
Pratt.
- Morris? Stay here.
Don't move.
I'm here for you, okay, buddy? - What up, chief? - We need to talk.
If this is about the lady who refused a Pap smear- You're the new chief resident.
Oh, my God.
Oh, m- This is fantastic.
Thank you, thank you.
Thank you, Dr.
Lewis.
Wait until my old man hears.
- He will eat his words.
- It is a provisional basis.
There'll be a 3-month probation.
- My presentation was a hit.
- I'll be your supervisor.
- I could feel the room- - Are you listening? It is so gratifying to see that meritocracy is alive and well at County that hard work is rewarded, and that an individual's ability is valued over politics, wealth, and the proverbial old-boys club.
Right.
You start today.
Yes, I do.
Yeah.
- Do I have any messages? - No.
- Are you sure? - Have I given you reason to doubt? - ER.
- Kitty-litter connoisseur given Benadryl drooling stopped.
Suggested she get a dog.
Hey, some guy on line one says the party's at 8 - and that a ball had too much bounce.
- Tell him a bet's a bet.
- Excellent as always.
- Pleurocentesis going upstairs.
- Need you to sign.
- Whatever happened with Eugene? Sickle cell kid? Sent him home.
Really? Then what's he still doing here? Morris didn't tell you, huh? - Tell me what? - Eugene's a frequent flyer.
Knows how to work the system.
- Hey, Morris? - Hang on, kiddo.
Can I have your attention, please? I am very proud to announce that effective immediately I am your new chief resident.
- This is a joke, right? - What? You didn't want it.
Explosion in apartment house.
Sixteen casualties, seven critical.
Okay.
Okay, nurses, restock the trauma rooms med students find an intern, docs at the ready.
Everybody, move out! I wonder what Abby's gonna say.
- Jesus Christ.
- Amen.
- Amen.
- Amen.
Do you reject Satan and all his works and all his empty promises? - I do.
- I do.
Do you believe in God the Father almighty, creator of heaven and earth? - I do.
- I do.
- Are you all right? - Do you believe in Jesus Christ Do you believe in Jesus Christ, his only son, our Lord born of the Virgin Mary, was crucified died, was buried, rose from the dead, and is now sitted at the right hand of the Father? - I do.
- Do you believe in the Holy Spirit the Holy Catholic Church, the communion of saints the forgiveness of sins, the resurrection of the body - and the life everlasting? - I do.
Nurse, five of morphine, normal saline, liter of bolus.
What's open? - Did you call me "nurse"? - Check for an H and H.
- Move him to Trauma 2.
- Hey, doc! - I'm busy, dude.
- But I can't walk! He's smart.
That makes it an emergency.
I need a wheelchair.
Looks like we have a non-ambulatory sickler here.
- For Eugene? - He says he can't walk.
- You're the doctor.
- Get me an IV, CBC, retic one liter of saline, two of MS, okay? - Thanks, man.
- Coming through! What are you doing? We've got multiples.
- What's her story? - Marilyn Bracken, 40, burns.
Lacs to the face, arms and belly.
- Was she altered? - No evidence of head trauma.
- Smoke inhalation? - Pulse ox, 100 percent.
- Can't do better.
- Lungs clear.
What the hell is wrong with me? - I was dumb.
- Heart rate's to 130.
Pretty tachy.
Internal hemorrhage? Not blood in Morrison's.
Hang in there.
- Tension pneumo? - Good breath sounds.
- Satting on 100.
- Cardiac contusion? - I shouldn't have started.
- No sign of trauma.
EKG looks normal.
- I give up.
What have we got? - We don't know.
Multifocal PVCs.
- I didn't mean it.
- Perfect, 100 of lidocaine.
- Hundred percent nonrebreather.
- Down to 80/60.
Not bleeding.
Lungs are up.
No sign of head trauma.
- No cardiac history.
- Respiratory rate's up to 40.
No tamponade.
Pressure's dropping.
- What are we gonna do? - We don't know.
Be ready with Etomidate and sux.
- Could this be spinal shock? - She's moving all extremities.
- Systolic's down to 65.
- Maybe she's allergic to latex.
No, no, no.
Just- Okay, let's step back and start over.
- Airway, breathing.
- Respiratory rate's up to 60.
- We need to intubate.
- Circulation.
- Repeat.
What else? - O-neg on the infuser.
- Wait.
Hold the meds.
Venous blood? - Yeah.
- Did you hit an artery? - No.
No way.
- Are we still doing- - No, it's cyanide toxicity.
Retinal arteries and veins are red.
Open an antidote kit.
She ingested cyanide? It's released when things like PVC, polyurethane foam and polyester wadding burn.
Amyl nitrate perles.
Got them.
Usually cyanide toxicity is fatal.
- Ten cc's of sodium nitrate.
- Intubation? We need to watch for cardiogenic and hemorrhagic etiologies.
Okay.
Let's just give it a minute for the meds to kick in.
- Do I just keep bagging? - BP's 90/60.
She's good.
Cool catch.
Okay, let's keep her at a hundred percent nonrebreather.
Send off for an RBC and plasma cyanide level.
Excuse me.
I thought you couldn't walk, man.
I had to pee.
What am I supposed to do? Well, you can stop playing me, for one thing.
No, man.
It's different.
I'm serious.
I need to be here.
The IV.
That's why my foot feels better.
Give me your arm.
Okay, you got your fix.
- Go.
- It's different.
I'm serious.
- I need to be here.
- I need to take care of patients.
- So go home and take your meds, okay? - I can't.
I'm all out.
All right.
MS Contin, 20 pills.
- Get your refill from Hematology, okay? - It's gonna be bad.
I know it.
- I'm starting to lose my patience.
- Let me stay one night.
Please, one night.
No.
- Nicely done.
- Thank you very much.
Cuts on your chest, arms, and some bruising.
Remarkable, considering your fall.
I jumped.
- Can you feel me touching your leg? - You're not pressing hard, right? Pratt, Kovac wants to know if you're done.
- We're getting slammed out here.
- Tell him we'll both be right there.
- Lateral lower-extremity numbness.
- Motor exam's limited by his pain.
- What? - Peroneal nerve injury.
- Possible diagnoses.
- Or cord injury.
Contusions, lacs, and all four limbs move.
You're making this more complicated.
Also had some partial saddle anesthesia.
DTRs are intact.
No sensory-level deficit.
Motor and sensory loss is usually incomplete with cauda equina syndrome.
- X-ray's back.
- Good.
Maybe now I'll get some respect around here.
Your roommates aren't here.
Doesn't mean they're not at a different hospital.
When did you see them last? C- spine's clear.
And, oh, look at that.
Bilateral calcaneal fractures.
I made my way to the window.
I told them, I was like, "Follow my voice.
" Look.
Compression fracture of L1.
- I saw flames.
- He broke his back.
It doesn't mean cord involvement.
I'll call CT.
I felt them, you know? I didn't wanna die, okay? Need some help here.
- Another one from the fire? - Yep.
Megan Nesbitt, alone.
Partial-thickness burns to hands and forearms.
Good radial pulses.
- How old are you, Megan? - Twelve.
Pretty young to be home alone.
One percent without epi.
Let's buffer with bicarb.
How are you feeling? - Where's my purse? - Is she still altered? - Is it here? - All right, sit back.
We're gonna numb and suture these cuts.
Ma'am, you remember what happened? I was in the lobby.
I was leaving and- - What time is it? -12:45 There was an explosion? I have to go home.
- My husband travels.
I should be there.
- All right.
Just calm down, Marilyn.
And your apartment building was very badly damaged during the fire.
That's not where I live.
It's okay to cry, Megan.
I know it hurts.
First and second degree.
Nothing circumferential.
Titrate two to four of MS.
We'll debride after that.
So you were home by yourself, huh? - That must have been pretty scary.
- I'm used to it.
Okay, Megan.
You have some bruising on your belly.
So I'm gonna look at it with something called an ultrasound.
- Reach the parents yet? - Jerry's calling them.
They're at the mall with Logan.
No blood in the abdomen.
But we still need consent for a CT.
Yeah, Jerry's on it.
Is that a problem? Nope.
You ready? - Jake.
How's my favorite cousin? - Patrick, how are you? - Hey, this is Abby.
- Abby, yes.
Hello.
- Care for some whiskey? - No, thank you.
Look, here.
It's Jake and Abby.
Well, she's a tiny little thing, isn't she? - Allow me to present my aunt and uncle- - Call us Aunt Eileen and Uncle Liam.
Okay.
So are you divorced or never married? Uncle Liam, we're gonna go sit down.
We'll catch up later, yeah? - Nice to meet you.
- Nice to meet you.
- Oh, there's a seat.
- Okay.
- Hi.
- Hi.
- Did you get the sodas? - Oh, yeah.
I put them down when I was shaking someone's hand.
- I'll go get them.
- Sit down.
I'll go get them.
- Hi.
- Hey.
Hi.
I'm Grandma Mary.
- We're so glad you could come today.
- Oh, thank you.
Me too.
We've heard so much about you.
- Good things, I hope.
- Oh, Jake goes on and on.
- Abby this.
- Abby that.
- You were a nurse.
- Now you're a doctor.
But he never mentioned any children.
I don't have any.
I had Eamon here when I was 35.
Cousin Grace had her first at 40.
Don't worry, Abby.
You've got time.
- I met him online.
- I'm almost done numbing.
Well, I never actually met him.
Oh, God.
I hope he's okay.
- So you never? - I got lost.
I found myself looking at one of those floor maps.
Okay, 30 cc syringe and a splash guard to Dr.
Lewis.
- Dropped her BP.
- This is really, really wrong.
Check her lungs.
She had equal breath sounds and no chest trauma.
Blast wave can collapse a lung.
Okay, let's up the dopamine to 20 mics.
- Dr.
Lewis, Dr.
Weaver's- - Oh, great.
Now she's calling me? - Can you tell me where it's hurting? - My stomach.
She wants you in her office at 7:00.
Okay.
Let's get a repeat chest.
Why so late? - No life? - Repeat HemoCue, 13.
4.
- Okay, so no blood loss.
- Temp's 101.
She could be septic from the belly.
- She's got some guarding on the right.
- No.
Look for another source.
The blast could've put glass right into her intestine.
Nothing on the x-ray.
These are superficial.
Can I get 3.
375 of Zosyn, please? I've irrigated the lacs.
Want me to probe all 30 of them? - Yeah.
- Okay, this one's superficial.
I'm telling you, there's nothing deeper than the sub-Q.
- What happened? - Something cut me.
Your parents are on their way in.
Did you tell them I almost died? No.
Could you? Megan, is everything okay with you and your folks? I guess.
- How about your little brother? - Half.
My mom got married again.
Could you at least tell them I got hurt? Like, really, really bad? Sam? Those guys you wanted me to check on, the jumper's friends Thank you, Jerry.
You are all done.
Why don't you get some rest and I'll be back soon, okay? I think we should get Social Services involved with Megan.
- The family here yet? - No.
But she is in a weird space.
- She just went through a traumatic event.
- Might be problems at home.
- Is that what she told you? - No.
Her parents left her.
They went shopping.
We've done the same with Alex.
- I just think she- - The girl was in a fire.
Give her family the chance to deal with that before pushing a social worker on them.
Two sets of cultures prior to antibiotics.
Start another line of saline.
Titrate the dopamine to a MAP of 90.
Free air.
Glass shard punctured her colon.
- Why didn't it show up? - Must have been unleaded.
Only heavy metals show up on x-ray.
Dr.
Carter, your father's returning your call on line two.
- Excuse me.
- By the way, congratulations.
- I heard you got early tenure.
- Yeah.
Thanks.
- Dr.
Lewis, how's the finger? - Sore.
- So is my arm.
- Tetanus hurts.
What can I say? Rapid HIV test on Mrs.
Brackens came back negative.
- Thank God.
- Hope this means you'll leave any deep probing to the surgeons.
Call the O.
R.
Tell them we're on our way.
- Weaver make tenure announcements? - Yeah.
This morning.
Why? - Wondering when she'd make her way.
- I hope ER fares better.
We only got one slot.
I'm sure it will though.
- Dr.
Lewis? - Yeah? Could you order a Social Services consult on Megan Nesbitt? - Kovac's patient? - Yeah.
- We just disagree on how to handle it.
- Oh, are you guys fighting? - Lack of money, sex, communication? - The last one.
Yeah.
There's a lot of that going around.
- Where is he? - Who? - Luka! - What are you doing? My job.
Come here.
Sam thinks that Megan Nesbitt needs a Social Services consult.
Went over my head? You totally blew me off.
Okay, despite working here This is a workplace.
It's an emergency room, my emergency room.
If you're having trouble, see a therapist.
If you can't, work separate shifts.
- Does that make sense? - Yep.
And as far as a consult goes, just call them because the parents will probably get here before they do anyway.
I took the clavicle fracture out of a figure-of-eight.
- All your fault by the way.
- What? Morris.
If you'd taken the job, we wouldn't be living this.
First day and already a mutiny? I'm ready to keelhaul him.
I'll try back.
MRSA abscess.
Allergic to sulfa.
- Clindamycin.
- Two words: voice mail.
What's all that? Friends of mine bugging me to go out and party after a long 12-hour shift.
That's the problem with non-medical.
They don't get it.
Dodged the admission of Eugene Bradley, foot pain.
Party at Ike's tonight.
Boss man is buying.
- Who's onboard? - Half the time medical types don't get it.
- Ray? - Other plans.
- Neela? - The Apprentice is on.
- Pratt? - I'm busy.
Dr.
Carter? Happy tenure to you - Happy tenure to you - Don't I get a cake? Happy tenure, Dr.
Carter Happy tenure to you Thank you.
Thank you very much.
Excuse me.
Excuse me.
They said my wife was in a fire? It's just down here.
She responded very well to the cyanide antidote.
Her blood pressure and pulse normalized.
- Good.
Good.
- A piece of shrapnel from the blast may have perforated her bowel.
She's gonna need surgery, maybe a colostomy.
- Oh, God.
- Which hopefully will be temporary.
I don't understand.
- I'm sorry? - How this happened.
From what I was told, there was an explosion- We're going over here.
- Followed by a fire.
- We live in Tinley Park.
Why was she at some apartment in the city? I don't know.
- She told me she had a dance class.
- Have a seat right here.
I know she's alone a lot.
It's my job.
We fight about it.
- Yeah.
Well, listen.
Let me see if I can- - Can I talk to her? - You probably wouldn't be able to- - Can you tell her something? Yeah.
Tell her that I'm here.
Susan.
How long have you been standing there? Not long.
Sorry I'm early.
You wanted to talk later.
Oh, sit down.
No point in rushing to tell me I didn't get tenure.
I'm sorry.
I've just been incredibly busy.
You wanna at least tell me why? There were a number of factors.
Significant budget cuts, your lack of published materials The criteria are complicated.
How about I simplify it? I've been an Attending for seven years.
Two more than Carter.
I've been an outstanding doctor a dedicated teacher and a committed chief.
No one's refuting your abilities as a clinician or a teacher.
And you do an excellent job running the department.
Which is where you want me to stay until you replace me.
- I don't follow.
- The ER runs smoothly.
One less thing for you to worry about.
That's ridiculous.
Because if I was tenured, I might work less shifts in favor of doing research and you might actually give a damn about the first floor of this hospital.
Did you honestly think your interest in an academic track would be taken seriously? What? That you could wait until your seventh year to start aggressively pursuing grants? - I've brought in some grants.
- $75,000.
By now you should've hit at least a million.
The university depends on grants to cover your salary.
That's not only unacceptable for a physician seeking tenure that's embarrassing.
So forget excellence, forget performance just write a check to build a new wing.
This hospital is in the business of staying open.
We have to make our choices accordingly.
Finger dislocation's at X-ray.
And shrimp allergy needs a recheck after sub-Q epi.
So why tell me? If I don't leave now, my band can't make its Evanston gig.
And that's my problem how exactly? Neela, I dispo'd ten patients in the last hour.
You get to pop a finger back in place.
Please? - Fine.
But you're cleaning the bathroom.
- All right, deal.
With actual cleaning products.
- Banker's hours now, Ray? - I'm like an ATM, babe.
Do business 24/7.
There we go.
Oh, taxi! Hey! Hey, taxi! Damn it.
Eugene? What are you doing? Hey, you need el fare? There we go.
Well, it's getting pretty late.
Your mom's gonna worry.
She's still at work.
Eugene, you need to go home now.
We are not going to admit you.
They're not gonna give you any more drugs.
You need to go home now.
Man, I ain't going back.
I can't.
Why not? He'd be there.
- Who? - Her boyfriend.
Your mom's.
Okay, so the two of you don't get along? He just does stuff.
Stuff like what? I just need to get some Dilantin.
Where is? Whoa, did somebody alphabetize these? Yeah, believe it or not.
- Why don't you just say it? - Say what? - You're mad.
- I'm not.
Right.
It didn't bother you one bit that I went over your head.
- See, that's what I'm talking about.
- What? You won't tell me how you feel.
- Because it's fine.
- It's not fine, Luka.
If it were fine, you wouldn't have avoided touching me just now.
- What? - You- You bury your feelings you pretend that they're not there.
I have feelings.
But I don't need to share them.
And I don't need to share them here, okay? Sorry to interrupt, but Megan says she's in a lot of pain.
Give her another four of morphine.
Bye.
Just try four of Zofran.
- How's your cake? - It's good.
It was unexpected.
They should've waited.
Could've had a cake for both of us.
- Snack cake? - No, thank you.
- What's wrong? - I didn't get tenure.
What? Wait.
Susan, who got the slots if you didn't get it? Slot, single.
Well, that'd be you.
I am so sorry.
Yeah, they gave me the usual drivel about budget cuts and No, no, no.
They've always had more than one tenure slot.
Well, till now.
Too bad it was the year you applied.
What do you mean by that? Just that- Nothing.
No, what do you mean? I didn't earn it? My funding of the outpatient clinic got me tenure? - Don't put words in my mouth.
- Worked my ass off.
- Yes, I know.
- Brought grants, published, taught.
I never asked for this.
You never wanted it, Carter.
You never did.
This is my home.
This is where I started.
This is where I want to stay.
And I get the feeling that half the time, you would rather be anywhere but here.
Yeah, I thought so.
Iron Chef in 3 needs a non-occlusive dressing, then he can go.
- How about you? You gonna go? - You don't give up, do you? Car's outside.
Give me trouble, you ride in the trunk.
All right, give me two minutes.
Don't try sneaking out the back.
Jerry, what's open? I thought you'd be covering "Smells Like Teen Spirit.
" - Anything in Exam Two? - We got one free bed.
- What are you doing? - Admitting him.
I can see that.
The question is why? - Chuny? - Yeah? - Can you get Eugene settled in? - Oh, sure.
You wanna come with me? He was raped.
This'll make you feel better.
I know her.
She lives in my building.
Her burns are minor.
She's gonna be okay, like you.
She used to bring food to the guy next door.
He was weird.
Had all this stuff stacked up.
He's probably dead, isn't he? Your neighbor? I don't know.
I was the one who called 911.
Smart girl.
They didn't come as quick as I thought they would.
I thought if I called them before I did it I tried to put it out but it got too big.
Honey, are you okay? Mommy.
Mommy.
It's okay.
It's okay.
It's okay.
It's gonna be okay.
It'll be okay.
Yeah.
Now, how do you get an Irishman up on the roof, huh? You tell him the drinks are on the house.
There's a man from Kerry, comes into the bar with a pig under his arm.
The bartender says - There you go.
- Thanks, lady.
Hey.
Hey, get over here.
- Her name's Abby.
- Sorry, Uncle Jake.
All right, get out of here.
Get out of here.
They're cute.
A little loud.
You have to be.
You gotta raise your voice in a clan this big.
How am I doing? Let's see.
With 99 percent of the votes in it appears that you are a keeper.
- Who's the holdout? - Aunt Cecelia.
You lost points when you told her you weren't sure if there was a heaven or hell.
- Well, I'm not.
- Doesn't bother me.
- I'm a pick-and-choose Catholic.
- Doesn't work that way.
Yeah, it does.
Honor thy father and mother, thou shall not kill, given.
No premarital sex, no birth control, not so much.
Hey! Pretty overwhelming, huh? But in a good way.
- Do you wanna hear something stupid? - I'd love to.
I never imagined there were families like this.
- You're really lucky.
- Thank you.
And having said that - Yeah? - I'm really, really ready to go home.
- All right.
- Okay.
Okay.
There you are.
And to think I was gonna leave because there wasn't any real men here.
- Give me some sugar.
- Good to see you.
About damn time you got your fine self here.
- How you doing? - Where have you been anyway? Just working hard.
I ain't going nowhere.
Keep it moving.
Sorry, ladies.
We'll be right back.
Yeah.
Yeah, yeah, look who's here! Oh, the doc.
Oh, man.
- Oh, my man.
- Happy birthday.
Now shut up and dance.
- Who the man? - You, son.
What's up, boy? What's up? - Happy to see your boy up.
- What's up? What you talking about? I see you here by yourself.
Where the chicks at? Just get Mrs.
Grayber started on Compazine.
- Yeah.
- Haleh.
We need an ankle series on Joan McVey in 3.
- Sure thing.
- Let me know how she's doing, okay? What's Eugene still doing here? Dr.
Barnett admitted him.
Ray, your band's on two.
- You're late.
- Tell them I'll be right there.
- Yes.
No, I realize that.
- Ray.
But no, no.
Hold on.
Yeah? Yes? You dispo patients faster than a speeding bullet and not in a good way.
Now that we're slammed, you dump a drug seeker on the next shift so you can get to your next gig? - I tried to warn him.
- It's more complicated.
Know what? You wanna be a rock star, go for it.
But play weddings and bar mitzvahs to make ends meet.
Because medicine is not a hobby or another way to pay the bills.
Or plan B in case you don't sell a million records.
It's what you wanna do or not.
Didn't mean for the fire to get so big.
She just wanted the firemen to come.
Pretty desperate for her parents' attention.
I think she felt shut out, you know? Now she has to live with even more pain.
Three people dead, more wounded.
Social worker said she's gonna go to juvie.
Twelve years old.
- Sad.
- Yeah.
Why is it that we can talk about anything other than us? I don't know.
I think Lewis is right.
I think we need help.
- You good? - No, man.
I'm good.
Hey, man.
Thought you had the job at print shop.
What happened? Downsize, man.
Gotta get a new job soon.
Teesha says I get in her way being home, mess up her routine.
I know.
Be a doctor.
- Yeah.
If Greg's one, how hard can it be? - Right, right.
What time is it? I gotta get up in the morning.
Hey, yo, check this out.
- Look at this.
- What you doing? - Put that away.
- You don't need that.
- Come on, man.
What? - That loaded? - Hell, yeah, it's loaded.
- Put it away.
- What are you doing? - Let's get back to the party, man.
- What you doing? - This is the real party here.
- Rooster.
- Remember when we shot the lights out? I remember.
That was a long time ago.
Now stop.
- What you doing? - Put that away! This fires a bit crooked.
I think that's the problem.
No, you drunk, man.
That's the problem.
I'm 30.
Last thing I need is to be arrested.
- Put that away.
- Nobody's gonna get arrested.
I'm still nice with it.
You're all just jealous, man.
- You stupid, man.
You stupid.
- Let's haul ass.
Let's haul ass, man.
How you doing? Listen, I I really wish you'd told me.
Or that I'd asked.
Are you tired? No.
Okay.
Why don't I stay here until your mom gets here? Are you a musician? Not tonight, man.
Oh, yeah.
You know what, babe? Weaver and the tenure board can kiss my big, white, semi-hairy ass.
I shouldn't have got my hopes up.
Our hopes up.
It's okay.
We're gonna be fine.
I just had all the money spent.
Buy a house, start a college fund for Cosmo, take a damn vacation.
Hey, we'll figure it out.
You know what's funny? I really wanted this.
I know.
I know you did.
I know.
Hello? Kem? Nothing.
Nothing's wrong.
Oh, not much.
I got awarded tenure today.
Thank you.
No, no, it is.
It's very nice.
It's very nice.
We will.
We will have to celebrate sometime.
Really? Are you serious? How's the clinic? Oh, they must have loved that.
I miss you too.
Yeah.
SDl Media Group
R.
Previously on E.
R.
- Church? - Yeah.
My niece is getting baptized.
- I have to hold her.
- Oh, you're the godfather.
You know, tenure means financial security.
Tenured Attendings need the ability to carry their own weight.
You mean, bring in grant money.
We would be interested in covering the construction costs.
The entire thing? - I had a gig.
- Screw your gig! Medicine isn't a day job! The Chief Resident in a busy, urban ER - We're not giving it to him though, right? - Considering it.
You out of your mind? PREGNANCY TEST E.
R.
11x20 "YOU ARE HERE" Hi.
- Hey.
- What you doing down there? I don't know.
Get back up here.
Oh, man.
I can't.
I want to, I do, but I gotta jam.
What, you got gigs during the day? Different gig.
I'm a doctor.
Oh, yeah, right.
No, really, I am.
I work at County.
And I'm looking at a 12-hour shift that starts in 29 minutes.
- So - You want some? Better than coffee.
Still, I gotta pass.
Oh, because you're a doctor? Pretty much, yeah.
That's one sucky day job you got.
- That's what I'm talking about.
- Yeah? - What you know about that? - Shut up and listen.
Ready to go to school, to get an education? - Show me something.
- Okay! Hey, yo, who you bringing to that party tonight? What party? You serious? - Darnell's 30th, man.
- Oh, man.
Let me guess, you too busy.
Hey, I wouldn't be out here at 7 whupping your ass if I wasn't.
- You ain't been back in a while, man.
- Hey, like you said, I'm a busy man.
Okay, Doc Ain't-Got-Time-For-My-Friends.
I make this shot you dragging your ass to that party.
- Right, like that's gonna happen.
- Okay.
Come on, show me something.
It's crunch time.
Don't be a bum out there.
Show me something.
Crunch time, baby.
- Game over.
- Hey, Sam? - Yeah? - Out of shaving gel.
Bo- Bottom drawer on the right.
Alex, move it! Carpool's here! - You find it? - Still looking.
PREGNANCY TEST It's all the way in the back.
- What? - The shaving gel.
You almost done in here then? Yeah.
Go ahead if you need to.
No, I can wait.
Mike - She in? - Let me check.
Make sure these QA files get to Anspaugh ASAP and I need five copies of this budget collated.
Call Surgery.
Tell them I'm still waiting for their M-and-M data and I'm not happy about it.
Yes, ma'am.
Oh, this coffee tastes like crap.
Doesn't anyone change filters around here? Sorry, new assistant.
Good help, you know? Hard to find.
So the formal announcement will come out later today but I wanted to tell you the news myself.
You've been awarded tenure.
Seriously? Yep.
Congratulations.
Wow, that's great! I just- I wasn't expecting it until next year or something.
Nonsense.
You've earned it.
Well, thank you, Kerry.
That means a lot to me.
Sure.
I still have some other notifications to make today so if you could keep this on a need-to-know basis After all, you got 30 years to gloat about it, right? What? You don't like that station? No, it's fine.
You feel okay today? Yeah.
Why? Well, you- You were in the bathroom a long time.
No more than usual.
So was it positive or negative? Negative.
- Were you gonna say anything? - I was worried.
I checked.
I was wrong.
What is there to say? - What, you'd rather I was pregnant? - I'd rather you didn't keep secrets.
- Yeah, that's funny coming from you.
- What's that supposed to mean? You've seen all of my dirty laundry.
I barely know a thing about you.
- That's not true.
- You don't talk, Luka.
- About what? - About anything.
How am I to know you're honest when you don't talk? About what? I'm not the one who lied - about a test.
- I didn't lie.
- Yeah, fine.
You omitted.
- You don't? What, what? What do I omit? Your past.
Your family.
I should check the traffic.
He's the author of a wonderful new book titled Growing Up Single.
Neela, cat-litter ingestion, uncontrollable drooling.
- Drooling? - Either that or a butt abscess - on a 300-pounder.
Your choice.
- Drooler.
- The labs are back on Mr.
Busto.
- All right, hang 500 of Levaquin.
Eugene Bradley's here complaining about pain again.
Here without a parent.
Morris, see what this kid's deal is.
Bet it's the same as last month: "My pills don't work.
" Last week: "I lost the bottle.
" There's: "When pain's this bad, I gotta have my IV.
" Can't blame him.
His disease has made him narcotic-dependent.
- A.
K.
A.
addict.
- No, there's a difference.
And we take complaints here seriously, so go.
Isn't it Abby's turn to treat this? - Abby's at some family thing with Jake.
- Looks like it's your turn.
TMJ's going out on NSAIDS, Gram's stain's negative on effusion.
Home and ortho follow-up.
Gonna start calling you "the closer," man.
All right.
Hey, kid over there.
Sickle cell.
Bit of pain, without his mother.
Get his story.
Call the Heme Clinic, give a heads up.
- If it's non-emergent, send him home.
- Sure.
Anyone ever tell you you got a cruel streak? - Have you seen Lewis? - No, she's hiding out.
But congrats by the way.
Associate Professor of Emergency Medicine.
Nice ring to it.
- How did you? - Oh, it's Who's "CoryB123"? Just someone on my IM Buddy List.
- A celebration is in order.
- Yeah.
Well, it's not exactly official yet, "JerrBear99.
" So keep it quiet, off the Internet.
Good news needs to be shared.
My mom's at work, but she told me to come.
It's a good pulse.
Minimal swelling.
It doesn't look that bad.
Unfortunately, we can't treat you without her consent.
I brought a note from her.
Hey, unless it's an emergency, we need the real deal, man.
Look, it hurts really bad this time.
Real bad.
You know? - What are you taking for it? - Morphine.
But most of the time, the pills are just a waste.
And my mom says I probably need an IV.
Okay.
Well, I'll tell you what I'm gonna do.
I'm gonna get you a couple of taxi vouchers.
You're gonna go home, take your pills, and stay off your feet.
If you're in pain when your mom gets home, have her bring you back.
Then I'm gonna have to wait again.
You just ask for Dr.
Barnett.
Bring you right in, okay? You getting organized on us? These two shelves, free samples.
Those cabinets, alphabetized.
Benzos and narcotics here and actually locked up.
If only I could do this with my kitchen.
- What's going on? - Nothing.
- Has Kerry found you yet? - No, I haven't seen her.
Why? They're making the tenure announcements today.
And you're not the only one getting it.
What? - When did this happen? - Just now.
No.
I mean, when did you apply? Are you surprised? No, of course you'd get tenure.
You're great.
I thought you said you were gonna wait a couple years.
Yeah, well, they kind of encouraged me to apply early.
Really? They didn't encourage me to apply at all.
Well, she's probably been trying to find you all morning.
Well, I've been in here busting my ass.
Yeah, because you're dedicated to reorganizing the drugs.
Or is it because you're avoiding Morris? Complaining of nausea, vomiting, diarrhea, pain.
It's the flu.
All right, I'll tell him.
Give the patellar fracture a shot of Toradol.
I can't stand hearing her whine.
Isn't Toradol contraindicated since she's going to the OR? - If you're busy, I can find Dr.
Pratt.
- Morris? Stay here.
Don't move.
I'm here for you, okay, buddy? - What up, chief? - We need to talk.
If this is about the lady who refused a Pap smear- You're the new chief resident.
Oh, my God.
Oh, m- This is fantastic.
Thank you, thank you.
Thank you, Dr.
Lewis.
Wait until my old man hears.
- He will eat his words.
- It is a provisional basis.
There'll be a 3-month probation.
- My presentation was a hit.
- I'll be your supervisor.
- I could feel the room- - Are you listening? It is so gratifying to see that meritocracy is alive and well at County that hard work is rewarded, and that an individual's ability is valued over politics, wealth, and the proverbial old-boys club.
Right.
You start today.
Yes, I do.
Yeah.
- Do I have any messages? - No.
- Are you sure? - Have I given you reason to doubt? - ER.
- Kitty-litter connoisseur given Benadryl drooling stopped.
Suggested she get a dog.
Hey, some guy on line one says the party's at 8 - and that a ball had too much bounce.
- Tell him a bet's a bet.
- Excellent as always.
- Pleurocentesis going upstairs.
- Need you to sign.
- Whatever happened with Eugene? Sickle cell kid? Sent him home.
Really? Then what's he still doing here? Morris didn't tell you, huh? - Tell me what? - Eugene's a frequent flyer.
Knows how to work the system.
- Hey, Morris? - Hang on, kiddo.
Can I have your attention, please? I am very proud to announce that effective immediately I am your new chief resident.
- This is a joke, right? - What? You didn't want it.
Explosion in apartment house.
Sixteen casualties, seven critical.
Okay.
Okay, nurses, restock the trauma rooms med students find an intern, docs at the ready.
Everybody, move out! I wonder what Abby's gonna say.
- Jesus Christ.
- Amen.
- Amen.
- Amen.
Do you reject Satan and all his works and all his empty promises? - I do.
- I do.
Do you believe in God the Father almighty, creator of heaven and earth? - I do.
- I do.
- Are you all right? - Do you believe in Jesus Christ Do you believe in Jesus Christ, his only son, our Lord born of the Virgin Mary, was crucified died, was buried, rose from the dead, and is now sitted at the right hand of the Father? - I do.
- Do you believe in the Holy Spirit the Holy Catholic Church, the communion of saints the forgiveness of sins, the resurrection of the body - and the life everlasting? - I do.
Nurse, five of morphine, normal saline, liter of bolus.
What's open? - Did you call me "nurse"? - Check for an H and H.
- Move him to Trauma 2.
- Hey, doc! - I'm busy, dude.
- But I can't walk! He's smart.
That makes it an emergency.
I need a wheelchair.
Looks like we have a non-ambulatory sickler here.
- For Eugene? - He says he can't walk.
- You're the doctor.
- Get me an IV, CBC, retic one liter of saline, two of MS, okay? - Thanks, man.
- Coming through! What are you doing? We've got multiples.
- What's her story? - Marilyn Bracken, 40, burns.
Lacs to the face, arms and belly.
- Was she altered? - No evidence of head trauma.
- Smoke inhalation? - Pulse ox, 100 percent.
- Can't do better.
- Lungs clear.
What the hell is wrong with me? - I was dumb.
- Heart rate's to 130.
Pretty tachy.
Internal hemorrhage? Not blood in Morrison's.
Hang in there.
- Tension pneumo? - Good breath sounds.
- Satting on 100.
- Cardiac contusion? - I shouldn't have started.
- No sign of trauma.
EKG looks normal.
- I give up.
What have we got? - We don't know.
Multifocal PVCs.
- I didn't mean it.
- Perfect, 100 of lidocaine.
- Hundred percent nonrebreather.
- Down to 80/60.
Not bleeding.
Lungs are up.
No sign of head trauma.
- No cardiac history.
- Respiratory rate's up to 40.
No tamponade.
Pressure's dropping.
- What are we gonna do? - We don't know.
Be ready with Etomidate and sux.
- Could this be spinal shock? - She's moving all extremities.
- Systolic's down to 65.
- Maybe she's allergic to latex.
No, no, no.
Just- Okay, let's step back and start over.
- Airway, breathing.
- Respiratory rate's up to 60.
- We need to intubate.
- Circulation.
- Repeat.
What else? - O-neg on the infuser.
- Wait.
Hold the meds.
Venous blood? - Yeah.
- Did you hit an artery? - No.
No way.
- Are we still doing- - No, it's cyanide toxicity.
Retinal arteries and veins are red.
Open an antidote kit.
She ingested cyanide? It's released when things like PVC, polyurethane foam and polyester wadding burn.
Amyl nitrate perles.
Got them.
Usually cyanide toxicity is fatal.
- Ten cc's of sodium nitrate.
- Intubation? We need to watch for cardiogenic and hemorrhagic etiologies.
Okay.
Let's just give it a minute for the meds to kick in.
- Do I just keep bagging? - BP's 90/60.
She's good.
Cool catch.
Okay, let's keep her at a hundred percent nonrebreather.
Send off for an RBC and plasma cyanide level.
Excuse me.
I thought you couldn't walk, man.
I had to pee.
What am I supposed to do? Well, you can stop playing me, for one thing.
No, man.
It's different.
I'm serious.
I need to be here.
The IV.
That's why my foot feels better.
Give me your arm.
Okay, you got your fix.
- Go.
- It's different.
I'm serious.
- I need to be here.
- I need to take care of patients.
- So go home and take your meds, okay? - I can't.
I'm all out.
All right.
MS Contin, 20 pills.
- Get your refill from Hematology, okay? - It's gonna be bad.
I know it.
- I'm starting to lose my patience.
- Let me stay one night.
Please, one night.
No.
- Nicely done.
- Thank you very much.
Cuts on your chest, arms, and some bruising.
Remarkable, considering your fall.
I jumped.
- Can you feel me touching your leg? - You're not pressing hard, right? Pratt, Kovac wants to know if you're done.
- We're getting slammed out here.
- Tell him we'll both be right there.
- Lateral lower-extremity numbness.
- Motor exam's limited by his pain.
- What? - Peroneal nerve injury.
- Possible diagnoses.
- Or cord injury.
Contusions, lacs, and all four limbs move.
You're making this more complicated.
Also had some partial saddle anesthesia.
DTRs are intact.
No sensory-level deficit.
Motor and sensory loss is usually incomplete with cauda equina syndrome.
- X-ray's back.
- Good.
Maybe now I'll get some respect around here.
Your roommates aren't here.
Doesn't mean they're not at a different hospital.
When did you see them last? C- spine's clear.
And, oh, look at that.
Bilateral calcaneal fractures.
I made my way to the window.
I told them, I was like, "Follow my voice.
" Look.
Compression fracture of L1.
- I saw flames.
- He broke his back.
It doesn't mean cord involvement.
I'll call CT.
I felt them, you know? I didn't wanna die, okay? Need some help here.
- Another one from the fire? - Yep.
Megan Nesbitt, alone.
Partial-thickness burns to hands and forearms.
Good radial pulses.
- How old are you, Megan? - Twelve.
Pretty young to be home alone.
One percent without epi.
Let's buffer with bicarb.
How are you feeling? - Where's my purse? - Is she still altered? - Is it here? - All right, sit back.
We're gonna numb and suture these cuts.
Ma'am, you remember what happened? I was in the lobby.
I was leaving and- - What time is it? -12:45 There was an explosion? I have to go home.
- My husband travels.
I should be there.
- All right.
Just calm down, Marilyn.
And your apartment building was very badly damaged during the fire.
That's not where I live.
It's okay to cry, Megan.
I know it hurts.
First and second degree.
Nothing circumferential.
Titrate two to four of MS.
We'll debride after that.
So you were home by yourself, huh? - That must have been pretty scary.
- I'm used to it.
Okay, Megan.
You have some bruising on your belly.
So I'm gonna look at it with something called an ultrasound.
- Reach the parents yet? - Jerry's calling them.
They're at the mall with Logan.
No blood in the abdomen.
But we still need consent for a CT.
Yeah, Jerry's on it.
Is that a problem? Nope.
You ready? - Jake.
How's my favorite cousin? - Patrick, how are you? - Hey, this is Abby.
- Abby, yes.
Hello.
- Care for some whiskey? - No, thank you.
Look, here.
It's Jake and Abby.
Well, she's a tiny little thing, isn't she? - Allow me to present my aunt and uncle- - Call us Aunt Eileen and Uncle Liam.
Okay.
So are you divorced or never married? Uncle Liam, we're gonna go sit down.
We'll catch up later, yeah? - Nice to meet you.
- Nice to meet you.
- Oh, there's a seat.
- Okay.
- Hi.
- Hi.
- Did you get the sodas? - Oh, yeah.
I put them down when I was shaking someone's hand.
- I'll go get them.
- Sit down.
I'll go get them.
- Hi.
- Hey.
Hi.
I'm Grandma Mary.
- We're so glad you could come today.
- Oh, thank you.
Me too.
We've heard so much about you.
- Good things, I hope.
- Oh, Jake goes on and on.
- Abby this.
- Abby that.
- You were a nurse.
- Now you're a doctor.
But he never mentioned any children.
I don't have any.
I had Eamon here when I was 35.
Cousin Grace had her first at 40.
Don't worry, Abby.
You've got time.
- I met him online.
- I'm almost done numbing.
Well, I never actually met him.
Oh, God.
I hope he's okay.
- So you never? - I got lost.
I found myself looking at one of those floor maps.
Okay, 30 cc syringe and a splash guard to Dr.
Lewis.
- Dropped her BP.
- This is really, really wrong.
Check her lungs.
She had equal breath sounds and no chest trauma.
Blast wave can collapse a lung.
Okay, let's up the dopamine to 20 mics.
- Dr.
Lewis, Dr.
Weaver's- - Oh, great.
Now she's calling me? - Can you tell me where it's hurting? - My stomach.
She wants you in her office at 7:00.
Okay.
Let's get a repeat chest.
Why so late? - No life? - Repeat HemoCue, 13.
4.
- Okay, so no blood loss.
- Temp's 101.
She could be septic from the belly.
- She's got some guarding on the right.
- No.
Look for another source.
The blast could've put glass right into her intestine.
Nothing on the x-ray.
These are superficial.
Can I get 3.
375 of Zosyn, please? I've irrigated the lacs.
Want me to probe all 30 of them? - Yeah.
- Okay, this one's superficial.
I'm telling you, there's nothing deeper than the sub-Q.
- What happened? - Something cut me.
Your parents are on their way in.
Did you tell them I almost died? No.
Could you? Megan, is everything okay with you and your folks? I guess.
- How about your little brother? - Half.
My mom got married again.
Could you at least tell them I got hurt? Like, really, really bad? Sam? Those guys you wanted me to check on, the jumper's friends Thank you, Jerry.
You are all done.
Why don't you get some rest and I'll be back soon, okay? I think we should get Social Services involved with Megan.
- The family here yet? - No.
But she is in a weird space.
- She just went through a traumatic event.
- Might be problems at home.
- Is that what she told you? - No.
Her parents left her.
They went shopping.
We've done the same with Alex.
- I just think she- - The girl was in a fire.
Give her family the chance to deal with that before pushing a social worker on them.
Two sets of cultures prior to antibiotics.
Start another line of saline.
Titrate the dopamine to a MAP of 90.
Free air.
Glass shard punctured her colon.
- Why didn't it show up? - Must have been unleaded.
Only heavy metals show up on x-ray.
Dr.
Carter, your father's returning your call on line two.
- Excuse me.
- By the way, congratulations.
- I heard you got early tenure.
- Yeah.
Thanks.
- Dr.
Lewis, how's the finger? - Sore.
- So is my arm.
- Tetanus hurts.
What can I say? Rapid HIV test on Mrs.
Brackens came back negative.
- Thank God.
- Hope this means you'll leave any deep probing to the surgeons.
Call the O.
R.
Tell them we're on our way.
- Weaver make tenure announcements? - Yeah.
This morning.
Why? - Wondering when she'd make her way.
- I hope ER fares better.
We only got one slot.
I'm sure it will though.
- Dr.
Lewis? - Yeah? Could you order a Social Services consult on Megan Nesbitt? - Kovac's patient? - Yeah.
- We just disagree on how to handle it.
- Oh, are you guys fighting? - Lack of money, sex, communication? - The last one.
Yeah.
There's a lot of that going around.
- Where is he? - Who? - Luka! - What are you doing? My job.
Come here.
Sam thinks that Megan Nesbitt needs a Social Services consult.
Went over my head? You totally blew me off.
Okay, despite working here This is a workplace.
It's an emergency room, my emergency room.
If you're having trouble, see a therapist.
If you can't, work separate shifts.
- Does that make sense? - Yep.
And as far as a consult goes, just call them because the parents will probably get here before they do anyway.
I took the clavicle fracture out of a figure-of-eight.
- All your fault by the way.
- What? Morris.
If you'd taken the job, we wouldn't be living this.
First day and already a mutiny? I'm ready to keelhaul him.
I'll try back.
MRSA abscess.
Allergic to sulfa.
- Clindamycin.
- Two words: voice mail.
What's all that? Friends of mine bugging me to go out and party after a long 12-hour shift.
That's the problem with non-medical.
They don't get it.
Dodged the admission of Eugene Bradley, foot pain.
Party at Ike's tonight.
Boss man is buying.
- Who's onboard? - Half the time medical types don't get it.
- Ray? - Other plans.
- Neela? - The Apprentice is on.
- Pratt? - I'm busy.
Dr.
Carter? Happy tenure to you - Happy tenure to you - Don't I get a cake? Happy tenure, Dr.
Carter Happy tenure to you Thank you.
Thank you very much.
Excuse me.
Excuse me.
They said my wife was in a fire? It's just down here.
She responded very well to the cyanide antidote.
Her blood pressure and pulse normalized.
- Good.
Good.
- A piece of shrapnel from the blast may have perforated her bowel.
She's gonna need surgery, maybe a colostomy.
- Oh, God.
- Which hopefully will be temporary.
I don't understand.
- I'm sorry? - How this happened.
From what I was told, there was an explosion- We're going over here.
- Followed by a fire.
- We live in Tinley Park.
Why was she at some apartment in the city? I don't know.
- She told me she had a dance class.
- Have a seat right here.
I know she's alone a lot.
It's my job.
We fight about it.
- Yeah.
Well, listen.
Let me see if I can- - Can I talk to her? - You probably wouldn't be able to- - Can you tell her something? Yeah.
Tell her that I'm here.
Susan.
How long have you been standing there? Not long.
Sorry I'm early.
You wanted to talk later.
Oh, sit down.
No point in rushing to tell me I didn't get tenure.
I'm sorry.
I've just been incredibly busy.
You wanna at least tell me why? There were a number of factors.
Significant budget cuts, your lack of published materials The criteria are complicated.
How about I simplify it? I've been an Attending for seven years.
Two more than Carter.
I've been an outstanding doctor a dedicated teacher and a committed chief.
No one's refuting your abilities as a clinician or a teacher.
And you do an excellent job running the department.
Which is where you want me to stay until you replace me.
- I don't follow.
- The ER runs smoothly.
One less thing for you to worry about.
That's ridiculous.
Because if I was tenured, I might work less shifts in favor of doing research and you might actually give a damn about the first floor of this hospital.
Did you honestly think your interest in an academic track would be taken seriously? What? That you could wait until your seventh year to start aggressively pursuing grants? - I've brought in some grants.
- $75,000.
By now you should've hit at least a million.
The university depends on grants to cover your salary.
That's not only unacceptable for a physician seeking tenure that's embarrassing.
So forget excellence, forget performance just write a check to build a new wing.
This hospital is in the business of staying open.
We have to make our choices accordingly.
Finger dislocation's at X-ray.
And shrimp allergy needs a recheck after sub-Q epi.
So why tell me? If I don't leave now, my band can't make its Evanston gig.
And that's my problem how exactly? Neela, I dispo'd ten patients in the last hour.
You get to pop a finger back in place.
Please? - Fine.
But you're cleaning the bathroom.
- All right, deal.
With actual cleaning products.
- Banker's hours now, Ray? - I'm like an ATM, babe.
Do business 24/7.
There we go.
Oh, taxi! Hey! Hey, taxi! Damn it.
Eugene? What are you doing? Hey, you need el fare? There we go.
Well, it's getting pretty late.
Your mom's gonna worry.
She's still at work.
Eugene, you need to go home now.
We are not going to admit you.
They're not gonna give you any more drugs.
You need to go home now.
Man, I ain't going back.
I can't.
Why not? He'd be there.
- Who? - Her boyfriend.
Your mom's.
Okay, so the two of you don't get along? He just does stuff.
Stuff like what? I just need to get some Dilantin.
Where is? Whoa, did somebody alphabetize these? Yeah, believe it or not.
- Why don't you just say it? - Say what? - You're mad.
- I'm not.
Right.
It didn't bother you one bit that I went over your head.
- See, that's what I'm talking about.
- What? You won't tell me how you feel.
- Because it's fine.
- It's not fine, Luka.
If it were fine, you wouldn't have avoided touching me just now.
- What? - You- You bury your feelings you pretend that they're not there.
I have feelings.
But I don't need to share them.
And I don't need to share them here, okay? Sorry to interrupt, but Megan says she's in a lot of pain.
Give her another four of morphine.
Bye.
Just try four of Zofran.
- How's your cake? - It's good.
It was unexpected.
They should've waited.
Could've had a cake for both of us.
- Snack cake? - No, thank you.
- What's wrong? - I didn't get tenure.
What? Wait.
Susan, who got the slots if you didn't get it? Slot, single.
Well, that'd be you.
I am so sorry.
Yeah, they gave me the usual drivel about budget cuts and No, no, no.
They've always had more than one tenure slot.
Well, till now.
Too bad it was the year you applied.
What do you mean by that? Just that- Nothing.
No, what do you mean? I didn't earn it? My funding of the outpatient clinic got me tenure? - Don't put words in my mouth.
- Worked my ass off.
- Yes, I know.
- Brought grants, published, taught.
I never asked for this.
You never wanted it, Carter.
You never did.
This is my home.
This is where I started.
This is where I want to stay.
And I get the feeling that half the time, you would rather be anywhere but here.
Yeah, I thought so.
Iron Chef in 3 needs a non-occlusive dressing, then he can go.
- How about you? You gonna go? - You don't give up, do you? Car's outside.
Give me trouble, you ride in the trunk.
All right, give me two minutes.
Don't try sneaking out the back.
Jerry, what's open? I thought you'd be covering "Smells Like Teen Spirit.
" - Anything in Exam Two? - We got one free bed.
- What are you doing? - Admitting him.
I can see that.
The question is why? - Chuny? - Yeah? - Can you get Eugene settled in? - Oh, sure.
You wanna come with me? He was raped.
This'll make you feel better.
I know her.
She lives in my building.
Her burns are minor.
She's gonna be okay, like you.
She used to bring food to the guy next door.
He was weird.
Had all this stuff stacked up.
He's probably dead, isn't he? Your neighbor? I don't know.
I was the one who called 911.
Smart girl.
They didn't come as quick as I thought they would.
I thought if I called them before I did it I tried to put it out but it got too big.
Honey, are you okay? Mommy.
Mommy.
It's okay.
It's okay.
It's okay.
It's gonna be okay.
It'll be okay.
Yeah.
Now, how do you get an Irishman up on the roof, huh? You tell him the drinks are on the house.
There's a man from Kerry, comes into the bar with a pig under his arm.
The bartender says - There you go.
- Thanks, lady.
Hey.
Hey, get over here.
- Her name's Abby.
- Sorry, Uncle Jake.
All right, get out of here.
Get out of here.
They're cute.
A little loud.
You have to be.
You gotta raise your voice in a clan this big.
How am I doing? Let's see.
With 99 percent of the votes in it appears that you are a keeper.
- Who's the holdout? - Aunt Cecelia.
You lost points when you told her you weren't sure if there was a heaven or hell.
- Well, I'm not.
- Doesn't bother me.
- I'm a pick-and-choose Catholic.
- Doesn't work that way.
Yeah, it does.
Honor thy father and mother, thou shall not kill, given.
No premarital sex, no birth control, not so much.
Hey! Pretty overwhelming, huh? But in a good way.
- Do you wanna hear something stupid? - I'd love to.
I never imagined there were families like this.
- You're really lucky.
- Thank you.
And having said that - Yeah? - I'm really, really ready to go home.
- All right.
- Okay.
Okay.
There you are.
And to think I was gonna leave because there wasn't any real men here.
- Give me some sugar.
- Good to see you.
About damn time you got your fine self here.
- How you doing? - Where have you been anyway? Just working hard.
I ain't going nowhere.
Keep it moving.
Sorry, ladies.
We'll be right back.
Yeah.
Yeah, yeah, look who's here! Oh, the doc.
Oh, man.
- Oh, my man.
- Happy birthday.
Now shut up and dance.
- Who the man? - You, son.
What's up, boy? What's up? - Happy to see your boy up.
- What's up? What you talking about? I see you here by yourself.
Where the chicks at? Just get Mrs.
Grayber started on Compazine.
- Yeah.
- Haleh.
We need an ankle series on Joan McVey in 3.
- Sure thing.
- Let me know how she's doing, okay? What's Eugene still doing here? Dr.
Barnett admitted him.
Ray, your band's on two.
- You're late.
- Tell them I'll be right there.
- Yes.
No, I realize that.
- Ray.
But no, no.
Hold on.
Yeah? Yes? You dispo patients faster than a speeding bullet and not in a good way.
Now that we're slammed, you dump a drug seeker on the next shift so you can get to your next gig? - I tried to warn him.
- It's more complicated.
Know what? You wanna be a rock star, go for it.
But play weddings and bar mitzvahs to make ends meet.
Because medicine is not a hobby or another way to pay the bills.
Or plan B in case you don't sell a million records.
It's what you wanna do or not.
Didn't mean for the fire to get so big.
She just wanted the firemen to come.
Pretty desperate for her parents' attention.
I think she felt shut out, you know? Now she has to live with even more pain.
Three people dead, more wounded.
Social worker said she's gonna go to juvie.
Twelve years old.
- Sad.
- Yeah.
Why is it that we can talk about anything other than us? I don't know.
I think Lewis is right.
I think we need help.
- You good? - No, man.
I'm good.
Hey, man.
Thought you had the job at print shop.
What happened? Downsize, man.
Gotta get a new job soon.
Teesha says I get in her way being home, mess up her routine.
I know.
Be a doctor.
- Yeah.
If Greg's one, how hard can it be? - Right, right.
What time is it? I gotta get up in the morning.
Hey, yo, check this out.
- Look at this.
- What you doing? - Put that away.
- You don't need that.
- Come on, man.
What? - That loaded? - Hell, yeah, it's loaded.
- Put it away.
- What are you doing? - Let's get back to the party, man.
- What you doing? - This is the real party here.
- Rooster.
- Remember when we shot the lights out? I remember.
That was a long time ago.
Now stop.
- What you doing? - Put that away! This fires a bit crooked.
I think that's the problem.
No, you drunk, man.
That's the problem.
I'm 30.
Last thing I need is to be arrested.
- Put that away.
- Nobody's gonna get arrested.
I'm still nice with it.
You're all just jealous, man.
- You stupid, man.
You stupid.
- Let's haul ass.
Let's haul ass, man.
How you doing? Listen, I I really wish you'd told me.
Or that I'd asked.
Are you tired? No.
Okay.
Why don't I stay here until your mom gets here? Are you a musician? Not tonight, man.
Oh, yeah.
You know what, babe? Weaver and the tenure board can kiss my big, white, semi-hairy ass.
I shouldn't have got my hopes up.
Our hopes up.
It's okay.
We're gonna be fine.
I just had all the money spent.
Buy a house, start a college fund for Cosmo, take a damn vacation.
Hey, we'll figure it out.
You know what's funny? I really wanted this.
I know.
I know you did.
I know.
Hello? Kem? Nothing.
Nothing's wrong.
Oh, not much.
I got awarded tenure today.
Thank you.
No, no, it is.
It's very nice.
It's very nice.
We will.
We will have to celebrate sometime.
Really? Are you serious? How's the clinic? Oh, they must have loved that.
I miss you too.
Yeah.
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