ER s12e04 Episode Script

E.
R.
Previously on E.
R.
Oh, Dr.
Kovac, I'm Eve Peyton.
- Our new nurse manager.
- It's Kovac.
Then maybe you can educate the nurses about inferior alveolar dental blocks.
What? Is there some sort of history between you and Dr.
Kovac? I don't think it's appropriate for you two to work together.
That's two less than I'm doing, which I can't afford, and I'll never see my kid.
E.
R.
12x04 "BLAME IT ON THE RAIN" One thousand, two thousand, three thousand, four thousand What are you doing? - Five- I'm counting.
Yes.
That part, I get.
The time between the lightning and the thunder tells you how far away the storm is.
- Getting closer.
- That's great.
You're going outside? Yep, I drew the short straw for the coffee run.
Where you going? We're getting slammed here.
I'm not on for six minutes.
I'm going out for coffee.
Then be a Flower Drum Song and grab me a bear claw.
Hi, I'm Dr.
Morris, chief resident.
What brings you here today? - Some guy rear-ended me.
- Ew.
Ouch.
- I hope you were driving.
- We're getting a little backed up here.
We can clear some of these necks clinically.
We? Okay, I think it's best if we left that decision to the doctors.
If patients meet all of the NEXUS criteria- What do you know about NEXUS? As research coordinator at Emory, I enrolled 2000 patients in the initial study.
That's really interesting.
Maybe you can bring it up at your next Nazi nurse rally.
Dr.
Morris, my knowledge of the human anatomy is so extensive, I could kill you with this finger.
Somehow I find that hard to- Ow! I saved your life.
Been telling them to keep these floors mopped.
Maybe it's time I fired a janitorial staff.
It's time you cleared some patients.
Glad you're back in the trenches with us.
Makes one of us.
What's the problem here? We've had like Every ED in the city is closed to saturation, which means we're all open.
Fender-benders are clogging the hallways.
I'm not sure they all need a C-spine film.
Of course not.
Get with it, Morris.
Half these patients don't need x-rays.
- Start clearing necks.
- All right, so they've What the hell's your problem? You can't wait for a little break in-? Hey! It's a crosswalk, you asshole! Diverticulitis grandma is being admitted to Medicine.
My mandible fracture's going to the OR with OMF and Mr.
McKay goes home with rest and ibuprofen.
On that note, I'm out of here with no pass-ons, thank you.
- Thought you'd help Neela clear necks.
- I did.
- Doc Rock will help you.
- I'm not working here today.
I start my Toxicology elective.
I picked Neurology, didn't get an elective.
You need to complete Pre-Hospital Care Training Requirements.
- My what? - Your ride-alongs.
You never did them as an intern and you've 24 hours in the field.
- Been meaning to do that.
- Come see me when you do.
Then we'll discuss your elective options.
Where'd you go for coffee, Milwaukee? The donuts are soggy.
God forbid you don't get your morning ration of deep fried fat, Frank.
Maybe I can dry them in the microwave.
- You okay? - Yeah.
Nothing a week in the Bahamas wouldn't cure.
What about you? Eve stuck me on nights.
Now I get less sleep, less money and I barely see Alex.
I have to have a babysitter spend the night.
What is it about rain that turns residents of this city into idiots? - Tell me about it.
- Haleh, what are you doing here? - Connie asked me to cover for her.
- I warned you about your overtime.
I'm just trying to help her out.
You should've told her to call someone else.
You want me to go back home? Unless you want another letter in your file.
Have a great day.
Sam, can you cover for me until I find someone else? Sam.
Why not? It's not like I'm gonna be home in time to see my kid off to school anyway.
- Who's this? - Blaire Collins, 29.
Sent in from Lakeshore Gardens for infection around her G-tube.
- Does this hurt, Blaire? Ma'am? - She's in a coma.
- Since when? - Six years.
No, come on.
No way.
No way, guys.
We don't have room.
She doesn't need to be here.
They can give her IV antibiotics and they can change her G-tube.
- What are we supposed to do? - I just told you, take her back.
We don't get paid for round trips.
Hey, guys.
Hey! What's wrong? Nursing-home dump.
What else is new? Come on.
I think Trauma Two is open.
Check the lobby.
We could use a nurse in Triage.
- You've gotta be kidding me.
- It's okay.
Don't worry about it.
No, this is ridiculous.
- Hey, Kerry? You gonna do something? - About what? The way she's managing the staff.
If it's a nursing issue, it's Eve's rice bowl.
You two work it out.
- Morning rounds are at 10 a.
m.
- Ten.
Ten is good.
We discuss our toxicology consultations from the entire county.
You will carry the pager every third day and research conference is Thursday afternoons.
Check it out.
Is it poisonous? Venomous? Yes.
I'm studying neurotoxic factors in crotalid venom.
How cool.
- Cool.
- Please, but- Don't do that.
Your main focus will be our Poison Control Center.
Calls come in from both the public and other health care facilities.
You have online access to an international POISlNDEX database and we're here to back you up.
You're number two.
Judy Anderson, 31, head-on collision, auto versus cinderblock wall.
- Where's my baby? Grace? - She's coming soon, ma'am.
- Any belly pain, Judy? - It hurts when I breathe.
- Driver with chest pain, good vitals.
- Any victims in the second vehicle? - Only one car.
- They forced me off the road.
- Who? - They were driving like maniacs.
- They hurt my daughter.
- Baby's with Rescue 73.
I'll take this one so you can take the baby.
Sure.
- Nice work.
Is that custom? - Yeah, Spanish Revival.
Ancef's onboard.
- Watch it, this thing's attached.
- He missed the femur.
He bagged the femoral artery, got a cold foot.
Give him 50 of fentanyl and we'll take him upstairs.
I'll be right back.
- Dr.
Dubenko.
Yeah.
Is everything else okay? He should be back to work in a few weeks.
- Well, I meant with you, actually.
- Oh.
I know this is none of my business but I was up in oncology last week with a patient and I had my annual PSA screening.
- Sorry.
- It came back 6.
5.
- It's a little high.
- Needle biopsy showed a moderately differentiated prostate cancer.
- I am so sorry.
- No.
It's okay.
We caught it early, stage T-One.
Good prognosis with surgery.
I gotta get your ischemic foot boy upstairs.
Um, Lucien? If you want to talk with someone or have a coffee or something Yeah, all right, maybe.
That would be nice.
Okay.
Hi, Frank.
Anything besides fender-benders? Well, the guy in Number Four got scalded while driving by the hospital by some crazy broad who was throwing coffee.
He thought she was a nurse.
Probably someone from ICU.
They're wacky up there.
Abby! Chest pain.
- When did it start? - Ten, 15 minutes ago.
- We came right in.
- What does it feel like? Heavy, heavy- Here.
- Are you on any medications? - Lipitor and aspirin.
All right.
First day labs, 12 lead.
- Lopressor and nitro.
- Got it.
- Is he having a heart attack? - We have look at his EKG to tell you that.
Three-months-old passenger.
Multiple lacs to the head, face and chest.
- Looks like she was ejected.
- Car seat wasn't anchored down? Looks that way.
Heart rate in the 160s.
- Access? - Tried twice.
IV blew.
Are you good with tiny veins? - Maybe.
- I'll take that as a yes.
- C-spine's clear.
Get her off the board.
- Pulse ox 97 on two liters.
When you say a truck, do you mean they were driving an SUV or a pickup? SUV.
It was blue or black.
It was definitely black.
- Okay, Judy, we're gonna sit you up a bit.
- Ow, my chest.
Did you see the driver or the passengers? There were at least two of them.
The driver was a young teenager.
- White, Black, Hispanic, Asian, what? - White.
I'm not sure about the passenger.
- Lungs are clear.
- BP, 112 over 78.
It hurts when I breathe.
- Stop! - I think you've broken your breastbone.
Add a sternal view, troponin, CT of head, abdomen and pelvis.
- What can you tell us about their vehicle? - There is a bike rack on the roof.
They tried to force me off the road.
They wanted to steal my car.
- Am I bleeding? - You hit the window.
It's not too bad.
- Will I need stitches? - Yep.
Did either of them have a weapon, ma'am? I don't know.
It happened so fast.
I just wanted to get out of there.
Enough for now.
She's had a concussion.
You need to let her rest before she goes into the CT.
- We're working here.
Sorry, Luka.
Got a trauma.
We need the room.
Hey, here we go.
Gently.
I've got the neck.
On my count.
One, two, three.
Here we go.
We're out of the infant c-collars.
Luka, do you know if we have infant c-collars? - You can use towel rolls.
- I'm gonna ask Peyton.
Can't hear breath sounds.
Do we have a sat? - Won't pick up.
- Kid's pink, sat's fine.
Twenty-four gauge going in on the right.
You want me to take this? I don't mind.
Why, you think I'm rusty? Superficial lacs, no step offs, left frontal-parietal hematoma.
Call CT and let them know we need a head.
Finally calming down.
Or going apnic.
Come on, baby, wake up.
Wake up.
All right.
Inez, miller one and a four-0.
She needs a tube.
The kid's screaming.
The airway's obviously fine.
She's got a good mechanism for a head injury.
She needs a CT.
You'll subject her to the risks of intubation to make things easier for the radiology tech? - She'll settle down.
- She doesn't have time.
Agitation could be an early sign of a head injury.
Or an appropriate response to a stressful situation.
- Babies cry when they're scared.
- Thank you, Dr.
Kovac.
But this is my patient and her mental status is waxing and waning.
- She could go apnic in the scanner.
- Then you bag her through it.
Point five of versed and vec.
You lose your neuro exam if you sedate.
Observe until Trauma gets here.
And watch her bleed into her brain? No, thanks.
Push the meds, Inez.
Look at her.
She's alert, pupils equal, good tone.
- Do it now.
- Point five versed, going in.
Kerry, we've seen enough head trauma to develop gut feelings about these things.
And my gut says intubate.
She needs a tube.
Giving the vec.
Suction.
The scope.
- Where are they taking my daughter? - She's going up to the CT.
What are all those tubes? Why isn't she moving? The tube helps her breathe.
It's just a precaution.
Sometimes babies have to be sedated for CAT scans.
It doesn't mean anything's wrong.
- Have the police found anything? - It's still early.
They will.
I should have waited until it stopped raining.
No one can control the weather.
The good news is that your brain and belly CT are normal.
You've broken your breastbone and we'll need to monitor your heart - to make sure it wasn't bruised.
- But I didn't have to go out.
I could have waited.
Grace was fussy all night.
Sometimes a car ride settles her down.
I'm gonna numb up the cuts on your face before I suture.
- What am I gonna tell my husband? - You need a new car? You're gonna feel a little pinprick and then some burning before it kicks in.
You have a bunch of phone messages.
No, no, no.
Tell Kayson to stop bothering me.
I'll call Anspaugh back when I get a chance.
Oh, crap.
Henry's got a birthday party tomorrow.
Hey, Jerry.
Could you go down to that toy store on Michigan Avenue for me? - You want me to go outside? - Yeah, it's just a few blocks.
I need a King Funshine.
I'll write it down for you.
- In the storm? - What, you afraid you'll melt? What about the lightning? I'm a big target.
Well, then I suggest you try running in a zigzag pattern.
Dr.
Weaver? The results are back for that little girl ejected from the car.
- Is she awake yet? - Not yet.
But I'll double check.
- Hey.
- Hey.
Baby's head CT is negative.
- Just some soft tissue swelling.
- Is she awake? - No, she is still sedated.
- Then you can't follow her neuro exam.
She'll wake up and we'll extubate.
This is Bradley Anderson.
His wife and daughter were brought in.
The police said there was an accident.
Yeah, they're doing well.
Come on, I'll take you to them.
Aren't you two supposed to keep 50 feet apart or something? - Bite me, Frank.
- Ask me, you're better off.
I didn't.
Second EKG is unchanged and troponin is negative.
He's pain-free after nitro and metoprolol.
So he's okay? Well, doesn't look like a heart attack, but I think he has unstable angina.
One of the arteries may be closing down.
You have to stay in the hospital for observation and more tests.
- For how long? - Could be just a day or two.
- You okay with that? - Like I got a choice? You hang in there.
I'll stop by later if I can.
Um, excuse me.
Excuse me, hi.
It might be better if you stayed.
The cardiologist is gonna have questions and instructions for you and your husband.
I'm not Lee's wife.
I'm his therapist.
Are you a doctor? I am his satisfaction facilitator.
What is that exactly? I have a select group of clients like Lee who require something they're not getting at home.
Something sexual? I provide the one thing that's missing.
Allows them to live happily ever after with their wives.
- Really? - I help women too.
- You call me if he needs anything.
- Okay.
Sixty cc's of gastrografin and check KUB.
What's this? Nursing-home dump.
I'm changing G-tubes on comatose patients now.
- How's your MI? - Unstable angina.
Just out of curiosity, what type of guy hires a satisfaction facilitator? I believe that's the politically correct term for call girl these days.
A smart one? We have a saying in Croatia: You know, if it floats, flies or - Fornicates? - Rent it.
- Hey, Dr.
Kovac.
- Hello.
Hello.
I thought I might take you up on that offer for coffee.
- If you've got a minute.
- Sure.
Page me if you need me.
How many stitches? Let's see.
There's seven on the forehead.
Five on the cheek.
That's 12 altogether.
It's not so bad.
Neela, this is Brad, Judy's husband.
Hey, baby.
- Honey, I'm so sorry.
- Come on, it wasn't your fault.
The police told me what happened.
The bastards should be shot.
- I tried to get away and I lost control.
- You did everything you could.
Don't worry.
The cops will get these guys.
- Have you seen Grace? - She looks good.
- They think she's gonna be okay.
- Really? We have to run a few tests.
Everything looks good, but soon as I can I'll bring her down so you can be with her.
Thanks.
I'm gonna go back and stay with Grace until they're ready to bring her in here.
- I love you.
- I love you too.
Your husband seems like a great guy.
- It's okay.
Everything's gonna be okay.
- I'm sorry.
I'm not usually like this.
Okay, well, the Venus Fly Trap is non-toxic so it's not a lethal if ingested.
However, the larger ones are extremely dangerous and have been known to devour pets and small children.
No, no, no, I made that last part up.
I'm sorry.
Ma'am, I- You're absolutely right.
This is not a venue for humor.
I understand.
I apologize.
You too.
Do you need any help with the snakes? - We could have gone to the cafeteria.
- This one.
Their coffee sucks.
You didn't mention seeing me upstairs to anyone else by any chance, did you? No.
I mean, I- I wouldn't have said anything to you but I thought you might wanna talk to someone or something- - No, yeah.
No, I appreciate the gesture.
- Okay.
- So, what are your treatment options? - Well I've opted for a radical prostatectomy.
My urologist, Dr.
Peter Singh.
You know him? No.
He does a bilateral nerve-sparing procedure for patients with low volume disease.
- That's great.
- Even in the best of circumstances there's a 25 percent chance of loss of erectile function.
Yeah.
Then you're looking at penile injection therapy intraurethral pharmacotherapy, vacuum erection devices or a penile prosthesis to achieve an adequate erection.
Well, I- Then the good news is that there's 75 percent chance of success.
Well, the procedure also eliminates the ability to ejaculate.
But the chance of urinary incontinence is low so I won't be wearing a diaper or need an artificial sphincter.
Well, there you go.
- Yeah.
- Yeah.
It is- It's just- It's rather daunting, knowing that you may never have sex again.
- Well, it sounds like you're in good hands.
- Yeah.
Look, I know this is rather unconventional and under different circumstances I certainly would have employed a more traditional approach with regards to courtship and romantic methodology and assuredly enjoyed all the ritual of that.
But given the time constraints and obviously what I'm potentially faced with- You know, you might just wanna kind of take- Look.
If I'm going down, I wanna go down swinging and I'd like it to be with you.
So you want me to sleep with you? Yeah.
Well, that's something.
That's I'm flattered, I think.
But I - I can't do that.
- No, no.
I understand.
- Nothing personal.
- No, I understand.
I was asking purely from a scientific approach.
What about after? - After what? - The surgery.
To see if anything still works.
I'm gonna have to take a pass on that too.
Yeah.
Abby, you want this? GSW to the upper chest.
I gotta- I better go back.
You wanna hop on? I mean, are you coming? To the- For the- Place the chest tube, call me if the initial output is over 500 cc's.
How's Grace? We moved her to one of our exam rooms, so we'll take you too.
I've brought some mug books for you to look through.
It all happened so fast, I'm not really sure what I remember seeing.
Take a look, maybe a face will jog your memory.
I can't.
- Why don't you give us a few minutes? - Sure.
I don't wanna look at those books.
You might identify the men who drove you off- I can't.
- Why not? - It was pouring rain.
I could barely see out the window.
Car started to skid, and I don't know.
I saw the wall coming, and I didn't stop.
I just kept driving.
I just- What are you saying, Judy? What happened? I didn't know that Grace's seat wasn't clicked in.
I would never do anything to hurt my child.
Did you do this on purpose? Sometimes, I I can't help it.
Sometimes- It's like I don't know how to snap out of it.
It's like everything's coming at me at once and I just want it all to go away.
- Judy, did you try to hurt yourself? - I just wanted it to stop.
- Do either of you have a moment? - Shoot.
My MVC mom's suffering from severe postpartum depression.
- Dr.
Weaver? - Just one second.
- It's the baby, Grace Anderson.
- What about her? She's waking up.
You might wanna extubate.
- Yeah, I'll be right there.
- What are her symptoms? She drove head-on into a wall with her baby in the car.
I think it was intentional.
I'd like to put her on a psych hold.
- Dr.
Rasgotra? - It's the husband.
Get Psych down here.
- Can my wife go home now? Not yet.
You moved Judy out of the trauma room.
I thought that meant she was good to go.
We needed to clear the room.
We have to rule out a cardiac contusion.
We need to monitor her heart to make sure it's not bruised.
For how long? I'm not sure.
It could be a while.
Mr.
Anderson Does Judy drink alcohol? No.
I mean, she has a glass of wine now and then.
Why? What about drugs? No.
What's this all about? Just routine questions for her chart to avoid any drug interaction, that sort of thing.
Have you noticed any change in her mood lately? Like what? - She seem depressed? - No.
Any loss of appetite or trouble sleeping? You're kidding, right? We have a three-month-old baby.
When Gracey doesn't sleep, none of us do.
The sooner I can get them both home, the sooner they can start getting better.
I don't want to send her home until I'm sure there's no danger.
No, of course.
You're right.
Thank you.
Dr.
Kovac, could you help me clear some beds? - I thought I was.
- If we work together- Look, what's going on in Exam Two? DUB needs an ultrasound to rule out fibroids.
Good crits, vitals stable.
How about an outpatient scan and GYN referral? - Well, if you can get her in this week.
- Done.
Okay, next.
Buster Freeman? Dirty puncture wound to the foot, waiting on IV Ancef.
Can he sit in a chair for that? It frees up a bed.
- Crystal Marranachio? - Waiting on an ortho consult.
She's been cleared.
I called the attending.
You what? It's new policy.
When we call for a consult the resident has 60 minutes to respond to the page or we call the attending.
All the department heads signed off on it except Psych.
Crazy bastards.
- Blaire Collins has been here forever.
- I've called the nursing home twice.
They were supposed to send a ride for her.
Well, if they're not here in 10, I'm putting her in a cab.
- She's comatose.
- I was kidding, Dr.
Kovac.
Frank, call Blaire Collins' nursing home again and tell those idiots she's been ready to go home for the last four hours.
- Tell them yourself.
I'm busy.
- Dr.
Kovac? I think I'm one of those idiots.
Trish Gorham, assistant director from the nursing home - that's been caring for Blaire Collins.
- I didn't mean that.
It's our policy to check on patients prior to transfer.
- I gather she's well enough to return.
- Yes, she's right over here.
This way.
To be honest with you, all she needs is a course of IV antibiotics.
And the G-tube could have been changed at your facility.
We're not staffed well and the gastroenterologist doesn't come out.
The earliest I could get anyone to see her was in two weeks.
- She have any family? - No.
Her mother died from the crash that did this.
There was a boyfriend, but he stopped coming around years ago.
He didn't even try to stop.
Somebody call my son.
A 47-year-old, victim of auto vs.
pedestrian.
I just ran out to get the kids some pizza.
He didn't even slow down.
Systolic's only 80 after a liter.
Pulse, 140.
Pale and diaphoretic.
Ecchymosis across the abdomen and pelvis.
Four units of O-neg and prime the rapid infuser.
Am I dying? No, but you may have some internal bleeding.
Resps are shallow.
Let's set up for intubation.
- How often are you sad? - Not often.
- What makes you happy, Judy? - Being with my baby, my husband.
Why are you asking me all this? We ask all patients these questions to assess mental status following a head injury.
Well, my mental status is fine.
Really.
Any thoughts about wanting to hurt yourself? Not unless you count wanting to take a carving knife to my hips.
Do you ever think about wanting to hurt your baby? Of course not.
What did you tell him? Judy, you said you were upset and that you couldn't snap out of it.
What are you talking about? You felt like everything was coming at you and that you wanted it all to stop.
No, no, I said that I lost control of the car and I couldn't stop.
You're putting words in my mouth.
It's not uncommon for new moms to have depression.
The first year with your baby can be stressful.
I'm not stressed and I'm not depressed although I will be if I have to spend any more time here.
So stop accusing me of being crazy and let me go.
Nobody's accusing you of anything.
We have to be extra careful whenever there's a child involved.
Look, I don't know.
I appreciate your concern, really.
There's nothing wrong with me.
I've had a rough day and I just wanna take my baby home and get some rest.
Well, I hope you have a speedy recovery, Mrs.
Anderson.
So are we good to go? Not quite, but you can go back inside now.
I'll be right in.
She's changed her story.
There are no vegetative symptoms, no anhedonia.
She doesn't have a depressed affect.
She's in good spirits.
Something's going on.
She as much as confessed to crashing her car.
- But she's not saying that.
- She's lying.
She's a prime candidate for severe- I wanna be sure she doesn't have postpartum depression as much as you do.
But it can be difficult to diagnose.
If the patient is in complete denial or lying to me not only can I not tell, but I cannot hold her.
I gave her every opportunity to let us know.
I'm sorry.
- You need a hand? - I need eight.
- God, it hurts.
- What's this? Driver of our auto versus pedestrian.
The guy ran out in front of me.
Please, give me something.
No neck pain, no chest pain, good vitals, but complains of bilateral thumb pain.
Look at this, I can't even make a fist.
- We're out of beds.
- I'll see what I can do.
Dr.
Weaver, Psych's refusing to admit Judy Anderson.
- Psych? - Her collision was a deliberate act.
I know you suspect postpartum depression, but did she admit it? Practically.
She drove head-on into a wall.
The baby's seat wasn't properly anchored.
She's obviously overwhelmed at home.
ER, please hold.
Please hold.
Please hold.
Has anybody seen Jerry? I sent him out on an errand, but he should be back by now.
- You sent him out? - You don't send Jerry out in the rain.
- I've heard that too.
- Maybe I should get DCFS involved.
Have you talked to the husband? Maybe he can convince her.
A voluntary admission would be better.
- I'll try.
- Frank, where's Jerry? Dr.
Weaver sent him on an errand.
- Oh, no, you didn't.
- What's the big deal? Big man does not do well in the wet weather.
What the hell does that mean? Excuse me.
Could you help us find our dad? Lawrence Digby? He was hit by a car.
The doctors are treating him.
- He got hit while crossing the street.
- Yeah, he was- Guy was talking on his cell phone went through the crosswalk.
I'll take you back to him.
You can go home.
Got a float from the ICU.
I'll stay and help with the kids.
You're welcome to do so, but you're off the clock.
- Fine with me.
Come on, you guys.
- Can I take her home now? We'd like to keep her overnight.
- Come on.
Overnight? Why? - I think your wife needs some help.
I've tried to talk her into getting a nanny but she doesn't want another woman raising her daughter.
It makes her feel like she's less of a mother or something.
I don't mean that kind of help.
I think Judy needs some psychiatric help.
- What? - Mr.
Anderson Brad, why don't we sit down? It's not uncommon for new moms to get overwhelmed with all the challenges of child care, especially in the first year.
So why are you making a big deal out of this? Usually, it's short-lived and goes away after the baby falls into a routine and the mom's hormones stabilize.
But occasionally, it lasts longer, becomes more severe and develops into something called postpartum depression.
Yeah, yeah, but that's not Judy.
Judy's not depressed.
Not like that.
I mean, sure, she's anxious to get back to work and sometimes she's a little down about that, but that's normal.
Purposely trying to hurt herself and your baby isn't.
What are you talking about? She had an accident.
- Some creep tried to run her off the road.
- I don't think so.
Dr.
Rasgotra.
Nosebleed on Coumadin in Two.
Okay.
Please, talk to your wife.
Ask her yourself.
Ask her what really happened in the car.
- Sux onboard.
- Yankauer.
- Assist ventilations.
- O-neg's going on the right antecube.
- We're going to need rapid infuser.
- Curtain four.
- They did an in-service.
I got it.
- Okay, let's take a look.
- Sats down to 92.
- Turn on the suction.
- It's on.
- No, it's not.
- I have it on high.
- I'm not getting anything here.
Inez, why don't you go next door and help Dr.
Lockhart with the chest tube? I'm not allowed to work with any of the nurses now? Patient is paralyzed, can't see the cords.
- I need suction.
- Hold your horses.
The suction container wasn't sealed properly.
- You're welcome.
- Tube.
- I found it.
- Two units on the infuser.
Set up for a subclavian.
Okay, bag him.
- End tidal CO2 is yellow.
- Yellow is good.
I'll be right back.
All right, hook me up.
O- silk is next.
- O-silk.
Come on.
- Here you go.
- I wanna auto-transfuse this guy.
- Okay.
You need a side collector on the thoraseal.
Just go help Dr.
Kovac with the rapid infuser.
No problem.
- What do you need? - Central line, supraumbilical DPL.
- Rapid infuser and a TPOD.
- What's a TPOD? - Fine, I'll get it.
Again.
- What do you want to do first? - Prime the O-neg.
- Everything okay in there? For the time being.
Call for four units of type specific.
- As soon as I get this up.
- Hey, Sam.
Hypotensive pelvic fracture.
He needs the works.
- Those are his kids out there.
- Hey, Frank.
Bring those guys to the family room.
- Sure, come on, kids.
This way.
- I'll be right in.
Great.
- Guidewire.
- I'm getting error signal.
That's because there's not enough water in the warmer.
- Thanks.
- Cordis inducer.
Stitch.
- Where's Dori with the TPOD? - TPODs are in the bottom shelf.
Update his vitals.
- Okay, infuser is on.
- Looks good.
- Cath- - Pressure's up to 95 palp.
- No gross blood.
- Where do you need me? - We're all set.
- She's good.
Thanks, Sam.
We'll take it from here.
- I'll go check on his kids.
- She's really not sure what happened.
She gave herself a good whack in the head.
We can't do anything if she doesn't identify her assailants.
That's okay.
Like I said, she's not sure what she remembers.
She's not even certain it was intentional now.
Fine.
Let me know if she changes her mind.
You did the right thing.
Next is get your wife help.
No, the next step is for me to take her home.
My wife is not crazy.
She had an accident.
It happens.
I'd rather she chose to stay than have Psychiatry put her on forced hold.
She's gonna be with me.
She's gonna be fine.
Just leave us alone.
I mean it.
Pressure's up to 100 systolic, crit's 28.
- Send another four units to angio.
- Daddy? Your dad has a broken pelvis which are the ring of bones around his waist.
Some of his blood vessels have also been damaged.
He's bleeding inside.
Can you fix it? We're gonna try, but he's lost a lot of blood already.
It's very serious.
It was supposed to be me.
I was supposed to get the pizza, but I didn't wanna go out in the rain.
It's not your fault and it's not your dad's fault.
- Hey, jerk-off.
- Jason.
I can't drive for a week.
Not that I could anyway.
My car's totaled.
What's so important you had to be talking while driving? - What was so damn important? - Hey, that's enough.
- Hey, get that guy away from me.
- Shut up.
Jason, I know you're mad, but your father's condition is very serious.
And your brother and sister need you right now, okay? Come on, Jason, I'll take you to the family room.
Dr.
Kovac, one of your patients is getting agitated.
- Which one? - The girl from the nursing home.
- She's in a coma, Inez.
- Not anymore.
- Blaire? - Where-? I'm Dr.
Kovac.
Where's my mom? Okay, keep your hands up as if you're holding a tray.
What's wrong with me? What's the last thing you remember? My mom and I were going to the mall and it was snowing.
And Were we in an accident? Is she okay? I didn't treat her, but Let me see what I can find out.
Okay? Okay.
- How is she? - She doesn't remember anything.
What are you gonna tell her? I don't know.
Your mother's dead and you've been in a coma for six years? - How are those kids doing? - They're hanging in there.
I got ahold of an aunt and uncle.
They're with them now.
- Inez, walk with me.
- Do I have to? - You have fantastic potential.
- I better get into this.
But in every spare moment, you've got to be honing your skills.
- Got a second? - Not really.
If you're so concerned with efficiency allow those of us who work well together to continue to do so.
If you want us to act like professionals, then you need to treat us as such.
You saw me with Dr.
Kovac and how well we worked together.
If that doesn't prove we can work the same shift then you don't know your job as well as you think you do.
Feel better? FYl, I already changed the schedule.
You're back on your old shifts next week.
Thank you.
When I first started, I could barely hook up an IV.
It's all muscle memory.
You'll get it.
I know you will.
I felt like an idiot.
I didn't even know what a T-POD was.
Everybody needs help with stuff.
When you do, come find me.
Thanks.
- Page me when he's out of surgery.
- Will do.
- You're back.
- Had a cancellation.
He's this way.
I tried Lee's cell but he wasn't answering.
- Is everything okay? - He's doing great.
We're just waiting for them to take him to the cath lab.
That sounds ominous.
They're going to do angioplasty, which is a procedure where we insert a catheter into a blood vessel in his leg, thread it up to his coronary artery which inflates a balloon that will open up the blockage.
Guess those cheese steaks caught up with me.
I've been telling him to eat better for years.
Lee? Hey, you.
Hey.
This is my wife, Viv.
- Hi.
- Hi.
I'm Dr.
Lockhart.
I've been treating your husband.
- Hi.
- Everything's okay.
I've got a little blockage, but they're gonna fix it.
I didn't get your name.
Shawna.
Hi.
And you are? Therapist.
From cardiology.
Really? Your husband has to undergo an angioplasty.
We insert a catheter into a blood vessel in his leg and use it to inflate a balloon that will hopefully open the blockage.
- Oh, okay.
- Well.
Good luck, Mr.
Rappaport.
I have to get back to my other patients.
It was nice to meet you.
Excuse me for just one second.
That was close.
Thanks, I really owe you one.
Hey, listen.
If you ever need a sex therapist? I think I'm good.
But now that you mention it, do you ever do any pro bono work? I spoke to your resident.
He felt a hold was unnecessary.
I disagree and all I'm asking is for a second assessment from another attending.
Watch it.
No, Dr.
Wakita, not you.
Where have you been? I was worried about you.
Everyone was acting as if I'd sent you out in a hurricane.
Are you okay? What the hell happened to King Funshine? Did you get hit by lightning again? He didn't get hit by lightning.
Here's your change.
Okay, let's get you on a cardiac monitor.
CBC, chem panel, EKG, CPK, troponin, UA and myoglobin I realize that, I'm sure he is.
But this isn't about me or him, or you.
It's about the welfare of a mother and her child.
You will? Great.
Thank you so much.
Psych attending will assess Judy Anderson.
If Dr.
Wakita asks, you agree with my assessment, right? Yeah, you got it.
Mr.
and Mrs.
Anderson, I have some good news.
One of the attendings agreed to speak with you.
- I've seen enough doctors today.
- We're going home.
- He's on his way down.
- We've been here for hours.
- This will only take a few minutes.
- I'm tired.
I just wanna go home and have a dinner and a bath and put Grace in her own crib.
- You want what's best for baby, so do I.
- Then leave us alone.
- Speak to someone.
- She just needs to rest.
You don't wanna hurt yourself or Grace.
You need professional help.
- Do you have children? - No.
- Then how do you know? - I'm a doctor.
- But you're not a mother.
- Judy, listen to me.
Please don't go.
My wife has a touch of the baby blues and you wanna lock her up.
No one's locking anyone up.
Just want her to get the help she needs.
- By giving her drugs? - Maybe.
Ignoring it is not gonna make it go away.
It needs to be treated the same as any other disease.
Now, this could happen again.
Only next time, it could be worse.
Judy, Judy, please.
You could die, Judy.
Your baby could die.