ER s13e04 Episode Script

Previously on ER: - Are you loving motherhood? - Yeah.
- Oh, this isn't awkward? - What ? That you and I are equals now? Dr.
Crenshaw is our new chief resident.
Neela Rasgotra.
Two years in the ER, then defected.
It took you that long to figure out you were wasting your time? - I'm your daddy.
- What's up? - How's the new intern doing? - She's very, uh, devoted.
- Thank you, Jesus.
- Were you the best one there? How many people did you save? Did you rock? Next time you don't do what I tell you to do, or any other attending tells you to do, you're gonna find yourself getting bum-rushed right out of this program.
You don't even appreciate the fact that I took the time and money to go out and buy you some new clothes.
I didn't ask you to do that.
No, because you'd rather go to school dressed like a bag lady.
Would you rather I dressed like a slut?! Because that's how most of the other girls dress.
I'd rather you dressed like someone that has a mother that cares about her.
- Tony, would you please say something? - Good morning.
What's wrong with the way I dress? She won't even try on the clothes I bought for her.
Those are nice.
They're ugly, and I refuse to conform to some anorexic, media-fueled ideal of beauty.
That's fine, but you're not leaving the house dressed like that.
Tony? I hate living here! We never resolved the nanny issue.
Do you really want someone else raising our child? Well, I'm just talking about a few hours a week so I can at least get some stuff done around here.
Oh, I thought we had agreed to stagger our shifts.
Well, and what, never see each other? I mean, even if that was practical, after your first day alone, you'd be begging for help, trust me.
Mm.
I think I can handle it.
Well, if you can handle it so well, help me get Joe in the car, will you ? We're late for our first Mommy and Baby class.
What? Nothing.
What? I thought it would be fun for What? I didn't say anything.
What? I'm late for work.
Bye.
I'll call you later.
Don't forget his frog.
I know.
Come here.
Oh.
Can you say "Daddy is a butthead," hmm? Why is your daddy a butthead? - I look like a dork.
- No, you don't.
This is not my style, and this is not me.
If you didn't like what your mother bought you, ask her to go shopping.
Then you guys buy something together.
What are you doing? Damage control.
- Sarah - What? - This is not cool.
- Do you mind? I'm changing.
I hope your mother doesn't find out about this.
She won't.
And besides, you don't know what it's like for girls my age these days.
There is a lot of pressure at school.
What you wear, what you eat, what you don't eat.
- What's his name? - Who ? This is obviously about a guy.
- No, it's not.
- Yes, it is.
Maybe I should dress like a hussy.
Maybe we should get you a plaid jacket.
We'll just tell everyone you're a lesbian.
- Adam.
- Huh? Adam Horner, but he doesn't even look at me.
Well, good.
I don't want some guy named Horndog anywhere near you.
It's Horner.
Listen, most guys are jerks, but if you want this guy Okay, wait a minute.
You're a guy.
Exactly, and if you want this guy to notice you, forget about your clothes and ignore him.
- That's your advice? - Yup.
- Ignore him? - Yup, that's right.
Wow.
You really suck at this.
Trust me.
Most guys want what they can't have.
You ignore him, that guy'll come running to you, all right? Try not to kill anyone today.
Bye.
- He's out.
- All right.
Hope you're going to take a deep breath, and you're going to hold it.
Now, if you don't get the tube in by the time you run out of air, we're gonna stop, and we're gonna bag.
Okay? Are you ready? With you and Jesus guiding my hand, I am.
Right.
Okay, sweep the tongue to the side and advance until you're in the vallecula.
Elevate the scope at a 45-degree angle.
See the cords? All right, I'll give you some cricoid pressure.
How's that? Come on, Hope.
The cords should be right there.
He's a young guy.
All right, pull up more, but do not rock back against the teeth.
Aim the end of the handle to where the wall meets the ceiling.
Can you see the aryepiglottic folds? Hello?! Sats are dropping.
Pratt.
Whoa.
All right, pull out.
You bag, you breathe.
I'm sorry I ran If you were doing what I told you to do, you should have been able to pass the tube.
- Come on.
- Maybe you should sit down.
Yeah.
I don't feel so good.
Uh, I'm in.
- Here, that should keep you from swelling.
- Oh, bless you, Sam.
What happened to her? - Nothing.
- Damn, it's only the morning test.
What are you doing with the transport beeper? I gave that to Jane.
You know, I don't think she really wanted it, so I offered.
You can't monopolize the beeper, Ray.
The other residents need the experience, too.
She gets airsick.
Hey, what's going on with your rhabdomyolysis guy? - He's pretty stable.
He's making urine.
- What about his creatinine? - I'd have to check the chart.
- Peak CPK? Medicine team's all over it.
Come on, man.
You got to be all over it.
You cannot let the internal med docs take over your patient's care.
- I can't? - Hey, I'm serious, man.
You've got critical patients.
You got to stay on top of the labs.
I know, but the guy was ready to hand off, and I - And what? - And that was a great talk.
What the hell's going on with the PACS system? Down again.
They said they should have it running in an hour, but they've been saying that since yesterday.
So, is it true? - Rumor is you killed an intern.
- Yeah, I wish.
You know, everything in this place is crap.
The equipment sucks; the students are incompetent; the interns can't finish a chart; the residents-- they don't give a damn about their patient Yeah, okay, okay, Kovac.
I see what you're going to say.
That I was the same way, right? But I wasn't.
- I didn't say anything.
- Yeah, I could chart, I could clear beds, - and I never passed out tubing a patient.
- I know, you were really, really special.
You need to go through in-service exam results with your residents.
Have you seen these? See, this is exactly what I'm talking about.
They don't know jack about emergency medicine.
Solomon is an idiot, Hope is annoying and incompetent, Gates should have stayed a paramedic, and Jane is like What's wrong with Jane? She is good.
No, Jane is creepy, I'm serious.
She's always sneaking up on me.
She's like those twins in The Shining.
Look, in-service shows you their strengths and weaknesses, so focus on that.
They all have their own learning process, so you need to adjust accordingly.
If the residents fail, it may be because you're a bad teacher.
Down on two, up on three, and mommies let go! Good.
Everyone pick up their babies.
Hi.
I'm sorry I'm late.
I'm Abby, and, uh, this is Joe.
Um, am-am I in the right place? This is the, uh, Mommy and Baby class? Yes.
Yes, it is.
Good.
Well, uh I'm a mommy and, uh and this is a baby.
Uh, yeah, being suspended by his crotch.
Excuse me? You're carrying your child in a device that can cause hip luxation and spinal injury.
He should be in a sling.
Oh, well, you know, I'm a doctor, um, and Then you'd think she'd know better.
She is sitting right here.
Well, um, then you should know that-- a happy, healthy baby is always carried in a sling.
Well, I do know that if you dress your baby like some sort of designer accessory, you're headed for problems.
But don't worry.
I work in the ER, so I'll be there to take care of her when she comes in 14, pregnant, - with a drug overdose.
- Maybe this isn't the best class for you.
Thank you so much for the lunch tray, Archie.
I particularly enjoyed the bread pudding.
Oh, you're welcome, Emma.
That's one of my favorites, too.
Ah, the return of Goat Boy.
I heard one of the doctors made a charm bracelet from all they took from his belly.
Okay, here's what we got: stable CHF, going to tele.
had levaquin.
Incomplete miscarriage.
Do a repeat pelvic in an hour to see if - everything passed and the os is closed.
- Wait a minute, wait a minute.
- What the hell are these? - Pass-ons.
Oh, and her BP's a little low, like 90 systolic.
It's up with two liters, and her crit was 24.
She's type-and-crossed for transfusion? No, but that's a that's a good idea.
Do that, totally.
Two-year-old with possible meningitis.
Ceftriaxone on board.
Currently at CT, needs an LP when he gets back.
- Morris, we do not sign out spinal taps.
- Since when? Wait a minute, wait a minute.
Hold on.
These aren't pass-ons.
They're train wrecks.
- I'm not taking them.
- Dude, I can't.
Max has a soccer game.
It's the playoffs.
- I promised him I'd be there.
- Who? My son.
It's a family thing.
Yeah, his family even know about you yet? No, no, no, no.
We're keeping that on the low-low for now.
You know what I'm saying? Exactly.
Thanks, dog.
Did you just see that? Yup.
He's your dogboy.
Please.
He's not my dog, and he's not my boy.
And we don't use the two together.
I know.
- So, you're gonna take one of these? - Nope.
I have a trauma coming in, and you're not always going to have the luxury of having another attending on shift with you.
You need to learn how to handle these things on your own.
Mr.
Jennings is on his way up to ortho and Lundquist is out of here.
Nice job, Ray.
Here's four more.
Are you kidding me? - Is this about the transport beeper? - The packing is Webril, and we wrap with bias.
We try to keep it tight enough to immobilize, but not to the point of discomfort.
- You don't want to cut off circulation.
- Salomon you know, you didn't do so hot on the Ortho section of the in-service.
So what's the difference between a Jones and a Dancer fracture? Dancer's a proximal avulsion.
Does great with conservative therapy.
Jones is transverse, a little more distal and you got to keep an eye on this bad boy because there's a good chance of non-union.
Let me guess: you just had a patient like that? No.
Right.
Come on.
Who's got somebody in Curtain 2? Uh, me, sir.
48-year-old - PSVT resolved with adenosine.
- Excuse me, doctor.
Is your boss still here? Excuse me.
I need to speak with Archie.
Dr.
Morris is not my boss and I'm afraid he's gone for the day.
Is there something I can help you with? No.
Jane, you need to focus on cardiology.
What are the options with a hemodynamically stable wide complex tachyarrhythmia? - Lidocaine if you think V tach.
- What else? Amiodarone.
Okay, I'm guessing Amiodarone.
Well, Procainamide and Amio can do the trick, but you want to stay away from beta and calcium blockers 'cause you'll end up with V fib if you have a bypass tract.
Right? So how'd you manage to fail every subsection of the in-service exam? I guess I just don't test well.
Well, you better start.
Come on.
Have you got something to present? No.
Actually I started with Dr.
Kovac Where are your charts? Let me see them.
Well, I'm still working on them.
I told you to keep them current.
You got to do them as you go.
What part of this concept don't you understand? Five-year-old with crush injury to abdomen.
He and grandpa were chopping down a tree.
They're bringing grandfather with chainsaw injuries.
All right, I got it.
Keep working up your patients and grab a couple more charts.
- Where do you think you're going? - Chainsaw injuries can be gnarly.
No, no, you need to finish with the patients you've got before you do anything else.
- Dr.
Rasgotra? - Yes.
Hi, I'm Katey Evans-- medical student.
Dr.
Crenshaw told me to shadow you today.
He did? I got the feeling I was getting on his nerves.
He gives that impression to everyone.
Hey, Katey.
Friend of yours? Hardly.
We went out a couple times.
- It didn't work out.
- Too bad.
He's cute.
Cute, but he's way too into himself and to be honest, he's orally challenged.
Oh, bad breath? Not exactly-- he won't go south of 14th Street.
You know He refuses to dine at the Y? Oh, I'm sorry.
This is what I'm talking about.
Making friends and saving lives.
Does it get any better than this, ladies? No, it does not.
So, Mrs.
Draper is back for her 27th hospital admission.
- Status: postpancreatic pseudocyst.
- 27th? Yes.
Someone needs to tell her the hospital stopped giving out frequent flier miles.
Oh, and she's a chronic rectal discomfort.
And you two get to work her up and review her old charts.
All 27? No.
Why don't you forget all about visits six, 13 and, um what do you think, 21? Yeah, that should keep it interesting.
It'll be like playing patient roulette.
Be prepared to present her at afternoon rounds.
Smiles all around.
Maybe he should use his extensive surgical skills to remove that bug from his ass.
Oh, saved by the bell.
We're paged to the ER.
I'm so glad I'm not doing an ER rotation.
I have heard horror stories.
Oh, it's not so bad-- once you get used to the smell.
The line is good to go.
Pressure's only 85 after the bolus.
How much O-neg? Chest and pelvis films are back.
- Let me see.
- Sam, your son's school called.
- Said he never showed up for homeroom.
- First hemoglobin is 9.
8.
What? I dropped him off this morning.
Type and cross four units.
He's losing a ton of blood.
- Crush injury? - Yeah.
Unstable pelvis.
Open book fracture with complete SI joint disruption and lateral displacement.
- I've got the T-POD.
- How's the belly? Spleen is okay.
Looks like a small liver lac.
So he goes to angio first? For embolization.
Hypotension and pelvic fracture has a 50% mortality.
- Blood at the meatus.
- Probably tore his urethra, - but that'll have to wait.
- Along with his liver.
If they can stop the pelvic bleeders in angio, he might make it to the OR.
Okay, bring blood, FFP, and get him on a portable monitor.
It wasn't a very big tree.
It was only about eight inches in diameter.
I was just finishing the cut when the chainsaw broke Ow! Sorry about that, Mr.
King.
We're going to get you really numbed up right now.
Another five of lido to me.
- How we doing in here? - He's pretty lucky.
Most of these wounds look superficial.
I'm just going to clean and close.
How's my grandson? His injuries are serious: he's bleeding internally, but he's hanging in there.
- Can I see him? - Not right now.
We're taking him upstairs and we're going to try to stop the bleeding, okay? You good down here if I go up to angio with him? Yeah.
I'm good.
Go.
Okay.
I was being so careful.
I thought he was safe.
Don't worry, sir.
We're doing everything we can to help him.
- Are you almost finished in here? - No.
Why? I could really use your help in Curtain 2.
You've got to be a little bit more specific, Ray.
Morris' little old UTI lady, the one that's just "waiting for a ride," has a systolic of 55.
Damn it, Morris.
All right, here, keep irrigating and set up another suture kit.
I'll be right back.
and gram-negative rods on the UA.
Morris said she was tucked, nothing to do.
- I guess he lied.
- Yeah.
Tachy after two liters, he should have seen this coming.
- Access? - PIV, we're working on another.
- Here.
- Rennie Stevens, welding tank explosion.
Second- and third-degree burns over chest, face, and arms.
- Vitals? - Tachy, BP: 138/90, sat 82.
- Other one's more stable.
- Other one? Luis Escobar, 23, shrapnel to neck and left chest.
- Vitals stable, good breath sounds.
- All right.
- I better page an attending.
- I am an attending.
I got this.
Put him in Trauma Two.
Jane! You're with Haleh.
Solomon, you're with me.
Come on, Trauma One.
Let's go.
Ray, titrate dopamine and mix up levophed if she doesn't respond to 10 mikes.
Alex, where are you? No, you're not.
Don't lie to me.
The school called the hospital.
Yeah, well, you got ten minutes to get your butt back to Solomon, help Sam make some room.
Please give me something for the pain! All right, another five of morphine.
Hang tough, Mr.
Stevens.
We're going to help you.
Start a second line with two liters of LR, wide open.
- Full thickness over the entire chest.
- I'll alert the burn unit.
Sats down to 83.
Okay, listen to me very closely, Mr.
Stevens.
We need to put a tube in to help you breathe, okay? Eight-oh and an intubation tray.
I'll be right back.
Talk to me, ladies.
Blunt and penetrating trauma.
Thrown against a wall by the blast.
Looks like shrapnel to the upper torso and neck.
- Hey, what's your name, man? - Luis.
Luis Escobar.
- How's Rennie? - Uh, we're working on him, but now it's your turn.
Tell me where it hurts.
My chest.
- BP: 95/65.
- Yup, he's decreased on the left.
- Sats 92%.
- Any pain here? All right, CBC, chemistry, coags, type-and-cross for two, liter of ringers, C-spine, chest, and pelvis.
Page surgery.
I'll be right back.
You're doing good, Mr.
Escobar.
That's it, Max.
That's it.
Hustle! Go, Stuart, stay with him.
Come on, Max, come on.
You take this guy.
If you can't go around him, you go through him! - Hey, come on, man.
- What? You're not setting a good example.
That's it.
Nice, nice, buddy.
You're killing them out there.
Who is that with your son? I don't know.
Excuse me, Coach? - Who's Max talking to? - I'm not sure.
He said he was a friend.
Chest x-ray on Escobar.
All right, pneumothorax on the left.
Set up for a chest tube.
I'll be right over.
We're having a hard time finding a second line.
- Dr.
Pratt, he's bradying down! - Hold on.
Try a saphenous.
If that doesn't work, we'll go central.
- Right.
- Heart rate's in the 40s! I need to put a tube in your chest to re-expand your lung, Mr.
Escobar.
- Need any help in here? - Push 50 mikes of fentanyl.
- What's going on with Morris' patient? - Uh, I think she's doing okay.
- I handed her off to Gates.
- Gates? - You left her with Gates? - Yeah, he's all over it.
All right, you're going to feel some pressure here, okay? Gates is an intern, Ray.
Who's supervising him? I guess, officially, you are.
Jane, find out what's going on with Gates.
- I'm not having any luck with the ABG.
- Angle the needle at 45 degrees.
I can't see.
My glasses keep fogging.
Well, maybe next time, you should leave the hazmat uniform at home.
- Feel for the pulse.
You see that? - Yo, Doc.
Your sheet metal guy in Exam 3 lost his foot pulse.
Nurses can't get his leg out.
All right, tell them to give him five more of morphine and, uh, grab me a Doppler.
I'll be there in a few minutes.
Someone grab me a central line kit.
This young lady needs a CVP monitor.
- You're putting it in a central line? - Yes.
Early Goal-Directed Therapy for Sepsis-- all the kids are doing it.
- Are we going to get in trouble? - No, this lady is in trouble.
We're trying to save her; that's what we do.
God, give us the strength and the knowledge to help save this sweet woman.
Hallelujah to that, sister.
Good embolization of the superior gluteals and pudendal arteries.
That ought to buy you a little time.
- Pressure's back down to 60.
- Another 400 of PRBCs.
Crenshaw's standing by in the OR.
Looks like the liver lac opened up.
- His heart rate's dropping.
- Damn it.
Okay, let's transfer him.
One, two, three.
Mig of atropine and squeeze in the blood.
Want me to continue bagging? No, see what they need in the ER.
I've got this.
Hi, it's me.
Mommy and Baby was a freak show.
So we're headed to the park and I thought maybe even if you only had a couple minutes, you might want to come by and say hi.
I'm going to look for some normal moms, so we'll be here for a while.
Bye.
- Hi.
- Hey.
- Can I sit here? - Sure.
Yo no quiero perder mi trabajo pero si mi jefa se entera, es la primera vez en mi trabajo y yo estoy muy nerviosa, - yo no se que hacer.
- Quisas estas tarde.
Is everything okay? She thinks she's pregnant.
- Oh, congratulations.
- Oh, no.
No? No, the father is the husband of the woman she works for.
Wow, that's What's she going to do? - I told her to have an abortion.
- That's what I did.
You got pregnant with the husband of the woman you work for, too? It happens.
Los uniqos hombres que no fantasayan con estar con sus nanas son los que ya estan haciendo.
What'd she say? Oh, "The only husbands that don't fantasize about banging their nanny are the ones who are already doing it.
" It's sort of our nanny motto.
Oh, you're all nannies? Yeah, aren't you? Yes.
Yes, I am.
All right, tube's in position, no pneumo.
- Vent pressures are almost 50.
- Damn it.
Chest wall's restricting lung expansion.
He needs an escharotomy.
Ten blade.
Sats down to 84.
All right, put the vent rate up to 25 and the tidal volume down to 500.
Solomon, I need room, man.
Okay, Mr.
King.
We're gonna find you a new parking spot.
Mr.
King? Mr.
King, can you hear me?! Son of a bitch.
Pratt! The little head lac's not so little.
All right, keep pressure on it.
He must've hit something arterial.
Recheck a crit and type and cross for two.
Okay, okay, sats are coming up.
- Thank you.
- We need an attending in here.
Pratt, take a look at this.
All right, what's that, fluid in the spleen? Looks like a hematoma.
- Where's surgery? - Paged them three times.
- Anything else in the abdomen? - Nothing in Morrison's.
- Vitals stable? - Tachy, but pressure's okay.
Second hematocrit 38.
Entrance and exit lateral to the midline.
- Doesn't penetrate platysma.
- Burn unit on two.
- IV blew.
- We can't get a second line in here.
- And grandpa's crit is down to 29.
- All right, I'll be right there.
- What's going on with Gates? - He's asking for a rib spreader.
What the hell would he be doing with a rib spreader? I'm not really sure.
- Pratt, what do you want me to do? - Just a sec.
What's going on out there? Sorry, sorry, we were stuck upstairs.
What do you need? - Burn unit is holding.
- All right, page Kovac.
Don't bother.
We left him with a pelvic trauma.
The boy crumped in angio.
All right, uh Neela, get this guy up to CT.
Ray will fill you in on the way.
Haleh, transfer that burn unit call next door.
Jam it into overdrive.
Go! Go! Go! Go! Go! Come on, ref.
That's a foul.
Come on, this is soccer, not water ballet.
Way to go, buddy, dig deep.
Work that ball.
Hey.
Sorry I'm late.
I got hung up at work.
- How are they doing? - Winning two to one.
- Go, Stuart.
Go, Stuart! - Come on, Max! Dude, you stay with him, buddy.
Come on, Maxie.
Kick in the afterburners, baby.
Do you know that guy? No, who is he? Apparently, he's a friend of Max's.
Never seen him before.
Oh, okay, don't get fancy.
Don't get fancy, just just put it in the net! Put it in the net! Goal! Yes! Baby! That was a rocket, huh?! That's got to hurt, right? Yes! All right! - Did you see that?! - Yeah, that was beautiful.
You were giving them a taste of Maximum destruction.
Hey! What the hell do you think you're doing? - Did you touch my kid?! - What? - You touched my kid.
- Whoa, whoa, wait.
He's not your kid? No, I don't know who this creep is.
Is this how you get your jollies, touching little boys at a park?! Whoa, whoa, whoa, you're making a big mistake here.
I think you're making the mistake you freakin' pervert.
- Back off, man.
- What, am I too big for you? Sir, are you okay? Wake up.
Wake up, sir.
- Call 911.
Get an ambulance.
- And the cops.
There's no need to panic.
It's all good.
I'm an ER doc.
I'm an ER doctor.
Everybody just back up.
Let me do what I have to do and give me They spent about one million dollars on fertility drugs to have this kid.
Look at her; that's not a million-dollar baby.
Right, like, take the hint, lady.
Maybe there's a good reason why Mother Nature doesn't want you having kids of your own.
The woman she works for is a bitch.
She felt sorry for her husband.
He seemed so lonely.
She was always going away with her friends.
And all she did was shop.
My boss has closets full of clothes she never wears.
Which il good for me.
So you wear her clothes? - What, you don't? - No.
- You fool around with her husband? - No.
- He's ugly? - No.
Oh, no, he's he's hot.
He's a doctor.
I worked for some doctors.
They wanted to kids safe so they let me drive the Lexus.
And they went away a lot, so I could always use their apartment.
Which they didn't know about.
Course not.
Course not.
How you feeling, Mr.
King? I was a little woozy there for a bit, but I feel better after my nap.
Bacitracin and a gauze dressing.
These need to come out in seven days.
You know, I could probably take those out myself.
No.
You need to come in for a wound check.
Hey, make sure that guy's X-ray goes up with him to the burn unit.
He's had three liters of fluid and needs seven more in the first eight hours.
Is there any chance I can be with my grandson? I don't think so, but we can get an update on his condition.
CT's back on Escobar.
Grade three splenic lac.
Okay, good.
Consent for surgery and he's all yours.
Sorry, but my chief wants to observe him down here for a while.
- You just told me he tore his spleen.
- With no free blood, and stable crits.
His belly's tender, he's tachycardic, and he'll have other fluid losses through his burn.
The OR's full.
We can't take him right now anyway.
Well, we can't keep him down here.
We're getting slammed and he's tying up a trauma room.
I don't know.
Put him in the ICU.
Crenshaw says we can't use our last bed in ICU.
Hey, that's not Crenshaw's call.
What do you want me to do? I want you to get rid of him.
If his crits are stable for six hours, he can go to telemetry.
Neela Luis Escobar's girlfriend is here.
All right, I got to go find Gates before he kills somebody.
When I get back, that guy better not be here.
Systolic pressure in the 70s after aggressive fluid resuscitation but responded well to a dopamine infusion at 10 mikes per kilo per minute.
- What have you been doing? - Excuse me.
Central venous oxygen saturation is in target range of 88%.
At this time, patient remains guarded but stable for critical care service.
- What is that? - I'm dictating my notes.
And you're kidding me, right? There's no time for you to send stuff to a transcription service.
I need your notes on the chart now.
Well, I find it so inefficient to write everything down.
Yeah, well, that's how we all do it, so you better figure it out.
And what were you doing with a rib spreader? Well, one of your minor victims from the explosion came in with metal wrapped around his leg.
It was occluding blood flow to the foot, so I used the rib spreader to pull the metal off.
- Seemed safer than a blowtorch, right? - Yeah, right, right, right.
Okay, hold on, hold on, one second, one second, man.
I get it, okay.
You're the cool guy, the paramedic who became a doctor.
And I'm pretty sure that all the residents are eating up your war stories and tales from the street-- - I don't tell war stories.
- But this is the ER.
And we have a way of doing things, a curriculum for shaping young doctors, even you.
Oh, is that what this is about? You feel the need to "shape" me? Why don't you just teach me.
I like the shape I'm in.
I can't teach somebody who thinks they know everything.
What are you talking about? Talking about you running around here unsupervised.
- Putting in central lines.
- What was I supposed to do? You were busy in a double trauma.
I saved some woman's life and some guy's foot.
And what would have happened if you had messed up on either one? I don't know.
Who would have been responsible for that? Not you.
Me.
It would have been my ass on the line.
So do we have to go through this every damn shift? I don't know.
You going to ride my ass every damn shift? Because you seem to be missing the point here.
I didn't mess up.
That's not the point, and that's your problem.
Who's got the urosepsis case? - Dr.
Gates.
At your service.
- Maya Tennyson, Critical Care.
Yeah, excuse me, Dr.
Tennyson, but we're in the middle of some She's still on dopa at 10? She's holding her pressure like a champ.
Hmm, nice work with the early goal-directed therapy.
By the way, I love the dictation.
I can never read anyone's writing down here.
The Bluetooth.
You just speak in this little machine right here and it prints up instantly at the desk.
I like it.
This ER needed an attending with some initiative.
Hey, I'm the attending.
He's an intern.
Well, actually, the Bluetooth was Dr.
Pratt's idea.
I want to see the rest of your charts now.
I bet you do.
Hey, Timmy, do they still put people's names on hats and stuff like that in the gift shop? You know what? I think so.
But if you want to write your name in your underwear or something, man, - a Sharpie works just as well.
- No, no, no.
I just need to get a gift for somebody.
What the hell happened to you? I was attacked by ninjas.
What's it look like? Who's this? Obnoxious soccer dad, blunt head trauma with LOC, breathing on his own, normal vitals.
What's open? - Talk to me, Morris.
- Nothing to talk about.
Guy came at me.
I defended myself.
I'm patching him up.
Why'd he come at you? Have you ever been to a kids' soccer game? Those parents are crazy.
I would never do anything to hurt my grandson, Irene.
It was an accident.
What were you thinking? He's only five years old.
He shouldn't be anywhere near a chainsaw.
He wasn't.
- Then why is he in surgery? - Hey, I'm Dr.
Pratt.
Dennis King, this is my wife, Irene.
I can't believe this.
We only leave our son with family, just to be safe, and this is how we're rewarded? We're doing everything we can for Thomas.
Why don't I have a nurse take you up so you can be with him when he gets out of surgery? Dennis, Dennis, I'm sorry.
You know I am.
I know, Dad, I know.
I raised my two boys by myself.
Wasn't easy being a single dad back then.
I I don't think I was very good at it.
I thought I could make up for it by being a terrific grandfather, but Looks like I blew that too.
Pratt.
You got a sec? Yeah.
I'll be right back, Mr.
King.
Thanks.
What's going on? The police are here for Morris in connection with an assault.
And there are two moms with the cops saying that Morris is a child molester.
What? I got a feeling the white mom's got a boxer's fracture.
What is Morris' problem? Brain damage is the first thing that comes to mind.
Dr.
Pratt.
Escobar's losing his airway.
Why didn't you intubate prophylactically? His face was spared.
He didn't seem like he had respiratory issues.
Damn, he's already got too much swelling.
Page Crenshaw again.
And get someone from ENT down here.
Sats down to 76.
All right, somebody get me a smaller tube.
A 7-5, 7-0.
It's too late for that.
You might need an open trach.
- Heart rate is dropping.
- Please help him.
- He was just talking to me.
- Damn, that 7-0 won't pass.
He needs a trach.
ENT is in OR 2 on a radical neck dissection.
- They can't come down right now.
- ENT needs to be here.
Well, they're not, and this guy needs an airway.
- And you're sure you can do this? - I think so.
You better know so.
How many have you done? - I've assisted on several.
- Oh, man.
All right, OR Girl, please do not make me regret this.
Okay, Katey, Betadine and sterile sixes.
Without electrocautery juice, this will be messy.
All right, Haleh.
Can you take Tina to the Family Room? - Sure.
- No, no, I want to stay with him.
- Come on, honey.
- No, I want to stay We'll come and get you as soon as we make him more comfortable.
Okay.
15 blade to me.
Neela.
Oh, I was hoping there were be a raisonnable explaination for your incessant paging, but you know what? - This is not it.
- I had to do a tracheotomy tube.
Oh, really, and who told you to do that? Because I sure didn't.
Nobody did.
My chief didn't answer his pages.
- You did this without any supervision? - Dr.
Pratt was here.
Oh, great, that is such a relief.
Unfortunately, your little ER forest friends don't count anymore.
You want to be a surgeon? Huh, want to be a big girl doctor? This isn't Barbie's Dream Doll Hospital you're playing in.
I am the ER attending.
Dr.
Rasgotra was only following my orders.
Oh.
I'm sorry.
Hello.
Dr.
Pratt, is it? I took your silence for subservience.
You know, not a lot of ER attendings have the skills to do a trach.
Very impressive, Dr.
Pratt.
Well, you just, uh, take care of my girl here and we'll call it even.
You don't need to worry about that.
Dr.
Rasgotra gets plenty of my attention.
Oh, I think I can manage this from here.
Why don't you girls, uh, finish up down here.
You've done more than enough.
Believe me.
Wow, you're so lucky.
He seems like a great guy.
Yeah, right.
I'm going to go and find the girlfriend, tell her what's happening.
Hey.
You did good, man.
Thanks.
Must be quiet if you have time to stand around.
How's the kid? Looks like he's going to pull through.
How's the grandfather? Eh, he's a little worried, but he'll be okay.
You make out okay down here? I heard you had two more traumas come in.
Nothing I couldn't deal with.
Well, if it's that quiet, maybe I'll leave a little early tonight.
Abby could probably use some help with the baby.
- Go ahead.
Go for it.
- Sure? Yeah.
I got it all dialed in down here.
This place practically runs itself.
Can one of you look at a suspected hand fracture? - Who ordered the films? - I did.
Everybody was busy.
I'll take it.
Did you find Alex? Oh, yes, he was ditching school with a friend at the mall.
I guess I have all that to look forward to, huh? Yep.
You saved that guy.
It was so cool.
- You mean "terrifying.
" - Dude, you rocked.
Did you see the look on Crenshaw's face? The one that suggested he was going to punish me for the rest of my natural life for what I just did? You spanked him.
Deep down, I think he probably likes it.
Seriously.
You know it's always those type-A guys that are so wound up they go home and put on a diaper or want to be led around by a leash.
- You're mad.
- Hey, Neela.
Ray Barnett.
I don't think we've officially met.
- Katey.
-Hey.
Um, I'm still getting some of your mail.
Oh.
I'm sorry.
I've tried to change everything over.
Well, I don't mind.
I just figured you might need some of these.
- Thank you.
- Okay.
Okay.
Uh, I'll see you guys around.
It was nice meeting you.
- You two lived together? - Oh, we were roommates.
Hope you had benefits.
It wasn't like that.
We were just friends.
Why? That guy is smoking hot.
- Does he have a girlfriend? - Not that I know of.
I just remembered something.
Um, I'll catch up with you later, okay? Witnesses confirm that the other guy started and you just pushed him away.
I told you that.
But that doesn't explain touching the kid.
I wasn't "touching" him.
My relationship to the boy is complicated.
It's, uh, sort of a secret.
No, no, not like that.
Well, your hand isn't broken; it's just sprained.
It would have been worth a fracture if I would have knocked out that freaky little leprechaun's teeth.
What's going to happen to him? He's going to jail.
What do you think about that, Max? Wait! Wait! Wait! Don't arrest my dad.
What did he say? - Max, what's going on? - This is where I leave.
Good luck with that, Pops.
Mom, Mom, this is my dad Dr.
Archie Morris.
What's up? Hey, Timmy, did you get it? Yeah, but I didn't get a chance to wrap it.
Nah, it's all good.
Gates! Just the man I was looking for.
Here, I got a present for you.
What's this for? It's so, uh, people know who you are.
- Hey.
You didn't have to do this.
- Yeah, I did.
Let's see.
What the hell is this? Students wear short coats.
It helps remind everyone, including you, that you are still learning.
- You feel better now? - I feel great, man.
Yeah.
How long has he been crying? About ten minutes.
I think he'll settle down.
- How was your shift? - Uh, the usual-- I had a five- year-old kid crushed by a tree.
I don't want to hear any stories about bad things happening to children.
He survived, okay? How about your day? It was divine.
Look, I've been thinking.
Maybe you're right, maybe we should get somebody like a nanny No, thanks.
- But I thought you - I changed my mind.
No nannies just us.
Doesn't sound like he's settling down, hmm? I'll get him.
Hey, hey, hey.
What's all that crying? Should I stay or should I go now? If I stay it will be trouble If I go it will be double That good, hmm? I should have stayed a paramedic.
No.
Doctors are much more sexy.
Rough day? Yeah, one of my attendings has it out for me.
Either that or he's in love with me.
I can't tell which.
How was your temp gig? Same thing, different people.
Nobody knows you.
Nobody really talks to you.
It's like being the office ghost.
Do you want a drink? No, I have to study.
Knock-knock.
You decent? I'm in my thong.
Guess what? I take it your homework is done? Yeah.
I've got some stuff from school you need to sign.
I left them on the table.
All right.
There's lasagna in the fridge if you get hungry later.
Thanks.
Well, you were right about Adam Horner.
I ignored him all day, even when he was looking at me, and tonight he IM'd me.
The Horndog comes through.
- It's Horner.
- it.
I bruise easy.
Did you save anyone today? Yes.
Actually, I separated a pair of Siamese twins.
Must be gross seeing all that blood, huh? Nah, I saw more blood when I was a paramedic.
Besides, I'm half vampire, so I kind of dig it.
Do you want me to help you study? No.
I want you to work things out with your mother.
I'd rather shave my head.
Oh.
All right, good, I have a razor in the bathroom; we can shave it into a nice little Mohawk.
Okay, I'm just kidding.
I'll talk to her.
Sometime.
- Tonight? - Yeah.
Hey.
Good night, baby girl.
Night, Doc.
For the next hour, we're going to be talking about abdominal pain in the elderly patient.
Now, I don't have to tell you what an important disease this is No pass-ons, no major tragedy, no deaths.
- Gates still here? - You just missed him.
- What about his charts? - They're over there.
Hey, you know, from what I've seen, Gates's a good doctor.
Oh, he's all right.
Plenty of room for improvement.
Dr.
Morris, I heard some guy attacked you.
Are you okay? Oh, yes, yeah, I turned the other cheek.
You know what Jesus said.
You know when the, those guys who trespassed against him, as those who trespassed against us-- can I get an amen? - Amen.
- Amen.
I have a patient waiting, so Good night, Dr.
Morris.
God bless you.
God bless all of us.
You want to grab a bite with me and Max and his moms? You worked things out, huh? Yeah.
Yeah, they're pretty cool.
And if everything goes well at Ike's, we may really work things out tonight.
if you know what I'm saying - Morris - and I think you do.
- You do know they're a couple, huh? - Yeah, a couple of lesbians in desperate need of a Morris sandwich.
You know you're sick, right? What? Good night, Archie.
Could you help me with a two-layer closure? Nope, nope, not now; I'm off.
Weaver should be here any minute now.
All right, wait, wait, wait.
First off, you never want to inject directly into the wound.
It distorts the anatomy for your repair.
He needs regional anesthesia.
Have you ever done an infraorbital block? Not really.
Okay, well, it's pretty easy once you know the tricks.
Now, first, what you want to do is you want to use your left index finger to palpate the infraorbital ridge.
- Got it.
- Good.
Now you're going to inject one centimeter lateral to the ala and advance upward until you're five millimeters from the ridge.
Good, good, very good.