ER s13e06 Episode Script
Heart of the Matter
Previously on E.
R.
Have you been RedNoFive? You want to check it out tonight? Maybe I can move into your place.
I came in with a cough and you sent me out a cripple.
Order! It would be good to get you in front of the press as the doctor found not guilty.
Oh, you're very optimistic.
I'm sorry.
I don't want to be alone.
Oh, God.
I'm coming! I'll be there in a second! - Who is it? - It's Ray.
What are you doing here? You wanted me to look at your TV? It's 6:30.
We got to be at work in an hour.
I brought Krispy Kremes.
Oh, God.
- You okay? - Yeah, I'm just a little out of sorts.
- Look, uh, my cable isn't working.
- Okay, I'll take a look at it.
Uh, I'm going to go get dressed.
The jury's been out three days.
That's too long.
It's a lot of complicated stuff.
You're going to be fine.
And remember, we have the Croatian Film Festival tonight-- something I know I've really been looking forward to.
Maybe it'll take your mind off it.
That sounds good.
- How's the weather, Frank? - Hurricane Up Yours is about to hit.
What do you want? I'm filing.
I'm just making small talk.
How's it going? Am I being Punk'd? You never wonder how I'm doing.
'Course I do.
How's the family? My wife has a goiter.
My kid has a hard time holding a job - Yeah.
I got to run, Frank.
Hey, Mayday! What are you doing later? You want to hook up? - Hook up? - Yeah, prep for the M&M.
Thought I'd give you a head's up before I kick your ass.
This is an educational exercise, not Survivor.
- Wow, somebody has their panties in a wad.
- Who's talking about my panties? Look, I'll try and find you later.
- Women are weird.
- No, Neela's weird.
- Indian and Brit-- bad combination.
- Channel Five wants a photogenic, well-spoken E.
R.
professional to do a health piece today.
Anybody interested? Let's start with "no" and work from there.
- Pretty boy, you in? - Uh, sorry.
Bad hair day.
- I'll do it.
- You're a newbie.
Put your hand down.
- What about Kovac? - He's worn out-- Gremlin's not sleeping.
What about you? No one wants to hear from a nurse.
- Guess it's all you, Morris.
- No.
Me ? No, I couldn't, I couldn't possibly.
I mean, if you guys are forcing me Okay, if you insist.
This is Lou Smith.
Head injury, altered, possible blunt abdominal trauma.
BP 90.
Tachycardic.
Clipped by an SUV.
Yeah.
I almost redlined it.
Abby's got the driver.
Ray, you're with me.
- Guy got hit by a car on his Harley.
- Luka, I need to talk to you.
My wife wanted me to get a bicycle.
- She's going to kill me for this.
- The jury's got a verdict.
C Spine, chest X-ray and trauma panel.
I'm a little busy right now.
Moving extremities but sats are borderline.
I told the court we'd be there within the hour.
Hope, what's the RSI protocol for intubation? - Etomidate for sedation.
- Trauma Two.
And succinylcholine as a paralytic.
Kerry can cover for you.
He's got a head injury.
Wouldn't you want to use Lidocaine first? Uh, yeah, it reduces the ICP response to the intubation.
- Good.
Good.
- Luka.
We have two major trauma patients coming in.
This is important.
You need to be there.
One, two, three.
- What are you doing? - My job ! You gotta talk to Luka.
Knowing Ames's lawyers, they've already called the press.
Do you know how bad County's gonna look if he doesn't show up? Go.
I'll make sure he gets there.
I promise.
- Hang a liter of saline.
- Luka.
I just talked to Angela.
You should go.
Why? So a bunch of people who don't understand what we do here can pass judgment on me? Think about how it reflects on the department if you don't show up to address the press.
Gram of Ancef.
I think you already asked for that.
It's hanging.
Let me take over from here.
What in the hell? Chuny, get maintenance down here.
He's going to need a portable monitor for CT anyway.
Hook him up and let's roll.
Hey, Luka, I've been through this.
Five years ago I had a patient with a runny nose who I sent home with meningitis.
I was sure the jury was gonna nail me.
They didn't.
Look, I'm telling you as your friend, hiding out here is sending the wrong message.
Is that what you want? Open up the saline.
I was trying to get to Union Station to pick up my wife.
Can somebody call her? Uh, why don't we just concentrate on getting you better right now, okay? You going to be okay without me? We're fine.
Just go.
Excuse me.
I looking for Dr.
Morris.
Miss Paik.
Hi.
Hi.
How's it going? Uh, she's a pre-med student, wanted a tour of the hospital.
- Why am I here, Archie? - Shh.
- All right, another liter, wide open.
- Pass me the Betadine.
CBC, trauma panel, type and cross for six.
I'll prime the infuser.
- It says Helen? - That's my wife.
Can we put that on speaker? - Hello? Garrett? - Mrs.
Palsey? Who the hell is this ? - This is Dr.
Lockhart.
- Who ? Garrett, are you still at work? Is that why you didn't pick me up at the train station? - Honey, I'm in the hospital.
- The what ? Haleh, you do the foley.
- Mr.
Garrett, you'll feel a stick here.
- Mrs.
Palsey, are you driving? No, my daughter's driving, thanks to Mr.
Undependable not being here.
All right, call for a portable C spine, chest and pelvis.
Mrs.
Palsey, your husband's been in an accident.
You need to get to County General.
He's been seriously injured.
Oh, my God, he's what? I'll be there as soon as I can! Hey, you guys, this is Dawn Archer.
She's moved here from New Orleans.
- She used to work at Charity.
- What's up, Donna? Ray.
Hey, Katey.
- Hi, I'm Neela, work in surgery.
- Hey, Neela.
Come check this out.
- She's busy.
- There's enough of her to go around.
All right, let's do a fast scan and we'll reassess.
- All right, what? - 15-year-old.
Everted ankle.
- Mighty glad to meet you.
- And? Well, it looks pretty angulated, don't you think? Well, that's terrible, but I'm not ortho.
Oh, sorry.
I got confused.
Want me to get the sonosite? Uh Gates, you know, we're really busy over here.
I'll get it.
Might I suggest you start off with an X-ray? Brilliant idea, Doctor.
Thank you.
All right, you guys got it from here? - We've gotta go.
- I'll call you after the ultrasound.
- Someone wheel her to X-ray, please? - Dawn.
It's all you.
Dawn! Meet Josie Weller.
Delightful to meet you.
I've been so looking forward to this day.
We're going to Radiology, not Disneyland.
Marvelous squared.
Josie goes to Mountain View.
It's a school for kids with special needs.
Did you know you can take the Red Line to Roosevelt and hop on the 12? You have to walk a little bit, but the whole thing should only take like half an hour, unless you're a slow walker and you miss your connection.
- Do you know why she goes to the school? - I study French and Math.
I'm just an aide, but they all have some sort of developmental disorder.
You have wonderful pecs.
Why do you hide them under that unflattering white coat? Do a tox screen after the film, okay? No problem.
Glad you made it.
Are we going to win, Daddy? So, of course we're gonna win.
We didn't come this far for nothing.
All right? All right.
Okay.
All right, I'm bagging at a rate of 16.
Somebody call for a vent.
- I'm having trouble getting another IV.
- All right, Neela, throw in the femoral.
What about a sternal intraosseous line? We don't have those down here.
- Yeah, we do.
We got 'em three weeks ago.
- The Army uses them a lot in Iraq.
Well, 500 cc's out.
- You guys have the ultrasound in here? - Yeah, but we need it.
Hemacue's 8.
5.
Okay, bleeding into the chest.
And the cool thing is, Abby's already prepped the chest for me.
What have you got? - Still 80 systolic.
- All right.
Damn it.
- All right, I'm doing a central line here.
- Don't bother.
Let me try this.
Wait a minute.
Uh n-n - Got it.
Run the saline in.
- Hook up the Thoraseal.
- Yeah.
I don't think that's the way - Nice.
Very nice.
Wow.
Ultrasound to Neela.
Dr.
Rasgotra, I'm missing an esophageal resection to respond to your trauma call.
I'd appreciate the bullet now.
Okay, 50-year-old driver versus motorcycle.
Hypotensive with a pneumo-hemothorax and.
fluid in Morrisons.
O-neg's running through a sternal IO.
Chest tube and airway are secure, I'm ready for the OR.
- Let's pack up and get him upstairs.
- All right, fine, but then I want you to get right back to the ER for consults.
- Yeah, well, I want to scrub in on this one.
- I'm sorry ? That is at the discretion of the chief resident-- that's me-- who, having considered your request, answers with a resounding "No!" I want you to stay down here with your little E.
R.
buddies and cover E.
R.
consults.
Now, bistra! Bistra! Gosh.
Poor Neela.
Is she why you haven't called me? What are you talking about? I've been very busy.
It's okay.
A few "Who's your daddy's" doesn't make us a couple.
Oh, whoa.
No worries.
It was good.
Just not that good.
What in the hell is that supposed to mean? You have to move your hips, honey.
You're not touring with the Grateful Dead.
- I move my hips.
- Then move them over to Admit.
We got two GSWs and an anitfreeze ingestion coming in.
Look, I can't afford to close a trauma room.
Have you had a problem there before? - Just a shootout a few months back.
- God knows what got hit in the walls.
I'm going to need to check the panel box and open the wall.
Well, do what you have to do.
Do it quickly.
Get down! Get down! Here.
Something going on in here? No.
No.
Benny Benny got jacked and passed out.
- I'm just sewing him up.
- And this is funny why? Uh He was He was talking in his sleep.
Yeah.
Told a real zinger, too.
These these two rabbits walk into a bar and, uh Okay, she's gone.
Ooh! Ooh! Watch the cuticles, all right? Last time, I was bleeding like a hemorrhoid.
She's got a displaced fibular fracture.
Needs reduction under fluro.
- You going to sedate her for that? - Yeah.
Set up for ketamine and versed.
You got it.
So how's it going down here? You like everybody? Everyone seems really friendly.
Happy birthday! Even the patients.
All rise! Has the jury reached a verdict? Yes, we have, Your Honor.
In the matter of Ames v.
Kovac, docket #06CH75255, we the jury find in favor of the defendant.
Thank you, ladies and gentleman, for your service.
The jury may now be excused.
and barely keeping his systolic above 80.
- Hemacue? - Dropped from 12 to 8.
3.
- We're ready for you, Dr.
Dubenko.
- That's my cue.
You need some help in there? Isn't there something else you should be doing? Well, not if you require my assistance.
All right, then.
Scrub in.
twisted her ankle during gym.
Displaced fibular fracture.
- Post production films look good.
- Dispo? Home after casting, pain meds and crutches.
Sounds good.
Follow up with ortho in a week.
All right.
Well, there's one more thing.
I just got off the phone with her school, - and she has Asperger's Syndrome.
- And ? And she's a little sexually forward for her age.
Ah! I'm guessing that that's her.
Yeah.
You see that sometimes with Asperger's.
Well, I was thinking about giving her some condom ed.
, and maybe start her on Depo-provera.
Depo? That may be a little too proactive.
Well, physically, she's a teenager, but mentally she's still a kid.
- I don't know if she - I don't need no wheelchair! I can walk! You're in the hospital.
Hospital policy for all of our patients.
Let go of me, Morris! Stop touching me.
Well, before you start any form of hormonal birth control, you need to check an ICON and do a pelvic.
Call me when you're ready.
I'll supervise.
Hey, Kerry, can you do me a favor and see my guy in Four? He's been here 14 hours for a pre-employment physical.
Doesn't have a primary care doc? Classic misuse of the ER.
Dr.
Lockhart, five pages in 45 minutes.
I hope someone's dying.
Stab wound to the right shoulder.
Thought you'd want to know.
Get Rasgotra.
I'm scrubbing in on an esophageal jejunostomy.
Well, hold up.
Neela's in the O.
R.
with an MVC.
- No.
Neela's here covering consults.
- No.
Neela's in the O.
R.
- Are you trying to irritate me? - Well, you make it so easy.
Take a bigger bite.
Don't be shy.
My wife is going to be pissed.
You were hit by a car.
It's not your fault.
The only times I've seen her mad were the day I brought the Harley home and the day we met.
The day you met? Yeah.
She's she's a photographer.
She was in the park shooting this Chicago Magazine thing, and I kept getting in the picture.
- Intentionally? - No.
Not at first, but when I saw it was getting to her, I kept doing it.
I told her I'd stop if she would give me her number.
Well, I guess that worked.
Six months later, we were engaged, looking at houses.
That's sweet.
I'm going to go check on my hemopheliac.
Make sure you evert the edges, okay? We had some we been through some tough times, but she got us through them.
- It's nice to have someone like that.
- Yeah.
Lou Smith? Came in as an MVC.
Hit on his motorcycle.
- Should have taken the train.
- Who's taking care of him? I wish I was.
Why the hand delivery? We could have seen this on the PACS.
Come on, Rach.
It's an excuse to see me, right? Wrong.
Look at this.
- Oh, man.
- Those are brain mets.
- What's his primary cancer? - Cancer? He came in as trauma.
Ventricles look good, no midline shift, no edema, but My husband-- Garret Palsey.
- He was brought in! - Hi.
I'm Abby Lockhart.
I worked on your husband.
What does that mean? Worked on him? Mom, it means she treated him.
Let me see if he's still in surgery.
Please, he needs me there with him.
Another round of platelets and FFP.
Neela, more lap pads.
He's oozing around the packing.
Think it's retroperitoneal? Yeah.
Probably.
Hold pressure over the portal triad.
Clamp.
This is the Pringle maneuver, right? - Yes, but - No one calls it that anymore.
Dr.
Crenshaw.
Was I unclear this morning when I assigned you to consults? Do I speak too fast, or is it that I accidentally lapsed into Aramaic, as I am prone to do.
- No.
I ! - Then please explain to me what you're doing here instead of seeing any of the eight consults currently waiting on you in the ER.
You didn't mention you were covering the ER, Dr.
Rasgotra.
I'm sorry.
I was up here, he was unstable, and I thought No.
You don't think.
You're years away from thinking.
If I tell you to do consults, that is not a suggestion.
That is an order.
Do you understand? - Pulse is dropping.
61.
- Give her a break, Dusty.
The patient's crashing, I needed another pair of hands.
I lost out on a most excellent esophageal jejunostomy because I had to clean up her mess.
Yeah.
Well, there's plenty to go around here.
Mobilize the left triangular ligament for me, will you? He's still in surgery, but I can bring you upstairs.
Did they say how he's doing? I'm sure they'll give us an update once we we get up there.
Frank, can you page me if my pediatrician calls again? I look like your girl Friday? - Hey, you're not in jail! - Not this time, Frank.
I just got off the phone with Angela.
Congratulations.
- Thanks for the pep talk.
- That's great news, Luka.
Morris owes me 50 bucks.
- He swore you were going down.
- I'm not going anywhere.
I knew you would win.
- I prayed on it, Dr.
Kovac.
- Well, it worked.
Thanks.
How are your patients? Oh, our motorcycle guy, Mr.
Smith, is thirsty.
- Can I give him some ice chips? - Yep.
That's a good idea.
He's going need more than ice chips.
Look at his scan.
Called his oncologist at Huntington.
Brain mets from pancreatic cancer.
Is he in treatment? He failed rescue chemotherapy.
From what this scan shows, he belongs in hospice.
What about radiation? For metastatic pancreatic cancer? Hospice can probably help him enjoy his remaining time.
- Which is just about up.
- Uh Dr.
Kovac? - Uh I'll talk to his family.
- I am the family.
- This is his wife, Mrs.
Smith.
- It's spread, hasn't it? - Can we Can we go over here? - Has it spread? Yes.
Yes.
I'm afraid so.
It's in his brain.
Oh, I thought we had a couple of years.
Maybe even more.
We were supposed to go on a bike tour in Provence.
Sorry, Mrs.
Smith.
Well, I guess this was supposed to happen.
Wow.
I think that it's best that comes from me.
I think that I should be the one to tell him.
Okay.
We'll give you some time.
When you're ready, I can come in and answer any questions.
Mr.
Gallagher, your slit lamp exam was negative.
There is nothing in your eye.
- It still hurts.
- Maybe it's because you keep rubbing it.
Look, maybe I'm missing something, okay? I'd like to see an eye specialist.
Your eye will be fine.
This doesn't warrant an ophthalmology consult.
Dr.
Weaver, the electrician is ready to see you.
Okay.
Give him a gram of Acetaminophen.
Wait a minute.
What are you gramming about? I got crap in my eye.
I want to see the doctor.
So we can fix it, but it's going to take about a week.
How much will it cost for a rush? It's not about the money.
I got to wait a week for parts.
I don't think you understand.
If we shut down the trauma, patients get diverted to other ERs, and there'll be longer transport times Can someone say "Chante"? Chante, his name's Chante Morris! What the hell you doing? My my eyebrows.
- The camera picks up everything.
- Get out! Dr.
Weaver, please There's a rectal prolapse in Curtain Two with your name on it.
Now, go.
- Leave me a little powder.
I tend to shine.
- Let's go! So Josie's ankle will be fine? Yeah.
A month in a cast, and she's good to go.
I told you, dear.
He thought you was gonna need a wheelchair or something.
No.
None of that.
Tony's very good for a neophyte.
- May I speak with you a second, please? - Sure.
I'd like to talk to you about your daughter.
She's, um She How do I say this? She got naked again? So it wasn't just me? Isn't he adorable? Sometimes her condition makes her act like that.
- It's no big deal.
- Well, this is a big deal.
Have you talked to her about birth control? Why would I do that? Because you're her father.
- The school will handle it.
- Well, that's not really their job.
You don't understand.
Her school is different.
That's why we sent her there.
Look, Mr.
Weller, I realize this is a difficult conversation.
You think birth control is the answer to her? - Honey, honey.
- Josie's a pretty girl.
She's smart, she's open.
She takes her clothes off in front of the wrong guy - Josie likes Hilary Duff and MySpace.
- I'm sure she does.
But Josie doesn't have the same ability to say no like other kids.
Thank you, Lucien, for letting me scrub in.
Wish it had ended better, but I appreciate Listen to me.
Dr.
Crenshaw is your chief, and he owns you.
He owns you.
As smart as you think you are, that guy is smarter.
You'll start respecting that today.
And if you ever play me like that again, ever run to daddy when you don't like mommy's rules, you will be done here, do you hear me? This is your only warning.
Now, Mr.
Palsey's family's waiting-- go.
Go! This is Mr.
Palsey's wife and daughter.
This is Dr.
Rasgotra.
How's Garret? Is he all right? Well, when we opened your husband's abdomen we found it full of blood.
But you can fix that? The accident tore the vena cava.
We tried to repair it for over an hour, but he was bleeding too fast.
Okay, so what happened to my father? Mrs.
Palsey he died.
Oh, God - Oh, God.
- We made every effort.
Whoa! Whoa! Whoa! Whoa! Okay, that's all right, I got her.
I got her, I got her.
- Mrs.
Palsey? - You okay? Mrs.
Palsey? Mrs.
Palsey? Mrs Palsey? Mrs.
Palsey? She should be waking up by now.
- Pulse ox only 91.
- All right, I'll bag her through this.
She's okay, right? Yeah, she just needs some time to come around.
Systolic's down to 88.
Donna, does your mother suffer from a heart condition? - No.
- High cholesterol? - What are you talking about? - She vaso-vagaled, Neela.
Look at the monitor.
ST elevation, T-wave inversion No way, the leads must be reversed.
There's nothing wrong with the leads.
Looks like a massive MI.
CBC, lytes and triponins.
An MI, I know what that is.
- V-tack, lost the pulse.
- My mother can't be having a heart attack.
She's 45, no risk factors.
- Charging to 360.
- Clear! - No change.
- All right.
Amp of epi.
Come on, Neela, pick up the pace.
- Is she on any medications? - No.
What's happening?! Your mom's heart's in a dangerous rhythm.
Abby, shock again after five cycles.
Okay, have lido ready.
Acute LV dysfunction after a sudden, tragic event.
This is Broken Heart Syndrome.
Yeah, yeah, I read about that.
Never seen a real case, though.
Stress cardiomyopathy from the catacholamine surge.
She has no cardiac risk factors.
It all fits.
- You want the lidocaine? - Yeah, all right, 75 mac two.
Someone call cardiology.
All right, so we're going to give you a shot.
- I don't like shots.
- Josie, it's going to be fine.
It'll pinch a little at first, but it's going to protect you.
Did you know the Blue Line goes right from O'Hare to Irving Park Road? Jump off there and take the 80 towards the lake.
It'll drop you right at Sheridan.
Josie, we're talking about something very serious now, hon, pay attention.
You're going to have to come back every three months for a shot.
I've talked to your father about it.
I'm going to give you some education on condom use.
For when we have sex.
No, not when we have sex, when you have sex.
That doesn't mean you're old enough or you're ready, but when the time comes, I just want to make sure you're prepared, okay? Can I get a pen and paper and take notes? Just no props or diagrams.
- What the hell is Morris doing? - Not his job, that's for sure.
Here we see firsthand the effect of over exuberant Halloween candy consumption.
Little Luke here has a bowel obstruction.
Too much taffy gummed up the works.
Now we're going to stick this tube into his stomach.
- He's not moving air.
- Point three epi, sub Q, Continuous albuterol, intubation tray, call RT.
Hey, you guys are in the way.
I'm just warning parents so people don't abuse the ER system.
Overeating Halloween candy is not draining the system, this is.
Can you explain the patient's condition, doctor? He's asthmatic.
He got laid off-- no job, no health insurance.
I got more stuff.
It's costing his insurance company ten bucks a month - This is my show, people.
- Taxpayers will spend tens of thousands of dollars taking care of him in the ER and ICU.
So, you're a proponent of a national health plan? If we had one, this guy would be home playing with his kids instead of fighting for his life.
That was gold.
What's her name? Dr.
Judas.
Asystole.
It's V-fib.
Another 50 of lidocaine.
Let's try amiodarone.
Neela, she's in asystole.
All right, let's try one more round of epi.
No, no, please don't stop.
The syndrome causes a transient ventricular weakness.
It's temporary.
It's reversible.
She'll get better.
We've been flogging her for 20 minutes.
- Epi's in.
- Her husband just died.
Please don't give up.
Five rounds of meds.
She's not responding.
All right, hold compressions.
Oh, God.
Mom Neela, stop.
Back in sinus.
You signed them out? No.
Mrs.
Smith? Got a great team here, doctor.
Do you have any questions you want me to answer? No, I'm just praying my Harley still runs.
Uh Dr.
Kovac, I'd like to sign those papers you were talking about.
Yeah, sure.
Right over there.
Give us a second, please.
You didn't tell your husband about the brain mets? No, he thinks the chemo worked.
So let's just leave it at that.
I don't lie to patients.
Look, when he first diagnosed, he shut down.
And for the past six months, he's been living it up-- he's been taking tango lessons and scuba lessons.
- And we're going to France in December.
- He has the right to know the truth.
Why should he spend his last months in fear? I mean, if he just has a little hope, at least there's still chance for a miracle.
Ray, take them back to the room, please.
Look, we wouldn't even be here if it wasn't for that stupid car accident.
Mrs.
Smith, I'm giving you a second chance.
Either you're going to tell him now or I'll tell him when I come back, okay? Mr.
Ames.
You were celebrating.
In court today.
You were celebrating.
Mr.
Ames, we were just happy the case was over, that's all.
You were happy that you got over, isn't that what you really mean? Look, I have patients.
I was a patient.
Don't you remember? Mr.
Ames, you shouldn't be back here.
Isn't this where the sick come to get healthy? - 'Cause I want to get healthy.
- Hey, do you need some help here? Do these people know what you did? It's under control, it's okay.
I came in here with a cough, and I went out like this.
I gave you the best treatment possible.
While I was having a stroke, you ignored me.
- Mr.
Ames, that's - You ignored me! - You did! - You should to go.
Go where? - Where am I going to go? - Security! If you had just let me go home in the first place, then none of this would've happened! - What do you want me to do? - I want you I want you to give me my life back! Give me my life back! Give it back! Give it back to me! Stop! Mr.
Ames Mr.
Ames, wait up.
I just I just wanted to make sure you're okay.
You want to make sure I'm okay? No, I'm not okay.
I'm not okay at all.
See, when you came in the court this morning, I was telling my kids about justice.
They were looking at that lady with the scales.
And I said that justice was going to be done today, but I don't think it was.
I know you don't feel that way, but Look, I just want to hear it from you, without the filters of lawyers or judges, anybody Did you give me the best possible care? At any given moment, I'm responsible for 40 acute patients.
We try our best to watch everyone.
It's hard, we're not gods.
So you feel you paid attention to me? I followed your progress, examined you once a shift.
Your wife and I were in constant contact.
You talked to my wife.
Listen the stress of something like this can cause No, no, no, you don't understand.
After the stroke, I came home one day and all her stuff was gone.
Same with the kids.
So I called her sister, I checked the machine Finally I get an E-mail telling me that this was too much.
This-- me pursuing you, pursuing this, it was it was too much.
She thought that that nothing was ever going to come of this, and that if I couldn't move on, then-- she was going to have to move on without me.
in an E-mail.
I figured that I just win this, you know, I win this case, and I'd send that E-mail back and then then she'd come back home.
There are people who can help you, groups But I don't want any help.
I want things back the way they were.
I want to work.
I don't want some government check.
I build things-- that's what I do.
I know.
But I just don't know how to fix this.
How do I fix this? I'm sorry, I have to get back.
I got it, I understand.
Look, if you need anything Curtis.
- My name is Curtis.
- Of course.
Curtis.
If you need anything, give me a call.
If a laparotomy is indicated to rule out a life-threatening condition, then the procedure doesn't become unnecessary just because the condition is ruled out.
Huh? You lost me.
Well, the E.
R.
keeps accusing us of performing unnecessary surgery, but we really believed the guy had a triple A.
If we waited, he'd die.
But he didn't have a triple A.
Given his symptoms, we would've been right 90% of the time, and then surgery would have saved his life.
Good.
Do it like that.
Okay.
Your turn.
I'm fine.
I know how to do this.
I'll just pull some articles, I'll be fine.
Look if you're not prepared, the surgery attendings are gonna have you on a spit-- - let me take a look.
- I'll be fine.
- Hey! - Give it! You're gonna see my secret winning strategy.
My spelling is awful, huh? - Tony - Worse than awful.
My my syntax, my grammar.
Yeah, but how do you I'm I'm a little dyslexic.
I've learned to work around it, and most of the time, it's fine.
- We're having girls' night tonight.
- You in, Neela? - I'm busy.
- I'm free.
- We're preparing for the M&M.
- Nah, that's okay, go with the girls.
- Tony - We'll talk about this later.
Maybe it's a good thing that you talked to him.
- Yeah.
He just feels alone.
- Dr.
Kovac looks like we still need to break the news to Mr.
Smith.
- She didn't tell him? - She's sticking to her guns.
Okay, uh go ahead and sign out.
I got to do this.
Wait a minute, though-- we have tickets to Ig-Ig - Igraci Sa Klupe.
- Yes.
In an hour.
Oh, I can just see it some other night.
- You're canceling? - Oh, my God, you're disappointed.
No, I guess I just have to go to Ike Ryan's with everybody.
I'll come and pick you up.
- I love Rome.
- I figured you'd like that.
How's it going? Hey, I'm ready to get out of here, Doc.
How's my CT look? Well, uh, the good news is, there is no, uh, skull fracture, there's no hemorrhage.
Oh, thank God.
I don't know if my wife told you, but three years ago I was diagnosed with pancreatic cancer.
I don't have time for some brain injury, too.
- I got trips to take, friends to see.
- Yeah, sounds like fun.
Yeah.
My wife and I, we're going to Provence for the holidays.
Might even go to Paris, eat some Grande Marnier crepes and some of the best Bordeaux we can find.
Well, I don't want to stand in the way of your plans.
Uh, all you have to do is, uh, sign these papers, and I'll start you on some new medications.
You can explain to my wife.
She handles all the medicines.
No problem.
Can we talk? Oh, my God, thank you, - thank you so much.
- He cannot ride the Harley.
Okay, but what about the trip? You better rent a car and do the driving.
He could have seizures or a stroke, and by letting you walk out of here, I want to make sure I'm not setting someone up to get hurt.
Okay, I promise.
- Okay.
Good luck.
- Thank you.
- Provence is beautiful.
- Thank you! How's your promotion going? I'm hanging in there.
Still got a few knuckleheads I got to beat into shape, but other than that, it's all right.
Are they showing you respect? Eh, you know how it is.
They do what they do, you keep pushing through it.
To pushing through it.
To pushing through it.
- You better get that.
- No, no.
It's probably a Jehovah's Witness.
- They're very persistent.
- Yeah.
Save my spot, okay? All right, hold on.
Hey, what you doing here, man? Now's not a good time.
Aw, man, it's Thursday-- you said I could move in Thursday.
No, no, no.
I said Friday.
Tomorrow.
Mañana.
Nah, you said I could move in on Thursday.
- I said Friday - What's up? Oh.
My bad.
Who's this? This is my brother Chaz.
- Hey.
- How you doing? You, uh, you moving in? Yeah, but he's supposed to move in Friday.
Aw, Greg, you cannot let him sit out there in the hallway.
Come on in.
Are you hungry? I'm 18.
I'm always hungry.
- Betina, come on.
- So, what can I get you? Okay, okay, okay, I would shag I don't know, I guess I would shag Pratt.
I knew you had the fever.
And shoot Morris, do us all a favor.
I think you're a little too hard on Dr.
Morris.
He has potential.
Apparently, Morris is in the process of bringing God into his life.
Dr.
Weaver, is that you on TV? Turn it up! Turn it up! Oh the camera really does show everything.
My hair looks like crap.
- Oh, my God, Kerry, you look good.
- Is that Morris? Morris looks like a fool! You okay? Bad day.
And the nights are I've been having these dreams.
About Michael? No.
Gates.
- It's stupid; it's my friggin' hormones.
- It's not stupid, it's it's human.
And he's cute, and he's nice.
And you can't just sit and mourn forever.
Yeah, but it's only been six months.
That's longer than you were married.
You always thought I rushed into it.
Well, Michael was a great guy-- you were just young and impetuous, and I don't think he'd want you to put your life on hold.
I know, you're right.
So, what exactly are these dreams you're having? Oh, your average intubation.
- Extubation.
Re-intubation.
- Okay, enough.
Why don't you call him? - Oh, God, no.
- No, come on, you better do it quick, 'cause one of these girls is gonna shag shag, shoot or marry him.
Well, we are studying for the M&M together.
Excuse me, could you set my friend up with some tequila? What are you up to? Answering e-mail.
What's up? - Sarah got an A on her English paper.
- That's great.
She had to write an essay on who she'd most like to have dinner with.
Guess who she picked? Me, of course.
Gandhi? Madame Curie? Keith.
She wants to ask him why he died.
Let me see that.
Every time I think she's gotten over losing her father This isn't bad.
You think? No, she wants to know why he fought in that war, why did he have to leave before she got to know him.
These are good questions.
All right, all right, all right, call him, call him.
Who is it? - It's Ray, isn't it? - Are you mad? - Somebody I met at a conference.
- Then hit those digits, sister.
God, I miss him, T.
Me, too.
- You do? - Yeah.
Yeah.
Every day.
Tony, my computer crashed again! In fact, yesterday I went by our old school.
I thought about all the touch football we used to play.
You mean how he used to burn you all the time? Yeah.
In his dreams.
Well, he did get the girl, huh? Yeah, he sure did.
Hello? Uh, is, uh, is Tony there? I'm sorry, he's a little busy right now.
Can I take a message? Never mind.
It's a wrong number.
- Do you want to try it again? - No, I'm good.
Is it Gates? Wait, wait, wait.
Let's get back to the game.
- Okay, Abby, shag, shoot - Not me, though.
- Oh, come on.
- No, no, no, no, I don't All right.
Um, I would definitely shag Luka.
Oh, please! I totally forgot about him.
I know.
Me, too.
R.
Have you been RedNoFive? You want to check it out tonight? Maybe I can move into your place.
I came in with a cough and you sent me out a cripple.
Order! It would be good to get you in front of the press as the doctor found not guilty.
Oh, you're very optimistic.
I'm sorry.
I don't want to be alone.
Oh, God.
I'm coming! I'll be there in a second! - Who is it? - It's Ray.
What are you doing here? You wanted me to look at your TV? It's 6:30.
We got to be at work in an hour.
I brought Krispy Kremes.
Oh, God.
- You okay? - Yeah, I'm just a little out of sorts.
- Look, uh, my cable isn't working.
- Okay, I'll take a look at it.
Uh, I'm going to go get dressed.
The jury's been out three days.
That's too long.
It's a lot of complicated stuff.
You're going to be fine.
And remember, we have the Croatian Film Festival tonight-- something I know I've really been looking forward to.
Maybe it'll take your mind off it.
That sounds good.
- How's the weather, Frank? - Hurricane Up Yours is about to hit.
What do you want? I'm filing.
I'm just making small talk.
How's it going? Am I being Punk'd? You never wonder how I'm doing.
'Course I do.
How's the family? My wife has a goiter.
My kid has a hard time holding a job - Yeah.
I got to run, Frank.
Hey, Mayday! What are you doing later? You want to hook up? - Hook up? - Yeah, prep for the M&M.
Thought I'd give you a head's up before I kick your ass.
This is an educational exercise, not Survivor.
- Wow, somebody has their panties in a wad.
- Who's talking about my panties? Look, I'll try and find you later.
- Women are weird.
- No, Neela's weird.
- Indian and Brit-- bad combination.
- Channel Five wants a photogenic, well-spoken E.
R.
professional to do a health piece today.
Anybody interested? Let's start with "no" and work from there.
- Pretty boy, you in? - Uh, sorry.
Bad hair day.
- I'll do it.
- You're a newbie.
Put your hand down.
- What about Kovac? - He's worn out-- Gremlin's not sleeping.
What about you? No one wants to hear from a nurse.
- Guess it's all you, Morris.
- No.
Me ? No, I couldn't, I couldn't possibly.
I mean, if you guys are forcing me Okay, if you insist.
This is Lou Smith.
Head injury, altered, possible blunt abdominal trauma.
BP 90.
Tachycardic.
Clipped by an SUV.
Yeah.
I almost redlined it.
Abby's got the driver.
Ray, you're with me.
- Guy got hit by a car on his Harley.
- Luka, I need to talk to you.
My wife wanted me to get a bicycle.
- She's going to kill me for this.
- The jury's got a verdict.
C Spine, chest X-ray and trauma panel.
I'm a little busy right now.
Moving extremities but sats are borderline.
I told the court we'd be there within the hour.
Hope, what's the RSI protocol for intubation? - Etomidate for sedation.
- Trauma Two.
And succinylcholine as a paralytic.
Kerry can cover for you.
He's got a head injury.
Wouldn't you want to use Lidocaine first? Uh, yeah, it reduces the ICP response to the intubation.
- Good.
Good.
- Luka.
We have two major trauma patients coming in.
This is important.
You need to be there.
One, two, three.
- What are you doing? - My job ! You gotta talk to Luka.
Knowing Ames's lawyers, they've already called the press.
Do you know how bad County's gonna look if he doesn't show up? Go.
I'll make sure he gets there.
I promise.
- Hang a liter of saline.
- Luka.
I just talked to Angela.
You should go.
Why? So a bunch of people who don't understand what we do here can pass judgment on me? Think about how it reflects on the department if you don't show up to address the press.
Gram of Ancef.
I think you already asked for that.
It's hanging.
Let me take over from here.
What in the hell? Chuny, get maintenance down here.
He's going to need a portable monitor for CT anyway.
Hook him up and let's roll.
Hey, Luka, I've been through this.
Five years ago I had a patient with a runny nose who I sent home with meningitis.
I was sure the jury was gonna nail me.
They didn't.
Look, I'm telling you as your friend, hiding out here is sending the wrong message.
Is that what you want? Open up the saline.
I was trying to get to Union Station to pick up my wife.
Can somebody call her? Uh, why don't we just concentrate on getting you better right now, okay? You going to be okay without me? We're fine.
Just go.
Excuse me.
I looking for Dr.
Morris.
Miss Paik.
Hi.
Hi.
How's it going? Uh, she's a pre-med student, wanted a tour of the hospital.
- Why am I here, Archie? - Shh.
- All right, another liter, wide open.
- Pass me the Betadine.
CBC, trauma panel, type and cross for six.
I'll prime the infuser.
- It says Helen? - That's my wife.
Can we put that on speaker? - Hello? Garrett? - Mrs.
Palsey? Who the hell is this ? - This is Dr.
Lockhart.
- Who ? Garrett, are you still at work? Is that why you didn't pick me up at the train station? - Honey, I'm in the hospital.
- The what ? Haleh, you do the foley.
- Mr.
Garrett, you'll feel a stick here.
- Mrs.
Palsey, are you driving? No, my daughter's driving, thanks to Mr.
Undependable not being here.
All right, call for a portable C spine, chest and pelvis.
Mrs.
Palsey, your husband's been in an accident.
You need to get to County General.
He's been seriously injured.
Oh, my God, he's what? I'll be there as soon as I can! Hey, you guys, this is Dawn Archer.
She's moved here from New Orleans.
- She used to work at Charity.
- What's up, Donna? Ray.
Hey, Katey.
- Hi, I'm Neela, work in surgery.
- Hey, Neela.
Come check this out.
- She's busy.
- There's enough of her to go around.
All right, let's do a fast scan and we'll reassess.
- All right, what? - 15-year-old.
Everted ankle.
- Mighty glad to meet you.
- And? Well, it looks pretty angulated, don't you think? Well, that's terrible, but I'm not ortho.
Oh, sorry.
I got confused.
Want me to get the sonosite? Uh Gates, you know, we're really busy over here.
I'll get it.
Might I suggest you start off with an X-ray? Brilliant idea, Doctor.
Thank you.
All right, you guys got it from here? - We've gotta go.
- I'll call you after the ultrasound.
- Someone wheel her to X-ray, please? - Dawn.
It's all you.
Dawn! Meet Josie Weller.
Delightful to meet you.
I've been so looking forward to this day.
We're going to Radiology, not Disneyland.
Marvelous squared.
Josie goes to Mountain View.
It's a school for kids with special needs.
Did you know you can take the Red Line to Roosevelt and hop on the 12? You have to walk a little bit, but the whole thing should only take like half an hour, unless you're a slow walker and you miss your connection.
- Do you know why she goes to the school? - I study French and Math.
I'm just an aide, but they all have some sort of developmental disorder.
You have wonderful pecs.
Why do you hide them under that unflattering white coat? Do a tox screen after the film, okay? No problem.
Glad you made it.
Are we going to win, Daddy? So, of course we're gonna win.
We didn't come this far for nothing.
All right? All right.
Okay.
All right, I'm bagging at a rate of 16.
Somebody call for a vent.
- I'm having trouble getting another IV.
- All right, Neela, throw in the femoral.
What about a sternal intraosseous line? We don't have those down here.
- Yeah, we do.
We got 'em three weeks ago.
- The Army uses them a lot in Iraq.
Well, 500 cc's out.
- You guys have the ultrasound in here? - Yeah, but we need it.
Hemacue's 8.
5.
Okay, bleeding into the chest.
And the cool thing is, Abby's already prepped the chest for me.
What have you got? - Still 80 systolic.
- All right.
Damn it.
- All right, I'm doing a central line here.
- Don't bother.
Let me try this.
Wait a minute.
Uh n-n - Got it.
Run the saline in.
- Hook up the Thoraseal.
- Yeah.
I don't think that's the way - Nice.
Very nice.
Wow.
Ultrasound to Neela.
Dr.
Rasgotra, I'm missing an esophageal resection to respond to your trauma call.
I'd appreciate the bullet now.
Okay, 50-year-old driver versus motorcycle.
Hypotensive with a pneumo-hemothorax and.
fluid in Morrisons.
O-neg's running through a sternal IO.
Chest tube and airway are secure, I'm ready for the OR.
- Let's pack up and get him upstairs.
- All right, fine, but then I want you to get right back to the ER for consults.
- Yeah, well, I want to scrub in on this one.
- I'm sorry ? That is at the discretion of the chief resident-- that's me-- who, having considered your request, answers with a resounding "No!" I want you to stay down here with your little E.
R.
buddies and cover E.
R.
consults.
Now, bistra! Bistra! Gosh.
Poor Neela.
Is she why you haven't called me? What are you talking about? I've been very busy.
It's okay.
A few "Who's your daddy's" doesn't make us a couple.
Oh, whoa.
No worries.
It was good.
Just not that good.
What in the hell is that supposed to mean? You have to move your hips, honey.
You're not touring with the Grateful Dead.
- I move my hips.
- Then move them over to Admit.
We got two GSWs and an anitfreeze ingestion coming in.
Look, I can't afford to close a trauma room.
Have you had a problem there before? - Just a shootout a few months back.
- God knows what got hit in the walls.
I'm going to need to check the panel box and open the wall.
Well, do what you have to do.
Do it quickly.
Get down! Get down! Here.
Something going on in here? No.
No.
Benny Benny got jacked and passed out.
- I'm just sewing him up.
- And this is funny why? Uh He was He was talking in his sleep.
Yeah.
Told a real zinger, too.
These these two rabbits walk into a bar and, uh Okay, she's gone.
Ooh! Ooh! Watch the cuticles, all right? Last time, I was bleeding like a hemorrhoid.
She's got a displaced fibular fracture.
Needs reduction under fluro.
- You going to sedate her for that? - Yeah.
Set up for ketamine and versed.
You got it.
So how's it going down here? You like everybody? Everyone seems really friendly.
Happy birthday! Even the patients.
All rise! Has the jury reached a verdict? Yes, we have, Your Honor.
In the matter of Ames v.
Kovac, docket #06CH75255, we the jury find in favor of the defendant.
Thank you, ladies and gentleman, for your service.
The jury may now be excused.
and barely keeping his systolic above 80.
- Hemacue? - Dropped from 12 to 8.
3.
- We're ready for you, Dr.
Dubenko.
- That's my cue.
You need some help in there? Isn't there something else you should be doing? Well, not if you require my assistance.
All right, then.
Scrub in.
twisted her ankle during gym.
Displaced fibular fracture.
- Post production films look good.
- Dispo? Home after casting, pain meds and crutches.
Sounds good.
Follow up with ortho in a week.
All right.
Well, there's one more thing.
I just got off the phone with her school, - and she has Asperger's Syndrome.
- And ? And she's a little sexually forward for her age.
Ah! I'm guessing that that's her.
Yeah.
You see that sometimes with Asperger's.
Well, I was thinking about giving her some condom ed.
, and maybe start her on Depo-provera.
Depo? That may be a little too proactive.
Well, physically, she's a teenager, but mentally she's still a kid.
- I don't know if she - I don't need no wheelchair! I can walk! You're in the hospital.
Hospital policy for all of our patients.
Let go of me, Morris! Stop touching me.
Well, before you start any form of hormonal birth control, you need to check an ICON and do a pelvic.
Call me when you're ready.
I'll supervise.
Hey, Kerry, can you do me a favor and see my guy in Four? He's been here 14 hours for a pre-employment physical.
Doesn't have a primary care doc? Classic misuse of the ER.
Dr.
Lockhart, five pages in 45 minutes.
I hope someone's dying.
Stab wound to the right shoulder.
Thought you'd want to know.
Get Rasgotra.
I'm scrubbing in on an esophageal jejunostomy.
Well, hold up.
Neela's in the O.
R.
with an MVC.
- No.
Neela's here covering consults.
- No.
Neela's in the O.
R.
- Are you trying to irritate me? - Well, you make it so easy.
Take a bigger bite.
Don't be shy.
My wife is going to be pissed.
You were hit by a car.
It's not your fault.
The only times I've seen her mad were the day I brought the Harley home and the day we met.
The day you met? Yeah.
She's she's a photographer.
She was in the park shooting this Chicago Magazine thing, and I kept getting in the picture.
- Intentionally? - No.
Not at first, but when I saw it was getting to her, I kept doing it.
I told her I'd stop if she would give me her number.
Well, I guess that worked.
Six months later, we were engaged, looking at houses.
That's sweet.
I'm going to go check on my hemopheliac.
Make sure you evert the edges, okay? We had some we been through some tough times, but she got us through them.
- It's nice to have someone like that.
- Yeah.
Lou Smith? Came in as an MVC.
Hit on his motorcycle.
- Should have taken the train.
- Who's taking care of him? I wish I was.
Why the hand delivery? We could have seen this on the PACS.
Come on, Rach.
It's an excuse to see me, right? Wrong.
Look at this.
- Oh, man.
- Those are brain mets.
- What's his primary cancer? - Cancer? He came in as trauma.
Ventricles look good, no midline shift, no edema, but My husband-- Garret Palsey.
- He was brought in! - Hi.
I'm Abby Lockhart.
I worked on your husband.
What does that mean? Worked on him? Mom, it means she treated him.
Let me see if he's still in surgery.
Please, he needs me there with him.
Another round of platelets and FFP.
Neela, more lap pads.
He's oozing around the packing.
Think it's retroperitoneal? Yeah.
Probably.
Hold pressure over the portal triad.
Clamp.
This is the Pringle maneuver, right? - Yes, but - No one calls it that anymore.
Dr.
Crenshaw.
Was I unclear this morning when I assigned you to consults? Do I speak too fast, or is it that I accidentally lapsed into Aramaic, as I am prone to do.
- No.
I ! - Then please explain to me what you're doing here instead of seeing any of the eight consults currently waiting on you in the ER.
You didn't mention you were covering the ER, Dr.
Rasgotra.
I'm sorry.
I was up here, he was unstable, and I thought No.
You don't think.
You're years away from thinking.
If I tell you to do consults, that is not a suggestion.
That is an order.
Do you understand? - Pulse is dropping.
61.
- Give her a break, Dusty.
The patient's crashing, I needed another pair of hands.
I lost out on a most excellent esophageal jejunostomy because I had to clean up her mess.
Yeah.
Well, there's plenty to go around here.
Mobilize the left triangular ligament for me, will you? He's still in surgery, but I can bring you upstairs.
Did they say how he's doing? I'm sure they'll give us an update once we we get up there.
Frank, can you page me if my pediatrician calls again? I look like your girl Friday? - Hey, you're not in jail! - Not this time, Frank.
I just got off the phone with Angela.
Congratulations.
- Thanks for the pep talk.
- That's great news, Luka.
Morris owes me 50 bucks.
- He swore you were going down.
- I'm not going anywhere.
I knew you would win.
- I prayed on it, Dr.
Kovac.
- Well, it worked.
Thanks.
How are your patients? Oh, our motorcycle guy, Mr.
Smith, is thirsty.
- Can I give him some ice chips? - Yep.
That's a good idea.
He's going need more than ice chips.
Look at his scan.
Called his oncologist at Huntington.
Brain mets from pancreatic cancer.
Is he in treatment? He failed rescue chemotherapy.
From what this scan shows, he belongs in hospice.
What about radiation? For metastatic pancreatic cancer? Hospice can probably help him enjoy his remaining time.
- Which is just about up.
- Uh Dr.
Kovac? - Uh I'll talk to his family.
- I am the family.
- This is his wife, Mrs.
Smith.
- It's spread, hasn't it? - Can we Can we go over here? - Has it spread? Yes.
Yes.
I'm afraid so.
It's in his brain.
Oh, I thought we had a couple of years.
Maybe even more.
We were supposed to go on a bike tour in Provence.
Sorry, Mrs.
Smith.
Well, I guess this was supposed to happen.
Wow.
I think that it's best that comes from me.
I think that I should be the one to tell him.
Okay.
We'll give you some time.
When you're ready, I can come in and answer any questions.
Mr.
Gallagher, your slit lamp exam was negative.
There is nothing in your eye.
- It still hurts.
- Maybe it's because you keep rubbing it.
Look, maybe I'm missing something, okay? I'd like to see an eye specialist.
Your eye will be fine.
This doesn't warrant an ophthalmology consult.
Dr.
Weaver, the electrician is ready to see you.
Okay.
Give him a gram of Acetaminophen.
Wait a minute.
What are you gramming about? I got crap in my eye.
I want to see the doctor.
So we can fix it, but it's going to take about a week.
How much will it cost for a rush? It's not about the money.
I got to wait a week for parts.
I don't think you understand.
If we shut down the trauma, patients get diverted to other ERs, and there'll be longer transport times Can someone say "Chante"? Chante, his name's Chante Morris! What the hell you doing? My my eyebrows.
- The camera picks up everything.
- Get out! Dr.
Weaver, please There's a rectal prolapse in Curtain Two with your name on it.
Now, go.
- Leave me a little powder.
I tend to shine.
- Let's go! So Josie's ankle will be fine? Yeah.
A month in a cast, and she's good to go.
I told you, dear.
He thought you was gonna need a wheelchair or something.
No.
None of that.
Tony's very good for a neophyte.
- May I speak with you a second, please? - Sure.
I'd like to talk to you about your daughter.
She's, um She How do I say this? She got naked again? So it wasn't just me? Isn't he adorable? Sometimes her condition makes her act like that.
- It's no big deal.
- Well, this is a big deal.
Have you talked to her about birth control? Why would I do that? Because you're her father.
- The school will handle it.
- Well, that's not really their job.
You don't understand.
Her school is different.
That's why we sent her there.
Look, Mr.
Weller, I realize this is a difficult conversation.
You think birth control is the answer to her? - Honey, honey.
- Josie's a pretty girl.
She's smart, she's open.
She takes her clothes off in front of the wrong guy - Josie likes Hilary Duff and MySpace.
- I'm sure she does.
But Josie doesn't have the same ability to say no like other kids.
Thank you, Lucien, for letting me scrub in.
Wish it had ended better, but I appreciate Listen to me.
Dr.
Crenshaw is your chief, and he owns you.
He owns you.
As smart as you think you are, that guy is smarter.
You'll start respecting that today.
And if you ever play me like that again, ever run to daddy when you don't like mommy's rules, you will be done here, do you hear me? This is your only warning.
Now, Mr.
Palsey's family's waiting-- go.
Go! This is Mr.
Palsey's wife and daughter.
This is Dr.
Rasgotra.
How's Garret? Is he all right? Well, when we opened your husband's abdomen we found it full of blood.
But you can fix that? The accident tore the vena cava.
We tried to repair it for over an hour, but he was bleeding too fast.
Okay, so what happened to my father? Mrs.
Palsey he died.
Oh, God - Oh, God.
- We made every effort.
Whoa! Whoa! Whoa! Whoa! Okay, that's all right, I got her.
I got her, I got her.
- Mrs.
Palsey? - You okay? Mrs.
Palsey? Mrs.
Palsey? Mrs Palsey? Mrs.
Palsey? She should be waking up by now.
- Pulse ox only 91.
- All right, I'll bag her through this.
She's okay, right? Yeah, she just needs some time to come around.
Systolic's down to 88.
Donna, does your mother suffer from a heart condition? - No.
- High cholesterol? - What are you talking about? - She vaso-vagaled, Neela.
Look at the monitor.
ST elevation, T-wave inversion No way, the leads must be reversed.
There's nothing wrong with the leads.
Looks like a massive MI.
CBC, lytes and triponins.
An MI, I know what that is.
- V-tack, lost the pulse.
- My mother can't be having a heart attack.
She's 45, no risk factors.
- Charging to 360.
- Clear! - No change.
- All right.
Amp of epi.
Come on, Neela, pick up the pace.
- Is she on any medications? - No.
What's happening?! Your mom's heart's in a dangerous rhythm.
Abby, shock again after five cycles.
Okay, have lido ready.
Acute LV dysfunction after a sudden, tragic event.
This is Broken Heart Syndrome.
Yeah, yeah, I read about that.
Never seen a real case, though.
Stress cardiomyopathy from the catacholamine surge.
She has no cardiac risk factors.
It all fits.
- You want the lidocaine? - Yeah, all right, 75 mac two.
Someone call cardiology.
All right, so we're going to give you a shot.
- I don't like shots.
- Josie, it's going to be fine.
It'll pinch a little at first, but it's going to protect you.
Did you know the Blue Line goes right from O'Hare to Irving Park Road? Jump off there and take the 80 towards the lake.
It'll drop you right at Sheridan.
Josie, we're talking about something very serious now, hon, pay attention.
You're going to have to come back every three months for a shot.
I've talked to your father about it.
I'm going to give you some education on condom use.
For when we have sex.
No, not when we have sex, when you have sex.
That doesn't mean you're old enough or you're ready, but when the time comes, I just want to make sure you're prepared, okay? Can I get a pen and paper and take notes? Just no props or diagrams.
- What the hell is Morris doing? - Not his job, that's for sure.
Here we see firsthand the effect of over exuberant Halloween candy consumption.
Little Luke here has a bowel obstruction.
Too much taffy gummed up the works.
Now we're going to stick this tube into his stomach.
- He's not moving air.
- Point three epi, sub Q, Continuous albuterol, intubation tray, call RT.
Hey, you guys are in the way.
I'm just warning parents so people don't abuse the ER system.
Overeating Halloween candy is not draining the system, this is.
Can you explain the patient's condition, doctor? He's asthmatic.
He got laid off-- no job, no health insurance.
I got more stuff.
It's costing his insurance company ten bucks a month - This is my show, people.
- Taxpayers will spend tens of thousands of dollars taking care of him in the ER and ICU.
So, you're a proponent of a national health plan? If we had one, this guy would be home playing with his kids instead of fighting for his life.
That was gold.
What's her name? Dr.
Judas.
Asystole.
It's V-fib.
Another 50 of lidocaine.
Let's try amiodarone.
Neela, she's in asystole.
All right, let's try one more round of epi.
No, no, please don't stop.
The syndrome causes a transient ventricular weakness.
It's temporary.
It's reversible.
She'll get better.
We've been flogging her for 20 minutes.
- Epi's in.
- Her husband just died.
Please don't give up.
Five rounds of meds.
She's not responding.
All right, hold compressions.
Oh, God.
Mom Neela, stop.
Back in sinus.
You signed them out? No.
Mrs.
Smith? Got a great team here, doctor.
Do you have any questions you want me to answer? No, I'm just praying my Harley still runs.
Uh Dr.
Kovac, I'd like to sign those papers you were talking about.
Yeah, sure.
Right over there.
Give us a second, please.
You didn't tell your husband about the brain mets? No, he thinks the chemo worked.
So let's just leave it at that.
I don't lie to patients.
Look, when he first diagnosed, he shut down.
And for the past six months, he's been living it up-- he's been taking tango lessons and scuba lessons.
- And we're going to France in December.
- He has the right to know the truth.
Why should he spend his last months in fear? I mean, if he just has a little hope, at least there's still chance for a miracle.
Ray, take them back to the room, please.
Look, we wouldn't even be here if it wasn't for that stupid car accident.
Mrs.
Smith, I'm giving you a second chance.
Either you're going to tell him now or I'll tell him when I come back, okay? Mr.
Ames.
You were celebrating.
In court today.
You were celebrating.
Mr.
Ames, we were just happy the case was over, that's all.
You were happy that you got over, isn't that what you really mean? Look, I have patients.
I was a patient.
Don't you remember? Mr.
Ames, you shouldn't be back here.
Isn't this where the sick come to get healthy? - 'Cause I want to get healthy.
- Hey, do you need some help here? Do these people know what you did? It's under control, it's okay.
I came in here with a cough, and I went out like this.
I gave you the best treatment possible.
While I was having a stroke, you ignored me.
- Mr.
Ames, that's - You ignored me! - You did! - You should to go.
Go where? - Where am I going to go? - Security! If you had just let me go home in the first place, then none of this would've happened! - What do you want me to do? - I want you I want you to give me my life back! Give me my life back! Give it back! Give it back to me! Stop! Mr.
Ames Mr.
Ames, wait up.
I just I just wanted to make sure you're okay.
You want to make sure I'm okay? No, I'm not okay.
I'm not okay at all.
See, when you came in the court this morning, I was telling my kids about justice.
They were looking at that lady with the scales.
And I said that justice was going to be done today, but I don't think it was.
I know you don't feel that way, but Look, I just want to hear it from you, without the filters of lawyers or judges, anybody Did you give me the best possible care? At any given moment, I'm responsible for 40 acute patients.
We try our best to watch everyone.
It's hard, we're not gods.
So you feel you paid attention to me? I followed your progress, examined you once a shift.
Your wife and I were in constant contact.
You talked to my wife.
Listen the stress of something like this can cause No, no, no, you don't understand.
After the stroke, I came home one day and all her stuff was gone.
Same with the kids.
So I called her sister, I checked the machine Finally I get an E-mail telling me that this was too much.
This-- me pursuing you, pursuing this, it was it was too much.
She thought that that nothing was ever going to come of this, and that if I couldn't move on, then-- she was going to have to move on without me.
in an E-mail.
I figured that I just win this, you know, I win this case, and I'd send that E-mail back and then then she'd come back home.
There are people who can help you, groups But I don't want any help.
I want things back the way they were.
I want to work.
I don't want some government check.
I build things-- that's what I do.
I know.
But I just don't know how to fix this.
How do I fix this? I'm sorry, I have to get back.
I got it, I understand.
Look, if you need anything Curtis.
- My name is Curtis.
- Of course.
Curtis.
If you need anything, give me a call.
If a laparotomy is indicated to rule out a life-threatening condition, then the procedure doesn't become unnecessary just because the condition is ruled out.
Huh? You lost me.
Well, the E.
R.
keeps accusing us of performing unnecessary surgery, but we really believed the guy had a triple A.
If we waited, he'd die.
But he didn't have a triple A.
Given his symptoms, we would've been right 90% of the time, and then surgery would have saved his life.
Good.
Do it like that.
Okay.
Your turn.
I'm fine.
I know how to do this.
I'll just pull some articles, I'll be fine.
Look if you're not prepared, the surgery attendings are gonna have you on a spit-- - let me take a look.
- I'll be fine.
- Hey! - Give it! You're gonna see my secret winning strategy.
My spelling is awful, huh? - Tony - Worse than awful.
My my syntax, my grammar.
Yeah, but how do you I'm I'm a little dyslexic.
I've learned to work around it, and most of the time, it's fine.
- We're having girls' night tonight.
- You in, Neela? - I'm busy.
- I'm free.
- We're preparing for the M&M.
- Nah, that's okay, go with the girls.
- Tony - We'll talk about this later.
Maybe it's a good thing that you talked to him.
- Yeah.
He just feels alone.
- Dr.
Kovac looks like we still need to break the news to Mr.
Smith.
- She didn't tell him? - She's sticking to her guns.
Okay, uh go ahead and sign out.
I got to do this.
Wait a minute, though-- we have tickets to Ig-Ig - Igraci Sa Klupe.
- Yes.
In an hour.
Oh, I can just see it some other night.
- You're canceling? - Oh, my God, you're disappointed.
No, I guess I just have to go to Ike Ryan's with everybody.
I'll come and pick you up.
- I love Rome.
- I figured you'd like that.
How's it going? Hey, I'm ready to get out of here, Doc.
How's my CT look? Well, uh, the good news is, there is no, uh, skull fracture, there's no hemorrhage.
Oh, thank God.
I don't know if my wife told you, but three years ago I was diagnosed with pancreatic cancer.
I don't have time for some brain injury, too.
- I got trips to take, friends to see.
- Yeah, sounds like fun.
Yeah.
My wife and I, we're going to Provence for the holidays.
Might even go to Paris, eat some Grande Marnier crepes and some of the best Bordeaux we can find.
Well, I don't want to stand in the way of your plans.
Uh, all you have to do is, uh, sign these papers, and I'll start you on some new medications.
You can explain to my wife.
She handles all the medicines.
No problem.
Can we talk? Oh, my God, thank you, - thank you so much.
- He cannot ride the Harley.
Okay, but what about the trip? You better rent a car and do the driving.
He could have seizures or a stroke, and by letting you walk out of here, I want to make sure I'm not setting someone up to get hurt.
Okay, I promise.
- Okay.
Good luck.
- Thank you.
- Provence is beautiful.
- Thank you! How's your promotion going? I'm hanging in there.
Still got a few knuckleheads I got to beat into shape, but other than that, it's all right.
Are they showing you respect? Eh, you know how it is.
They do what they do, you keep pushing through it.
To pushing through it.
To pushing through it.
- You better get that.
- No, no.
It's probably a Jehovah's Witness.
- They're very persistent.
- Yeah.
Save my spot, okay? All right, hold on.
Hey, what you doing here, man? Now's not a good time.
Aw, man, it's Thursday-- you said I could move in Thursday.
No, no, no.
I said Friday.
Tomorrow.
Mañana.
Nah, you said I could move in on Thursday.
- I said Friday - What's up? Oh.
My bad.
Who's this? This is my brother Chaz.
- Hey.
- How you doing? You, uh, you moving in? Yeah, but he's supposed to move in Friday.
Aw, Greg, you cannot let him sit out there in the hallway.
Come on in.
Are you hungry? I'm 18.
I'm always hungry.
- Betina, come on.
- So, what can I get you? Okay, okay, okay, I would shag I don't know, I guess I would shag Pratt.
I knew you had the fever.
And shoot Morris, do us all a favor.
I think you're a little too hard on Dr.
Morris.
He has potential.
Apparently, Morris is in the process of bringing God into his life.
Dr.
Weaver, is that you on TV? Turn it up! Turn it up! Oh the camera really does show everything.
My hair looks like crap.
- Oh, my God, Kerry, you look good.
- Is that Morris? Morris looks like a fool! You okay? Bad day.
And the nights are I've been having these dreams.
About Michael? No.
Gates.
- It's stupid; it's my friggin' hormones.
- It's not stupid, it's it's human.
And he's cute, and he's nice.
And you can't just sit and mourn forever.
Yeah, but it's only been six months.
That's longer than you were married.
You always thought I rushed into it.
Well, Michael was a great guy-- you were just young and impetuous, and I don't think he'd want you to put your life on hold.
I know, you're right.
So, what exactly are these dreams you're having? Oh, your average intubation.
- Extubation.
Re-intubation.
- Okay, enough.
Why don't you call him? - Oh, God, no.
- No, come on, you better do it quick, 'cause one of these girls is gonna shag shag, shoot or marry him.
Well, we are studying for the M&M together.
Excuse me, could you set my friend up with some tequila? What are you up to? Answering e-mail.
What's up? - Sarah got an A on her English paper.
- That's great.
She had to write an essay on who she'd most like to have dinner with.
Guess who she picked? Me, of course.
Gandhi? Madame Curie? Keith.
She wants to ask him why he died.
Let me see that.
Every time I think she's gotten over losing her father This isn't bad.
You think? No, she wants to know why he fought in that war, why did he have to leave before she got to know him.
These are good questions.
All right, all right, all right, call him, call him.
Who is it? - It's Ray, isn't it? - Are you mad? - Somebody I met at a conference.
- Then hit those digits, sister.
God, I miss him, T.
Me, too.
- You do? - Yeah.
Yeah.
Every day.
Tony, my computer crashed again! In fact, yesterday I went by our old school.
I thought about all the touch football we used to play.
You mean how he used to burn you all the time? Yeah.
In his dreams.
Well, he did get the girl, huh? Yeah, he sure did.
Hello? Uh, is, uh, is Tony there? I'm sorry, he's a little busy right now.
Can I take a message? Never mind.
It's a wrong number.
- Do you want to try it again? - No, I'm good.
Is it Gates? Wait, wait, wait.
Let's get back to the game.
- Okay, Abby, shag, shoot - Not me, though.
- Oh, come on.
- No, no, no, no, I don't All right.
Um, I would definitely shag Luka.
Oh, please! I totally forgot about him.
I know.
Me, too.