ER s14e06 Episode Script
The Test
- Abby.
- Just a second.
Crap.
Med Staff office says you can't work tonight.
- Right.
See you.
- I'm serious.
- Banned until you deal with your charts.
- Excuse me, Frank.
Told them I was gonna sling you over my shoulder and carry you myself.
- Sling me over your shoulder? You're backed up six months.
Good.
You're here.
Bringing in a guy out of his head, combative.
- We could use the extra set of hands.
- Ativan? They gave him 10 migs already, hasn't touched him.
Abby, don't go out there.
I think Frank has a crush on me.
And go see the Med Staff.
They're bugging me about your charts.
- Nemo Lynch, 32.
- There's a snake! Ran through the water tower, jumped through a plate-glass window.
Sounds like PCP.
Twenty of ziprasidone, I.
M.
Got it! Whoa, whoa, whoa.
Hey, you need some help here? Moretti's got me triaging.
Don't worry about that, worry about keeping patients out of the door.
Vitals are stable, abdomen's non-tender, wounds look superficial.
Why is the ER calling for a surgeon? You're a great mentor.
That was a question.
Why does this guy need an ex-lap? Can't trust the exam if the patient's high.
You even listening to a word I'm saying? Can I ask a question? It's a little embarrassing.
It's better to ask rather than fake it.
I appreciate your attitude towards that, I really do.
It's reassuring to know that - Harold, sometime today.
- My girlfriend, Lacey.
- Her homecoming dance is coming.
- Homecoming dance? She's in the court.
Out of my league looks-wise.
But there's cachet in dating a doctor when you're still in high school.
- Your girlfriend's in high school? - A senior at Woodland.
Anyway, there are certain skills, expectations.
Certain rites of passage that a certain homecoming princess is gonna be counting on, you know? No, I'm not sure I do.
I've never been to the dance.
I don't know how to do the mambo or pin the corsage.
- Do you have any idea? - I didn't grow up in this country.
- I'm not sure I'm the best person to ask.
- Neela, help me.
I'm a virgin.
MORETTl: You guys all right in here? Get away, you freak! - You wrote the map of the skin! - We're doing just fine.
I will not be the conduit.
Sedation's kicking in.
Interns, your first-quarter evaluations are in your boxes.
- Find me if you want to discuss.
- Not a good time.
- Nobody told us we were tested.
- Every patient is a test.
Of your intellect, of your wit, of your organizational skills.
Get the snake! - Shut up! Hold still.
We're gonna get the snake.
Hear that? Every patient's a test.
And Sam just got an A this time.
Guess I spoke too soon.
I stole this from the G YN clinic.
- What? - I didn't "steal" steal it.
- I'll take it back just as - I'm not touching that.
Just go over the relevant anatomy.
Oh, come on, man.
Put that thing away.
No air under the diaphragm.
He's just so smug all the time.
Have you ever met anybody so smug? Let me guess.
Moretti? Every time, you guys are talking about the same thing.
Well, he's an ass, but I can't deny he's a smart guy.
C- spine is fine.
- Should I take off his collar? - No.
Upstairs.
This one's fun.
Get him up before sedation wears off.
- Here's everything you need to know.
- We're good.
Go.
He can't hear anything? He's had enough sedation to down an elephant.
Okay, so where exactly is the G-spot? Put that thing away.
Hey.
I hope you're on top of your game.
Boards tomorrow.
You're taking the hard cases.
- Why are you working before boards? - It's Morris', he's taking them too.
- Couldn't find anybody? - Nope.
And he swore that he would fail if I didn't bail him out.
But I'll do fine.
I test well.
- You hear from Luka? - Taking longer than he expected.
He has to retrofit his dad's house for a wheelchair.
This is completely unfair.
- Guy's clearly on a power trip.
Abby, check this out.
Four pages of categories: Procedures, patient relations, intellectual curiosity.
- Each rated one to five.
- He gave us ones across the board.
Is that good or bad? - Bad.
No comments, no feedback.
- Just ones.
- So uncool.
I'm never gonna get a toxicology fellowship.
That's not true.
- Are we supposed to learn from this? You have to talk to him.
Yeah, would you? Please? Frank, what's up with the lab? I've been waiting three hours for a CBC.
Something about a flow cytometer.
It'll be a while.
Oh, your kid's school called twice.
Alex biting off lizard heads again? Shut up.
He's not a sociopath.
That's right, ignore the problem.
It'll go away.
Well, it's too late, I have to call them tomorrow morning.
Mm-hm.
Hey, Sam.
You're supposed to be covering Triage right now.
- What? - Yeah.
Nurses rotate every two hours.
You're up.
Come on.
Excuse me.
- Yeah.
Hi.
- Hi.
Slamming the interns without giving any concrete suggestions isn't helping.
These numeric evaluations are useless.
Don't worry, Abby.
I gave you solid threes.
Listen, they're freaking out about the bad evaluations instead of focusing on how to improve.
- lllustrating my point.
- Which is what, exactly? Are they concerned about giving patients sub-optimal care? No.
They're worried about how it's gonna look They need mentors, constructive feedback, guidance.
They're just kids.
Arrogance and inexperience are a lethal combination.
- There's gotta be a more effective way - Abby, look, I understand " it's" your natural instinct to listen, to wanna be supportive.
But in the end, with Forget it.
Can't.
Excuse me.
Okay.
Ma'am, why are you here? He got a cough.
Oh, yeah? Let me see.
Hey, let me see.
Well, his breathing's okay.
I'll try to get you back as soon as I can.
Hello.
Sir, let me see your hand.
Let me see.
- Come over here.
Sit down.
Hey.
- Hey.
- Yes? I've been here.
This guy just walked in.
- Well, this guy's bleeding.
- Okay, well, my head is exploding.
- You look comfortable to me.
- Well, don't tell me what I'm feeling.
You get headaches a lot? Never like this.
All right, here.
Grab that.
I'll get back to you in a second.
Follow me.
- This place is gross.
- Well, you get used to it.
- What's your name? - Heather.
Heather, I'm Dr.
Gates.
This is Sam.
Sam, Heather here says she has an exploding headache.
Hm.
Let's get you checked out.
- Moretti have you working in Waiting? - All day.
He's doing that to all the Residents.
Well, I better get back.
Take a seat over here.
On a scale of one to 10, how bad is your headache? It's a 10.
You're pretty calm for a 10.
Yeah.
So you think I'm lying? - I have a high tolerance for pain.
- Where are your parents? I don't know.
Out.
Give me their numbers.
We need permission for any treatment.
Sam, you seen Pratt? He's in Exam 3 reducing a shoulder.
Are you on tonight? You mean "on" as in lively and invigorated, or "on" as in working? - What? - Morris.
- What are you doing? - I'm looking for you.
- Why aren't you studying? - I got too much nervous energy.
There's no way I'm gonna sleep.
I came in so we could study.
I took over your shift so that you could stay home.
Come on.
We can help each other get psyched, get focused.
Listen, if you're here, I'm out.
Dude, you need to work on your game face.
- What? - Game face, Greg.
What's wrong with you? Shrug your shoulders.
- Can I open my eyes now? - Yep.
Okay, the good news is your neuro exam is totally normal.
- But you have trigger points.
- Which means? It's tension.
You'll feel better with ibuprofen.
Aren't you gonna do a CAT scan? You don't need one.
Well, do one anyway.
We don't do tests just because patients want them.
Why not? It's a waste of resources.
Okay, well, make my dad pay, he's rich.
That's not really the issue.
You just said it was about resources, so - Is this your home phone number? - Yeah.
So when I call it, why do I get a video rental store? Video rental? I didn't even know those still existed.
That isn't funny.
My mom is dead, my dad is in New York.
And he doesn't need you guys bothering him, so Not that big a deal.
Six hundred of ibuprofen.
Get consent.
And give us his real number.
No more games.
That was so cool, defending us to Moretti.
Well, we were just discussing different teaching philosophies.
Yours is better.
There's no way I'm gonna present to him.
- You got a minute? - You can't boycott an Attending.
I can't? Come on, just for today.
Hanging out in Waiting is inefficient.
- Just get back out there.
- I should be here clearing beds.
A woman arrested in an ER waiting room because nobody was paying attention - Brian? - Hey.
MORETTl: What are you doing here? - Thirteen-year-old in respiratory distress.
Tony.
It's really bad this time.
I know this kid.
Got a neuromuscular disorder.
- I know him from ICU.
- Okay.
Hey, buddy, how you doing? - Pretty good.
- Yeah? Did you see D.
Lee hit for the cycle last night? No, I missed it.
Have to give me the play-by-play.
- Pulse ox is only 78.
Let's go.
He needs oxygen.
Sam, you're with me.
Where we going? Trauma 1.
- Brian, wait right here.
I'll be back.
All right, let's set up a non-rebreather and let's get an ABG going.
Find someone else to cover Triage.
I'm staying with this kid.
MORETTl: He left? What do you mean, he left? He was here and then he was gone.
- Is that clear enough for you? - Did he say where he was going? Frank, where's the Crohn's fistula? Ask me again in English.
Never mind, I found her.
Do women need additional lubrication? Harold, get a consult form.
If you're willing to put in the time to sufficiently stimulate the area Isn't there anyone in your life that would be more appropriate for this? Like a brother, uncle, anyone? No, just Grandpa.
And he thinks I still believe in the stork.
Is there anything special I should know about the Crohn's lady? She's narcissistic, she's addicted to "morphine " " and" if she says that she's allergic to NSAIDs, she's lying.
Thanks for the warning.
Excuse me.
I'm looking for you.
Dr.
Moretti, I'm Skye Wexler, new Attending.
We spoke on the phone.
Yeah.
I didn't realize you were starting.
- Yeah, tonight's the night.
- All right.
Follow me.
When you Write your initials in this column when you pick up a patient.
And chart any progress in this column over here, okay? Frank.
Sorry, this is Dr.
Wexler.
She's gonna be taking some shifts over the next month or so.
And this is one of our lifers, Haleh.
Hey.
- Hello.
- Hi.
You new to Chicago? Doing locums to make some extra cash.
Locums? Yeah, it's like moonlighting.
Mostly nights.
- Ah.
That's when I work too.
- Oh.
Yeah.
Much better than being stuck in a hospital all day when it's beautiful outside.
I hear you.
I'm a big hiker myself.
You bump your head? Hang in there, Josh.
I'm almost done.
ABG's back, 7.
18.
CO2, 66.
Yeah, he's retaining.
- What does that mean? - It means he's tiring out.
You try breathing 50 times a minute.
You're gonna have washboard abs after this.
Art line's in.
So we can check your blood gases without needles.
See this shadow? - Yeah, is that fluid? Yeah, most likely aspiration pneumonia.
His muscles are weak.
It's not protecting his - Airway.
- Right.
I never should've let you go to that Kelly Clarkson concert.
That's not why I have pneumonia.
Did she just say Kelly Clarkson? - Problem? - Good thing you're sick.
I'd be giving you so much crap.
Kelly Clarkson? Hey, Sam.
Gram of ceftriaxone, liter of NS.
- Which one of you is Pratt? - That would be him.
Hey, Skye Wexler, new Attending.
I'm doing overnights.
- Nice to meet you.
- Call Hopkins.
We're supposed to report ER visits to the study coordinator.
Boards tomorrow.
- Yeah.
I'll hang here so you can study.
Really.
Go.
- Gates, you good with this? Yeah.
All right, buddy.
We'll get you feeling better soon, okay? Looks like you're stuck with me, Josh.
Let me take a look at the film.
Here.
Your feet must be tired.
This hospital bites.
Been here hours, nobody's done anything.
We get busy.
- What are you doing? - Trying to find someone who gives a crap.
Yeah, well, those computers are for staff only.
Go back to your bed.
Okay, did you hear me? I have chest pain.
And it's really, really bad.
I'll get someone to check you out.
MORETTl: How's the boy doing? - Struggling, headed for a tube.
- So, what are you doing out here? - The new Attending came and said - Wait, wait, wait.
You left a patient in respiratory failure with an untested Attending you've never met? - Oh, well, I - I'm kidding.
I sent her in.
- Okay.
Thanks.
- Hey, doctor.
Check me out.
Hey.
What happened? There you are.
You show up out of nowhere and then suddenly you disappear.
- How you doing? - Good.
You seemed busy.
I didn't wanna get in your way.
Is everything all right? You look like hell.
No, I drove all night, so - Oh.
- Yeah.
Dr.
Pratt, I'm sorry, this is Brian, my son.
- Oh, really? Hey.
- Yeah.
Yeah.
Aren't you in college on the East Coast? MORETTl: Yes, he is.
- Yeah.
And now this is the part where you tell me why you're not in "school " " and" you're here visiting me at work.
- What's that? - Happy birthday.
You drove all night to give me a book? No, it's not just a book, not just a book.
It's like a new way of thinking.
Really? All right, well Remember in college you got so excited about everything that you learned? Come, let's get out of here.
You look like you haven't eaten in a week.
- Okay.
- Hey, Skye has my sign-out.
All right.
- Okay.
It's the natural course of Fazio-Londe disease.
The respiratory muscles aren't strong enough to clear secretions.
So there are no other options.
This is Dr.
Bazzano from Pediatric Neurology.
Hi, Joshua.
- You're his mom? - Yeah.
Acidosis is worse.
So listen up, buddy.
Your muscles that help you breathe are starting to get tired.
Tell me something I don't know.
So we're gonna have to put a tube down and that will breathe for you.
Oh, God.
The ventilator's temporary.
His muscles rest so the antibiotics do their thing.
And after the pneumonia's treated, we can take the tube out? Well, that's the hope.
Okay.
It's gonna be okay.
We talked about this possibility.
I have to run upstairs.
I'll see you guys up in the ICU.
Thanks, doctor.
Do you understand everything? Yeah.
- Mom.
- Yeah, honey? The situation demands a Slushee.
Josh, sorry, but you gotta be NPO.
Come on.
Let's give the kid a Slushee, huh? You can live with that, huh? Sweet.
Okay.
Where do I? The Jumbo Mart.
My kid loves them too.
It's across the street.
Come on, I'll take you.
Be right back.
Good catch.
You're not tubing me.
Headache's gone.
Now it's chest pain.
EKG was fine, exam was normal.
Did you do a Beta HCG? Could explain this whole thing.
Keep her on oxygen, call if she has sustained decels.
Abby.
HCG? Oh, yeah.
It was negative.
I have to check on a sick asthmatic.
- Oh, that's cool.
I got this.
- Okay.
Hey.
I'm Dr.
Wexler.
I'm in charge tonight.
Lucky you.
Deep breath.
- I can't.
- You can try.
Again.
Well, your heart and lungs sound good.
Oxygen level's perfect.
Better keep looking, then.
Your pain can't be that "bad " " if" you're able to text your friends all through my exam.
I'm not texting.
I'm trying to get online.
Reception in here sucks.
Is there a computer in here I can use? Do you know where Pratt is? I can't find him anywhere.
- Try the break room.
He's studying.
- Thanks.
Sorry.
You were saying? Just forget it.
Never mind.
Of course we have the grand old dame of cramming, caffeine.
Grand old dame? Three hundred milligrams, baby.
Keep our engines nice and revved.
Oh, and this.
Okay? This.
This is the silver bullet.
If you get stuck on the test, squeeze this, the answer will come.
Hey, I don't need any good-luck charms.
You can't reject a good-luck charm.
That's like the opposite of good luck, as in bad luck.
Don't believe in luck.
I believe in preparation.
And I'm prepared.
Whoa, what's all this? We got boards tomorrow.
Yeah, and how exactly does this fit in? Something to perk us up when our stamina flags.
Do you guys mind if Harold hangs for a while? He could benefit from your tutelage.
No, we have too much ground to cover.
If you don't know it, this isn't gonna help.
That's not true.
Studies have shown that cramming can improve short-term performance.
See? Have a seat, Harold.
Oh, excellent.
Great guys.
Smart, experienced.
So, what topics do you wanna cover? Just some basic fundamentals.
No appetite? Dairy is pumped full of hormones, and wheat is genetically modified.
Right.
Okay, I'll try to find you some organic Jell-O.
Urine aminolevulinic acid is elevated.
Suggests a problem with porphryin metabolism.
She does seem to have a serious fear of food.
Acute porphyria can be brought on by caloric restriction.
Well, see, it fits.
Hematology said to order an erythrocyte enzyme assay.
Okay.
Cool case, Grady.
But make sure I keep moving other patients through.
- Okay.
Hey, Abby.
- Hey.
- How is everything? It's better.
Much better.
- You been going to meetings? - Yes.
Okay, because I haven't seen you.
Well, the last couple of times, I worked late.
So I couldn't make it to St.
Mark's.
Oh, I see.
And I kind of wanted to go somewhere where nobody knew me.
Hm.
Why is that? I don't know.
Look, the church on Franklin's got meetings all hours, day and night.
Okay.
Thanks.
That's good to know.
When your infection clears, capacity will improve " and" they'll take the tube out.
Be real.
I'll never get off the vent.
Don't say that, Josh.
I've been thinking about this moment continuously since I got my diagnosis.
No tube.
So that's it? You're just gonna give up now? And I need to make it look like it's your decision.
What? It would kill my mom if she knew this was my idea.
I promised her I'd fight.
So fight.
They're doing research on neuromuscular diseases all over the world.
It's not gonna help me.
They could come up with a breakthrough.
They're years away from a cure.
Whether we like it or not, this is happening.
My mom can start getting over it now " or" a year from now when she's given up everything to be by my bed while I wither away on a ventilator.
Josh.
Tony, you get me.
I know you understand.
He's a bright kid.
He knows what's in store.
Intellectual understanding isn't the same as emotional maturity.
No, I know him.
He understands what he's doing.
You're absolutely sure about this? Yeah.
Okay.
Do me a favor and run it by Ethics.
You can tell them your Attending's on board.
Thank you.
Hey, Sam.
- It is Sam, right? - Yeah.
Could you give our asthmatic in 2 I already did.
Part of Moretti's new protocol.
You don't need orders if the patient meets criteria.
Efficient.
I like it.
- Could I take a look? - Sure.
Hey, Frank, do you have the asthma flowchart? Hey, kid.
This is a hospital, not an Internet café.
What's wrong with you? What is wrong with you? I called your dad.
Somebody's on their way to get you.
You shouldn't have.
He didn't wanna be bothered.
- Of course he does.
- How can you say that? You don't know him, you don't know me.
- I'm a parent, I understand a parent's - Oh, shut up, you phony bitch.
It's "like " It's already after 3 and I think it's about time we go to bed.
No.
I think it's time we opened another bottle of champagne.
Here.
Really? Did I tell you I'm taking a course on the history of wine? - No.
- I know, I know.
It sounds like major slacker territory, huh? But it's actually this awesome survey of Western civilization.
There's the Last "Supper " Spanish Inquisition, Yalta Conference.
You name it, somehow wine was involved.
- Yeah, well, wine is - Oh, I switched my major.
To semiotics.
A degree in the meaning of meaning.
I mean, could there be anything cooler than that? No, I don't But, Brian I know what you're gonna say.
I know.
I don't wanna be premed, Dad.
I thought you were cool with that.
No, I am.
That's not - Why are you here? - It's your birthday.
All right, but what's the real reason? I remember when I was in fourth grade you showed up, and you said It was right before lunch.
And you said "We're gonna go on this secret surprise mission.
" That's what you said.
And I remember looking out the window of the car, just I'm thinking, I'm wondering, "Where are we gonna go?" And that, I just I swear, that was just one of the That was the most exciting moment of my life.
The time we went ice fishing? Yeah.
It was you and me and the lake.
And I just I just wanted to thank you.
Thanks for that.
Thanks.
You're welcome.
I'll call school.
They can send a new syllabus to the ICU.
Thanks, Mom.
Sat is 81.
You guys ready? Actually, we're gonna hold off.
What do you mean, hold off? - We're not intubating.
He won't tolerate the pressure generated by the ventilator.
- But I thought you said before I have new information.
The clinical picture's changed.
What kind of new information? Are you on board? Dr.
Gates and I have discussed the options at length.
You think this is such a good idea on your first night? I've been Attending for 10 years.
I don't understand.
This wasn't the plan.
- Well, we have a different plan now.
But he's in respiratory failure.
We'll give him medicine to keep him comfortable take away the air hunger.
- Tony, no.
- Trust him, Mom.
Okay.
How's your new interns doing? Uh, overzealous and inexperienced, but they seem like an okay bunch.
Well, I had to send mine to man camp today.
So I wake up the next morning and I look over and that best-in-show hottie from before big, hairy mustache.
And that, lads, is why drinking is bad.
You have your noses to the grindstone.
Yeah, well, we got a little distracted.
It's only 4:00.
The night is still young, huh? Go, go, go.
Go, go, go.
Go, go, go.
Harold, I need you upstairs now.
But we were getting to toys and accessories.
It's not an invitation.
Paranoid chemical lady in 2 dropped her pressure.
All right.
Come on, party's over.
Come on.
Whatever advice they gave you you must forget it immediately.
- Most of what they said made sense.
- God, what did they tell you? Well, Morris said the greatest sex happens when you're in love.
- Oh.
He did? - Yeah.
Pratt talked about how to keep the lines of communication open.
You're joking.
I still do have some unanswered questions, though.
Do two orgasms 40 minutes apart still qualify as multiple? Pulse ox is 84.
It's progressive.
There's no cure.
He has the right to stop.
- His mother, doesn't she have rights? - My obligation is to my patient.
- Josh doesn't want his mom to know.
- He's 13.
People make bad decisions.
Laying in a bed hooked to a ventilator is not a life.
He can think, communicate.
Maybe he's around when they discover a cure.
He doesn't want to lay in bed waiting for a miracle.
What part of that do you not understand? We're not intubating, Sam.
What are you doing? - Who's on call for Ethics today, please? - It's Larabee.
- I'm not gonna sit - All right, stop! This is my call.
Either go mix his morphine drip or take yourself off this case.
We're done here.
Suction.
She had headaches, abdominal pain, rash, mood swings.
Tube.
Porphyria seemed to explain all her complaints.
Okay, I'm in.
Pass me the bag.
- Nice job, Abby.
- Yeah, Abby.
Real nice job.
You and your intern spent hours working up a zebra without ruling out common causes for abdominal pain.
X- ray's back.
Air under the diaphragm.
Probably a perfed ulcer.
Which might not be perfed if you had diagnosed this four hours ago.
O.
R.
3 is ready.
Haleh will help you get her upstairs.
All right, that's it, you two, okay? I got this.
Sats coming up.
What's her access? Did you send the coags? Yep.
They're cooking.
Gotta have them done.
Flagyl's running.
I'm sorry.
I went down the wrong path.
You got excited about your hypothesis.
It's fine.
It's good.
This is my fault.
I'm supposed to know better.
Excuse me.
I'm here to pick up Heather Baker.
- Are you family? - I oversee the Chicago property.
I have a letter which allows you to release her to me.
I don't know where she is.
And I'm busy.
Gonna have to wait.
Well, I've been waiting almost an hour.
Sorry.
I have a kid who needs the wax cleaned out of his ear.
I'm a little tied up now.
And if you could pull up the troponins for our rule-out MI.
I don't have a password for the computer yet.
Lily.
Lily.
Take this to Gates.
Heather! Stop! Heather, stop! No, I don't want this.
- Hold still.
You're making this harder.
- Hypoxia makes people combative.
She was here alone with vague complaints none of us wondered why.
- Kept changing her story.
She's calming.
That's the valium.
Next she's gonna stop breathing.
Eighteen gauge in the antecube.
- Give the flumazenil.
- I totally missed it again.
- Yeah, I saw her too.
I blew her off.
Big occipital lac back here.
I knocked her down hard.
She cracked her head.
Page Psych.
They need to come see her.
- NG's in.
Tape.
Placement's good.
Charcoal.
Fifty grams.
Yeah.
Here goes.
I thought she was playing games.
I should've seen it.
You saved her life, Sam.
Don't be too hard on yourself.
Hey.
- Hey.
Thank you.
What can I say? - I overreacted about the ulcer.
- No, you didn't.
It happens to everyone.
And she did great in the O.
R.
How do people do this? Working with interns is always tricky.
It's hard to supervise without micromanaging.
It's not just the interns.
It's everything.
Some guy shoved me on the El today and I lost it.
I followed him off the train screaming even though it wasn't my stop.
I also fired the nanny, which is totally irrational.
Joe's fall had nothing to do with her.
I couldn't look at her without thinking about it.
- That's understandable.
- No, it's not.
It's like I'm actually trying to screw things up.
- It sounds like you need a day off.
- I wish it were that simple.
Anything I can do? Do you mind if I sign out a little early? Sure.
Thanks.
I finished the brow lac on the carpenter.
Wow, that was fast.
Didn't need a two-layer closure? Actually, Dr.
Morris just had me Dermabond it.
Oh, okay.
And how's our gastroenteritis girl doing? Is she keeping Gatorade down? I didn't end up pushing "fluids " because Dr.
Morris said to just go ahead with the bolus.
I saw Ortho down here reducing that shoulder.
- How much ketamine? - I ended up using propofol because Dr.
Morris Well, he decided that it "wasn't " - Morris.
- What? What? Jeez.
I ask for Benadryl, patient gets Atarax.
I order a splint, kid gets an ace.
What kind of creepy loser hangs out in the break room all night second-guessing Attendings when he's not on schedule? I don't know if I'm being punked or if you haze all new Attendings " but" don't double-check my work.
The only reason I am here is to make cash for a surf trip.
Come December, I am gone.
So you can stop worrying that I'm after your job or your "promotion " or whatever you and your micropenis are so afraid of.
Hi.
Archie Morris.
I have no idea who you are or what you're talking about.
Gotta bounce.
You good? Hey.
You're okay.
Got rid of all the pills you took.
Heather, we didn't take very good care of you last night.
I'm sorry for that.
Your dad's on a plane.
He'll be here in an about hour.
- Is Eliza-bitch coming too? - Who? His wife.
He married her after my mom died.
Eight months after my mom died.
She convinced him to move to New York and leave me here.
What do you mean, leave you here? She didn't want a step-kid.
So he visits.
Takes me out to lunch and buys me things.
But mainly he just pays people to tend to me " like" I'm a high-maintenance garden.
Why did you do it? - Why did you save me? - Heather.
I wanted to die.
Things will get better, I swear.
- Don't you have to get out of here? - Yeah, it doesn't start for another hour.
I can't believe you worked the overnight before the boards.
After a few years of getting no sleep, you get used to it.
No, not me.
I don't think I'll get used to it.
I hate nights.
- Always have.
- Here.
- And good luck today.
- Thanks.
He's unconscious and bradycardic, but he's still breathing.
So it could be a while before he actually Yeah.
I get it.
His mom's in shock.
I don't think she was expecting this.
But she knew that he had a fatal Today.
She wasn't expecting this today.
She thought they had more time.
Of course she did.
Serena, this is Julia.
She's a chaplain here.
Chaplain? Yeah.
I'm so sorry.
I can't do this.
It's not the natural order of things.
Do you wanna say a prayer? - No.
Okay.
Do you want me to say a prayer? No.
- Just a second.
Crap.
Med Staff office says you can't work tonight.
- Right.
See you.
- I'm serious.
- Banned until you deal with your charts.
- Excuse me, Frank.
Told them I was gonna sling you over my shoulder and carry you myself.
- Sling me over your shoulder? You're backed up six months.
Good.
You're here.
Bringing in a guy out of his head, combative.
- We could use the extra set of hands.
- Ativan? They gave him 10 migs already, hasn't touched him.
Abby, don't go out there.
I think Frank has a crush on me.
And go see the Med Staff.
They're bugging me about your charts.
- Nemo Lynch, 32.
- There's a snake! Ran through the water tower, jumped through a plate-glass window.
Sounds like PCP.
Twenty of ziprasidone, I.
M.
Got it! Whoa, whoa, whoa.
Hey, you need some help here? Moretti's got me triaging.
Don't worry about that, worry about keeping patients out of the door.
Vitals are stable, abdomen's non-tender, wounds look superficial.
Why is the ER calling for a surgeon? You're a great mentor.
That was a question.
Why does this guy need an ex-lap? Can't trust the exam if the patient's high.
You even listening to a word I'm saying? Can I ask a question? It's a little embarrassing.
It's better to ask rather than fake it.
I appreciate your attitude towards that, I really do.
It's reassuring to know that - Harold, sometime today.
- My girlfriend, Lacey.
- Her homecoming dance is coming.
- Homecoming dance? She's in the court.
Out of my league looks-wise.
But there's cachet in dating a doctor when you're still in high school.
- Your girlfriend's in high school? - A senior at Woodland.
Anyway, there are certain skills, expectations.
Certain rites of passage that a certain homecoming princess is gonna be counting on, you know? No, I'm not sure I do.
I've never been to the dance.
I don't know how to do the mambo or pin the corsage.
- Do you have any idea? - I didn't grow up in this country.
- I'm not sure I'm the best person to ask.
- Neela, help me.
I'm a virgin.
MORETTl: You guys all right in here? Get away, you freak! - You wrote the map of the skin! - We're doing just fine.
I will not be the conduit.
Sedation's kicking in.
Interns, your first-quarter evaluations are in your boxes.
- Find me if you want to discuss.
- Not a good time.
- Nobody told us we were tested.
- Every patient is a test.
Of your intellect, of your wit, of your organizational skills.
Get the snake! - Shut up! Hold still.
We're gonna get the snake.
Hear that? Every patient's a test.
And Sam just got an A this time.
Guess I spoke too soon.
I stole this from the G YN clinic.
- What? - I didn't "steal" steal it.
- I'll take it back just as - I'm not touching that.
Just go over the relevant anatomy.
Oh, come on, man.
Put that thing away.
No air under the diaphragm.
He's just so smug all the time.
Have you ever met anybody so smug? Let me guess.
Moretti? Every time, you guys are talking about the same thing.
Well, he's an ass, but I can't deny he's a smart guy.
C- spine is fine.
- Should I take off his collar? - No.
Upstairs.
This one's fun.
Get him up before sedation wears off.
- Here's everything you need to know.
- We're good.
Go.
He can't hear anything? He's had enough sedation to down an elephant.
Okay, so where exactly is the G-spot? Put that thing away.
Hey.
I hope you're on top of your game.
Boards tomorrow.
You're taking the hard cases.
- Why are you working before boards? - It's Morris', he's taking them too.
- Couldn't find anybody? - Nope.
And he swore that he would fail if I didn't bail him out.
But I'll do fine.
I test well.
- You hear from Luka? - Taking longer than he expected.
He has to retrofit his dad's house for a wheelchair.
This is completely unfair.
- Guy's clearly on a power trip.
Abby, check this out.
Four pages of categories: Procedures, patient relations, intellectual curiosity.
- Each rated one to five.
- He gave us ones across the board.
Is that good or bad? - Bad.
No comments, no feedback.
- Just ones.
- So uncool.
I'm never gonna get a toxicology fellowship.
That's not true.
- Are we supposed to learn from this? You have to talk to him.
Yeah, would you? Please? Frank, what's up with the lab? I've been waiting three hours for a CBC.
Something about a flow cytometer.
It'll be a while.
Oh, your kid's school called twice.
Alex biting off lizard heads again? Shut up.
He's not a sociopath.
That's right, ignore the problem.
It'll go away.
Well, it's too late, I have to call them tomorrow morning.
Mm-hm.
Hey, Sam.
You're supposed to be covering Triage right now.
- What? - Yeah.
Nurses rotate every two hours.
You're up.
Come on.
Excuse me.
- Yeah.
Hi.
- Hi.
Slamming the interns without giving any concrete suggestions isn't helping.
These numeric evaluations are useless.
Don't worry, Abby.
I gave you solid threes.
Listen, they're freaking out about the bad evaluations instead of focusing on how to improve.
- lllustrating my point.
- Which is what, exactly? Are they concerned about giving patients sub-optimal care? No.
They're worried about how it's gonna look They need mentors, constructive feedback, guidance.
They're just kids.
Arrogance and inexperience are a lethal combination.
- There's gotta be a more effective way - Abby, look, I understand " it's" your natural instinct to listen, to wanna be supportive.
But in the end, with Forget it.
Can't.
Excuse me.
Okay.
Ma'am, why are you here? He got a cough.
Oh, yeah? Let me see.
Hey, let me see.
Well, his breathing's okay.
I'll try to get you back as soon as I can.
Hello.
Sir, let me see your hand.
Let me see.
- Come over here.
Sit down.
Hey.
- Hey.
- Yes? I've been here.
This guy just walked in.
- Well, this guy's bleeding.
- Okay, well, my head is exploding.
- You look comfortable to me.
- Well, don't tell me what I'm feeling.
You get headaches a lot? Never like this.
All right, here.
Grab that.
I'll get back to you in a second.
Follow me.
- This place is gross.
- Well, you get used to it.
- What's your name? - Heather.
Heather, I'm Dr.
Gates.
This is Sam.
Sam, Heather here says she has an exploding headache.
Hm.
Let's get you checked out.
- Moretti have you working in Waiting? - All day.
He's doing that to all the Residents.
Well, I better get back.
Take a seat over here.
On a scale of one to 10, how bad is your headache? It's a 10.
You're pretty calm for a 10.
Yeah.
So you think I'm lying? - I have a high tolerance for pain.
- Where are your parents? I don't know.
Out.
Give me their numbers.
We need permission for any treatment.
Sam, you seen Pratt? He's in Exam 3 reducing a shoulder.
Are you on tonight? You mean "on" as in lively and invigorated, or "on" as in working? - What? - Morris.
- What are you doing? - I'm looking for you.
- Why aren't you studying? - I got too much nervous energy.
There's no way I'm gonna sleep.
I came in so we could study.
I took over your shift so that you could stay home.
Come on.
We can help each other get psyched, get focused.
Listen, if you're here, I'm out.
Dude, you need to work on your game face.
- What? - Game face, Greg.
What's wrong with you? Shrug your shoulders.
- Can I open my eyes now? - Yep.
Okay, the good news is your neuro exam is totally normal.
- But you have trigger points.
- Which means? It's tension.
You'll feel better with ibuprofen.
Aren't you gonna do a CAT scan? You don't need one.
Well, do one anyway.
We don't do tests just because patients want them.
Why not? It's a waste of resources.
Okay, well, make my dad pay, he's rich.
That's not really the issue.
You just said it was about resources, so - Is this your home phone number? - Yeah.
So when I call it, why do I get a video rental store? Video rental? I didn't even know those still existed.
That isn't funny.
My mom is dead, my dad is in New York.
And he doesn't need you guys bothering him, so Not that big a deal.
Six hundred of ibuprofen.
Get consent.
And give us his real number.
No more games.
That was so cool, defending us to Moretti.
Well, we were just discussing different teaching philosophies.
Yours is better.
There's no way I'm gonna present to him.
- You got a minute? - You can't boycott an Attending.
I can't? Come on, just for today.
Hanging out in Waiting is inefficient.
- Just get back out there.
- I should be here clearing beds.
A woman arrested in an ER waiting room because nobody was paying attention - Brian? - Hey.
MORETTl: What are you doing here? - Thirteen-year-old in respiratory distress.
Tony.
It's really bad this time.
I know this kid.
Got a neuromuscular disorder.
- I know him from ICU.
- Okay.
Hey, buddy, how you doing? - Pretty good.
- Yeah? Did you see D.
Lee hit for the cycle last night? No, I missed it.
Have to give me the play-by-play.
- Pulse ox is only 78.
Let's go.
He needs oxygen.
Sam, you're with me.
Where we going? Trauma 1.
- Brian, wait right here.
I'll be back.
All right, let's set up a non-rebreather and let's get an ABG going.
Find someone else to cover Triage.
I'm staying with this kid.
MORETTl: He left? What do you mean, he left? He was here and then he was gone.
- Is that clear enough for you? - Did he say where he was going? Frank, where's the Crohn's fistula? Ask me again in English.
Never mind, I found her.
Do women need additional lubrication? Harold, get a consult form.
If you're willing to put in the time to sufficiently stimulate the area Isn't there anyone in your life that would be more appropriate for this? Like a brother, uncle, anyone? No, just Grandpa.
And he thinks I still believe in the stork.
Is there anything special I should know about the Crohn's lady? She's narcissistic, she's addicted to "morphine " " and" if she says that she's allergic to NSAIDs, she's lying.
Thanks for the warning.
Excuse me.
I'm looking for you.
Dr.
Moretti, I'm Skye Wexler, new Attending.
We spoke on the phone.
Yeah.
I didn't realize you were starting.
- Yeah, tonight's the night.
- All right.
Follow me.
When you Write your initials in this column when you pick up a patient.
And chart any progress in this column over here, okay? Frank.
Sorry, this is Dr.
Wexler.
She's gonna be taking some shifts over the next month or so.
And this is one of our lifers, Haleh.
Hey.
- Hello.
- Hi.
You new to Chicago? Doing locums to make some extra cash.
Locums? Yeah, it's like moonlighting.
Mostly nights.
- Ah.
That's when I work too.
- Oh.
Yeah.
Much better than being stuck in a hospital all day when it's beautiful outside.
I hear you.
I'm a big hiker myself.
You bump your head? Hang in there, Josh.
I'm almost done.
ABG's back, 7.
18.
CO2, 66.
Yeah, he's retaining.
- What does that mean? - It means he's tiring out.
You try breathing 50 times a minute.
You're gonna have washboard abs after this.
Art line's in.
So we can check your blood gases without needles.
See this shadow? - Yeah, is that fluid? Yeah, most likely aspiration pneumonia.
His muscles are weak.
It's not protecting his - Airway.
- Right.
I never should've let you go to that Kelly Clarkson concert.
That's not why I have pneumonia.
Did she just say Kelly Clarkson? - Problem? - Good thing you're sick.
I'd be giving you so much crap.
Kelly Clarkson? Hey, Sam.
Gram of ceftriaxone, liter of NS.
- Which one of you is Pratt? - That would be him.
Hey, Skye Wexler, new Attending.
I'm doing overnights.
- Nice to meet you.
- Call Hopkins.
We're supposed to report ER visits to the study coordinator.
Boards tomorrow.
- Yeah.
I'll hang here so you can study.
Really.
Go.
- Gates, you good with this? Yeah.
All right, buddy.
We'll get you feeling better soon, okay? Looks like you're stuck with me, Josh.
Let me take a look at the film.
Here.
Your feet must be tired.
This hospital bites.
Been here hours, nobody's done anything.
We get busy.
- What are you doing? - Trying to find someone who gives a crap.
Yeah, well, those computers are for staff only.
Go back to your bed.
Okay, did you hear me? I have chest pain.
And it's really, really bad.
I'll get someone to check you out.
MORETTl: How's the boy doing? - Struggling, headed for a tube.
- So, what are you doing out here? - The new Attending came and said - Wait, wait, wait.
You left a patient in respiratory failure with an untested Attending you've never met? - Oh, well, I - I'm kidding.
I sent her in.
- Okay.
Thanks.
- Hey, doctor.
Check me out.
Hey.
What happened? There you are.
You show up out of nowhere and then suddenly you disappear.
- How you doing? - Good.
You seemed busy.
I didn't wanna get in your way.
Is everything all right? You look like hell.
No, I drove all night, so - Oh.
- Yeah.
Dr.
Pratt, I'm sorry, this is Brian, my son.
- Oh, really? Hey.
- Yeah.
Yeah.
Aren't you in college on the East Coast? MORETTl: Yes, he is.
- Yeah.
And now this is the part where you tell me why you're not in "school " " and" you're here visiting me at work.
- What's that? - Happy birthday.
You drove all night to give me a book? No, it's not just a book, not just a book.
It's like a new way of thinking.
Really? All right, well Remember in college you got so excited about everything that you learned? Come, let's get out of here.
You look like you haven't eaten in a week.
- Okay.
- Hey, Skye has my sign-out.
All right.
- Okay.
It's the natural course of Fazio-Londe disease.
The respiratory muscles aren't strong enough to clear secretions.
So there are no other options.
This is Dr.
Bazzano from Pediatric Neurology.
Hi, Joshua.
- You're his mom? - Yeah.
Acidosis is worse.
So listen up, buddy.
Your muscles that help you breathe are starting to get tired.
Tell me something I don't know.
So we're gonna have to put a tube down and that will breathe for you.
Oh, God.
The ventilator's temporary.
His muscles rest so the antibiotics do their thing.
And after the pneumonia's treated, we can take the tube out? Well, that's the hope.
Okay.
It's gonna be okay.
We talked about this possibility.
I have to run upstairs.
I'll see you guys up in the ICU.
Thanks, doctor.
Do you understand everything? Yeah.
- Mom.
- Yeah, honey? The situation demands a Slushee.
Josh, sorry, but you gotta be NPO.
Come on.
Let's give the kid a Slushee, huh? You can live with that, huh? Sweet.
Okay.
Where do I? The Jumbo Mart.
My kid loves them too.
It's across the street.
Come on, I'll take you.
Be right back.
Good catch.
You're not tubing me.
Headache's gone.
Now it's chest pain.
EKG was fine, exam was normal.
Did you do a Beta HCG? Could explain this whole thing.
Keep her on oxygen, call if she has sustained decels.
Abby.
HCG? Oh, yeah.
It was negative.
I have to check on a sick asthmatic.
- Oh, that's cool.
I got this.
- Okay.
Hey.
I'm Dr.
Wexler.
I'm in charge tonight.
Lucky you.
Deep breath.
- I can't.
- You can try.
Again.
Well, your heart and lungs sound good.
Oxygen level's perfect.
Better keep looking, then.
Your pain can't be that "bad " " if" you're able to text your friends all through my exam.
I'm not texting.
I'm trying to get online.
Reception in here sucks.
Is there a computer in here I can use? Do you know where Pratt is? I can't find him anywhere.
- Try the break room.
He's studying.
- Thanks.
Sorry.
You were saying? Just forget it.
Never mind.
Of course we have the grand old dame of cramming, caffeine.
Grand old dame? Three hundred milligrams, baby.
Keep our engines nice and revved.
Oh, and this.
Okay? This.
This is the silver bullet.
If you get stuck on the test, squeeze this, the answer will come.
Hey, I don't need any good-luck charms.
You can't reject a good-luck charm.
That's like the opposite of good luck, as in bad luck.
Don't believe in luck.
I believe in preparation.
And I'm prepared.
Whoa, what's all this? We got boards tomorrow.
Yeah, and how exactly does this fit in? Something to perk us up when our stamina flags.
Do you guys mind if Harold hangs for a while? He could benefit from your tutelage.
No, we have too much ground to cover.
If you don't know it, this isn't gonna help.
That's not true.
Studies have shown that cramming can improve short-term performance.
See? Have a seat, Harold.
Oh, excellent.
Great guys.
Smart, experienced.
So, what topics do you wanna cover? Just some basic fundamentals.
No appetite? Dairy is pumped full of hormones, and wheat is genetically modified.
Right.
Okay, I'll try to find you some organic Jell-O.
Urine aminolevulinic acid is elevated.
Suggests a problem with porphryin metabolism.
She does seem to have a serious fear of food.
Acute porphyria can be brought on by caloric restriction.
Well, see, it fits.
Hematology said to order an erythrocyte enzyme assay.
Okay.
Cool case, Grady.
But make sure I keep moving other patients through.
- Okay.
Hey, Abby.
- Hey.
- How is everything? It's better.
Much better.
- You been going to meetings? - Yes.
Okay, because I haven't seen you.
Well, the last couple of times, I worked late.
So I couldn't make it to St.
Mark's.
Oh, I see.
And I kind of wanted to go somewhere where nobody knew me.
Hm.
Why is that? I don't know.
Look, the church on Franklin's got meetings all hours, day and night.
Okay.
Thanks.
That's good to know.
When your infection clears, capacity will improve " and" they'll take the tube out.
Be real.
I'll never get off the vent.
Don't say that, Josh.
I've been thinking about this moment continuously since I got my diagnosis.
No tube.
So that's it? You're just gonna give up now? And I need to make it look like it's your decision.
What? It would kill my mom if she knew this was my idea.
I promised her I'd fight.
So fight.
They're doing research on neuromuscular diseases all over the world.
It's not gonna help me.
They could come up with a breakthrough.
They're years away from a cure.
Whether we like it or not, this is happening.
My mom can start getting over it now " or" a year from now when she's given up everything to be by my bed while I wither away on a ventilator.
Josh.
Tony, you get me.
I know you understand.
He's a bright kid.
He knows what's in store.
Intellectual understanding isn't the same as emotional maturity.
No, I know him.
He understands what he's doing.
You're absolutely sure about this? Yeah.
Okay.
Do me a favor and run it by Ethics.
You can tell them your Attending's on board.
Thank you.
Hey, Sam.
- It is Sam, right? - Yeah.
Could you give our asthmatic in 2 I already did.
Part of Moretti's new protocol.
You don't need orders if the patient meets criteria.
Efficient.
I like it.
- Could I take a look? - Sure.
Hey, Frank, do you have the asthma flowchart? Hey, kid.
This is a hospital, not an Internet café.
What's wrong with you? What is wrong with you? I called your dad.
Somebody's on their way to get you.
You shouldn't have.
He didn't wanna be bothered.
- Of course he does.
- How can you say that? You don't know him, you don't know me.
- I'm a parent, I understand a parent's - Oh, shut up, you phony bitch.
It's "like " It's already after 3 and I think it's about time we go to bed.
No.
I think it's time we opened another bottle of champagne.
Here.
Really? Did I tell you I'm taking a course on the history of wine? - No.
- I know, I know.
It sounds like major slacker territory, huh? But it's actually this awesome survey of Western civilization.
There's the Last "Supper " Spanish Inquisition, Yalta Conference.
You name it, somehow wine was involved.
- Yeah, well, wine is - Oh, I switched my major.
To semiotics.
A degree in the meaning of meaning.
I mean, could there be anything cooler than that? No, I don't But, Brian I know what you're gonna say.
I know.
I don't wanna be premed, Dad.
I thought you were cool with that.
No, I am.
That's not - Why are you here? - It's your birthday.
All right, but what's the real reason? I remember when I was in fourth grade you showed up, and you said It was right before lunch.
And you said "We're gonna go on this secret surprise mission.
" That's what you said.
And I remember looking out the window of the car, just I'm thinking, I'm wondering, "Where are we gonna go?" And that, I just I swear, that was just one of the That was the most exciting moment of my life.
The time we went ice fishing? Yeah.
It was you and me and the lake.
And I just I just wanted to thank you.
Thanks for that.
Thanks.
You're welcome.
I'll call school.
They can send a new syllabus to the ICU.
Thanks, Mom.
Sat is 81.
You guys ready? Actually, we're gonna hold off.
What do you mean, hold off? - We're not intubating.
He won't tolerate the pressure generated by the ventilator.
- But I thought you said before I have new information.
The clinical picture's changed.
What kind of new information? Are you on board? Dr.
Gates and I have discussed the options at length.
You think this is such a good idea on your first night? I've been Attending for 10 years.
I don't understand.
This wasn't the plan.
- Well, we have a different plan now.
But he's in respiratory failure.
We'll give him medicine to keep him comfortable take away the air hunger.
- Tony, no.
- Trust him, Mom.
Okay.
How's your new interns doing? Uh, overzealous and inexperienced, but they seem like an okay bunch.
Well, I had to send mine to man camp today.
So I wake up the next morning and I look over and that best-in-show hottie from before big, hairy mustache.
And that, lads, is why drinking is bad.
You have your noses to the grindstone.
Yeah, well, we got a little distracted.
It's only 4:00.
The night is still young, huh? Go, go, go.
Go, go, go.
Go, go, go.
Harold, I need you upstairs now.
But we were getting to toys and accessories.
It's not an invitation.
Paranoid chemical lady in 2 dropped her pressure.
All right.
Come on, party's over.
Come on.
Whatever advice they gave you you must forget it immediately.
- Most of what they said made sense.
- God, what did they tell you? Well, Morris said the greatest sex happens when you're in love.
- Oh.
He did? - Yeah.
Pratt talked about how to keep the lines of communication open.
You're joking.
I still do have some unanswered questions, though.
Do two orgasms 40 minutes apart still qualify as multiple? Pulse ox is 84.
It's progressive.
There's no cure.
He has the right to stop.
- His mother, doesn't she have rights? - My obligation is to my patient.
- Josh doesn't want his mom to know.
- He's 13.
People make bad decisions.
Laying in a bed hooked to a ventilator is not a life.
He can think, communicate.
Maybe he's around when they discover a cure.
He doesn't want to lay in bed waiting for a miracle.
What part of that do you not understand? We're not intubating, Sam.
What are you doing? - Who's on call for Ethics today, please? - It's Larabee.
- I'm not gonna sit - All right, stop! This is my call.
Either go mix his morphine drip or take yourself off this case.
We're done here.
Suction.
She had headaches, abdominal pain, rash, mood swings.
Tube.
Porphyria seemed to explain all her complaints.
Okay, I'm in.
Pass me the bag.
- Nice job, Abby.
- Yeah, Abby.
Real nice job.
You and your intern spent hours working up a zebra without ruling out common causes for abdominal pain.
X- ray's back.
Air under the diaphragm.
Probably a perfed ulcer.
Which might not be perfed if you had diagnosed this four hours ago.
O.
R.
3 is ready.
Haleh will help you get her upstairs.
All right, that's it, you two, okay? I got this.
Sats coming up.
What's her access? Did you send the coags? Yep.
They're cooking.
Gotta have them done.
Flagyl's running.
I'm sorry.
I went down the wrong path.
You got excited about your hypothesis.
It's fine.
It's good.
This is my fault.
I'm supposed to know better.
Excuse me.
I'm here to pick up Heather Baker.
- Are you family? - I oversee the Chicago property.
I have a letter which allows you to release her to me.
I don't know where she is.
And I'm busy.
Gonna have to wait.
Well, I've been waiting almost an hour.
Sorry.
I have a kid who needs the wax cleaned out of his ear.
I'm a little tied up now.
And if you could pull up the troponins for our rule-out MI.
I don't have a password for the computer yet.
Lily.
Lily.
Take this to Gates.
Heather! Stop! Heather, stop! No, I don't want this.
- Hold still.
You're making this harder.
- Hypoxia makes people combative.
She was here alone with vague complaints none of us wondered why.
- Kept changing her story.
She's calming.
That's the valium.
Next she's gonna stop breathing.
Eighteen gauge in the antecube.
- Give the flumazenil.
- I totally missed it again.
- Yeah, I saw her too.
I blew her off.
Big occipital lac back here.
I knocked her down hard.
She cracked her head.
Page Psych.
They need to come see her.
- NG's in.
Tape.
Placement's good.
Charcoal.
Fifty grams.
Yeah.
Here goes.
I thought she was playing games.
I should've seen it.
You saved her life, Sam.
Don't be too hard on yourself.
Hey.
- Hey.
Thank you.
What can I say? - I overreacted about the ulcer.
- No, you didn't.
It happens to everyone.
And she did great in the O.
R.
How do people do this? Working with interns is always tricky.
It's hard to supervise without micromanaging.
It's not just the interns.
It's everything.
Some guy shoved me on the El today and I lost it.
I followed him off the train screaming even though it wasn't my stop.
I also fired the nanny, which is totally irrational.
Joe's fall had nothing to do with her.
I couldn't look at her without thinking about it.
- That's understandable.
- No, it's not.
It's like I'm actually trying to screw things up.
- It sounds like you need a day off.
- I wish it were that simple.
Anything I can do? Do you mind if I sign out a little early? Sure.
Thanks.
I finished the brow lac on the carpenter.
Wow, that was fast.
Didn't need a two-layer closure? Actually, Dr.
Morris just had me Dermabond it.
Oh, okay.
And how's our gastroenteritis girl doing? Is she keeping Gatorade down? I didn't end up pushing "fluids " because Dr.
Morris said to just go ahead with the bolus.
I saw Ortho down here reducing that shoulder.
- How much ketamine? - I ended up using propofol because Dr.
Morris Well, he decided that it "wasn't " - Morris.
- What? What? Jeez.
I ask for Benadryl, patient gets Atarax.
I order a splint, kid gets an ace.
What kind of creepy loser hangs out in the break room all night second-guessing Attendings when he's not on schedule? I don't know if I'm being punked or if you haze all new Attendings " but" don't double-check my work.
The only reason I am here is to make cash for a surf trip.
Come December, I am gone.
So you can stop worrying that I'm after your job or your "promotion " or whatever you and your micropenis are so afraid of.
Hi.
Archie Morris.
I have no idea who you are or what you're talking about.
Gotta bounce.
You good? Hey.
You're okay.
Got rid of all the pills you took.
Heather, we didn't take very good care of you last night.
I'm sorry for that.
Your dad's on a plane.
He'll be here in an about hour.
- Is Eliza-bitch coming too? - Who? His wife.
He married her after my mom died.
Eight months after my mom died.
She convinced him to move to New York and leave me here.
What do you mean, leave you here? She didn't want a step-kid.
So he visits.
Takes me out to lunch and buys me things.
But mainly he just pays people to tend to me " like" I'm a high-maintenance garden.
Why did you do it? - Why did you save me? - Heather.
I wanted to die.
Things will get better, I swear.
- Don't you have to get out of here? - Yeah, it doesn't start for another hour.
I can't believe you worked the overnight before the boards.
After a few years of getting no sleep, you get used to it.
No, not me.
I don't think I'll get used to it.
I hate nights.
- Always have.
- Here.
- And good luck today.
- Thanks.
He's unconscious and bradycardic, but he's still breathing.
So it could be a while before he actually Yeah.
I get it.
His mom's in shock.
I don't think she was expecting this.
But she knew that he had a fatal Today.
She wasn't expecting this today.
She thought they had more time.
Of course she did.
Serena, this is Julia.
She's a chaplain here.
Chaplain? Yeah.
I'm so sorry.
I can't do this.
It's not the natural order of things.
Do you wanna say a prayer? - No.
Okay.
Do you want me to say a prayer? No.