ER s15e09 Episode Script
Let it Snow
GATES: Oh, your lasagna was amazing.
Really good.
Yeah.
In fact, we all had seconds.
Yeah, they're hitting the books.
You make it there okay?.
Don't have to send out a rescue party?.
No, but I can use a yak with a cask of brandy.
GATES [OVER PHONE.]
: I'll see what I can do.
-Did you get any sleep?.
-Maybe three hours.
SAM: Go to bed early.
And give Alex a big hug and kiss from me.
Hey, Alex.
Your mom says good night.
-Night.
-That's the best you' re gonna get.
SAM: See you in the morning.
All right.
Have a good shift.
Bye.
ALEX: The contractile vacuole of the paramecium excretes excess water regulating osmotic pressure.
I knew that once.
How's the English paper?.
In spite of a terminal illness, Johnny Gunther lives with passion emphasizing the theme of living like there's no tomorrow.
I hope you can back that up with specifics.
Are you gonna let us go to that party?.
-Didn't we talk about this?.
-It's Friday night.
Y eah, and tomorrow you wanna go to Alpine Valley because you wanna go snowboarding for the weekend.
-lt-- Besides, it's a blizzard out there.
-It's only five blocks away.
-We'll walk, and we'll be home by ten.
-No.
We all made a deal.
Homework.
[ALEX SlGHS.]
BRENNER: Migraine headache?.
-Just got imitrex.
Slip and fall?.
Broken coccyx, wife's coming to pick him up.
Yeah?.
Don't count on it.
Already a foot on the ground.
-Jumbo Mart's closing early.
-You are a snow angel.
And that, my friends, is the board.
-Wow.
Your day was pretty quie-- -Hey, hey.
Do not say the ""Q"" word.
You can think it, but you can never say it.
Okay, well, if it stays, uh, not busy, we'll do a suture lab with pigs' feet.
-Hmm.
Guess I'll have to miss that one.
-No.
-Kaya's snowed in.
You get to stay.
-I was up until two last night.
-I didn't leave Tracy's until almost four.
-I got an extra one.
-Can't we get somebody else-- -Take it like a man, Grady.
Oh, uh, Banfield's stuck in Omaha at an ACEP conference.
She wants you to cover her day shift tomorrow.
-No.
She got, like, twelve hours to try-- -Yeah?.
Take it like a man, Brenner.
Were you aware that Mrs.
Mendenhall complained of red stools?.
-lt wasn't discussed.
-Dr.
Wade tried to bring it up but you told him to ""stick to the thyroid.
"" Do you recall that?.
The patient was here for a routine elective surgery.
Didn't Dr.
Wade have important information?.
NEELA: In retrospect, yes.
Is it your standard practice to cut off an intern's presentation?.
It is when we have an hour to round on fifty patients.
-Being busy is an excuse for negligence?.
-Objection.
Lacks foundation.
Did you know that your intern went to the family and admitted fault?.
Assumes facts not in evidence.
Dr.
Wade had the moral fortitude to be honest with the family.
Objection.
Argumentative.
-Dr.
Wade lacks experience.
-I advise my client not to answer.
How long does it take to lose integrity?.
This is a teaching hospital.
We are overwhelmed.
We have the added burden of training young doctors.
T o get through the day, we have to rely on interns.
It's not perfect but it's the best we have.
-Things can fall through the cracks.
-I said we need a recess.
Fine.
REBACK: You are not following my instructions.
I need to explain what happened.
No.
You need to keep your mouth shut.
Answer ""yes,"" ""no,"" or ""l don't know.
"" Be a good girl and you won't lose your medical license.
[MAN SPEAKlNG lNDlSTlNCTLY ON TV.]
ARNlE: There you go.
-Oh, I'm sorry, uh, I didn't order a-- A Bahama Mama.
Courtesy of the gentleman at the end of the bar.
Take the drink back, thank the gentleman -ask him to leave me alone.
-I can't do that.
-Why not?.
-He was very insistent.
[SlGHS.]
NEELA: I was in there for four hours.
That is a long time on the hot seat.
It was ridiculous.
I came across like a fool.
That's to be expected.
Their job is to discredit you.
They're good at it.
After that, even I think I'm incompetent.
You're not.
Take a break and I'll, uh-- I'll keep the surgical consults to a minimum.
You're being nice or you don't want me touching your patients.
-Simon, can you re-assess our fever girl?.
BRENNER: No problem.
Uh, if you don't mind, can you check on the interns in the break room?.
-Temp's down, no source.
-She needs a catheterized urine.
That can be a little traumatic.
How about conscious sedation?.
She might stop breathing or drop her BP.
-It's too risky for a simple procedure.
-You sure?.
Sam, T ony called, I couldn't find you.
REPORTER: With two feet of snow predicted authorities say to stay indoors.
FRANK: Chicago, I hope you' re listening.
NEELA: Hey, Chaz.
-Hey, Neela.
Frank.
Surprised you made it in.
I'm dedicated.
Supposed to observe every Friday night.
You can observe a drunk sleeping it off in Exam Three.
Or you can help me with the Christmas decorations.
There's nothing going on.
You may as well go home.
Now that I'm here?.
-I mean, I was lucky to make it this far.
NEELA: Good point.
Stay subcuticular through the flap but distal to the tip.
-Half-buried vertical mattress?.
-Yeah.
-Uh-huh.
-Looks good.
So, dude, what was up with you and Dawn last night?.
-Nothing.
-Nothing?.
You were slow dancing.
-lf you can call that dancing.
-Where was your wife?.
We couldn't get a babysitter.
Look, Dawn got drunk-- You guys go to lke's last night?.
-There was a party.
-Oh, really.
I didn't hear about it.
At Tracy's.
Just for the interns.
-And the nurses.
-And a couple of residents.
REPORTER [ON TV.]
: --as the storm moves across the central plains we 're well past Omaha 's previous record snowfall of 27 inches set in March of 1960.
-Mm, you sure you don't want some?.
-Positive.
[SlGHS.]
Last time I saw you was at registration.
I thought we were in the same classes.
It's like you've been avoiding me for three days.
-Y eah, l, uh, changed my schedule.
-Okay.
Can you believe every flight's been cancelled?.
And now, every hotel room in town is booked.
Yes, I know.
Listen, um, what we talked about that time in the break room.
Y eah, I had a very bad day that day.
You know, if there's ever anything more you wanna discuss.
-l-- I'm a very private person.
-I understand that.
-lt would be between you and me.
-I have a lot of reading to do.
[MORRlS SlGHS.]
They say the storm'll pass by morning.
Figure the airports will open up by noon.
BUDDY: You know, folks, it might be a little cold outside but we are gonna warm it up with a trip to a little place I like to call ""Kokomo.
"" [MlD-TEMPO BEAT PLAYlNG ON SYNTHESlZER.]
[SlNGlNG THE BEACH BOYS' ""KOKOMO"".]
[SlNGlNG.]
Well, he's not too bad.
Hey.
You know what?.
Good music, good company, good booze.
This could be an okay night.
Aah.
Things were slow in the O.
R.
I borrowed a nitrous setup.
-Are you sure it's safe?.
-Very.
Sam, are we authorized to use this?.
Dental assistants use this stuff like water.
They don't have monitoring capabilities.
-ls there a problem?.
-[lN UNlSON.]
No.
-All right, we're good to go.
-Very cool.
Why don't you use it down here all the time?.
-Good question.
-All done.
-She didn't even flinch.
CHAZ: I'll go run it to the lab.
She'll be awake in five minutes.
-Thank you.
-Mm-hm.
Nice work.
I'll, uh, get ready for the traumas.
Hey, everybody.
How are you doing?.
Can I have your attention please for a second?.
Uh.
[COUGHS.]
Is there a doctor in the house?.
[LAUGHS.]
I know you're all doctors.
Uh, well, you know, we're-- We're gonna be here all night uh, might as well get to know each other.
All right?.
I'm Archie Morris, from County General in Chicago.
And, uh, you know what?.
Why don't we-- Why don't we go around?.
Okay, we'll go around, tell us your name, where you're from, maybe.
Maybe a story of your funniest ER patient?.
Whatever you want.
Who wants to go first?.
Okay, I'll start.
I'll start by introducing my colleague, the chair of our department.
The very beautiful and talented Dr.
Catherine Banfield.
-Anything you wanna share, Cate?.
-Not really.
You know what?.
I'll be honest.
She has a reputation of bit of a hardass.
Does your boyfriend need another beer?.
He's not my boyfr-- Give me a refill, please.
Make it a double.
You know, deep down inside, she really, really, really cares.
Ah.
[SlREN WAlLlNG.]
-Did you ever call Gates back?.
-Oh, man.
-Good thing I'm here.
-Teenage girl, full arrest.
SAM: What took you guys so long?.
Waiting on the damn snowplows.
Her name's Ashley.
Back seat passenger, car versus utility pole.
She was ejected through the rear window.
Very drunk.
-Did she ever have a pulse?.
-No.
-ls that grey matter?.
-Looks like an open skull fracture.
One, two, three.
-Asystole on the monitor.
NEELA: Resume compressions.
SAM: What do you guys want?.
-Blunt trauma, no vitals.
-It's not an indication for thoracotomy.
DAWN: She's so young.
Let's try and fix anything reversible.
Pneumothorax, tamponade.
NEELA: Bilateral chest tubes, pericardial tap and four units of O-neg.
-Patient number two is here.
-At least they're not doing CPR.
-Grady wants a nurse.
-We're a little busy.
DAWN: We got this.
-You go check it out.
-You tell us what they need.
SAM: Fine.
SAM: What's the story?.
Driver with altered mental status chest trauma and a bad shoulder dislocation.
What's your name?.
Come on, tell us your name.
[GROANS.]
Portable C-spine, chest, pelvis, and left shoulder.
[GASPS.]
SAM: Alex?.
-Alex?.
Alex.
ALEX: Mom.
-Call her parents?.
-Left a voicemail.
-The cops should go to her house.
-I could use a thoraseal.
Be right back.
-l' m in, bag him.
SAM: T ony, wake up.
Alex snuck out of the house.
He was in a car crash.
You need to check on Sarah.
-Not much blood in the chest.
-Let's get O-neg and a vent.
-You ready for the reduction?.
-Soon as we tape this in.
DAWN: Sam, I can take over in here.
-No, I'm okay.
-Suri can do it.
SAM: She's got another trauma.
I'm not going.
Let's fix this before his paralytics wear off.
-Come back as soon as you're done.
-Ready, steady, pulling.
-Uh, the humeral head is stuck.
NEELA: Okay, let's try again.
I'll give you direct pressure.
Go for it.
[EKG BEEPlNG.]
-No, won't budge.
I'll get skin hooks.
SAM: Labs are ready.
-Trauma panel, type and cross for four?.
-Blood alcohol level.
No, he doesn't drink.
HOLLlS: Is the girl gonna make it?.
-Pretty unlikely.
-How about the boy?.
-T oo soon to tell.
LAVERNE: Back seat passenger, drugs and alcohol.
LEO: I gotta see her.
Where is she?.
-Titrate, Ativan and get a head CT.
-Also has a sternal contusion.
-EKG and chest X-ray.
-Where did you put her?.
-T ry to relax.
-l' m right here, Ashley.
SAM: No.
No, that's not a good answer, I wanna talk to your supervisor.
BRENNER: Skin hooks.
Blood bank is out of O-neg.
Red Cross can't deliver.
-He's got a good crit.
-For now.
What is up with O-neg?.
We have multiple trauma victims what do you expect us to do?.
-We should get Dawn in here.
SAM: Uh, send O +.
The patient is a male, that'll work until we get the cross match.
Pulling.
-Ugh NEELA: There you go.
[EKG BEEPlNG.]
-Got a pulse back at the wrist.
-Shoulder immobilizer and right to CT.
I got the lifepak, and O2 tank is full, the chest tube's on water seal.
Okay, I'll go check on Grady.
-I'll help you with the sling.
-I think I've got it.
I got a little musical game that we're gonna have some fun with.
And the hotel has generously donated prizes to all the winners.
Stuffed mushrooms and, uh, potato skins.
Your choice.
Okay?.
Y eah.
You guys ready?.
Okay.
[SlNGlNG ""LET lT SNOW"".]
No winners yet.
[CONTlNUES SlNGlNG.]
Stop.
[CROWD LAUGHlNG.]
Let it stop.
Make it stop.
[LAUGHlNG.]
[APPLAUSE.]
Whoo! Stranded in Omaha in the dead of winter listening to lame-ass music.
[CHUCKLES.]
Does this suck, or what?.
[LAUGHS.]
You know what?.
-Dermatology gets to go to Maui.
-I know.
Radiology to Acapulco.
I mean, just like always, ER gets no respect.
Uh-huh.
We bust our asses, taking care of people that no one else wants to touch 24/7.
We deserve better.
[CHUCKLES.]
[WHlSPERlNG.]
Do you think we deserve better?.
[CROWD CHEERlNG.]
[LAUGHlNG.]
[ROCK MUSlC PLAYlNG.]
Ready and switch.
No tension pneumo, no effusion.
-Did they ever find the parents?.
-Two more units, then call it.
DAWN: Faster and deeper, Ryan.
-How's the CT?.
-Good news.
-Abdomen's benign, no brain bleed.
-But he's won't wake up.
-Give him time.
-My God.
I was trying to triage her, she wouldn't wait.
Are you okay?.
Broken wrist on the right.
I need to get back out there.
BRENNER: Prep a subclavian on the right.
-How is he?.
-How does he look, huh?.
-Were you drinking?.
-No.
-A little.
But he wasn't.
BRENNER: Sam.
You were supposed to be home studying.
-We were.
SAM: You snuck out.
-lt wasn't like that.
-He has got a learner's permit.
He needs an adult in that car.
Ashley was too drunk to drive, he was trying to help.
You can't call Tony, or you can't call me or a cab?.
-What the hell is wrong with you, Sarah?.
-What's wrong with you?.
Uh, I need a thin wall, not a 25, Sam.
-You got this?.
-Yeah.
Okay.
Let's check you over, Sarah.
I wanna stay here.
We'll be back in a few minutes.
Come on.
[SlNGlNG JOAN JETT'S ""l LOVE ROCK N' ROLL"".]
[ALL SlNGlNG.]
[ALL CHEERlNG.]
Dude, you've got the coolest boss in the whole world.
Whoo.
How y'all doing?.
Why don't we get Archie up here so we can do a duet?.
CROWD [CHANTlNG.]
: Archie, Archie, Archie.
Yeah, give him some love.
Yeah, give him some love.
Yeah, give him some love.
CROWD [CHANTlNG.]
: Archie! Archie! Archie! [CHUCKLES.]
Hi.
Whoo.
[LAUGHS.]
-What do we wanna sing, huh?.
-I don't-- -""White Christmas?.
"" WOMAN: Yeah.
[GRUNTS.]
I don't think so.
[ALL LAUGH.]
""Freebird.
"" ""Freebird! "" [CROWD CHEERlNG.]
You know ""Walk This Way""?.
[ALL CHEERlNG.]
You know ""Walk This Way""?.
All right.
Whoo.
Tell you what, guys.
Uh, we-- We are gonna ""walk this way"" because I think the show is over.
I'm sorry.
I know.
Let's get you some coffee.
Let's get you some coffee.
However, A-- ACEP rocks, I mean it.
It's, uh-- You okay?.
[SHOUTS.]
[ALL CHEERlNG.]
Good-- Goodnight, Omaha.
[EKG BEEPlNG.]
Hold compressions.
-Asystole.
-That's it.
One fifty-seven.
I'll get a shroud.
I'll clean her up.
Let's move her to the suture room.
Tidal volume 5OO, AC 1 4, turn him down to 8O percent.
You called it?.
BRENNER: Crit's good, 41.
Blood alcohol level is zero.
He wasn't drinking.
GATES: Sam.
CT's were all good.
Small hemothorax and a bad concussion.
Dawn, this ET tube can use a little suctioning.
You wanna step out?.
-Sarah's here.
She's getting a cast.
GATES: Yeah.
I know.
Things seem stable in there.
[SAM SNlFFLES.]
How are you doing?.
He was driving some drunk girl's car.
She just died.
[SHUDDERS.]
And I don't know if he's gonna wake up.
I'm sorry.
I shouldn't have given in to them.
What are you talking about?.
I let them go to the party.
You what?.
I tried to call you.
No.
No, no.
We are not doing this now.
Sam.
[RETCHlNG.]
MORRlS: All right.
All right.
There you go.
Now you're gonna feel a whole lot better.
All right?.
Well, I hate to say this, but there's a lesson here.
[GROANS.]
Yup.
Red wine and scotch don't mix.
You gotta remember that.
-You okay?.
Wanna take a little rest?.
-Hmm.
Let me know when you're ready.
[GRUNTS.]
[GROANS.]
[MORRlS TAPPlNG FOOT.]
Sorry.
[MORRlS SlGHS.]
You know my dad was born in Lincoln, not too far from here.
When I was little, he used to drive us to my grandma's house.
I remember the ride took forever.
And he'd-- He'd yell at me for kicking the back of his seat or getting crumbs on the floor, or breathing too loud.
[CHUCKLES.]
That was my dad.
Yeah.
You know, he, uh-- He died last year.
We hadn't spoken in years.
He's got this storage locker in lndiana.
[MORRlS SlGHS.]
They can either trash it or I can go deal with his stuff.
It could be a complete waste of time.
Or maybe I'd learn something about a father I didn't really know.
-Ortho can take Alex in an hour.
-No problems, his vitals are stable.
Dr.
Brenner, Leo's positive for opiates, benzos and marijuana.
-Okay.
-How about, um, aspirin and Tylenol?.
We sent them.
None detected.
See that?.
I get attitude from all the interns.
Maybe they don't like you picking on one of them.
You mean Andrew?.
We've worked through that.
When I was an intern, I was friends with my residents.
-You're more like an attending.
-I don't feel that way.
You make them nervous.
You showed them some teeth.
Man, no one's delivering pizza in this snow.
How can you be hungry at a time like this?.
-You still gotta eat.
-I may have to nuke the pigs' feet.
-Has anyone seen Trauma Two's chart?.
-Right here, Dr.
Rasgotra.
-Oh, Brenner, I got family in here from-- LAVERNE: I need some help, here.
[SlGHS.]
Wait a minute, Chaz.
-Weren't you with that Ashley girl?.
-Yeah.
-Somebody has to talk to her brother.
-I'm supposed to observe.
I've been stalling him for an hour.
You're all I've got.
This is Chaz Pratt, he's one of our student doctors.
Where's Ashley?.
[SlGHS.]
-You two are the brothers?.
-No, just Tyler.
-And you are?.
-The babysitter, I guess.
Tyler was supposed to hang out at my place until midnight.
Two hours ago.
The little guy was freaking out so I brought him in.
-Can I see my sister?.
-Her doctors are working on her.
-Where are their parents?.
JETT: Europe for a couple weeks.
You two got it from here?.
I gotta get my truck towed or dug out or something.
Satting well at 5O percent.
Less that 1 OO cc's from the chest.
Sam, I let them go to the party as a reward.
They busted their asses on their homework.
We all agreed.
No party tonight.
-I quizzed him.
He knew it.
-Great.
I tried to call you.
They walked to the party.
I don't know what to do.
I'm trying to be his friend.
-I'm trying to be a good father.
-Tony.
SARAH: Did Ashley really die?.
-Yeah.
[CRYlNG.]
I can't believe it.
-This is awful.
-lt is.
I'm sorry.
Alex is doing better.
Come on, let's go get you some Kleenex.
NEELA: Head CT was negative?.
-No fracture, no bleed.
-ls that Leo?.
-Leo?.
The kid that calls you every night?.
-What's going on?.
-Looks like a bad drug OD.
-He's had eight of Ativan.
-I told him not to take that crap.
-What crap?.
SARAH: It's called trail mix.
Kids steal prescription pills from their parents and everyone throws them into a big bowl.
Sat's are down, intubation tray.
It could be anti-depressants.
Push bicarb.
Okay, 1 OO milli-equivalents over two minutes.
Come on.
MAN 1 [ON TV.]
: Would you like to pick one up? MAN 2: --forecast doesn 't look-- MAN 3: --in only 30-- - You 're gonna spend a hundred and 29-- -Am I ready for a facelift? Nothing but news and infomercials.
-When can I see Ashley?.
-ln a little bit.
We got some magazines.
Eh, I know where they have some video games.
-I wanna see my sister.
-Okay.
I'll go check with her doctors.
Hey, Frank, I need Brenner to talk to the little brother.
He's all tied up.
-Well, how about a social worker?.
-At 3:OO in the morning?.
Is there an on-call chaplain or something?.
Grab a cut down tray, he's in tamponade.
Chaz, find me an ultrasound.
DEBBlE: Table for two?.
-Some, uh, coffee for you folks?.
MORRlS: Definitely.
BANFlELD: I'll have some hot tea.
We've got a couple of night owl specials.
A, um-- Apple pancakes and a spicy breakfast burrito.
-Ooh.
What's in the burrito?.
DEBBlE: Uh, eggs, onions, bell peppers.
Uh, Chorizo, jalapeno-jack cheese and chunky salsa.
One of those and a large OJ.
I'll have some dry toast.
And some napkins when you get a chance.
You need silverware.
I completely forgot to set your table.
Pregnancy brain.
I'd forget my head if it wasn't screwed on.
Heh.
It's called a pericardial window.
They're removing blood clots from around Leo's heart so it can beat stronger.
-I can't watch this.
-All right.
Dawn.
DAWN: No problem.
Come on.
-We'll let you know.
-Heart rate's up to 1 20.
-Run in a liter of saline.
-What for?.
-ln case we're behind on fluids.
-What if he's bleeding?.
GATES: CT was negative.
-Things change.
Get Neela in here.
-Let's run another crit and fast exam.
Maybe Grady can reassess him.
Blood loss is unlikely.
I think it's hypoxia, dehydration, pain.
What do you know?.
I want a surgeon in here.
-How's he doing?.
-Okay.
Have you guys seen a little boy?.
I left him in the break room.
He's not in here.
Why won't she wake up?.
Why won't she wake up?.
Pressure's up to 1 1 0.
-That's a hell of a lot better than 6O.
-Cardiac team's waiting in the O.
R.
Nice work, doctor.
He's in sinus tach.
His crit went from 41 to 38.
Could be just dilutional from all the fluids.
Or it could be pain.
We can dial up the sedation.
-You'd miss an intra-abdominal bleed.
-Ultrasound's negative.
-He's not bleeding in the belly.
-Or the chest.
Well, you can't be sure of that without a repeat CT.
I really think that my kid deserves a surgical attending.
-Where's Dubenko?.
Where's Crenshaw?.
-Not available.
Alex is in good hands.
Let's take a break.
I don't need a break! GATES: You want a cup of coffee?.
Something to eat?.
You never listen to me.
I'm checking for blood loss, I've ordered a third CBC.
Neela and Brenner agree.
You gotta trust us.
Trust you?.
Why would I trust you.
I wanted Alex to stay home and study.
You knew that.
-Sam.
-What?.
-You'd rather be his friend than an adult.
-I know how to be a parent.
Why would I believe that?.
You don't know anything.
You let them do whatever they want.
You've made mistake with your kid, and you wanna do the same with mine.
Go ahead and keep screwing up Sarah.
I'm sure as hell I'm not gonna let you near Alex again.
-I know you're upset-- -Don't you touch me! Okay.
That's okay.
I need to be with him.
I saw what my classmates were doing during med school and during residency.
But I wasn't going there, you know.
I mean, every other night on call.
That's no way to raise a kid.
You know, so I put if off.
Oh.
Nothing wrong with that.
I mean, by the time I was pregnant I had a good salary, a good schedule.
I was secure.
I was older.
A lot of people prefer it that way.
Hmm.
When we lost Daryl, I was 40 but we tried.
You know.
You know, eventually it worked out.
I mean, everything looked pretty great.
The baby looked perfect on the ultrasound.
[SlGHS.]
Then, you know.
Then at three months.
You had a miscarriage?.
I'm sorry.
No, I just took it as a sign it wasn't supposed to be.
[SlGHS.]
Look, I made a choice, I devoted myself to my training, to my profession.
And now, I'm chief of an academic department.
Yeah.
It's a huge accomplishment.
I invested in my career, I've been a great success.
[SlGHS.]
Can't have everything.
I thought you were sleeping.
Leo's surgery went well.
They fixed his heart.
Good.
And Alex is going up for shoulder surgery.
-You wanna go see him?.
-I hate that room.
Okay.
Later, then, huh?.
You're okay in here?.
Okay, why don't you lie down and get some sleep.
-I heard Sam yelling.
-Yeah, she's mad at me.
She's right to be.
It'll be okay.
DAWN: His third crit went up.
That's good.
-How's he doing?.
-Better with fluids and versed.
-Brought you a water.
-Just put it on the counter, please.
-Heart rate's 1 60.
-Pressure's down to 80 systolic.
Get Neela back in here.
He needs blood.
-You don't know that.
-It's my best guess.
-Two units in cooler.
-You think he's bleeding?.
SAM: We need to transfuse.
NEELA: Give me the ultrasound.
-Start portable chest.
-Repeat the hemocue.
-Simon, you see any P waves?.
-What?.
-They' re there, you just can't see them.
-Excuse me.
I can't get to the subclavian.
BRENNER: Breath sounds a bit down.
-Place another chest tube.
BRENNER: Uh, I need to prep.
-What are you doing?.
-Back off.
I'm gonna run the EKG.
-lt'll spread out the complexes.
NEELA: I need to ultrasound.
-There be hemothorax.
GATES: All right, shut up and look.
No P waves.
It's not sinus tach, it's SPT.
We need to cardiovert.
He's not bleeding, he's got arrhythmia from a bruised heart.
-Get them on there, Sam.
-Hold on.
Clear.
[THUDS.]
[EKG BEEPlNG.]
BRENNER: Heart rate's 82.
NEELA: Looks like normal sinus.
DAWN: BP's 1 1 0 over 74.
Thank you.
CHAZ: Dr.
Brenner.
-Yeah?.
CHAZ: You got a minute?.
-Looks like I do now.
-Let's run a twelve lead.
NEELA: CK, troponin and cardiac echo.
-The girl who died, her brother's here.
-What about the parents?.
They're out of town and he saw her body.
I don't really think he gets it, but I don't know what to do.
Okay.
I'll-- Come on, I'll talk to him.
DEBBlE: More coffee?.
-No, just the check, please.
Okey-dokey.
I'll be right back.
[PHONE RlNGlNG.]
Hello.
Yes.
Oh, hold on, just a minute.
-A room just opened up at the hotel.
-Great.
-Just one room.
-Oh.
Yeah, go ahead.
Go ahead.
I can hang out here.
-Are you sure?.
-Yeah.
All right, I'll take it.
Okay, thank you.
[SlGHS.]
Here you go.
You folks have a-- Oh.
I think my baby just kicked.
First time.
[CHUCKLES.]
That's wonderful.
Uh, can you feel it?.
-It's like popcorn popping.
-Yes, it is.
-Congratulations.
-I gotta go call my husband.
[MlMlCS EXPLOSlON.]
-Hey, Tyler.
-Hi.
-This is Dr.
Brenner.
-Nice to meet you, Tyler.
Is Ashley awake yet?.
Tyler your sister was in a car crash.
-She flew out the window.
-Right.
And she hit the ground very hard.
And it made her stop breathing and then her heart stopped beating.
We did everything we could for her, and we.
We gave her medicine and oxygen and blood.
But sometimes.
Sometimes people are injured so bad, that we can't save them.
And that's what happened to your sister.
We did everything we could for her, but we couldn't help her.
And she died.
Maybe you can try some more.
Maybe she needs another operation.
That wouldn't work.
-Are you sure?.
-I'm sorry.
Your mom and dad are gonna come back to town tomorrow.
In the meantime, we're gonna keep an eye on you.
Can you stay with me now?.
I'm not going anywhere.
Hey, Dr.
Brenner, Alex is going up to surgery, everyone else is tucked in.
Okay if we send the interns home early?.
-Y eah, it's fine by me.
-Cool.
I was gonna catch some Zs up in the call room.
But I think I'll go home, see my kids.
[NEELA SlGHS.]
I thought this shift would never end.
-Yeah.
-Uh-huh.
You know, when I was an intern after a rough night, my resident would take us all out for breakfast.
My treat, what do you say?.
You know, with the snow, I'm sure everything's closed.
Right.
-But thank you, Dr.
Rasgotra.
-Maybe next time.
-They all hate me.
-You're the boss.
It's not fun hanging out with the boss.
If I hurry, I can pre-round before I sign out.
-You did a fantastic job on the traumas.
-Everyone pitched in.
Incredible saves.
I wouldn't wanna be stuck here with anyone but you.
-That's enough.
-No, I'm serious.
Forget about the deposition.
If the case goes to court, I'll testify on your behalf.
You'll be golden.
And for what it's worth, you can ask me out to breakfast any morning.
Except this morning.
I've gotta cover for Banfield.
[SlGHS.]
Good night, Dr.
Banfield.
Good night, Dr.
Morris.
[GROANS.]
[SlGHS.]
BANFlELD: Just for the record tonight never happened.
Sarah fell asleep.
When Alex goes to surgery I'm gonna take her.
You want me to pick you up a change of clothes?.
-Y eah, sure.
-Okay.
Uh.
Sorry about your son.
I was out at the investigation.
He swerved to avoid a minivan that skidded through a red light.
Missed them completely.
Could have been a lot worse.
Yeah.
Ortho wants a couple more films before they take him up.
Alex, your mom's back.
-Did he just open his eyes?.
-I think so.
Alex.
Hey.
Over here.
Hi.
Hi.
It's okay.
It's okay to sleep, I'm right here.
All right?.
I gotta get these to the lab.
I was really mad.
I am-- Those things that I said, Tony, l.
What I said about Sarah, I didn't mean that.
GATES: Okay.
I know you try and that we all make mistakes.
It's just-- This is a pretty big mistake.
Because he's everything to me.
And I'm still just trying to deal with it.
[BUBBLlNG.]
What the hell?.
[MACHlNES BEEPlNG.]
-Oh, God.
-Pressure's down.
Lost the pulse.
-We gotta open his chest.
-PEA arrest.
I'll bag him.
GATES: Four units packed cells, four FFP.
-Two liters gushed out.
-Delayed aortic rupture.
We need to get a side clamp on it.
I've got it.
Hold CPR.
Get ready for internal compressions.
DAWN: Two units hanging.
BRENNER: Chest incision, right now.
Rib spreader, please.
Really good.
Yeah.
In fact, we all had seconds.
Yeah, they're hitting the books.
You make it there okay?.
Don't have to send out a rescue party?.
No, but I can use a yak with a cask of brandy.
GATES [OVER PHONE.]
: I'll see what I can do.
-Did you get any sleep?.
-Maybe three hours.
SAM: Go to bed early.
And give Alex a big hug and kiss from me.
Hey, Alex.
Your mom says good night.
-Night.
-That's the best you' re gonna get.
SAM: See you in the morning.
All right.
Have a good shift.
Bye.
ALEX: The contractile vacuole of the paramecium excretes excess water regulating osmotic pressure.
I knew that once.
How's the English paper?.
In spite of a terminal illness, Johnny Gunther lives with passion emphasizing the theme of living like there's no tomorrow.
I hope you can back that up with specifics.
Are you gonna let us go to that party?.
-Didn't we talk about this?.
-It's Friday night.
Y eah, and tomorrow you wanna go to Alpine Valley because you wanna go snowboarding for the weekend.
-lt-- Besides, it's a blizzard out there.
-It's only five blocks away.
-We'll walk, and we'll be home by ten.
-No.
We all made a deal.
Homework.
[ALEX SlGHS.]
BRENNER: Migraine headache?.
-Just got imitrex.
Slip and fall?.
Broken coccyx, wife's coming to pick him up.
Yeah?.
Don't count on it.
Already a foot on the ground.
-Jumbo Mart's closing early.
-You are a snow angel.
And that, my friends, is the board.
-Wow.
Your day was pretty quie-- -Hey, hey.
Do not say the ""Q"" word.
You can think it, but you can never say it.
Okay, well, if it stays, uh, not busy, we'll do a suture lab with pigs' feet.
-Hmm.
Guess I'll have to miss that one.
-No.
-Kaya's snowed in.
You get to stay.
-I was up until two last night.
-I didn't leave Tracy's until almost four.
-I got an extra one.
-Can't we get somebody else-- -Take it like a man, Grady.
Oh, uh, Banfield's stuck in Omaha at an ACEP conference.
She wants you to cover her day shift tomorrow.
-No.
She got, like, twelve hours to try-- -Yeah?.
Take it like a man, Brenner.
Were you aware that Mrs.
Mendenhall complained of red stools?.
-lt wasn't discussed.
-Dr.
Wade tried to bring it up but you told him to ""stick to the thyroid.
"" Do you recall that?.
The patient was here for a routine elective surgery.
Didn't Dr.
Wade have important information?.
NEELA: In retrospect, yes.
Is it your standard practice to cut off an intern's presentation?.
It is when we have an hour to round on fifty patients.
-Being busy is an excuse for negligence?.
-Objection.
Lacks foundation.
Did you know that your intern went to the family and admitted fault?.
Assumes facts not in evidence.
Dr.
Wade had the moral fortitude to be honest with the family.
Objection.
Argumentative.
-Dr.
Wade lacks experience.
-I advise my client not to answer.
How long does it take to lose integrity?.
This is a teaching hospital.
We are overwhelmed.
We have the added burden of training young doctors.
T o get through the day, we have to rely on interns.
It's not perfect but it's the best we have.
-Things can fall through the cracks.
-I said we need a recess.
Fine.
REBACK: You are not following my instructions.
I need to explain what happened.
No.
You need to keep your mouth shut.
Answer ""yes,"" ""no,"" or ""l don't know.
"" Be a good girl and you won't lose your medical license.
[MAN SPEAKlNG lNDlSTlNCTLY ON TV.]
ARNlE: There you go.
-Oh, I'm sorry, uh, I didn't order a-- A Bahama Mama.
Courtesy of the gentleman at the end of the bar.
Take the drink back, thank the gentleman -ask him to leave me alone.
-I can't do that.
-Why not?.
-He was very insistent.
[SlGHS.]
NEELA: I was in there for four hours.
That is a long time on the hot seat.
It was ridiculous.
I came across like a fool.
That's to be expected.
Their job is to discredit you.
They're good at it.
After that, even I think I'm incompetent.
You're not.
Take a break and I'll, uh-- I'll keep the surgical consults to a minimum.
You're being nice or you don't want me touching your patients.
-Simon, can you re-assess our fever girl?.
BRENNER: No problem.
Uh, if you don't mind, can you check on the interns in the break room?.
-Temp's down, no source.
-She needs a catheterized urine.
That can be a little traumatic.
How about conscious sedation?.
She might stop breathing or drop her BP.
-It's too risky for a simple procedure.
-You sure?.
Sam, T ony called, I couldn't find you.
REPORTER: With two feet of snow predicted authorities say to stay indoors.
FRANK: Chicago, I hope you' re listening.
NEELA: Hey, Chaz.
-Hey, Neela.
Frank.
Surprised you made it in.
I'm dedicated.
Supposed to observe every Friday night.
You can observe a drunk sleeping it off in Exam Three.
Or you can help me with the Christmas decorations.
There's nothing going on.
You may as well go home.
Now that I'm here?.
-I mean, I was lucky to make it this far.
NEELA: Good point.
Stay subcuticular through the flap but distal to the tip.
-Half-buried vertical mattress?.
-Yeah.
-Uh-huh.
-Looks good.
So, dude, what was up with you and Dawn last night?.
-Nothing.
-Nothing?.
You were slow dancing.
-lf you can call that dancing.
-Where was your wife?.
We couldn't get a babysitter.
Look, Dawn got drunk-- You guys go to lke's last night?.
-There was a party.
-Oh, really.
I didn't hear about it.
At Tracy's.
Just for the interns.
-And the nurses.
-And a couple of residents.
REPORTER [ON TV.]
: --as the storm moves across the central plains we 're well past Omaha 's previous record snowfall of 27 inches set in March of 1960.
-Mm, you sure you don't want some?.
-Positive.
[SlGHS.]
Last time I saw you was at registration.
I thought we were in the same classes.
It's like you've been avoiding me for three days.
-Y eah, l, uh, changed my schedule.
-Okay.
Can you believe every flight's been cancelled?.
And now, every hotel room in town is booked.
Yes, I know.
Listen, um, what we talked about that time in the break room.
Y eah, I had a very bad day that day.
You know, if there's ever anything more you wanna discuss.
-l-- I'm a very private person.
-I understand that.
-lt would be between you and me.
-I have a lot of reading to do.
[MORRlS SlGHS.]
They say the storm'll pass by morning.
Figure the airports will open up by noon.
BUDDY: You know, folks, it might be a little cold outside but we are gonna warm it up with a trip to a little place I like to call ""Kokomo.
"" [MlD-TEMPO BEAT PLAYlNG ON SYNTHESlZER.]
[SlNGlNG THE BEACH BOYS' ""KOKOMO"".]
[SlNGlNG.]
Well, he's not too bad.
Hey.
You know what?.
Good music, good company, good booze.
This could be an okay night.
Aah.
Things were slow in the O.
R.
I borrowed a nitrous setup.
-Are you sure it's safe?.
-Very.
Sam, are we authorized to use this?.
Dental assistants use this stuff like water.
They don't have monitoring capabilities.
-ls there a problem?.
-[lN UNlSON.]
No.
-All right, we're good to go.
-Very cool.
Why don't you use it down here all the time?.
-Good question.
-All done.
-She didn't even flinch.
CHAZ: I'll go run it to the lab.
She'll be awake in five minutes.
-Thank you.
-Mm-hm.
Nice work.
I'll, uh, get ready for the traumas.
Hey, everybody.
How are you doing?.
Can I have your attention please for a second?.
Uh.
[COUGHS.]
Is there a doctor in the house?.
[LAUGHS.]
I know you're all doctors.
Uh, well, you know, we're-- We're gonna be here all night uh, might as well get to know each other.
All right?.
I'm Archie Morris, from County General in Chicago.
And, uh, you know what?.
Why don't we-- Why don't we go around?.
Okay, we'll go around, tell us your name, where you're from, maybe.
Maybe a story of your funniest ER patient?.
Whatever you want.
Who wants to go first?.
Okay, I'll start.
I'll start by introducing my colleague, the chair of our department.
The very beautiful and talented Dr.
Catherine Banfield.
-Anything you wanna share, Cate?.
-Not really.
You know what?.
I'll be honest.
She has a reputation of bit of a hardass.
Does your boyfriend need another beer?.
He's not my boyfr-- Give me a refill, please.
Make it a double.
You know, deep down inside, she really, really, really cares.
Ah.
[SlREN WAlLlNG.]
-Did you ever call Gates back?.
-Oh, man.
-Good thing I'm here.
-Teenage girl, full arrest.
SAM: What took you guys so long?.
Waiting on the damn snowplows.
Her name's Ashley.
Back seat passenger, car versus utility pole.
She was ejected through the rear window.
Very drunk.
-Did she ever have a pulse?.
-No.
-ls that grey matter?.
-Looks like an open skull fracture.
One, two, three.
-Asystole on the monitor.
NEELA: Resume compressions.
SAM: What do you guys want?.
-Blunt trauma, no vitals.
-It's not an indication for thoracotomy.
DAWN: She's so young.
Let's try and fix anything reversible.
Pneumothorax, tamponade.
NEELA: Bilateral chest tubes, pericardial tap and four units of O-neg.
-Patient number two is here.
-At least they're not doing CPR.
-Grady wants a nurse.
-We're a little busy.
DAWN: We got this.
-You go check it out.
-You tell us what they need.
SAM: Fine.
SAM: What's the story?.
Driver with altered mental status chest trauma and a bad shoulder dislocation.
What's your name?.
Come on, tell us your name.
[GROANS.]
Portable C-spine, chest, pelvis, and left shoulder.
[GASPS.]
SAM: Alex?.
-Alex?.
Alex.
ALEX: Mom.
-Call her parents?.
-Left a voicemail.
-The cops should go to her house.
-I could use a thoraseal.
Be right back.
-l' m in, bag him.
SAM: T ony, wake up.
Alex snuck out of the house.
He was in a car crash.
You need to check on Sarah.
-Not much blood in the chest.
-Let's get O-neg and a vent.
-You ready for the reduction?.
-Soon as we tape this in.
DAWN: Sam, I can take over in here.
-No, I'm okay.
-Suri can do it.
SAM: She's got another trauma.
I'm not going.
Let's fix this before his paralytics wear off.
-Come back as soon as you're done.
-Ready, steady, pulling.
-Uh, the humeral head is stuck.
NEELA: Okay, let's try again.
I'll give you direct pressure.
Go for it.
[EKG BEEPlNG.]
-No, won't budge.
I'll get skin hooks.
SAM: Labs are ready.
-Trauma panel, type and cross for four?.
-Blood alcohol level.
No, he doesn't drink.
HOLLlS: Is the girl gonna make it?.
-Pretty unlikely.
-How about the boy?.
-T oo soon to tell.
LAVERNE: Back seat passenger, drugs and alcohol.
LEO: I gotta see her.
Where is she?.
-Titrate, Ativan and get a head CT.
-Also has a sternal contusion.
-EKG and chest X-ray.
-Where did you put her?.
-T ry to relax.
-l' m right here, Ashley.
SAM: No.
No, that's not a good answer, I wanna talk to your supervisor.
BRENNER: Skin hooks.
Blood bank is out of O-neg.
Red Cross can't deliver.
-He's got a good crit.
-For now.
What is up with O-neg?.
We have multiple trauma victims what do you expect us to do?.
-We should get Dawn in here.
SAM: Uh, send O +.
The patient is a male, that'll work until we get the cross match.
Pulling.
-Ugh NEELA: There you go.
[EKG BEEPlNG.]
-Got a pulse back at the wrist.
-Shoulder immobilizer and right to CT.
I got the lifepak, and O2 tank is full, the chest tube's on water seal.
Okay, I'll go check on Grady.
-I'll help you with the sling.
-I think I've got it.
I got a little musical game that we're gonna have some fun with.
And the hotel has generously donated prizes to all the winners.
Stuffed mushrooms and, uh, potato skins.
Your choice.
Okay?.
Y eah.
You guys ready?.
Okay.
[SlNGlNG ""LET lT SNOW"".]
No winners yet.
[CONTlNUES SlNGlNG.]
Stop.
[CROWD LAUGHlNG.]
Let it stop.
Make it stop.
[LAUGHlNG.]
[APPLAUSE.]
Whoo! Stranded in Omaha in the dead of winter listening to lame-ass music.
[CHUCKLES.]
Does this suck, or what?.
[LAUGHS.]
You know what?.
-Dermatology gets to go to Maui.
-I know.
Radiology to Acapulco.
I mean, just like always, ER gets no respect.
Uh-huh.
We bust our asses, taking care of people that no one else wants to touch 24/7.
We deserve better.
[CHUCKLES.]
[WHlSPERlNG.]
Do you think we deserve better?.
[CROWD CHEERlNG.]
[LAUGHlNG.]
[ROCK MUSlC PLAYlNG.]
Ready and switch.
No tension pneumo, no effusion.
-Did they ever find the parents?.
-Two more units, then call it.
DAWN: Faster and deeper, Ryan.
-How's the CT?.
-Good news.
-Abdomen's benign, no brain bleed.
-But he's won't wake up.
-Give him time.
-My God.
I was trying to triage her, she wouldn't wait.
Are you okay?.
Broken wrist on the right.
I need to get back out there.
BRENNER: Prep a subclavian on the right.
-How is he?.
-How does he look, huh?.
-Were you drinking?.
-No.
-A little.
But he wasn't.
BRENNER: Sam.
You were supposed to be home studying.
-We were.
SAM: You snuck out.
-lt wasn't like that.
-He has got a learner's permit.
He needs an adult in that car.
Ashley was too drunk to drive, he was trying to help.
You can't call Tony, or you can't call me or a cab?.
-What the hell is wrong with you, Sarah?.
-What's wrong with you?.
Uh, I need a thin wall, not a 25, Sam.
-You got this?.
-Yeah.
Okay.
Let's check you over, Sarah.
I wanna stay here.
We'll be back in a few minutes.
Come on.
[SlNGlNG JOAN JETT'S ""l LOVE ROCK N' ROLL"".]
[ALL SlNGlNG.]
[ALL CHEERlNG.]
Dude, you've got the coolest boss in the whole world.
Whoo.
How y'all doing?.
Why don't we get Archie up here so we can do a duet?.
CROWD [CHANTlNG.]
: Archie, Archie, Archie.
Yeah, give him some love.
Yeah, give him some love.
Yeah, give him some love.
CROWD [CHANTlNG.]
: Archie! Archie! Archie! [CHUCKLES.]
Hi.
Whoo.
[LAUGHS.]
-What do we wanna sing, huh?.
-I don't-- -""White Christmas?.
"" WOMAN: Yeah.
[GRUNTS.]
I don't think so.
[ALL LAUGH.]
""Freebird.
"" ""Freebird! "" [CROWD CHEERlNG.]
You know ""Walk This Way""?.
[ALL CHEERlNG.]
You know ""Walk This Way""?.
All right.
Whoo.
Tell you what, guys.
Uh, we-- We are gonna ""walk this way"" because I think the show is over.
I'm sorry.
I know.
Let's get you some coffee.
Let's get you some coffee.
However, A-- ACEP rocks, I mean it.
It's, uh-- You okay?.
[SHOUTS.]
[ALL CHEERlNG.]
Good-- Goodnight, Omaha.
[EKG BEEPlNG.]
Hold compressions.
-Asystole.
-That's it.
One fifty-seven.
I'll get a shroud.
I'll clean her up.
Let's move her to the suture room.
Tidal volume 5OO, AC 1 4, turn him down to 8O percent.
You called it?.
BRENNER: Crit's good, 41.
Blood alcohol level is zero.
He wasn't drinking.
GATES: Sam.
CT's were all good.
Small hemothorax and a bad concussion.
Dawn, this ET tube can use a little suctioning.
You wanna step out?.
-Sarah's here.
She's getting a cast.
GATES: Yeah.
I know.
Things seem stable in there.
[SAM SNlFFLES.]
How are you doing?.
He was driving some drunk girl's car.
She just died.
[SHUDDERS.]
And I don't know if he's gonna wake up.
I'm sorry.
I shouldn't have given in to them.
What are you talking about?.
I let them go to the party.
You what?.
I tried to call you.
No.
No, no.
We are not doing this now.
Sam.
[RETCHlNG.]
MORRlS: All right.
All right.
There you go.
Now you're gonna feel a whole lot better.
All right?.
Well, I hate to say this, but there's a lesson here.
[GROANS.]
Yup.
Red wine and scotch don't mix.
You gotta remember that.
-You okay?.
Wanna take a little rest?.
-Hmm.
Let me know when you're ready.
[GRUNTS.]
[GROANS.]
[MORRlS TAPPlNG FOOT.]
Sorry.
[MORRlS SlGHS.]
You know my dad was born in Lincoln, not too far from here.
When I was little, he used to drive us to my grandma's house.
I remember the ride took forever.
And he'd-- He'd yell at me for kicking the back of his seat or getting crumbs on the floor, or breathing too loud.
[CHUCKLES.]
That was my dad.
Yeah.
You know, he, uh-- He died last year.
We hadn't spoken in years.
He's got this storage locker in lndiana.
[MORRlS SlGHS.]
They can either trash it or I can go deal with his stuff.
It could be a complete waste of time.
Or maybe I'd learn something about a father I didn't really know.
-Ortho can take Alex in an hour.
-No problems, his vitals are stable.
Dr.
Brenner, Leo's positive for opiates, benzos and marijuana.
-Okay.
-How about, um, aspirin and Tylenol?.
We sent them.
None detected.
See that?.
I get attitude from all the interns.
Maybe they don't like you picking on one of them.
You mean Andrew?.
We've worked through that.
When I was an intern, I was friends with my residents.
-You're more like an attending.
-I don't feel that way.
You make them nervous.
You showed them some teeth.
Man, no one's delivering pizza in this snow.
How can you be hungry at a time like this?.
-You still gotta eat.
-I may have to nuke the pigs' feet.
-Has anyone seen Trauma Two's chart?.
-Right here, Dr.
Rasgotra.
-Oh, Brenner, I got family in here from-- LAVERNE: I need some help, here.
[SlGHS.]
Wait a minute, Chaz.
-Weren't you with that Ashley girl?.
-Yeah.
-Somebody has to talk to her brother.
-I'm supposed to observe.
I've been stalling him for an hour.
You're all I've got.
This is Chaz Pratt, he's one of our student doctors.
Where's Ashley?.
[SlGHS.]
-You two are the brothers?.
-No, just Tyler.
-And you are?.
-The babysitter, I guess.
Tyler was supposed to hang out at my place until midnight.
Two hours ago.
The little guy was freaking out so I brought him in.
-Can I see my sister?.
-Her doctors are working on her.
-Where are their parents?.
JETT: Europe for a couple weeks.
You two got it from here?.
I gotta get my truck towed or dug out or something.
Satting well at 5O percent.
Less that 1 OO cc's from the chest.
Sam, I let them go to the party as a reward.
They busted their asses on their homework.
We all agreed.
No party tonight.
-I quizzed him.
He knew it.
-Great.
I tried to call you.
They walked to the party.
I don't know what to do.
I'm trying to be his friend.
-I'm trying to be a good father.
-Tony.
SARAH: Did Ashley really die?.
-Yeah.
[CRYlNG.]
I can't believe it.
-This is awful.
-lt is.
I'm sorry.
Alex is doing better.
Come on, let's go get you some Kleenex.
NEELA: Head CT was negative?.
-No fracture, no bleed.
-ls that Leo?.
-Leo?.
The kid that calls you every night?.
-What's going on?.
-Looks like a bad drug OD.
-He's had eight of Ativan.
-I told him not to take that crap.
-What crap?.
SARAH: It's called trail mix.
Kids steal prescription pills from their parents and everyone throws them into a big bowl.
Sat's are down, intubation tray.
It could be anti-depressants.
Push bicarb.
Okay, 1 OO milli-equivalents over two minutes.
Come on.
MAN 1 [ON TV.]
: Would you like to pick one up? MAN 2: --forecast doesn 't look-- MAN 3: --in only 30-- - You 're gonna spend a hundred and 29-- -Am I ready for a facelift? Nothing but news and infomercials.
-When can I see Ashley?.
-ln a little bit.
We got some magazines.
Eh, I know where they have some video games.
-I wanna see my sister.
-Okay.
I'll go check with her doctors.
Hey, Frank, I need Brenner to talk to the little brother.
He's all tied up.
-Well, how about a social worker?.
-At 3:OO in the morning?.
Is there an on-call chaplain or something?.
Grab a cut down tray, he's in tamponade.
Chaz, find me an ultrasound.
DEBBlE: Table for two?.
-Some, uh, coffee for you folks?.
MORRlS: Definitely.
BANFlELD: I'll have some hot tea.
We've got a couple of night owl specials.
A, um-- Apple pancakes and a spicy breakfast burrito.
-Ooh.
What's in the burrito?.
DEBBlE: Uh, eggs, onions, bell peppers.
Uh, Chorizo, jalapeno-jack cheese and chunky salsa.
One of those and a large OJ.
I'll have some dry toast.
And some napkins when you get a chance.
You need silverware.
I completely forgot to set your table.
Pregnancy brain.
I'd forget my head if it wasn't screwed on.
Heh.
It's called a pericardial window.
They're removing blood clots from around Leo's heart so it can beat stronger.
-I can't watch this.
-All right.
Dawn.
DAWN: No problem.
Come on.
-We'll let you know.
-Heart rate's up to 1 20.
-Run in a liter of saline.
-What for?.
-ln case we're behind on fluids.
-What if he's bleeding?.
GATES: CT was negative.
-Things change.
Get Neela in here.
-Let's run another crit and fast exam.
Maybe Grady can reassess him.
Blood loss is unlikely.
I think it's hypoxia, dehydration, pain.
What do you know?.
I want a surgeon in here.
-How's he doing?.
-Okay.
Have you guys seen a little boy?.
I left him in the break room.
He's not in here.
Why won't she wake up?.
Why won't she wake up?.
Pressure's up to 1 1 0.
-That's a hell of a lot better than 6O.
-Cardiac team's waiting in the O.
R.
Nice work, doctor.
He's in sinus tach.
His crit went from 41 to 38.
Could be just dilutional from all the fluids.
Or it could be pain.
We can dial up the sedation.
-You'd miss an intra-abdominal bleed.
-Ultrasound's negative.
-He's not bleeding in the belly.
-Or the chest.
Well, you can't be sure of that without a repeat CT.
I really think that my kid deserves a surgical attending.
-Where's Dubenko?.
Where's Crenshaw?.
-Not available.
Alex is in good hands.
Let's take a break.
I don't need a break! GATES: You want a cup of coffee?.
Something to eat?.
You never listen to me.
I'm checking for blood loss, I've ordered a third CBC.
Neela and Brenner agree.
You gotta trust us.
Trust you?.
Why would I trust you.
I wanted Alex to stay home and study.
You knew that.
-Sam.
-What?.
-You'd rather be his friend than an adult.
-I know how to be a parent.
Why would I believe that?.
You don't know anything.
You let them do whatever they want.
You've made mistake with your kid, and you wanna do the same with mine.
Go ahead and keep screwing up Sarah.
I'm sure as hell I'm not gonna let you near Alex again.
-I know you're upset-- -Don't you touch me! Okay.
That's okay.
I need to be with him.
I saw what my classmates were doing during med school and during residency.
But I wasn't going there, you know.
I mean, every other night on call.
That's no way to raise a kid.
You know, so I put if off.
Oh.
Nothing wrong with that.
I mean, by the time I was pregnant I had a good salary, a good schedule.
I was secure.
I was older.
A lot of people prefer it that way.
Hmm.
When we lost Daryl, I was 40 but we tried.
You know.
You know, eventually it worked out.
I mean, everything looked pretty great.
The baby looked perfect on the ultrasound.
[SlGHS.]
Then, you know.
Then at three months.
You had a miscarriage?.
I'm sorry.
No, I just took it as a sign it wasn't supposed to be.
[SlGHS.]
Look, I made a choice, I devoted myself to my training, to my profession.
And now, I'm chief of an academic department.
Yeah.
It's a huge accomplishment.
I invested in my career, I've been a great success.
[SlGHS.]
Can't have everything.
I thought you were sleeping.
Leo's surgery went well.
They fixed his heart.
Good.
And Alex is going up for shoulder surgery.
-You wanna go see him?.
-I hate that room.
Okay.
Later, then, huh?.
You're okay in here?.
Okay, why don't you lie down and get some sleep.
-I heard Sam yelling.
-Yeah, she's mad at me.
She's right to be.
It'll be okay.
DAWN: His third crit went up.
That's good.
-How's he doing?.
-Better with fluids and versed.
-Brought you a water.
-Just put it on the counter, please.
-Heart rate's 1 60.
-Pressure's down to 80 systolic.
Get Neela back in here.
He needs blood.
-You don't know that.
-It's my best guess.
-Two units in cooler.
-You think he's bleeding?.
SAM: We need to transfuse.
NEELA: Give me the ultrasound.
-Start portable chest.
-Repeat the hemocue.
-Simon, you see any P waves?.
-What?.
-They' re there, you just can't see them.
-Excuse me.
I can't get to the subclavian.
BRENNER: Breath sounds a bit down.
-Place another chest tube.
BRENNER: Uh, I need to prep.
-What are you doing?.
-Back off.
I'm gonna run the EKG.
-lt'll spread out the complexes.
NEELA: I need to ultrasound.
-There be hemothorax.
GATES: All right, shut up and look.
No P waves.
It's not sinus tach, it's SPT.
We need to cardiovert.
He's not bleeding, he's got arrhythmia from a bruised heart.
-Get them on there, Sam.
-Hold on.
Clear.
[THUDS.]
[EKG BEEPlNG.]
BRENNER: Heart rate's 82.
NEELA: Looks like normal sinus.
DAWN: BP's 1 1 0 over 74.
Thank you.
CHAZ: Dr.
Brenner.
-Yeah?.
CHAZ: You got a minute?.
-Looks like I do now.
-Let's run a twelve lead.
NEELA: CK, troponin and cardiac echo.
-The girl who died, her brother's here.
-What about the parents?.
They're out of town and he saw her body.
I don't really think he gets it, but I don't know what to do.
Okay.
I'll-- Come on, I'll talk to him.
DEBBlE: More coffee?.
-No, just the check, please.
Okey-dokey.
I'll be right back.
[PHONE RlNGlNG.]
Hello.
Yes.
Oh, hold on, just a minute.
-A room just opened up at the hotel.
-Great.
-Just one room.
-Oh.
Yeah, go ahead.
Go ahead.
I can hang out here.
-Are you sure?.
-Yeah.
All right, I'll take it.
Okay, thank you.
[SlGHS.]
Here you go.
You folks have a-- Oh.
I think my baby just kicked.
First time.
[CHUCKLES.]
That's wonderful.
Uh, can you feel it?.
-It's like popcorn popping.
-Yes, it is.
-Congratulations.
-I gotta go call my husband.
[MlMlCS EXPLOSlON.]
-Hey, Tyler.
-Hi.
-This is Dr.
Brenner.
-Nice to meet you, Tyler.
Is Ashley awake yet?.
Tyler your sister was in a car crash.
-She flew out the window.
-Right.
And she hit the ground very hard.
And it made her stop breathing and then her heart stopped beating.
We did everything we could for her, and we.
We gave her medicine and oxygen and blood.
But sometimes.
Sometimes people are injured so bad, that we can't save them.
And that's what happened to your sister.
We did everything we could for her, but we couldn't help her.
And she died.
Maybe you can try some more.
Maybe she needs another operation.
That wouldn't work.
-Are you sure?.
-I'm sorry.
Your mom and dad are gonna come back to town tomorrow.
In the meantime, we're gonna keep an eye on you.
Can you stay with me now?.
I'm not going anywhere.
Hey, Dr.
Brenner, Alex is going up to surgery, everyone else is tucked in.
Okay if we send the interns home early?.
-Y eah, it's fine by me.
-Cool.
I was gonna catch some Zs up in the call room.
But I think I'll go home, see my kids.
[NEELA SlGHS.]
I thought this shift would never end.
-Yeah.
-Uh-huh.
You know, when I was an intern after a rough night, my resident would take us all out for breakfast.
My treat, what do you say?.
You know, with the snow, I'm sure everything's closed.
Right.
-But thank you, Dr.
Rasgotra.
-Maybe next time.
-They all hate me.
-You're the boss.
It's not fun hanging out with the boss.
If I hurry, I can pre-round before I sign out.
-You did a fantastic job on the traumas.
-Everyone pitched in.
Incredible saves.
I wouldn't wanna be stuck here with anyone but you.
-That's enough.
-No, I'm serious.
Forget about the deposition.
If the case goes to court, I'll testify on your behalf.
You'll be golden.
And for what it's worth, you can ask me out to breakfast any morning.
Except this morning.
I've gotta cover for Banfield.
[SlGHS.]
Good night, Dr.
Banfield.
Good night, Dr.
Morris.
[GROANS.]
[SlGHS.]
BANFlELD: Just for the record tonight never happened.
Sarah fell asleep.
When Alex goes to surgery I'm gonna take her.
You want me to pick you up a change of clothes?.
-Y eah, sure.
-Okay.
Uh.
Sorry about your son.
I was out at the investigation.
He swerved to avoid a minivan that skidded through a red light.
Missed them completely.
Could have been a lot worse.
Yeah.
Ortho wants a couple more films before they take him up.
Alex, your mom's back.
-Did he just open his eyes?.
-I think so.
Alex.
Hey.
Over here.
Hi.
Hi.
It's okay.
It's okay to sleep, I'm right here.
All right?.
I gotta get these to the lab.
I was really mad.
I am-- Those things that I said, Tony, l.
What I said about Sarah, I didn't mean that.
GATES: Okay.
I know you try and that we all make mistakes.
It's just-- This is a pretty big mistake.
Because he's everything to me.
And I'm still just trying to deal with it.
[BUBBLlNG.]
What the hell?.
[MACHlNES BEEPlNG.]
-Oh, God.
-Pressure's down.
Lost the pulse.
-We gotta open his chest.
-PEA arrest.
I'll bag him.
GATES: Four units packed cells, four FFP.
-Two liters gushed out.
-Delayed aortic rupture.
We need to get a side clamp on it.
I've got it.
Hold CPR.
Get ready for internal compressions.
DAWN: Two units hanging.
BRENNER: Chest incision, right now.
Rib spreader, please.