ER s15e12 Episode Script
Dream Runner
NEELA: The toughest thing about being a doctor isn 't the terrible hours.
It isn 't the loneliness, the isolation, or the knowledge that one day we all lose out to the relentless decay of the human body.
No, it's something else.
[CELL PHONE RlNGlNG "" MAD WORLD"" .]
Ray.
It's 5 a.
m.
[PAGER BEEPlNG.]
Y es, I know, but sometimes we do actually get to sleep on call.
Good.
You should be.
You know I have those stupid interviews later today.
No.
I didn't forget.
Happy birthday.
Of course I was gonna call.
It's 5 a.
m.
, man, give me a chance.
[PAGER BEEPlNG.]
It's my intern, I better answer.
I'll call you later, okay?.
Bye.
Hey, Ana.
You having a party in here?.
Something like that.
T achy all night and then the BP took a dive.
Crackles bilaterally.
I left mine in the ER.
Sensitivities come back on the blood culture?.
Vanco-resistant enterococcus.
That's what you were worried about, right?.
Yeah.
Let the PlCU know we're coming.
Pick a color and a number between one and 1 0.
Blue and three.
-B-L-U-E.
One, two, three.
DUBENKO: Hey, at this point removing the source of infection is our best option.
-You mean taking out my gall bladder.
DUBENKO: Yeah.
Let's finally get you better okay?.
Hurry up, I'm getting sick of you people.
I'm gonna go call your mom.
Hang in there, I'll check on you in a little while.
Don't you want to hear your fortune?.
I'll be back soon, I promise.
Lucien, are you sure about this?.
No, but the conservative approach doesn't seem to be working out.
She's bacteremic and if we go in now.
NEELA: The toughest thing is making the right call when it counts.
-Forget it.
No, it's fine.
-What?.
You' re gonna be an attending soon, better assert yourself.
No, you' re probably right-- You know, these decisions are the hardest part of our job.
Consider the alternatives, follow through in your mind, make a choice.
Can't control what happens after that.
O.
R.
in 1 O minutes.
I'll meet you there.
Yeah, that's totally gonna make the elevator come faster.
[DOOR OPENS.]
Sorry, l.
Found it.
[DOOR OPENS.]
Dr.
Rasgotra, perfect timing.
NEELA: Page the intern, I'm not really here.
Nick Vasquez, 28, fell through a second story window.
-A closed window, unfortunately.
-How did you fall?.
I was, uh, bailing out of a plane.
-ln my dream.
Uh, I'm a dream runner.
NEELA: Dream runner?.
NlCK: Most people are paralyzed during REM they don't do what they dream about.
My brain chemistry's off, so that paralysis thing doesn't work right.
So you act things out?.
NlCK: Big-wave surfing, car chases, dragon slaying.
-I've done it all.
-On my count.
One, two, three.
All right, vitals stable en route, complaining about abdominal pain.
NEELA: Well, that's understandable.
GATES: Tib-fib displaced, -I'm gonna get a Stryker probe.
NEELA: What?.
Why?.
Missed a compartment syndrome, doesn't wanna get burned.
It's a good pedal pulse, no swelling.
-I doubt it's compartment syndrome.
-I'll be right back.
Hey.
Hey.
-Here.
-What's this?.
Those Blackhawk tickets that we got.
It's, uh, this week.
You take them, Sam.
Take Alex.
No, no, no.
It was your idea.
You might wanna take someone else?.
Gates, you have six patients on the board including a fresh trauma so cut the chatter.
Dr.
Morris, four of your patients bounced back tonight.
It would be okay if you did.
GATES: If I did what?.
-Take someone else.
Sam, will you stop it?.
There's no one else I wanna take.
Here.
Gates, get plain films, then remove shards and then irrigate.
We could use you too, poor guy's lV keeps blowing.
-No problem.
Check crit q 30 and-- -What was that?.
-What was what?.
-Banfield, man.
One minute she's kind of loose and cool then snap, she's back to piranha queen.
She was annoyed at me for being short.
She made Frank take off his tie and throw it in the trash.
Dr.
Morris, come with me.
It's important.
-Uh, good luck with the interview thing.
-Oh, right.
-Okay, you ready?.
-Uh-huh.
Ta-da.
I got under the mud flaps and matched the original color.
You are kidding.
I rebuilt the engine, threw away the amels and installed Mikuni carburetors.
My-- My dad showed up on this for his first date with my mom.
Yeah, she was mortified, made them walk to the movies.
A month later she was riding on the back wearing nothing but a macrame bikini.
Yeah, these have that effect on people.
Okay.
Go ahead.
Try out your new bike.
No, my new--?.
No, no Jerry.
I said-- I said you could have it.
No way.
This belongs with you.
Fire it up.
[ENGlNE REVS.]
Keep the shiny side up.
[SCREAMS.]
[GRUNTS.]
DUBENKO: Take breaths, when you wake up we'll be done.
Dr.
Rasgotra?.
You're gonna be here the whole time, right?.
The whole time.
Did you remember the music?.
Sure did.
[""SUlTE FOR SOLO CELLO NO.
1 lN G"" PLAYlNG ON SPEAKERS.]
That's nice.
""Suite for Solo Cello Number 1 in G.
"" Dr.
Rasgotra, you rock.
DUBENKO: Okay, let's get started.
Neela needs to get out of here to work on her future.
It's okay.
I cancelled my appointments.
DUBENKO: What?.
Why?.
SHlRLEY: First liter's up.
NEELA: I'm post-call and exhausted.
I called in some favors to get you those interviews.
-You feel bad about me not having a job.
-Who told you that?.
You've been acting like you'd never let me leave, but I get it, things change.
Where's this coming from?.
You-- You and I have never had a serious conversation about of you staying.
-Exactly.
Eleven blade.
-Trocar.
Ooh.
It's hot in here.
Is it hot in here?.
No, check this out.
-It's fine.
-Except for the pelvic fracture, right?.
[SlGHS.]
Uh, grade two, non-displaced.
Somebody's here to see you.
[CHUCKLES.]
Hey, honey.
NlCK: Find someone to take Oliver?.
Yeah, your mom came over.
Thank God you're okay.
-Give us some room.
-You know, we've tried everything.
Sleeping bags, mitts, hand-cuffing him to the bed.
Hey, now.
But every few months he has a crazy dream and ends up back in the hospital.
-Oliver's your son?.
-Y eah.
Just turned 1.
Crit dropped another two points.
Oh, dilutional, most likely.
We'll check another hemacue in a half-hour.
What, and meanwhile we just let it keep dropping?.
-I thought you said it was dilutional.
-Recheck it now, Sam.
I already signed out to Suri, I'll have her know.
-What?.
You're leaving?.
-My shift's over.
-They're waiting for me.
-Shifts and breaks such a nursey concept, I've always hated them.
Bye, Mr.
Vasquez.
Damn, I think I nicked the common bile duct.
DUBENKO: You think you did or you did?.
You did.
NEELA: So much inflamed tissue, I couldn't see.
You had no business cutting.
Ten blade, we're converting to open.
SHlRLEY: Systolic's 86.
Everyone knows Samantha Taggart from the ER?.
Starting clinicals for my nurse anesthetist program.
DUBENKO: Sponge.
PERRY: Record vitals q five minutes.
I'm going next door.
-You're leaving?.
-Precepting a trainee.
I'll be in and out.
NEELA: Bovie.
SAM: Something matter?.
NEELA: Not the best teach.
DUBENKO: Countertraction.
SAM: Thanks.
NEELA: Don't take it personally.
SAM: It's a teaching hospital.
NEELA: I'm aware.
Operating on her was dicey to begin with.
SAM: That's your call.
NEELA: We should have our A team.
SAM: A team?.
Why don't you focus on your job and let me do mine.
-Oh, my God.
-Aah! [HEART MONlTOR BEEPlNG.]
I dialed the halothane down when her pressure got dicey.
-I forgot to tell you to turn it back up.
-You forgot?.
-I'm so sorry.
-Tell it to the girl.
Okay, let's clean this mess up and move on.
Run a six, giving lido.
Forty milligram bolus.
Right.
Then point-five per minute.
It's the ER.
They need a surgeon down there.
Surgery's got an unstable kid on the table, gonna be a while.
Great.
Cordis in.
That wasn't so bad.
He's got a high tolerance for pain.
GATES: Hang a unit of type specific.
-How's it going?.
He's tachy and crit's down to 29.
All right, let's pack him up, and get him to angio.
Angio?.
You mean CT, right?.
No, I mean angio.
He has a pelvic fracture.
GATES: Fracture's non-displaced, unlikely to bleed.
The ultrasound was negative.
GATES: Could be retroperitoneal.
BANFlELD: If the angiogram is normal we'll explore that.
Right now the pelvis is where the money is.
In all these dreams you're always there.
You are always the girl.
[HEART MONlTOR BEEPlNG.]
-Nick?.
-Mac three and an eight-oh.
SUZANNAH: What's happening?.
DUBENKO: Five thousand units heparin.
Protein C first?.
Not standard, there have been good outcomes -for DlC or sepsis.
DUBENKO: Go ahead.
Thing is you have to give it before you give the heparin or it won't work.
-Something that came up in a class.
-Okay, protein C, and then the heparin.
V-tach.
NEELA: I can't believe this.
DUBENKO: Point four of epi.
SAM: Going in.
[DEFlBRlLLATOR CHARGlNG.]
Clear! -No change.
-Again.
Clear.
-No change.
-Again.
Clear.
Hey?.
What happened?.
What'd the angio show?.
Lost his pulse before we could do the study.
Charged to 36O.
Clear.
-No change.
-Give the amiodarone.
Sorry to belabor, but you don't drop crit 1 O points from non-displaced pelvis.
If you'd scanned him you might have seen what I'm seeing in time.
Go find an O.
R.
The belly's full of blood.
-You know where it's coming from?.
-Go! SAM: Fourth epi's in.
Someone needs to update the mother.
NEELA: I should have fought you.
DUBENKO: You should have.
GATES: Dream runner's bleeding out in angio.
DUBENKO: Okay, go.
NEELA: I promised I'd stay.
DUBENKO: Hold compressions.
SHlRLEY: V-fib.
DUBENKO: Switch out.
Go, Neela.
Go.
Go.
[CELL PHONE RlNGlNG ""MAD WORLD"".]
Ray.
I'll call later.
[HEART MONlTOR BEEPlNG.]
BANFlELD: Hold compressions.
MORRlS: Still asystole.
This is over.
[SHUTS OFF HEART MONlTOR.]
Please know that we did everything we could.
[DOOR OPENS.]
Excuse me.
[DOOR OPENS.]
This can't really be happening.
I'm so sorry.
This feels like a dream.
BANFlELD: We can 's see the future.
Sometimes we can, actually.
With this handy new technology called the CT.
You heard of it?.
Fine.
Do I wish I could do it over?.
Yeah, I do.
-There was no way to know-- -Gates was begging to get the scan.
Gates is a resident.
Don't make this about hierarchy.
If any of us refuse to hear another opinion, the system breaks down.
What system?.
You guys don't have a system.
-All I see here is chaos and disorder.
MORRlS: Maybe that's the problem.
Maybe that's why after five months you still don't get it, still don't fit in.
-Fit in?.
This isn't junior high.
-We are a team.
We work together.
But you think that you're so much better than all of us.
So much smarter.
You'll never let yourself be part of it.
If you wanna be a queen go into private practice back to lndonesia, leave medicine altogether.
But don't torture us here.
Dr.
Banfield.
-Jerry, turn this in to human resources.
NEELA: What are you doing?.
Going home.
NEELA: This isn't your fault.
-lf I'd come down sooner l-- -It's not about you.
What's really going on?.
Are you sick?.
I mean, this morning -the injection.
-Please.
Leave me alone.
[CELL PHONE RlNGlNG.]
Hello?.
Yes.
I'll sign the death certificate.
Well, now, what did the phone do to deserve that?.
Hi, Simon, great to see you.
How was Australia?.
Good.
Heh.
You okay?.
It's just been an unbelievably horrible day.
You know what you need?.
A didgeridoo.
Banfield just quit and I just helped kill two patients.
Oh.
Uh, Neela, I'm sorry.
Neela.
NEELA: The care of every patient is a twisty maze that leads to an infinite number of potential outcomes.
We hope that knowledge and experience guide us but sometimes it becomes obvious a wrong turn was made.
[CELL PHONE RlNGlNG "" MAD WORLD"" .]
Ray.
It's 5 a.
m.
[PAGER BEEPlNG.]
I know, but sometimes we do actually get to sleep on call.
Pick a color and a number between one and 1 0.
Blue and three.
-B-L-U-E.
One, two, three.
DUBENKO: Hey, at this point removing the source of infection is our best option.
-You mean taking out my gall bladder.
DUBENKO: Let's finally get you better.
Hurry up, I'm getting sick of you people.
I'm gonna go call your mom.
Hang in there Ana, I'll check on you in a little while.
Don't you wanna hear your fortune?.
I'll be back soon, I promise.
NEELA: If only it were possible to apply the wisdom of our mistakes go back to the fork in the road and this time be assertive.
Choose the road we think we should take.
Not the path of least resistance.
Forget it.
No, wait.
Don't forget it.
She could die on the table.
She could die if we do nothing.
These decisions are the hardest part of our job.
Wait one more day.
We'll move her to PlCU, I'll get lD to approve the synercid.
There's no improvement, we'll take her to the O.
R.
tomorrow.
-Okay.
-Okay?.
Yeah, you're almost an attending, I need to start listening to you.
Meet me in the unit for rounds in 1 0.
Yeah, that's totally gonna make the elevator come faster.
What are you, like, in seventh grade?.
I look young, I know.
[ELEVATOR DlNGS.]
[ELEVATOR DlNGS.]
Of course I realize that pressing a button 1 O times is not gonna make it faster but sometimes when you're powerless in a situation, you gotta do something.
That's why you're a surgeon, right?.
You like to cut, fix, do.
I suppose.
Ah, but to choose inaction is in and of itself action, isn't it?.
-Who are you?.
-Ned Roth.
Patient transport specialist.
Buddhist.
Omnivore.
-Neela Ras-- -Rasgotra.
Yes, I know.
[ELEVATOR DlNGS.]
Have a nice day, doctor.
[ELEVATOR DlNGS.]
What are you doing?.
And don't say it's none of my business because it is.
It is?.
-How's that?.
-lf you're doing drugs, we need to know.
And if you wanted to keep it a secret you wouldn't be in the break room.
It's 5:30 in the morning.
I didn't think anyone would be in here.
It's recombinant FSH hormone.
We're trying to have a baby.
Oh, wow.
We're giving in vitro a try.
Well, that's exciting.
Well, we better all hope it works the first time.
I tell you, these drugs and doctoring is a dangerous mix.
Why do you say that?.
I'm erratic, indecisive and I've been a real bitch to the staff.
Really?.
Even more than I usually am.
Everyone and everything just seems to get on my nerves.
I don't know, maybe I should quit.
Oh, no.
Don't be silly.
-Neela?.
This conversation?.
-lt never happened.
Dr.
Rasgotra, perfect timing.
Page the intern, I'm not really here.
A guy fell out of a second-story window, they need a surgeon in Trauma 1.
All right.
Page Dubenko and let him know, okay?.
I hear you're interviewing for attending positions at trauma conference today.
-You did?.
-Yeah.
Lucien's whining about losing you to another institution.
He was?.
Don't look shocked, you know he's grooming you for a faculty position.
NEELA: He's the one who set up all the interviews.
BANFlELD: That's the game.
NEELA: What do you mean?.
My brain chemistry's off, that paralysis thing doesn't work right.
So you act things out?.
Big-wave surfing, car chases, dragon slaying.
-I've done it all.
-On my count.
One, two, three.
Mr.
Vasquez, please meet our esteemed surgical colleague -Dr.
Neela Rasgotra.
-Hello.
-Am I going to need surgery?.
-I hope not.
Oh.
These seem superficial, but let's get an x-ray to be sure.
-Ultrasound?.
-Just called for the machine.
Tib-fib displaced, I'm gonna get a Stryker probe.
Good pedal pulse, no swelling.
He doesn't have compartment syndrome.
Gates missed a compartment syndrome last week, he's got PTSD.
-That's ridiculous.
-Five minutes.
Can't let a bad case derail your focus on the patient in front of you.
Someone ate their Wheaties this morning.
-You guys looking for this?.
-Yeah.
NEELA: Can we lower the table, please?.
-Hey.
I haven't seen you all week.
-I know.
-It's weird.
-Yeah, really.
Sam, we need a second line over here.
I have something that I wanna give you later, okay?.
I'm not getting a good look at the spleen, but the belly looks clear.
No sign of internal injuries.
-I'll stay here, you run the board.
-I'm already in on this.
I am in no mood to move the meat.
I have the authority to do what I want.
Drunks, drug seekers, hysterical parents.
They're all yours.
Shoo.
-Okay.
-I gotta run rounds in the PlCU.
[SlGHS.]
Hi.
How's the new digs.
Okay, except for no TV.
Well, at least you have your own room up here, right?.
Her, uh, oxygen level's still a bit low.
So what now?.
We wait.
And hope her own immune system conquers the infection.
She can do it.
She's tough.
I need you to get better so you can help me download Scrabble on my cell.
Okay.
Hey.
How's she doing?.
Twenty of dopamine, sats hanging around 9O, lactate's on the edge.
DUBENKO: Well, next 24 hours will give us our answer.
-You off to interviews?.
-I was thinking of cancelling.
Are you crazy?.
I should see this through.
No, go.
I'll take care of it.
I'll call you if anything changes.
Trauma programs will be fighting over you.
All right then.
-You know, um, I don't get it.
-Get what?.
You seem to be dying to get rid of me you keep mumbling about the hiring freeze at County pushing me to do interviews all over.
-But then I keep hearing other things.
-What other things?.
If you want me to stay, how come you never asked?.
We can't have this discussion until you've seen what else is out there.
I'm serious.
Just go.
Get out of here.
[GATES HUMMlNG.]
Wow.
Look at you.
How's our dream walker guy doing?.
Runner.
Dream runner.
He's stable, waiting for ortho.
Good.
I should be on the El right now, rushing to this interview thing but instead I'm here obsessing over cheese or ranch.
You know what else I'm thinking about?.
-Twinkies?.
-Sam.
I think I always sort of underestimated her.
I feel bad about that.
You know, you two should never have broken up.
It's sort of complicated and I think it's best if I lay low right now.
Well, inaction is in and of itself action.
-What?.
-Don't listen to me.
I'm post-call and you know how I get.
[CELL PHONE RlNGlNG.]
Daria.
[GRUNTS THEN SlGHS.]
BRENNER: Hey, stranger.
-Hey, when did you get back?.
-Last night.
Sorry, l, uh, haven't eaten in, like, 24 hours.
Do you wanna go and get a proper lunch?.
Uh, no, I can't.
I've got a bunch of attending interviews.
-Cool.
-ls it?.
I'm not so sure.
I'm supposed to know things, have goals, and-- How can I have gotten this far in my life, have no idea what I want from my life?.
Sorry.
I'm rambling.
And self-absorbed.
How was your trip?.
Don't have to know where you're going, you just gotta keep moving forward.
That is the key to happiness, really.
Well, you've got it all figured out, don't you?.
See you later, Simon.
[BUSKER SlNGlNG ""MAD WORLD"".]
-Hello, I'm-- -Neela Rasgotra.
I'm so glad you're here.
I thought you were in London all this time.
It was great for a while but I'd been gone too long and England just didn't feel like my home anymore.
Believe me, I know what you mean.
And then I got the call from Duke.
-How's Ella doing?.
-Amazing.
Eight, if you can believe it.
Oh, wow.
-She's beautiful.
-Ha, ha.
Durham's a great place to raise a kid.
I thought I was gonna miss the city, but I don't.
So, uh, when I left County you were still doing emergency medicine.
Yeah, well, I saw the light.
Are you looking mainly at academic positions or community hospitals?.
-Uh, l-- I don't know.
Uh, both, I guess.
-Mm-hm.
And are you hoping to focus on trauma surgery or are you open to elective cases as well?.
I'm open.
And, uh, do you have any research areas?.
I haven't really figured any of that out yet.
Not really the sort of thing one says at a job interview.
No, but I appreciate the honesty.
So is Lucien helping you?.
Helping me with what?.
Figure things out.
[PAGER BEEPlNG.]
Uh, sort of.
Not really.
I don't think County's really in my future.
County's an amazing place.
What I learned there.
It was a very intense period in my life.
But it made me the doctor that I am now, the person that I am now.
Did you ever consider coming back?.
Yes, briefly.
There is something to be said for getting away -from the place where you trained.
-Oh?.
They've known you since you were a student.
And at some level, the faculty will always see you as little Neela.
You go somewhere new, you'll be taken seriously in a way that will not happen if you stay.
[PAGER BEEPlNG.]
You know, you really should turn that off during interviews.
-Oh.
I've gotta get back to the hospital.
-You don't have someone covering?.
I'm so sorry.
-Let's just finish up, we're almost done.
-Thank you so much.
Maybe you should come by and visit County sometime.
Yeah.
Maybe sometime I will.
[DOOR CLOSES.]
Sam, there's a bunch of stuff I need to say to you.
Me too.
GATES: I miss how-- -These are yours.
Gates, Morris is intubating your sleepwalker guy.
[GATES SlGHS.]
-What happened?.
MORRlS: Suction.
-Crit dropped, he got altered.
-I'm in, bag him.
Call angio, tell them we're on the way.
-Angio?.
-Angio?.
Crit drop, pelvic fracture, he needs angio.
-What's angio?.
-Run of v-tach.
Three hundred amiodarone, two units on rapid infuser.
-Somebody please explain?.
GATES: Bleeding internally.
-We have to find out where fast.
-Can I talk to you outside for a minute?.
All right, pack him up.
Let's get ready to move.
[CELL PHONE RlNGlNG ""MAD WORLD"".]
Hey, Ray.
I'll call you back later, okay?.
[WOMAN GRUNTS.]
We can't wait any longer.
Please.
I want Neela here.
-Sat's 87.
DUBENKO: I'm sorry, honey.
We have to do this now.
Ana, honey, you can do this.
You've been through worse.
Oh.
Mommy, the music.
[""SUlTE FOR SOLO CELLO NO.
1 lN G"" PLAYlNG.]
I love you, sweetie.
Push the etomidate.
He's bleeding from the belly, not the pelvis.
He needs a CT.
The angio's negative, he'll get one.
He's about to code.
There's not enough time for two studies.
We gotta make the right decision now, the clock is ticking.
Neela, dropping crit status post abdominal trauma and a non-displaced pelvic fracture.
CT or angiogram?.
This our dream runner guy?.
I'd get a CT.
[ELEVATOR DlNGS.]
All right, take him to the scanner.
SHlRLEY: Epi's in.
NEELA: What happened?.
Acute chest, sepsis, she started third-spacing everywhere.
Still PEA.
Code team page.
Ana, honey, please.
I know you hear me.
Don't do this, okay?.
NEELA: This is my fault.
-lnfection's fault.
You wanted to take her to O.
R.
I knew this was wrong.
Could've been screwed either way.
Made a choice.
Can't control what happens.
I'll be there.
Full arrest in the scanner.
Some guy jumped through a window.
Ana, stay with us, okay?.
Please.
Get me the transcutaneous pacer.
Hold compressions.
[EKG FLATLlNlNG.]
This is over.
[MOTHER SOBBlNG.]
NEELA: For some patients, there is no road to recovery.
Nothing we do as doctors will alter the outcome.
At least that's what we tell ourselves.
[CELL PHONE RlNGlNG "" MAD WORLD"" .]
Ray.
It's 5 a.
m.
-B-L-U-E.
One, two, three.
DUBENKO: Hey, at this point removing the source of infection is our best option.
You mean taking out my gall bladder, right?.
Let's finally get you better, okay?.
Hurry up, I'm getting sick of you people.
I'm gonna go call your mom.
Hang in there Ana, I'll check on you in a little while.
Don't you want to hear your fortune?.
I'll be back soon, I promise.
NEELA: When their way doesn 't work and your way doesn 't work you 've got to accept defeat or find another way.
What about percutaneous drainage?.
Maybe the pus reaccumulated or she developed an abscess.
-Not likely.
-Less anesthesia, lower risk might still allow us to remove the nidus of infection.
Okay, then what?.
-Switch to synercid, watch in the PlCU-- -Set it up.
I'll meet you in PlCU in 1 O.
You're almost an attending, I need to start listening to you.
[MUSlC PLAYlNG OVER HEADPHONES.]
[CELL PHONE RlNGlNG ""MAD WORLD"".]
NEELA: Ray.
Happy birthday.
No, I didn't forget.
Jeez, man.
I've never heard of someone being so psyched to turn 3O.
I'll call you back later, okay?.
Big-wave surfing, car chases, dragon slaying.
I've done it all.
Dr.
Dubenko says hurry, he's in lR with your girl.
I'm not getting a good look at the spleen.
Will you hand me a DPL kit?.
Are you serious?.
We don't do DPLs anymore.
It'll give us a fast answer and spare him the radiation.
-1 O-blade, betadine, and lido, come on.
-I'll give you a hand with that.
Here.
-Thanks.
GATES: Hey, listen, um.
-Those Hawks tickets that we bought.
-Yeah, what about them?.
Game's coming up, I was thinking I could take Alex if you were cool with that.
SAM: I don't know.
-Well, he loves hockey.
And it could give us a little guy time and give you the night off.
I'll think about it.
MORRlS: Fluid's pink.
-What's that mean?.
You have internal bleeding and you're gonna need an operation.
-Wow.
-We're gonna be able to fix everything up.
NEELA: Morris, let the O.
R.
know, okay?.
Dubenko's waiting for me.
-NPO and check the crit q 30.
-What the hell was that?.
-What was what?.
-Gates.
Following Sam around like a puppy in there.
Guy does not know how to play it cool.
Uh, Dr.
Morris uh, come with me, it's important.
[""SUlTE FOR SOLO CELLO NO.
1 lN G"" PLAYlNG OVER SPEAKERS.]
NEELA: Sorry, Ana, I got stuck in the ER.
DUBENKO: There, that's the liver.
Good.
Aspirating.
SHlRLEY: Sats up to 92.
-Wow.
-What?.
DUBENKO: A lot of purulent material here.
I don't want you to be late for interviews.
I can't leave in the middle.
DUBENKO: Be hours before we know anything.
Go, mingle, all the top trauma programs will be there.
-Flush.
NEELA: If you say so.
DUBENKO: And when you've weighed all your options, -I hope you'll decide to stay.
-What?.
DUBENKO: Assistant professor, full benefits research and admin time.
You'll get an official offer letter in a few weeks.
-Lucien.
DUBENKO: Whatever happens you've got a back-up plan here.
-l-- I don't know what to say.
-Shut up and go.
Wow.
Where are you going?.
NEELA: Job interviews.
I'm late.
-Good luck.
Hey, um, did our dream runner guy make it to the O.
R.
yet?.
-He's next.
-Do me a favor.
Repeat the ultrasound, stay ahead of the blood loss.
-Yeah.
-Okay.
MAN: Whoa.
-Hello, Neela.
-You're back.
I'm, uh, so sorry.
I'm late for these interviews and I have to get the train.
-I can't believe this.
-I had the guy replace all the chrome.
Install Mikuni carburetors.
Do you mind if we borrow your bike?.
Well, you know, surfing, barbecues, all the usual January stuff.
Bastard.
Still, I missed this dark, cold, miserable place.
Every day.
Really?.
And what exactly did you miss?.
I don't know.
It wasn't the weather or, uh, my apartment.
It wasn't even the job, really.
Although there's this certain surgeon-- Am l, uh-- Am I boring you?.
I.
I couldn't seem to get her out of my head.
You, doctor need to go.
I do?.
Oh, I do.
You are gonna kick ass in there, Neela, I know it.
Simon.
I missed you too.
A little.
O.
R.
's gonna be another hour at least.
You just did that 1 O minutes ago.
I know, but I promised Neela I'd check again.
Yeah, I don't feel so good.
He looks pale.
Don't you think he looks pale?.
All right.
Hang two units on the rapid infuser and please call the O.
R.
again.
What?.
What is it?.
The next thing, you need to come visit Durham.
Can you really see me living down south?.
It's a lovely city, it's much more cultured than you think.
NEELA: Simon?.
-How'd it go?.
Uh, very well, I'd say.
Uh, Simon, this is Elizabeth Corday, Chief of Trauma Surgery at Duke.
And Simon is an ER attending at County.
Nice to meet you.
Give me a call when you've thought about things and we'll talk details.
Take her out for some champagne.
Well, that sounds like you killed it.
You spend all these years scrambling for the privilege of becoming a doctor.
-lt feels crazy to be, you know, wanted.
-Well, get used to it.
What's this?.
-Second unit's up.
BANFlELD: I'm in, call for a vent.
Introducer.
Forty-five minutes till they give us an O.
R.
-That's too long.
-We'll never keep up.
What choice do we have?.
Get a second infuser, hang an lJ.
No, I've got the subclavian.
Dump in blood and the FFP until the room is ready.
Nick, hang on, okay?.
I need you.
Oliver needs you.
BANFlELD: V-tach.
-No pulse.
-You're charged.
SAM: Mig of epi.
-All right.
MORRlS: Clear! -Units 1 1 and 1 2 are up.
-Clear.
MORRlS: No change.
Resume compressions.
-Please, baby.
Don't do this.
GATES: Again.
Okay, enough.
Sterile sevens and a thoracotomy tray.
I cannot bear another one of these right now.
Another what?.
What are you doing?.
A room shortage is a stupid reason to die.
I'll clamp the aorta and fix this myself if I have to.
Well, all right.
Where are you going?.
I have to go to the hospital and check on a patient.
You are kidding.
Have one of the interns do it.
Just stay here, I'll be back in an hour.
And don't say it.
Say what?.
You know what.
I told you so.
-Ah, it keeps slipping.
-Try a bigger clamp.
GATES: Heart's barely filling.
[BANFlELD GRUNTS.]
[CELL PHONE RlNGlNG ""MAD WORLD"".]
[CELL PHONE BEEPS.]
I got it.
All right, run in another liter and shock him again.
All right.
[DEFlBRlLLATOR CHARGlNG.]
-Clear.
-Sounds like you could use a surgeon.
-Back in sinus.
-Hallelujah.
Thank you.
After I ran into you, I came back and checked.
He was bleeding out.
-Could have gone the other way.
-Now, this isn't a done deal.
Okay, well, let's get him upstairs while he's still got a pulse.
[BANFlELD GRUNTS.]
[SlGHS.]
Hey, Tony.
I'm sure Alex would love to go to that Hawks game with you.
Thank you.
Anytime.
Get some sleep, Ana.
No more 2 a.
m.
Guitar Hero with the clerks.
I'll see you in the morning.
Don't you want to hear your fortune?.
MOTHER: It can wait, honey.
-She's been awake for two days.
-Yeah, go home already.
""Your actions are the seeds of fate.
"" Not exactly a fortune, more of a theory, really, but I'll take it.
Hey, you never did my fortune.
Pick a color and a number between one and 1 0.
-Goodnight, guys.
-Okay.
Rounds are at 7.
Okay.
Green and six.
G-R-E-E-N.
One, two, three, four, five, six.
[CELL PHONE RlNGlNG ""MAD WORLD"".]
It isn 't the loneliness, the isolation, or the knowledge that one day we all lose out to the relentless decay of the human body.
No, it's something else.
[CELL PHONE RlNGlNG "" MAD WORLD"" .]
Ray.
It's 5 a.
m.
[PAGER BEEPlNG.]
Y es, I know, but sometimes we do actually get to sleep on call.
Good.
You should be.
You know I have those stupid interviews later today.
No.
I didn't forget.
Happy birthday.
Of course I was gonna call.
It's 5 a.
m.
, man, give me a chance.
[PAGER BEEPlNG.]
It's my intern, I better answer.
I'll call you later, okay?.
Bye.
Hey, Ana.
You having a party in here?.
Something like that.
T achy all night and then the BP took a dive.
Crackles bilaterally.
I left mine in the ER.
Sensitivities come back on the blood culture?.
Vanco-resistant enterococcus.
That's what you were worried about, right?.
Yeah.
Let the PlCU know we're coming.
Pick a color and a number between one and 1 0.
Blue and three.
-B-L-U-E.
One, two, three.
DUBENKO: Hey, at this point removing the source of infection is our best option.
-You mean taking out my gall bladder.
DUBENKO: Yeah.
Let's finally get you better okay?.
Hurry up, I'm getting sick of you people.
I'm gonna go call your mom.
Hang in there, I'll check on you in a little while.
Don't you want to hear your fortune?.
I'll be back soon, I promise.
Lucien, are you sure about this?.
No, but the conservative approach doesn't seem to be working out.
She's bacteremic and if we go in now.
NEELA: The toughest thing is making the right call when it counts.
-Forget it.
No, it's fine.
-What?.
You' re gonna be an attending soon, better assert yourself.
No, you' re probably right-- You know, these decisions are the hardest part of our job.
Consider the alternatives, follow through in your mind, make a choice.
Can't control what happens after that.
O.
R.
in 1 O minutes.
I'll meet you there.
Yeah, that's totally gonna make the elevator come faster.
[DOOR OPENS.]
Sorry, l.
Found it.
[DOOR OPENS.]
Dr.
Rasgotra, perfect timing.
NEELA: Page the intern, I'm not really here.
Nick Vasquez, 28, fell through a second story window.
-A closed window, unfortunately.
-How did you fall?.
I was, uh, bailing out of a plane.
-ln my dream.
Uh, I'm a dream runner.
NEELA: Dream runner?.
NlCK: Most people are paralyzed during REM they don't do what they dream about.
My brain chemistry's off, so that paralysis thing doesn't work right.
So you act things out?.
NlCK: Big-wave surfing, car chases, dragon slaying.
-I've done it all.
-On my count.
One, two, three.
All right, vitals stable en route, complaining about abdominal pain.
NEELA: Well, that's understandable.
GATES: Tib-fib displaced, -I'm gonna get a Stryker probe.
NEELA: What?.
Why?.
Missed a compartment syndrome, doesn't wanna get burned.
It's a good pedal pulse, no swelling.
-I doubt it's compartment syndrome.
-I'll be right back.
Hey.
Hey.
-Here.
-What's this?.
Those Blackhawk tickets that we got.
It's, uh, this week.
You take them, Sam.
Take Alex.
No, no, no.
It was your idea.
You might wanna take someone else?.
Gates, you have six patients on the board including a fresh trauma so cut the chatter.
Dr.
Morris, four of your patients bounced back tonight.
It would be okay if you did.
GATES: If I did what?.
-Take someone else.
Sam, will you stop it?.
There's no one else I wanna take.
Here.
Gates, get plain films, then remove shards and then irrigate.
We could use you too, poor guy's lV keeps blowing.
-No problem.
Check crit q 30 and-- -What was that?.
-What was what?.
-Banfield, man.
One minute she's kind of loose and cool then snap, she's back to piranha queen.
She was annoyed at me for being short.
She made Frank take off his tie and throw it in the trash.
Dr.
Morris, come with me.
It's important.
-Uh, good luck with the interview thing.
-Oh, right.
-Okay, you ready?.
-Uh-huh.
Ta-da.
I got under the mud flaps and matched the original color.
You are kidding.
I rebuilt the engine, threw away the amels and installed Mikuni carburetors.
My-- My dad showed up on this for his first date with my mom.
Yeah, she was mortified, made them walk to the movies.
A month later she was riding on the back wearing nothing but a macrame bikini.
Yeah, these have that effect on people.
Okay.
Go ahead.
Try out your new bike.
No, my new--?.
No, no Jerry.
I said-- I said you could have it.
No way.
This belongs with you.
Fire it up.
[ENGlNE REVS.]
Keep the shiny side up.
[SCREAMS.]
[GRUNTS.]
DUBENKO: Take breaths, when you wake up we'll be done.
Dr.
Rasgotra?.
You're gonna be here the whole time, right?.
The whole time.
Did you remember the music?.
Sure did.
[""SUlTE FOR SOLO CELLO NO.
1 lN G"" PLAYlNG ON SPEAKERS.]
That's nice.
""Suite for Solo Cello Number 1 in G.
"" Dr.
Rasgotra, you rock.
DUBENKO: Okay, let's get started.
Neela needs to get out of here to work on her future.
It's okay.
I cancelled my appointments.
DUBENKO: What?.
Why?.
SHlRLEY: First liter's up.
NEELA: I'm post-call and exhausted.
I called in some favors to get you those interviews.
-You feel bad about me not having a job.
-Who told you that?.
You've been acting like you'd never let me leave, but I get it, things change.
Where's this coming from?.
You-- You and I have never had a serious conversation about of you staying.
-Exactly.
Eleven blade.
-Trocar.
Ooh.
It's hot in here.
Is it hot in here?.
No, check this out.
-It's fine.
-Except for the pelvic fracture, right?.
[SlGHS.]
Uh, grade two, non-displaced.
Somebody's here to see you.
[CHUCKLES.]
Hey, honey.
NlCK: Find someone to take Oliver?.
Yeah, your mom came over.
Thank God you're okay.
-Give us some room.
-You know, we've tried everything.
Sleeping bags, mitts, hand-cuffing him to the bed.
Hey, now.
But every few months he has a crazy dream and ends up back in the hospital.
-Oliver's your son?.
-Y eah.
Just turned 1.
Crit dropped another two points.
Oh, dilutional, most likely.
We'll check another hemacue in a half-hour.
What, and meanwhile we just let it keep dropping?.
-I thought you said it was dilutional.
-Recheck it now, Sam.
I already signed out to Suri, I'll have her know.
-What?.
You're leaving?.
-My shift's over.
-They're waiting for me.
-Shifts and breaks such a nursey concept, I've always hated them.
Bye, Mr.
Vasquez.
Damn, I think I nicked the common bile duct.
DUBENKO: You think you did or you did?.
You did.
NEELA: So much inflamed tissue, I couldn't see.
You had no business cutting.
Ten blade, we're converting to open.
SHlRLEY: Systolic's 86.
Everyone knows Samantha Taggart from the ER?.
Starting clinicals for my nurse anesthetist program.
DUBENKO: Sponge.
PERRY: Record vitals q five minutes.
I'm going next door.
-You're leaving?.
-Precepting a trainee.
I'll be in and out.
NEELA: Bovie.
SAM: Something matter?.
NEELA: Not the best teach.
DUBENKO: Countertraction.
SAM: Thanks.
NEELA: Don't take it personally.
SAM: It's a teaching hospital.
NEELA: I'm aware.
Operating on her was dicey to begin with.
SAM: That's your call.
NEELA: We should have our A team.
SAM: A team?.
Why don't you focus on your job and let me do mine.
-Oh, my God.
-Aah! [HEART MONlTOR BEEPlNG.]
I dialed the halothane down when her pressure got dicey.
-I forgot to tell you to turn it back up.
-You forgot?.
-I'm so sorry.
-Tell it to the girl.
Okay, let's clean this mess up and move on.
Run a six, giving lido.
Forty milligram bolus.
Right.
Then point-five per minute.
It's the ER.
They need a surgeon down there.
Surgery's got an unstable kid on the table, gonna be a while.
Great.
Cordis in.
That wasn't so bad.
He's got a high tolerance for pain.
GATES: Hang a unit of type specific.
-How's it going?.
He's tachy and crit's down to 29.
All right, let's pack him up, and get him to angio.
Angio?.
You mean CT, right?.
No, I mean angio.
He has a pelvic fracture.
GATES: Fracture's non-displaced, unlikely to bleed.
The ultrasound was negative.
GATES: Could be retroperitoneal.
BANFlELD: If the angiogram is normal we'll explore that.
Right now the pelvis is where the money is.
In all these dreams you're always there.
You are always the girl.
[HEART MONlTOR BEEPlNG.]
-Nick?.
-Mac three and an eight-oh.
SUZANNAH: What's happening?.
DUBENKO: Five thousand units heparin.
Protein C first?.
Not standard, there have been good outcomes -for DlC or sepsis.
DUBENKO: Go ahead.
Thing is you have to give it before you give the heparin or it won't work.
-Something that came up in a class.
-Okay, protein C, and then the heparin.
V-tach.
NEELA: I can't believe this.
DUBENKO: Point four of epi.
SAM: Going in.
[DEFlBRlLLATOR CHARGlNG.]
Clear! -No change.
-Again.
Clear.
-No change.
-Again.
Clear.
Hey?.
What happened?.
What'd the angio show?.
Lost his pulse before we could do the study.
Charged to 36O.
Clear.
-No change.
-Give the amiodarone.
Sorry to belabor, but you don't drop crit 1 O points from non-displaced pelvis.
If you'd scanned him you might have seen what I'm seeing in time.
Go find an O.
R.
The belly's full of blood.
-You know where it's coming from?.
-Go! SAM: Fourth epi's in.
Someone needs to update the mother.
NEELA: I should have fought you.
DUBENKO: You should have.
GATES: Dream runner's bleeding out in angio.
DUBENKO: Okay, go.
NEELA: I promised I'd stay.
DUBENKO: Hold compressions.
SHlRLEY: V-fib.
DUBENKO: Switch out.
Go, Neela.
Go.
Go.
[CELL PHONE RlNGlNG ""MAD WORLD"".]
Ray.
I'll call later.
[HEART MONlTOR BEEPlNG.]
BANFlELD: Hold compressions.
MORRlS: Still asystole.
This is over.
[SHUTS OFF HEART MONlTOR.]
Please know that we did everything we could.
[DOOR OPENS.]
Excuse me.
[DOOR OPENS.]
This can't really be happening.
I'm so sorry.
This feels like a dream.
BANFlELD: We can 's see the future.
Sometimes we can, actually.
With this handy new technology called the CT.
You heard of it?.
Fine.
Do I wish I could do it over?.
Yeah, I do.
-There was no way to know-- -Gates was begging to get the scan.
Gates is a resident.
Don't make this about hierarchy.
If any of us refuse to hear another opinion, the system breaks down.
What system?.
You guys don't have a system.
-All I see here is chaos and disorder.
MORRlS: Maybe that's the problem.
Maybe that's why after five months you still don't get it, still don't fit in.
-Fit in?.
This isn't junior high.
-We are a team.
We work together.
But you think that you're so much better than all of us.
So much smarter.
You'll never let yourself be part of it.
If you wanna be a queen go into private practice back to lndonesia, leave medicine altogether.
But don't torture us here.
Dr.
Banfield.
-Jerry, turn this in to human resources.
NEELA: What are you doing?.
Going home.
NEELA: This isn't your fault.
-lf I'd come down sooner l-- -It's not about you.
What's really going on?.
Are you sick?.
I mean, this morning -the injection.
-Please.
Leave me alone.
[CELL PHONE RlNGlNG.]
Hello?.
Yes.
I'll sign the death certificate.
Well, now, what did the phone do to deserve that?.
Hi, Simon, great to see you.
How was Australia?.
Good.
Heh.
You okay?.
It's just been an unbelievably horrible day.
You know what you need?.
A didgeridoo.
Banfield just quit and I just helped kill two patients.
Oh.
Uh, Neela, I'm sorry.
Neela.
NEELA: The care of every patient is a twisty maze that leads to an infinite number of potential outcomes.
We hope that knowledge and experience guide us but sometimes it becomes obvious a wrong turn was made.
[CELL PHONE RlNGlNG "" MAD WORLD"" .]
Ray.
It's 5 a.
m.
[PAGER BEEPlNG.]
I know, but sometimes we do actually get to sleep on call.
Pick a color and a number between one and 1 0.
Blue and three.
-B-L-U-E.
One, two, three.
DUBENKO: Hey, at this point removing the source of infection is our best option.
-You mean taking out my gall bladder.
DUBENKO: Let's finally get you better.
Hurry up, I'm getting sick of you people.
I'm gonna go call your mom.
Hang in there Ana, I'll check on you in a little while.
Don't you wanna hear your fortune?.
I'll be back soon, I promise.
NEELA: If only it were possible to apply the wisdom of our mistakes go back to the fork in the road and this time be assertive.
Choose the road we think we should take.
Not the path of least resistance.
Forget it.
No, wait.
Don't forget it.
She could die on the table.
She could die if we do nothing.
These decisions are the hardest part of our job.
Wait one more day.
We'll move her to PlCU, I'll get lD to approve the synercid.
There's no improvement, we'll take her to the O.
R.
tomorrow.
-Okay.
-Okay?.
Yeah, you're almost an attending, I need to start listening to you.
Meet me in the unit for rounds in 1 0.
Yeah, that's totally gonna make the elevator come faster.
What are you, like, in seventh grade?.
I look young, I know.
[ELEVATOR DlNGS.]
[ELEVATOR DlNGS.]
Of course I realize that pressing a button 1 O times is not gonna make it faster but sometimes when you're powerless in a situation, you gotta do something.
That's why you're a surgeon, right?.
You like to cut, fix, do.
I suppose.
Ah, but to choose inaction is in and of itself action, isn't it?.
-Who are you?.
-Ned Roth.
Patient transport specialist.
Buddhist.
Omnivore.
-Neela Ras-- -Rasgotra.
Yes, I know.
[ELEVATOR DlNGS.]
Have a nice day, doctor.
[ELEVATOR DlNGS.]
What are you doing?.
And don't say it's none of my business because it is.
It is?.
-How's that?.
-lf you're doing drugs, we need to know.
And if you wanted to keep it a secret you wouldn't be in the break room.
It's 5:30 in the morning.
I didn't think anyone would be in here.
It's recombinant FSH hormone.
We're trying to have a baby.
Oh, wow.
We're giving in vitro a try.
Well, that's exciting.
Well, we better all hope it works the first time.
I tell you, these drugs and doctoring is a dangerous mix.
Why do you say that?.
I'm erratic, indecisive and I've been a real bitch to the staff.
Really?.
Even more than I usually am.
Everyone and everything just seems to get on my nerves.
I don't know, maybe I should quit.
Oh, no.
Don't be silly.
-Neela?.
This conversation?.
-lt never happened.
Dr.
Rasgotra, perfect timing.
Page the intern, I'm not really here.
A guy fell out of a second-story window, they need a surgeon in Trauma 1.
All right.
Page Dubenko and let him know, okay?.
I hear you're interviewing for attending positions at trauma conference today.
-You did?.
-Yeah.
Lucien's whining about losing you to another institution.
He was?.
Don't look shocked, you know he's grooming you for a faculty position.
NEELA: He's the one who set up all the interviews.
BANFlELD: That's the game.
NEELA: What do you mean?.
My brain chemistry's off, that paralysis thing doesn't work right.
So you act things out?.
Big-wave surfing, car chases, dragon slaying.
-I've done it all.
-On my count.
One, two, three.
Mr.
Vasquez, please meet our esteemed surgical colleague -Dr.
Neela Rasgotra.
-Hello.
-Am I going to need surgery?.
-I hope not.
Oh.
These seem superficial, but let's get an x-ray to be sure.
-Ultrasound?.
-Just called for the machine.
Tib-fib displaced, I'm gonna get a Stryker probe.
Good pedal pulse, no swelling.
He doesn't have compartment syndrome.
Gates missed a compartment syndrome last week, he's got PTSD.
-That's ridiculous.
-Five minutes.
Can't let a bad case derail your focus on the patient in front of you.
Someone ate their Wheaties this morning.
-You guys looking for this?.
-Yeah.
NEELA: Can we lower the table, please?.
-Hey.
I haven't seen you all week.
-I know.
-It's weird.
-Yeah, really.
Sam, we need a second line over here.
I have something that I wanna give you later, okay?.
I'm not getting a good look at the spleen, but the belly looks clear.
No sign of internal injuries.
-I'll stay here, you run the board.
-I'm already in on this.
I am in no mood to move the meat.
I have the authority to do what I want.
Drunks, drug seekers, hysterical parents.
They're all yours.
Shoo.
-Okay.
-I gotta run rounds in the PlCU.
[SlGHS.]
Hi.
How's the new digs.
Okay, except for no TV.
Well, at least you have your own room up here, right?.
Her, uh, oxygen level's still a bit low.
So what now?.
We wait.
And hope her own immune system conquers the infection.
She can do it.
She's tough.
I need you to get better so you can help me download Scrabble on my cell.
Okay.
Hey.
How's she doing?.
Twenty of dopamine, sats hanging around 9O, lactate's on the edge.
DUBENKO: Well, next 24 hours will give us our answer.
-You off to interviews?.
-I was thinking of cancelling.
Are you crazy?.
I should see this through.
No, go.
I'll take care of it.
I'll call you if anything changes.
Trauma programs will be fighting over you.
All right then.
-You know, um, I don't get it.
-Get what?.
You seem to be dying to get rid of me you keep mumbling about the hiring freeze at County pushing me to do interviews all over.
-But then I keep hearing other things.
-What other things?.
If you want me to stay, how come you never asked?.
We can't have this discussion until you've seen what else is out there.
I'm serious.
Just go.
Get out of here.
[GATES HUMMlNG.]
Wow.
Look at you.
How's our dream walker guy doing?.
Runner.
Dream runner.
He's stable, waiting for ortho.
Good.
I should be on the El right now, rushing to this interview thing but instead I'm here obsessing over cheese or ranch.
You know what else I'm thinking about?.
-Twinkies?.
-Sam.
I think I always sort of underestimated her.
I feel bad about that.
You know, you two should never have broken up.
It's sort of complicated and I think it's best if I lay low right now.
Well, inaction is in and of itself action.
-What?.
-Don't listen to me.
I'm post-call and you know how I get.
[CELL PHONE RlNGlNG.]
Daria.
[GRUNTS THEN SlGHS.]
BRENNER: Hey, stranger.
-Hey, when did you get back?.
-Last night.
Sorry, l, uh, haven't eaten in, like, 24 hours.
Do you wanna go and get a proper lunch?.
Uh, no, I can't.
I've got a bunch of attending interviews.
-Cool.
-ls it?.
I'm not so sure.
I'm supposed to know things, have goals, and-- How can I have gotten this far in my life, have no idea what I want from my life?.
Sorry.
I'm rambling.
And self-absorbed.
How was your trip?.
Don't have to know where you're going, you just gotta keep moving forward.
That is the key to happiness, really.
Well, you've got it all figured out, don't you?.
See you later, Simon.
[BUSKER SlNGlNG ""MAD WORLD"".]
-Hello, I'm-- -Neela Rasgotra.
I'm so glad you're here.
I thought you were in London all this time.
It was great for a while but I'd been gone too long and England just didn't feel like my home anymore.
Believe me, I know what you mean.
And then I got the call from Duke.
-How's Ella doing?.
-Amazing.
Eight, if you can believe it.
Oh, wow.
-She's beautiful.
-Ha, ha.
Durham's a great place to raise a kid.
I thought I was gonna miss the city, but I don't.
So, uh, when I left County you were still doing emergency medicine.
Yeah, well, I saw the light.
Are you looking mainly at academic positions or community hospitals?.
-Uh, l-- I don't know.
Uh, both, I guess.
-Mm-hm.
And are you hoping to focus on trauma surgery or are you open to elective cases as well?.
I'm open.
And, uh, do you have any research areas?.
I haven't really figured any of that out yet.
Not really the sort of thing one says at a job interview.
No, but I appreciate the honesty.
So is Lucien helping you?.
Helping me with what?.
Figure things out.
[PAGER BEEPlNG.]
Uh, sort of.
Not really.
I don't think County's really in my future.
County's an amazing place.
What I learned there.
It was a very intense period in my life.
But it made me the doctor that I am now, the person that I am now.
Did you ever consider coming back?.
Yes, briefly.
There is something to be said for getting away -from the place where you trained.
-Oh?.
They've known you since you were a student.
And at some level, the faculty will always see you as little Neela.
You go somewhere new, you'll be taken seriously in a way that will not happen if you stay.
[PAGER BEEPlNG.]
You know, you really should turn that off during interviews.
-Oh.
I've gotta get back to the hospital.
-You don't have someone covering?.
I'm so sorry.
-Let's just finish up, we're almost done.
-Thank you so much.
Maybe you should come by and visit County sometime.
Yeah.
Maybe sometime I will.
[DOOR CLOSES.]
Sam, there's a bunch of stuff I need to say to you.
Me too.
GATES: I miss how-- -These are yours.
Gates, Morris is intubating your sleepwalker guy.
[GATES SlGHS.]
-What happened?.
MORRlS: Suction.
-Crit dropped, he got altered.
-I'm in, bag him.
Call angio, tell them we're on the way.
-Angio?.
-Angio?.
Crit drop, pelvic fracture, he needs angio.
-What's angio?.
-Run of v-tach.
Three hundred amiodarone, two units on rapid infuser.
-Somebody please explain?.
GATES: Bleeding internally.
-We have to find out where fast.
-Can I talk to you outside for a minute?.
All right, pack him up.
Let's get ready to move.
[CELL PHONE RlNGlNG ""MAD WORLD"".]
Hey, Ray.
I'll call you back later, okay?.
[WOMAN GRUNTS.]
We can't wait any longer.
Please.
I want Neela here.
-Sat's 87.
DUBENKO: I'm sorry, honey.
We have to do this now.
Ana, honey, you can do this.
You've been through worse.
Oh.
Mommy, the music.
[""SUlTE FOR SOLO CELLO NO.
1 lN G"" PLAYlNG.]
I love you, sweetie.
Push the etomidate.
He's bleeding from the belly, not the pelvis.
He needs a CT.
The angio's negative, he'll get one.
He's about to code.
There's not enough time for two studies.
We gotta make the right decision now, the clock is ticking.
Neela, dropping crit status post abdominal trauma and a non-displaced pelvic fracture.
CT or angiogram?.
This our dream runner guy?.
I'd get a CT.
[ELEVATOR DlNGS.]
All right, take him to the scanner.
SHlRLEY: Epi's in.
NEELA: What happened?.
Acute chest, sepsis, she started third-spacing everywhere.
Still PEA.
Code team page.
Ana, honey, please.
I know you hear me.
Don't do this, okay?.
NEELA: This is my fault.
-lnfection's fault.
You wanted to take her to O.
R.
I knew this was wrong.
Could've been screwed either way.
Made a choice.
Can't control what happens.
I'll be there.
Full arrest in the scanner.
Some guy jumped through a window.
Ana, stay with us, okay?.
Please.
Get me the transcutaneous pacer.
Hold compressions.
[EKG FLATLlNlNG.]
This is over.
[MOTHER SOBBlNG.]
NEELA: For some patients, there is no road to recovery.
Nothing we do as doctors will alter the outcome.
At least that's what we tell ourselves.
[CELL PHONE RlNGlNG "" MAD WORLD"" .]
Ray.
It's 5 a.
m.
-B-L-U-E.
One, two, three.
DUBENKO: Hey, at this point removing the source of infection is our best option.
You mean taking out my gall bladder, right?.
Let's finally get you better, okay?.
Hurry up, I'm getting sick of you people.
I'm gonna go call your mom.
Hang in there Ana, I'll check on you in a little while.
Don't you want to hear your fortune?.
I'll be back soon, I promise.
NEELA: When their way doesn 't work and your way doesn 't work you 've got to accept defeat or find another way.
What about percutaneous drainage?.
Maybe the pus reaccumulated or she developed an abscess.
-Not likely.
-Less anesthesia, lower risk might still allow us to remove the nidus of infection.
Okay, then what?.
-Switch to synercid, watch in the PlCU-- -Set it up.
I'll meet you in PlCU in 1 O.
You're almost an attending, I need to start listening to you.
[MUSlC PLAYlNG OVER HEADPHONES.]
[CELL PHONE RlNGlNG ""MAD WORLD"".]
NEELA: Ray.
Happy birthday.
No, I didn't forget.
Jeez, man.
I've never heard of someone being so psyched to turn 3O.
I'll call you back later, okay?.
Big-wave surfing, car chases, dragon slaying.
I've done it all.
Dr.
Dubenko says hurry, he's in lR with your girl.
I'm not getting a good look at the spleen.
Will you hand me a DPL kit?.
Are you serious?.
We don't do DPLs anymore.
It'll give us a fast answer and spare him the radiation.
-1 O-blade, betadine, and lido, come on.
-I'll give you a hand with that.
Here.
-Thanks.
GATES: Hey, listen, um.
-Those Hawks tickets that we bought.
-Yeah, what about them?.
Game's coming up, I was thinking I could take Alex if you were cool with that.
SAM: I don't know.
-Well, he loves hockey.
And it could give us a little guy time and give you the night off.
I'll think about it.
MORRlS: Fluid's pink.
-What's that mean?.
You have internal bleeding and you're gonna need an operation.
-Wow.
-We're gonna be able to fix everything up.
NEELA: Morris, let the O.
R.
know, okay?.
Dubenko's waiting for me.
-NPO and check the crit q 30.
-What the hell was that?.
-What was what?.
-Gates.
Following Sam around like a puppy in there.
Guy does not know how to play it cool.
Uh, Dr.
Morris uh, come with me, it's important.
[""SUlTE FOR SOLO CELLO NO.
1 lN G"" PLAYlNG OVER SPEAKERS.]
NEELA: Sorry, Ana, I got stuck in the ER.
DUBENKO: There, that's the liver.
Good.
Aspirating.
SHlRLEY: Sats up to 92.
-Wow.
-What?.
DUBENKO: A lot of purulent material here.
I don't want you to be late for interviews.
I can't leave in the middle.
DUBENKO: Be hours before we know anything.
Go, mingle, all the top trauma programs will be there.
-Flush.
NEELA: If you say so.
DUBENKO: And when you've weighed all your options, -I hope you'll decide to stay.
-What?.
DUBENKO: Assistant professor, full benefits research and admin time.
You'll get an official offer letter in a few weeks.
-Lucien.
DUBENKO: Whatever happens you've got a back-up plan here.
-l-- I don't know what to say.
-Shut up and go.
Wow.
Where are you going?.
NEELA: Job interviews.
I'm late.
-Good luck.
Hey, um, did our dream runner guy make it to the O.
R.
yet?.
-He's next.
-Do me a favor.
Repeat the ultrasound, stay ahead of the blood loss.
-Yeah.
-Okay.
MAN: Whoa.
-Hello, Neela.
-You're back.
I'm, uh, so sorry.
I'm late for these interviews and I have to get the train.
-I can't believe this.
-I had the guy replace all the chrome.
Install Mikuni carburetors.
Do you mind if we borrow your bike?.
Well, you know, surfing, barbecues, all the usual January stuff.
Bastard.
Still, I missed this dark, cold, miserable place.
Every day.
Really?.
And what exactly did you miss?.
I don't know.
It wasn't the weather or, uh, my apartment.
It wasn't even the job, really.
Although there's this certain surgeon-- Am l, uh-- Am I boring you?.
I.
I couldn't seem to get her out of my head.
You, doctor need to go.
I do?.
Oh, I do.
You are gonna kick ass in there, Neela, I know it.
Simon.
I missed you too.
A little.
O.
R.
's gonna be another hour at least.
You just did that 1 O minutes ago.
I know, but I promised Neela I'd check again.
Yeah, I don't feel so good.
He looks pale.
Don't you think he looks pale?.
All right.
Hang two units on the rapid infuser and please call the O.
R.
again.
What?.
What is it?.
The next thing, you need to come visit Durham.
Can you really see me living down south?.
It's a lovely city, it's much more cultured than you think.
NEELA: Simon?.
-How'd it go?.
Uh, very well, I'd say.
Uh, Simon, this is Elizabeth Corday, Chief of Trauma Surgery at Duke.
And Simon is an ER attending at County.
Nice to meet you.
Give me a call when you've thought about things and we'll talk details.
Take her out for some champagne.
Well, that sounds like you killed it.
You spend all these years scrambling for the privilege of becoming a doctor.
-lt feels crazy to be, you know, wanted.
-Well, get used to it.
What's this?.
-Second unit's up.
BANFlELD: I'm in, call for a vent.
Introducer.
Forty-five minutes till they give us an O.
R.
-That's too long.
-We'll never keep up.
What choice do we have?.
Get a second infuser, hang an lJ.
No, I've got the subclavian.
Dump in blood and the FFP until the room is ready.
Nick, hang on, okay?.
I need you.
Oliver needs you.
BANFlELD: V-tach.
-No pulse.
-You're charged.
SAM: Mig of epi.
-All right.
MORRlS: Clear! -Units 1 1 and 1 2 are up.
-Clear.
MORRlS: No change.
Resume compressions.
-Please, baby.
Don't do this.
GATES: Again.
Okay, enough.
Sterile sevens and a thoracotomy tray.
I cannot bear another one of these right now.
Another what?.
What are you doing?.
A room shortage is a stupid reason to die.
I'll clamp the aorta and fix this myself if I have to.
Well, all right.
Where are you going?.
I have to go to the hospital and check on a patient.
You are kidding.
Have one of the interns do it.
Just stay here, I'll be back in an hour.
And don't say it.
Say what?.
You know what.
I told you so.
-Ah, it keeps slipping.
-Try a bigger clamp.
GATES: Heart's barely filling.
[BANFlELD GRUNTS.]
[CELL PHONE RlNGlNG ""MAD WORLD"".]
[CELL PHONE BEEPS.]
I got it.
All right, run in another liter and shock him again.
All right.
[DEFlBRlLLATOR CHARGlNG.]
-Clear.
-Sounds like you could use a surgeon.
-Back in sinus.
-Hallelujah.
Thank you.
After I ran into you, I came back and checked.
He was bleeding out.
-Could have gone the other way.
-Now, this isn't a done deal.
Okay, well, let's get him upstairs while he's still got a pulse.
[BANFlELD GRUNTS.]
[SlGHS.]
Hey, Tony.
I'm sure Alex would love to go to that Hawks game with you.
Thank you.
Anytime.
Get some sleep, Ana.
No more 2 a.
m.
Guitar Hero with the clerks.
I'll see you in the morning.
Don't you want to hear your fortune?.
MOTHER: It can wait, honey.
-She's been awake for two days.
-Yeah, go home already.
""Your actions are the seeds of fate.
"" Not exactly a fortune, more of a theory, really, but I'll take it.
Hey, you never did my fortune.
Pick a color and a number between one and 1 0.
-Goodnight, guys.
-Okay.
Rounds are at 7.
Okay.
Green and six.
G-R-E-E-N.
One, two, three, four, five, six.
[CELL PHONE RlNGlNG ""MAD WORLD"".]