ER s15e14 Episode Script

A Long, Strange Trip

[PHONE RlNGS.]
[SlREN WAlLlNG lN DlSTANCE.]
Frank, we gotta get these tele admits up.
-I'm all over it.
-There's at least 30 in the rack.
What were you doing last night?.
Playing ""Guitar Hero,"" doing Jell-O shots.
-Two messages from Kelly.
-Kelly who?.
She said you'd know.
That's her phone number at Swissotel.
-Car crash victim coming in.
-Clear Trauma 1 and get Surgery.
-We're gridlocked.
-Quick dispo in Curtain 1.
Grady?.
Off duty, and going to Jumbo Mart for caffeine to get me through my charting.
-Well, who else is on?.
-Well, we got Brenner, Morris and-- What do you need?.
That's okay.
-I haven't picked up a patient yet.
-No, go meet the trauma.
It's busy.
I got time.
Okay, fooling around with her boyfriend, and they lost the condom.
She's fully dressed in the ER.
She should be in a private room with a chaperone for a pelvic.
-Yeah, there's no need, actually.
-What?.
Go on.
Go get the history.
-Hello, I'm Dr.
Gates.
-Tammy.
So the proverbial lost condom.
Yeah, it is kind of embarrassing.
Well, don't worry.
Tell me what happened.
The condom came off, and I couldn't reach it.
My boyfriend tried to help, but he's useless.
I went to the bathroom and gagged myself but I couldn't vomit it up either.
I'm not gonna suffocate, am l?.
-Dr.
Rasgotra.
-Dr.
Brenner.
How was your night?.
Four hours of sleep.
You would've got a lot less than that if you were in my bed.
Next time, you should spend the night with me in the call room.
What, you mean on a twin bed with scratchy sheets and phone interruptions every hour?.
That's kind of hot.
You know, I was thinking of getting Neil Young tickets for Saturday.
-That sounds good.
-You like him?.
Yeah, I love him.
Especially his early stuff.
-Really?.
-Yeah.
""Old Man"", ""Only Love Can Break Your Heart.
"" -""Heart of Gold.
"" -""Heart of Gold.
"" MARQUEZ: Neela.
Trauma coming in.
Thank you.
Ahem.
Are we out of sugar?.
I don't think so.
[SlREN WAlLS.]
What are they doing?.
Our old medical records are going in remote storage.
Let me ask you something, kind of man-to-man.
Do you believe in the three-date rule?.
You seeing someone new?.
I don't know if we're actually seeing each other.
We had lunch together in the cafeteria.
I bought her a burger one night at lke's.
Wow, sounds serious.
I like her.
I just can't tell if she's interested in me.
Well, I'm pretty sure I'm not the right guy to ask for relationship advice.
Hey, the run got diverted to Mercy.
Ooh.
Whoa, whoa.
Hey, you all right?.
T ony, Archie, I need some help.
-Grab a gurney.
-Looks like this guy got beat up.
-What's your name, sir?.
-Oliver.
-Oliver what?.
-No wallet, no lD.
-Pupils are equal.
-You know where you are?.
Hospital.
Oriented to place.
What year is it?.
Who's the president?.
Do you know who the president is?.
CROWD [CHANTlNG.]
: Hey, hey, LBJ, how many kids did you kill today? Chicago is a police state.
-Violating our constitutional rights.
-Let's go, come on, move.
Come on.
Hey, hey, hey, LBJ.
You don't have to talk.
We'll take good care of you.
Relax, brother, enjoy the ride.
Decent breath sounds.
Looks like he got kicked a bunch of times.
-Yeah, or fell.
-He looks too good to be homeless.
No blood in the belly.
Abrasion where somebody stole his watch.
Definite assault.
We already called in the police.
Chest is normal.
The head CT's gonna be normal too.
Not if there's a brain bleed.
These old altered guys, it's always something metabolic.
Just order more lV fluids.
Let me go clear the board.
No, stay on this.
Buff him up, find out where he belongs.
-Scanner's ready.
-Potentially unstable.
Dr.
Gates can monitor him in Radiology.
Last BP was 1 1 0/65.
-Hold it, hold it, hold it.
-Excuse us.
WOMAN: Are you a student driver?.
I'm sorry.
I'm sorry you had to pull me out of my car.
Is the oxygen helping, Donna?.
I think so.
Have you ever had any trouble breathing?.
Not till last week.
-Mom, I parked the car.
DONNA: Thanks, honey.
-That's my son, Dylan.
-Hey.
She couldn't even talk.
So you were saying about last week?.
They told me I had lung cancer.
-Where are you being treated?.
-Nowhere yet.
We were supposed to go to Northwestern but in the car, her breathing got so bad that I pulled into here.
I have papers and x-rays, if.
The Willow Ridge Medical Center.
Our local hospital where they diagnosed me.
Okay, do you smoke cigarettes, Donna?.
T en to 1 5 percent of lung cancer occurs in nonsmokers.
-We've been on the lnternet a bit.
-It's in the left upper lobe.
Liver function tests are elevated.
Okay, and did they explain the brain CT results to you, Donna?.
Two spots.
They thought that surgery and chemo and radiation could buy me some time.
Stage four lung cancer has a five-year survival rate of 5 percent.
-But one in 20 survive.
-Well.
Okay, well, we'll have our surgeons and oncologists consult.
-I was hoping to go to Northwestern.
-Yeah, you're too sick to move.
DYLAN: Y eah, I'm gonna cancel the audition, Mom.
No, Dylan, you're not canceling anything.
Now, get to orchestra hall on time and you can stay with Aunt Harriet tonight, okay?.
Okay.
[BUZZER SOUNDS.]
Dr.
Morris, I'm looking for an old guy, victim of assault.
-He should be right back.
-Okay.
You know, I could be wrong, but I thought I saw you and Officer Diaz eating lunch the other day.
-Yeah, we were on a case together.
-Really?.
Because I've had cases with you, but we've never had lunch together.
Plus, it must've been a funny case, because I noticed a lot of smiling.
Yeah, well, Officer Diaz is a nice lady.
We all know that.
And I know you know cops stick together.
-Y eah.
-So be careful.
If you break her heart, we may have to break you.
Head CT was normal, just as I predicted.
And guess what, he's hypernatremic.
-How bad is his sodium?.
-Hundred and sixty-five, dry as a bone.
-Does this guy talk?.
-Not really.
I'll check for Missing Person reports.
-Did you calculate free water deficit?.
-Six liters.
Hypernatremia shouldn't be corrected at-- One milli-equivalent per liter per hour.
Need a doctor here.
-You can have Dr.
Gates.
-Well, shouldn't I stay here and finish?.
No, you've been wanting off this case from the get-go.
See you.
-He's starting to open his eyes.
-That's a good sign.
Oliver?.
Oliver, try to squeeze my hand.
Oliver?.
Curtain 3 is open.
GATES: Hi, I'm Dr.
Gates.
-Damien.
My wife, Corazon.
-Hello.
FRANK: Sam, did you ever call Kelly?.
I didn't think so, because now she's coming to see you.
Let me know when she gets here.
-You don't see many of these.
-It's a negative pressure ventilator.
When the air is sucked out of the chamber, it flows into his lungs.
I had polio when I was 3.
Don't breathe too well on my own.
-ls that why you're here today?.
-No, fever abdominal pain, possible appendicitis.
I'm a retired RN.
-I need to get a BP.
-I'm gonna need to examine his belly.
There are portholes on the side.
Stick your arms through the neoprene if you wanna poke me.
All right.
Are you in this all the time?.
We have three kids, so, no, not all the time.
I use it 1 8 hours a day.
-How long have you guys been together?.
-Forty-five years.
[MACHlNE BEEPS.]
NEELA: I got an e-mail from Yale.
They want two more letters of recommendation.
That seems pointless if Dubenko can offer you a position.
I'm not sure he thinks I'm right for the job.
Oh, man.
That's the head CT.
This must be the lung mass, yikes.
-Where's the patient?.
-LFTs and CBC.
Looks like the horse is out of the barn.
Son's at bedside.
No dad.
Donna, this is Dr.
Rasgotra, Dr.
Dubenko.
Her son.
-Hello.
-Dylan.
-Hello.
-Hi, nice to meet you.
I've reviewed the films and I'm sorry to say that the tumor is far too advanced for surgery.
Are you sure?.
With cancer in the liver, the brain and bones, I'm afraid that an operation would only mean pain and suffering without prolonging your life.
-It's in my bones?.
-We think so.
-What about chemotherapy?.
-It's possible, but-- We'll see what the oncologists say.
Have you thought about your wishes for life support?.
Perhaps this is better discussed later.
DONNA: I made a living will about 1 O years ago.
I don't wanna be kept alive -if I've terminal-- -Mom.
DUBENKO: You might wanna explore hospices.
We don't need to talk-- What's a hospice?.
What is that?.
A way to keep people comfortable in the final stages of illness.
Are you saying that--?.
Look, we' re gonna come back after you've had a little bit more time to consider.
-Yeah.
BRENNER: Okay.
Doctors?.
-What are you doing?.
-What?.
I asked for surgical opinion, not for the Grim Reaper.
I was being truthful.
They have barely processed the cancer diagnosis-- You want me to sugarcoat it?.
T o lie?.
I want you to give them a bit of hope.
Maybe there's something positive to offer.
Thoracentesis?.
Good idea.
That should make her feel better.
Good, well, why don't we lead with-- Frank said you guys have fresh coffee.
I hope you have half-and-half.
Okay, I'll just make a fresh pot.
Oh, okay.
Hi, I'm Kelly.
Hi, I'm Dr.
Gates.
Oh.
What kind of doctor are you?.
Well, this is an ER, so.
That must be complicated.
You gotta know a lot of stuff about everything.
How long you worked here?.
-A couple of years.
-Cool.
I've only been in town for two nights, and I'm craving deep-dish pizza.
Oh, Lou Malnati's.
Oh, yeah?.
Yeah, that sounds great.
What are you doing for dinner?.
I don't think that would be such a good idea.
Why not?.
I just got out of a relationship.
When you fall off a bike, you get right back on it.
You got a sesame seed.
-Kelly?.
-Sammy.
Wha?.
What are you--?.
Oh, my God.
-Hi.
-What are you--?.
Oh, my God, look at you.
Look at you.
Hi.
I'm really sorry to just barge in on you at work.
SAM: You know, I got your message, but I've been busy at work and.
KELLY: No, that's fine.
So how do you two know each other?.
Tony, this is my sister, Kelly.
[CHUCKLES.]
Tie up a few loose ends, I could take a break.
I'll be fine, me and the Home Shopping Network.
Ortho's on Line 4, and they need you at the lung tap.
Go save some lives.
Stay out of trouble.
That's your sister, huh?.
-She seems very nice.
-Y eah.
GATES: Ortho?.
-Sam, cytology and culture on this.
Take a deep breath.
DONNA: Much easier.
-Good, we can pull three liters.
-Dylan, it's late, you should go.
-I'm not going.
He has an audition today for the Juilliard School in New York.
-lmpressive.
-What instrument?.
English horn.
I used to play the viola.
The English horn is lovely.
Honey, they're only here once a year.
You might never get another shot.
I'm much better.
You think it's okay if he goes?.
-Yeah, I don't see why not.
-lt'd be best to stay.
With the extent of your disease, things could suddenly take a turn for the worse.
-You mean, that could happen today?.
-That's pretty unlikely.
Yeah, I should, I should stay.
-Dylan-- -Mom, I'm staying.
Let's wait a bit and see how she's doing, okay?.
-Sam, you seen the old guy?.
-Not in a while.
Oxygen's off, so are the monitors.
-Looks like he eloped.
-Great.
-What happened?.
-I think we lost a patient.
-Check the bathroom.
-We can see your polio guy now.
I need you on a paramedic run.
Tell my sister it's gonna be a while.
I gotta find a demented grandpa pick up an incoming off a rig and pull a patient out of an iron lung.
[SlREN WAlLlNG.]
ZADRO: April Robinson, syncopal episode at Walgreen's, still altered.
-Any seizure activity?.
-No.
-What's up with the handcuffs?.
-Passed out, busted for shoplifting.
MORRlS: How convenient.
ZADRO: No, she's real.
Blood sugar is over 4OO, I gave a liter of saline and got her sats up.
-What do we have?.
ZADRO: This lady fainted at Woolworth's.
-Heart history?.
ZADRO: You got me.
-Doesn't have a pulse.
MORRlS: When did she stop breathing?.
They pay me to drive them to the hospital.
Lucky I had an oxygen tank.
-She needs a cardiac arrest cart.
-lt may be too late for that.
Dilated appendix, non-compressible.
-So I'll need surgery?.
-Y es, most definitely.
-Can it be done with the laparoscope?.
-We'll try.
Sometimes we have to convert to a conventional procedure.
DAMlEN: You mean opening up my belly.
-Yeah.
I use my abdominal muscles to help me breathe.
His friend had colon surgery and ended up traked for life.
All right, well, we'll do the best we can.
Dr.
Rasgotra will be back with the consent form.
-He's a perfect candidate for NOTES.
-What?.
Natural Orifice Transluminal Endoscopic Surgery.
You wanna remove his appendix through his mouth?.
He needs the least invasive procedure, and NOTES is it.
We don't do that here.
It's experimental.
There's Dr.
Horta from San Diego doing trials at Northwestern.
He's had over 50 cases.
You're cutting a hole in his stomach, setting up for peritonitis.
It's a 2-millimeter incision that's occluded by a balloon and transport.
When you're done, you close with g-Prox.
-They've had success.
-Wanna call this guy?.
Chance to be state-of-the-art.
See if he's willing to help and available today?.
Long shot.
Blood sugar's down to 350.
Neela wants me in Curtain 2.
Drop the insulin to five an hour before you go.
-What's going on here?.
-Your diabetes is out of control.
-Paramedics brought you to the ER.
-Think of it as a pit stop before jail.
-What are you talking about?.
-Why don't you take it easy.
-Step out until she's medically cleared.
-I didn't do anything.
Camera shows you pocketing lipstick and mascara.
I was gonna to pay for that.
I got distracted.
You can't keep me.
My daughter needs me home.
-Should've thought about that before.
MORRlS: Hey, come on, officer.
Can I ask you a question?.
""l was gonna pay for it.
"" What a load of crap.
You know, she doesn't seem like a crook.
-Does she have any priors?.
-Any priors?.
You have been hanging out with Claudia.
GATES: Hey, Morris, we found him.
-Excuse me.
Outside, barely conscious.
Pulse ox, 78 on room air.
Probably blossoming pulmonary contusions from trauma.
-Open an airway tray at 8-O.
-Where's Sam?.
MORRlS: On her way.
-Are we gonna do this?.
-Y eah.
This guy could be sharp as a tack.
-What do you need?.
-Sublingual captopril, four of morphine.
Hey, Sammy, I've been here for, like, two hours.
-It's kind of a bad time.
-I know, I just can't really wait around.
-I got appointments.
-Can you just let us finish?.
-Has everyone met Sam's sister?.
-I didn't know you had a sister.
-Hello.
-Hi.
Sam, take a break.
Chuny will take over.
Yeah, you know, looks like you could use one.
Hey, doc, we busted the mugger.
I got an empty wallet and a retirement watch from County.
Maybe he worked here.
-Suction on high.
-Call for a vent.
GATES: End tidal CO2 detector.
SAM: You look good.
I mean, considering the last time I saw you, we were both in pigtails.
Yeah.
Yeah, it's been a really long time.
We got some catching up.
You wanna go to dinner?.
I get off at 8.
Uh-- No, you know, my flight's at 7:3O, and I've got my last meeting at 5.
What kind of meetings?.
Well, I'm here for the apparel show.
Oh, my God, I remember those dresses you used to make for your Cabbage Patch Kids, oh, my.
What, you actually turned that into a job?.
KELLY [CHUCKLES.]
: Yeah.
My clothing line just got bought by Billabong for about $2 million.
-You're kidding.
-No.
You're kidding me.
Yeah, it's.
Well, I've got to travel to Europe and Japan -to launch the new collection, so.
-Wow.
Wow.
What, did you just come all the way from Dallas to rub it in my face?.
No.
No, I came to talk about Mom.
I had to move her to assisted living.
You know, her emphysema got worse.
-Y eah, well, three packs a day will do it.
-She also had a stroke.
You know, I visit her, like, twice a week.
And it's not a lot, but it makes her happy.
And I'm gonna be traveling for months at a time, so.
You know, I wanna move her to Chicago.
-No, please don't.
-I'll pay for everything.
Her moving expenses, living expenses.
All you've gotta do is just go visit her.
Look, I've been doing this for a really long time now, okay?.
-I think it's your turn.
-No, it's not.
Look, she's your mother.
You know, even after everything, she's still your mother.
Who I haven't spoken to since I was 1 5.
Well, you know, maybe it's time that changed too.
All right, I'm in.
Bag him.
AC, 1 4, tidal volume, 5OO.
Have Frank check personnel records, see if we can figure out who he is.
NEELA: Post-expansion pulmonary edema.
-Let's get her son back over here.
-He went to his audition.
-I thought he'd stay.
-I said he could go.
-How soon can he get back?.
-I don't know.
We need BiPAP and set up for an intubation.
Intubation?.
She has a living will, she asked for no heroic measures.
Okay, Donna, Donna, I need to ask you a question.
-Donna?.
Donna?.
-I should call her son.
Exactly what I didn't wanna have happen.
Start with the BiPAP.
It's noninvasive, in the spirit of her wishes.
-That's a good idea.
-This isn't a surgical problem.
You're the primary physician on the case, so you call it.
Let's go, Neela.
Did you reach the son?.
No.
I might have to intubate.
With a DNR?.
Can you even do that?.
Well, temporarily.
I can always remove it later.
I promised her son she would be alive when he got back.
-I see.
BRENNER: Wait.
There's fluid around the heart.
We can drain that, buy her some time.
Neela, Dr.
Horta's here on your Porta-Lung appy.
PeriVac kit, Betadine.
Well, good luck.
SAM: Serum ketones are negative.
-ls that a problem?.
MORRlS: Medically, it's good news.
But it means we have no reason to keep you in the hospital overnight.
So I'm going to jail?.
I think they'll let you out if you pay a fine.
I don't have the money.
What about a loan?.
They won't give you a credit if you don't have a job.
Ever since I got laid off, I've been cleaning houses.
Barely covers the rent.
-My daughter.
-Your daughter?.
Pregnant.
On bed rest.
I'm trying to buy her a crib and stuff.
You can talk to a social worker about getting some help.
I have worked hard my whole life.
I've raised two babies, never been on welfare.
I had to get my medicine.
-So why would you--?.
-Steal a tube of lipstick?.
I return it for store credit.
Use the credit to buy my insulin.
It works.
Dr.
Morris.
We're making some progress lDing your old guy.
There's a patient missing from a nursing home on Dearborn.
Fits his age and description.
You hear that, Oliver?.
Sounds like we found out where you belong.
-Systolic's down to 8O.
-Run in a liter.
GATES: You need a hand?.
I just need to thread the catheter over the guide wire.
[MONlTOR BEEPlNG RAPlDLY.]
[BEEPlNG SLOWS DOWN.]
There's the pericardial fluid.
It should help.
I'll check another blood pressure, doctor?.
[OLlVER PANTlNG.]
GATES: What's wrong?.
What do you need?.
You in pain?.
-Relax, you're okay.
BRENNER: Hit him with some Versed.
GATES: ""TB.
"" TB?.
By any chance, does your lady have tuberculosis?.
No, she has cancer.
You're sure?.
Do you have a confirmation on the path report?.
It'd be unusual, but TB could explain everything.
Infection in the lung, the bone, liver, the brain, around the heart.
GATES: You need a sputum stain for AFB.
Better get a mask on her.
You think your guy was a doctor?.
Oliver, were you a doctor?.
Wouldn't pull you out if it wasn't important.
Real quick, what's the fine for shoplifting?.
And the maximum jail time?.
No, the guys didn't put me up to this.
Thank you.
Get back to class.
-You don't look like you've good news.
-Could be up to six months.
SAM: All jails are overcrowded.
It won't be that long.
Her daughter's having her baby next week.
Hey, Morris.
Okay, I will be back as soon as I can.
Excuse me, my captain wants to know how much longer she's gonna be.
-This needs to run in over an hour.
-I thought she was ready.
-lf I discharge her, she'll bounce back.
-I gotta call the station.
You know what sucks?.
There are guys stealing cars, shooting guns.
-You're here babysitting a decent lady.
-I'm just doing my job.
-Where's Brenner?.
MARQUEZ: He ran to the lab.
We think this lady has TB.
Yeah, and this guy might have figured it out.
Really?.
-How long does an AFB stain take?.
-Less than an hour.
MORRlS: ""T o O.
M.
K.
35 years of service.
"" Oh, my God.
Do you know who this is?.
Yeah, this is Dr.
Oliver Kostin.
As in Kostin 's Textbook of Emergency Medicine? He's a legend.
-Dr.
Morgenstern.
-The one and only.
Hey, Chuny.
So good to see you.
So good to see you.
This is Dr.
Morris and Dr.
Gates.
-Hi.
-Hello.
Dr.
Morgenstern ran this place back in the day.
-What are you doing here?.
-I got a call from the nursing home.
Ollie, you gotta stop wandering.
Are you his doctor?.
No, his proxy.
His wife died a few years ago.
They never had any children, so I got a durable power of attorney.
You must have been close.
He taught me everything.
Treated me like a son.
He knows you're here.
And he's having a good day.
What's his baseline?.
Multi-infarct dementia and going downhill fast.
Mm.
He had a great mind.
Now, there's nothing left.
Well, something's going on in there.
He thinks that lady has tuberculosis.
[CHUCKLES.]
Does she?.
We don't know yet.
The swelling behind the right ear.
Could be scrofula.
It's a TB-infected lymph node.
Used to be in the textbooks, it's not anymore.
-So if he's right, he's still capable-- -No.
It's a flash of an old memory.
Every once in a while, a stimulus, a sight or a sound brings up something from the past, but it doesn't last long.
For all intents and purposes, he doesn't interact with the present.
He hardly speaks.
I brought a copy of his DNR order.
So we shouldn't have tubed him?.
He never wanted to end up like this.
Could we take him off the vent?.
Maybe move him into a private room?.
Sure.
What about T rauma 1?.
He might be getting a few visitors.
You know, the ER used to end right here.
He designed your trauma rooms and got them built 4O years ago.
Dr.
Horta cleared his entire schedule to operate on you.
-Thanks, doc.
-My pleasure.
-We'll see you upstairs.
-I'll be right behind you, honey.
I'm really looking forward to this.
It's gonna blow your mind.
Oh, Lucien, this is Dr.
Horta from San Diego.
Oh, hi.
Yeah, I've heard all about you.
So this thing's really gonna happen?.
-We're all set to go.
-Oh, you should scrub in.
I can't, I've got a couple of cases to check in on.
-Let the residents do it.
-Go ahead, I'll be in and out, you guys.
-Let's take the stairs.
-Okay.
-Nice to meet you.
-Yeah.
Lucien, I heard about the NOTES appy.
Pretty cool.
Yeah, it is pretty cool.
Excuse me, officer.
How can I stay at home when they're sending you off to jail?.
You need to be on bed rest.
This is crazy, Mom.
This isn't you.
Dr.
Morris, this is April's daughter, Kendra.
-Hello.
-Hello.
Is she okay now?.
Her diabetes is back under control.
Mom, why would you do something like this?.
-I don't know, I guess I wasn't thinking.
-Your mother was trying to help.
-This is between her and me, thank you.
KENDRA: Mom, talk to me.
BP's way up, 1 70/1 00.
We should let her rest.
Yeah, I think you're upsetting her.
What do you think she's doing to me?.
Sam, cycle the dynamap.
-Ow.
-ls that a contraction?.
Kyle, grab a gurney, let's get her up to OB.
-No problem.
-Slow deep breaths.
I'm okay.
I don't need all that.
No, we have to monitor your baby.
-Morris, positive AFB.
-Whoa.
ER's been exposed.
Everybody needs testing and follow-up.
We assumed it was a tumor but the other hospital cytology was equivocal.
-Chuny, we're intubating.
-You are?.
Positive TB stain.
She doesn't have cancer, she has a treatable infection.
MARQUEZ: All right, GlideScope's ready.
Good call, Oliver.
TB is the great imitator.
That's what he taught us.
BRENNER: Twenty of etomidate, DOCTOR: Dr.
Kostin, are you mad? Dr.
Kostin, you can't give succinylcholine down here.
I just did.
DOCTOR: Paralytics and intubation require an anesthesiologist.
I'll keep that in mind.
Your patient's too sick for the emergency ward.
Patients like this die in the elevator when we try to move them up to the lCU without an airway.
Okay, gentlemen, my work is done.
BRENNER: Beautiful shot of the cords.
Passing the tube.
Nice.
Sats are fine.
MORRlS: Cuff is down.
-All right.
Deep breath in, Oliver.
And out.
[COUGHS.]
David.
Where do we start rounds?.
Right here, Ollie.
You're right where you need to be.
Look, I have to get back.
But I'm really glad you got in touch.
Yeah.
Yeah, you know, I've been trying for 1 5 years.
Hasn't been easy.
You know, one day, I had a big sister and then the next day, you took off, just pregnant by some dude.
I didn't take off.
Mom kicked me out of the house.
-You could've called.
-She wouldn't let me talk to you.
-Written a letter.
-I did.
She must have tore them up.
I never knew that.
I had a baby.
I had to work.
After a while, I just stopped trying.
I figured you probably hated me.
I didn't.
[CHUCKLES.]
You know, after you left, this is the only guidance that I got.
SAM: My diary?.
You must've left in a hurry, found it underneath your mattress.
Oh, my God.
Are you kidding me?.
-What?.
Did you read this?.
-Yeah, of course, like, a hundred times.
You taught me how to French kiss, how to pierce my ears how to roll a joint.
Heh.
[KELLY CHUCKLES.]
-Six Flags?.
-Yeah, when I was 7.
-That was the happiest day of my life.
-Oh, my God.
Mom took us home early because you puked your funnel cake all over Shock Wave.
Oh, you are so wrong.
No, she took us home because when she went to the bathroom you went and tried to bum a cigarette.
-I did not.
-Yes, you did.
You were grounded for an entire week.
[BOTH LAUGH.]
I was so stupid.
[CHUCKLES.]
[SlGHS.]
She's really bad, huh?.
Yeah, it won't be long.
FRANK: Well, lCU could take Trauma 1.
-Okay, let's move Dr.
Kostin.
-Dylan, how'd it go?.
-It's okay.
Where's my mom at?.
She's in a different room on a breathing machine but something amazing happened.
It turns out your mom doesn't have cancer.
-Are you serious?.
-It's tuberculosis.
They told us that-- Cells from other hospital were suggestive of cancer but they weren't definitive.
So we ran a special stain, and we found TB.
Thank you.
Thank you, that's incredible.
She's not out of the woods yet.
Well, if it's a drug-resistant strain, then she's gonna have very rough course.
But it's better than cancer, right?.
I mean, her prognosis, it's good?.
We're gonna have to keep you in isolation -till we find out you're not infectious.
-Not a problem.
Donna, there's someone here to see you.
Mom, I heard the great news.
I kind of rocked it.
They're not supposed to give feedback, but the head of the woodwind department said, ""See you in September.
"" Sam, I'm gonna be up in the O.
R.
for a bit.
Prescription for insulin and an appointment with a diabetes clinic.
-Where are you taking her?.
-County jail.
Are you okay?.
I got some medicine to stop the contractions.
I've to wait till the baby's ready.
-We should be going.
-Hold on.
You've got nothing to say?.
You're not gonna explain this to me?.
Maybe later.
She's had a rough day.
I thought I was gonna have some help with this baby, but I'll do it on my own.
I just thought you wanted to be a part of it.
-But if this is how you want it, fine! -Come here.
You know what?.
Come here.
-What are you doing?.
-Come with me.
What's going on?.
I need you to understand what your mother's doing.
-Shoplifting makeup.
-T o trade for insulin.
She loves you.
She's made sacrifices for you and your baby.
She almost died today because she ignored her own health to buy you a crib.
-I didn't know.
-Yeah, she's too proud to say it.
I know it's hard, but try to appreciate what you have.
[BUZZER SOUNDS.]
Stump is tied off.
EndoShears.
Nicely done.
HORTA: Tension as you pull, Neela.
BRENNER: They're still at it.
Yeah, you're just in time for the big finish.
NEELA: Appendix is out.
-How cool was that?.
-Very.
-You heard about the TB case?.
-Yeah.
HORTA: g-Prox, please.
Yeah, we were all guilty of diagnosis momentum.
Despite incomplete evidence, we heard the word cancer and we all ran down the wrong path.
It's a glimpse of the future in there.
Yeah, I wasn't on board at first, but Neela persisted, so.
Well, that's a good quality to have.
Especially in an Attending.
There are a lot of candidates this year, you know.
It's going to be very competitive.
Well, whoever gets her will be lucky.
[ELEVATOR BELL DlNGS.]
You think he's really mad at me?.
You did undermine his authority.
-But it was in the interest of the patient.
-Yeah, I agree.
I think he must be in Trauma 1.
I just hope he doesn't hurt my chances here.
Well, if it does, then they're all crazy.
I can't imagine anyone more brilliant and skilled, and compassionate, and sexy.
And you'd better take a nap, because you're gonna need it for later.
I was pre-med, volunteering at the hospital when they made him chief in '68.
Back then, the ER was a glorified walk-in clinic where you were seen by unsupervised interns and residents with no training.
And the community ERs were even worse.
Staffed by moonlighting dermatologists and psychiatrists or drunks who'd been banned from private practice.
There was no 91 1.
No paramedics.
And if you needed an ambulance, you called a funeral home.
[ENGLlSH HORN PLAYlNG HAUNTlNG MELODY.]
What the hell is that?.
Ollie once said: ""You stand a better chance of surviving a gunshot wound in Vietnam than a car crash in Chicago.
"" But he changed all that.
He developed the 91 1 system, he trained thousands of paramedics and started one of the finest residency programs in emergency medicine.
You're all here because of this guy.
Gunshot wound to the left chest, dumped from a moving car.
[MONlTOR BEEPlNG RAPlDLY.]
GRADY: Lost the pulse.
SAM: Starting compressions.
MORRlS: Thoracotomy tray.
NEELA: Four of O-neg and Betadine.
BRENNER: Yankauer.
SAM: Rapid infuser is primed.
-Prep for a subclavian.
GATES: I need a cricoid.
BRENNER: Hold compressions.
NEELA: Okay, opening the chest now.
Shot in the chest outside of a liquor store.
Ready?.
And lift.
Hold an elevator.
He's gotta go right up to the trauma ward.
Someday we're gonna take care of guys like this down here.
-The surgeons will never sign off on that.
-You wait and see.
Dream on, Dr.
Kostin.
NEELA: Foley's in the heart defect.
BRENNER: lnflating to 20 cc's.
SAM: Bleeding's slowing down.
-He's had six of O-neg, six of FFP.
I got a pulse, strong pulse.
NEELA: Cardio-thoracic team's here.
MORRlS: Take him away, guys.
SAM: Door to O.
R.
, 1 2 minutes.
BRENNER: Not bad.
MORRlS: Yup.
He could walk out of the hospital.
[BREATHlNG HEAVlLY.]
How are you doing, Ollie?.
Another two of morphine.
Got it.
Let's TKO his fluids.
[ALARM BEEPlNG.]
He's bradying down.
Might as well turn off the alarm.
[EKG FLATLlNlNG.]

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