Chicago Med (2015) Episode Scripts

Us

Thank you.
Stop trying to calm me down.
You're not good at it.
I'm just saying, there's no reason to be nervous.
Joey, it's Match Day.
They're gonna hand me a piece of paper telling me where I'm doing my residency.
I understand.
It's literally the turning point in my life, both the world's assessment of my past and a map of my future.
It's my whole life.
That's an awfully dramatic way to put it.
That's because you're not good at calming me down.
Pathology at Chicago Med is your top choice.
Everyone here thinks very highly of you.
You're at the top of your class.
Plus you are extremely attractive.
- Joey.
- Reese.
It's going to be pathology.
You'll be down in the basement with me.
I'm still not calm.
Well, I-I really don't mean to nag, but I think it's important.
I understand.
I know it's what Jeffrey would have wanted.
I'll think about it, okay? Bye, sweetie.
I'll see you later.
All right.
[sighs] Hey.
How are you doing? Fine.
Really? Jennifer Baker.
The drug trial I got her on, I found out they're giving her a placebo.
Oh, Will, I'm sorry.
They're treating her cancer with sugar water.
How are you doing? Well, my mother-in-law is driving me crazy.
Cloth diapers again? No.
She wants me to get Owen christened.
So? She's Catholic.
It's what we do.
So was Jeff.
Lapsed Catholic.
And he hated parochial school.
Always told me horror stories about all the nuns.
Eh, we all tell those stories.
Doesn't mean a thing.
Hey, take it from a formal altar boy.
Baptism's a piece of cake.
A lot easier than a briss.
But I'm not religious.
Wouldn't it be hypocritical? Eh, think of it like a vaccination.
Do it and get it over with.
Hey, this is my world.
I'll make a few calls, hook you up.
We'll do this together.
- [alert beeping] - Incoming.
[indistinct P.
A.
announcements] Lisa Patrick, early 30's.
Penetrating head wound from falling ice off the Citadel Center.
Tubed in the field.
BP's 90 over 50, GCS 3.
That's her husband.
Dr.
Rhodes, you're going to Baghdad.
We were just walking down the street.
It fell out of nowhere.
Tell radiology we're sending them a head CT.
Got it.
Set her up on tele and get a pulse ox.
- Easy.
- Set on my count.
One, two, three.
- Oh, God, is she gonna be okay? - Maggie Sir, I'm gonna need you to step to the side.
They're gonna do everything they can.
Gonna need an O2 sat.
She's completely unresponsive.
- Pupils are fixed and dilated.
- Her head is crushed.
The ice is penetrating through the side and the back of her skull.
Yeah, looks like the ice clipped the carotid.
It's up against the wound, but if we move it, she'll start to pump.
And the ice is melting, we've got a minute, two minutes tops, and then she'll bleed out.
All right, we got to clamp off the carotid now.
Well, without a scan, we don't know what we're dealing with.
Agreed, but we don't have time.
No, you're right.
Let's do it.
All right, chest and plastics tray.
We're gonna explore the neck to get control of the artery.
All right, I'll get suction.
She's bleeding faster.
All right, turn her.
But gently.
If that ice moves, she's gonna gush like a hose.
- Knife.
- Here, doctor.
Okay, here we go.
There's too much blood.
I can't see the carotid.
Feel like your surgical residency again? Not in a good way.
Bleeding's picking up.
There it is.
Damn it, I missed.
Ice is melting.
Suction can't keep up with the bleeding.
- All right, gauze.
- 4 by 4.
Wait, wait, wait, look.
Yup, there.
- Clamp.
- Clamp.
All right.
Pull with the Richardson.
I need a little more exposure.
Uh-huh.
One more.
And there.
Got it.
Bleeding's stopped.
Let's cover it up and get her up to CT now.
Nice work.
Crushed skull.
Too much damage.
She's never gonna wake up.
- Page from Dr.
Choi.
- He's in Trauma 1.
- I want it off.
- That guy's crazy.
I want it off! Please take it off.
Tell ortho hand we're coming up.
Get a CBC, ABG, chem panel and type and cross him for four.
Got it.
- This is Mr.
Tacker.
- He was in a hardware store.
Grabbed a hatchet, tried to hack his arm off.
It's not me! Medics gave him a milligram of Versed and four morphine in the ambo.
Mr.
Tacker, I'm Dr.
Charles.
- What's going on? - Can you cut it off? I'm not a surgeon, but I'd like to try and help you.
The only way you can help me is if you cut off my arm! How bad's the injury? Cut through the radial artery, but I think we can save the arm.
No, no, no, no, please don't Mr.
Tacker, I promise you we'll talk about this later, but right now, our concern is your safety, so we got to get you up to surgery.
No, no! Cut it off! - We'll talk later.
- I want it off! Any idea what that's about? Hmm.
I definitely want to do a drug screen, but I think we might be dealing with something else.
Crazy.
Poor guy.
Mr.
Patrick, I'm Dr.
Halstead.
I just saw your wife's scans.
I'm afraid I have bad news.
The damage is catastrophic.
"Catastrophic"? Her heart is beating, but the ventilator is the only thing keeping her alive.
I'm sorry, but her brain is injured beyond repair.
Lisa is never going to wake up.
- I'm very sorry.
- No No.
Mr.
Patrick, you take as long as you need.
Before we take your wife off the ventilator, someone will be in to talk to you about organ donation.
Again, I'm so sorry.
[exhaling heavily] Agnes, let's call Gift of Hope.
But we'll give him some time to process this, okay? - Uh-huh.
- Thank you.
Dr.
Halstead.
About organ donation? You don't have to think about that right now.
No.
We've been trying to have a baby for months now.
I read where you could still use someone's eggs when they're like this.
To make a baby.
I believe so, yes.
That's what I want to do.
I want a baby.
Our baby.
Roger! Roge Roger, I'm tired of waiting on these bedpans.
This is not something people can do without.
They better be.
Or you're gonna be up here mopping the floor.
- Hey, Maggie.
- Uh-huh? You know anything about the Maldives? - The what? - Chain of islands near India.
Bert is retiring at the end of the school year, so now he's on this, uh, this big travel kick.
Ah.
A week at the beach sounds pretty good to me.
No, no, he's talking months.
Wants to experience it like a local.
And he thinks you're just gonna let him take off like that? He wants me to retire with him.
What? Ms.
Goodwin? Yes.
We lost a patient this morning, Lisa Patrick.
Her husband wants to harvest her eggs.
Do we have a protocol for that? We do.
Ms.
Patrick will have to be on life support for two weeks for hormone stimulation therapy, followed by the retrieval itself.
It's an expensive and complicated procedure.
Well, he seems pretty committed.
He says his wife really wanted to have a child.
Well, I imagine she meant she wanted a child she could mother and raise.
This is a little different.
A lot different.
I'll call gynecology and get the process started.
- Thank you.
- Mm-hmm.
I didn't know what else to do.
My ex-wife's in China.
I, uh, couldn't get a hold of her, so I brought him here.
Hi, I'm Dr.
Manning.
- Mr.
Jenkins? - Yes.
And you must be Eric.
I heard you swallowed some magnets.
From a game I got on my desk.
Like these.
Sorry, I thought it was candy.
I took my eyes off him for two seconds to get a juice box.
Kid's got quicker moves than me.
Mr.
Jenkins used to play for the Bears.
Oh, yeah, I think I remember.
My husband was a big football fan.
So how many magnets did Eric swallow? Two, maybe three.
It's probably nothing, right? When I was a kid, I swallowed a quarter.
Went right through me.
Have you had a tummy ache? Has he thrown anything up? How long ago did he swallow them? Couple hours.
It's not serious, is it? Well, before I say that, I'd like to take some pictures of Eric's belly, just to make sure that everything's moving through okay.
Is that all right with you, if I take some pictures of your tummy? - Daddy? - It's gonna be okay, son.
- Don't worry.
- I want to go home.
- Do what you need to.
- Hey, hey, Eric.
Do you like to play with building blocks? Because I happen to have the biggest block collection in this whole hospital.
Yeah? Okay.
Stay right here.
I think I have so many blocks, I'm gonna need a truck to bring them in.
- Really? - Uh-huh.
I'll check back in a little bit.
- Full abdominal series? - You got it.
Nurse? Nurse? Hey, nurse! - Are you talking to me? - Hello? Been here for two hours with snot pouring out my nose.
I'm sorry, but we need to see patients in order of urgency.
And I'm dying of a sinus infection.
Maybe if you got off that iPad and did a little work, things would go faster.
Maybe you just need to wait your turn.
And I'm not a nurse.
Handled like a true pathologist.
I know, I'm sorry.
My Match Day, I threw up six times and passed out, so I'd say you're doing fine.
You did not throw up and pass out.
Wanted to, though.
Was emergency medicine your first choice? My only choice.
All I ever wanted to do.
Even though it comes with a lifetime supply of angry snot guys? Has it's downsides.
Then again, how many jobs are there where you literally get to save lives? I'm sure you'll find pathology just as rewarding.
- You are? - No.
I don't get it at all.
It's still there.
Yeah.
I guess they were able to save it.
Oh, God.
I'm sorry, it's, uh it's important to us that you don't hurt yourself.
Mr.
Tacker I'm a psychiatrist and I'd very much like to help you.
But I need to understand why you tried to to sever your arm.
I told you.
It's not mine.
It's not part of me.
How long have you felt this way? Since I was a little boy.
Four or five.
I'd look at it and it just felt strange.
Like it belonged to somebody else.
It's like walking around with something dead on me.
Sounds terrible.
I talked to a doctor a couple months ago, asked him if he could remove it.
He threw me out of his office.
Told me I was crazy.
But I'm not crazy.
I've been on the Internet.
There are others like me.
I've tried to cope.
I just can't stand it anymore.
Mr.
Tacker.
If it's any comfort, I'm gonna do everything I can to help you.
So I got ahold of Father Brady.
He's a sweet old guy.
Of course, he asked me when was the last time I went to confession.
Anyway, he's pretty booked up, but he says if we commit today, he can baptize Owen next Sunday.
- That soon? - Yeah.
Dr.
Halstead? I need to see you.
Let me just think about it, okay? I just examined your patient for the egg harvest protocol, and I can't in good conscience go forward with it.
Why? This woman didn't want to have children.
Why would you say that? She was using birth control.
Look.
- An IUD.
- Mm-hmm.
It's not true.
I can show you the ultrasound.
The IUD is definitely there.
Maybe it's something else? A growth? Mr.
Patrick, your wife was on birth control.
But it doesn't make sense.
We were trying to start a family.
I can understand how hard this must be for you.
No! We were tracking her cycles, using ovulation kits.
We had names picked out.
I know how much you wanted a child.
I'm sorry things didn't work out.
And I'm sorry you can't ask her.
Excuse me, sir.
- Oh.
- I'm sorry.
Oh, man I'm so sorry.
Oh, please, this is the least disgusting thing I've cleaned up all day.
[laughs] I, uh, wanted to thank you for the way you calmed Eric down.
Since his mom and I split, he really doesn't get that sort of thing much.
Well, it was my pleasure.
He's falling for you.
No, he isn't.
I've seen that look a million times.
His angel of mercy.
Dr.
Charles.
What's the word on Mr.
Tacker? No physical issues that would make him want to self-amputate.
His labs are clean, he's not on drugs.
Psychotic.
He is, in fact, entirely rational.
Rational people do not try to cut off their arms.
I think he might be suffering from a very rare condition, something I never dealt with before.
B.
I.
I.
D.
Body Integrity Identity Disorder.
Bear with me now.
These people believe that one of their limbs, a part of their body, is not their own.
His sense of self does not extend to the fingers of his left arm.
It stops at the elbow.
[chuckles] Sorry.
Sounds a little out there to me.
I mean, who are any of us to say where we end, right? Or begin? I mean, physicists will tell you there's no physical self at all.
Right? Just waves of energy.
A mystic will say that we're all one big soup.
I'm not a physicist or a mystic.
I'm a doc who's spent his career treating wounded soldiers who begged me, "Save my leg, save my arm.
" You don't think you should commit this guy? At this point, my only option is to put him on a 72-hour suicide hold.
And then I got to let him go home.
And then what? He'll try it again? Unless I can find a way to treat him.
Will.
Hey.
What'd you decide? Should I call Father Brady? No, it's, uh, it's something else.
Jennifer Baker.
I heard from a trial nurse.
What? She's going downhill.
Fast.
I'm sorry.
I know it was coming.
But still If I'd just left her alone, she would've been spared all of this.
Dr.
Manning.
The little boy, Eric Jenkins, his x-rays are up.
Better take a look.
Page Dr.
Rhodes, please.
Will do.
I'll talk to you later.
And arms up.
So they ever give you guys breaks? Only as often as the state requires.
Maybe after Eric gets the all-clear, we could go out for coffee sometime? I'll try not to spill it on you.
[laughs] That's really sweet, but we're discouraged from going out with our patients or their families.
I won't tell if you won't.
Um oh, gosh, I'm sorry, Eric.
I there is this thing called transference.
Um, people develop feelings for their caregivers.
It's not real.
[knocking] Hi, Mr.
Jenkins, I'm Dr.
Rhodes.
Dr.
Manning's asked me to consult.
Would you mind stepping out for a minute? - Sure.
- Thanks.
Eric, can you show me what you just made? What is that? These are Eric's x-rays, and these two dots are the magnets.
They're attracted to one another, and if they meet, they could pin separate parts of his digestive tract together and erode through the thin intestinal walls.
Which could cause systemic infection, obstruction, bleeding.
And any of those things could be life-threatening.
All right, so okay, so, um, so what should we do? In my opinion, we should remove them surgically.
Now.
But isn't surgery kind of risky, too? Uh, yes, there is the possibility of adhesions, motility issues.
What does that mean? His digestive tract wouldn't work as well.
The argument for surgery outweighs the possible risks.
Every minute that we wait increases the chance of a bad outcome.
I still can't reach my ex-wife.
I should talk to her first.
Why don't you think about it? I'll monitor Eric closely, we'll get another set of x-rays, and then we'll check back in a little bit, okay? - Thank you.
- Yeah.
Natalie.
The kid needs surgery.
Surgery could leave him with a lifetime of complications.
It's not an easy decision to make, and that dad has to make it all on his own.
You have no idea how difficult that is.
[thudding and crashing] [rapid electronic beeping] Mr.
Wirtz? Mr.
Wirtz! His pressure just shot up over 190.
He's not breathing and his pupils are blown.
Call neurosurgery.
I need to intubate.
He just got a head CT.
Look.
That's a Mount Fuji sign.
Air building up in his skull, which means this is not mucous coming out of his nose.
It's cerebrospinal fluid from his brain.
He must've fallen a few days ago.
This isn't a sinus infection.
This is an anterior skull fracture.
And if we don't release the pressure immediately, he's gonna die.
I'm in.
Maggie, get the drill.
- Got you.
- Code blue team to the ED.
Dr.
Choi, I need you to drill a burr hole.
Can't.
Gunshot just came in.
- But this man's got about - You've seen it done.
Do it.
- Who's gonna do this? - I am.
But you're a med student.
You can't drill a hole into a man's head.
- Somebody has to.
- [sighs] Here.
We're both gonna catch hell for this.
[sighs] Yeah.
[drill whirring] [drill whirring] Are you sure you're in the right spot? Three centimeters from the midline.
Should be right above the pocket of air.
"Should be"? [drill whirring] I'm through.
BP back down 130 over 74.
[laughs] Damn, Reese, you did it.
Uh-huh.
See what's taking neuro so long to get down here.
Got you.
So I'm thinking our best approach would be a course of both medication a serotonin reuptake inhibitor and psychotherapy.
It's not gonna work.
How do you know until we've tried? You see that guy out there? They gave him something called a nerve block.
What, exactly, is that? It's a regional anesthetic injected near a nerve to block a specific site.
Maybe that could work for me? You know, so I wouldn't be so aware of the arm.
Well, it wouldn't be a permanent fix.
I would do anything to make this feeling go away, even for a minute.
Right.
I understand, I understand.
And I would try the meds and the psychotherapy along with it.
I would need your assurance that you'd both stick with your therapy and that you wouldn't harm yourself.
I promise.
Look, why don't I consult an anesthesiologist and, um and we'll go from there.
Dr.
Charles? Do you think someone could get me out of these restraints? All in due time.
For now, frankly, I'm just, uh I'm really encouraged that we've come up with a plan.
Ms.
Patrick's still hooked up to the ventilator.
Her husband agree to organ donation? Not yet.
He said anything? Just sits there.
[phone vibrating] Hey, Father.
No, no, she hasn't decided yet.
As soon as she does, I'll I'll call you, okay? All right, thanks.
Helping Natalie with the baptism.
Uh-huh.
She wants you to do that? Course.
Why wouldn't she? What? You want my opinion? Sounds like I'm going to get it.
You need to give that woman some space.
Did you drill the burr hole in the patient's head? I did.
Ms.
Reese, you're not a doctor.
You're a student granted access to this hospital, strictly for learning purposes, which means you are not licensed to perform an invasive procedure on a patient without direct supervision by an actual physician.
It is, in fact, illegal.
- I understand.
- I gave the order.
Excuse me? I was confident she was capable of this procedure.
I'd warn you to be very careful what you say.
I've had extensive clinical experience with student doctor Reese.
I have full faith in her abilities.
If you disagree with this patient's treatment, your disagreement is with me.
[sighs] Don't either of you ever put me in this position again.
You did not have to do that.
It's the truth, Reese.
And you're family.
We rise or fall together.
Some help here! I need some help! Daddy, Daddy! He threw up blood.
Call the OR.
We're taking him up now.
Okay.
It's like you said, right? The bleeding.
We should have operated.
Wait here.
We'll keep you updated.
It's my fault.
This is this is my fault.
Looking for magnets in the intestine is a little bit like looking for a piece of gum in a garden hose.
How's the bowel look? Obstructed, but no gross ischemia.
Looks like we got here in time.
All right.
Found 'em.
One's in the stomach, the other small intestine.
Let's get him out of here while the bowel still has some life in it.
Damn.
What is it? The magnets must have eroded through an artery.
- Get in here.
- What? I need an extra set of hands now.
I haven't done that since medical school.
- Call a surgical resident.
- There's no time.
Get in here.
Here.
Hold this back.
There.
Right there.
I'm getting a ton of blood from the NG tube.
I got to give him a unit.
He's a kid.
Not yet.
I keep slipping.
Can you get it? No, I lost it.
Wait, wait, wait, wait.
Hold still.
There.
Pinch down.
Right there.
- Got it.
- Good.
- Clamps.
- Clamp.
I don't see the vessel.
It's buried in the fat, but you've got it.
Trust me.
All right.
Now let go.
BP's stable.
Good.
Let's tie these off, close up the holes, and get him on his way.
Thank you, Dr.
Manning.
Eric did fine.
He's gonna be okay.
Thank you.
Thank you.
Dr.
Rhodes will come soon and talk to you.
- Can I see my son? - Yes.
In a little while.
Eric will be in the hospital for four to five days, maybe a week.
So I guess I'll be seeing you.
Yeah.
Got to get back to work.
Sure.
He's a young kid, he's healthy.
He will heal fast.
Now be honest, you kind of liked using the giant intestine stapler.
[laughs] I kind of liked using the giant intestine stapler.
- Everybody does.
- [giggles] Hey, I'm sorry for earlier.
- When I snapped at you.
- It's okay.
I just I felt for that dad.
Single parent, having to make that decision by himself.
I imagine it can't be easy.
I have a decision of my own to make.
Nothing so momentous, but I'm having a tough time.
My mother-in-law is insisting I get Owen baptized.
Oh, family drama.
Now you're in my wheelhouse.
Yeah.
Family and religion.
You know, religion was actually the one topic we managed to avoid.
Dad never saw the upside to it.
- You're lucky.
- I don't know.
I always kind of envied the kids who went to church.
You know, they were a part of something.
It's like they had their own tribe.
Mr.
Tacker.
I see you've had your nerve block.
Should be starting to feel it by now.
I feel so much better.
How long will it last? Oh, several hours.
But we could always re-administer for longer periods.
I wanted to use the nerve block in conjunction with another approach that I've been looking into.
It's called "pretend therapy.
" Pretend? The idea is that you function as if the limb weren't there.
You pretend.
See what it's like to go through life without it.
It's cognitive work.
Sorry, I'm so tired.
You know what? The anesthesiologist administered a mild sedative before giving you the block.
Why don't I check back with you in a bit, and we'll get started? Could you pull my covers up? I'm just a little cold.
Dr.
Charles.
Thank you.
For everything.
Come on.
We're a team.
[sighs] Hope you're not planning on jumping.
No.
Everything is mixed up.
I saved a life.
And that was good, really good.
And then I got in trouble, and that was bad.
And then Dr.
Choi stuck up for me.
Called me family.
That sounds good, too.
It was.
So why are you out here? [laughs] 'Cause it's Match Day, and everything's mixed up! It'll all be clear very soon.
Yeah.
Mrs.
Baker is too sick to continue the trial.
She's going home.
She's finally getting her wish.
Yes.
Dr.
Halstead.
Dr.
Halstead.
Guy in three dislocated his shoulder.
Go.
Pop it back in.
Okay.
[screaming] Blood pressure spiked.
Mr.
Tacker? I'm sorry! [groaning] He slipped his restraint! He made a tourniquet out of tubing.
- Half milligram dilaudid.
- Yes, Dr.
Charles.
No, no, no, don't touch it! The arm's dead.
You dump potassium into the bloodstream, he'd go into cardiovascular collapse.
We have to amputate his arm.
Let's go! I'm sorry.
I had to! [screaming] Yes! Yes! Here you go.
Mayo, baby! [laughs] Yes! [laughs] Reese, Sarah.
I haven't got room for them! Yes, this is your problem, Roger.
Get them out of here! This is a lot of bedpans.
Are we expecting a listeria outbreak? Some idiot in supply added a zero to my order.
- So instead of four dozen - You got 40 dozen? Uh-huh.
[laughs] [both laughing] See? You can't retire.
How could you give all this up? Yeah, how could I? It's so much better than the Maldives.
[both laughing] Well? [laughs] You got it! Chicago Med, pathology.
This calls for celebration.
Yeah.
I'll get my coat, and um, check Groupon, and see where I can get a deal.
Congratulations.
Reese.
You get your match? Uh-huh.
Pathology.
Congrats! That's what you wanted, right? Yeah.
Yeah, um, but this was starting to feel sort of like home.
Yeah.
We'll miss you.
He played us.
You mean me.
Look, nobody likes getting snookered.
But that's not what's bothering me.
It's why I fell for it.
He's a good liar.
Not really.
I didn't see the depth of his desperation.
You know, didn't want to.
So I just pulled out my standard playbook meds, psychotherapy.
What else could you have done? I could have gone up to ortho.
Looked for somebody to take his arm off.
Dr.
Charles, we can't intentionally maim a patient.
Of course not.
All I'm saying in cases like this, are the decisions we're making really in the patient's best interest, or are they in ours? To make us feel better? 'Cause like it or not, that's a happy ending.
Mr.
Patrick You didn't know her.
I knew her.
[knocking] Come in.
- You paged? - Uh, yes.
Mr.
Patrick wants to go forward with the egg harvesting protocol.
I don't understand.
Despite the IUD, he says his wife would want this.
Hospital council says we have no choice.
We have to restart Ms.
Patrick on the protocol.
It's not right.
That woman's body is telling us no.
- Loud and clear.
- Yes.
I agree.
So why won't he listen? Well, Dr.
Halstead, sometimes we want to believe something so badly, we ignore the reality in front of us.
You're familiar with that, aren't you? Yeah.
Hey.
Hey.
So I-I appreciate all the trouble you've gone to.
The church, the priest.
And I want to get Owen baptized, just Just not like that.
Like that? I want Owen to be a part of a community.
I just want it to be one that I'm a part of.
So I'm gonna do it my own way.
I know Helen's gonna be upset, but I hope you won't be.
No.
Natalie it's your life.
And I want whatever's best for you.
I need to move on.
So, as Father Brady would say, "Go in peace.
" [sighs] Can you just watch her for a minute? Thank you.
Thank you for not giving up on Jen.
[crying] We're here today to celebrate the newest member of our community.
And as we do at weddings and funerals, to offer our love and support.
It is the people in our lives who bring us joy.
They are the color of our lives.
The beauty and the grace.
I can see by this gathering today, you will not walk through life alone.
And so, little man, I wish you Godspeed.
In front of all these gathered on your behalf, I baptize you, Owen Jeffrey Manning.
[applause] I thought he was gonna hit me.
But he thanked me.
Must've been a relief.
Jay, she was on a placebo.
They never knew.
It was all for nothing.
No, you cared.
I think, if we care, then whatever happens, it's for something.
We might not see the effect, but It goes out there and it circulates around.
It makes us all better, you know? My brother, cop and philosopher.
You've got to think big picture.
[chuckles]