Code Black (2015) s03e08 Episode Script

Angels, this is unit 51.
We've got a young boy coming in with a possible caustic ingestion.
He's having difficulty breathing.
ETA two minutes.
Oh, my God.
Please, help! Don't worry, sweetheart.
We got him.
We got him.
- What do you got? - Doug Kessler, 8 years old, sister found him in severe respiratory distress after ingesting boiling water through a straw.
- Why would he do that? - He said he saw it on the Internet or something.
He's choking on his own secretions.
We need to intubate, and we need to get him to center stage now.
Hey, we got him.
What do you see, Dr.
Avila? Talk to me.
I-I don't know.
There's too much swelling.
- Okay, well, keep trying.
- What do we got? We got severe thermal damage on the esophagus.
Let me see the X-ray.
- How's that intubation going? - Oh, I'm almost there.
Oxygen sat down 75%.
I'm almost there.
Give me a second, all right? He doesn't have a second.
Move.
Here we go.
Pneumomediastinum.
He ruptured his esophagus.
He needs the OR now.
Where are the parents? - They are not here yet.
- Let's go.
Move, move, move, move, move, move.
Mother's phone goes straight to voicemail.
I left a few messages at her office.
- I'll keep trying.
- Where are they taking him? To the OR.
Your brother needs surgery to repair his throat.
Will they be able to fix it? I'm staying positive, and I want you to stay positive, too, okay? - Okay.
- Oh, honey.
Come here.
It's okay.
Hey, Savetti, this is three days in a row you've been on the rig with us.
What gives? I gotta have a reason to do my job? I'm just saying it's been a minute since you've been on a ridealong.
Will you say something hopeful? Anything.
Purest Tahitian blue, bright as Egyptian tan, - cured by a woman's hue.
- Willis.
Aside from the soul of man.
What are you lookin' at? He got a Realtor.
My dad.
For my brother's house.
- You gonna sell? - No.
It's all he wanted, was a home.
Would've wanted me to finish it.
Then that's what you should do.
Squad 15, squad 15.
Two boat crash at Beaman's Wharf in San Pedro.
Multiple injuries.
I hate boats.
Hi.
Hi.
Um, I have to go to work.
Okay All right, let's go.
All right, I'll take the walking wounded.
You take the trawler.
- Which one's the trawler? - The one on fire.
All right.
Hey, hey, hey.
My dad he needs help.
He's on the charter.
He's pinned.
The trawler came in too fast.
- You gotta help him! - I got it.
Hey, sir? Sir, can you hear me? Sir? All right, what is your name, sir? Lars.
Captain Jonathan Larssen.
Good.
Where's my wife? Okay, we're gonna find her, but right now, we need to get you out of here.
I'm gonna need a firefighter over here! I got one up here! Shallow pulse.
Help me get him down.
Gotta get him back to Angels.
One, two - Aah! - Here's the good news.
I can take this out without severing the artery.
You good with that? Not really, but you're gonna do it anyway, aren't you? Okay, bite down on that.
Let's go.
It's not safe here.
Is anyone else up here?! Over here! This is the Los Angeles Port Hey, guys, there's someone in the water! All marine craft, please stay clear of the area.
Willis! Wait a minute, wait, wait, wait, where's my mom? - Your mom was in the boat? - Yes.
Willis, the boat's leaking fuel! Wait here.
Stay there.
That's her.
That's my mom.
No! Let me get her.
- No.
No.
- Get off of me! - Too late.
Too late! - No! Where's my wife? Is she okay? We need to worry about you right now.
Hi, Sally.
So Doug is still in surgery, and we won't know anything for a little while.
Did you talk to my mom yet? Not yet.
She can't answer the phone while she's working.
- Mm-hmm.
- I hope she gets here soon.
I'm sure she will.
Listen, I'm sorry.
She's gone.
I gotta go help your father.
Do not tell him about your mother, okay? - What are you talking about? - Do you understand what I'm saying? Willis! Can I get some help over here?! Not now, okay? Not now.
No femoral pulse.
This winch is crushing his pelvis.
But he still has circulation north of his hips.
We're gonna get you out of here, sir.
I how are you gonna get a 1,200-pound piece of steel off him? Get it together, Charlie.
Okay, this mast is still attached to the other boat.
LAFD is gonna have to cut the arm and lift it out.
But when they do, all that circulation's gonna run south, he's gonna code.
Charlie, make sure your mom's okay.
Just do what I tell ya! I'm staying here with you.
Okay, start the insertion at the mid-axillary line.
- Dad? - Emily, don't look at this.
Get back to my office.
Am I supposed to sit there all day? You have a book.
Now go.
Why can't I just call Mom? I'm not gonna get into this right now.
Can you see that I have a patient? You always have a patient.
- Oh, my God.
How old is he? - He's 8.
What's wrong with him? He burned his throat on a dumb prank.
Now go.
Get outta here.
Go.
- You okay? - I'm fine.
Focus.
- Hello? - Oh.
Hi.
I'm not like some rando.
Dr.
Campbell's my father.
I'm Emily.
Oh, hi.
I'm Ariel.
So you, like, work here? Why is everyone surprised by that? - Here.
- Oh.
Thank you.
You know, I heard two guys on the elevator talking about a guy upstairs with a cucumber stuck in his butt.
What? - Oh, God.
- So gross.
- Ew! - I know, right? He was short of breath, so I asked Marjorie to drive us here.
Only one at the assisted living with a license.
I'm very popular.
- You're wheezing.
- COPD.
But it doesn't slow me down, though, does it, Gloria? Harold, you're embarrassing me.
150 milligrams of solumedrol and start him on a nebulizer.
You'll feel better soon.
He had a little fever, too.
I told you I run hot, Gloria.
I'm gonna get him on a CBC, do a chest X-ray, and then check his urine.
You getting with that pretty nurse? Doctor.
And no.
Not ever.
First guy you sent from the boat crash? DOA.
His sister's here.
And I'm so sorry, but I need you to verify this is your brother.
Oh.
Oh, God! - That's him.
- Okay.
Okay.
I think I just need to go sit somewhere.
Is there a a chapel? Yeah.
Yeah, I can take you there.
We have to call Child Protective Services.
I called the mom's office.
She was fired weeks ago.
She has a gambling problem.
She goes to the casino for days at a time.
Okay, wait, wait, wait, hold on.
I wanna talk to her first.
I wanna get all the facts.
We'd have to hunt her down first.
Right? - That's not our job.
- She is their mother.
And you're not.
We have two minors here without a guardian.
One is in post-op.
Our job is to protect them.
Make the call or I will.
Good.
He's got a thready pulse.
We need more blood.
Fire department says they need 20 minutes to get this off him.
We don't have 20 minutes.
Charlie, if we can't get this off him, is there a way to lower the boat? Charlie! Is there a way to lower the boat? I don't know.
Uh, yeah.
Yeah.
I can reverse the bilge pump.
She'll take on water.
You've been trying to sink this boat for years.
Not now, Dad.
Hey, I'm the one under a pile of ship here.
I'll say whatever the hell I want.
You should go back to your fancy bank job.
- Leave this to the men.
- No offense taken.
He was here to foreclose on the boat.
My boat.
It wasn't me.
It was the bank.
You work for the bank, don't you? Yes, but I don't make the decisions.
God, do you ever stop?! Hey, hey, Charlie, Charlie, this isn't the time.
I really need your help with the bilge pump.
Me and Harriet, we were gonna retire on this boat.
But you didn't have the guts to tell her yourself! It'll break her heart when I tell her.
You listening, Charlie? She'll never speak to you again! You listening to me?! Yeah, well, she's never gonna speak to me again anyway, okay, 'cause she's dead.
All right? Mom's dead! - Dad? - He's hemorrhaging! Dad! Charlie, is there any way to speed this whole thing up? I reversed the pump.
She's taking on water.
I don't know what else! Willis, his pulse is barely there.
God, I shouldn't have told him.
- What's done is done.
- You think this is my fault, don't you? I didn't say that.
You think this is really gonna work? It has to.
Stay as long as you like.
I really am sorry.
Could you sit with me for a moment? Uh, I can get the chaplain, but I really have to get back.
Please.
You don't have to pray, just sit.
Okay.
I'm not religious at all.
Me neither.
Why'd you wanna come in? I don't know where else to go.
Do I go home and what would I do when I got there? I mean, do I get the mail? I mean, what an insult it would be to my brother to get the stupid mail the day he died.
I know you have to go.
I really am sorry.
I'll let the chaplain know you're here.
Um, excuse me.
I'm Pamela Kessler.
I'm looking for my kids, Doug and Sally.
I was told they were here.
We've been trying to reach you.
Yeah, I'm I'm sorry.
I just got the message.
Is Doug okay? You're gonna need to speak with Dr.
Rorish.
- Wait.
Surgery? - Yes.
I don't understand.
You said he drank hot water.
Boiling water through a straw.
His esophagus needed extensive reconstruction.
But he's young, he's healthy, and hopefully, he'll recover.
Hopefully? And where's where's Sally? Where are my kids? They're here, and they're safe.
But Child Protective Services is opening an investigation.
Wait.
What? You you called them? I did.
It's standard in incidents like this.
Wait, hang on, hang on.
I had to work.
Okay? My mother couldn't come What what else was I supposed to do? Okay, Pamela, we spoke to your boss.
We know you weren't at work.
You don't know me.
You don't know anything about me.
You don't know anything about my kids! - You weren't there for them.
- I demand to see my kids! - I'll get security.
- No, no.
Please, please.
That's not necessary.
Please.
My kids need me.
Please.
- Feel that? - Yeah.
Is that okay? Oh, here we are.
Phoebe, this is Dr.
Leighton, one of our surgical residents.
Well, thank you for coming.
I need an ex-lap.
Okay, hold on a minute.
What's going on? Abdominal pain, tenderness in the lower left quadrant.
And what makes you think it's surgical? I swallowed a bunch of tacks.
Way to bury the lede.
What does the X-ray show? Well, so far, no perforations.
I'm gonna examine you, Phoebe.
It's okay.
Relax.
Just relax.
Well, the abdomen is still soft.
That's good.
Your chart here says you've had several psych evaluations - over the years.
- Excuse me? It's a form of OCD.
I can't help myself.
- Am I getting the surgery? - No.
But it hurts.
I want the surgery.
And you've got three scars to prove that.
I'm sorry, Phoebe.
You're not having surgery today.
Most likely the tacks will pass on their own, but, Dr.
Guthrie, let me know if that changes, okay? Excuse me, Phoebe.
Dr.
Leighton, I need a word with you.
I called you for a surgical consult, not a psychiatric one.
Or maybe I should've called Dr.
Campbell.
Call him.
I'm not clogging up the OR schedule with an unnecessary surgery.
Let me know if she perfs.
- How we doing, Charlie? - She dropped about 2 or 3 inches.
Yeah, I could see some space.
We're getting close.
All right, let's get that Stryker ready and bring me a backboard.
- He's crashing.
- Okay, we're free.
We're free! Come on, let's get him out of here.
- Okay, let's go.
Careful.
- All right.
On my count.
One two three.
Let's get him to Angels.
Come on, Charlie.
You, too.
No, no, he doesn't want me here.
I'm not asking.
No, no, I can't.
If he doesn't make it to the hospital, you're gonna regret not being with him for the rest of your life.
You understand? Oh, that thing worked like gangbusters.
You did good, Red.
There's just one other thing.
You tested positive for gonorrhea.
Crap.
It's easily cured with doxycycline, but we strongly suggest you inform your sexual partner.
Yeah.
Gloria, come here.
I got the clap! Shh! Keep your voice down.
Who's listenin'? Which one is the clap? Syphilis? No.
Gonorrhea.
It's way better.
Hey, uh, call the nursing home.
There's gonna be a gonorrhea tornado.
- What are you talking about? - My man here is a player.
- Come on.
He's 80.
- Game recognizes game, Red.
Excuse me.
But I just heard what Harold said.
I think I need to get tested, too.
He lost pulse en route.
Let's get him hooked up to a monitor.
- Another amp of epi.
- On it.
Trace pericardial effusion, poor cardiac activity.
- Where's Charlie? - Who? His son.
Should be here.
Ah, let's do it.
Clear.
Clear.
Okay, pulse is back.
Sinus tach.
O2 sats at 78.
Come on.
Come on.
Poor sonographic window.
I can't see.
Give me an 18 gauge.
The son should be here! He's gone.
Sats improving.
Okay, good.
Let's get a chest tube in him.
Get him packed up for the OR.
- Hey.
- Hey.
I feel like I haven't seen you all day.
I've just been busy.
That's all.
- Everything okay? - Fine.
Heard you lost a patient today.
Yeah, I know.
I was there.
Day didn't start great either.
What do you mean? We fought.
Don't you remember? No, whatever it was, it's fine.
- Second time you've said "fine"" - What's wrong with "fine"? "Good" means good.
"Great" means great.
- "Fine" never means fine.
- Just give me a break, okay? - Come on.
Don't - My dad died a year ago today.
What? Why didn't you tell me? Because I'm fine.
What's wrong? You have to tell me.
- Whoa.
What Excuse me.
- You can tell me.
It's okay.
You're not supposed to have any contact right now.
Something's wrong with her.
- Something's wrong.
- Let me see.
Her voice.
It's strange.
And and she's hot.
- Get me Dr.
Rorish! - Sally? Sally, honey, can you tell Mama the truth? - Did you do the dare, too? - It's all my fault.
I did it first.
- Doug was just copying me.
- What's the problem? - She did it, too.
- I'm sorry, Mom.
Sally, can you open your mouth, please? Okay, she's got blisters on her throat.
She may have perforated - like her brother.
- Gurney.
- Oh, my God! - Call Dr.
Campbell! Oh, my God.
What's happening? What what is happening? I need to assess her.
You have to save her.
Please.
You can't let anything happen to her.
Whoa, whoa, whoa.
You need to wait here.
- That's my daughter.
Please.
- Security! Park this woman right here till we get back.
Sally! Sal Sally's in surgery.
Uh, she has severe burns in her throat.
Um, it'll be a couple hours, but I promise you I'll keep you updated, okay? I never meant for any of this to happen.
They're gonna take them from me.
Aren't they? I think everybody wants what's best for Sally and Doug.
I think that's what you want, too.
I just I just don't wanna lose them.
Then you're going to have to change.
You're going to have to take responsibility.
You're going to have to fight for them.
What? You know, Freud says we cast people around us to replay the stuff in our lives we couldn't fix before.
What does that even mean? Ask Freud.
I'm asking you.
We see a lot of stuff.
Horrible things.
What is it about this that's getting under your skin? He should be stronger Charlie.
You don't even know him.
I know a son should be there for his father.
Who are we talking about right now? I don't know.
Who are you talking about right now? Freud.
So let me get this straight did he try to kiss or not? I mean, I think so.
I couldn't really tell.
- He either did this - Or he didn't.
It was, like, in more, like, slow motion.
You have to take charge.
- Me? - Yeah, why not? Why do they get to make all the choices? You ever kissed a boy before? Yeah, totally.
Me, too.
I'm totally lying.
Me, too.
Wait, so you haven't? I have spina bifida, remember? - So what? - So boys aren't into that.
Boys are stupid.
Hey.
Doxycycline, 100 milligrams, two times a day.
You English whore.
- Whoa.
- He liked me first, but you had to go and get your hooks into him.
Okay, ladies, please.
Why do women always attack each other? It's on him, too.
I mean, girl power, right? We're best friends.
How could you do this to me? I'm sorry.
But it had been so long, and he he made me feel young again.
- He has a gift.
- Okay.
Um I hate to pour gasoline on this fire, but have either one of you had any other sexual partners? - Hell, no! - Watch your mouth.
What about Harold? So she's a friend of yours? Yeah, I mean, we just met, but she's really cool so Did I freak you out this morning? Wait.
Uh, w-was that okay? I'm not like a like a slut or anything? Oh, no! No, that was great.
Of course.
Um how was it for you? 'Cause I feel like I can do better.
Um, me, too.
- Max? - Dad, what are you doing here? I said I'd be right back.
Who's this? This is Ariel.
She's a candy striper and my friend.
Girlfriend.
Girlfriend? Well, nice to meet you, Ariel.
Do you mind if I speak to my son in private? Sure, I gotta go to work anyway, so I was looking for you.
Told me I needed some head scan.
- Where's my dad? - He's in surgery.
Well, how is he? That's all the information I have right now.
We have nothing in common.
That's not true.
You both loved your mom.
Now she's gone.
Which means the two of you are all you have left.
Excuse me, Dr.
Rorish.
I'm Owen Edwards, Max's father.
Oh! Hi.
It's really nice to meet I just found Ariel kissing my son.
Well, surely Max was also kissing Ariel.
My son is a patient here, and Ariel is an employee.
I find that relationship highly inappropriate.
Okay, well, I really don't think that you need to Max has pulmonary adenocarcinoma in sit We have been on the lung transplant waiting list for over a year.
He needs to focus on his health.
I understand that this is very difficult for you.
She's preying on a sick kid.
Now as a doctor and a mother, it's your responsibility.
Keep her away from my son.
- Are we clear? - Crystal.
Don't hit him.
Hit me.
I just helped tear two kids away from their mother.
I got reamed by Max's father.
And my case worker says I'm a bad mother.
You're bad at a lot of things.
Mothering isn't one of them.
Oh, yeah? What am I bad at? Okay.
I got a list right here.
Wait, wait.
Oh, don't read number seven! Please! Now I need you to listen to me, Phoebe.
Your bowel has ruptured.
And these people are gonna take you up to sur What the hell is going on here? I just heard Dr.
Sistulli was paged for a perfed bowel.
That's right.
You're not the only surgeon in this hospital.
- She is my patient.
- No, she's not.
Remember? You didn't want her.
So I got somebody else.
Now if you'll excuse me, Dr.
Leighton.
Let's go.
Where did you get gonorrhea? 'Cause it wasn't from either of us.
I have no idea.
But listen, I'm old as dirt, and you ain't much younger.
So now do we really wanna spend any more time fighting? Or do we wanna have some fun? We've shared a lot of things over the years.
I can live with it if you can.
Share him? Deal.
But not at the same time.
I'm not into that.
Harold is my spirit animal.
For sure.
You're gonna be fine.
Okay? Okay, just breathe.
Look at me.
Look at me.
Oh, God.
Get help.
- What happened? - He started having trouble breathing.
- I counted 36 breaths per minute.
- Good job, Ariel.
All right, I need you girls to stay back there.
Max, you stay with me, buddy.
Stay with me.
Clear the way! He's not moving any air at all.
We're here for you.
Okay, let's get him on a continuous nebulizer treatment, - 15 milligrams albuterol.
- Right away.
- He needs a continuous treatment.
- We're doing that right now.
Okay, here we go.
- Okay? That's good.
- Want a bipap now? Not yet.
Have it standing by just in case.
Not yet.
Oh, God.
Ariel, it's okay.
This happens.
This isn't your fault.
- It's not your fault.
- Okay.
Sats are improving.
He's gonna be all right.
He's stable.
We're gonna take him into Sides.
Incoming! - What happened? - Charlie was in the CT scanner.
Started to seize.
Gave him 2 of ativan five minutes ago.
Give him 2 more, give him 3 milligrams of dilantin.
CT show anything? Starting seizing before they could finish the scan.
Need that CT.
Okay, keep loading him up on the anti-epileptics.
We gotta stop these seizures.
It's the second kid today.
Second kid, same woman's negligence.
Sutures are holding.
Let's get ready to close her up.
Heart rate's 140.
Pressure's dropping.
- Did you hit a vessel? - No, there's no blood.
Heart rate's 200.
No bleeding, no air embolus.
What is it, Dr.
Leighton? - Reaction to the anesthesia? - No.
She's in a hypokalemic rhythm from too much vomiting.
- Crash cart now.
- She's going to arrest.
Still not responding to the meds.
- We need to paralyze and intubate him.
- Not yet.
We're risking permanent brain damage if this goes on any longer.
It's time to induce a coma.
Need 4 more milligrams - of ativan, 3 of keppra.
- Wait, what? You're playing the odds with a man's brain.
- Charlie will die if we don't act now.
- Shut up! Willis, I am pushing propofol.
His brain can't take it anymore.
You do not touch this patient.
You once told me there was a difference between being a cowboy and being reckless.
Which one are you right now, huh? He is going to die.
How did you know? Sometimes you just have your gut.
All right, let's get him up to CT, make sure there isn't a bleed.
And what I said was there's a difference between being a cowboy and an idiot.
I'm an attending physician.
You're a resident.
Don't ever contradict me in here again.
No organized cardiac activity.
Ready to shock.
Pulse is back.
It worked.
You don't seem happy.
Just close her up.
She's gonna be okay.
I want her mother to see her.
Before you say anything, she came back when it mattered the most.
Yes, protecting those kids is our job.
Punishing their mother is not.
Will, trust me.
You start being punitive, and it's a very difficult hole to climb out of.
My dad died because he took terrible care of himself.
There was no higher or lower power at play.
Isn't a higher power kind of part of the 12 step deal? Yeah, it just seems crazy.
What's God gonna say to me? Maybe it isn't about hearing God.
Maybe it's just about being in a place where you can listen to yourself.
- I feel stupid.
- We're the only ones here.
Mr.
Savetti, it's Noa.
I'm sleeping with your son.
Hey, Dad.
I, uh I wish things had been better with us.
I wish we had had more time.
Maybe we could've figured it out.
I miss you.
Whoa, whoa, easy.
You still have anesthesia in you.
Where's my boy? Where's Charlie? He's right there.
He had a seizure.
But he's gonna be fine.
A seizure? Why why a seizure? He had a traumatic brain injury.
But the good news is the C doesn't show any bleed.
Is he gonna be okay? Yeah.
He's gonna have to be in the hospital for a few days, but he should be fine.
I'll tell you what he does need.
What? His father.
He has his father.
He knows that.
Does he? Fine.
So I don't hug him all the time or tell him I love him twice a day like his mom does.
Boo-freakin'-hoo.
He knows.
He knows I love him.
Dad.
Hey, pal.
How you feelin'? Should ask you the same question.
I'm tough.
So are you.
Sorry about Mom.
Yeah.
Me, too.
What are we gonna do? We're gonna get through it.
Together.
I hear the surgery went well.
Hmm.
She'll be dining on nails in no time.
Look, why didn't you call me? Medicine is not just a science, son.
It's an art.
It's about collaboration.
We collaborate with our patients, the same way we collaborate with each other.
I get it.
I didn't listen to you.
No, you didn't hear me.
It's different.
You know, I've been doing this for a long time.
I know the percentages as well as you do, and I knew that that woman didn't need surgery right away.
That's not it.
Campbell's been teaching me to own my decisions, to be more assertive, like him.
Son, if your goal is to become Will Campbell, good luck.
Thanks.
'Cause that's never gonna happen.
But if your goal is to become a great doctor, you have got to blaze your own trail.
Remember who you are, young squire.
It's the only way you're going to become who you're truly meant to be.
Almost there.
Ooh! Ooh.
What you got? What you Go fish.
You just hustling me, huh, buddy? They come by it honestly.
- Mommy! - Hey, Mom.
Go ahead.
I missed you so much.
You know, I should've been here.
I should've been here.
I was just You can do this.
Okay.
You guys deserve the best mommy in the world.
And right now I'm just not her.
What happened to you guys It was my fault.
And I am so sorry.
Do we get to go home with you? I've spoken to your mommy's case worker, and if she's willing to get treatment then yes.
You do get to go home with her.
You know I love you so much.
Sliders for the lady.
Wow.
Whole day stuck in your office, and now you're buying me dinner from a truck? Mm.
I heard you weren't actually in my office all day.
And you were in center stage.
I heard you were a big help with Max.
Is he okay? Yes, thanks to you and Ariel.
I just went to get help.
I'm glad you were there.
Proud of you.
Mom! - Oh! I missed you.
- How are you? I am so good.
Look at you.
Thank you, Will.
It's just, um, eat your food.
Thank you, Daddy.
So what's for dinner? Sweetie? Time to go home.
Can we have, like, five more minutes, please? Okay.
I'll be waiting over here.
Oh, hi.
We were just about to leave.
Um I think we got off on the wrong foot.
I'm sorry.
They like each other.
Ethan.
Tell me something hopeful.
Please.
Anything.
That poem that your brother wrote.
Will you tell me that? - What are you staring at? - Huh? - What are you staring at? - Nothing.
- Nothing? - I was just wondering how they're doing, - Larssen and his son.
- They're talking.
Who knows how long it'll last? Apple fell pretty far from the tree.
But it still came from the tree.
Who are we talkin' about now? Freud.