ER s06e04 Episode Script
Sins of the Fathers
E.
R.
Previously on E.
R Under no circumstances is that man to go into that operating room.
Call security if you have to, and enjoy your first solo surgery.
I don't need you to feel sorry or tender or anything.
I just need you to go away.
Paula Trancoso, Chicago Gazette.
Elizabeth Corday, my associate Head of Surgery.
I want you to meet Gabe Lawrence, our new Attending.
Gabe, this is Dr.
Mark Green.
Gabe is coming over from New Werstern as our new attending.
As our new attending? I said the lap-chole at 11, the gastric bypass at 3.
Have you seen my earring? Why don't you try to get hold of him and then call me back? Already dressed? My schedule's all jumbled up.
I need to get in.
Besides, Romano's got me buried in paperwork.
Oh, there they are.
Oh, come on.
You're going to cover me in shaving cream.
Hi.
Did you get him? Yes, hello.
Yes.
He's right here, actually.
It's your father.
I'm sorry.
Hi, Dad.
Calm down.
What? What happened? Was anyone hurt? - Is everything all right? - That's good.
So this was last night? - You need me to stay? - Catch you later.
So, Dad? Okay, all right.
Look, it's just a fender.
Okay, a fender and a cypress tree.
You know what? Just corn flakes and a small orange juice, please.
That's it? - No room left for food.
- I'm eating like a horse.
Well, twins.
They are squishing my stomach.
I just got one.
Is squishing more than that.
- Meg, I can't read this.
What's it say? - Two over medium.
Large coffee to go, please.
- Morning, Carol.
- Hi.
What? You have shaving cream on your ear.
Thank you.
How is Mark? Clean-shaven.
- That's twice in one morning.
- I'm sorry.
Clean it up.
And get this guy another order.
- How do you manage without coffee? - It's not so bad.
It's growing out of my maternity wear that worries me.
Not to worry.
You'll drop a couple of pounds breast-feeding.
See you later.
- Here.
- Oh, thank you.
- Not easy, is it? - No.
- Know what you're having? - No.
- Nothing on the ultrasound? - Haven't had one.
You should.
It's important for the baby.
Who's your OB? - I've got an order.
- You do have an OB? My boss is gonna yell at me.
Can I borrow your pencil and pad? I'm a nurse at County.
I'm gonna write down my name.
You should come by after your shift.
We'll examine you and check out the baby.
I don't know.
I don't have insurance.
It's OK.
Where I work, you don't need it.
- Morning.
- Hey, the celebrity herself! Beg your pardon? - Dr.
Corday, right? - What are you talking about? "Prescription for Danger: Are You Safe at County General?" Good picture.
Oh, my God! Stop it! Get that thing away from me! Leave me alone! Let go! - Robin, calm down.
- It's not so bad.
- I hate you! - Yosh? - Do you like koala bears, Robin? - Why? I have a bear that wants to meet you, Mr.
Koala Bear.
- I hate bears! - Robin, stop it.
Can you hold her, Mrs.
Bourke? If you're good, I'll take you to the toy store.
- When did she start vomiting? - This morning, after she drank her juice.
Mommy, make him stop! We had takeout last night.
I hate you! - Any diarrhea? - A little.
- Childhood illnesses? - Just a few colds.
Prescription medicines, you keep those out of reach? Yes, our home is childproof.
Probably food poisoning.
I'll give her Compazine for the nausea.
And observe her for a few hours.
Honey, did you hear that.
We're gonna stay here so they can take care of you.
- I hate it here! - Wait- Okay.
- Looking for me? - Yo, Dr.
Pete.
I've got one seriously hot appy for you.
- Hot appy? - Ready to be sliced and diced.
Why don't you call for a surgical consult? - I told you.
- Thought you'd want it.
- He can't do general surgery.
- I don't do general surgery.
- Told you.
- Thanks, Connie.
You're welcome Doctor Dave.
I don't blame you.
Hernias, appys- Boring, right? You're like me.
You like the guts, the glory, the bright lights, the big city.
We're cut from the same cloth.
You know what means "to be skating on thin ice"? Ok.
This is me backing off.
That's good.
Stay up there as long as you can.
You're doing great.
- Kerry, hi.
- Morning, Gabe.
How much longer? The expulsion of flatus marches to its own drummer, Mr.
Rineberry.
The more I fart the better I'll feel? To put it somewhat indelicately, yes.
I'll be back.
Stay with him.
Keep your eye on him, okay? - I was just gonna grab a cup of coffee.
- Great, I'll join you.
So, you're starting your day with a little splenic flexure syndrome? The guy, he didn't want to stand on his head till I reminded him gas rises.
It seems like you're settling in well? - Everybody's been terrific.
- Good.
Great.
Mark Green is still pissing on trees- Do you want me to say something to him? - Dr.
Lawrence? - Yeah, Lily? - It's Lucy.
- Lucy.
Sorry.
Did you want to order Oxacillin for the cellulitis in Four? Cellulatis in four.
Yeah, he should have some.
You just didn't sign for it.
Easily fixed.
- Here you go.
Thanks.
- Sure.
Is it me, or are medical students younger than they used to be? It's definitely the students.
I haven't felt this old since your class graduated from med school.
My class? I remember your mom came by to me and she was thanking me for you know, for inspiring you to go into emergency medicine.
And the whole time she's talking to me all I can think is: "My God, We're practically the same age.
" Oh, no.
She had a year or two on you anyway.
- How is she.
How is she doing? - She passed away a couple of years ago.
- Oh, I'm sorry.
That's rough.
- Yeah, it is.
How is your family doing? All my ex-wives are alive and living well.
And your son was going into medicine too, wasn't he? That was my dream, not his, as he would say.
Of course, he doesn't say much of anything to me anymore.
Families, huh? Go figure.
Get away from me! Get away from me! - Get away from me! - Sorry.
Excuse us.
- Think I'll have more cream.
- Sure I certainly never meant to convey any deficiency at County.
I could hardly anticipate a shootout.
And not everything in the account is negative.
You're right and I particularly enjoyed the description of Dr.
Carter clamping off his first aortic rupture in an 8 years old.
Yeah, which as the account clearly states, was successful.
Do you remember, Lizzie, the point of this article? To toot County's horn.
Actually, it was to toot my horn.
Which is why you'd understand that I'm disturbed that, not only at getting heat on this from upstairs, but at finding my picture in a sidebar next to the obituaries.
I'd gladly give up the front page.
Lizzie, when I appointed you Associate Chief it was for two reasons: One, to serve; Two to protect my needs, my interests.
But I've sensed some reluctance.
- To what? - Corralling Benton for one.
- We settled that.
- Oh, have we? So, I haven't made a mistake in appointing you? No, you haven't made a mistake.
Good.
By the way, theres been some slop-over from the Anspaugh administration.
It seems Donald's still scheduling his own surgeries.
Speak to him about it, would you? You can't be serious.
It's interfering with my schedule.
I'm completely serious.
- Dr.
Corday.
- Carter.
Is Elaine Nichols' path report back yet? You'll need to speak to her about that.
Right, of course, I will when she comes in to have her sutures out, which generally is about a week after the operation, right? Generally.
And in Elaine's case, that could be some time today.
This morning maybe.
- Carter.
- This afternoon? - Carter.
- Yes? There's some chance it'll be this afternoon, say around 3:00.
Thank you.
By the way, loved the article.
Tommy Stevens.
- Attempted suicide by hanging.
- Yeah that makes one nasty rope burn, huh? - What? - Finish up, Dumar.
Vital signs.
Shallow resp.
I didn't want to intubate in the field in case he broke his neck.
Nice and easy.
On my count: One, two, three.
He's getting dusky.
We need to tube him.
- Will be a tricky intubation.
- Tricky is my middle name.
- And potentially dangerous.
- Like I said, danger's my middle name.
- Pulse ox down to 84.
- Let's get in.
Whatever you do, do not extend the neck.
I'm as gentle as a kitten, sir.
BP's still 80.
Run another liter of saline.
I can't see the cords.
We need to crike him.
Hold on.
Bag him.
We need a fiberoptic laryngoscope.
I'll get it.
Fiberoptics.
That is cool.
- You ever done one? - I've certainly seen them.
- So, that's a no, huh? - But, you Dr.
Green could change all that.
Ok, I'll give you one shot.
Then it's mine.
It doesn't look too bad.
Not very deep.
Probably it just needs a couple of stitches.
Did the paramedics bring you in? Would you get us some more four-by-fours? We're running low.
So your parents weren't with you when this happened, huh? No.
This may sting a little, Becky.
How did it happen? He wasn't outside.
- Who wasn't outside? - Tommy.
My boyfriend.
Did he cut you? I didn't know they had a basement.
I saw a light bulb hanging.
And there he was, right next to it.
- In the basement? - He tied a rope around a pipe.
So I ran back up to the kitchen and got a knife.
And you used the knife to cut the rope? He just fell down.
I couldn't hold him.
- The knife slipped.
- And you cut yourself.
Will he be okay? Did the paramedics bring him? They wouldn't let me come with him.
I came in a different ambulance.
If you wait here, I'll go check and see what I can find out.
- Tell me when you're at the cords.
- About to make contact.
- I'm there.
- Advance into the trachea and slide down the tube.
Yeah.
The eagle has landed.
Let's bag him.
Okay.
Let's get X-ray down here.
Good breath sounds on both sides.
Nice work.
Thanks, boss.
Pulse ox up to 91.
This the suicide? Tommy? - How is he doing? - Great.
Neck is swollen up.
Couldn't even see the cords.
Dr.
Greene let me do a fiberoptic.
It was like threading a needle.
- How's he doing? - He's pinking up.
But with the prolonged oxygen deprivation I'm not sure about his neuro status.
Come one, he was blue for too long.
You might be looking at veggie burger.
Dr.
Greene.
Oh, God! - Tommy! - Haleh.
Come on.
- Let's get you outside.
- Tommy! Is he all right? What does he mean? Is he gonna be all right? - You a resident? - Yeah.
Well, you still need to learn that every patient in here is somebody's boyfriend, father, mother, son.
They don't exist simply for you to learn new and interesting procedures.
- I didn't see her standing there.
- Well, next time open your eyes before you open your mouth.
What's with the new guy? Which new guy would that be, Malucci? Dr.
Lawrence or you? Never said anything about killing himself.
It's not your fault, Becky.
You should be thankful you found him.
He's got a good chance.
I almost didn't go back inside.
I was gonna be late for school.
But I don't know, I just did.
- Were his parents there? - No.
At work.
His dad.
His mom lives in Florida.
You know where does his father work? Some kind of construction.
I don't really know him.
He's not around much.
Are you sick? You don't look good.
She's just a little tired.
Who do you belong to? Here, I'll make you better.
Say "ah.
" Thank you, but this patient already has a doctor.
Let go of me! Robin! Wait one second.
One second.
- Your mommy is right over here.
- No! Let me go! I'm so sorry, Dr.
Lawrence.
No, that's quite all right.
I have that effect on women.
May I have my stethoscope back, please? When? triggering the vent on his own.
Tommy, my name's Dr.
Greene.
You're in the hospital.
Your girlfriend found you and cut you down.
The paramedics brought you in.
What's his PO-2? Tommy, we have this tube down your throat to help you breathe.
But we can take it out, okay? - You extubating him? - He's got good tidal volume.
You gave us a scare, Tommy.
I got it.
Thanks.
So, Tommy, what I want you to do is take a deep breath and blow out when I pull out the tube.
Take a deep breath.
All the way in.
Good, good.
And blow.
Good job.
It's gonna be a little tender.
Don't try and speak right away.
- Where's Becky? - Becky's here.
She's fine.
She's worried about you of course.
Says your mom's in Florida, so we'll call your dad.
You know his number at work? I could talk to him for you if you want.
Pager number? Here.
Look, why don't you write it? Okay.
All right.
When you're ready.
- Dr.
Lawrence, you have a second? - Sure.
Tommy, I'll be right back.
What are you doing? Getting his father in here.
We're working on it.
Chicago PD's working on it.
Don't pimp the kid.
He's suicidal.
Calling a psych consult? - Yes.
- Good.
Think I should find out the sex? Well, everyone is different.
Some people like to know, some don't.
- What about you? - I don't know.
Oh, come on.
You know.
- You're a nurse.
- So? Seems like you'd know, that's all.
Well, I figure there are few really true surprises in life.
- This is for your scrapbook.
- Thanks.
Everything okay? Fine.
Little small for 32 weeks.
- We'll put you on prenatal vitamins.
- It's not too late? - Meg, are you smoking? - No.
I mean not a lot.
It's really bad for the baby.
It can cause prematurity, low birth weight.
I know.
I know.
I'm just- I'm just really stressed.
You know, I lost that stupid job.
- At Doc Magoo's? - I didn't move fast enough.
Excuse me, you know, I'm seven months pregnant! Well, you know, I could call a social worker, see if they could get you some aid.
How about here? Do they need people here? Maybe the cafeteria? I don't know.
I could check.
That would be great.
Thanks.
If you promise to stop smoking.
Deal.
Dad, just have the insurance guy call me here.
Mark, we got a double trauma coming in.
Can you take it? Because Romano's called this emergency meeting for spin control- - Dad, if you want to handle it why - Where's Benton? - He took up some MVA.
- Page Corday then.
You can't catch me! You can't catch me! No running.
Hey, no running! Stop! And that stuff is expensive! - I don't care! Daddy's rich! - I'm calling Security.
- Brat.
- Dad, I'll call you back.
- What's up? - My dad got his insurance canceled.
Can you take it? Because all the department heads have to go to this public relations meeting.
This newspaper thing is a disaster.
I don't know what Elisabeth was doing.
- What newspaper thing? - Here.
Seen Lawrence? I've got the neighbor of the suicide kid.
Says he's got the dad's number.
- For Lawrence? - Yes.
I'll take it.
Dr.
Greene here.
in parachute accident.
Bilateral tip fractures.
Good vitals.
- Your chute didn't open? - My lines got tangled.
- Four dead on scene.
- What about Larry? - Head trauma.
- What do you mean head trauma? Intubated for agonal respirations.
Blown pupil.
Dropped his BP to 90 over 60.
Flip you for it.
Come on, the other guy just has leg fractures.
- That's too bad.
- Come on, call it.
It's your lucky day.
Set up 0-neg on the rapid infuser.
Look at you.
I think lucky.
You can't lose.
- I'm not calling it, Dave.
- Pulse ox is dropping to 90.
You're the man.
It's your world.
I just live in it.
Come on, call it.
Heads.
Ouch, hell! Sorry, buddy.
Stay away from blackjack tables.
Give me a portable C spine, just the pelvis.
Send off a trauma panel.
Type cross by four.
On my count.
One.
Two.
Three.
Talk to me, Carter.
Fall from high.
Hypertense with severe head injury.
Regular rate and rhythm.
Traqueal shift to the left, survey says.
Chest tube.
10-blade.
Dave's your man.
I got the leg fractures.
- Pressure is 80.
Non-responsive.
- Pupils fixed and dilated.
GCS, five.
- Brave son of bitch for an old guy.
- He's 51.
He was probably trying a canopy.
It's a thing of beauty when is done well, actually.
- I'm in.
Thoraseal.
- Need me? - We're okay.
Horizontal mattress, Dave.
- Yeah, I know.
- Where's Peter? - He took up a hernia.
A hernia? Don't worry, Evel Knievel is in good hands.
Excuse me.
- How about I throw in a subclavian? - I don't think so.
We have good access.
- Art line? - How about a thoracotomy, while you're at it? - Really? - Dave.
Chest is clear.
He'll need a tetanus.
Apply traction with dorsiflexion, to disengage the talus.
- Like this? - Good.
Now I apply anterior pressure to the posterior calf.
- I felt a pop.
- Good.
- You guys okay in here? - Got it covered.
- Pedal pulse is stronger.
- Good.
Nurse, call X-ray.
You got it.
- Ever do the Wick-catheter technique? - No.
- Today you're gonna try it.
- Good, can I help? Get a pressure monitor.
Dave, I you to take this guy to CT.
Can't you get a nurse to do that? He's got a critical head injury.
I need a doctor stay with him.
- I was gonna help this guys out.
- I think we got it covered, Dave.
I want a neuro check every five minutes.
And tell me if his pressure drops.
- You won him fair and square, Dave! - Oh, Gabe my patient, the kid? The neighbor called and I got the dad's number.
Okay, thanks.
I'll get the transducer.
Urine dip is four plus positive for blood.
Get a cystogram.
And let's get X- ray in here for a post reduction film.
- I heard you the first time.
- Right.
- Where was I? - Wick-catheter technique.
Oh, right.
Grab two pieces of aught Dexon All right.
I've opened the peritoneal sac.
- Can you see the fascial ring? - Almost.
I'm glad our schedules synced up, Peter.
It's been a long time since we operated together.
No adhesions to the anterior wall.
Oh, there's another defect.
We'd better do a Gortex repair.
Metz.
Hey, Elizabeth.
Interesting article in the paper this morning.
Excuse me, Donald.
Peter, will you please step out? I'm in the middle of operating here.
I'm sure Dr.
Anspaugh can handle it.
Please step out.
What's going on? Peter's a trauma fellow and he should be down in the ER, not up here covering elective hernias.
Right, but this patient needed surgery.
And I was called down to cover your multi-victim trauma.
I was down there all morning.
As you should be.
Now for third time, please, step out.
Dr.
Anspaugh, would you take over? - Hey, I saw you touch that.
- Barely.
- Can't you make up your mind? - Nothing looks good.
How about a grilled cheese sandwich? It looks less than a day old.
- Mark, please.
- Here, this.
It's on me.
- I'm not gonna eat that.
- You've gotta eat something.
I have a mother, thank you.
She calls every Sunday.
That's nothing.
My dad called four times this morning obsessing about this cypress tree that he crashed into last night.
- Is he okay? - His pride's a little wounded.
Front fender is extremely wounded.
And aparently the neighbor's is circling the drain.
How about Jell-O? Everybody has room for Jell-O.
- Got your employed discount card? - Yeah.
And I need to speak to the manager.
Is someone around? Viola Simpson.
Acting like she be the big boss right there.
- Great.
- I saw you eating that carrot.
Gotta pay for it.
Okay.
She's kept down the juice I gave her and doesn't have any abdominal pain.
She should be fine at home.
Just give her some fluids and come back for vomiting or fever.
Thank you, Dr.
Finch.
And you too, Yosh.
You're welcome.
She's been a completely fascinating patient.
Robin, Robin, we're going home.
You wanna thank the nice doctor and nurse? - No! - Okay.
Then hold my hand.
- I don't want to hold your hand! - Thanks again! Wait! Robin! No, no! Don't go outside! - Okay, Mr.
Raybush.
Safe and sound.
- How was the CT? It looks like somebody scrambled his brain with an egg beater.
- A subdural? - Wanna look? No.
Mostly diffuse swelling, microhemorrages.
Nothing we can fix.
- Have you seen Dr.
Lawrence? - In the lounge.
All right, hyperventilate him.
Call Neurosurgery.
Get an ICP monitor.
Ok I think I'll check the board and see what else is in, right? You track down his family.
He's wearing a wedding ring.
He must have a wife.
- Shouldn't a nurse do that? - Only if you fail.
Elaine? John.
- How are you feeling? - Lighter.
Sorry.
That's a stupid joke.
May I sit down? I tried calling you.
Dr.
Corday said the tests are clear.
My cancer hasn't spread.
That's great news.
- Yeah, so everyone says.
- But you don't feel that way? - I don't know what I feel.
- I think that's probably normal.
- I think most people probably- - John.
Sorry.
I'll spare you the platitudes.
- You waiting for Dr.
Corday? - Yeah, I'm early.
Maybe we can get together later.
Go for a walk, get a drink or talk.
- Talk? - About anything except your surgery and my miserable life here.
- And what would that leave? - Sports.
Or music, or art, or the Y2K thing.
Oh, yeah.
The Y2K thing.
- I'm grasping at straws here.
- Yeah.
I see that.
But I'm not giving up.
Well I guess I'm probably free at 7.
Mrs.
Raybush, the parachute accident was extremely serious and he's in a coma.
I think you need to get here as soon as you can.
You're in Dallas.
Dallas.
Right, of course.
Three-hour flight.
I need to be honest with you.
There is a good chance he won't be able to hold out that long.
I'm very sorry.
Excuse me? You want to dictate a message and have it read to him? I don't think- Do it.
Of course I can do that.
Yes, I have a pen.
Dr.
Greene, it's your dad.
- Hey, Dad.
What is it? - Go ahead.
He wants a replacement cypress.
Seems reasonable.
How much? Well, I know it's a Connie, who's that talking to Dr.
Lawrence? It's the father of the kid, Tommy Stevens.
Listen, dad, I gotta go.
You'll see we'll work something out.
No, I'll call you later.
- Yeah, I will.
I'll call you later.
Bye.
- I'm working two jobs.
That's a hell of a lousy excuse.
I had to take on extra projects.
We need the money.
What? More than you need your son? Hi.
I'm Dr.
Greene.
Can I be of some help? Yeah, you can get this guy out of my face.
He hasn't even let me see my son yet.
Tommy is in a very fragile state right now, Mr.
Stevens.
I'm not sure that it's good for him to see you.
- What the hell?! I'm his father! - You mean like for an hour a day? Dr.
Lawrence, just a minute.
Mr.
Stevens, you do have a right to see your son.
Can you take Mr.
Stevens down to Curtain Area 3? This way, Sir.
- What was that about? - He expects- - He's his father.
- Somebody needs to give this guy a talking-to! - That's not your job.
- The hell it isn't, man! - You don't know the details.
- I know enough! And what did you say her name was? Viola Simpson.
She said she was glad you have food experience.
Was she glad to hear I was pregnant? Not glad is an overstatement, but she didn't seem to care.
- Your appointment is at 5:30.
- That gives me plenty of time.
I can pick up my stuff at Magoo's and still get home and change.
- Thanks, Mrs.
Hathaway.
- Carol.
You're welcome.
Let me know how it goes.
And stay off the cigarettes! Scout's honor.
No.
Not a retraction really, just simply the other side of the story.
Yeah.
Well, think about it.
- You wanted to talk? - Please.
Yes, thank you.
Is it a bad time? No.
Not if you don't mind my scrubbing.
Not at all.
Was this mirror always here? I believe it's a recent Rocket addition.
Whatever for? One can only imagine.
God, I hate these caps.
I look like a Yorkshire pudding.
- Elizabeth? - Yes I do need to talk to you, Donald.
I'm sorry to even have to mention it.
Don apologize.
Someone has to do the devil's work.
I'm relieved you see it that way.
- And it's not easy managing colleagues.
- Yeah, I'm beginning to realize that.
When I was doing my rotten job, much of which you've recently taken on, I always tried to get to the core of the issue.
Right.
Ask yourself this: Do you believe Peter Benton is a good surgeon? Peter Benton? Yes, of course, he's an excellent surgeon.
Ah, even better.
Now, ask yourself this: Should County have excellent surgeons on its staff? Absolutely.
Then don't you think we should all want Peter to practice surgery whenever he can? Yes.
I do, actually.
I don't agree with Dr.
Romano.
One thing to keep in mind in your new position: If you don't agree with the dirty work, don't do it.
Malooch.
I've got a gnarly split kneecap in Exam Two.
- You're teasing.
- No.
It's a disgusting mess.
Your kind of case.
- I got some reading to catch up on.
- Sure you do.
What happened? - He coded.
- Dr.
Benton called it.
You called it? That's usually what I do when a patient dies.
Oh, man.
What the hell do I do with this? - The 4-year-old? - She was here this morning.
- I remember.
- I couldn't wake her up.
Found her in V-fib, unresponsive to defibrillation.
Connie, get Cleo.
- She's been down at least 30 minutes.
- Do something! We will, Mrs.
Bourke, everything we can.
On my count: One, two, three.
Gently.
What happened? Cardiac arrest.
- See anything earlier? - Thought it was gastroenteritis.
- Hold compresions.
Check the rhythm.
- She's still in V-fib.
- Paddles.
Charge to 30.
- Is she gonna be all right? - Clear! - Clear.
Oh, my God! - Procainamide, 17 per kilo.
- Did she ingest anything? Just the Chinese food.
I already told Dr.
Finch that.
What about drugs, antidepressants, toxics, insecticides? No.
- Gas, bleach- - Cleo, are you running this? Yes.
Charge to 50.
Think, Mrs.
Bourke.
Iron tablets, detergents- We keep vitamins on the kitchen table.
- Vitamins with iron? - Yes.
It's iron poisoning.
Clear! - Clear.
- Oh, God! - She's asystole.
- Pupils are fixed and dilated.
High-dose epi! - Connie, move her out.
- No, no.
I want to stay.
I want to stay.
Oh, my God! I want to stay! Dr.
Finch, you want atropine? Do you want atropine, Dr.
Finch? No.
We got a case number from the Coroner's office.
Why don't you see if you can track down the family pediatrician? The nurses can do that.
I wanna do it.
I'm sorry.
You know there'll be an M and M.
And there could also be medical-legal issues.
Do you mind if I look over your notes? Chart's on the counter.
What was your discharge impression? Food poisoning.
Or a mild case of gastroenteritis.
You asked about household poisons? The mom said the house was childproofed.
- Prescription meds? - Out of reach.
Did you ask about iron? No.
I'm not sure I would have either.
The chart looks good.
Everything you did was within the standard of care.
Risk Management won't have a problem.
Is that it? Cleo, you saw the child in the second phase of the overdose.
She looked and felt completely normal.
You did what anyone of us would have done.
I should have asked.
Iron is on the differential.
- So are 200 other things.
- I should've asked.
You did everything you could.
No, I didn't.
She's dead.
Malucci, did you call Public Health about that bat bite? That guy in Exam Three needs a rabies series.
He died on me.
The parachute guy.
Massive head injuries.
Didn't stand much of a chance.
I wrote what his wife wanted to tell him on the spot.
But he died before I had time to read it.
You took the message more for her than for him.
I guess.
It just feels weird throwing it away now.
She said some really nice things.
Private things.
I've got a bad nosebleed.
Can someone take it? If we had a bed.
- Why is that rhinitis still in Four? - I don't know.
Ask Dr.
Lawrence.
Let me.
I think I know where he is.
I used to work all the time.
Even volunteered for the shift at Christmas.
Didn't mean I didn't love my kids.
Dads are like that.
How you feeling, Tommy? Okay.
His blood gas is back.
Good PO-2.
Good.
Thanks.
Tommy's father had to leave.
- Back to work.
- There was a problem at the site.
- Were you able to talk to Dr.
DeRaad? - The shrink? It's hard talking to somebody you don't know.
They're here to listen.
- I'm not crazy.
- I didn't say that.
I just- I know you think it's stupid.
But I love her.
- I mean, I really love her.
- Who? Your girlfriend? And she loved me.
And then suddenly she didn't.
How can somebody love you so much, then just stop? - When did she tell you? - I didn't believe her till today.
Lizzie.
You talk to Anspaugh? - Yes.
- How did he take it? I didn't discuss it with him.
Didn't get around to it? I hope you offered me this position you did it because my surgical skills aside, you trust my judgment.
Naturally.
Now if I'm here to protect your interests I have to tell you it's in your best interest to keep Donald Anspaugh happy.
Not only is he a great asset to the surgical staff and to you but he is also on special consideration.
Now if this interferes with your tennis lessons in any way then I'm sorry- I don't play tennis.
Whatever.
The point is, if you want to push Donald out, you'll have to do it yourself- Who said anything about pushing him out? Well, I assume this is the first step.
Lizzie, when you "assume," you make an "ass" of "u" and "me.
" - What? - Look, I just wanted Fridays off.
I thought you could talk to Donald about the schedule.
But If you're not comfortable doing it, I understand.
Yeah, that's all right.
You're feeding it wrong.
Try folding it longways.
And then flip up the corners and fold it flat.
Or you can just tell me to mind my own business.
- Go ahead.
- I'm kidding.
I use quarters myself.
What do you want? Coke.
Caffeine, the ER doc's best friend.
Tommy went up to Medicine.
DeRaad put him on a hold.
You don't have to fill me in.
I jumped to conclusions with his dad.
I wanted to help.
- Wanna sit down? - Sure.
Thanks.
Well, the kid's in trouble.
You know, you go to the parents first.
Dad was still an ass for going back to work.
- You have a family? - A daughter.
You divorced? Get to see her a lot? She lives in St.
Louis.
You know, when I was about your age my son was brought into the ER.
He'd fallen out of a tree.
They patched him up, good as new.
Later I realized he had jumped from the tree.
He wanted to come see me.
- That was then- - Dr.
Lawrence? Mr.
Henderson's going to the O.
R.
I just need you to you sign his chart? I can do that.
- Thanks for the Coke.
- You bet.
- Did you check a second crit? -38, and the EKG was normal.
I reviewed the films with Radiology.
And you were right.
- The cystogram was normal.
- Why did you get a cystogram? You ordered it when the urine tested positive for blood.
He had microscopic hematuria.
I ordered an IVP.
No, you said cystogram.
I wouldn't order one for 30 red cells.
You did.
Lucy, I've treating trauma patients for 30 years.
I think I know what I ordered.
- Get an IVP before he goes up.
- He's already on his way.
Catch him and get him to Radiology.
He's not going to surgery without an IVP.
Sutured the scalp lac.
Bye.
Sign out your patients? Hold on.
You forgot this.
Hey, Dad.
It's Mark.
Nothing.
I'm just calling to see how you're doing.
- I'm sure it's a mistake.
- See you, Mark.
You're taking off? I gotta go home soak my feet, and the rest of my body.
- Carol? - Meg, how did it go? - I screwed up.
- What happened? I missed the interview.
I thought you said 6:30 but it was 5:30.
I blew it.
It's not true.
- I couldn't go through with it.
- Why not? No one wants to hire a pregnant woman.
And I can't blame them.
Why should I waste their time? I'm gonna have to quit in a month anyway.
Meg, stop.
We're gonna go together and work something out, okay? - Coming in! - Six years old.
Fever- - Carter! - I'm off in 15 minutes.
- I got it.
- Pulse 140.
BP 60.
- What is it? - No IV.
- Cleo, you don't have to- - What is it? Altered with fever.
Maybe meningitis.
On my count: One, two, three, lift.
CBC, blood cultures, chem panel.
Let's get a line in.
- Dry as a bone.
- No response to painful stimuli.
- No veins.
Can't get a draw.
- Call Surgery.
- I'll try a central line.
- His veins are collapsed.
If I can't do it, call Surgery.
Systolic's down to 50.
Pulse 145.
Okay, do it.
Cutdown tray now.
Two liters of saline, one at the ankle, one at the head.
- Pulse ox 92.
- Here's the blood.
- Get a crit.
- I want a bolus of 20 per kilo, about 400 cc's.
Run in a gram of ceftriaxone and catch a urine.
I'm in.
Let's go.
Dr.
Weaver, I have Robin Bourke's pediatrician on line two.
- Cleo, you got this? - Yeah, I got this.
Send up a UA and culture.
I'll do an LP.
- Carter, you have a second? - Not really.
Did you hear Dr.
Lawrence order that cystogram for Mr.
Henderson? - Gross hematuria? - No, just microscopic.
- You don't need one.
- That's what I thought but he told me to order it.
- You must have heard him wrong.
- No, he said cystogram.
Dr Lawrence wouldn't order a cystogram for microscopic hematuria.
It seemed strange to me but I figured he knew what he was doing.
He does know what he's doing.
You ran the wrong test.
See you tomorrow.
"I love you Larry, the girls love you, you've been the best husband and father the love of our lives, our true north.
You could never leave us you'll be with us and in us.
We'll love you always.
" - What did you tell him? - That I spoke to the adjuster and agreed to accept a late payment.
- Except they canceled his policy.
- Right.
- So who pays for the cypress tree? - You're looking at him.
- The dutiful son.
- Well, duty comes at a price.
- You're gonna have to buy me dinner.
- Okay.
Whatever you want.
- Good, cause I'm hungry.
- What have you got? What have you got? Mark! Quit grabbing! - I'm gonna grab.
- I got it framed for your office.
You've just lost dinner, mister.
- Hey, Dr.
Lawrence.
- It's Gabe.
- You off? - Almost.
We are getting something to eat.
You care to join us? No, thanks, I still have some dictations.
We'll be at Doc Magoo's if you change your mind.
Right, thanks.
- Have a good night.
- Yeah, You too.
Good night.
Not everybody gets to be on the front page of a newspaper.
R.
Previously on E.
R Under no circumstances is that man to go into that operating room.
Call security if you have to, and enjoy your first solo surgery.
I don't need you to feel sorry or tender or anything.
I just need you to go away.
Paula Trancoso, Chicago Gazette.
Elizabeth Corday, my associate Head of Surgery.
I want you to meet Gabe Lawrence, our new Attending.
Gabe, this is Dr.
Mark Green.
Gabe is coming over from New Werstern as our new attending.
As our new attending? I said the lap-chole at 11, the gastric bypass at 3.
Have you seen my earring? Why don't you try to get hold of him and then call me back? Already dressed? My schedule's all jumbled up.
I need to get in.
Besides, Romano's got me buried in paperwork.
Oh, there they are.
Oh, come on.
You're going to cover me in shaving cream.
Hi.
Did you get him? Yes, hello.
Yes.
He's right here, actually.
It's your father.
I'm sorry.
Hi, Dad.
Calm down.
What? What happened? Was anyone hurt? - Is everything all right? - That's good.
So this was last night? - You need me to stay? - Catch you later.
So, Dad? Okay, all right.
Look, it's just a fender.
Okay, a fender and a cypress tree.
You know what? Just corn flakes and a small orange juice, please.
That's it? - No room left for food.
- I'm eating like a horse.
Well, twins.
They are squishing my stomach.
I just got one.
Is squishing more than that.
- Meg, I can't read this.
What's it say? - Two over medium.
Large coffee to go, please.
- Morning, Carol.
- Hi.
What? You have shaving cream on your ear.
Thank you.
How is Mark? Clean-shaven.
- That's twice in one morning.
- I'm sorry.
Clean it up.
And get this guy another order.
- How do you manage without coffee? - It's not so bad.
It's growing out of my maternity wear that worries me.
Not to worry.
You'll drop a couple of pounds breast-feeding.
See you later.
- Here.
- Oh, thank you.
- Not easy, is it? - No.
- Know what you're having? - No.
- Nothing on the ultrasound? - Haven't had one.
You should.
It's important for the baby.
Who's your OB? - I've got an order.
- You do have an OB? My boss is gonna yell at me.
Can I borrow your pencil and pad? I'm a nurse at County.
I'm gonna write down my name.
You should come by after your shift.
We'll examine you and check out the baby.
I don't know.
I don't have insurance.
It's OK.
Where I work, you don't need it.
- Morning.
- Hey, the celebrity herself! Beg your pardon? - Dr.
Corday, right? - What are you talking about? "Prescription for Danger: Are You Safe at County General?" Good picture.
Oh, my God! Stop it! Get that thing away from me! Leave me alone! Let go! - Robin, calm down.
- It's not so bad.
- I hate you! - Yosh? - Do you like koala bears, Robin? - Why? I have a bear that wants to meet you, Mr.
Koala Bear.
- I hate bears! - Robin, stop it.
Can you hold her, Mrs.
Bourke? If you're good, I'll take you to the toy store.
- When did she start vomiting? - This morning, after she drank her juice.
Mommy, make him stop! We had takeout last night.
I hate you! - Any diarrhea? - A little.
- Childhood illnesses? - Just a few colds.
Prescription medicines, you keep those out of reach? Yes, our home is childproof.
Probably food poisoning.
I'll give her Compazine for the nausea.
And observe her for a few hours.
Honey, did you hear that.
We're gonna stay here so they can take care of you.
- I hate it here! - Wait- Okay.
- Looking for me? - Yo, Dr.
Pete.
I've got one seriously hot appy for you.
- Hot appy? - Ready to be sliced and diced.
Why don't you call for a surgical consult? - I told you.
- Thought you'd want it.
- He can't do general surgery.
- I don't do general surgery.
- Told you.
- Thanks, Connie.
You're welcome Doctor Dave.
I don't blame you.
Hernias, appys- Boring, right? You're like me.
You like the guts, the glory, the bright lights, the big city.
We're cut from the same cloth.
You know what means "to be skating on thin ice"? Ok.
This is me backing off.
That's good.
Stay up there as long as you can.
You're doing great.
- Kerry, hi.
- Morning, Gabe.
How much longer? The expulsion of flatus marches to its own drummer, Mr.
Rineberry.
The more I fart the better I'll feel? To put it somewhat indelicately, yes.
I'll be back.
Stay with him.
Keep your eye on him, okay? - I was just gonna grab a cup of coffee.
- Great, I'll join you.
So, you're starting your day with a little splenic flexure syndrome? The guy, he didn't want to stand on his head till I reminded him gas rises.
It seems like you're settling in well? - Everybody's been terrific.
- Good.
Great.
Mark Green is still pissing on trees- Do you want me to say something to him? - Dr.
Lawrence? - Yeah, Lily? - It's Lucy.
- Lucy.
Sorry.
Did you want to order Oxacillin for the cellulitis in Four? Cellulatis in four.
Yeah, he should have some.
You just didn't sign for it.
Easily fixed.
- Here you go.
Thanks.
- Sure.
Is it me, or are medical students younger than they used to be? It's definitely the students.
I haven't felt this old since your class graduated from med school.
My class? I remember your mom came by to me and she was thanking me for you know, for inspiring you to go into emergency medicine.
And the whole time she's talking to me all I can think is: "My God, We're practically the same age.
" Oh, no.
She had a year or two on you anyway.
- How is she.
How is she doing? - She passed away a couple of years ago.
- Oh, I'm sorry.
That's rough.
- Yeah, it is.
How is your family doing? All my ex-wives are alive and living well.
And your son was going into medicine too, wasn't he? That was my dream, not his, as he would say.
Of course, he doesn't say much of anything to me anymore.
Families, huh? Go figure.
Get away from me! Get away from me! - Get away from me! - Sorry.
Excuse us.
- Think I'll have more cream.
- Sure I certainly never meant to convey any deficiency at County.
I could hardly anticipate a shootout.
And not everything in the account is negative.
You're right and I particularly enjoyed the description of Dr.
Carter clamping off his first aortic rupture in an 8 years old.
Yeah, which as the account clearly states, was successful.
Do you remember, Lizzie, the point of this article? To toot County's horn.
Actually, it was to toot my horn.
Which is why you'd understand that I'm disturbed that, not only at getting heat on this from upstairs, but at finding my picture in a sidebar next to the obituaries.
I'd gladly give up the front page.
Lizzie, when I appointed you Associate Chief it was for two reasons: One, to serve; Two to protect my needs, my interests.
But I've sensed some reluctance.
- To what? - Corralling Benton for one.
- We settled that.
- Oh, have we? So, I haven't made a mistake in appointing you? No, you haven't made a mistake.
Good.
By the way, theres been some slop-over from the Anspaugh administration.
It seems Donald's still scheduling his own surgeries.
Speak to him about it, would you? You can't be serious.
It's interfering with my schedule.
I'm completely serious.
- Dr.
Corday.
- Carter.
Is Elaine Nichols' path report back yet? You'll need to speak to her about that.
Right, of course, I will when she comes in to have her sutures out, which generally is about a week after the operation, right? Generally.
And in Elaine's case, that could be some time today.
This morning maybe.
- Carter.
- This afternoon? - Carter.
- Yes? There's some chance it'll be this afternoon, say around 3:00.
Thank you.
By the way, loved the article.
Tommy Stevens.
- Attempted suicide by hanging.
- Yeah that makes one nasty rope burn, huh? - What? - Finish up, Dumar.
Vital signs.
Shallow resp.
I didn't want to intubate in the field in case he broke his neck.
Nice and easy.
On my count: One, two, three.
He's getting dusky.
We need to tube him.
- Will be a tricky intubation.
- Tricky is my middle name.
- And potentially dangerous.
- Like I said, danger's my middle name.
- Pulse ox down to 84.
- Let's get in.
Whatever you do, do not extend the neck.
I'm as gentle as a kitten, sir.
BP's still 80.
Run another liter of saline.
I can't see the cords.
We need to crike him.
Hold on.
Bag him.
We need a fiberoptic laryngoscope.
I'll get it.
Fiberoptics.
That is cool.
- You ever done one? - I've certainly seen them.
- So, that's a no, huh? - But, you Dr.
Green could change all that.
Ok, I'll give you one shot.
Then it's mine.
It doesn't look too bad.
Not very deep.
Probably it just needs a couple of stitches.
Did the paramedics bring you in? Would you get us some more four-by-fours? We're running low.
So your parents weren't with you when this happened, huh? No.
This may sting a little, Becky.
How did it happen? He wasn't outside.
- Who wasn't outside? - Tommy.
My boyfriend.
Did he cut you? I didn't know they had a basement.
I saw a light bulb hanging.
And there he was, right next to it.
- In the basement? - He tied a rope around a pipe.
So I ran back up to the kitchen and got a knife.
And you used the knife to cut the rope? He just fell down.
I couldn't hold him.
- The knife slipped.
- And you cut yourself.
Will he be okay? Did the paramedics bring him? They wouldn't let me come with him.
I came in a different ambulance.
If you wait here, I'll go check and see what I can find out.
- Tell me when you're at the cords.
- About to make contact.
- I'm there.
- Advance into the trachea and slide down the tube.
Yeah.
The eagle has landed.
Let's bag him.
Okay.
Let's get X-ray down here.
Good breath sounds on both sides.
Nice work.
Thanks, boss.
Pulse ox up to 91.
This the suicide? Tommy? - How is he doing? - Great.
Neck is swollen up.
Couldn't even see the cords.
Dr.
Greene let me do a fiberoptic.
It was like threading a needle.
- How's he doing? - He's pinking up.
But with the prolonged oxygen deprivation I'm not sure about his neuro status.
Come one, he was blue for too long.
You might be looking at veggie burger.
Dr.
Greene.
Oh, God! - Tommy! - Haleh.
Come on.
- Let's get you outside.
- Tommy! Is he all right? What does he mean? Is he gonna be all right? - You a resident? - Yeah.
Well, you still need to learn that every patient in here is somebody's boyfriend, father, mother, son.
They don't exist simply for you to learn new and interesting procedures.
- I didn't see her standing there.
- Well, next time open your eyes before you open your mouth.
What's with the new guy? Which new guy would that be, Malucci? Dr.
Lawrence or you? Never said anything about killing himself.
It's not your fault, Becky.
You should be thankful you found him.
He's got a good chance.
I almost didn't go back inside.
I was gonna be late for school.
But I don't know, I just did.
- Were his parents there? - No.
At work.
His dad.
His mom lives in Florida.
You know where does his father work? Some kind of construction.
I don't really know him.
He's not around much.
Are you sick? You don't look good.
She's just a little tired.
Who do you belong to? Here, I'll make you better.
Say "ah.
" Thank you, but this patient already has a doctor.
Let go of me! Robin! Wait one second.
One second.
- Your mommy is right over here.
- No! Let me go! I'm so sorry, Dr.
Lawrence.
No, that's quite all right.
I have that effect on women.
May I have my stethoscope back, please? When? triggering the vent on his own.
Tommy, my name's Dr.
Greene.
You're in the hospital.
Your girlfriend found you and cut you down.
The paramedics brought you in.
What's his PO-2? Tommy, we have this tube down your throat to help you breathe.
But we can take it out, okay? - You extubating him? - He's got good tidal volume.
You gave us a scare, Tommy.
I got it.
Thanks.
So, Tommy, what I want you to do is take a deep breath and blow out when I pull out the tube.
Take a deep breath.
All the way in.
Good, good.
And blow.
Good job.
It's gonna be a little tender.
Don't try and speak right away.
- Where's Becky? - Becky's here.
She's fine.
She's worried about you of course.
Says your mom's in Florida, so we'll call your dad.
You know his number at work? I could talk to him for you if you want.
Pager number? Here.
Look, why don't you write it? Okay.
All right.
When you're ready.
- Dr.
Lawrence, you have a second? - Sure.
Tommy, I'll be right back.
What are you doing? Getting his father in here.
We're working on it.
Chicago PD's working on it.
Don't pimp the kid.
He's suicidal.
Calling a psych consult? - Yes.
- Good.
Think I should find out the sex? Well, everyone is different.
Some people like to know, some don't.
- What about you? - I don't know.
Oh, come on.
You know.
- You're a nurse.
- So? Seems like you'd know, that's all.
Well, I figure there are few really true surprises in life.
- This is for your scrapbook.
- Thanks.
Everything okay? Fine.
Little small for 32 weeks.
- We'll put you on prenatal vitamins.
- It's not too late? - Meg, are you smoking? - No.
I mean not a lot.
It's really bad for the baby.
It can cause prematurity, low birth weight.
I know.
I know.
I'm just- I'm just really stressed.
You know, I lost that stupid job.
- At Doc Magoo's? - I didn't move fast enough.
Excuse me, you know, I'm seven months pregnant! Well, you know, I could call a social worker, see if they could get you some aid.
How about here? Do they need people here? Maybe the cafeteria? I don't know.
I could check.
That would be great.
Thanks.
If you promise to stop smoking.
Deal.
Dad, just have the insurance guy call me here.
Mark, we got a double trauma coming in.
Can you take it? Because Romano's called this emergency meeting for spin control- - Dad, if you want to handle it why - Where's Benton? - He took up some MVA.
- Page Corday then.
You can't catch me! You can't catch me! No running.
Hey, no running! Stop! And that stuff is expensive! - I don't care! Daddy's rich! - I'm calling Security.
- Brat.
- Dad, I'll call you back.
- What's up? - My dad got his insurance canceled.
Can you take it? Because all the department heads have to go to this public relations meeting.
This newspaper thing is a disaster.
I don't know what Elisabeth was doing.
- What newspaper thing? - Here.
Seen Lawrence? I've got the neighbor of the suicide kid.
Says he's got the dad's number.
- For Lawrence? - Yes.
I'll take it.
Dr.
Greene here.
in parachute accident.
Bilateral tip fractures.
Good vitals.
- Your chute didn't open? - My lines got tangled.
- Four dead on scene.
- What about Larry? - Head trauma.
- What do you mean head trauma? Intubated for agonal respirations.
Blown pupil.
Dropped his BP to 90 over 60.
Flip you for it.
Come on, the other guy just has leg fractures.
- That's too bad.
- Come on, call it.
It's your lucky day.
Set up 0-neg on the rapid infuser.
Look at you.
I think lucky.
You can't lose.
- I'm not calling it, Dave.
- Pulse ox is dropping to 90.
You're the man.
It's your world.
I just live in it.
Come on, call it.
Heads.
Ouch, hell! Sorry, buddy.
Stay away from blackjack tables.
Give me a portable C spine, just the pelvis.
Send off a trauma panel.
Type cross by four.
On my count.
One.
Two.
Three.
Talk to me, Carter.
Fall from high.
Hypertense with severe head injury.
Regular rate and rhythm.
Traqueal shift to the left, survey says.
Chest tube.
10-blade.
Dave's your man.
I got the leg fractures.
- Pressure is 80.
Non-responsive.
- Pupils fixed and dilated.
GCS, five.
- Brave son of bitch for an old guy.
- He's 51.
He was probably trying a canopy.
It's a thing of beauty when is done well, actually.
- I'm in.
Thoraseal.
- Need me? - We're okay.
Horizontal mattress, Dave.
- Yeah, I know.
- Where's Peter? - He took up a hernia.
A hernia? Don't worry, Evel Knievel is in good hands.
Excuse me.
- How about I throw in a subclavian? - I don't think so.
We have good access.
- Art line? - How about a thoracotomy, while you're at it? - Really? - Dave.
Chest is clear.
He'll need a tetanus.
Apply traction with dorsiflexion, to disengage the talus.
- Like this? - Good.
Now I apply anterior pressure to the posterior calf.
- I felt a pop.
- Good.
- You guys okay in here? - Got it covered.
- Pedal pulse is stronger.
- Good.
Nurse, call X-ray.
You got it.
- Ever do the Wick-catheter technique? - No.
- Today you're gonna try it.
- Good, can I help? Get a pressure monitor.
Dave, I you to take this guy to CT.
Can't you get a nurse to do that? He's got a critical head injury.
I need a doctor stay with him.
- I was gonna help this guys out.
- I think we got it covered, Dave.
I want a neuro check every five minutes.
And tell me if his pressure drops.
- You won him fair and square, Dave! - Oh, Gabe my patient, the kid? The neighbor called and I got the dad's number.
Okay, thanks.
I'll get the transducer.
Urine dip is four plus positive for blood.
Get a cystogram.
And let's get X- ray in here for a post reduction film.
- I heard you the first time.
- Right.
- Where was I? - Wick-catheter technique.
Oh, right.
Grab two pieces of aught Dexon All right.
I've opened the peritoneal sac.
- Can you see the fascial ring? - Almost.
I'm glad our schedules synced up, Peter.
It's been a long time since we operated together.
No adhesions to the anterior wall.
Oh, there's another defect.
We'd better do a Gortex repair.
Metz.
Hey, Elizabeth.
Interesting article in the paper this morning.
Excuse me, Donald.
Peter, will you please step out? I'm in the middle of operating here.
I'm sure Dr.
Anspaugh can handle it.
Please step out.
What's going on? Peter's a trauma fellow and he should be down in the ER, not up here covering elective hernias.
Right, but this patient needed surgery.
And I was called down to cover your multi-victim trauma.
I was down there all morning.
As you should be.
Now for third time, please, step out.
Dr.
Anspaugh, would you take over? - Hey, I saw you touch that.
- Barely.
- Can't you make up your mind? - Nothing looks good.
How about a grilled cheese sandwich? It looks less than a day old.
- Mark, please.
- Here, this.
It's on me.
- I'm not gonna eat that.
- You've gotta eat something.
I have a mother, thank you.
She calls every Sunday.
That's nothing.
My dad called four times this morning obsessing about this cypress tree that he crashed into last night.
- Is he okay? - His pride's a little wounded.
Front fender is extremely wounded.
And aparently the neighbor's is circling the drain.
How about Jell-O? Everybody has room for Jell-O.
- Got your employed discount card? - Yeah.
And I need to speak to the manager.
Is someone around? Viola Simpson.
Acting like she be the big boss right there.
- Great.
- I saw you eating that carrot.
Gotta pay for it.
Okay.
She's kept down the juice I gave her and doesn't have any abdominal pain.
She should be fine at home.
Just give her some fluids and come back for vomiting or fever.
Thank you, Dr.
Finch.
And you too, Yosh.
You're welcome.
She's been a completely fascinating patient.
Robin, Robin, we're going home.
You wanna thank the nice doctor and nurse? - No! - Okay.
Then hold my hand.
- I don't want to hold your hand! - Thanks again! Wait! Robin! No, no! Don't go outside! - Okay, Mr.
Raybush.
Safe and sound.
- How was the CT? It looks like somebody scrambled his brain with an egg beater.
- A subdural? - Wanna look? No.
Mostly diffuse swelling, microhemorrages.
Nothing we can fix.
- Have you seen Dr.
Lawrence? - In the lounge.
All right, hyperventilate him.
Call Neurosurgery.
Get an ICP monitor.
Ok I think I'll check the board and see what else is in, right? You track down his family.
He's wearing a wedding ring.
He must have a wife.
- Shouldn't a nurse do that? - Only if you fail.
Elaine? John.
- How are you feeling? - Lighter.
Sorry.
That's a stupid joke.
May I sit down? I tried calling you.
Dr.
Corday said the tests are clear.
My cancer hasn't spread.
That's great news.
- Yeah, so everyone says.
- But you don't feel that way? - I don't know what I feel.
- I think that's probably normal.
- I think most people probably- - John.
Sorry.
I'll spare you the platitudes.
- You waiting for Dr.
Corday? - Yeah, I'm early.
Maybe we can get together later.
Go for a walk, get a drink or talk.
- Talk? - About anything except your surgery and my miserable life here.
- And what would that leave? - Sports.
Or music, or art, or the Y2K thing.
Oh, yeah.
The Y2K thing.
- I'm grasping at straws here.
- Yeah.
I see that.
But I'm not giving up.
Well I guess I'm probably free at 7.
Mrs.
Raybush, the parachute accident was extremely serious and he's in a coma.
I think you need to get here as soon as you can.
You're in Dallas.
Dallas.
Right, of course.
Three-hour flight.
I need to be honest with you.
There is a good chance he won't be able to hold out that long.
I'm very sorry.
Excuse me? You want to dictate a message and have it read to him? I don't think- Do it.
Of course I can do that.
Yes, I have a pen.
Dr.
Greene, it's your dad.
- Hey, Dad.
What is it? - Go ahead.
He wants a replacement cypress.
Seems reasonable.
How much? Well, I know it's a Connie, who's that talking to Dr.
Lawrence? It's the father of the kid, Tommy Stevens.
Listen, dad, I gotta go.
You'll see we'll work something out.
No, I'll call you later.
- Yeah, I will.
I'll call you later.
Bye.
- I'm working two jobs.
That's a hell of a lousy excuse.
I had to take on extra projects.
We need the money.
What? More than you need your son? Hi.
I'm Dr.
Greene.
Can I be of some help? Yeah, you can get this guy out of my face.
He hasn't even let me see my son yet.
Tommy is in a very fragile state right now, Mr.
Stevens.
I'm not sure that it's good for him to see you.
- What the hell?! I'm his father! - You mean like for an hour a day? Dr.
Lawrence, just a minute.
Mr.
Stevens, you do have a right to see your son.
Can you take Mr.
Stevens down to Curtain Area 3? This way, Sir.
- What was that about? - He expects- - He's his father.
- Somebody needs to give this guy a talking-to! - That's not your job.
- The hell it isn't, man! - You don't know the details.
- I know enough! And what did you say her name was? Viola Simpson.
She said she was glad you have food experience.
Was she glad to hear I was pregnant? Not glad is an overstatement, but she didn't seem to care.
- Your appointment is at 5:30.
- That gives me plenty of time.
I can pick up my stuff at Magoo's and still get home and change.
- Thanks, Mrs.
Hathaway.
- Carol.
You're welcome.
Let me know how it goes.
And stay off the cigarettes! Scout's honor.
No.
Not a retraction really, just simply the other side of the story.
Yeah.
Well, think about it.
- You wanted to talk? - Please.
Yes, thank you.
Is it a bad time? No.
Not if you don't mind my scrubbing.
Not at all.
Was this mirror always here? I believe it's a recent Rocket addition.
Whatever for? One can only imagine.
God, I hate these caps.
I look like a Yorkshire pudding.
- Elizabeth? - Yes I do need to talk to you, Donald.
I'm sorry to even have to mention it.
Don apologize.
Someone has to do the devil's work.
I'm relieved you see it that way.
- And it's not easy managing colleagues.
- Yeah, I'm beginning to realize that.
When I was doing my rotten job, much of which you've recently taken on, I always tried to get to the core of the issue.
Right.
Ask yourself this: Do you believe Peter Benton is a good surgeon? Peter Benton? Yes, of course, he's an excellent surgeon.
Ah, even better.
Now, ask yourself this: Should County have excellent surgeons on its staff? Absolutely.
Then don't you think we should all want Peter to practice surgery whenever he can? Yes.
I do, actually.
I don't agree with Dr.
Romano.
One thing to keep in mind in your new position: If you don't agree with the dirty work, don't do it.
Malooch.
I've got a gnarly split kneecap in Exam Two.
- You're teasing.
- No.
It's a disgusting mess.
Your kind of case.
- I got some reading to catch up on.
- Sure you do.
What happened? - He coded.
- Dr.
Benton called it.
You called it? That's usually what I do when a patient dies.
Oh, man.
What the hell do I do with this? - The 4-year-old? - She was here this morning.
- I remember.
- I couldn't wake her up.
Found her in V-fib, unresponsive to defibrillation.
Connie, get Cleo.
- She's been down at least 30 minutes.
- Do something! We will, Mrs.
Bourke, everything we can.
On my count: One, two, three.
Gently.
What happened? Cardiac arrest.
- See anything earlier? - Thought it was gastroenteritis.
- Hold compresions.
Check the rhythm.
- She's still in V-fib.
- Paddles.
Charge to 30.
- Is she gonna be all right? - Clear! - Clear.
Oh, my God! - Procainamide, 17 per kilo.
- Did she ingest anything? Just the Chinese food.
I already told Dr.
Finch that.
What about drugs, antidepressants, toxics, insecticides? No.
- Gas, bleach- - Cleo, are you running this? Yes.
Charge to 50.
Think, Mrs.
Bourke.
Iron tablets, detergents- We keep vitamins on the kitchen table.
- Vitamins with iron? - Yes.
It's iron poisoning.
Clear! - Clear.
- Oh, God! - She's asystole.
- Pupils are fixed and dilated.
High-dose epi! - Connie, move her out.
- No, no.
I want to stay.
I want to stay.
Oh, my God! I want to stay! Dr.
Finch, you want atropine? Do you want atropine, Dr.
Finch? No.
We got a case number from the Coroner's office.
Why don't you see if you can track down the family pediatrician? The nurses can do that.
I wanna do it.
I'm sorry.
You know there'll be an M and M.
And there could also be medical-legal issues.
Do you mind if I look over your notes? Chart's on the counter.
What was your discharge impression? Food poisoning.
Or a mild case of gastroenteritis.
You asked about household poisons? The mom said the house was childproofed.
- Prescription meds? - Out of reach.
Did you ask about iron? No.
I'm not sure I would have either.
The chart looks good.
Everything you did was within the standard of care.
Risk Management won't have a problem.
Is that it? Cleo, you saw the child in the second phase of the overdose.
She looked and felt completely normal.
You did what anyone of us would have done.
I should have asked.
Iron is on the differential.
- So are 200 other things.
- I should've asked.
You did everything you could.
No, I didn't.
She's dead.
Malucci, did you call Public Health about that bat bite? That guy in Exam Three needs a rabies series.
He died on me.
The parachute guy.
Massive head injuries.
Didn't stand much of a chance.
I wrote what his wife wanted to tell him on the spot.
But he died before I had time to read it.
You took the message more for her than for him.
I guess.
It just feels weird throwing it away now.
She said some really nice things.
Private things.
I've got a bad nosebleed.
Can someone take it? If we had a bed.
- Why is that rhinitis still in Four? - I don't know.
Ask Dr.
Lawrence.
Let me.
I think I know where he is.
I used to work all the time.
Even volunteered for the shift at Christmas.
Didn't mean I didn't love my kids.
Dads are like that.
How you feeling, Tommy? Okay.
His blood gas is back.
Good PO-2.
Good.
Thanks.
Tommy's father had to leave.
- Back to work.
- There was a problem at the site.
- Were you able to talk to Dr.
DeRaad? - The shrink? It's hard talking to somebody you don't know.
They're here to listen.
- I'm not crazy.
- I didn't say that.
I just- I know you think it's stupid.
But I love her.
- I mean, I really love her.
- Who? Your girlfriend? And she loved me.
And then suddenly she didn't.
How can somebody love you so much, then just stop? - When did she tell you? - I didn't believe her till today.
Lizzie.
You talk to Anspaugh? - Yes.
- How did he take it? I didn't discuss it with him.
Didn't get around to it? I hope you offered me this position you did it because my surgical skills aside, you trust my judgment.
Naturally.
Now if I'm here to protect your interests I have to tell you it's in your best interest to keep Donald Anspaugh happy.
Not only is he a great asset to the surgical staff and to you but he is also on special consideration.
Now if this interferes with your tennis lessons in any way then I'm sorry- I don't play tennis.
Whatever.
The point is, if you want to push Donald out, you'll have to do it yourself- Who said anything about pushing him out? Well, I assume this is the first step.
Lizzie, when you "assume," you make an "ass" of "u" and "me.
" - What? - Look, I just wanted Fridays off.
I thought you could talk to Donald about the schedule.
But If you're not comfortable doing it, I understand.
Yeah, that's all right.
You're feeding it wrong.
Try folding it longways.
And then flip up the corners and fold it flat.
Or you can just tell me to mind my own business.
- Go ahead.
- I'm kidding.
I use quarters myself.
What do you want? Coke.
Caffeine, the ER doc's best friend.
Tommy went up to Medicine.
DeRaad put him on a hold.
You don't have to fill me in.
I jumped to conclusions with his dad.
I wanted to help.
- Wanna sit down? - Sure.
Thanks.
Well, the kid's in trouble.
You know, you go to the parents first.
Dad was still an ass for going back to work.
- You have a family? - A daughter.
You divorced? Get to see her a lot? She lives in St.
Louis.
You know, when I was about your age my son was brought into the ER.
He'd fallen out of a tree.
They patched him up, good as new.
Later I realized he had jumped from the tree.
He wanted to come see me.
- That was then- - Dr.
Lawrence? Mr.
Henderson's going to the O.
R.
I just need you to you sign his chart? I can do that.
- Thanks for the Coke.
- You bet.
- Did you check a second crit? -38, and the EKG was normal.
I reviewed the films with Radiology.
And you were right.
- The cystogram was normal.
- Why did you get a cystogram? You ordered it when the urine tested positive for blood.
He had microscopic hematuria.
I ordered an IVP.
No, you said cystogram.
I wouldn't order one for 30 red cells.
You did.
Lucy, I've treating trauma patients for 30 years.
I think I know what I ordered.
- Get an IVP before he goes up.
- He's already on his way.
Catch him and get him to Radiology.
He's not going to surgery without an IVP.
Sutured the scalp lac.
Bye.
Sign out your patients? Hold on.
You forgot this.
Hey, Dad.
It's Mark.
Nothing.
I'm just calling to see how you're doing.
- I'm sure it's a mistake.
- See you, Mark.
You're taking off? I gotta go home soak my feet, and the rest of my body.
- Carol? - Meg, how did it go? - I screwed up.
- What happened? I missed the interview.
I thought you said 6:30 but it was 5:30.
I blew it.
It's not true.
- I couldn't go through with it.
- Why not? No one wants to hire a pregnant woman.
And I can't blame them.
Why should I waste their time? I'm gonna have to quit in a month anyway.
Meg, stop.
We're gonna go together and work something out, okay? - Coming in! - Six years old.
Fever- - Carter! - I'm off in 15 minutes.
- I got it.
- Pulse 140.
BP 60.
- What is it? - No IV.
- Cleo, you don't have to- - What is it? Altered with fever.
Maybe meningitis.
On my count: One, two, three, lift.
CBC, blood cultures, chem panel.
Let's get a line in.
- Dry as a bone.
- No response to painful stimuli.
- No veins.
Can't get a draw.
- Call Surgery.
- I'll try a central line.
- His veins are collapsed.
If I can't do it, call Surgery.
Systolic's down to 50.
Pulse 145.
Okay, do it.
Cutdown tray now.
Two liters of saline, one at the ankle, one at the head.
- Pulse ox 92.
- Here's the blood.
- Get a crit.
- I want a bolus of 20 per kilo, about 400 cc's.
Run in a gram of ceftriaxone and catch a urine.
I'm in.
Let's go.
Dr.
Weaver, I have Robin Bourke's pediatrician on line two.
- Cleo, you got this? - Yeah, I got this.
Send up a UA and culture.
I'll do an LP.
- Carter, you have a second? - Not really.
Did you hear Dr.
Lawrence order that cystogram for Mr.
Henderson? - Gross hematuria? - No, just microscopic.
- You don't need one.
- That's what I thought but he told me to order it.
- You must have heard him wrong.
- No, he said cystogram.
Dr Lawrence wouldn't order a cystogram for microscopic hematuria.
It seemed strange to me but I figured he knew what he was doing.
He does know what he's doing.
You ran the wrong test.
See you tomorrow.
"I love you Larry, the girls love you, you've been the best husband and father the love of our lives, our true north.
You could never leave us you'll be with us and in us.
We'll love you always.
" - What did you tell him? - That I spoke to the adjuster and agreed to accept a late payment.
- Except they canceled his policy.
- Right.
- So who pays for the cypress tree? - You're looking at him.
- The dutiful son.
- Well, duty comes at a price.
- You're gonna have to buy me dinner.
- Okay.
Whatever you want.
- Good, cause I'm hungry.
- What have you got? What have you got? Mark! Quit grabbing! - I'm gonna grab.
- I got it framed for your office.
You've just lost dinner, mister.
- Hey, Dr.
Lawrence.
- It's Gabe.
- You off? - Almost.
We are getting something to eat.
You care to join us? No, thanks, I still have some dictations.
We'll be at Doc Magoo's if you change your mind.
Right, thanks.
- Have a good night.
- Yeah, You too.
Good night.
Not everybody gets to be on the front page of a newspaper.