ER Episode Scripts

N/A - s07e22

E.
R.
Previously on E.
R.
We had something.
- Are you his mother? - Neighbour.
He's a friend of my son's.
- Any way to contact the parents? - He just has a father.
I left a message.
We found some unusual bruising on your son, Mr.
Fossen.
- Do you know about that? - No.
I'm afraid Ben's gonna have to stay here for a few days, Mr.
Fossen.
What? You're not doing this to us! - No! Dad! Please! - You bastard! Please! You're returning my application? Did you honestly think that you'd make the first cut? E.
R.
7x22 "RAMPAGE" How'd she do? Up from 3:30 to 6.
Then she wanted to feed at 7.
Lie down.
Take a nap.
- Are you leaving? - Yeah.
Please don't go.
I have to.
I want you to stay.
So do I.
Can't you call in sick? - I wish I could.
- Just do it.
I'll leave the van.
What was that? It's 8:00.
They're demolishing the old textile building on State.
That'll wake you up.
Exactly our problem.
They blow up a manufacturing plant to build a mall.
What's wrong with a mall? Fifty cents.
All we do is buy and sell.
We don't produce nothing.
See? What do you do? - What? - For a living? - I'm a doctor.
- Okay.
Bad example.
What are you talking about? You're building the mall.
Not for long.
Mark Ainsley, 12 years old.
GSW through the upper left arm.
- Is the neuro-circ still intact? - Complains of pain and paresthesia.
- Can you squeeze my hand? - It hurts.
- What happened? - Open fire in a foster-care facility.
- Foster care? - Twelve down.
- Can you feel this? - A little.
- Think about a vascular study.
- Got it.
Mark! Mark! Take that one.
Go! - It's still in me.
It still hurts.
- We're gonna help you out.
Entrance wound only.
Palpable in the sub-Q.
Got this, Dave? As long as there's no compartment syndrome.
- I can't breathe.
- Slow your breathing down.
Maria Fredrikkson, with significant blood loss.
BP, 90/palp.
Tachy at 120.
- Any belly pain, ma'am? - No.
My leg is cold.
- Foot pulses are diminished.
- Did they get him? - Who? - The man with the gun.
- I don't know.
Did you see him? - We were hiding in a closet.
- But he just shot through the door.
- Foot is pale.
Poor capillary refill.
- Trauma 1, coming through! - Who's on for Trauma? - We're bringing everybody in! - Two more of saline, order pre-op labs.
- Doesn't she have an ischemic leg? - Get through to Surgery! - We have an 8-year-old girl in arrest.
- Where was she hit? Shot in the head.
Intubated.
Bradyed down to 30, then lost her pulse.
- Pupils fixed and dilated.
- P.
E.
A.
Let's get her epi.
You just get here? Nice way to start.
Well, I was gonna call in sick.
E.
R.
Dr.
Weaver, gluteal gunshot wound.
He needs a cystourethrogram.
- Try a rigid sigmoidoscopy.
- He should see a surgeon.
Yeah, get in line.
Where's Benton? - Charge to 60.
- You getting a rhythm? Degenerated into V-fib.
Clear.
Another 120.
Looks like brain-stem failure.
GSW to the chest.
- Is he hypotensive? - No change.
-120 again.
- No.
- Fine.
Bring him in.
- Is it the same gunman? Yeah.
He shot the gardener on his way out.
Clear.
- Surprised he had any bullets left.
- Push another.
3 of epi.
- Want to try mannitol? - Couldn't hurt.
30 grams.
- Do you need an angiogram? - No, I don't think so.
No bruit or thrill.
Is that Helen? - Who? - Helen.
She's new.
Foster-mom bailed on her.
I don't know.
- Clear! - Expanding hematoma.
No pulse deficit.
They catch the guy yet? - No.
Dispatch doesn't know anything.
- He was mad at Mrs.
Buckley.
What's that? He was waving the gun at Mrs.
Buckley, yelling, then shot her.
- Did we get a Mrs.
Buckley? - DOA.
Gram of cefazolin, follow with neuro exam.
We've also got a GSW to the lateral malleolus in Exam 2 still waiting.
Portable x-ray and a Doppler scope.
Make sure the bullet didn't damage the bone.
Go ahead.
I got this.
Let's get an AP lateral to the left humerus.
- Did you turn it in? - What? Weaver said my application was incomplete.
Missing my peer reference.
- Right, yeah.
I'll do that today.
- It's due today.
- Yeah.
I'll do it.
- Okay, thanks.
I need you here! Femoral artery's pumping blood.
I can't control it without my finger in it.
Get me surgeons.
I got three unstable patients and a fourth coming in.
Anspaugh's gonna take this one.
I'll be back.
- Dr.
Weaver? - Yeah.
Officer Napolitano.
I need someone to pull out a bullet for the crime lab.
- Which patient? - Calf wound.
He's stable.
We'll get to him soon.
- As long as we get evidence.
- Find the shooter.
We'll get him.
I was in the bathroom.
I heard a loud explosion.
It scared me for a second.
But then I remembered that they were tearing down that building.
Then I heard all this screaming, and BP, 132/78.
Pulse, 96.
He was out front in the bushes.
Took us a while to find him.
We were inside.
- Kerry, what happened? - Lunatic shot at a foster-care facility.
- Why? - Who knows? Go.
Curtain 3.
Go! You were right to stay.
I should have gone to help, done something.
No.
You did the right thing.
I'll be right back.
Can I get a cigarette? I need a cigarette.
Yeah.
I'll see what I can do.
Kerry, I've got a hypotensive social worker.
Probably just stress - but you should check it out.
- Thanks.
Hello.
- I read your letter.
- Good.
I was wondering.
Dr.
Legaspi, Dr.
Romano, line three, for you.
Tell him I'll call him back.
She'll call you right back.
Anyway, I appreciate the sentiment.
"Sentiment"? He says for you to get on the line now.
He needs to talk to you about a transfer.
She's busy.
He should be too.
We could have as many as eight GSWs going.
Nine.
Carjack victim.
We're swamped with this.
Tell them to divert to Mercy.
Mercy said no ET As 9 to 10.
Why do they bother calling? Anyway, thank you but I don't think that anything's changed.
Right.
Okay.
- Okay.
I should get back.
- Yeah.
Chuny, grab Cleo.
The kid she's with isn't gonna make it.
Clear.
Asystole.
- How long has she been down? - At least an hour since the shooting.
Dr.
Finch, can you take a carjack victim rolling up? Go ahead.
This is a fatal wound.
- What is it? - GSW to the abdomen.
Someone should have told me that today was gun day.
Time of death, 9: 12.
- This the carjacking? - Yeah.
Mr.
Jeffries.
GSW to the left lateral abdomen.
- You need to be careful.
- He has AIDS.
- How's his pressure? -140/82.
- Okay, good.
That's good.
- What do you got? Entrance wound below the costal margin and the anterior axillary line.
No exit.
Mr.
Jeffries is HIV-positive.
I was getting out of the car.
He shot me anyway.
- Frank, what's open? - Nothing.
- I got a GSW.
- Don't make you special today.
- Mark called in.
Trauma 1.
- That's fine.
Let's go.
Let's set him up.
Get him a portable chest.
- Hey! - Roger? - Stay away from my wife! - What? You stay away from my wife! She told me everything.
You had your chance.
She's my wife now.
- I don't know what you're- - I'll take care of Carla.
- Frank, call Security! - Get him out of here! - Stay away! - I haven't touched her! - I'll kick your ass! - Knock it off.
Come on.
Nothing happened.
Chuny, get a trauma panel.
Type and cross for four.
- He really nailed you.
- Mind your business! - Is this the carjacking? - Yes.
- Sir, I'm sorry about that.
- Sir? Sir, I'm Officer Napolitano.
You told the officer your assailant was Caucasian? - Yeah, that's right.
- Did he wear a yellow windbreaker? Yeah, you know.
How did you know that? I think he might have shot some people at a foster-care facility.
- Same guy? - And three.
- Can you remember your license plate? - No.
- Pressure's down to 90.
- Two liters saline, wide open.
- But it's a black Acura Legend, correct? - What's wrong? You'll have to do this later.
Check with DMV.
- Might be bleeding in your abdomen.
- How do you know for sure? - Let's get an ultrasound in here.
- It's a black Acura Legend? What? Yeah.
We have to put a tube in your chest to help you breathe.
Prep the chest.
- You okay from here? - Got it.
- Lidocaine.
- Pulse ox, 98.
- You almost missed your deadline.
- What? I was eating breakfast and saw your med school reinstatement form on your counter.
- What did you do? - Ten blade.
You were lucky.
Lady in the registrar's office has a daughter who is a nurse.
The registrar's office? Told her you had a bunch of night shifts, and she slipped it in with the others.
-32 French.
- Wait.
- You handed it in? - Yeah.
This morning.
- Luka, why'd you do that? - It was due Monday.
- I didn't want to turn it in.
- I thought you forgot.
- No.
I changed my mind.
- Why? Now they'll come after me for summer tuition.
- I can help you with the money.
- I don't want help.
- I just wanted to let it go.
- Then why did you fill it out? I'll get you some Xeroform.
Lesion by the shoulder.
The bullet passed mid-shaft.
This is much more proximal.
Look at the lateral.
It's in front of the bone.
- Could be soft-tissue sarcoma.
- Get a biopsy.
- Is your kid stable? - Yeah.
I just have to do an FNA.
Clear the room.
Next round coming in.
Two more gunshot wounds.
- One chest, one neck.
- Two more? It's not even 10:00.
- It's the same guy again.
- What? CPD tracked a carjacked Acura to a private residence.
Found a mother and son shot inside.
- Did they get the shooter? - Not yet.
- Do we have the ORs? - Cleaning two now.
- Peter still needs to go up.
- That leaves one.
And Anspaugh should be finishing soon.
Psych nurses aren't trained to handle ostomy care.
If they need ostomy care, he can check his own damn bag.
We need you.
Two more GSWs rolling up.
- In a minute.
- Abby, let's go outside.
And when I call you, you get on the phone! She was helping with the mass casualty.
I needed to clear Recovery for the barrage of gunshot wounds you keep accepting! I'm not taking responsibility for post-op complications in the psych ward! Well, then we'll have to find somebody who's interested in responsibility.
- What is that supposed to mean? - DeRaad can finish your shift.
- What? - Nice knowing you.
GSW through the right lateral neck.
Airway's clear.
- What's his pressure? -110/70.
- Hi.
What's your name? - Ted.
- Ted, can you swallow for me? - Where's my mom? - Is all this his? - Dr.
Greene? No.
His mom was wrapped around him.
The bullet went through her into his neck.
- Mommy! - Dr.
Greene.
Get Dr.
Weaver to scope him.
He may need an esophagram.
We're gonna take you inside.
Okay, Ted? I think this is the lady that brought in your abused kid last week.
Simple gunshot wound to the back.
BP, 128/74.
- Mrs.
Shayatovich.
- Where's Ted? Where's Ted? He's gonna be okay.
There's another doctor looking at him.
Please, help him.
He was bleeding.
His neck was bleeding.
Who shot you, Mrs.
Shayatovich? Derek.
I told the policeman it was Derek Fossen.
Your neighbor.
He was looking for Ben.
I told him I didn't know where he was.
He said if I was gonna take his boy away he was gonna take mine from me.
Please, please help him.
He was bleeding.
We're gonna take care of him.
Let's get a HemoCue and a pulse ox.
Roll her, roll her, roll her! Oh, God! That looks like about two liters.
May be an aorta-esophageal fistula.
- She's out.
- Okay, bag her.
I'll intubate her inside.
Get a thoracotomy tray and all the O-negative we got.
Fossen.
Derek Fossen.
F-O-S-S-E-N.
Looks like it was contained until it blew through the esophagus.
- Do you have an address? - He lives next door to her.
- Can't get a pressure.
- Squeeze in two units of O-neg.
I'm in.
We put his son into protective custody.
His name is Ben.
He should be somewhere in the foster-care system.
- Lost the pulse.
- All right.
Rib spreader.
Find the son.
That's who he's looking for.
Abby, get the infuser.
Pressure's up to 120 after two liters.
- Do you need this? - No.
Liver and spleen are intact.
So maybe I'm not bleeding.
No.
You've got a slow leak from a small vessel.
- You're gonna need surgery.
- I don't want surgery.
Look, we'll make a midline incision, find the bleeding artery and then tie it off.
Doc, I'm already dying.
Your infection might slow your recovery but it's routine surgery.
People live with HIV.
I know that.
I've been fighting this disease since 1986.
I responded to the AZT, and the protease inhibitors were a miracle.
They gave me an extra five years.
But my T cells have been dropping since July.
My viral load's gone through the roof, even with all these antivirals.
Mr.
Jeffries, I need your consent.
No.
I had pneumocystis three months ago.
- If we don't operate, you'll die.
- I am already dead, doc.
This may just allow me to skip a very painful end.
- Another Satinsky.
- Unit eight is up.
- Heart's not filling.
Clamp the aorta.
- Greene, the injury is high and posterior.
- Just trying to bring you more light.
- That'll help.
- Can't you get your finger in the hole? - If I could see it.
More light.
- Just call for FFP and platelets.
- Forget it, forget it.
- I can't close this defect.
- Another amp of epi.
She'll go out of thoracic aorta and exsanguinate in seconds.
- Let's try bypass.
- It's too late for that.
Call it.
Time of death, 11:40.
We pull the sample out with a needle.
And then we look under a microscope.
- You think it's cancer? - It could be scar tissue.
Or a cyst.
Cancer's only one possibility.
My mom died of cancer.
- How old was she? -35.
I'm 12.
Let's see the biopsy first.
That way we can talk about what we know as opposed to what we don't know.
Do you have anybody that you'd like me to call? - I'm in foster care.
- Yeah, I know.
Foster parents? - No.
I'm between homes.
- Right.
- She make it? - No.
- This guy's on a rampage.
- They didn't catch him yet? I don't know.
They're gonna go to his house.
So much violence, huh? - Were you gonna tell me? - Tell you what? - I heard a rumor.
- Oh, yeah? A good one? Dr.
Rosen called.
You know, from the emergency department at Northwestern.
- You took the message? - He wanted to set up an appointment.
- Just looking at options.
- Are you leaving? I still have to make up three months of my residency.
- Well, after that? - I don't know.
I'm not even being considered for Chief Resident.
I have to write this damn peer review for Chen.
They're not even talking me about an Attending position.
Have you talked to Weaver about an Attending position? - No.
- Why not? Because if she wanted me, she would have asked me about it.
Maybe she doesn't think you're interested.
Maybe I'm not.
Carter, is your cirrhosis patient ready to go to the floor? No.
I have to do a paracentesis first.
- We need the bed.
- Got it.
What's the chest tube output on the gardener? - You still angry at me? - I wasn't angry.
- You seemed angry.
- It's my fault.
I should have ripped it up.
I thought you wanted to go back to school.
Maybe I do.
Just not now.
- What happened? - Nothing.
You don't want to be a doctor anymore? I don't know.
- You don't know? - I don't know.
It's $40,000 in tuition.
It's lost wages.
It's another six years of me killing myself.
Then it's over and you'll be doing what you want.
Maybe I'm doing what I want.
If that were true, you would have never started.
Maybe I realized being a nurse is good enough.
Is it not good enough for you? No, no.
It's fine.
Okay.
You did great, Ted.
The bullet went through a muscle in your neck.
But you're gonna be okay.
- Can I see my mom now? - Let me find out.
- Do you know your dad's work number? - No.
- Okay.
Do you know where he works? - Abysco.
- Abysco? Is that a company? - He makes binders.
He makes binders.
All right.
You want to draw some more? - Yeah.
- I'll be right back.
- The mom didn't make it? - The proximal aorta was shredded.
I have to track down his father.
What do you want to tell the boy? - I'll stall.
- Dr.
Greene? This him? Yeah.
He has a record? One arrest.
Domestic dispute.
He hit his girlfriend.
He wasn't at his house? - I'll let you know when we have him.
- What about his son? We tracked down the foster parents.
A patrol car's picking him up now.
- I think he's coming here.
- What? Well, he was pissed at the neighbor for bringing him to the ER.
- You took his kid away from him, right? - Right.
- Thanks, Frank.
- I'll send in some extra units.
Mark, he couldn't come here.
He knows there's too many cops around.
He hasn't displayed a lot of sound judgment so far.
- What is he shooting with? - Semiautomatic pistol, 13-round clip.
- He's been reloading.
- Maybe picked it up at Kmart on the way.
- It's not the guns.
People kill people.
- Yeah, right.
- But not as fast.
- He would have found another weapon.
Fourteen shots so far, Frank.
Six deaths.
You can't affect mass murder with a Chinese throwing star.
Rescue 78 coming in with an injured cop.
Motorist dragged him for half a block.
There you go.
He hit him with a car.
- That's assault with a deadly weapon.
- Shut up! Free air under the diaphragm.
Must have nicked the bowel too.
His crit's down to 23.
I can't dilute him much further.
I checked his viral load.
It's over 50,000.
He'll die of an opportunistic infection within a year.
Well, that doesn't mean we should help him commit suicide.
He didn't shoot himself.
If we let him refuse surgery, it's the same thing.
- Get a court order then.
- He'll be dead by the time it's approved.
Then it's his choice.
All right.
I went over there.
She was upset.
She was crying.
She came on to me.
I didn't do anything.
I didn't want to do anything.
Maybe she felt guilty and she told Roger and she put a spin on it.
- And you wouldn't put a spin on it.
- No.
Then why didn't you tell me? - To avoid this.
- What? You looking at me like I did something wrong.
I see.
You didn't trust me and I'm supposed to trust you.
- I didn't think it was worth getting into.
- At least I know where I stand.
Cleo, that's not what I meant and you know it.
- Peter, his pressure's dropping.
- Go.
Run in another liter of saline.
- Any chest pain or dizziness? - No.
Let's get two units from the blood bank and transfuse each over an hour.
No, no, no.
I don't want a blood transfusion.
Your hematocrit is drifting to a dangerously low level.
I understand.
No.
Thank you.
What about your family? I mean, if you don't care about yourself, what about them? I haven't spoken to my mother in over 30 years.
I outlived the two people that I loved in the world.
I've lived longer than I expected.
Just let me go.
I'm ready.
- Hi.
- Hi.
- How are you feeling? - My neck hurts.
I'll ask one of the nurses to come give you some medicine.
Can I see my mom? Not yet.
I'm trying to reach your dad.
Can I stay with her until you do? I don't think so.
She's having an operation right now.
Is she okay? We're having a little trouble trying to get the bleeding stopped around her heart.
- She was hurt bad.
- I know.
- You hungry? - No.
- Where's all this blood from? - Tore off part of his ear.
Give him more pain medicine.
Titrate 10 of morphine.
Did you lose consciousness? - I don't think so.
- Got him, Luka? Yeah.
Trauma panel - Did you get a good look at him? - Not really.
- Yellow windbreaker? - Yeah.
He saw blood on the collar.
Fossen did this? - Just a minute.
- Colby asked him to step out.
When he opened the door, the guy smashed our unit and took off.
Colby's jacket must've got snagged.
He was screaming.
He got dragged forever.
- He didn't stop.
- Where did he get the car? Probably boosted it.
Jeep Grand Cherokee, first three license numbers G74? - That's all I got down.
- Could it be G79? - You got him? - Shots fired at 823 Piedmont.
Jeep Grand Cherokee parked at the corner.
License number G79-6L5.
- Woman found down inside.
- Oh, God.
Here we go.
- Easy.
Is she dead? - Called in the paramedics.
We're all overworked, Robert.
You can't insinuate you'll fire someone every time you're frustrated.
- I'm not.
She's fired.
- Robert.
- Cleaning out her locker right now.
- You can't do that.
This is a county facility.
Employees cannot be summarily fired.
She was already on probation for that other matter.
She was exonerated.
And she's had a history of violation of institutional policy.
- Like what? - What do you care? She's a good doctor.
A good doctor who has had 30 delinquent charts awaiting discharge summaries.
- So does half the staff.
- She used the telephone watch line - for personal calls.
- You're kidding! - She yelled at a patient in public.
- You're trying to find a way to fire her.
There's plenty of documentation that the disciplinary committee has reviewed.
- Dr.
Weaver.
- Give me a minute.
- It's Adele.
She's been shot.
- What? - That maniac shot her at her house.
- The social worker? Chest x-ray, T and L spine.
- Get an ultrasound.
Feel this? - Yeah.
Did you get a look at the man who shot you? He looked familiar.
He said something about his son.
We put his son Ben into protective custody last week.
- Oh, my God.
- Okay.
Adele, can you feel this? No.
Cord injury, 1.
8 grams Solu-Medrol over 15 minutes.
- Hi, Adele.
- Hi.
She was shot mid-back.
She can't move her legs.
White male, late 30s, yellow windbreaker? Yeah.
I think so.
- Any pain in the belly? - BP, 92/65.
Pulse, 110.
- Any pain in your belly? - Not really.
- Could be a pneumothorax.
- Lungs sound good.
Pulse ox is 99.
- For an intra-abdominal bleed? - There's spinal shock.
- How did he know where I lived? - What? I only saw him at the hospital.
- They can find anything on the Internet.
- What? - Get someone over to my house.
- What? Send someone over to my house now.
[***] She's still hypotensive.
Want dopamine? Start her on five mics.
Come on, Elizabeth.
Pick up.
Pick up.
- Does this feel sharp? - Yes.
- What's her crit? - Working on it.
- How about here? - Yes.
- Do you have voice mail or machine? - Machine.
- Would she hear you leaving a message? - I don't know.
- How about here? - No.
Were you already home or was he waiting for you? He came in.
I was sitting at my desk doing my bills.
Patellar reflexes are absent.
Dr.
Greene, no one's answering the door.
Do you want them to search the house? - Yeah.
- They'd have to force entry.
- Search the house! -942, go ahead.
- Still hypotensive.
- Up her to 10 mics.
- She needs volume.
- I'm not in yet.
Adele, can you bend your knee? - I can't move it.
- Look, I don't care.
We may have an emergency laminectomy.
Fine.
Check.
Go.
Doc, they'll call it in when they have it secured.
- Am I paralyzed? - Hopefully, it's only temporary.
- That's it.
Give me a new kit.
- Check for sacral sparing.
Come on, now.
Now.
Set up the microscope.
We're coming up.
Maybe she went out, went to the store.
- Did you page her? - What? - Did you page her? - No.
I need you to page Dr.
Corday.
I don't- I know that! Page her! Mr.
Jeffries.
Mr.
Jeffries.
- What's his HemoCue? - Down to five.
- Barely responds to painful stimuli.
- Hang two units of blood.
- He doesn't want that.
- Where's the consent form? - On the cart.
- You can't take him without consent.
He's unable to give consent now.
I need two physicians' signatures for emergency surgery.
No.
- You'd have him die? - I'll respect his wishes.
Good, Adele.
The spinal injury is incomplete.
We can operate.
- I need an emergency signature.
- Not now.
IJ's in.
Let's get another chest.
- He's bleeding out.
- Run the Solu-Medrol.
325 an hour.
- Gunshot wound to the belly- - Yeah, yeah.
Whatever.
Whatever.
Go.
Systolic's up to 100.
All right.
Let's get him up.
Can you get a repeat CBC? - Whatever you want, Peter.
- I've got my two signatures.
He made himself clear.
Look, he has advanced AIDS.
He probably has an HIV encephalopathy.
No.
He was alert and oriented.
- You should have called Psych.
- I did.
They never showed up.
- Laura called.
They're still- - Damn it! - Oh, God! I'm sorry.
- Hold on.
Did you cut yourself? I don't think so.
The glove just tore there.
- Peter.
- Hold on.
Hold on.
Let me get some gauze pads.
Come on.
Let me see it, all right? - Oh, God.
- Keep irrigating it.
- Where are the Zerowets? - Bottom left drawer.
Pharmacy? This is Dr.
Benton.
I need you to pull a PEP kit for me.
All right.
Use two liters.
What? No.
Look, I'm on my way up there right now.
- What about the patient? - Keep transfusing him.
- Talk to Neuro? - They're doing a craniotomy.
Watch it, Peter.
I need help with a thoracic decompression.
There's a piece of bone in your mid-back, pressing on your spinal cord.
That's why I can't move my legs? Yes.
But if they remove the fragment, you may recover.
No one's at your house.
We did a sweep.
- Check my garage? - Yeah.
Nothing.
- Call me if you find her.
- Will I be paralyzed? - Not if I can help it.
- I still need to talk to you.
Drop it.
It's over.
- Is my van still there? - What? - The garage.
Was my van there? - Yeah.
Yeah.
- But you have two cars.
- Hers is in the shop.
- Does she take the baby out? - She's been going for walks around 3.
- It's 1:05.
- It depends on the baby's schedule.
Can you keep a unit there until she gets home? - Nick.
- Yeah.
- Nick, listen.
- Shot in the head from the back.
- The guy was riding in the back seat.
- Cab driver on Roosevelt.
Roger that, 27.
Rescue's en route.
Okay, that'll be us.
Can you give it to Luka? I have to go upstairs.
- Think it's him? - Yeah, that's him.
I can't reach this boy's father.
- And he's figuring it out.
- Who? The neck wound.
His mother died.
You need to talk to him.
I'll be right there.
Carter, we got a GSW to the head coming in.
I want you to prep Trauma 1.
- Get Dilantin, mannitol and Decadron.
- ETA? - Check with dispatch.
- Ewing seems pretty aggressive.
We'll need a chest and abdominal C to rule out metastatic disease.
- You sure? It's a soft-tissue mass.
- Extra-osseous.
It's rare.
You might want to write it up.
- Thank you.
- Want me to talk to the parents? He doesn't have any parents.
Where is she? Where is my mom? Where is this operation? The bullet She was shot in the back.
The bullet passed through her heart.
She lost so much blood that her heart stopped beating.
We opened up her chest for an emergency surgery.
We gave her blood transfusions.
The best surgeon in the hospital did it.
She wasn't in any pain.
She didn't suffer.
We worked on her for a long time.
We couldn't stop the bleeding.
And we couldn't get her heart to beat again.
Ted, your mother died.
I'm sorry.
Here.
You need to take these now.
- Shouldn't we draw baseline labs first? - No.
Now.
The sooner the better.
Peter, two units are in.
I can't get his pressure above 80.
- All right.
Hold on.
- He's already drug-resistant.
- You don't have a large viral load.
- He does.
Cleo, listen to me.
The conversion rate with meds is less than 3 in 1000.
Peter.
Crit is 14.
If he's going, he has to go now.
Okay? All right.
Get another two units.
I'll meet you at the elevator.
Call Infectious Disease.
See if they need to modify the post-exposure regimen.
I'm surprised my code still works.
- It's not gonna happen, Kim.
- What isn't? - They can't let you go, not legally.
- No.
They always intended to fire me.
They would have done it sooner, but they needed a thick Human Resource file first.
Which is bogus.
They'll never get away with it.
- They already have.
- Only if you let them.
It's not worth the effort.
I'm not interested in working for a place that doesn't want me.
You have the right to due process.
We can find a civil-rights attorney.
We? It's not right, Kim.
You know why they're firing you.
You have to fight it.
You have to fight this.
I'm supposed to fight? You're hiding but I'm supposed to fight.
Well, I'm sorry.
But I don't want to fight.
I just want to move on.
So should you.
Chris and Hillary.
It's Mark Greene.
I'm looking for Elizabeth.
If you see her, could you ask her to give me a call? - Thanks.
- Dr.
Greene, we got him.
He opened fire in Lincoln Park.
Shot three people before being taken down by a civilian packing a 9mm.
- Is he still alive? - So far.
- What's he had? - Two amps of epi and atropine.
Is this the cabby? Shot at the base of his skull.
- Cleo, jump in on this? - High cervical injury.
Blew out his brains.
- Cleo! - Any vitals in the field? - No.
Just lots of brain matter.
- Any witnesses? - No.
But we think it was Fossen.
- Well, why? on the driver's log at 1: 14 p.
m.
- What? - The house you had searched.
Fossen must have been on his way over there.
Cabby probably heard his description on the radio.
- Dr.
Greene? - Bang.
Fossen blew his brains out.
- Dr.
Greene? - Don't worry, doc.
- That means he never got there.
- Dr.
Greene! He's coming in.
Was that a record number of gunshot wounds for one shift? By the same guy? Absolutely.
He has a good chance.
Like you said, you found it early.
It's more that he has to go through it alone, you know? As if having cancer as a kid wasn't bad enough.
He could get passed over for Chief Resident.
Or he could get kicked out of med school and be forced to work as an ER nurse.
- I was not kicked out.
- What would you call it? Suspended for being a deadbeat.
Do you know he offered to pay my tuition? - Who? - Luka.
And I know he means well.
It's just frustrating for me sometimes because I have to explain my every feeling.
And normally when you're with someone for a while, they learn your moods.
- But he doesn't do that.
- You know what? - Stop it.
- What? Don't talk to me about Luka.
I'm not your girlfriend.
- And I shouldn't even be here with you.
- Why not? Because I don't want to wish bad things for you and Luka.
And I don't want to sit on the sidelines waiting for you two to break up.
And I don't want to be your friend.
It might be convenient for you, but it's not doing much for me.
What are you talking about? Where did you put him? Where did you put my son? - How much O-neg do you want? - Four units.
- You can't take me from him! - Quiet! So we can listen! - Two entrance wounds on the right.
- One on the left.
Another two in the belly.
A total of five.
You.
You did this.
Set up for bilateral chest tubes and a central line.
- Systolic's low at 80.
- I'll intubate.
- This is your fault! - Ready for the chest tubes.
Now.
Paralyze.
One of Pavulon, 100 of sux.
You stole my son.
You destroyed my family.
Ambu-bag.
He's my son! What gives you the right to? You can't take my son away! It starts with one bad cell that multiplies.
And then it grows out of control.
You usually don't know it's there until it is big enough that it causes pain.
We're very lucky that we found it today.
So you're saying I'm lucky I got shot.
In a way, yeah.
It's just gonna take longer to die.
No.
That's what I'm telling you.
Since we caught it early, there's a good chance that you're not gonna die.
What's a good chance? Seventy percent.
- You know what 70 percent is? - Yeah.
It leaves 30.
Well, let's concentrate on the 70, okay? - Dr.
Carter, GSW's rolling in.
- Okay.
Be right there.
So, what happens to me now? Now I'm gonna have a cancer doctor, an oncologist, come and take a look at you.
No.
I mean, where do I live? I don't know.
I'll find out.
When was your last tetanus booster? I don't know.
Do I need an x-ray? - It looks like just a graze.
- Is that the guy? Yes.
Multiple GSWs to the chest and abdomen.
At the range, they teach you to shoot for the center mass.
It's not always fatal but it takes him down.
- You shot him? - I got mugged last year.
Same park.
I don't go there now without protection.
He started shooting people! Someone had to do something! We should arm the whole city.
Hey, I stopped him.
He would have kept going.
- You're lucky.
- Lucky I was packing.
- Carter, you free? - Sort of.
GSW to the right flank.
Vitals are stable, but I need you to check for gross hematuria.
Okay.
I'll be right there.
- I handed it in to her.
- What? Your reference.
Should put you over the top.
All fives.
- Wow! Thanks.
- I had to lie.
- Now, Carter.
- Coming.
First two are in.
Another subclavian.
Put the next two on the infuser.
- How's the chest tube output? - Couple hundred cc's.
- Only 50 on my side.
- Is he gonna make it? Probably.
Didn't hit any vital structures.
- After five shots? - Some guys get lucky.
He's lucky we didn't take him down.
- Dr.
Greene, Dr.
Corday's on line four.
- Could you get it for me? - Pressure's up to 85.
-3-0 nylon.
What's in the Foley? Seventy cc's.
Dips are negative for heme.
Can you cut this? Elizabeth? - Mark, what's going on? - Where were you? I was at the Farmer's Market.
There were police in the house and the front door's been kicked in.
- I told them to.
- Why? Long story.
Vaseline gauze.
You're not gonna tell me what happened? Nothing.
It's just a bit of a scare.
- You' re all right? - Yeah, I'm fine.
Call you later? - I told the police to stay until I called you.
- Yeah.
Yeah, he can go now.
You' re not gonna tell me what's going on? Not right now.
Everything's okay.
Okay, then.
- Will you be off at 7? - Yes.
I will be there.
Okay.
- I love you.
- Me too.
Elastoplast.
Get ready for a portable chest.
Keep the dopamine at 10 mics.
Neuro checks, 30 minutes.
A CBC in an hour.
- Any cord contusion? - No, extrinsic hematoma.
- Did they find Elizabeth? - She's fine.
- Good.
- What about her paralysis? - Ask me in 24 hours.
What's this? - GSW to the renal parenchyma.
Marge, clear OR 2.
We got another customer.
I'll be right back.
- Robert, I need to talk to you.
- Yeah, sure.
Anything but Legaspi.
You're making a mistake.
My main mistake was not firing her three months ago when I first found out.
- What? - That she is incompetent.
- That's not what you were gonna say.
- Really? In addition to your diagnostic skills, you're a mind reader.
- It's because she's gay.
- Of course I'm not.
That would be politically incorrect.
She's a pain in the ass.
Like Maggie Doyle was? - Let's stop right there.
- And avoid your history of discrimination? If you don't rethink this, there's a good chance you'll be out of a job.
Dr.
Legaspi has demonstrated not only poor judgment but a reckless attitude towards patients and a blatant disregard for authority.
She's out.
She's fired.
End of discussion.
- If she goes, I go.
- What? You heard me.
- Are you giving me an ultimatum? - I swear to God.
- I will walk out if you don't back off.
- I do not respond well to ultimatums! You had better choose your battles very carefully! You're the Chief of Emergency Medicine, not the county's lesbian advocate.
That's where you're wrong.
Because I am both.
I am the Chief of Emergency Medicine, and I am a lesbian.
If you pursue this matter, I will take it to the County Board of Supervisors the ACLU, the press, and anyone else who will listen! So I suggest you choose your battles very carefully! - BP's 100/60.
- Going in the right direction.
- Last HemoCue? -9.
5.
You want me to bring him up? - Mark? - What? - You want me to bring him up? - No, no.
I got it.
They are sending cross-matched blood to the OR.
Good.
Could you bring the chart back down so I can write my note? Sure.
He's gonna need some more Pavulon.
Damn it! I forgot the drug box.
Be right back.