ER Episode Scripts

s15e18

-Sit? Do you want me to sit? Yeah, we're rolling.
OK.
It's a little warm in here.
Must be the, uh All right, so you guys started yesterday, huh? You can relax, Dr Carter.
And you're interested in, what? life in the ER? We're documenting the challenges of emergency care in the 21st century.
And you want to know what? About you, the people who work here.
What you do.
OK.
How long have you been at County? I started about 15 years ago.
That's actually kind of hard to believe.
Wow Can you focus here? Yeah.
Oh, here? Yeah.
Sorry.
Oh, uh, I was a med student then, and, uh Well, the thing that you realize pretty soon is that you see it all.
You see all of human experience.
Does that sound a little pretentious? It did, right? Sound a little pretentious, uh Well, you guys are going to probably Go on with that.
Yeah? Good? Um, well, whatever you can imagine, it happens here.
Sometimes you're there for the end.
And that part never gets any easier.
Uh, it can be the loneliest place in the world.
Or where you go for a second chance.
And every once in a while, if you're smart, or lucky, maybe you find exactly what you need right here.
Come on.
You can be a little late.
No, I can't.
What's so important? Um, a murder investigation? Oh, that's the best you can come up with? You're cute.
Hey, did you mean what you said? You hate the way this place is decorated? You're a man, OK? Just get rid of the futon.
I love that futon.
And what's with this paint job? It's like shades of faeces.
I was a bachelor till very recently.
Give a guy a break.
I'll whip you into shape.
The one thing that you keep learning is that you can never think that you know what's coming.
Policia! Because when the rig rolls up, and the doors pop open, you have no idea what's inside.
Diaz?! Diaz, talk to me! my partner's been shot.
I need an ambulance at 2549 West Harrison, third floor, rear landing.
Returned fire, offender's locked inside.
So the only rule isnever relax.
< Dr Carter? Sorry to interrupt.
Two GSWs five minutes out.
One's a police detective.
Set up both trauma rooms and call for some O-neg.
I got to go.
Can we finish this later? Yeah.
If you can find me.
The most common thing I see? That's easy.
Rectal insertions.
Seriously.
I say, I say "stat.
" Yeah, I say "stat" quite often.
This guy, he was, um he was high on PCP.
But he was, like, over seven feet tall, and we had him strapped down.
I mean, the funny part is, is that it doesn't matter if it's a shampoo bottle, a light bulb, whatever.
They always tell you the same story - "I fell on it.
" "Thoracotomy, stat!" "I fell on it.
" And that guy got up, and he had the gurney strapped tostrapped to his back.
And he was chasing us all up and down the hall.
Men People in Australia can understand me, which is good.
I've got an accent, you see, um "Just clerks"? Those were his words? "Just clerks.
" He said that we didn't count as emergency healthcare providers.
Who is "he"? A writer, I think.
Of a documentary? Documentaries have writers? Well, he pieces it together.
Well, that's what's wrong with TV.
He seemed like a pipsqueak to me.
So you've met him? He interviewed us yesterday.
The nurses? Got their own day? Get over it, Frank.
We go to school for this.
That's it.
If they can make their own stupid reality show, so can I.
Can't argue with that.
I don't think that's such a good idea.
Here.
Press and point.
You know how to work it.
There's nothing wrong with a life lived out of the spotlight.
A stack of files, a broken stapler, a three-hole punch But lives are saved and lost right here.
It's a desk, Frank.
Admit, the nerve center of the ER.
What you're about to see is a document of the gatekeepers.
My name is Frank Martin.
Jerry Markovic.
The few, the proud The desk clerks.
That film crew get to you yet? They just asked me questions about the effect of the economy.
People get poor and they use guns to get money and the ER stays busy.
What are we getting? I heard officer down.
A detective.
How'd he get shot? He's a she.
This one's ours.
Perp's coming behind.
Claudia Diaz, I think you guys know her.
She and Morris have a thing.
"A thing"? Is that what it is? What happened? Son of a bitch shot me when I was walking away.
Lucky you had your vest on.
Yeah, I feel real lucky! Here's the shooter.
Took multiple shots from her partner.
Let's get chest and abdominal films, type and cross Type and cross four You OK? Yeah.
Work on access when we get in there.
Does Archie know yet? My partner said he'd call him.
I'll try, too, just to be sure.
Thank you for bringing breakfast.
Yeah, this is nice.
You like it? I was torn between eggshell white and something bolder.
Like a, like a robin's egg type thing.
Now I sound gay.
I mean, not that there's anything wrong with that.
You're nervous.
It's kind of risky, asking her to move in.
Maybe she'll say "no.
" I think any girl appreciates a guy willing to repaint for her.
How are things going with the wonder from Down Under? GoodI guess.
As long as we don't talk much.
Typical guy.
You fellas have to have your deepest thoughts and feelings pried from your cold, dead fingers, but Still, he's hard to figure.
Well, it's understandable with what happened to him as a kid.
I told him he needs to see somebody.
You know, if you've been hurt like that sexually, at a young age, it doesn't just go away on its own.
Well, it's, umgood he confides in you.
Well, it's been hard for him.
There's you and there's me.
His whole circle of friends.
Real ones, anyway.
Right.
Wait.
You didn't? He never told you? Hmm-mm, it, um Neela, I'm sorry.
It explains a lot.
I have to get to work by 9am.
We've got a complicated triple-a repair, so um No, Neela I'll see you later.
Hello? Decreased on the right; ten blades, sterile eights and a, um And a chest tube tray.
Hey.
She took two shots, one to the buttock, one to the shoulder.
We got an exit wound in the right chest.
I told you to get a desk job.
Shot me in the back.
How's your partner? He's OK.
You were covered? Any pain here? OW, yeah! It wasn't like that.
How do you know? It was clean, Archie.
Fur milligrams morphine IV, set up Is 32 OK? No, it's not, it's too big! John, let's just get the films.
I'll do the chest tube.
Sats 88.
Just dig up a 28, would you? Are you sure you're OK with this? It's all you guys.
This has to stay on you, OK? Let me get the sterile eights, please.
Bullet crossed the mediastinum.
That doesn't sound good.
Probable aortic injury.
I need a 28.
Try the hallway.
Whoa, whoa, half a litre out.
Hold compressions.
He's still asystole.
OK, start up.
Let's, uh, let's hang another unit.
Should we do a thoracotomy? There isn't much point.
It's worth a shot.
When you're new, everything's a question.
Even when you know you know something, you say it with an inflection.
It's never, "thoracotomy!" It's more like, um, "thoracotomy?" You got my smokes? Hi.
The orderly said he'd get me a carton of Salems for the right price.
That was two days ago.
I hate smoking these things.
Taste like wet leaves.
Where's Carlos? I was, uh, hoping today would be the day you'd remember me.
I remember youwell enough.
I'm your daughter.
I'm Sam.
I said, I know who you are.
They told me you been around.
It's good.
You're more alert.
Yeah, this place is like a dream come true.
I feel like i won the Super Lotto.
Turn off my tank for me, would you? You can't smoke in here, it's against the rules.
What? So it's your turn now, is that right? I want to make sure that you're OK.
Kelly and I both do.
Kelly never left.
Kelly stayed home and took care of me.
I don't know what you've been doing.
You kicked me out.
I didn't.
You called me a "whore" and a "slut.
" You said you didn't care what happened to me.
You were always dramatic.
You told me no-one would even notice I was gone.
I was 15 years old.
What happened to that baby of yours? His name's Alex.
Alex? When a head injury rolls into the ER, every minute counts.
And, um Delays.
Talk about delays.
A delay of even 15 minutes can mean the difference between life and death.
Here's the pelvic film.
And Brenner's calling it next door.
Guy lost a lot of blood.
How are we doing in here? I'm going to be late for a meeting.
She's not lucid.
They lose him? -Yeah.
I doubt anyone'll miss him.
A guy died.
Bullet traversed the pelvis.
Could've hit the bladder or uterus.
Where's surgery? In the OR.
They promised they'd send someone in a few minutes.
There's fluid around the liver.
Tachy, 134.
Let's hang another unit.
She going to need an ex lap.
Or maybe not.
Let's CT her.
She could be in and out of the scanner in, like, ten minutes.
Christ.
Mac 4 and 7.
5.
Intubate? Yeah, we've got to protect her airway.
Her lungs are re-expanded.
THIS ISN'T THE TIME! IT IS THE TIME.
He's right.
You're right.
Laryngoscope and a tray, please.
How's she doing? How's it look? Hang in there, Diaz.
What happened? We were taking witness statements.
Some guy started shooting through the door.
Can I get that laryngoscope, please?! Where were you? Right next to her.
Huh, not a scratch.
You're a lucky guy.
Problem? Not so long as you had her back.
You'll want to think about slowing your roll here.
Is that what I want to do? Archie A badge beats a lab coat any day.
Band of brothers, right? Where's the department? On their way, pal.
Ease up.
This guy always such an asshole? You want to get into it with me, huh?! Hey, hey! All right, you got us both in frame there, Boris? You are freakishly tall and Frank's head is square like block of wood.
Thanks, Spielberg.
In this segment, we are going to highlight some of the unsung heroes of the ER.
First up is Sadiq, the computer guy.
Sadiq Gilbran-Hassani.
I'm not just a "computer guy.
" My family has illustrious history in Syria before we were forced out.
Let's just try to stay on point, sadiq, OK? Without me, there'd be no timely lab results or X-ray readings which are crucial.
You let me know when I can speak again.
OK, Uncle Sam? Thank you, Sadiq.
You're the boss.
And this is Crystal Hung, pharmacy tech.
OK, when a doctor says, "I need an amp of lidocaine," a nurse gets it.
No lidocaine, it's a problem.
I put the lidocaine in the cart every damn day.
So that's that.
Interesting.
Very interesting.
And here we have good ol' Fred Tennyson, service engineer and catcher for the softball team.
I switch out whatever's broken.
Like light bulbs.
Without light bulbs, it's hard to see.
And doctors, they Well, you know, they need to see stuff.
And uh, here we have? From the cafeteria? And without food, we would all go hungry.
And on camera, we have Boris from Media services.
Please, leave me out of this.
This is horrible.
When was your last dialysis? Dialysis? Banfield thought I should know.
Since you were gonna be working.
Two days ago.
Must be fluid overloaded since he's not making urine.
Are you waiting on a kidney transplant? Yes.
Long story.
Any fever? No.
Increased salt or fluid intake? Maybe an extra sip of coffee, a handful of popcorn, nothing crazy.
Sometimes this kind of thing is idiopathic.
It can happen with chronic dialysis.
I know.
Systolic's down to 92.
Let's get nephrology down here.
I'll grab the ultrasound.
If there's a big effusion, we need to tap it.
Get my nephrologist - Gustavo Petrov at Northwestern.
Anyone else you want us to call? No.
I'll be right back.
Pelvic trajectory goes through the soft tissues.
Could have bagged the iliac vessels.
How's she doing? She needs angio.
She should go to the OR first.
It didn't enter the peritoneum.
We don't know that.
Let's not argue here.
I'm not denying she needs surgery.
Let's look at the iliacs first.
There's no hematoma.
She starts bleeding while you're in the OR? We'll deal with it.
Vascular standing by? You're not listening to me.
You're not thinking things through.
No? No.
We've got time to be systematic here.
Systematic? Angio, retrograde cystogram.
Let's not lose our heads.
Calm down and make a decision.
Archie, it's your call.
Angio or surgery? You guys need to decide this.
Bone fragments to the bladder wall.
She needs the OR.
The pace down here is visceral.
It demands being instinctive in the moment.
I prefer having time to think something through, hash out different possible versions, make a plan.
I mean that's why I'm better at being a surgeon than I was working in the ER.
You're going to get in trouble if they catch you.
Maybe they'll throw me out.
You know, if you don't want me here, you should just say so.
It's not like I'm going to leave, but at least we could talk about it.
Why don't we just try to forget our mistakes and wipe the slate clean? Mistakes? What mistakes? The ones that we both made.
Speak for yourself.
I'm not going to sit here and play along with you as the martyr and me as the evil child.
You don't have to sit here at all.
I was young and dumb and in love, Mom.
I believed everything he said.
I raised you better than that.
No, you didn't.
You actually No, you didn't.
What is this? it's all wet.
You spill something? Leave it.
I'll get somebody to clean it up.
No, it's just fine.
It's what they get paid for.
I said stop it.
It's disgusting.
It's not Would you please get out of here, you little bitch! Get out! Just get out of here! Give it to me! Give it to me! Just get out! Mary, I was coming to get you for flex and fun.
You ready? Do I look like I'm ready for flex and fun, you idiot? So your mother's stroke affected her frontal lobe.
Do you know what that is? Yes, I'm a nurse.
I thought you were in fashion.
No, that's my sister.
I didn't realize there were two of you.
What we see with frontal lobe injuries is the filters come down.
The ability to self-censor, be sensitive, tends to be affected.
Yeah, I know what you're getting at.
So the things that she says it's not really her.
It's the stroke talking.
I appreciate what you're saying.
I do, but the thing is, is that my mother hasn't changed a bit.
What you see in there that's who I grew up with.
That's exactly how I remember her.
Could use a bit more angle on that needle.
Eureka.
Good.
I'll be right back.
We'll, um, do a liver lac, then explore the pelvis.
Urology will fix the bladder.
Gyn will scrub in to address the uterine issue.
Primary repair will get it done? She may need a hysterectomy.
Whatever you have to do.
Four more units cross-matched.
We'll have 'em sent up with her.
OR's ready.
I hate the fact that you put yourself in danger every day.
Every time you do, I'm so proud of you.
OK, let's go.
How's it going? Fluid is serosanguinous and Johnny boy here is a backseat driver.
Dr Carter? John? Dr Carter? John! He's in v-tach! No pulse.
Did I irritate his myocardium? No, it's not your fault.
amp of D50, 10 of insulin.
We don't know his potassium level.
Trust me, it's high if the kidneys can't excrete it.
Charge to 360.
Clear! Still v-tach.
Again! Clear! Again! Hi, you guys have a consult for renal? Mig of epi, 150 of amiodarone.
Excuse me, Dr.
? Emily Haverman from nephrology.
Gates, switch.
You're a med student? Fourth year.
I'm doing a rotation.
That is an ER attending coding on the table, so please turn around, walk out, get your attending, and come back now.
I'm sure Dr Wheeler would prefer it if I If you're not walking away from me within three seconds, I swear to God, I may start doing compressions on your head.
I spent a lot of years in the army jumping out of choppers and I thought I was a team player.
I wasn't.
Not until I got here.
Whoa, k's 7.
6.
Calcium's on board.
Going again.
Clear! Back in sinus.
Carotid's good.
Recheck the lytes now and q 30.
I'm Dr Wheeler from nephrology.
My attending.
Perfect timing.
Morris You saved me? I'll never live it down.
Mom? I gotta get to work.
When's Kelly coming back? I'm not sure.
A week, maybe.
I must have spilled some water on that blanket or something.
I don't know.
I'll take care of it.
I'll get it back to you tonight.
I'm gonna keep coming here, no matter what.
You won't go through this alone.
You do what you gotta do.
We all have our cross to bear.
You know, the unos list can take a long time.
Have you thought about direct donation? Yeah.
And? Your wife not a match? If not, you know, we have a paired organ-donor program here.
The two of you could qualify for that.
I'm aware of that.
I just haven't talked to Kem about that yet.
There's very little risk in testing.
It's just not something we're in a place to get together on right now.
Does she know about your status? She knows that I have some medical issues.
I came back to Chicago.
She's in France.
She's visiting her family.
I left the whole thing kind of vague.
OK.
I will shut up now.
I'm just kind of tired.
I'll split.
Pull that curtain for me? You got it, boss.
Hey, I didn't realize you were coming in.
Yeah, me, either.
I got paged for an organ transport - heart donor.
Plane leaves in two hours.
How's your mom? feel like Jodie Foster in Silence Of The Lambs.
Fun.
Hey, no offense, but this smells like piss.
I'm supposed to bring that to her tonight, but now I'm never gonna make it.
I'll take care of it for you.
Really? Yeah.
All you really have to do is send it up to laundry.
Not a problem.
Sure you don't mind? Did I not just volunteer? You know, you're not such an ass as some people say.
Thank you.
Um, what were we talking about? Oh.
But you know, eventually, I started to figure things out as a doctor, you know, and how I fit in professionally with this place, this community of people.
Yeah, that's a big, big part of it for me is being good with yourself and who you are and who you're meant to be.
You know, finding yourself.
And then there's the next step after that, which is finding somebody else.
And sometimes you think "No, that's just "That's never gonna happen for me.
" And you meet someone who makes you feel you know who-who-who gets you.
And-and you get her.
Some-someone you can, you can imagine I'm sorry.
I'm sorry.
People think all we do is scrub poop and vomit off the floor, pero I refill the paper towels, the toilet papers, stock the soap, the dispensers.
Without clean hands, you get lots of bad infections.
She's right.
Nosocomial infections cause over 30,000 deaths in the US each year.
He knows.
So, boys, what's this all about? Oh, the interview guy said that we were non-essential staff.
Non-essential? We're offering a rebuttal.
You're essential.
You're quintessential.
Yeah.
I'm sure you'll set him straight.
Let me get a little rest, eh? Yeah.
Hey, hey, I think this lady's having an allergic reaction or something.
We'll page somebody.
Let's put her right over here.
Let's get Morris.
Morris is upstairs.
Brenner? Uh, critical ICU.
How long have you had this rash? An hour.
She's having trouble breathing.
Penis! Did she say "penis"? This is getting a little weird.
Pea-nuts! Peanuts! I knew a kid who had this in school.
And? He died.
Oh, man, she's not moving any air.
We need help.
Uh Uh No, we don't.
Oh, thank you! Yeah? Oh, in your face, reality boy! Yeah, do we look non-essential now?! I thought you'd be upstairs working on Claudia.
Uh, urology's doing the bladder reconstruction.
They swapped me out for their own resident.
Ah.
I'm, um, going on a heart retrieval, so I figured I'd grab a coffee.
What do you have? A heart retrieval for Joanie? Yeah, it's good news.
That's fantastic! The, uh, heart's in Seattle, so we won't be back until the middle of the night.
Right.
Are we all right? What do you think? Um, that something's bothering you? Clever twist.
Forget it.
No.
Explain it to me.
How is my being worried about you a twist? Because you keep turning everything around.
I don't think I'm smart enough to fight with you.
Like that.
You're plenty smart enough, but right now it's easier to make me seem hyper-analytical and this morning, wasn't going your way, so I was "irrational.
" I never said you were I'm the one who's bothered by something.
I'm the one refusing to have a reasonable conversation, and I'm the one who doesn't make sense.
It's all a defense mechanism.
Defense for what? I don't know.
Something you haven't told me? I don't tell anyone everything.
Then what are we doing? We hit a speed bump weeks ago and you react by disappearing.
We see each other all the time.
We talk.
We sleep together There's a way to do all those things and still disappear.
Why would I want to do that? Tell me.
Look, Neela, there are There are things that should be kept private.
Not if we are trying to figure out if they belong together.
I'm comfortable with you.
Well, maybe that's not enough, not when I have to find out important things about you from other people.
Oh, so that's it? What, I'm not chatty enough, so you go snooping around, trying to get under my skin? No.
It's not like that.
Trying to make me share my emotions and and talking about every stupid damn thing that bothers me? No.
NO! Look, a terrible thing was done to you.
I understand that.
And I hate that it happened.
But somewhere in all of what's gone on between us, one thing is clear.
We're not meant to be together.
It doesn't mean we don't care about each other deeply, but You know, I truly believe there's something better out there for both of us.
Whenever we're ready for it.
Better? Something more right.
So, Northwestern, huh? Too good for County.
Well, what can I say, Frank? I've seen how you care for your patients here.
Dr Morris says to make sure they check another potassium as soon as you get there.
Thanks, Haleh.
We're going to see you soon, right? Not if I see you first.
You can visit him when we're not on the clock.
Um Primary repair worked.
So, I guess the world can look forward to, uh, a gaggle of olive-skinned kids with red hair and freckles.
If that's something that you want.
The life you lead, the things you have been through They define how you do your job, the quality of the quality of your work.
Especially in a place like this.
So at the, um At the end of the day, you choose to deny or deal.
And which do you choose? It's evolving.
I'm evolving.
Um All I know is that I know um, that there is a lot of work that I need to do.
Can you be more specific about that? No.
Not with you.
Mrs Taggart? Hi.
Tony Gates.
I work with Sam.
I used to play.
You know, Christmas time.
Play the carols.
It's all gone now.
Yeah.
Well, Sam wanted me to get this back to you.
Well, she said she was coming by.
Well, she can't tonight.
She's on a work call.
Uh-huh.
And you are? I am a friend.
A friend? Do you smoke? No, ma'am, I don't.
That's too bad.
You're a good-looking fella, though, aren't you? Hmm, must be the lighting in here.
Do you know that out of all these people in here, I'm the youngest one by about 15 years? What the hell did I do to deserve this? I can't imagine.
I don't want her to stop coming.
So, if she thinks that's so, you tell her it's not.
OK.
You know, Sam's an amazing person.
She's very strong.
She's overcome a lot of obstacles.
You get to know her, you'd be very proud.
She hates me.
No, she doesn't.
Well, she thinks that I hate her.
Well, then, change that.
Sure.
Ta-dah! Changed! Well It's up to you.
Have a good night.
Hey.
You're not lying, are you? She's going to come back tomorrow? When Sam makes up her mind, nothing stops her.
I love helping people.
You know, originally, I wanted to, um, be the first baseman for the Chicago Cubs.
The thing I hate most about my job? Mm-hm.
- Smells.
- The smells.
The human body's got some pretty interesting smells.
What's-what's the dating life like? Well, I'm not going to tell you.
It's personal.
A patient is a patient.
Umpain is pain.
It's-it's universal.
I reached a point about five years ago where I started to feel that every day was the same thing, and I'd had enough.
But I've been through a lot of stuff since then.
And now, I try to embrace the idea that everything that happens has never happened before.
Like that saying that you can't stand in the same river twice because by the time that you come back, it's not the same river.
And you're not the same man.
Anyway I look around this place now and I can't imagine ever finding it boring.
Cos right at the moment that you think you've seen it all something happens that you never could have expected.