St. Elsewhere (1982) s01e06 Episode Script
Legionnaires: Part 1
1
- Tonight on St. elsewhere.
- Okay. How long?
- Thirty-five minutes.
- Give it up.
Two, three [Steady beep]
[Laughing] Somethin' funny?
- No, sir.
- Mr. Roecklein, a young lady just died in here!
You have a rotten sense of timing. You know that?
It's going, "lub-dub, lub-dub." No, no, ehrlich.
If there's a murmur, it would be, "lub-schtub, lub-schtub."
Oh, I see. "Lub-schtub."
Don't you ever, ever question my authority again, lady,
or I'll slam the door so hard on
you, you won't know what hit you.
You're a good doctor, but you're an inadequate woman.
I know it. Everybody knows it. You've got a cold heart.
You can have $300 for a new beeper,
but we can't get $20 for a diaper service.
I'm tired of it, Peter! I'm just sick of it!
Three people have died with symptoms of legionnaires'.
Donald would like to close down the ward.
I'm not a doctor, but don't you think
closing it down is a little extreme?
No, I don't, not if it's legionnaires'.
I ask him what the word "impale" means.
He stuck this letter opener on his
hand and said, "stick that sucker through."
I gave it a good listen, and
it's going, "lub-dub, lub-dub."
No, no, ehrlich. If there's a murmur,
it would be, "lub-schtub, lub-schtub."
Oh, I see. "Lub-schtub." Try to remember that, will you?
It could be the difference between
your patient being alive or dead.
If he's a c.O.P.D.-Er, you're gonna need
a baseline pulmonary function test.
Is he still giving you that story
about coughing up blood? Mm-hmm.
Have pulmonary scope him and check for
lesions, then get a biopsy with brushings.
[Beeping] Never a dull moment.
Where's my [Samuels] hmm?
I found this on the body of a 78-year-old patient.
"Where are the dope fields? The helicopters are green."
He came down from c.C.U. He was
there for four straight weeks.
I.c.u. Psychosis.
Where are the dope fields?
There are some calcified granulomas on his chest X-ray.
That means the first thing we have to worry about is c.A.
Call feldman and have him bronched. Excuse me.
Hey, hey. I'm going down to Chestnut hill
reservoir later, do some night fishing.
You wanna come? What are you, high on vitamin "c"?
Fishing's illegal at Chestnut hill.
I know that, but everybody does it.
Illegal, as in put you in the same cell
as son of Sam, the Boston strangler,
John wilkes booth.
Come on. Fishing's fun.
Ehrlich, sitting on concrete, holding a
stick with a string dangling in the water
And ducking into the woods every
time a cop car passes is not fun.
A cardiac arrest in the middle of rem sleep that's fun.
A wino with an e.E.G. Of two spikes that's fun.
A little dalliance in the on call room
Oh, wait a second. I see. You have other plans.
Uh-huh. Mm-hmm. Cathy Martin, I presume.
Oh, lucky for her, I'm not pumpin' iron.
Yeah, well, my sister had a midwife.
Shirley, this doctor's wife is
not gonna give birth at home.
There were no problems whatsoever.
Yeah, but still,
I want Nina to have the baby in a hospital.
I want her to have the best care possible.
Jack, if you're so worried, why
don't you deliver the baby yourself?
Mrs. Weingrot could have waited until rounds. Who?
338. The woman you woke me for.
She complained of stomach pains.
Missing a bowel movement is not an emergency.
[Sighs]
Did you look under it? Well, come on! Look under it!
[Chattering]
It isn't? Damn it! I wouldn't do that if I were you.
Yes, I looked in the cafeteria. I
looked in every inch of this place.
All right. It's $260. I'll get
the money. I'll get the money.
Peter. Look, I gotta go now.
Tell you what if you find it, you call me, okay?
Okay? Bye-bye.
Hell of a tumor board this morning. Yeah, I heard.
Where were you? Megan fell off a swing in the playground.
Oh, no. Anything serious? Yeah, it's always serious.
It was funny as hell this morning.
Jackson gets up and starts carrying on.
He goes [clears throat] "Death
certificates prove that thyroid cancer"
"Hasn't increased in the last 10 years.
What are we doing about it?"
Craig gets bent out of shape and screams,
"because death certificates are
written before they do an autopsy!"
I thought they were gonna mix it up right there.
Samuels is gonna do a radical neck.
Pure physical mutilation. You want to watch? No, thanks.
Okay. I'll catch you later.
[Woman on P.A.] Dr. Menlow, call 10-14.
I was just, uh, trying to get a little sleep.
You haven't seen my beeper around
here, have you? Oh, no. No beeper.
Beeper.
If, uh if I do, I will let you know. Uh, thanks.
Donald! Do you have a second to look in on a patient?
Who's the attending? Gannon, but he's in surgery all day.
I'm very worried about her. Why?
Her name's Francine delgado.
She, seven days ago, had a mitral valve replacement.
What's her post-op course been like?
It was excellent until about 24 hours ago.
She started vomiting, having diarrhea.
Her temperature went through the roof.
In the last few hours, she's been
coughing without sputum production.
Hmm. Has she been complaining about any weakness?
Yes, she has, and I just don't understand it.
This is the first temp spike and 9.I. Distress
she's had since she came out of surgery.
Will you see her? Sure. Where is she?
Follow me.
I'm going down to x-rays right now
to take a look at it for you, okay?
Good. Peter? I can't talk right now. I lost my beeper.
Mm-hmm.
Excuse me.
Did you see the head of hair on him? It's disgusting.
Now, Mark, he's only a kid. I know. I know.
So, you're off to cabo San Lucas? Tomorrow morning.
That's terrific. You deserve a rest.
This place is not gonna run very
smoothly without you though.
Nonsense. Between Don westphall
and b.J. Cummings, I have no worries.
You know, that cummings kid may
be a good hospital administrator,
but sometimes he can be a real hard nose.
I don't like people like that.
You've caught an infection, Francine, but
it has nothing to do with your operation.
I feel like I'm on fire. I can't stop shaking.
I already ordered a chest X-ray
and sent a urine for culture.
Speed up her I.V. To a hundred per hour.
Nothing by mouth.
Get a sputum, send it down for routine
culture and sensitivity and a dieterle stain.
Blood culture times three, 15 minutes apart.
Then get her started on cephalothin, one gram six hours,
and erythromycin, one gram every six hours.
I.v. Piggyback, stat. Okay.
I feel so bad, Dr. Westphall.
I know, sweetheart. I know.
Should we isolate her?
Yeah.
[Exhaling, coughing]
I'm spittin' up phlegm.
Have you cut down on your cigarettes? Yeah, a little.
I gotta tell you, Mr. Andover
Two packs of cigarettes a day, 40 years
Your lungs look like the hills of West Virginia.
I don't mind spittin' up so much, but it's green.
He could be coming down with pneumonia.
Get respiratory therapy down here for a pulmonary toilet,
including an I.P.P.B. With bronkosol.
Save me some of the sputum for a gram's stain.
Mr. Andover, I'm gonna put you on some medication.
I don't want you coming down with
pneumonia on top of everything else.
Put him on methicillin, one gram q6 hours, I.V.
Mr. Andover, can I get you anything else?
Boy, I'm dyin' for a smoke.
Eh! [Sighs]
Fifteen boxes of hemostats have
disappeared in the last two months.
I mean, it's getting worse, not better.
What makes you think they're not
being used for medical purposes?
I seen them at the head shops in Harvard square.
They use them as roach clips. You know what I mean.
I'm a bourbon-straight-up man myself.
You mean they use them to smoke pot?
Yeah, so they don't burn their fingers.
Necessity is the mother of invention.
If it doesn't stop, when they reach for one in
an operation, they might have to use pliers.
Got ya.
I need the charts on two deceased
patients from last last week.
I don't have their numbers. Sorry.
Their names are Brenda Perez
And Lila rothlein R-o-t-h-l-e-i-n.
They were Dr. Chandler's patients.
Thank you.
Solitary pulmonary lesion. Mmm.
Probably cancer. Mmm.
Yeah, it's a classic lesion of bronchogenic cancer
Uneven margins with calcifications like a crab.
See here? Trabeculae invading the tissue.
Do we have autopsies on those
two patients that died of pneumonia?
Perez and rothlein? No, we didn't see any reason to.
Cause of death was respiratory
arrest emphysema with complications.
Oh. What's up, Dr. Westphall?
I have a similar case Francine delgado.
Well, there's lots of infections in these old wards.
No, this isn't typical pneumonia.
Compromised host, prodromal diarrhea,
high temperature, slow pulse, productive cough.
- Sounds like legionnaires'.
- Mmm.
Did Perez or rothlein have any features
that might be consistent with legionnaires'?
I don't remember. They went pretty
fast. How are you treating miss delgado?
I gave her erythromycin and cephalothin.
I had a patient with diarrhea. Oh, wait.
- What?
- She came in with it. Uh, food poisoning.
Oh. Well, all this is premature, so let's keep it quiet.
Sure, Dr. Westphall. People get crazy.
[Drill whirring]
Hi, Cathy. How's it going?
Police just brought this one in. Found
him lying in the meat packing district.
All his teeth were pulled out, and
whoever did it really smashed in his chest.
What can I do for you?
I have a sputum coming down for acid fast,
fungal studies and a dieterle silver stain.
Can you look at it right away? Dieterle?
Have we got legionnaires'? Let's hope not.
The stain will take a while. All right.
I also have a serum titers for legionella cooking.
Let me know what you think, huh? Yeah.
Donald has come to me quite concerned
about the recent deaths on ward 5.
- And you think it's legionnaires'.
- Possibly.
Uh-huh. Uh-huh.
Have you checked with the center
for disease control in Atlanta?
No, not yet. We have a dieterle down in pathology now.
So we'll just have to wait until the results
come in. I don't think that's very wise.
Donald would like to close down the ward.
Ward 5 has 35 beds.
Now, I'm not a doctor,
but don't you think closing it
down is a little extreme, premature?
No, I don't, not if it's legionnaires'.
You see, there's a separate air conditioner in there.
Are you aware that we're due for our quarterly census?
If we close down ward 5, even for a couple of days,
we'll lose several thousand dollars.
Three people have died with symptoms of legionnaires'.
That's quite a coincidence.
Were the patients in good health? No.
Two of them were elderly women with
histories of chronic respiratory disease.
The third had just come out of open-heart surgery,
but she was on ward 5 before the operation.
There are a lot of infections
running loose around a hospital.
There were three million cases of
pneumonia in the United States last year.
One third of them were of unknown origin.
This is our most recent report on nosocomial infections.
Were any of these people on a respirator? Two.
Well, we have hospital-acquired
pseudomonas infections from a respirator,
two methicillin-resistant staph infections
And recently a run of gram-negative
enteric bacilli e. Coli klebsiella.
They're not sensitive to any of
the standard antibacterial drugs.
They're not even sensitive to the
third-generation cephalosporins.
In each case I know.
We isolate the patient, put them on
triple antibiotics and hope that one hits,
but we do not close down a ward.
No, we don't.
I think we should wait for the
dieterle and the legionella titers.
We know he checked out, fiscus. Was he "0" or was he "q"?
"Q." definite "q." [Laughing]
Hey, Cathy. Sit over here.
What, with everybody? What everybody? Ehrlich? Come on.
All right. I'll get that. Here.
Let's get you a chair. [Ehrlich] Sit down.
Enjoy. Okay, where was I? Oh, yeah.
So I go over to the wife and tell her she's a widow.
She gets all upset and says, "I
knew he'd pull something like that."
And then she proceeds to ask my advice
in how to spend the insurance money.
Interesting you should say that.
The history of the residency
program is quite fascinating actually.
As William Stewart halstead,
the noted endocrinologist [yawns]
And a close personal friend of my father, once said
It's not a psychological problem, v.J.
No? Mm-mmm. It's one of diction.
You don't need a therapist, you need a tutor. Yes?
Hmm. Sure. Look, v.J.
It's impossible to be witty or charming or warm
If you don't speak the language.
No matter how smart you are,
it's interpreted as being stupid.
Uh-huh.
He's going on and on about how a certain
patient died of c.H.F. From mitral stenosis.
Talks for about two hours.
When it's time for pathology to give its findings,
a third-year path resident stands
up, looks Frazier right in the face
And says, "the mitral valve was perfectly normal."
Frazier gets totally bent out of shape.
"I know it was mitral stenosis!
I heard the murmur. I should know!"
The resident holds up his hand.
He's got the valve in a jar and says to Frazier,
"I have the valve. Have you got the murmur?"
- It was perfect.
- That's great.
Dr. White? Your patient, Mr. Andover?
You prescribed methicillin.
Yes. Are you aware that the man is allergic to penicillin?
The last thing he needs is to
go into an anaphylactic reaction.
I can't believe I did that. I've
been really preoccupied lately.
Try to concentrate on your patients, doctor.
This is going down on your evaluation.
Calling every time a patient has constipation
or an I.V. Pops out isn't normal procedure.
I mean, loceff has never been overly friendly or open.
I always chalked it up to a difference in
personalities, but this is just getting worse.
Why is loceff giving you such a hard time? I don't know.
Obviously she resents you.
I mean, look, face it sisterhood,
togetherness that's fine up to a point.
The bottom line is you're a doctor,
she's a nurse.
My first day in the O.R., when I was a medical student,
this old nurse says to me,
"don't you wear a nylon slip
under your scrub gown, young lady.
"It might set up electrical charges
And cause an explosion of the
anesthetic gases and damage the O.R."
They don't even use explosive gases anymore.
You want my advice? Fight fire with fire.
Make her monitor vital signs every 15 minutes.
Let her do a hundred urines at night, huh?
She'll get the message. That's not my style.
Waking up at 4:00 in the morning
to put in an I.V that's your style?
Behavior modification can be a wonderful thing.
Why are they putting me into
this contraption, Dr. Morrison?
We have to weigh you so we can monitor you
For malnutrition, dehydration, things like that.
Geez! I survived the depression, eight years of boxing
Thanks, guys. Being pancaked on a carrier in the pacific.
Hell, I made it through three marriages.
But this damn hernia is putting
me away like nobody's business.
It was an incarcerated hernia, Leo.
Doesn't sound like much, but it is.
We're gonna let you rest up here a while, Leo.
It'll prevent bedsores.
Would you believe a rotting dinosaur like me
Used to be a handsome young buck like Dr. Morrison here?
180 pounds.
- Heavyweight, Leo?
- No, I was a light-heavyweight.
I made number six. Oh, yeah?
Yeah. Then uncle Sam, he grabbed me.
Damn war probably kept me from getting killed.
I mean, I couldn't jab to save my life.
- Mean uppercut, no doubt.
- Yeah, that's right.
Hey, come here. When can I you-know-what again?
We'll try and take the catheter out in a day or so.
It's killing me, doc. I mean, it's humiliating.
Oh, I was just asking the doc if a beautiful
doll like you is married. That's all.
[Woman on P.A.] Dr. Cavanero, room 254.
Dr. Cavanero, room 254.
[Groans] Annie.
Hmm? They want you in room 254.
[Groans] I was just about to give
Tom Selleck a complete physical.
[Chuckles] Sorry.
[Sighs]
Too bad, Tom. You'll just have to wait.
Hi, Cathy. Hi.
Bye.
Are you off for the rest of the day? Uh-huh.
Nice dress.
You know, I've never seen you wear white.
I'm going to a funeral.
Cathy, usually people wear black to funerals.
I've noticed that.
But you see, in Asia, white is worn for mourning.
They consider white The absence of color
The absence of life.
Whereas black the combination of all colors
Is a symbol of life.
I see.
Who died?
I don't know his name.
You don't know the person who's being buried?
They brought him into the morgue yesterday.
They're going to dump him in the
city cemetery no marker or anything.
Oh, that is really
Why don't you come over to our
house for dinner sometime this week?
I'd love for my husband to meet you.
That'd be nice, Jacqueline. Thanks.
And bring fiscus. Robert loves fiscus.
Everybody does.
He's so funny.
You know, I wish Robert had fiscus's sense of humor.
Robert just doesn't know how to have a good time.
Your husband's boring?
No. Well, sometimes a little.
He's a workaholic.
He's very low-keyed, very analytical.
And it drives me crazy when he trims his own beard
Because he leaves little hair clippings all over the sink.
Ugh. How horrible.
I guess I'm being a little hard on him,
but my husband is not what you'd call a romantic.
Why do you stay with him? Because I love him.
Hmm.
Well, what do you say? Thursday?
My husband is a terrible chef.
His lobster archduke will kill you. Oh?
But we've got a great wine cellar.
[Chuckles] Okay. Good.
Will you ask fiscus or should I?
Um, I'm seeing him tonight.
I'll let you know.
I'd better get going. I don't
want to be late for the funeral.
Right.
- Good-bye.
- Bye.
I told her that shh.
I tried to tell that nurse this was no kind of big deal.
It's just a little upset stomach. That's what I thought.
It happens when you go back on solids.
I want you to eat real light for a couple of days
Juices, soups, jell-o's That kind of thing.
How 'bout fruit? Mm-mmm.
[Man] Yeah, but Mrs. shallo ordered a bucket.
I don't care what Mrs. Shallo told you on the telephone.
She cannot have a bucket of chicken
two hours before her operation!
Loceff? Why did you call me for Mr. Prensky?
He was having stomach cramps. It was simple indigestion.
I'm gonna say this one more time.
Indigestion, insomnia, constipation
None of these are emergencies.
They can wait until rounds.
I'm not paid to make those judgments, Dr. Cavanero.
I have been up for 36 hours. I
was trying to catch a little sleep.
I'm sorry, but that's not my problem.
Nurse loceff, I would like you to give a tap water enema
To patients weingrot, Malian
and O'Connell when they wake up.
Also I would like daily weights
and I&o's on all my patients.
Is that clear? Yes, Dr. Cavanero.
Good.
Four, five. One, two, three, four, five.
- Okay. How long?
- Thirty-five minutes.
One, two, three, four, five. [Daniels] Come on, Francine.
Come on. Come on.
Okay. Stop c.P.R. Let's get a reading here.
[Steady beep]
Asystole.
Can somebody relieve me? I'm dead.
Okay. We'll go until the next blood gas comes in.
Nurse, give me one amp I.V. Epi, one to 1,000.
[Daniels] One and two and three and four and five.
Come on, sweetheart. Live.
One and two and three and four and five.
- One and two and three and four and five.
- Give me the numbers.
Po2: 40, pco2: 65, bicarb: 15, p.H.: 7.05.
Three and four and five.
One and two and three and four and five.
- Give it up.
- One and two and three and four and five.
I'll inform the family.
My hands are numb.
One, two, three.
Cause of death was acute respiratory arrest.
Either the meds didn't kick in fast enough
Or she was too weak after the open
heart surgery to fight the infection.
I want an autopsy. It's after 4:30,
Dr. Westphall. Pathology's closed.
Open it. Yeah, 'cause people are dying to get in.
[Laughing] Something funny?
- No, sir.
- What's your name?
- Joe roecklein.
- Mr. Roecklein, a young lady just died in here.
You have a rotten sense of timing. You know that?
Hey, you!
What do you think you're doing? Sorry?
That's my flyer you just covered up.
English lessons?
Yes, I want to learn to speak better,
to be able to communicate better.
Yeah, well, you should have saw
to that before you came over here.
I wouldn't go to India to live
if I couldn't talk to the natives.
Shows a lack of respect, kochar.
Sorry, doctor.
I don't have time to dillydaddle with you.
If you want to find a tutor,
call the foreign languages department at Boston university.
¿Comprende?
I have a car to sell.
And "lessons" is spelled with two s's, not a "c."
Learn the language.
[White] $300? What are you talking about, $300?
Listen, a doctor without his
beeper is like a cop without his gun.
But I thought it was $260.
What do you expect? Everything costs more. Now, sign here.
Check or cash? Bill me for it.
Bill you? [Laughing]
Hey, what do you think this is, filene's or something?
I'll put a check in the mail tomorrow. Oh, no, no, no, no.
Look, you'll get your money. I promise you. Mm-mmm.
Just give me a break this one time.
Please.
Mmm. Here.
Thank you.
Ready for the main event? [Chuckles]
I've had more tea than the Boston tea party.
Leo, I'd still like to wait another day.
No, listen, doc.
I've been in training for the last 76 hours.
When Leo rauschkolb goes on
the card, he's on the card to stay.
If you're not able to go to the bathroom,
we'll have to put the catheter back in.
I got ya. Forty-five minutes.
You're looking at Leo rauschkolb.
My bladder does exactly what
I tell it to. Knockout in three.
[Chuckles]
Okay, Leo.
This isn't gonna hurt a bit. Yeah.
And the check is in the mail.
♪[Child humming]
♪[Continues]
♪[Continues]
Megan, honey, I cannot study if you make that noise.
- Will you please stop it?
- Megan, honey. Megan.
Come on now. Stop playing
with your spaghetti. [Baby crying]
Mommy? oh, honey, honey.
- Mommy, I want ketchup.
- We don't eat ketchup with spaghetti.
Peter? No.
[Bawling]
Diaper service wants their check tomorrow.
Peter! I heard you. I'm trying to read.
Why are you always reading, daddy?
He's trying to read a medical book, honey. Why?
So he can be a good doctor.
Look, why don't you two just talk?
I'll just drop out of the residency program. I won't study.
I don't see why we can't wash these diapers ourselves.
"We" is me, and I don't have the
time or the energy to clean diapers.
[Bawling resumes]
Look at that. All right. Well, look.
All right. We're gonna have to lose the diaper service.
No way, Peter.
You want somebody to clean once a week,
we got somebody to come clean once a week.
You want somebody to watch the kids while you
go to graduate school, fine, we got somebody.
We are not talking about extravagances, Peter.
Mommy, I want ketchup!
All I'm saying is we can't do
everything. "We" can't, but you can.
[Screaming] Mommy!
Mommy! Will you please be quiet!
I'll get the ketchup. Mommy!
Look, don't jump up from the table like that
You can have $300 for a new beeper,
but we can't get $20 for a diaper service.
I'm tired of it, Peter. I'm just sick of it.
You're not a husband anymore. You're not a father.
You're just nothing anymore!
Just a damn resident. I can't handle it.
All right. I'll get the money.
Hi, Mrs. Sylvester.
Hello. May I see the vitals?
As soon as I'm finished.
Still having pains in your abdomen?
Could you roll over for me?
[Grunts]
Could you give me a hand? Huh?
A little help. I'll be finished in a minute.
Miss loceff, may I see you outside?
Excuse us, Mrs. Sylvester.
What are you trying to pull?
I don't know what you're
talking about. Like hell you don't.
What do you call putting me down in front of a patient?
Don't you ever, ever question my authority again, lady,
or I'll slam the door so hard on
you, you won't know what hit you!
And when I tell you to do something, you do it!
If you've got a problem with that,
you take it up with your union or your psychiatrist!
But when I say jump, you jump!
Now, do you get that?
May I speak?
I don't like you.
You're a good doctor, but you're an inadequate woman.
I know it. Everybody knows it.
You've got a cold heart.
Can you try sitting down?
I tried everything.
Couple of days, it'll be a breeze.
Don't put me back on that
catheter, please. A deal's a deal.
Just give me a couple more minutes. Sorry, Leo.
Get me a number 16 foley catheter, please.
[Urinating]
The winner! Still "champine"! Leo rauschkolb!
- I saw ninotchka yesterday.
- Uh-huh.
It was up at the Orson welles cinema,
on a double bill with idiot's delight.
Yeah? I was kind of disappointed.
I thought there'd be more action. Garbo was funny.
All right. Choose. What's this?
Open it.
Congratulations, miss Martin.
You've just won an all-expense-paid
trip to nantucket, Massachusetts,
where you and the Lithuanian of your choice
Will spend two wonderful days and one tempestuous night
In shady acres cottage "b,"
where you'll walk along the beach, dance under the moon
And romp with the loons till the cows come home.
So what do you say? I can't, Wayne.
No, no. It's all set. I talked to Bobby
Ackerman about covering for you.
Every single detail's taken care of.
I even bought you some new thermal underwear. You did?
Yeah! But you can trade all that
for what's in envelope number three
An all-expense-paid trip to Martha's vineyard!
I hear they've got great sunsets there.
Oh, Wayne.
Wh where are you goin'?
Oh, I get it. You want number one, don't you?
I have to
Listen, uh, I've got to get out of here.
What? I've gotta go.
You've gotta go? Go where? Are you serious?
You are serious. Wait a second. Talk to me.
Don't you understand? I've got to get out of here now.
Well, tell me why! If you really knew me, then you'd know.
If if I really knew you, I'd know what?
What does that mean? I don't know what that means.
Please.
You can't just wait a second.
You can't just walk out the door.
I don't understand. Tell me what's going on.
All you wanted out of this was a good time, remember?
That's what you said you wanted, and that's what I want.
But now, Wayne, it's Say it!
I don't want to have a relationship.
What do you mean? We have a relationship.
[Sighs]
All right. You don't want a
relationship? We won't have a relationship.
You want to call it something else? It's just a word.
It'll be a brouhaha, a bagatelle, a bric-a-brac.
Will you listen to me? You never listen to what I'm saying.
I do too. I don't want a relationship.
You mean you don't want a relationship,
or you don't want a relationship with me?
With you.
I like you, Wayne.
I don't love you.
You've been so nice to me. I
don't want to hurt you. Mm-hmm.
But every time I try to get serious,
you always turn it into a joke.
I'm sorry.
What are you doing here? I thought you took the night off.
What can I say? I can't, uh, stay away from the place.
Yeah, I know. It's paradise. To me it is.
See, the trouble with the real
world is it just isn't real enough.
It lacks intensity, excitement,
the element of the unpredictable.
Give me a 9.I. Bleeder, a full arrest
or a coma of unknown etiology,
and I'm in heaven.
Not only that, I love the free food.
Are you okay? You look terrible.
Sure, I look terrible, but I feel terrific.
My pulse is racing. My eyes are dilating.
My white corpuscles are
fighting off infection at every turn.
But what about you, cavanero?
I mean, I hate to be the one to tell
you this, but you're beginning to sag.
Time and the pressures of the medical
profession are beginning to take their toll.
You should get some outside interests,
like yodelling or bareback riding.
Are you sure you're all right?
If you want, I'd be happy to let you ride bare on my back.
They put you on hold and they forget about you.
All right. Look, Wendy. I'm stuck.
What, Peter? I need to go pick
up my car. Can you cover for me?
For how long? Hour, hour and a
half tops. Probably not even that.
[Sighs] Yeah, sure.
Hey, thanks.
I owe you one. Really. I owe you one.
Still painting, Hugh?
Still lifes.
Apples and pears and stuff like that, huh?
I'm not very good with things that move.
Do you try to make them look real,
or are you a fan of that abstract malarkey?
I got an artist to paint a picture
of my wife, my son and myself.
You should have boy, I had real problems with it.
I mean, he caught my wife all right,
but what he did to my son
You'd have thought he had a cleft palate.
It's just a little dimple is all.
Never hurt kirk Douglas.
[Woman on P.A.] Dr. Ross to I.C.U.
Dr. Ross to I.C.U.
[Spits]
Damn smoke gets into everything.
A man wants to kill himself,
you'd think he'd have the decency
To not stink up everything.
For crying out loud, we're in a hospital!
I mean, we've got enough germs crawling around as it is.
Sure, they wash the floors, but, you
know, they don't get into the corners.
And did you ever check under the beds?
Tumblin' tumbleweed under there.
Hair on the sinks.
Window smudges.
Crud in the soap dishes.
[Clears throat]
Check and mate.
Hi, ira. Hi. Listen, honey. I'm
not gonna be home for a while.
Helen, do you have an aspirin? It's in the back.
Thanks. What? Yeah. We got a problem here.
[Weeping]
Thank you.
Can I get you something?
I just feel so lousy.
I don't even know why.
I'm 37 years old.
I come to work, I go home to an empty apartment
And I go to sleep.
Twelve years. And I hate it.
I used to fantasize I'd meet someone
And my life would be different.
Now I can't even imagine living with someone again.
You seem to have everything going for you.
That makes me hurt even more.
I haven't had a relationship A real one with a man
In longer than I care to remember.
When I go out with a guy, either
he can't handle my being a doctor
Or I'm afraid I'll be swallowed
up and then lose my independence.
So, consequently,
I can't seem to get this work-love
thing to work together at the same time.
And one without the other just isn't enough.
Sometimes I feel as though I've
been sold a bill of goods. Yeah.
[Chuckles]
Is it because everything has gotten so difficult,
or is it because everything is just too easy?
So, you see, you're not alone.
[Chuckles] Where the hell is that aspirin?
[Woman on P.A.] Security, report to E.R. immediately.
Security, report to E.R.
You've gotta be crazy to eat in this place voluntarily.
Hey, Peter white. Sit down. Yeah.
Believe me, the food here is better than
anything we get at the courthouse cafeteria.
They season everything with jurisprudence.
What are you doing here? Oh, I'm visiting a client.
Her gardener had the bad taste to hit her with a shovel.
Haven't seen you for a while.
Man, this place keeps me pretty busy.
I've been meaning to give you a call. Oh, yeah? About what?
Last time I saw you at Danny's barbecue,
you'd just quit levine-lambert.
Yeah, I wanted out of the corporate game something awful.
You were saying how difficult it is
to find clients for a new law firm.
If you want to go out on your own,
you gotta be willing to pay the Piper.
I don't exactly get the crème de la crème yet.
I run into a lot of potential
legal cases here at the hospital
Hit and run, insurance claims, negligence.
That sort of thing, you know? Uh-huh. Yeah?
I-I thought maybe we could work out an arrangement
Where you get first crack at some of these cases.
Uh, yeah, sure. Great. I'd like that.
As a matter of fact, I got a couple of
other buddies over at Boston general
Also residents
And we've worked out a similar arrangement.
Everybody does it these days.
They get a hundred bucks for every
referral that turns into a client.
But, uh, just so we both know what's goin' on here, Peter,
under your city contract, it's not exactly legal
For you to solicit business for someone like myself.
Putting your card in somebody's
pocket's not gonna hurt anybody.
Hey, look, Peter, we don't know
each other all that well, but listen.
Why don't you think the whole thing over?
Okay. Thank you.
Sure.
He was admitted with an anaphylactic reaction
Which required additional I.V. Antibiotics.
Your basic infected bee sting.
At 6:30 this morning, he complained
of slight dizziness and some diarrhea.
He had a fever of 99.6,
and Dr. Ehrlich prescribed ancef, one gram q6 hours.
1:30, he had a temperature that had risen to 101.
He complained of diarrhea, fever, chills and
had some dyspnea with a productive cough.
How old is he? Nineteen.
Any previous respiratory problems? None.
102.6.
Hi, pal. I hear you had a pretty rough day.
It really burns when I breathe deeply.
Is he bringing up phlegm? He's
also got a stool that's 90% water.
Can't you do something for me, doctor?
Start him on erythromycin, one gram
every six hours. I already ordered it.
Now, don't worry, son. You're gonna be all right. Helen?
[Woman on P.A.] Dr. Buckingham to n.I.C.U.
Dr. Buckingham to n.I.C.U.
[Sighs]
Close down the ward.
Sorry to keep you waiting.
You're in your second year of residency? First.
Married? Yes.
Any kids?
Yes. Our daughter is four, and Timothy is almost 10 months.
Planning any more? No. We're all done.
Everything looks fine. Give this to Sally out front.
She'll explain our entire procedure
to you and write you out a check.
Thank you. Mention us to your colleagues.
We're always glad when a
doctor decides to donate his sperm.
The fomites and the culture
media will all have to be picked up
And checked for cross contamination.
These are your fomites Isolation gown, tubing,
bottles of saliva.
[Woman] How about papers or books that sort of thing?
[Westphall] Basically, anything that's
been in contact with the infection.
Now, the culture medium
Food, water, custard
Anywhere the bacteria can grow.
[Rosenthal] Now listen to me.
Everything that you pick up will be
run through Dr. Borovay from c.D.C.,
so it'll save me a lot of time if you'll
divide things up among yourselves, okay?
[Man] Are you sure we're not gonna catch nothing?
[Westphall] Wear your masks and keep
your hands washed. You'll be all right.
[Luther] What about catching it from another patient?
[Westphall] It's not transmitted from person to person.
We'll be grading all our patients
Putting them into two groups.
Group one: Low probability
Young patients, first day patients, asthmatics, pre-ops.
This group will be re-shuttled
into the general hospital population.
Group two are the high probabilities
Anyone with compromised
respiratory status or immune deficient,
and anyone over 65.
We take them to ward 4 east.
Take special care with the old people.
Nothing goes in, nothing comes out.
Ward 5 is to be completely sealed.
[Shouting]
[Mews]
- Tonight on St. elsewhere.
- Okay. How long?
- Thirty-five minutes.
- Give it up.
Two, three [Steady beep]
[Laughing] Somethin' funny?
- No, sir.
- Mr. Roecklein, a young lady just died in here!
You have a rotten sense of timing. You know that?
It's going, "lub-dub, lub-dub." No, no, ehrlich.
If there's a murmur, it would be, "lub-schtub, lub-schtub."
Oh, I see. "Lub-schtub."
Don't you ever, ever question my authority again, lady,
or I'll slam the door so hard on
you, you won't know what hit you.
You're a good doctor, but you're an inadequate woman.
I know it. Everybody knows it. You've got a cold heart.
You can have $300 for a new beeper,
but we can't get $20 for a diaper service.
I'm tired of it, Peter! I'm just sick of it!
Three people have died with symptoms of legionnaires'.
Donald would like to close down the ward.
I'm not a doctor, but don't you think
closing it down is a little extreme?
No, I don't, not if it's legionnaires'.
I ask him what the word "impale" means.
He stuck this letter opener on his
hand and said, "stick that sucker through."
I gave it a good listen, and
it's going, "lub-dub, lub-dub."
No, no, ehrlich. If there's a murmur,
it would be, "lub-schtub, lub-schtub."
Oh, I see. "Lub-schtub." Try to remember that, will you?
It could be the difference between
your patient being alive or dead.
If he's a c.O.P.D.-Er, you're gonna need
a baseline pulmonary function test.
Is he still giving you that story
about coughing up blood? Mm-hmm.
Have pulmonary scope him and check for
lesions, then get a biopsy with brushings.
[Beeping] Never a dull moment.
Where's my [Samuels] hmm?
I found this on the body of a 78-year-old patient.
"Where are the dope fields? The helicopters are green."
He came down from c.C.U. He was
there for four straight weeks.
I.c.u. Psychosis.
Where are the dope fields?
There are some calcified granulomas on his chest X-ray.
That means the first thing we have to worry about is c.A.
Call feldman and have him bronched. Excuse me.
Hey, hey. I'm going down to Chestnut hill
reservoir later, do some night fishing.
You wanna come? What are you, high on vitamin "c"?
Fishing's illegal at Chestnut hill.
I know that, but everybody does it.
Illegal, as in put you in the same cell
as son of Sam, the Boston strangler,
John wilkes booth.
Come on. Fishing's fun.
Ehrlich, sitting on concrete, holding a
stick with a string dangling in the water
And ducking into the woods every
time a cop car passes is not fun.
A cardiac arrest in the middle of rem sleep that's fun.
A wino with an e.E.G. Of two spikes that's fun.
A little dalliance in the on call room
Oh, wait a second. I see. You have other plans.
Uh-huh. Mm-hmm. Cathy Martin, I presume.
Oh, lucky for her, I'm not pumpin' iron.
Yeah, well, my sister had a midwife.
Shirley, this doctor's wife is
not gonna give birth at home.
There were no problems whatsoever.
Yeah, but still,
I want Nina to have the baby in a hospital.
I want her to have the best care possible.
Jack, if you're so worried, why
don't you deliver the baby yourself?
Mrs. Weingrot could have waited until rounds. Who?
338. The woman you woke me for.
She complained of stomach pains.
Missing a bowel movement is not an emergency.
[Sighs]
Did you look under it? Well, come on! Look under it!
[Chattering]
It isn't? Damn it! I wouldn't do that if I were you.
Yes, I looked in the cafeteria. I
looked in every inch of this place.
All right. It's $260. I'll get
the money. I'll get the money.
Peter. Look, I gotta go now.
Tell you what if you find it, you call me, okay?
Okay? Bye-bye.
Hell of a tumor board this morning. Yeah, I heard.
Where were you? Megan fell off a swing in the playground.
Oh, no. Anything serious? Yeah, it's always serious.
It was funny as hell this morning.
Jackson gets up and starts carrying on.
He goes [clears throat] "Death
certificates prove that thyroid cancer"
"Hasn't increased in the last 10 years.
What are we doing about it?"
Craig gets bent out of shape and screams,
"because death certificates are
written before they do an autopsy!"
I thought they were gonna mix it up right there.
Samuels is gonna do a radical neck.
Pure physical mutilation. You want to watch? No, thanks.
Okay. I'll catch you later.
[Woman on P.A.] Dr. Menlow, call 10-14.
I was just, uh, trying to get a little sleep.
You haven't seen my beeper around
here, have you? Oh, no. No beeper.
Beeper.
If, uh if I do, I will let you know. Uh, thanks.
Donald! Do you have a second to look in on a patient?
Who's the attending? Gannon, but he's in surgery all day.
I'm very worried about her. Why?
Her name's Francine delgado.
She, seven days ago, had a mitral valve replacement.
What's her post-op course been like?
It was excellent until about 24 hours ago.
She started vomiting, having diarrhea.
Her temperature went through the roof.
In the last few hours, she's been
coughing without sputum production.
Hmm. Has she been complaining about any weakness?
Yes, she has, and I just don't understand it.
This is the first temp spike and 9.I. Distress
she's had since she came out of surgery.
Will you see her? Sure. Where is she?
Follow me.
I'm going down to x-rays right now
to take a look at it for you, okay?
Good. Peter? I can't talk right now. I lost my beeper.
Mm-hmm.
Excuse me.
Did you see the head of hair on him? It's disgusting.
Now, Mark, he's only a kid. I know. I know.
So, you're off to cabo San Lucas? Tomorrow morning.
That's terrific. You deserve a rest.
This place is not gonna run very
smoothly without you though.
Nonsense. Between Don westphall
and b.J. Cummings, I have no worries.
You know, that cummings kid may
be a good hospital administrator,
but sometimes he can be a real hard nose.
I don't like people like that.
You've caught an infection, Francine, but
it has nothing to do with your operation.
I feel like I'm on fire. I can't stop shaking.
I already ordered a chest X-ray
and sent a urine for culture.
Speed up her I.V. To a hundred per hour.
Nothing by mouth.
Get a sputum, send it down for routine
culture and sensitivity and a dieterle stain.
Blood culture times three, 15 minutes apart.
Then get her started on cephalothin, one gram six hours,
and erythromycin, one gram every six hours.
I.v. Piggyback, stat. Okay.
I feel so bad, Dr. Westphall.
I know, sweetheart. I know.
Should we isolate her?
Yeah.
[Exhaling, coughing]
I'm spittin' up phlegm.
Have you cut down on your cigarettes? Yeah, a little.
I gotta tell you, Mr. Andover
Two packs of cigarettes a day, 40 years
Your lungs look like the hills of West Virginia.
I don't mind spittin' up so much, but it's green.
He could be coming down with pneumonia.
Get respiratory therapy down here for a pulmonary toilet,
including an I.P.P.B. With bronkosol.
Save me some of the sputum for a gram's stain.
Mr. Andover, I'm gonna put you on some medication.
I don't want you coming down with
pneumonia on top of everything else.
Put him on methicillin, one gram q6 hours, I.V.
Mr. Andover, can I get you anything else?
Boy, I'm dyin' for a smoke.
Eh! [Sighs]
Fifteen boxes of hemostats have
disappeared in the last two months.
I mean, it's getting worse, not better.
What makes you think they're not
being used for medical purposes?
I seen them at the head shops in Harvard square.
They use them as roach clips. You know what I mean.
I'm a bourbon-straight-up man myself.
You mean they use them to smoke pot?
Yeah, so they don't burn their fingers.
Necessity is the mother of invention.
If it doesn't stop, when they reach for one in
an operation, they might have to use pliers.
Got ya.
I need the charts on two deceased
patients from last last week.
I don't have their numbers. Sorry.
Their names are Brenda Perez
And Lila rothlein R-o-t-h-l-e-i-n.
They were Dr. Chandler's patients.
Thank you.
Solitary pulmonary lesion. Mmm.
Probably cancer. Mmm.
Yeah, it's a classic lesion of bronchogenic cancer
Uneven margins with calcifications like a crab.
See here? Trabeculae invading the tissue.
Do we have autopsies on those
two patients that died of pneumonia?
Perez and rothlein? No, we didn't see any reason to.
Cause of death was respiratory
arrest emphysema with complications.
Oh. What's up, Dr. Westphall?
I have a similar case Francine delgado.
Well, there's lots of infections in these old wards.
No, this isn't typical pneumonia.
Compromised host, prodromal diarrhea,
high temperature, slow pulse, productive cough.
- Sounds like legionnaires'.
- Mmm.
Did Perez or rothlein have any features
that might be consistent with legionnaires'?
I don't remember. They went pretty
fast. How are you treating miss delgado?
I gave her erythromycin and cephalothin.
I had a patient with diarrhea. Oh, wait.
- What?
- She came in with it. Uh, food poisoning.
Oh. Well, all this is premature, so let's keep it quiet.
Sure, Dr. Westphall. People get crazy.
[Drill whirring]
Hi, Cathy. How's it going?
Police just brought this one in. Found
him lying in the meat packing district.
All his teeth were pulled out, and
whoever did it really smashed in his chest.
What can I do for you?
I have a sputum coming down for acid fast,
fungal studies and a dieterle silver stain.
Can you look at it right away? Dieterle?
Have we got legionnaires'? Let's hope not.
The stain will take a while. All right.
I also have a serum titers for legionella cooking.
Let me know what you think, huh? Yeah.
Donald has come to me quite concerned
about the recent deaths on ward 5.
- And you think it's legionnaires'.
- Possibly.
Uh-huh. Uh-huh.
Have you checked with the center
for disease control in Atlanta?
No, not yet. We have a dieterle down in pathology now.
So we'll just have to wait until the results
come in. I don't think that's very wise.
Donald would like to close down the ward.
Ward 5 has 35 beds.
Now, I'm not a doctor,
but don't you think closing it
down is a little extreme, premature?
No, I don't, not if it's legionnaires'.
You see, there's a separate air conditioner in there.
Are you aware that we're due for our quarterly census?
If we close down ward 5, even for a couple of days,
we'll lose several thousand dollars.
Three people have died with symptoms of legionnaires'.
That's quite a coincidence.
Were the patients in good health? No.
Two of them were elderly women with
histories of chronic respiratory disease.
The third had just come out of open-heart surgery,
but she was on ward 5 before the operation.
There are a lot of infections
running loose around a hospital.
There were three million cases of
pneumonia in the United States last year.
One third of them were of unknown origin.
This is our most recent report on nosocomial infections.
Were any of these people on a respirator? Two.
Well, we have hospital-acquired
pseudomonas infections from a respirator,
two methicillin-resistant staph infections
And recently a run of gram-negative
enteric bacilli e. Coli klebsiella.
They're not sensitive to any of
the standard antibacterial drugs.
They're not even sensitive to the
third-generation cephalosporins.
In each case I know.
We isolate the patient, put them on
triple antibiotics and hope that one hits,
but we do not close down a ward.
No, we don't.
I think we should wait for the
dieterle and the legionella titers.
We know he checked out, fiscus. Was he "0" or was he "q"?
"Q." definite "q." [Laughing]
Hey, Cathy. Sit over here.
What, with everybody? What everybody? Ehrlich? Come on.
All right. I'll get that. Here.
Let's get you a chair. [Ehrlich] Sit down.
Enjoy. Okay, where was I? Oh, yeah.
So I go over to the wife and tell her she's a widow.
She gets all upset and says, "I
knew he'd pull something like that."
And then she proceeds to ask my advice
in how to spend the insurance money.
Interesting you should say that.
The history of the residency
program is quite fascinating actually.
As William Stewart halstead,
the noted endocrinologist [yawns]
And a close personal friend of my father, once said
It's not a psychological problem, v.J.
No? Mm-mmm. It's one of diction.
You don't need a therapist, you need a tutor. Yes?
Hmm. Sure. Look, v.J.
It's impossible to be witty or charming or warm
If you don't speak the language.
No matter how smart you are,
it's interpreted as being stupid.
Uh-huh.
He's going on and on about how a certain
patient died of c.H.F. From mitral stenosis.
Talks for about two hours.
When it's time for pathology to give its findings,
a third-year path resident stands
up, looks Frazier right in the face
And says, "the mitral valve was perfectly normal."
Frazier gets totally bent out of shape.
"I know it was mitral stenosis!
I heard the murmur. I should know!"
The resident holds up his hand.
He's got the valve in a jar and says to Frazier,
"I have the valve. Have you got the murmur?"
- It was perfect.
- That's great.
Dr. White? Your patient, Mr. Andover?
You prescribed methicillin.
Yes. Are you aware that the man is allergic to penicillin?
The last thing he needs is to
go into an anaphylactic reaction.
I can't believe I did that. I've
been really preoccupied lately.
Try to concentrate on your patients, doctor.
This is going down on your evaluation.
Calling every time a patient has constipation
or an I.V. Pops out isn't normal procedure.
I mean, loceff has never been overly friendly or open.
I always chalked it up to a difference in
personalities, but this is just getting worse.
Why is loceff giving you such a hard time? I don't know.
Obviously she resents you.
I mean, look, face it sisterhood,
togetherness that's fine up to a point.
The bottom line is you're a doctor,
she's a nurse.
My first day in the O.R., when I was a medical student,
this old nurse says to me,
"don't you wear a nylon slip
under your scrub gown, young lady.
"It might set up electrical charges
And cause an explosion of the
anesthetic gases and damage the O.R."
They don't even use explosive gases anymore.
You want my advice? Fight fire with fire.
Make her monitor vital signs every 15 minutes.
Let her do a hundred urines at night, huh?
She'll get the message. That's not my style.
Waking up at 4:00 in the morning
to put in an I.V that's your style?
Behavior modification can be a wonderful thing.
Why are they putting me into
this contraption, Dr. Morrison?
We have to weigh you so we can monitor you
For malnutrition, dehydration, things like that.
Geez! I survived the depression, eight years of boxing
Thanks, guys. Being pancaked on a carrier in the pacific.
Hell, I made it through three marriages.
But this damn hernia is putting
me away like nobody's business.
It was an incarcerated hernia, Leo.
Doesn't sound like much, but it is.
We're gonna let you rest up here a while, Leo.
It'll prevent bedsores.
Would you believe a rotting dinosaur like me
Used to be a handsome young buck like Dr. Morrison here?
180 pounds.
- Heavyweight, Leo?
- No, I was a light-heavyweight.
I made number six. Oh, yeah?
Yeah. Then uncle Sam, he grabbed me.
Damn war probably kept me from getting killed.
I mean, I couldn't jab to save my life.
- Mean uppercut, no doubt.
- Yeah, that's right.
Hey, come here. When can I you-know-what again?
We'll try and take the catheter out in a day or so.
It's killing me, doc. I mean, it's humiliating.
Oh, I was just asking the doc if a beautiful
doll like you is married. That's all.
[Woman on P.A.] Dr. Cavanero, room 254.
Dr. Cavanero, room 254.
[Groans] Annie.
Hmm? They want you in room 254.
[Groans] I was just about to give
Tom Selleck a complete physical.
[Chuckles] Sorry.
[Sighs]
Too bad, Tom. You'll just have to wait.
Hi, Cathy. Hi.
Bye.
Are you off for the rest of the day? Uh-huh.
Nice dress.
You know, I've never seen you wear white.
I'm going to a funeral.
Cathy, usually people wear black to funerals.
I've noticed that.
But you see, in Asia, white is worn for mourning.
They consider white The absence of color
The absence of life.
Whereas black the combination of all colors
Is a symbol of life.
I see.
Who died?
I don't know his name.
You don't know the person who's being buried?
They brought him into the morgue yesterday.
They're going to dump him in the
city cemetery no marker or anything.
Oh, that is really
Why don't you come over to our
house for dinner sometime this week?
I'd love for my husband to meet you.
That'd be nice, Jacqueline. Thanks.
And bring fiscus. Robert loves fiscus.
Everybody does.
He's so funny.
You know, I wish Robert had fiscus's sense of humor.
Robert just doesn't know how to have a good time.
Your husband's boring?
No. Well, sometimes a little.
He's a workaholic.
He's very low-keyed, very analytical.
And it drives me crazy when he trims his own beard
Because he leaves little hair clippings all over the sink.
Ugh. How horrible.
I guess I'm being a little hard on him,
but my husband is not what you'd call a romantic.
Why do you stay with him? Because I love him.
Hmm.
Well, what do you say? Thursday?
My husband is a terrible chef.
His lobster archduke will kill you. Oh?
But we've got a great wine cellar.
[Chuckles] Okay. Good.
Will you ask fiscus or should I?
Um, I'm seeing him tonight.
I'll let you know.
I'd better get going. I don't
want to be late for the funeral.
Right.
- Good-bye.
- Bye.
I told her that shh.
I tried to tell that nurse this was no kind of big deal.
It's just a little upset stomach. That's what I thought.
It happens when you go back on solids.
I want you to eat real light for a couple of days
Juices, soups, jell-o's That kind of thing.
How 'bout fruit? Mm-mmm.
[Man] Yeah, but Mrs. shallo ordered a bucket.
I don't care what Mrs. Shallo told you on the telephone.
She cannot have a bucket of chicken
two hours before her operation!
Loceff? Why did you call me for Mr. Prensky?
He was having stomach cramps. It was simple indigestion.
I'm gonna say this one more time.
Indigestion, insomnia, constipation
None of these are emergencies.
They can wait until rounds.
I'm not paid to make those judgments, Dr. Cavanero.
I have been up for 36 hours. I
was trying to catch a little sleep.
I'm sorry, but that's not my problem.
Nurse loceff, I would like you to give a tap water enema
To patients weingrot, Malian
and O'Connell when they wake up.
Also I would like daily weights
and I&o's on all my patients.
Is that clear? Yes, Dr. Cavanero.
Good.
Four, five. One, two, three, four, five.
- Okay. How long?
- Thirty-five minutes.
One, two, three, four, five. [Daniels] Come on, Francine.
Come on. Come on.
Okay. Stop c.P.R. Let's get a reading here.
[Steady beep]
Asystole.
Can somebody relieve me? I'm dead.
Okay. We'll go until the next blood gas comes in.
Nurse, give me one amp I.V. Epi, one to 1,000.
[Daniels] One and two and three and four and five.
Come on, sweetheart. Live.
One and two and three and four and five.
- One and two and three and four and five.
- Give me the numbers.
Po2: 40, pco2: 65, bicarb: 15, p.H.: 7.05.
Three and four and five.
One and two and three and four and five.
- Give it up.
- One and two and three and four and five.
I'll inform the family.
My hands are numb.
One, two, three.
Cause of death was acute respiratory arrest.
Either the meds didn't kick in fast enough
Or she was too weak after the open
heart surgery to fight the infection.
I want an autopsy. It's after 4:30,
Dr. Westphall. Pathology's closed.
Open it. Yeah, 'cause people are dying to get in.
[Laughing] Something funny?
- No, sir.
- What's your name?
- Joe roecklein.
- Mr. Roecklein, a young lady just died in here.
You have a rotten sense of timing. You know that?
Hey, you!
What do you think you're doing? Sorry?
That's my flyer you just covered up.
English lessons?
Yes, I want to learn to speak better,
to be able to communicate better.
Yeah, well, you should have saw
to that before you came over here.
I wouldn't go to India to live
if I couldn't talk to the natives.
Shows a lack of respect, kochar.
Sorry, doctor.
I don't have time to dillydaddle with you.
If you want to find a tutor,
call the foreign languages department at Boston university.
¿Comprende?
I have a car to sell.
And "lessons" is spelled with two s's, not a "c."
Learn the language.
[White] $300? What are you talking about, $300?
Listen, a doctor without his
beeper is like a cop without his gun.
But I thought it was $260.
What do you expect? Everything costs more. Now, sign here.
Check or cash? Bill me for it.
Bill you? [Laughing]
Hey, what do you think this is, filene's or something?
I'll put a check in the mail tomorrow. Oh, no, no, no, no.
Look, you'll get your money. I promise you. Mm-mmm.
Just give me a break this one time.
Please.
Mmm. Here.
Thank you.
Ready for the main event? [Chuckles]
I've had more tea than the Boston tea party.
Leo, I'd still like to wait another day.
No, listen, doc.
I've been in training for the last 76 hours.
When Leo rauschkolb goes on
the card, he's on the card to stay.
If you're not able to go to the bathroom,
we'll have to put the catheter back in.
I got ya. Forty-five minutes.
You're looking at Leo rauschkolb.
My bladder does exactly what
I tell it to. Knockout in three.
[Chuckles]
Okay, Leo.
This isn't gonna hurt a bit. Yeah.
And the check is in the mail.
♪[Child humming]
♪[Continues]
♪[Continues]
Megan, honey, I cannot study if you make that noise.
- Will you please stop it?
- Megan, honey. Megan.
Come on now. Stop playing
with your spaghetti. [Baby crying]
Mommy? oh, honey, honey.
- Mommy, I want ketchup.
- We don't eat ketchup with spaghetti.
Peter? No.
[Bawling]
Diaper service wants their check tomorrow.
Peter! I heard you. I'm trying to read.
Why are you always reading, daddy?
He's trying to read a medical book, honey. Why?
So he can be a good doctor.
Look, why don't you two just talk?
I'll just drop out of the residency program. I won't study.
I don't see why we can't wash these diapers ourselves.
"We" is me, and I don't have the
time or the energy to clean diapers.
[Bawling resumes]
Look at that. All right. Well, look.
All right. We're gonna have to lose the diaper service.
No way, Peter.
You want somebody to clean once a week,
we got somebody to come clean once a week.
You want somebody to watch the kids while you
go to graduate school, fine, we got somebody.
We are not talking about extravagances, Peter.
Mommy, I want ketchup!
All I'm saying is we can't do
everything. "We" can't, but you can.
[Screaming] Mommy!
Mommy! Will you please be quiet!
I'll get the ketchup. Mommy!
Look, don't jump up from the table like that
You can have $300 for a new beeper,
but we can't get $20 for a diaper service.
I'm tired of it, Peter. I'm just sick of it.
You're not a husband anymore. You're not a father.
You're just nothing anymore!
Just a damn resident. I can't handle it.
All right. I'll get the money.
Hi, Mrs. Sylvester.
Hello. May I see the vitals?
As soon as I'm finished.
Still having pains in your abdomen?
Could you roll over for me?
[Grunts]
Could you give me a hand? Huh?
A little help. I'll be finished in a minute.
Miss loceff, may I see you outside?
Excuse us, Mrs. Sylvester.
What are you trying to pull?
I don't know what you're
talking about. Like hell you don't.
What do you call putting me down in front of a patient?
Don't you ever, ever question my authority again, lady,
or I'll slam the door so hard on
you, you won't know what hit you!
And when I tell you to do something, you do it!
If you've got a problem with that,
you take it up with your union or your psychiatrist!
But when I say jump, you jump!
Now, do you get that?
May I speak?
I don't like you.
You're a good doctor, but you're an inadequate woman.
I know it. Everybody knows it.
You've got a cold heart.
Can you try sitting down?
I tried everything.
Couple of days, it'll be a breeze.
Don't put me back on that
catheter, please. A deal's a deal.
Just give me a couple more minutes. Sorry, Leo.
Get me a number 16 foley catheter, please.
[Urinating]
The winner! Still "champine"! Leo rauschkolb!
- I saw ninotchka yesterday.
- Uh-huh.
It was up at the Orson welles cinema,
on a double bill with idiot's delight.
Yeah? I was kind of disappointed.
I thought there'd be more action. Garbo was funny.
All right. Choose. What's this?
Open it.
Congratulations, miss Martin.
You've just won an all-expense-paid
trip to nantucket, Massachusetts,
where you and the Lithuanian of your choice
Will spend two wonderful days and one tempestuous night
In shady acres cottage "b,"
where you'll walk along the beach, dance under the moon
And romp with the loons till the cows come home.
So what do you say? I can't, Wayne.
No, no. It's all set. I talked to Bobby
Ackerman about covering for you.
Every single detail's taken care of.
I even bought you some new thermal underwear. You did?
Yeah! But you can trade all that
for what's in envelope number three
An all-expense-paid trip to Martha's vineyard!
I hear they've got great sunsets there.
Oh, Wayne.
Wh where are you goin'?
Oh, I get it. You want number one, don't you?
I have to
Listen, uh, I've got to get out of here.
What? I've gotta go.
You've gotta go? Go where? Are you serious?
You are serious. Wait a second. Talk to me.
Don't you understand? I've got to get out of here now.
Well, tell me why! If you really knew me, then you'd know.
If if I really knew you, I'd know what?
What does that mean? I don't know what that means.
Please.
You can't just wait a second.
You can't just walk out the door.
I don't understand. Tell me what's going on.
All you wanted out of this was a good time, remember?
That's what you said you wanted, and that's what I want.
But now, Wayne, it's Say it!
I don't want to have a relationship.
What do you mean? We have a relationship.
[Sighs]
All right. You don't want a
relationship? We won't have a relationship.
You want to call it something else? It's just a word.
It'll be a brouhaha, a bagatelle, a bric-a-brac.
Will you listen to me? You never listen to what I'm saying.
I do too. I don't want a relationship.
You mean you don't want a relationship,
or you don't want a relationship with me?
With you.
I like you, Wayne.
I don't love you.
You've been so nice to me. I
don't want to hurt you. Mm-hmm.
But every time I try to get serious,
you always turn it into a joke.
I'm sorry.
What are you doing here? I thought you took the night off.
What can I say? I can't, uh, stay away from the place.
Yeah, I know. It's paradise. To me it is.
See, the trouble with the real
world is it just isn't real enough.
It lacks intensity, excitement,
the element of the unpredictable.
Give me a 9.I. Bleeder, a full arrest
or a coma of unknown etiology,
and I'm in heaven.
Not only that, I love the free food.
Are you okay? You look terrible.
Sure, I look terrible, but I feel terrific.
My pulse is racing. My eyes are dilating.
My white corpuscles are
fighting off infection at every turn.
But what about you, cavanero?
I mean, I hate to be the one to tell
you this, but you're beginning to sag.
Time and the pressures of the medical
profession are beginning to take their toll.
You should get some outside interests,
like yodelling or bareback riding.
Are you sure you're all right?
If you want, I'd be happy to let you ride bare on my back.
They put you on hold and they forget about you.
All right. Look, Wendy. I'm stuck.
What, Peter? I need to go pick
up my car. Can you cover for me?
For how long? Hour, hour and a
half tops. Probably not even that.
[Sighs] Yeah, sure.
Hey, thanks.
I owe you one. Really. I owe you one.
Still painting, Hugh?
Still lifes.
Apples and pears and stuff like that, huh?
I'm not very good with things that move.
Do you try to make them look real,
or are you a fan of that abstract malarkey?
I got an artist to paint a picture
of my wife, my son and myself.
You should have boy, I had real problems with it.
I mean, he caught my wife all right,
but what he did to my son
You'd have thought he had a cleft palate.
It's just a little dimple is all.
Never hurt kirk Douglas.
[Woman on P.A.] Dr. Ross to I.C.U.
Dr. Ross to I.C.U.
[Spits]
Damn smoke gets into everything.
A man wants to kill himself,
you'd think he'd have the decency
To not stink up everything.
For crying out loud, we're in a hospital!
I mean, we've got enough germs crawling around as it is.
Sure, they wash the floors, but, you
know, they don't get into the corners.
And did you ever check under the beds?
Tumblin' tumbleweed under there.
Hair on the sinks.
Window smudges.
Crud in the soap dishes.
[Clears throat]
Check and mate.
Hi, ira. Hi. Listen, honey. I'm
not gonna be home for a while.
Helen, do you have an aspirin? It's in the back.
Thanks. What? Yeah. We got a problem here.
[Weeping]
Thank you.
Can I get you something?
I just feel so lousy.
I don't even know why.
I'm 37 years old.
I come to work, I go home to an empty apartment
And I go to sleep.
Twelve years. And I hate it.
I used to fantasize I'd meet someone
And my life would be different.
Now I can't even imagine living with someone again.
You seem to have everything going for you.
That makes me hurt even more.
I haven't had a relationship A real one with a man
In longer than I care to remember.
When I go out with a guy, either
he can't handle my being a doctor
Or I'm afraid I'll be swallowed
up and then lose my independence.
So, consequently,
I can't seem to get this work-love
thing to work together at the same time.
And one without the other just isn't enough.
Sometimes I feel as though I've
been sold a bill of goods. Yeah.
[Chuckles]
Is it because everything has gotten so difficult,
or is it because everything is just too easy?
So, you see, you're not alone.
[Chuckles] Where the hell is that aspirin?
[Woman on P.A.] Security, report to E.R. immediately.
Security, report to E.R.
You've gotta be crazy to eat in this place voluntarily.
Hey, Peter white. Sit down. Yeah.
Believe me, the food here is better than
anything we get at the courthouse cafeteria.
They season everything with jurisprudence.
What are you doing here? Oh, I'm visiting a client.
Her gardener had the bad taste to hit her with a shovel.
Haven't seen you for a while.
Man, this place keeps me pretty busy.
I've been meaning to give you a call. Oh, yeah? About what?
Last time I saw you at Danny's barbecue,
you'd just quit levine-lambert.
Yeah, I wanted out of the corporate game something awful.
You were saying how difficult it is
to find clients for a new law firm.
If you want to go out on your own,
you gotta be willing to pay the Piper.
I don't exactly get the crème de la crème yet.
I run into a lot of potential
legal cases here at the hospital
Hit and run, insurance claims, negligence.
That sort of thing, you know? Uh-huh. Yeah?
I-I thought maybe we could work out an arrangement
Where you get first crack at some of these cases.
Uh, yeah, sure. Great. I'd like that.
As a matter of fact, I got a couple of
other buddies over at Boston general
Also residents
And we've worked out a similar arrangement.
Everybody does it these days.
They get a hundred bucks for every
referral that turns into a client.
But, uh, just so we both know what's goin' on here, Peter,
under your city contract, it's not exactly legal
For you to solicit business for someone like myself.
Putting your card in somebody's
pocket's not gonna hurt anybody.
Hey, look, Peter, we don't know
each other all that well, but listen.
Why don't you think the whole thing over?
Okay. Thank you.
Sure.
He was admitted with an anaphylactic reaction
Which required additional I.V. Antibiotics.
Your basic infected bee sting.
At 6:30 this morning, he complained
of slight dizziness and some diarrhea.
He had a fever of 99.6,
and Dr. Ehrlich prescribed ancef, one gram q6 hours.
1:30, he had a temperature that had risen to 101.
He complained of diarrhea, fever, chills and
had some dyspnea with a productive cough.
How old is he? Nineteen.
Any previous respiratory problems? None.
102.6.
Hi, pal. I hear you had a pretty rough day.
It really burns when I breathe deeply.
Is he bringing up phlegm? He's
also got a stool that's 90% water.
Can't you do something for me, doctor?
Start him on erythromycin, one gram
every six hours. I already ordered it.
Now, don't worry, son. You're gonna be all right. Helen?
[Woman on P.A.] Dr. Buckingham to n.I.C.U.
Dr. Buckingham to n.I.C.U.
[Sighs]
Close down the ward.
Sorry to keep you waiting.
You're in your second year of residency? First.
Married? Yes.
Any kids?
Yes. Our daughter is four, and Timothy is almost 10 months.
Planning any more? No. We're all done.
Everything looks fine. Give this to Sally out front.
She'll explain our entire procedure
to you and write you out a check.
Thank you. Mention us to your colleagues.
We're always glad when a
doctor decides to donate his sperm.
The fomites and the culture
media will all have to be picked up
And checked for cross contamination.
These are your fomites Isolation gown, tubing,
bottles of saliva.
[Woman] How about papers or books that sort of thing?
[Westphall] Basically, anything that's
been in contact with the infection.
Now, the culture medium
Food, water, custard
Anywhere the bacteria can grow.
[Rosenthal] Now listen to me.
Everything that you pick up will be
run through Dr. Borovay from c.D.C.,
so it'll save me a lot of time if you'll
divide things up among yourselves, okay?
[Man] Are you sure we're not gonna catch nothing?
[Westphall] Wear your masks and keep
your hands washed. You'll be all right.
[Luther] What about catching it from another patient?
[Westphall] It's not transmitted from person to person.
We'll be grading all our patients
Putting them into two groups.
Group one: Low probability
Young patients, first day patients, asthmatics, pre-ops.
This group will be re-shuttled
into the general hospital population.
Group two are the high probabilities
Anyone with compromised
respiratory status or immune deficient,
and anyone over 65.
We take them to ward 4 east.
Take special care with the old people.
Nothing goes in, nothing comes out.
Ward 5 is to be completely sealed.
[Shouting]
[Mews]