Chicago Med (2015) s11e10 Episode Script
Frost on Fire
1
What the hell were you thinking
going to that house by yourself?
[TENSE MUSIC]
What the hell were
you thinking following me?
Novak, can I maybe grab your number?
Do you have a pen?
Didn't think it would
be that easy, did you?
- You've met Dean.
- Mark Asher.
He's not exactly a fan of our situation.
You'd agree that there's value
in having two parents in the same home?
Hannah will be an incredible mother,
with or without my help.
This Archer guy is head-over-heels
in love with you.
[SCOFFS]
All I'm asking is next time,
next time you're hosting folks
at our place,
just give me a heads-up, okay?
Wait, you just said our place.
Rip, bring it in, man.
You're gonna make me cry.
- Did you hear what I said?
- Hey, hey.
Thanks again for letting us use
your apartment for poker night.
Yeah, actually, Doris,
it is, uh, it's our place now.
- Oh, how cute.
- Yeah.
Where are you two registered?
[TABLET BEEPS] Oh, heads up.
Novak and Violet are ten minutes out
with a college basketball player.
Injured her knee
during their morning game.
- Mm.
- I can take it.
Hmm, I wonder why he's so eager.
Could it have something
to do with a certain paramedic?
[CLEARS THROAT] Or because
I'm just a really good doctor.
- Oh.
- So yeah.
- Is that it?
- No.
No.
I'm gonna take you up
for an MRI shortly, Mr. Riley.
You got any metal on you?
Nope.
Oh, wait, yes.
Yes, there is.
Okay, what?
A wedding band? A wristwatch?
It's not really on me.
It's, um, in me.
Oh, okay. Pacemaker? Piercings?
No.
Where
[SIGHS]
Is it in your rectum?
In my what?
Is it up your butt?
Yes.
Okay. And what is up your butt?
It's a
[WHISPERS] Plug.
I'm sorry, I didn't catch that.
He said a plug, Dr. Archer.
Like a butt plug.
A a
We were trying a new position
when I fell off the bed.
And my girlfriend it was her idea.
It's okay. You don't have to
- She thought I might
- Yeah, yeah, sure.
I'd take it out myself.
No, no, no, no. That that
that's that's why I'm here.
All right.
Let's roll Mr. Riley onto his side.
What do we got?
Oh, this is real white glove service.
Most docs wouldn't walk
the extra ten feet.
I'm not most docs.
We've got Kristen Thompson,
21-year-old female.
Pain and swelling to the left knee
after a sudden stop
and change in direction.
It's my ACL.
I know I tore it. I heard the pop.
Okay, we're going to Treatment 5.
Right this way.
Gave 50 mics of fentanyl in the field.
A scout from the Sky
is coming to our next game.
No chance I'm gonna be able to play.
Hey, let's not get ahead of ourselves
until we know what's going on, okay?
[SUSPENSEFUL MUSIC]
Good morning.
Oh, hello.
What you got there?
Ah, it's, uh
No.
No.
Nothing.
So what brings you
to our humble department?
Well, I seem to recall
that you were telling me
it's sacrilege that I haven't
been to the Green Mill yet.
Well, as a so-called
jazz enthusiast, absolutely.
So I plan on rectifying that
this evening.
Oh, well, that's great to hear.
You should try to get them
to seat you in Al Capone's old spot.
You might need to invite a friend or two
to help you snag his booth, but
You know, I, uh,
I had someone special in mind.
Oh, well, good. That's great.
Whoever they are, they're
gonna have a great time.
It's it's you, Dean. [CHUCKLES]
I'm asking you out.
Oh. Oh, okay.
Sorry, I'm a I'm a little
Slow on the uptake?
- And rusty.
- [CHUCKLES]
[SIGHS] I am gonna sneak in
a quick coffee run
before our next call.
Do either of you guys want
anything from the café?
I'm good, thanks.
- I'll take a caramel frappe.
- Mm-hmm.
Oh, ah with a cinnamon roll.
[SCOFFS] She has a metabolism
of a teenager.
It's insane.
So you got a sweet tooth, huh?
Sweet, salty, umami.
I don't discriminate.
Nice.
You should check out my buddy
Frankie's new donut stand
down at Navy Pier.
He's got some wild flavors.
Bacon maple, dill pickle,
mango chili lime.
Sold.
When are we going?
How about tonight?
Dr. Frost, need some help in here.
[SUSPENSEFUL MUSIC]
Said she was feeling sleepy,
then suddenly,
her sats started dropping.
Okay, let's get her on oxygen
and a cardiac monitor.
[MACHINE BEEPING] Hey, Kristen.
Kristen, wake up.
Wake up. Kristen?
- Okay. What's going on here?
- No clue.
She came in with a suspected ACL injury.
- Shallow respirations.
- Okay, you brought her in?
Yeah. She was fine in the ambo.
Alert and oriented.
She hit her head or lose
consciousness at any point?
- No. Mm-mm.
- All right.
[MACHINE BEEPING]
Yeah, pupils are pinpoint.
She's OD'ing.
What?
Sats are down to 82. Heart rate's 40.
All right, bag her and
get me Narcan fast, please.
♪
- Narcan.
- Okay, push 2 milligrams IV.
Okay.
[SUSPENSEFUL MUSIC]
Meds are in.
- All right.
- Okay.
- Sats are improving.
- Okay. Kristen, hey.
Open your eyes for me, Kristen.
Hello? Kristen?
GCS is really low.
She's not protecting her airway.
I'll intubate. 20 etomidate, 50 of roc.
They were deep in the third
quarter when we got there.
When would she have taken drugs?
Did she mention any
medication she might have taken
or recent illnesses, anything like that?
She had a lingering cough
from a bout of bronchitis last night.
She went to campus health yesterday.
They prescribed her guaifenesin
with codeine.
Maybe she accidentally took too much.
Possibly. Codeine converts
to morphine in the liver.
Okay, let's get an EKG, a chest X-ray,
a head CT, knee MRI,
and then a full trauma panel
with a tox screen.
And let me know when
she's opening her eyes
and following orders
so I can extubate, okay?
Got it. [PHONE BUZZES]
Oh, it's Violet.
I gotta go.
Let me know what you find out.
All right, will do.
♪
We're going to Trauma 1.
Ruth Williams, 88-year-old female
and a history of dementia.
No anticoagulant use.
Complaint of left hip pain
after a ground-level fall.
Vitals are normal.
Are you the doctor?
I am indeed. I'm Dr. Ripley.
Handsome young man.
- [CHUCKLES]
- Ruth, you flirt.
Hey, Mike. Gonna need an X-ray in here.
Let's get 2 of morphine.
It's easy when they look like that.
[LAUGHTER]
So what precipitated the fall?
Missed the chair when
she went to sit down.
I think her lens prescription
is out of date.
I keep telling her daughter
that she needs to take her mom
to the eye doctor.
My daughter?
I'm talking about Grace, Ruth.
Oh, okay.
- Does Grace live in the city?
- Yeah.
I keep trying to reach her,
but it's going to voicemail.
I left a message.
Okay, I'm just gonna gently
move your leg.
[GROANS AND WHIMPERS]
Sorry. All done.
Tamika, is that you?
Hey.
I thought your interview
was this afternoon.
- It is.
- Interview?
Yes, uh, Tamika's applying
for the nursing externship program.
- Oh, wow.
- Yeah.
I was just bringing in Ruth Williams.
Do you remember Ruth?
Ah.
Bert's apartment was
a few doors down from hers.
- Yes.
- Hello, dear.
- Hello, Ms. Williams.
- [CHUCKLES]
We were at that ice cream
parlor next to Sinai Gardens.
- Uh-huh.
- When she had a little fall.
Oof.
We decided to have dessert before lunch.
Well, I'm sorry to hear that,
but I hope you at least got
to enjoy your ice cream first.
My favorite is rum raisin.
[LAUGHS]
Let's set up for a pelvis and left hip.
You know, my mother used to make
rum raisin ice cream from scratch
that was out of this world.
You know what her secret was?
Tell me.
She would soak those raisins for a week
in my father's Appleton Estate
with a shot of sherry
just for a little kick.
Oh. [LAUGHTER]
[ELEVATOR BELL RINGS]
Dr. Lenox, hi.
Oh, no, no.
Please stop.
Oh, yeah, yeah, yeah.
Hey, hey, no. Stop.
She hates this, so, you know
louder.
[CHEERS AND APPLAUSE]
I didn't think you were
coming back until next week.
Uh, we were planning a big party.
Well, now I'm very glad I came in early.
Hey, how was your, uh,
mandated two-week vacation?
I was going crazy at home.
Are you sure you took enough time to
Organize my spice rack
and clean out my closet?
- Yeah.
- I was gonna say heal.
- I'm healed.
- And process.
Process what?
Hey, Dr. Lenox,
we have a pregnant patient in 4
with peripheral edema.
Dr. Asher had to run up to L&D
for a delivery.
Just let me put my stuff down.
I'll be right there.
1+ pitting edema bilaterally.
No calf tenderness.
I'm just the oven. [CHUCKLES]
And favorite future auntie.
It's Jacob's sperm
"and this 5'9" goddess
from Harvard's egg.
[GIGGLES] I swear
she looks just like Beyoncé.
Well, swelling can be a completely
normal byproduct of pregnancy,
but I'd like to do an ultrasound
to check on the baby.
Of course, yeah.
And to be clear,
my husband and I chose our egg donor
for her scholastic achievements.
Total lie.
He just doesn't want you
to think he's shallow.
The aesthetics were simply a bonus.
This might feel a little cool.
I take it you two have
been friends for a while.
He's been stuck with me
since the first day
of freshman orientation.
When she demanded I be her friend.
Best friend.
Hmm.
Is everything okay?
You said this was a single pregnancy?
Yes, a boy.
Why?
I am definitely seeing a second fetus.
- Shut up.
- We're having twins?
- Surprise.
- [GIGGLES]
Yeah, the second fetus must have been
hiding behind their brother
during previous ultrasounds.
Oh, I can't believe this.
Would you like to know
the second baby's sex?
Yes. Yes, please.
It's a girl.
Oh, my God,
we're having a boy and a girl.
We have to FaceTime Ryan!
Ryan's the other daddy.
He's on a business trip.
I can never remember.
Is China 13 hours ahead or behind?
Who cares? Wake him up.
Let's get a CBC, CMP, fetal echo,
and level two ultrasound.
Is something wrong?
Oh, um, given the new finding of twins,
I wanna make sure that the female fetus
has a thorough assessment.
The female fetus
looks considerably smaller
than her brother, right?
She could have selective
fetal growth restriction
from twin-to-twin transfusion syndrome.
Let me know when Dr. Asher
is back from L&D.
We need to loop her in on this.
Yeah.
[SOMBER MUSIC]
All right, everyone,
we will finalize the
capital investments proposal
at our next meeting.
Please send your suggested
edits to Tiffany ASAP.
Thank you.
- Sharon.
- Yes.
I understand you're overseeing
the selection committee
for Gaffney's
nursing externship program?
Yeah, that's right.
I was just speaking with
Jessica Ewing on the committee,
and she mentioned that you have
one spot left to fill.
I happen to have the perfect candidate.
My nephew Colton graduated from UPenn.
Bachelor of Science in Nursing.
Uh, so did Colton submit an application?
He missed the deadline.
The truth is, I didn't even know
about the program
until Jessica mentioned it.
I was hoping that his résumé
and a good word from a board
member might make up for it.
Uh, I'd be happy to meet Colton.
Uh, have him call Tiffany
to set up a time this week.
Any chance at all you could
squeeze it in for today?
Colton's flying to Aspen
tomorrow for a ski trip.
It's a belated graduation present
from his aunt and uncle.
Okay, um, have him
come by my office at 1:00.
You're the best, Sharon.
I took two doses
of cough syrup at halftime.
But the doctor said I should do that
if my cough started acting up
during the game.
Okay, so you took 10 mils last night,
10 when you woke up,
and then 20 at halftime?
- Is that too much?
- No.
No, no, not nearly
enough to cause an overdose.
Do you have any history
with seizures, Kristen?
No.
Fainting or any heart arrhythmias?
I see you were prescribed
an SSRI about six months ago.
Yeah, after my grandma passed away.
We were really close, and I
had a pretty hard time with it.
But the medication didn't actually help,
so I stopped taking it.
And how have you been
managing your mental health
since stopping?
Once basketball season started
and I got back in my routine,
I began to feel better.
Have you ever taken any medication
that you weren't prescribed
to help regulate your moods,
like OxyContin or Percocet?
No, never.
Listen, Kristen.
Everything that you tell us
is confidential.
Nothing will be reported
to your parents or your coach.
I've never done drugs.
Not even weed.
My brother got hooked on Vicodin
after he had back surgery
for a volleyball injury.
He's better now, but I
would never put my family
through that again, I swear.
All right, Kristen, they're
ready to start your MRI, okay?
[PENSIVE MUSIC]
But was it really necessary
to call an ambulance?
She couldn't get off the ground.
We didn't wanna make it worse
by trying to move her.
[SIGHS]
Hi. Uh, you must be Ruth's daughter.
Grace Evans.
It's nice to meet you, Mrs. Evans.
I'm Dr. Ripley.
What is the issue?
Your mother's X-ray confirmed
that she has a fractured hip.
Isn't he handsome?
He's nice too.
Can't you see I'm trying
to talk to the doctor?
When's lunch? I'm hungry.
I'll go grab you a snack, Ruth.
Uh, the next step is to get a CT scan.
Why? You already know what's wrong.
Yes, but orthopedics
needs more detailed imaging
in order to determine
if it will heal on its own
or if Ruth will need an operation.
An operation?
I think I want a turkey sandwich.
Are you kidding me?
No mayonnaise.
This is not a restaurant, okay?
You're in a hospital.
And they serve food.
[SIGHS]
We'll know more after the CT.
How long is that gonna take?
I'm supposed to volunteer
at my granddaughter's preschool at 1:00.
Well, I-I doubt radiology will be able
to read the results that fast.
[SIGHS] Okay.
I will call my son
and let him know that
I'm not gonna make it.
Excuse me.
I'm sorry.
[SUSPENSEFUL MUSIC]
Here you go, Ruth.
Don't look like a turkey sandwich.
Well, they'll bring you lunch soon,
don't you worry.
Couldn't help but notice.
Notice what?
Oh, you know.
Just, uh,
you and Kingston looked
pretty cozy this morning.
You should ask her out.
Actually, she asked me out.
Wait, she did? That's that's great.
Yeah.
I declined the invitation.
Why?
Because.
Because of me.
[LAUGHS] Yeah.
You know, uh,
it wouldn't be respectful
to you in in your condition.
I'm sorry, my condition?
That's not the right words.
I didn't mean to say that.
What did you mean?
I mean, you're not
you're not dating currently,
- so
- How do you know I'm not?
Oh, uh, are you?
No.
But it doesn't mean
I couldn't if I wanted to,
and it certainly doesn't
mean that you can't.
I mean, it's not like we're together.
Right.
Yeah, we're just two friends
having a baby.
Remember?
Yeah.
Oh, good, you're back.
Dr. Lenox is looking for you.
Okay.
I think we can rule out
twin-to-twin transfusion syndrome.
I mean, these babies both have
their own placentas and sacs,
so they're unlikely
sharing any blood supply.
So what's causing the size difference?
[SIGHS] Not sure.
Can you pull up
Olivia's last ultrasound?
Oh, my God.
What is it?
I see why they missed the second fetus
on her prior ultrasound.
It's not clearly visible yet, but
I don't think that the female
fetus is growth-restricted.
I think she's younger
than the male fetus.
- You lost me.
- These are not twins.
These babies are of
different gestational ages.
About four weeks apart, I'd estimate.
How is that possible?
I think that this is an extremely
rare case of superfetation.
[SIGHS]
Olivia became pregnant after
she was already pregnant.
♪
- Hey, Kristen's tox came back.
- Yeah?
It's positive for opioids and fentanyl.
Well, I'm inclined to believe her
that the only opioid she took
was codeine.
I'm the father of an addict.
I got a extra sensitive nose for bull.
Of course, that leaves the fentanyl.
Well, we know where that came from.
Novak gave her 50 mics in the field.
Well, that's what
Novak said she gave her.
Y-you're not suggesting
Oh, listen, man, you know,
I hate to go there, but, uh,
paramedics are human.
Mistakes happen.
And in the absence of
any other explanation
You think Novak overdosed her?
Uh, seems like
the most likely possibility.
But obviously,
before we run up the chain
to Paramedic Chief Robinson,
we should probably notify Novak
as a professional courtesy, right?
You two seem to have a a rapport.
Maybe you wanna talk to her.
Yeah, sure.
[TENSE MUSIC]
Well, I see you have certifications
in advanced cardiac life support
and you helped administer the vaccine
to at-risk communities during COVID.
Yes, that's right.
Mm-hmm.
So, uh, what did you take away
from that experience,
being on the front lines
of the pandemic?
I learned firsthand how critical it is
for hospital systems to have
the proper infrastructure
to respond to a pandemic.
No, no, no.
- Personally.
- Ah.
What did you learn about yourself?
I learned how to work well in a team
and implement new protocols quickly.
What drew you to nursing?
Well, my mom's a CRNA
and my dad's a radiologist.
And as I'm sure you know,
my Aunt Miranda
has worked in the public
health sector for decades.
So I guess it's kind of in my DNA.
You know, Colton,
your résumé is very impressive.
Thank you.
So I hope I'm not
speaking out of turn here
when I say I'm getting a sense that
this isn't something
you actually want to do.
Am I wrong?
Ah correct me if I'm wrong.
No, you're not.
My family pushed me
to apply to the BSN program.
But after I did my
clinical rotations, I
I realized I don't wanna be a nurse.
Please don't tell my aunt.
I know she pulled strings
to get me this interview,
and she'll tell my parents,
and it'll be a whole thing.
No, I won't.
Thanks.
So what is it that you wanna do?
Tell
tell me what brings you joy.
I, um
I really love photography.
- Yeah?
- [CHUCKLING] Yeah.
One of my photos was
actually just accepted
- into a show in a gallery.
- Really?
Yeah.
It's a small gallery and I only get paid
if it sells, but
Well, an artist has
to start somewhere, yeah?
Yeah. [CHUCKLES]
Show me one of your photos.
Okay. [CHUCKLES]
Oh, wow. [LAUGHS]
So after Olivia was
implanted with our embryo,
she became pregnant
with her own biological baby?
Yes, exactly.
Uh, usually, the pregnancy
hormones prevent the body
from being able to get pregnant again,
but Olivia's body managed
to bypass that system.
I thought we agreed that
you weren't gonna
sleep around while pregnant.
And if you did, you would
at least use protection.
I didn't sleep around.
Who's the father?
It's
Zane.
The dates line up
with when we were on again.
Zane? Olivia
Maybe you could sort this out later.
There is more we need
to discuss with you.
Your fetal echo and level two ultrasound
revealed that the female fetus,
Olivia's biological baby,
has a congenital
pulmonary airway malformation.
It's a cyst on the lungs
putting pressure on the baby's heart.
This is causing a buildup of fluid
that your body is essentially mirroring,
and that's why you're
experiencing swelling.
Okay, so so what do we do?
How do we fix this?
Well, we can try
an ultrasound-guided procedure
to drain the cyst, put in a shunt,
and relieve pressure from the heart.
And then the baby will be okay?
That's our hope, yes.
But there are risks that
the shunt won't work
and the cyst will return.
And if that happens,
what do you try next?
[SOMBER MUSIC]
If this procedure is unsuccessful,
it is highly unlikely that
the female fetus will survive.
So this is the only option?
It's our best option.
Uh, there are other risks
associated with this procedure
that you both should be aware of.
What risks?
Any in-utero procedure puts Olivia
in danger of her water breaking,
sending her to preterm labor.
With your baby at 21 weeks
and Olivia's at roughly 17
Neither would be viable.
We'd lose them both?
I'm so sorry.
We know that this is a lot to take in.
Oh, Olivia, I'm so sorry.
[SIGHS]
Ruth has avascular necrosis
in her left hip.
The blood supply to the head
of the bone has been disrupted,
essentially causing it to disintegrate.
Orthopedics is recommending
a hip replacement
as soon as possible
to prevent further damage.
Well, what are the other options?
There really aren't any.
Without a hip replacement,
Ruth's gonna be bedridden
and unable to walk.
Which would be such a shame.
Ruth is very mobile.
She goes on excursions,
takes weekly dance classes.
So she gets the surgery.
She spends, what, a night
or two in the hospital,
and then she can go back
to Sinai Gardens?
Not right away, no.
She'd need to spend at least a few weeks
at an acute rehab facility.
Which will cost
a small fortune, I'm sure.
I'd be happy to arrange
for you to speak with someone
from case management.
[SIGHS]
Forget it.
Just keep her off her feet.
Keep her in the bed.
And when I get back, I'll take
her to get a second opinion.
When you get back? Where are you going?
I told Denise months ago.
John and I are leaving Monday
on a three-week cruise.
This really can't wait weeks.
I'm in charge of Ruth's medical care.
And I want her discharged
back to Sinai Gardens.
[TENSE MUSIC]
♪
I've seen what happens when
patients become immobile.
They develop bedsores,
pneumonia, infections.
You're not wrong.
I just
I just wish there was
something we could do.
♪
You think I overdosed her?
I think if you did,
it was a total accident.
Kristen's fine, by the way.
I probably should have led with that.
I didn't.
I gave her 50 mics. I'm positive.
Well, that's good.
Look, I believe you, okay?
I do.
It's just she OD'd on something.
Okay, look, you're a doctor.
I get it.
When the math isn't mathing,
you blame the paramedic.
No, that is not what I'm doing, okay?
That's actually what Archer is doing.
I'm trying to prevent this
from going up the chain.
I don't need your protection, okay?
If if Archer wants to
file a report with Robinson,
then he can go ahead.
I'm I'm not worried.
Maybe there's another explanation.
Is there something else that
you observed at the scene or
There definitely is another explanation.
But I don't have it, okay?
I told you everything I know.
My work was thorough, and I stand by it.
Maybe you should double-check your own.
You're taking this personally.
I absolutely am not, okay?
I'm just hungry.
All I've had today is a frappe,
a cinnamon roll,
two bags of Pirate's Booty,
and some Red Vines.
I am starving,
and it's deep dish for lunch.
It's that insane metabolism, right?
[APPREHENSIVE MUSIC]
♪
[SIGHS]
♪
Wait, you're petitioning to have
a judge remove me as
my mother's power of attorney?
Mrs. Evans, I understand you're upset.
You got some nerve, you know that?
We're concerned about
your mother's welfare.
Medical neglect is
a form of elder abuse.
You think I'm abusing her?
Why don't we take this
to the consultation room?
You don't know what
you're talking about.
You don't have a clue.
You look at my mother, and you see
this feeble, sweet, innocent old lady.
But that's not who she is, who she was.
Most times, dementia
turns people mean, right?
Yes, unfortunately.
I experienced that
with my late ex-husband.
Well, it had the opposite
effect on my mother.
What'd the doctor call it?
Pleasant dementia?
Well, let me tell you, Ruth Williams,
the real Ruth Williams,
was anything but pleasant.
When she was drunk,
which was most nights,
I was her ashtray.
And she was even nastier
when she was sober.
The only names I heard growing
up was fat, ugly, and stupid.
[TENSE MUSIC]
She said she wished I was never born,
that I ruined her life.
Are you a mother?
I am, yes.
Can you imagine
saying such hateful things
to your own child?
No.
She never hugged me.
She never told me that she loved me.
So you all can stand there and judge me
like I'm some terrible person, but
We're not judging you, Mrs. Evans.
I'm nothing like her.
I am a good mother.
And I am a good wife.
Mrs. Evans, I am so sorry
for what you went through.
I know
I know that I should be able
to forgive and to forget.
I I mean, look at her.
[SOBS SOFTLY]
But there are some things
we can't forgive.
Your mother needs to be cared for.
I know. I
But it's okay if you can't
be the one to take care of her.
We will look after her.
I promise you that.
Absolutely.
[SOBS AND SNIFFLES]
[SOMBER MUSIC]
♪
Hey.
Uh, the doctors are
gonna take care of you.
[SOBS]
That lady looked so sad.
Is she gonna be okay?
Yeah.
[EXHALES SLOWLY]
♪
Hey.
So have we made a decision?
Yes, I, um
I wanna do the surgery.
Okay.
I've already spoken to
our fetal surgery team,
and there's an OR available
in the next few hours,
so we'll move you to pre-op shortly.
I'm just gonna call Ryan to update him.
♪
Hey.
You okay?
He doesn't agree with my decision.
He said that?
No, he didn't have to.
Jacob's always wanted to be a father.
Ryan and I joke that
he's the quintessential dad,
just without the kid yet.
He takes care of everyone.
His family, his friends, me.
Especially me.
I was so happy to finally be
able to do something for him.
Look, I know that the last
thing you would ever wanna do
is put Jacob's baby at risk.
But you can't feel guilty
for wanting to do everything
you possibly can to save yours.
Lab tests have revealed
that you are what's called
an ultra-rapid metabolizer,
so you have a genetic variation
which causes you to metabolize
certain medications faster
than the general population.
Leading to two potential
outcomes depending on the drug.
Overdose, like you experienced
today with the codeine
Or a complete lack
of therapeutic effect,
which is why your
antidepressants didn't work.
I've had this my whole life?
Mm-hmm.
Why haven't I overdosed before?
Ultra-rapid metabolizers
don't experience these effects
- with all medications.
- Right.
It's actually a fairly narrow list
of drugs you need to avoid
going forward,
codeine being the most obvious one.
And that's the good news.
So as far as your knee goes
Yeah?
Orthopedics has looked at your MRI,
and you're gonna need surgery
to repair the tear.
[SIGHS] There goes the season.
And probably the rest
of my basketball career.
Look, this is not gonna be easy.
That's not what I'm saying, all right?
But a lot of players return
to the court after ACL surgery.
Yeah, maybe.
Look, I know this is a huge blow,
so I got you a little something
to hopefully cheer you up a little bit.
[CHUCKLES]
Oh, this is so cool.
Sloot's, like, my idol.
Hey, I'll be
I'll be right back, okay?
Let me see.
Okay, there you go. [CHUCKLES]
Kristen, I would like you to meet
- Sloot!
- Hey, Kristen.
[LAUGHS]
You know Courtney Vandersloot?
I know a guy who knows a guy
who knows Courtney Vandersloot.
I'm so sorry to hear about your knee.
I tore my ACL this past summer in a game
against the Indiana Fever.
Yeah, I watched it happen
right as you were going in for a layup.
Yeah, it was a huge bummer
to have to miss the rest of the season,
but I'm working really hard
post-surgery,
and I'm gonna be back
on the court next season
stronger than ever.
- That's awesome.
- And you will too.
And when you're ready,
we'll get you down to Wintrust,
and you and I will get some shots up.
I'd love that.
This is for you, by the way.
Wow.
[GIGGLES] Thank you so much.
[LAUGHS] Thank you.
[SOFT MUSIC]
Courtney Vandersloot.
So the judge granted
our emergency motion.
They'll assign a new
court-appointed conservator
in the coming days.
We're admitting Ruth
to the orthopedic unit
while she awaits surgery.
They're hoping to get her
on the schedule
before the end of the week.
Where where am I going?
We are taking you upstairs.
I'm gonna go with you, okay?
I'll come visit tomorrow.
Maybe I'll sneak in
some rum raisin, okay?
Okay.
You know, it's always made me sad
that I don't really know who
these people used to be
before dementia took their identity,
but maybe it's a blessing.
Lets me care for them
without being burdened by
Their past sins.
You seem to have a lot riding
on this not being Novak's fault.
Well, there was a
potential date depending on it,
but I'm not so sure about that anymore.
Yeah, well, not that
I particularly care,
but, uh, I thought that you
and Dr. Howard were an item.
Or at least on your way to becoming one.
Yeah, that's what I was hoping,
but long story short,
just didn't work out.
Yeah, they move on fast.
Carry a torch too long,
you're bound to get burned.
[SOFT DRAMATIC MUSIC]
♪
Oh, Tamika.
Oh, good. I was hoping I'd catch you.
- Everything okay with Ruth?
- Oh, yes. She's fine.
On behalf of the selection committee,
I'd like to offer you a spot
in Gaffney's upcoming
nursing externship.
Ah!
I got in?
[LAUGHS]
Thank you for everything.
Well, this was all you.
Congratulations.
Yes.
Oh.
How'd it go? Is Olivia okay?
Olivia did very well,
as did your baby boy.
[SIGHS]
And Olivia's baby?
Were you able to remove the cyst?
[SIGHS]
We initially thought that
the repair was successful,
but when we did our fetal heart
check after, she had passed.
I'm so sorry.
There was just too much
pressure on her little heart.
Does Olivia know?
No, she's just waking up.
I'm about to go in and talk to her now.
Can I tell her? Do you mind?
Sure.
I'll be in after
to answer any questions.
Right here.
Thank you, Dr. Asher.
[SOMBER MUSIC]
♪
So if it's not too late
or, uh, you haven't
invited anybody else,
I'd love to go
to the Green Mill tonight.
What about your plans?
Well, I could lie and say
they fell through, but I
I don't know.
I think I, uh, I'd like
to try honesty instead.
So, um
I'm in a somewhat complicated situation.
Too complicated, I thought, to date.
But I I'll let you be the judge.
I thought you said you were single.
I am.
- Are you gay?
- No.
Celibate?
Definitely not.
[CHUCKLES]
Okay, well, I'm okay with complicated.
Why don't you tell me more over drinks?
Okay.
Colton said you went
with another candidate.
Oh, yes, but I truly
enjoyed meeting with him.
Tam-ika?
Tamika, yes.
[SCOFFS] Yeah, well,
I'm glad you got the candidate
you wanted.
What an amazing opportunity for her.
Yes, it is.
Tamika is highly qualified,
which is why the committee
unanimously voted to accept her.
Well, I'm sure a recommendation from you
didn't hurt either.
Miranda.
Nope, I get it. I understand.
You're throwing your support
behind someone who would
benefit from the same
opportunities you were given.
You know, I'm not gonna
dignify that statement
with a response, but I will say this.
I think you should have a
conversation with your nephew.
[SOFT TENSE MUSIC]
♪
Hey.
So how was it, your first day back?
Fine.
You sure you're good?
I need an elevator.
Forget it. I'll take the stairs.
Hey.
Okay, what's your deal?
You think showing any sign
of emotion is is a weakness?
You you went through
something really traumatic.
I we both did.
I've served in combat zones.
This was nothing.
- I understand that, but
- What do you want?
You want me to start crying,
tell you I can't sleep,
I'm having nightmares,
and I keep flashing back to that night?
I can't stop thinking about it.
Well, I'm sorry to hear that.
I've moved on.
I don't buy it.
You're not a robot.
Something is going on with you,
and it has been for a while.
You keep throwing yourself
headfirst into these
dangerous situations
like you got a death
[UPBEAT ROCK MUSIC]
♪
Well, thank you for letting me
attempt to make up for today.
Oh, don't sweat it.
I knew I had nothing to worry about.
And watching you grovel is fun.
Yeah?
How were you so confident?
The six rights.
Yeah, it hasn't let me down yet.
Right patient,
right medication, right dose,
right route, right time, right document.
I go through that checklist
every time I dispense meds.
- That is very efficient.
- Yeah.
What do you say we get out of here?
No, no, no, okay?
Trust me, these donuts
are worth the wait.
There are other ways
to make up for today.
♪
You wanna go back to your place?
Yes.
Yes, uh, just
just give me one second.
- Yeah.
- Yeah? Okay.
[CLEARS THROAT]
[PHONE BUZZING]
♪
[LAUGHS]
♪
What the hell were you thinking
going to that house by yourself?
[TENSE MUSIC]
What the hell were
you thinking following me?
Novak, can I maybe grab your number?
Do you have a pen?
Didn't think it would
be that easy, did you?
- You've met Dean.
- Mark Asher.
He's not exactly a fan of our situation.
You'd agree that there's value
in having two parents in the same home?
Hannah will be an incredible mother,
with or without my help.
This Archer guy is head-over-heels
in love with you.
[SCOFFS]
All I'm asking is next time,
next time you're hosting folks
at our place,
just give me a heads-up, okay?
Wait, you just said our place.
Rip, bring it in, man.
You're gonna make me cry.
- Did you hear what I said?
- Hey, hey.
Thanks again for letting us use
your apartment for poker night.
Yeah, actually, Doris,
it is, uh, it's our place now.
- Oh, how cute.
- Yeah.
Where are you two registered?
[TABLET BEEPS] Oh, heads up.
Novak and Violet are ten minutes out
with a college basketball player.
Injured her knee
during their morning game.
- Mm.
- I can take it.
Hmm, I wonder why he's so eager.
Could it have something
to do with a certain paramedic?
[CLEARS THROAT] Or because
I'm just a really good doctor.
- Oh.
- So yeah.
- Is that it?
- No.
No.
I'm gonna take you up
for an MRI shortly, Mr. Riley.
You got any metal on you?
Nope.
Oh, wait, yes.
Yes, there is.
Okay, what?
A wedding band? A wristwatch?
It's not really on me.
It's, um, in me.
Oh, okay. Pacemaker? Piercings?
No.
Where
[SIGHS]
Is it in your rectum?
In my what?
Is it up your butt?
Yes.
Okay. And what is up your butt?
It's a
[WHISPERS] Plug.
I'm sorry, I didn't catch that.
He said a plug, Dr. Archer.
Like a butt plug.
A a
We were trying a new position
when I fell off the bed.
And my girlfriend it was her idea.
It's okay. You don't have to
- She thought I might
- Yeah, yeah, sure.
I'd take it out myself.
No, no, no, no. That that
that's that's why I'm here.
All right.
Let's roll Mr. Riley onto his side.
What do we got?
Oh, this is real white glove service.
Most docs wouldn't walk
the extra ten feet.
I'm not most docs.
We've got Kristen Thompson,
21-year-old female.
Pain and swelling to the left knee
after a sudden stop
and change in direction.
It's my ACL.
I know I tore it. I heard the pop.
Okay, we're going to Treatment 5.
Right this way.
Gave 50 mics of fentanyl in the field.
A scout from the Sky
is coming to our next game.
No chance I'm gonna be able to play.
Hey, let's not get ahead of ourselves
until we know what's going on, okay?
[SUSPENSEFUL MUSIC]
Good morning.
Oh, hello.
What you got there?
Ah, it's, uh
No.
No.
Nothing.
So what brings you
to our humble department?
Well, I seem to recall
that you were telling me
it's sacrilege that I haven't
been to the Green Mill yet.
Well, as a so-called
jazz enthusiast, absolutely.
So I plan on rectifying that
this evening.
Oh, well, that's great to hear.
You should try to get them
to seat you in Al Capone's old spot.
You might need to invite a friend or two
to help you snag his booth, but
You know, I, uh,
I had someone special in mind.
Oh, well, good. That's great.
Whoever they are, they're
gonna have a great time.
It's it's you, Dean. [CHUCKLES]
I'm asking you out.
Oh. Oh, okay.
Sorry, I'm a I'm a little
Slow on the uptake?
- And rusty.
- [CHUCKLES]
[SIGHS] I am gonna sneak in
a quick coffee run
before our next call.
Do either of you guys want
anything from the café?
I'm good, thanks.
- I'll take a caramel frappe.
- Mm-hmm.
Oh, ah with a cinnamon roll.
[SCOFFS] She has a metabolism
of a teenager.
It's insane.
So you got a sweet tooth, huh?
Sweet, salty, umami.
I don't discriminate.
Nice.
You should check out my buddy
Frankie's new donut stand
down at Navy Pier.
He's got some wild flavors.
Bacon maple, dill pickle,
mango chili lime.
Sold.
When are we going?
How about tonight?
Dr. Frost, need some help in here.
[SUSPENSEFUL MUSIC]
Said she was feeling sleepy,
then suddenly,
her sats started dropping.
Okay, let's get her on oxygen
and a cardiac monitor.
[MACHINE BEEPING] Hey, Kristen.
Kristen, wake up.
Wake up. Kristen?
- Okay. What's going on here?
- No clue.
She came in with a suspected ACL injury.
- Shallow respirations.
- Okay, you brought her in?
Yeah. She was fine in the ambo.
Alert and oriented.
She hit her head or lose
consciousness at any point?
- No. Mm-mm.
- All right.
[MACHINE BEEPING]
Yeah, pupils are pinpoint.
She's OD'ing.
What?
Sats are down to 82. Heart rate's 40.
All right, bag her and
get me Narcan fast, please.
♪
- Narcan.
- Okay, push 2 milligrams IV.
Okay.
[SUSPENSEFUL MUSIC]
Meds are in.
- All right.
- Okay.
- Sats are improving.
- Okay. Kristen, hey.
Open your eyes for me, Kristen.
Hello? Kristen?
GCS is really low.
She's not protecting her airway.
I'll intubate. 20 etomidate, 50 of roc.
They were deep in the third
quarter when we got there.
When would she have taken drugs?
Did she mention any
medication she might have taken
or recent illnesses, anything like that?
She had a lingering cough
from a bout of bronchitis last night.
She went to campus health yesterday.
They prescribed her guaifenesin
with codeine.
Maybe she accidentally took too much.
Possibly. Codeine converts
to morphine in the liver.
Okay, let's get an EKG, a chest X-ray,
a head CT, knee MRI,
and then a full trauma panel
with a tox screen.
And let me know when
she's opening her eyes
and following orders
so I can extubate, okay?
Got it. [PHONE BUZZES]
Oh, it's Violet.
I gotta go.
Let me know what you find out.
All right, will do.
♪
We're going to Trauma 1.
Ruth Williams, 88-year-old female
and a history of dementia.
No anticoagulant use.
Complaint of left hip pain
after a ground-level fall.
Vitals are normal.
Are you the doctor?
I am indeed. I'm Dr. Ripley.
Handsome young man.
- [CHUCKLES]
- Ruth, you flirt.
Hey, Mike. Gonna need an X-ray in here.
Let's get 2 of morphine.
It's easy when they look like that.
[LAUGHTER]
So what precipitated the fall?
Missed the chair when
she went to sit down.
I think her lens prescription
is out of date.
I keep telling her daughter
that she needs to take her mom
to the eye doctor.
My daughter?
I'm talking about Grace, Ruth.
Oh, okay.
- Does Grace live in the city?
- Yeah.
I keep trying to reach her,
but it's going to voicemail.
I left a message.
Okay, I'm just gonna gently
move your leg.
[GROANS AND WHIMPERS]
Sorry. All done.
Tamika, is that you?
Hey.
I thought your interview
was this afternoon.
- It is.
- Interview?
Yes, uh, Tamika's applying
for the nursing externship program.
- Oh, wow.
- Yeah.
I was just bringing in Ruth Williams.
Do you remember Ruth?
Ah.
Bert's apartment was
a few doors down from hers.
- Yes.
- Hello, dear.
- Hello, Ms. Williams.
- [CHUCKLES]
We were at that ice cream
parlor next to Sinai Gardens.
- Uh-huh.
- When she had a little fall.
Oof.
We decided to have dessert before lunch.
Well, I'm sorry to hear that,
but I hope you at least got
to enjoy your ice cream first.
My favorite is rum raisin.
[LAUGHS]
Let's set up for a pelvis and left hip.
You know, my mother used to make
rum raisin ice cream from scratch
that was out of this world.
You know what her secret was?
Tell me.
She would soak those raisins for a week
in my father's Appleton Estate
with a shot of sherry
just for a little kick.
Oh. [LAUGHTER]
[ELEVATOR BELL RINGS]
Dr. Lenox, hi.
Oh, no, no.
Please stop.
Oh, yeah, yeah, yeah.
Hey, hey, no. Stop.
She hates this, so, you know
louder.
[CHEERS AND APPLAUSE]
I didn't think you were
coming back until next week.
Uh, we were planning a big party.
Well, now I'm very glad I came in early.
Hey, how was your, uh,
mandated two-week vacation?
I was going crazy at home.
Are you sure you took enough time to
Organize my spice rack
and clean out my closet?
- Yeah.
- I was gonna say heal.
- I'm healed.
- And process.
Process what?
Hey, Dr. Lenox,
we have a pregnant patient in 4
with peripheral edema.
Dr. Asher had to run up to L&D
for a delivery.
Just let me put my stuff down.
I'll be right there.
1+ pitting edema bilaterally.
No calf tenderness.
I'm just the oven. [CHUCKLES]
And favorite future auntie.
It's Jacob's sperm
"and this 5'9" goddess
from Harvard's egg.
[GIGGLES] I swear
she looks just like Beyoncé.
Well, swelling can be a completely
normal byproduct of pregnancy,
but I'd like to do an ultrasound
to check on the baby.
Of course, yeah.
And to be clear,
my husband and I chose our egg donor
for her scholastic achievements.
Total lie.
He just doesn't want you
to think he's shallow.
The aesthetics were simply a bonus.
This might feel a little cool.
I take it you two have
been friends for a while.
He's been stuck with me
since the first day
of freshman orientation.
When she demanded I be her friend.
Best friend.
Hmm.
Is everything okay?
You said this was a single pregnancy?
Yes, a boy.
Why?
I am definitely seeing a second fetus.
- Shut up.
- We're having twins?
- Surprise.
- [GIGGLES]
Yeah, the second fetus must have been
hiding behind their brother
during previous ultrasounds.
Oh, I can't believe this.
Would you like to know
the second baby's sex?
Yes. Yes, please.
It's a girl.
Oh, my God,
we're having a boy and a girl.
We have to FaceTime Ryan!
Ryan's the other daddy.
He's on a business trip.
I can never remember.
Is China 13 hours ahead or behind?
Who cares? Wake him up.
Let's get a CBC, CMP, fetal echo,
and level two ultrasound.
Is something wrong?
Oh, um, given the new finding of twins,
I wanna make sure that the female fetus
has a thorough assessment.
The female fetus
looks considerably smaller
than her brother, right?
She could have selective
fetal growth restriction
from twin-to-twin transfusion syndrome.
Let me know when Dr. Asher
is back from L&D.
We need to loop her in on this.
Yeah.
[SOMBER MUSIC]
All right, everyone,
we will finalize the
capital investments proposal
at our next meeting.
Please send your suggested
edits to Tiffany ASAP.
Thank you.
- Sharon.
- Yes.
I understand you're overseeing
the selection committee
for Gaffney's
nursing externship program?
Yeah, that's right.
I was just speaking with
Jessica Ewing on the committee,
and she mentioned that you have
one spot left to fill.
I happen to have the perfect candidate.
My nephew Colton graduated from UPenn.
Bachelor of Science in Nursing.
Uh, so did Colton submit an application?
He missed the deadline.
The truth is, I didn't even know
about the program
until Jessica mentioned it.
I was hoping that his résumé
and a good word from a board
member might make up for it.
Uh, I'd be happy to meet Colton.
Uh, have him call Tiffany
to set up a time this week.
Any chance at all you could
squeeze it in for today?
Colton's flying to Aspen
tomorrow for a ski trip.
It's a belated graduation present
from his aunt and uncle.
Okay, um, have him
come by my office at 1:00.
You're the best, Sharon.
I took two doses
of cough syrup at halftime.
But the doctor said I should do that
if my cough started acting up
during the game.
Okay, so you took 10 mils last night,
10 when you woke up,
and then 20 at halftime?
- Is that too much?
- No.
No, no, not nearly
enough to cause an overdose.
Do you have any history
with seizures, Kristen?
No.
Fainting or any heart arrhythmias?
I see you were prescribed
an SSRI about six months ago.
Yeah, after my grandma passed away.
We were really close, and I
had a pretty hard time with it.
But the medication didn't actually help,
so I stopped taking it.
And how have you been
managing your mental health
since stopping?
Once basketball season started
and I got back in my routine,
I began to feel better.
Have you ever taken any medication
that you weren't prescribed
to help regulate your moods,
like OxyContin or Percocet?
No, never.
Listen, Kristen.
Everything that you tell us
is confidential.
Nothing will be reported
to your parents or your coach.
I've never done drugs.
Not even weed.
My brother got hooked on Vicodin
after he had back surgery
for a volleyball injury.
He's better now, but I
would never put my family
through that again, I swear.
All right, Kristen, they're
ready to start your MRI, okay?
[PENSIVE MUSIC]
But was it really necessary
to call an ambulance?
She couldn't get off the ground.
We didn't wanna make it worse
by trying to move her.
[SIGHS]
Hi. Uh, you must be Ruth's daughter.
Grace Evans.
It's nice to meet you, Mrs. Evans.
I'm Dr. Ripley.
What is the issue?
Your mother's X-ray confirmed
that she has a fractured hip.
Isn't he handsome?
He's nice too.
Can't you see I'm trying
to talk to the doctor?
When's lunch? I'm hungry.
I'll go grab you a snack, Ruth.
Uh, the next step is to get a CT scan.
Why? You already know what's wrong.
Yes, but orthopedics
needs more detailed imaging
in order to determine
if it will heal on its own
or if Ruth will need an operation.
An operation?
I think I want a turkey sandwich.
Are you kidding me?
No mayonnaise.
This is not a restaurant, okay?
You're in a hospital.
And they serve food.
[SIGHS]
We'll know more after the CT.
How long is that gonna take?
I'm supposed to volunteer
at my granddaughter's preschool at 1:00.
Well, I-I doubt radiology will be able
to read the results that fast.
[SIGHS] Okay.
I will call my son
and let him know that
I'm not gonna make it.
Excuse me.
I'm sorry.
[SUSPENSEFUL MUSIC]
Here you go, Ruth.
Don't look like a turkey sandwich.
Well, they'll bring you lunch soon,
don't you worry.
Couldn't help but notice.
Notice what?
Oh, you know.
Just, uh,
you and Kingston looked
pretty cozy this morning.
You should ask her out.
Actually, she asked me out.
Wait, she did? That's that's great.
Yeah.
I declined the invitation.
Why?
Because.
Because of me.
[LAUGHS] Yeah.
You know, uh,
it wouldn't be respectful
to you in in your condition.
I'm sorry, my condition?
That's not the right words.
I didn't mean to say that.
What did you mean?
I mean, you're not
you're not dating currently,
- so
- How do you know I'm not?
Oh, uh, are you?
No.
But it doesn't mean
I couldn't if I wanted to,
and it certainly doesn't
mean that you can't.
I mean, it's not like we're together.
Right.
Yeah, we're just two friends
having a baby.
Remember?
Yeah.
Oh, good, you're back.
Dr. Lenox is looking for you.
Okay.
I think we can rule out
twin-to-twin transfusion syndrome.
I mean, these babies both have
their own placentas and sacs,
so they're unlikely
sharing any blood supply.
So what's causing the size difference?
[SIGHS] Not sure.
Can you pull up
Olivia's last ultrasound?
Oh, my God.
What is it?
I see why they missed the second fetus
on her prior ultrasound.
It's not clearly visible yet, but
I don't think that the female
fetus is growth-restricted.
I think she's younger
than the male fetus.
- You lost me.
- These are not twins.
These babies are of
different gestational ages.
About four weeks apart, I'd estimate.
How is that possible?
I think that this is an extremely
rare case of superfetation.
[SIGHS]
Olivia became pregnant after
she was already pregnant.
♪
- Hey, Kristen's tox came back.
- Yeah?
It's positive for opioids and fentanyl.
Well, I'm inclined to believe her
that the only opioid she took
was codeine.
I'm the father of an addict.
I got a extra sensitive nose for bull.
Of course, that leaves the fentanyl.
Well, we know where that came from.
Novak gave her 50 mics in the field.
Well, that's what
Novak said she gave her.
Y-you're not suggesting
Oh, listen, man, you know,
I hate to go there, but, uh,
paramedics are human.
Mistakes happen.
And in the absence of
any other explanation
You think Novak overdosed her?
Uh, seems like
the most likely possibility.
But obviously,
before we run up the chain
to Paramedic Chief Robinson,
we should probably notify Novak
as a professional courtesy, right?
You two seem to have a a rapport.
Maybe you wanna talk to her.
Yeah, sure.
[TENSE MUSIC]
Well, I see you have certifications
in advanced cardiac life support
and you helped administer the vaccine
to at-risk communities during COVID.
Yes, that's right.
Mm-hmm.
So, uh, what did you take away
from that experience,
being on the front lines
of the pandemic?
I learned firsthand how critical it is
for hospital systems to have
the proper infrastructure
to respond to a pandemic.
No, no, no.
- Personally.
- Ah.
What did you learn about yourself?
I learned how to work well in a team
and implement new protocols quickly.
What drew you to nursing?
Well, my mom's a CRNA
and my dad's a radiologist.
And as I'm sure you know,
my Aunt Miranda
has worked in the public
health sector for decades.
So I guess it's kind of in my DNA.
You know, Colton,
your résumé is very impressive.
Thank you.
So I hope I'm not
speaking out of turn here
when I say I'm getting a sense that
this isn't something
you actually want to do.
Am I wrong?
Ah correct me if I'm wrong.
No, you're not.
My family pushed me
to apply to the BSN program.
But after I did my
clinical rotations, I
I realized I don't wanna be a nurse.
Please don't tell my aunt.
I know she pulled strings
to get me this interview,
and she'll tell my parents,
and it'll be a whole thing.
No, I won't.
Thanks.
So what is it that you wanna do?
Tell
tell me what brings you joy.
I, um
I really love photography.
- Yeah?
- [CHUCKLING] Yeah.
One of my photos was
actually just accepted
- into a show in a gallery.
- Really?
Yeah.
It's a small gallery and I only get paid
if it sells, but
Well, an artist has
to start somewhere, yeah?
Yeah. [CHUCKLES]
Show me one of your photos.
Okay. [CHUCKLES]
Oh, wow. [LAUGHS]
So after Olivia was
implanted with our embryo,
she became pregnant
with her own biological baby?
Yes, exactly.
Uh, usually, the pregnancy
hormones prevent the body
from being able to get pregnant again,
but Olivia's body managed
to bypass that system.
I thought we agreed that
you weren't gonna
sleep around while pregnant.
And if you did, you would
at least use protection.
I didn't sleep around.
Who's the father?
It's
Zane.
The dates line up
with when we were on again.
Zane? Olivia
Maybe you could sort this out later.
There is more we need
to discuss with you.
Your fetal echo and level two ultrasound
revealed that the female fetus,
Olivia's biological baby,
has a congenital
pulmonary airway malformation.
It's a cyst on the lungs
putting pressure on the baby's heart.
This is causing a buildup of fluid
that your body is essentially mirroring,
and that's why you're
experiencing swelling.
Okay, so so what do we do?
How do we fix this?
Well, we can try
an ultrasound-guided procedure
to drain the cyst, put in a shunt,
and relieve pressure from the heart.
And then the baby will be okay?
That's our hope, yes.
But there are risks that
the shunt won't work
and the cyst will return.
And if that happens,
what do you try next?
[SOMBER MUSIC]
If this procedure is unsuccessful,
it is highly unlikely that
the female fetus will survive.
So this is the only option?
It's our best option.
Uh, there are other risks
associated with this procedure
that you both should be aware of.
What risks?
Any in-utero procedure puts Olivia
in danger of her water breaking,
sending her to preterm labor.
With your baby at 21 weeks
and Olivia's at roughly 17
Neither would be viable.
We'd lose them both?
I'm so sorry.
We know that this is a lot to take in.
Oh, Olivia, I'm so sorry.
[SIGHS]
Ruth has avascular necrosis
in her left hip.
The blood supply to the head
of the bone has been disrupted,
essentially causing it to disintegrate.
Orthopedics is recommending
a hip replacement
as soon as possible
to prevent further damage.
Well, what are the other options?
There really aren't any.
Without a hip replacement,
Ruth's gonna be bedridden
and unable to walk.
Which would be such a shame.
Ruth is very mobile.
She goes on excursions,
takes weekly dance classes.
So she gets the surgery.
She spends, what, a night
or two in the hospital,
and then she can go back
to Sinai Gardens?
Not right away, no.
She'd need to spend at least a few weeks
at an acute rehab facility.
Which will cost
a small fortune, I'm sure.
I'd be happy to arrange
for you to speak with someone
from case management.
[SIGHS]
Forget it.
Just keep her off her feet.
Keep her in the bed.
And when I get back, I'll take
her to get a second opinion.
When you get back? Where are you going?
I told Denise months ago.
John and I are leaving Monday
on a three-week cruise.
This really can't wait weeks.
I'm in charge of Ruth's medical care.
And I want her discharged
back to Sinai Gardens.
[TENSE MUSIC]
♪
I've seen what happens when
patients become immobile.
They develop bedsores,
pneumonia, infections.
You're not wrong.
I just
I just wish there was
something we could do.
♪
You think I overdosed her?
I think if you did,
it was a total accident.
Kristen's fine, by the way.
I probably should have led with that.
I didn't.
I gave her 50 mics. I'm positive.
Well, that's good.
Look, I believe you, okay?
I do.
It's just she OD'd on something.
Okay, look, you're a doctor.
I get it.
When the math isn't mathing,
you blame the paramedic.
No, that is not what I'm doing, okay?
That's actually what Archer is doing.
I'm trying to prevent this
from going up the chain.
I don't need your protection, okay?
If if Archer wants to
file a report with Robinson,
then he can go ahead.
I'm I'm not worried.
Maybe there's another explanation.
Is there something else that
you observed at the scene or
There definitely is another explanation.
But I don't have it, okay?
I told you everything I know.
My work was thorough, and I stand by it.
Maybe you should double-check your own.
You're taking this personally.
I absolutely am not, okay?
I'm just hungry.
All I've had today is a frappe,
a cinnamon roll,
two bags of Pirate's Booty,
and some Red Vines.
I am starving,
and it's deep dish for lunch.
It's that insane metabolism, right?
[APPREHENSIVE MUSIC]
♪
[SIGHS]
♪
Wait, you're petitioning to have
a judge remove me as
my mother's power of attorney?
Mrs. Evans, I understand you're upset.
You got some nerve, you know that?
We're concerned about
your mother's welfare.
Medical neglect is
a form of elder abuse.
You think I'm abusing her?
Why don't we take this
to the consultation room?
You don't know what
you're talking about.
You don't have a clue.
You look at my mother, and you see
this feeble, sweet, innocent old lady.
But that's not who she is, who she was.
Most times, dementia
turns people mean, right?
Yes, unfortunately.
I experienced that
with my late ex-husband.
Well, it had the opposite
effect on my mother.
What'd the doctor call it?
Pleasant dementia?
Well, let me tell you, Ruth Williams,
the real Ruth Williams,
was anything but pleasant.
When she was drunk,
which was most nights,
I was her ashtray.
And she was even nastier
when she was sober.
The only names I heard growing
up was fat, ugly, and stupid.
[TENSE MUSIC]
She said she wished I was never born,
that I ruined her life.
Are you a mother?
I am, yes.
Can you imagine
saying such hateful things
to your own child?
No.
She never hugged me.
She never told me that she loved me.
So you all can stand there and judge me
like I'm some terrible person, but
We're not judging you, Mrs. Evans.
I'm nothing like her.
I am a good mother.
And I am a good wife.
Mrs. Evans, I am so sorry
for what you went through.
I know
I know that I should be able
to forgive and to forget.
I I mean, look at her.
[SOBS SOFTLY]
But there are some things
we can't forgive.
Your mother needs to be cared for.
I know. I
But it's okay if you can't
be the one to take care of her.
We will look after her.
I promise you that.
Absolutely.
[SOBS AND SNIFFLES]
[SOMBER MUSIC]
♪
Hey.
Uh, the doctors are
gonna take care of you.
[SOBS]
That lady looked so sad.
Is she gonna be okay?
Yeah.
[EXHALES SLOWLY]
♪
Hey.
So have we made a decision?
Yes, I, um
I wanna do the surgery.
Okay.
I've already spoken to
our fetal surgery team,
and there's an OR available
in the next few hours,
so we'll move you to pre-op shortly.
I'm just gonna call Ryan to update him.
♪
Hey.
You okay?
He doesn't agree with my decision.
He said that?
No, he didn't have to.
Jacob's always wanted to be a father.
Ryan and I joke that
he's the quintessential dad,
just without the kid yet.
He takes care of everyone.
His family, his friends, me.
Especially me.
I was so happy to finally be
able to do something for him.
Look, I know that the last
thing you would ever wanna do
is put Jacob's baby at risk.
But you can't feel guilty
for wanting to do everything
you possibly can to save yours.
Lab tests have revealed
that you are what's called
an ultra-rapid metabolizer,
so you have a genetic variation
which causes you to metabolize
certain medications faster
than the general population.
Leading to two potential
outcomes depending on the drug.
Overdose, like you experienced
today with the codeine
Or a complete lack
of therapeutic effect,
which is why your
antidepressants didn't work.
I've had this my whole life?
Mm-hmm.
Why haven't I overdosed before?
Ultra-rapid metabolizers
don't experience these effects
- with all medications.
- Right.
It's actually a fairly narrow list
of drugs you need to avoid
going forward,
codeine being the most obvious one.
And that's the good news.
So as far as your knee goes
Yeah?
Orthopedics has looked at your MRI,
and you're gonna need surgery
to repair the tear.
[SIGHS] There goes the season.
And probably the rest
of my basketball career.
Look, this is not gonna be easy.
That's not what I'm saying, all right?
But a lot of players return
to the court after ACL surgery.
Yeah, maybe.
Look, I know this is a huge blow,
so I got you a little something
to hopefully cheer you up a little bit.
[CHUCKLES]
Oh, this is so cool.
Sloot's, like, my idol.
Hey, I'll be
I'll be right back, okay?
Let me see.
Okay, there you go. [CHUCKLES]
Kristen, I would like you to meet
- Sloot!
- Hey, Kristen.
[LAUGHS]
You know Courtney Vandersloot?
I know a guy who knows a guy
who knows Courtney Vandersloot.
I'm so sorry to hear about your knee.
I tore my ACL this past summer in a game
against the Indiana Fever.
Yeah, I watched it happen
right as you were going in for a layup.
Yeah, it was a huge bummer
to have to miss the rest of the season,
but I'm working really hard
post-surgery,
and I'm gonna be back
on the court next season
stronger than ever.
- That's awesome.
- And you will too.
And when you're ready,
we'll get you down to Wintrust,
and you and I will get some shots up.
I'd love that.
This is for you, by the way.
Wow.
[GIGGLES] Thank you so much.
[LAUGHS] Thank you.
[SOFT MUSIC]
Courtney Vandersloot.
So the judge granted
our emergency motion.
They'll assign a new
court-appointed conservator
in the coming days.
We're admitting Ruth
to the orthopedic unit
while she awaits surgery.
They're hoping to get her
on the schedule
before the end of the week.
Where where am I going?
We are taking you upstairs.
I'm gonna go with you, okay?
I'll come visit tomorrow.
Maybe I'll sneak in
some rum raisin, okay?
Okay.
You know, it's always made me sad
that I don't really know who
these people used to be
before dementia took their identity,
but maybe it's a blessing.
Lets me care for them
without being burdened by
Their past sins.
You seem to have a lot riding
on this not being Novak's fault.
Well, there was a
potential date depending on it,
but I'm not so sure about that anymore.
Yeah, well, not that
I particularly care,
but, uh, I thought that you
and Dr. Howard were an item.
Or at least on your way to becoming one.
Yeah, that's what I was hoping,
but long story short,
just didn't work out.
Yeah, they move on fast.
Carry a torch too long,
you're bound to get burned.
[SOFT DRAMATIC MUSIC]
♪
Oh, Tamika.
Oh, good. I was hoping I'd catch you.
- Everything okay with Ruth?
- Oh, yes. She's fine.
On behalf of the selection committee,
I'd like to offer you a spot
in Gaffney's upcoming
nursing externship.
Ah!
I got in?
[LAUGHS]
Thank you for everything.
Well, this was all you.
Congratulations.
Yes.
Oh.
How'd it go? Is Olivia okay?
Olivia did very well,
as did your baby boy.
[SIGHS]
And Olivia's baby?
Were you able to remove the cyst?
[SIGHS]
We initially thought that
the repair was successful,
but when we did our fetal heart
check after, she had passed.
I'm so sorry.
There was just too much
pressure on her little heart.
Does Olivia know?
No, she's just waking up.
I'm about to go in and talk to her now.
Can I tell her? Do you mind?
Sure.
I'll be in after
to answer any questions.
Right here.
Thank you, Dr. Asher.
[SOMBER MUSIC]
♪
So if it's not too late
or, uh, you haven't
invited anybody else,
I'd love to go
to the Green Mill tonight.
What about your plans?
Well, I could lie and say
they fell through, but I
I don't know.
I think I, uh, I'd like
to try honesty instead.
So, um
I'm in a somewhat complicated situation.
Too complicated, I thought, to date.
But I I'll let you be the judge.
I thought you said you were single.
I am.
- Are you gay?
- No.
Celibate?
Definitely not.
[CHUCKLES]
Okay, well, I'm okay with complicated.
Why don't you tell me more over drinks?
Okay.
Colton said you went
with another candidate.
Oh, yes, but I truly
enjoyed meeting with him.
Tam-ika?
Tamika, yes.
[SCOFFS] Yeah, well,
I'm glad you got the candidate
you wanted.
What an amazing opportunity for her.
Yes, it is.
Tamika is highly qualified,
which is why the committee
unanimously voted to accept her.
Well, I'm sure a recommendation from you
didn't hurt either.
Miranda.
Nope, I get it. I understand.
You're throwing your support
behind someone who would
benefit from the same
opportunities you were given.
You know, I'm not gonna
dignify that statement
with a response, but I will say this.
I think you should have a
conversation with your nephew.
[SOFT TENSE MUSIC]
♪
Hey.
So how was it, your first day back?
Fine.
You sure you're good?
I need an elevator.
Forget it. I'll take the stairs.
Hey.
Okay, what's your deal?
You think showing any sign
of emotion is is a weakness?
You you went through
something really traumatic.
I we both did.
I've served in combat zones.
This was nothing.
- I understand that, but
- What do you want?
You want me to start crying,
tell you I can't sleep,
I'm having nightmares,
and I keep flashing back to that night?
I can't stop thinking about it.
Well, I'm sorry to hear that.
I've moved on.
I don't buy it.
You're not a robot.
Something is going on with you,
and it has been for a while.
You keep throwing yourself
headfirst into these
dangerous situations
like you got a death
[UPBEAT ROCK MUSIC]
♪
Well, thank you for letting me
attempt to make up for today.
Oh, don't sweat it.
I knew I had nothing to worry about.
And watching you grovel is fun.
Yeah?
How were you so confident?
The six rights.
Yeah, it hasn't let me down yet.
Right patient,
right medication, right dose,
right route, right time, right document.
I go through that checklist
every time I dispense meds.
- That is very efficient.
- Yeah.
What do you say we get out of here?
No, no, no, okay?
Trust me, these donuts
are worth the wait.
There are other ways
to make up for today.
♪
You wanna go back to your place?
Yes.
Yes, uh, just
just give me one second.
- Yeah.
- Yeah? Okay.
[CLEARS THROAT]
[PHONE BUZZING]
♪
[LAUGHS]
♪