Chicago Med (2015) s12e03 Episode Script
They Call Me Ms. Goodwin
1
[TONE CHIMES]
[GASPS]
Nice work, Dr. Wu.
Why does she know me?
She's the new Ms. Goodwin.
And who is Ms. Goodwin?
You said you had patients stacking up.
You know, you gotta
think outside the box,
find a solution.
I'm worried about you.
You can't fix this.
Just leave it alone.
I'm resigning as executive director
effective immediately.
How could you take the deal?
This isn't what it looks like.
I was speaking with a charge nurse.
She'd be willing to take this job.
I look forward to meeting her.
[KOKO TAYLOR'S "WANG DANG DOODLE"]
♪
Tell Automatic Slim ♪
To tell Razor-totin' Jim ♪
To Tell Butcher-knife-totin' Annie ♪
To tell Fast-talking Fanny ♪
We gonna pitch a ball ♪
Down to that Union Hall ♪
We gonna romp
and tromp till midnight ♪
Why did you step down?
Is this a permanent thing?
Is it true Miranda demoted you?
Listen, I know you're
all eager for answers.
Unfortunately, for legal reasons,
I can't speak of the events
that led me to resigning.
But coming back to nursing
was my decision.
So
let's just get to work.
- [LAUGHTER]
- We missed you.
- Welcome back.
- Welcome back.
Thank you.
You're looking particularly
fly today, Ms. G.
Well, thank you, Dr. Frost.
So, uh, they took this
photograph out of your file.
Didn't know if you
want to take a new pic.
Yeah, this'll do.
- Thank you, Dean.
- Welcome home.
Thanks.
We need to have a word.
Did you really think I wouldn't
notice you on the floor?
Those are scrubs
you're wearing, Sharon,
not camouflage.
The grays would blend in better.
We had a deal.
You are no longer employed here.
The exit agreement I signed stipulated
that I could no longer work here
in an administrative capacity.
It didn't say anything about nursing.
She's right, Miranda.
You really need to
read the fine print.
I don't need a board vote
to dismiss an RN.
No, but you might want to
consult Legal first.
Firing someone without cause might
be frowned upon by the courts,
especially someone
whose gender, racial identity,
and age are legally protected.
Do you know how silly
you look, Sharon?
Scrubs and sneakers
it's beneath you.
Come on, Miranda.
Did you really think
I was gonna sit home
and make quilts while you undermine
the mission of this hospital?
Well, enjoy your little
trip down memory lane.
I will have your walking papers
in hand by the end of the day.
[SPEAKING CANTONESE]
What seems to be the problem?
Mr. Lam's G-tube is clogged
for some unknown reason.
Yeah, normally
we would just replace it.
Because it's brand-new,
Dr. Archer said it
was unsafe to pull just yet.
How are you feeling, Mr. Lam?
He doesn't speak English.
My Google Translate was able
to identify it as Cantonese,
but it froze up after that.
Yeah, and Nancy's at lunch,
and my Chinese
is a little rusty, so
I should call Dr. Archer.
Yeah, and maybe an interpreter.
That'll take too long.
We can solve this.
Either of you have any quarters?
The acid and carbonation
work to break down the food
that's clogging it up.
That's working.
Imagine the effect
on an empty stomach.
But I drink it anyway.
Cool trick.
That's super old-school, right?
I like to call it tried and true.
So you're the infamous Sharon Goodwin.
I'm Dr. Annabelle Wu,
EM resident, fourth year.
Feel free to call me Annie,
but in front of the patients,
I'd prefer if you call me Doctor.
That works for me, Dr. Wu.
I heard you basically ran
this place for 20 years.
So what's with the downshift?
Some kind of late-life crisis?
- Something like that.
- Oh.
Ambo's incoming with
multiple vics from an MVC.
Seems like a big rig
did a little damage.
OK, looks like they're
playing our song.
[MACHINE BEEPING]
Guy must've been thrown a
good 10 feet when he was hit.
Looks like his head took
the bulk of the blow.
GCS on the floor. No motor response.
Pupils fixed and dilated.
Mr. Driscoll, if you can
hear me, open your eyes,
- please, sir.
- Geoff, honey,
please open your eyes for the doctor.
Sorry, ma'am, are you his wife?
- Mm-hmm.
- I'm sorry,
I just need some room, please, OK?
Push a gram of Keppra
and start him at 3%.
- And then get him to the scan.
- Gail Gehrig, 61,
complaining of left chest pain.
She might have a broken rib or two.
Go ahead. I got it.
You, come with me.
[TENSE MUSIC]
♪
On my count.
1, 2, 3.
[GRUNTS]
[PANTING]
Hey, Gail, I'm Dr. Wu.
I'm gonna take a listen
to those lungs, OK?
OK.
OK, breath sounds bilateral,
but diffuse wheezes.
Let's get her an albuterol neb.
Ms. Gehrig,
I'm Officer Cobb, Chicago PD.
- Remember?
- Yeah.
When we spoke in the ambo,
you said an oncoming car
crossed the dividing line,
and that's why you swerved?
To avoid a [PANTING]
Head-on collision.
And that's when you struck
Mr. Driscoll?
I'm sorry, I-I did
I didn't see him.
Please please tell me
he's gonna be OK.
The doctors are working with him now.
We're gonna need to get
a blood draw just to check
for any possible intoxication.
Wait, was she drinking?
Were you drinking?
No, I wasn't drinking.
I don't drink,
at least not when I'm
when I'm driving.
I wish I could take your word,
but I still gotta get that blood draw.
Not before we've completed a workup.
Time is a factor.
I'm good whenever.
You see, she's giving you her consent.
OK, if you're not capable
of controlling yourself,
Ms. Driscoll,
I'm gonna have to ask you
to step out of the room.
My husband is in the other
room fighting for his life
because this blue hair
couldn't control her vehicle,
and I am the problem?
Uh, why don't we take
Ms. Gehrig to grab some X-rays
so that Mr. And Mrs. Driscoll
can have some privacy?
You want to stay with
your husband, right?
OK.
OK, let's get this one to imaging.
Thanks for the assist.
Not that I had a choice.
♪
So your CT scans show
some pulmonary contusions
and a couple of broken ribs.
It's probably pretty painful, huh?
Only when I breathe.
Well, we'll get pain service
in to place a serratus block.
And my bigger concern, however,
is the pulmonary fibrosis
I'm seeing.
There's some severe scarring
that we typically see
in patients with
chemical or asbestos exposure.
Was this something you were aware of?
Uh-huh.
I used to roughneck in the Gulf
once upon a time.
OK, that might explain it.
Has anyone ever spoken to you
about a lung transplant?
I haven't had access
to anything but urgent care
for a while now.
They got me puffing on an inhaler,
but I can't say it helps.
Any word on that man I hit?
I'll update you as soon as I can.
- Oh.
- OK?
You were pretty quick
to defuse that situation
in the trauma bay.
Well, it just required
a little diplomacy.
Moving forward, don't suggest
a course of treatment
without consulting me first.
It's sows confusion
as to who's in charge.
So did I hear right that
you two were in your car
when the truck hit it?
Yeah, we were just parked
on the side of the road.
Ooh, that is bad timing.
Were you parking
or about to pull away?
- We just found a spot
- We were just pulling away
Yep, you're right.
It was it was horrible timing.
OK, well, Harper, it looks
like your blood pressure
is a bit elevated.
That's something that you'll
need to monitor very closely
over these last few weeks.
OK.
OK, why don't we grab an ultrasound,
get a better look at that baby, OK?
Blue towel, please.
Ah!
You OK, Matthew?
Looks like you're favoring
that shoulder.
Uh, yeah.
I probably just
tweaked it in the crash.
OK, well, we'll have to
get that looked at too.
Harper, that is, um
that is a pretty crazy rash
you've got there.
I know.
I've heard that it's pretty
common during pregnancy
though, right?
Uh-huh.
What did your OB say about it?
Um
we haven't had a chance to ask yet.
The next appointment is soon, though.
Mm.
- OK.
- [LIGHT KNOCKING]
Sorry, guys,
but I just had it confirmed.
Your car was towed to the impound lot.
What? No.
No, no, no, no, no.
There are some things
that we really need
- to get out of there.
- Yeah.
Write up a list.
I'll talk to my guy,
see what we can do, OK?
Thank you, Doris.
Also, um, can you check
with Dr. Ripley
to see if he can maybe take
a look at Matthew's shoulder?
Yeah, no problem.
OK, thank you.
Well, I have got some good news.
While it looks like mom
has been jostled a bit,
your baby appears just fine.
Oh, is that her there?
Mm-hmm.
See, I told you
everything was gonna be OK.
Did you not hear what the
nurse just said, Matthew?
The car is gone.
Neurology is performing a
clinical brain death exam now
and nuc med's on deck.
Wow.
He wasn't even 40.
I guess it's a reminder
to look both ways
before you cross, I suppose.
Hey, Dean, what do
you think about Dr. Wu?
I mean, she's competent, I suppose.
Why are you asking?
Well, it looks like our patient
needs an expedited placement
on the transplant list.
- The truck driver?
- Yeah, Gail Gehrig.
I don't want Dr. Wu to feel
like I'm stepping on her toes,
but I just don't want this
to fall through the cracks.
I've got a contact over at ODA.
Perhaps you can
reach out to him directly,
emphasize the need?
Yeah, send me the deets, and
I'll call over there right now.
- Thanks, Dean.
- Yeah.
Out of sight, out of mind, I know,
but I still was told the
linens need restocking
in the overflow room.
OK, I'm on it.
We'll do it, Ms. Goodwin.
- We were headed there anyway.
- Thanks, ladies,
but I think I'm capable
of changing some bedding.
[BOTH CHUCKLE]
OK.
Oof.
Buddy, that must really hurt, huh?
Alex's teacher was concerned
when he showed up
to school like that.
Our nurse figured
better safe than sorry.
No, that's attention-worthy for sure.
Yeah, really.
Alex, can you tell me
how this happened?
I was making oatmeal for breakfast.
Let me guess.
Was it apple cinnamon?
No.
Maple brown sugar.
[GRUNTS]
That was my second guess.
So what, you just put the water
into the microwave, and then
I guess it spilled.
It didn't hurt.
Really.
I swear.
Well, that is because
you are so brave.
How did your parents react
when they saw this?
Alex lives with his
grandmother, Joanne.
We already called her,
so she's on her way.
OK.
Well, Alex, we're gonna
get you bandaged up, OK?
Some Silvadene, 4 by 4s, and
a tub of soapy water, Trini.
Thank you.
I just wanna check how far up
this splash got on your arm,
all right, Alex?
Would you mind undoing your shirt?
OK, let me help you.
[TENSE MUSIC]
♪
Alex, can you tell me
what happened here?
Sorry.
I came as soon as I could.
Oh, my God.
♪
You poor thing.
Oh, baby.
♪
Of course, but in the meantime,
is there a particular flavor
of yogurt you prefer?
Anything but strawberry, OK?
OK.
Hey, you sure you
thought this through?
Well, how do you mean? [CHUCKLES]
I mean, you sure you're
ready to change catheters
and run yogurts all day?
You sure you're ready to pay
all that deference again?
- Deference?
- Deference.
Like taking orders from some
clueless teenage resident,
keeping your mouth shut?
Last I checked you were kind of
fond of having the last word.
- I don't know.
- OK.
What's the point
you're trying to make,
that people can't evolve?
People evolve all the time,
but they rarely devolve
unless they don't have a choice.
Not not at our age, anyway.
And what's that supposed to mean?
What's that supposed to mean
is are you sure
Miranda didn't have a little
something to do with this?
Hey, you told me you didn't do
the things she accused you of.
That, at least, you clued me in on.
Daniel, it's more complicated
than that.
OK, how? How's it more complicated?
I can't get into it.
You have got to be kidding me!
Will you keep your voice down?
No, I won't, because
I've had it up to here
with you stonewalling me
like this whole situation
is none of my business.
I have really tried to be
so patient and respectful
of this bizarre boundary you
keep laying down, all right?
But then today without so much
as even a cursory heads-up
you show up in scrubs?
What conclusion am I supposed to draw
except for you lost your job
protecting mine?
Well, guess what.
I'm not OK with that, all right?
I did not make that deal, which
makes this the very definition
of my business.
So when you're finally ready
to tell me
what the hell is going on here,
look, I'll be all ears.
But until then,
I got better things to do.
Daniel.
Daniel.
Dr. Wu wants to increase
your flow of oxygen,
so we're fitting you
with this BiPAP mask, OK?
Mm-hmm.
I'm presuming
the man I hit has passed,
given no one's told me
anything to the contrary?
Mr. Driscoll was
pronounced brain-dead, yes.
I'm sorry, Gail.
I'd I'd ask you
to send my condolences,
but
I'm afraid it might be
not welcomed just yet.
Can I help you?
Uh, no.
I'm just trying to get up
to speed on the truck
crash.
Um, you're I'm sorry.
We haven't met.
I am Mallory Sloan.
- I'm the new
- Me?
- Right.
- Yeah. [CHUCKLES]
Yeah.
Um, this is awkward.
I spoke to your guy at ODA.
Definitely helped.
Gail's placement's been expedited.
- Thank you, Dean.
- Sure.
- That's wonderful news.
- Yeah.
I'm I'm sorry. The ODA?
Yeah, Organ Donors of America.
Gail Gehrig's in need
of a new pair of lungs,
and she's on the transplant list.
So this is the truck driver
we're talking about?
Yeah, that's right.
Oh.
Ms. Goodwin, so the blood
draw came back negative
for alcohol, as she predicted.
Great news.
The traffic cams pretty
much confirmed her story,
and Driscoll was actually
jaywalking at the time.
So chalk it up to bad voodoo.
I'd still like to ask her
a few questions,
if it's all right with you.
[CLEARS THROAT]
Uh, well, actually, Officer Cobb,
the person you should be
speaking to is right here.
Mallory Sloan.
She's the new executive director
of patient and medical services.
Oh.
My apologies, force of habit.
That's fine.
Um, Dr. Archer, would
you like to lead the way?
Sure.
X-ray reveals an old fracture
in the clavicle
with malalignment
and callus formation,
like it was never set right.
Yeah, or never set at all.
And, of course, the kid
insists he never felt it.
But it just feels like
Maybe saying that
to protect his grandma?
Yeah.
She claims she has no idea
how Alex broke his collarbone
or burned his hand,
that he never complained about it.
Huh.
We know what happened with parents?
Dad's gone. No one knows where.
Mom is behind bars on drug charges.
[SIGHS]
You know, my first instinct was
to contact DCFS to investigate,
given the possibility that
what we're seeing here might be abuse.
But you called me instead.
I guess with all this
kid's been through,
I don't want to believe the worst.
Sorry.
How much longer
am I expected to wait here?
I've got three kids that need feeding.
Sorry, we're just waiting
for someone from orthopedics
to come down and look
at Alex's collarbone.
OK. And who's this, then?
Hi, Joanne. I'm I'm Dr. Charles.
Hello.
Dr. Charles is an extremely
qualified psychiatrist
with a lot of experience
in emergency pediatrics.
Emergency?
What's the emergency?
He had a hand that needed bandaging.
Ms. Bly, I hope you can
understand that, you know,
from our perspective,
when a child comes in
with an array of injuries like Alex's,
it's standard procedure
for somebody like me
to come down and say hello,
check out the family dynamic,
make sure everybody is
healthy and safe.
Am I being suspected of abuse?
We are just trying to
figure out why Alex has been
such a magnet for injuries.
He's a six-year-old boy, that's why.
You two better bring an army
if you intend to separate me
from my grandchildren.
You know what?
How about we, um, go someplace quiet
to wait for the orthopedist?
You know, maybe get the kids a snack?
There's even a play area.
I would say,
all in all, you guys, uh
you guys got very lucky given
how your vehicle was struck.
You're both ready for discharge.
But
What's this?
Some kind of intervention?
We know that you're unhoused,
and we just need to make sure
that you have a safe place
to sleep tonight.
I knew I shouldn't have said anything.
Well, we're only asking because you're
so close to delivery.
I don't want you to feel
like we're judging you
But aren't you?
You can't possibly imagine
how hard it is
to find a place to rent.
Do either of you have any
friends that you might be able
to stay with, any any family
that you could go home to?
Home is wherever this one is.
We're gonna figure it out.
- Don't worry about us.
- Yeah.
Well, uh, Matthew, you're
you're showing signs of edema
in your lower legs and malnutrition,
and you both have those
infected bedbug rashes.
And most importantly, Harper,
you're possibly
developing preeclampsia.
These next few weeks
are very critical.
You need as much bed rest
and observation as possible.
What do you expect us to do?
Aren't you kicking us out now?
I do know of a women's shelter
that's not too far from here.
A woman's shelter?
What about Matthew?
Matthew can come visit you,
but he would need to find
a different place to sleep and bathe.
No. No, I'm not going there alone.
I don't feel safe in the shelters.
This shelter is safe and clean.
I can promise you that.
It'd only be temporary,
just until you can deliver safely.
Hmm.
Maybe we should consider it, Harper.
No.
We can't be separated
right now, Matthew.
I need you too much.
You get that, right?
Of course, babe.
I'm not letting you
out of my sight, OK?
[MACHINE BEEPING]
Excuse me, a little help in here.
[TENSE MUSIC]
Ah, she's decompensating.
How you holding up, Gail?
Sat's at 88 and dropping.
We need to intubate.
Get the airway kit
and ready 50 of etomidate
and 100 of succ.
We do that, there's no guarantee
we'll ever be able to wean her off.
Kit, please. I don't wanna
have to ask twice.
She'll lose her spot
on the transplant list
if we intubate, Dean.
OK, we're down to 79.
We gotta make a call now.
♪
All right, let's just bag her
for the time being,
put her on ECMO instead, V-V.
Just call in a perfusionist,
and we'll do the cannulation
in the hybrid OR.
You don't think ECMO's overkill?
We'd be risking a whole host
of complications.
Hey, I'll do the procedure
myself, unless you've
got an objection.
No, we're good.
I guess ECMO it is.
♪
Hey, um, hey, where's Harper?
What do you mean?
Well, I was up in radiology
getting a scan,
and when I got back she was gone.
I can't find her anywhere.
Did you send her away
to get more tests?
No.
OK, this isn't good.
Um, we really need to find her.
OK, Matthew, I'm sure she's OK.
She's probably just using
the restroom or something.
No. OK, you don't understand.
She can't be alone out there, OK?
She really needs looking after.
OK. Um
hey, Doris, let's get the word out.
We got a near-term pregnant
woman missing and in distress.
- Yeah.
- Hey, it's OK.
- We're gonna find her.
- Please.
It's not every day
you find a nurse so fluent
in respiratory intervention.
Well, I've seen so many
over the years,
I've got a pretty good handle
on the pros and cons.
Ah, well, it's obvious
Dr. Archer thinks so.
It's hard to get a word in
edgewise when your attending
only has one ear open.
Well, perhaps you'd benefit by keeping
both ears open as well.
I guess we made the right
call putting Gail on ECMO, hmm?
Oh, you found
a new pair of lungs for her?
Geoff Driscoll's, yeah.
- The man that she ran over?
- That's right.
How did she get priority?
She just got put on the list.
Well, lungs don't travel well.
I guess they prioritized geolocation,
given that they matched.
But now is the time for somebody
to break the good news,
and I feel at this point,
that should be you.
Oh, no, no.
You and Dr. Wu should do that.
I've got some restocking to do anyway.
Don't get too comfortable.
But I am needed back in the ED,
so I'll just text her to reschedule.
OK? Thanks.
[BREATHING HEAVILY]
Hey. Hey, hey.
You all right?
I'm Dr. Frost.
Friends call me Jonathan.
Would you mind if I took a look
at your wristband,
just so I know who I'm talking to?
Yeah? OK.
You're OK.
It's all right.
It's OK.
You're OK.
Harper.
Well, listen, Harper,
sometimes when I am struggling
to catch my breath,
I like to just slow things
down a little bit, all right?
It'll get rid of that tightness
that you're probably feeling
right now on your chest.
Am I right?
OK.
I find it helpful to use
the diaphragm.
Breathe into your belly.
I've obviously not done this
while pregnant,
but I think the theory still holds.
Would you like to try it with me?
Yeah?
All right. Take my hand.
You're OK.
You don't have to say
anything, all right?
We're gonna inhale through
the nose for four long beats,
all right?
1, 2, 3, 4.
Great. Now hold it two seconds.
One, two.
Now release.
[EXHALES]
Slow, controlled.
OK, even longer.
You're doing so great.
All right, let's do it
one more time, all right?
[INHALES]
Some days, like today, I just
I just want my life back.
Alex sounds like a bit of
a handful all by himself.
Oh, no.
Alex is an angel.
I wish his sisters were more like him.
He basically just
takes care of himself.
He dresses himself.
He cleans up after himself. He's
Makes his own breakfast?
How could I not have noticed
that he burned his arm so bad
or that he broke his collarbone?
I mean, that must have been
so painful.
But that's Alex.
I mean, he never complains.
He's so brave.
He wants so badly
to be the man of the house.
Huh.
When you say he never
complains, I mean,
how do you mean?
I don't know.
I mean, when he was a baby,
even when his mom would
take him to get shots,
I mean, he never cried.
- Not a peep.
- Right.
So also physically brave.
Yes.
Absolutely.
Is something wrong, Dr. Charles?
No, not at all.
But, um, you know,
with your permission,
I'd like to run a test on Alex.
For most people, submerging
your hand like this,
it pretty quickly
brings on intense pain.
You know, as the severe cold
constricts our blood vessels
and triggers these dense nerve
endings we have under our skin
called nociceptors.
Yeah.
I'm done with that.
You like that?
Whew.
You really can't feel anything, Alex?
Nope.
I don't understand.
What are you trying to prove?
We think Alex has a condition
known as CIP
Congenital Insensitivity to Pain.
It's a rare disorder that has
prevented his pain receptors
from developing correctly.
Pain, as much as we'd love
to banish it from our lives,
it actually serves as this crucial
biological alarm system.
You know, like telling us
to pull our hand out
of a pot of boiling water.
Or letting you know
that you've broken a bone.
We have to confirm this
via genetic sequencing.
But I don't know, man.
You know, we caught it pretty early,
so I'm optimistic
that Alex is gonna live
a normal, healthy life.
So what happens now?
Well, for starters,
you might want to pull
your hand out of there
before you get frostbite, bud.
Yeah, we don't need
to do that anymore.
Good job, baby.
You good?
- Yep.
- All right.
She has a hard time sometimes
moving through the world.
Like she's a little bit
anxious and OCD, I think.
Confrontational.
She's, like, also super superstitious.
She hangs this, uh,
St. Joseph medallion
wherever we find ourselves,
for protection, you know.
Yeah, I'm familiar.
Yeah.
We had it hanging from
a rear-view mirror.
A lot of good that did.
Well, you did walk away in one piece.
You have a point.
Anyways, thank you for everything.
And, uh, don't worry about us.
We'll figure something out.
I am terrified of what
might happen to that poor girl
on the streets.
Yeah.
Hopefully she delivers before
the weather turns too bad.
OK, don't tell Dean,
but I am half-considering
exaggerating the risk
of her preeclampsia
to get her admitted.
But at least she would get
the care that she needs.
Still only solves half the problem.
Well, any chance that ortho
might authorize an overnight
for a separated shoulder?
What, are we running a hotel now?
Believe me, Ms. Goodwin,
I would never try
and game the system.
This is just purely
frustration talking.
We we got these kids,
and they just
lost whatever home they had
in that car crash.
It's like they can't catch a break.
Pull up their charts.
I might have a solution.
Do you want to thank the doctors
for taking such good care
of you today, Alex?
Thank you.
You're very welcome, buddy.
Thank you, guys. Come here, bubba.
Oh, let's go.
We've been here forever.
- Excuse me, Ms. Bly?
- Yeah.
Hi, I'm Madeline Gastern
with the Department of Children
and Family Services.
Can I talk to you for a minute?
I've got my hands full right now.
That's OK.
You can leave the kids
with Ms. Quinn here.
Madeline, what's going on?
[TENSE MUSIC]
Sorry, did Alex's school contact you?
Because this has all
been straightened out
I'm sorry, but I regret to inform you
that due to the nature
of Alex's injuries,
DCFS will be removing him
from your custody
- Whoa. Whoa, whoa, whoa.
- Until a formal investigation
can be conducted.
Madeline, what
are you doing here right now?
- You don't understand.
- There's no abuse.
The kid's got CIP.
Everything's been straightened out.
Hey, hey, hey!
I'm sorry.
Dan, there's new protocols in place.
I'm just trying to follow them.
What protocols are you talking about?
Madeline.
What are you doing?
Ms. Sloan!
♪
I don't understand.
I get why you want to
keep an eye on Harper,
but why am I being admitted?
Well, technically,
you're both being boarded,
and it's, uh it's
because of those insect bites
you guys suffered.
And I don't know
if you've seen on the news,
but there's been a couple cases
of typhus identified recently
in the Great Lakes region,
uh, spread via flea bites, actually.
Now, it's unlikely
that you have typhus,
but it can't be ruled out completely
without two negative blood
tests seven days apart.
So as a precaution to
the public at large
We're going to need to
hold you both here
until we can safely rule it out.
How long would that take?
[TRILLS LIPS]
Depends on, uh, how busy the lab is.
- Yeah.
- Could take a few days.
Well, maybe even a few weeks.
They've been running behind lately.
It's the only way to know for sure.
I'm sorry for any inconvenience.
No, no, no, no, no.
We we totally get it.
I guess we'll just have to grit
our teeth and grind it out.
Hey, guys.
PD brought this in.
What they could salvage from your car.
- Thanks, Doris.
- Yeah.
[GENTLE MUSIC]
My medallion.
♪
Is it OK if I hang this up here?
Absolutely.
♪
I was afraid of what
things might look like
if you were gone for good.
I guess we don't need
to worry anymore.
♪
I'm just not understanding
the problem.
Tell DCFS to stand down.
And once they open a file,
they have their own internal
process to follow.
Well, how'd the file get
opened in the first place?
DCFS isn't supposed to get
involved unless we notify them.
And neither of us did.
- Did you?
- No.
Well, then who did?
The system did.
What system?
Well, staying in compliance
with reporting guidelines
has been a challenge,
as I'm sure you're both aware.
So now we have an algorithm
to address that.
- An algorithm?
- Come on.
How is an algorithm
supposed to address that?
By taking the decision out of
our hands, by removing as much
subjectivity as possible
from the process
- What are you talking about?
- And, Dr. Charles,
do I need to remind you
about the tens of millions of dollars
this hospital pays per year
in malpractice insurance?
OK, well, you better get ready
to pay a whole lot more, 'cause
that lady is coming for you.
Ms. Sloan, only human beings
can investigate these questions
because subjectivity is so
critical to the entire process.
It's why Dr. Frost and I,
two human beings,
declined to notify DCFS this morning
until we could be absolutely
certain that there
wasn't another explanation.
And what do you know? There was!
- Well, what do you mean?
- The kid has CIP.
That's why he had
so many unreported injuries.
I understand your frustration,
but I still think
having DCFS manage this
- is the most prudent path
- Prudent? How?
If you're right and
nothing worrisome is going on
in that household,
then Alex and his siblings
will be returned to his
grandmother's custody
in ten days.
- Ms. Sloan
- Oh, my God.
You rip this child away
from his grandmother like this,
he'll have emotional scars
that could last him a lifetime.
Dr. Frost, I think you're somewhat
underestimating the resiliency
of a six-year-old.
All due respect, I think
Dr. Frost and I might know
a tiny bit more about the resiliency
of a six-year-old than you do.
It's just a hunch.
Well, like I said,
it is out of our hands.
- I am sorry.
- Out of your hands?
I'm sorry.
Do you want to try
to do the right thing?
Ms. Sloan!
[TENSE MUSIC]
♪
Ms. Goodwin,
they're ready for Gail.
♪
So how long before I'll be
able to drive my truck again?
Your recovery will be
about two to three weeks
between the hospital and rehab.
And soon after that,
you'll hopefully be able
to do a lot more than just drive.
I had to stop swimming in the ocean
'cause I couldn't catch my breath.
Will I be able to do that again?
I can't see any reason why not.
No, that's what I'm saying.
We're just one floor down.
So it would expedite things
if you would just come straight down
after Mr. Driscoll's procurement.
Wait a minute.
My husband's lungs are
going to the truck driver?
There must be
some kind of mistake, right?
I mean, this can't
be allowable, can it?
She's the one who killed my husband!
We all appreciate
the gravity of your loss.
The organ donation process
can feel arbitrary.
But trust me, the system is
designed to be as impartial
Trust you?
Who the hell are you?
Why is this nurse all up in my face?
Security, a little help?
He's gone!
My husband's gone, and now
you're gonna benefit from it.
Does that seem fair to you?
No one's giving my husband
a second chance!
♪
Gail, I'm so sorry.
This was supposed to be
anonymous and discreet.
The donor's family
is not supposed to know
any details about
who's receiving the organs.
She's right.
I I can't do this.
♪
I can't accept those lungs.
[PENSIVE MUSIC]
♪
I know you went above and
beyond to get me those lungs.
I'm sorry I let you down.
Well, I'm not the one
you owe an apology to.
You are awfully hard on yourself.
And that accident today
was just that, an accident.
It wasn't your fault.
You have earned
a second chance at life.
You need to forgive yourself.
[PENSIVE MUSIC]
♪
Come sunrise this morning,
I could feel myself drowsing off.
But the only way I get
that load to Gatlinburg
by the end of the day
is to put Chicago rush hour
in my rear view.
So I leaned on a cup of joe,
maybe two.
♪
That was just a pale substitute.
The truth is, I should
have pulled off the road
and caught some Zs.
So no,
you can't really say
it wasn't my fault.
♪
For a second,
I thought I just might
be able to turn back time.
♪
But who was I fooling?
♪
There is a real chance
that those lungs
won't find a new home
before they become unviable,
for starters, and now
we have a patient on ECMO
indefinitely with no roadmap
of how or when to come off.
Yeah, is this about me
overruling you earlier?
Hey, you are my boss.
I can accept you wanting to go
in a different direction.
But when it is a nurse
who is pointing the way
A nurse?
Sharon. Yes.
All I'm saying is, I'm not sure
you make that call
if she's not chirping in your ear.
OK, that nurse has earned
enough respect
to say whatever the hell she wants.
Do you understand?
In fact, she's earned enough respect
so that going forward,
you will cease referring
to her as Sharon.
It's Ms. Goodwin to you.
No, no.
Dean, she's right.
I was out of line.
No, you are not.
Can we have a moment, please?
Mm-hmm.
Look, Dean,
all day, you, Doris,
pretty much everyone except Dr. Wu
has been treating me with kid gloves
and an overabundance of of regard.
And I will admit I allowed it,
because I felt it was my due.
Because it is your due.
It might have been.
But the only way this is
going to work moving forward,
me wearing scrubs,
is if I'm treated
like any other nurse.
I can't be Ms. Goodwin on that floor.
I can only be Sharon.
So you were right.
I can't stop Sharon
working here as a nurse.
But I can control who runs
the ED moving forward,
and that's no longer going to be you.
Oh, you mean I get to spend
more time with my baby girl?
How dare you?
You're making the wrong enemies, Dean.
Yeah, well,
it's a temp gig anyway.
Besides, Lenox will be back
in a few weeks, right?
Last I heard.
You're right.
He did not last the month.
Keep it.
You'll need it to pay for
that tablet you assassinated.
If there's anything I could
have done to save my job,
to protect this hospital,
don't you think I would have done it?
Well, I wouldn't really know, would I?
You know, yours wasn't the
only job I was trying to save.
I made a mistake, Daniel.
I left my computer open in my office,
and Doris came across it.
She was the one that leaked the
information about Dr. Rabari,
but she was only
trying to protect you.
And you only fell on
your sword to protect her?
Well, like I said, I had no choice.
I have a code, and it doesn't allow me
to turn my back on someone
who did what I should have done.
Huh.
Well, at this point,
there's really only
one thing left for me to say.
And what's that?
Thank you.
From the bottom of my heart.
How did I get so lucky
to have a pal like you?
And Doris.
How?
Will you allow me
to show my appreciation
with a wee dram of middling
whisky, Nurse Goodwin?
[SHARON CHUCKLES]
You know, I really
stepped in it today, Daniel.
Turns out I don't like
not having the last word.
Yeah. [CHUCKLES] Me neither.
It's amazing we're still friends.
[CHUCKLES]
I'm telling you,
I don't know how much longer
I'm gonna last with,
you know, Miranda's little
Stormtrooper stomping around.
- Oh, Mallory?
- Yeah. You saw what happened.
I-it's not tenable.
I'm gonna have to scram
before she turns me
into a frickin' algorithm.
I'm assuming that Miranda
is not playing
on the level, right?
No. I know she's not.
The problem is proving it.
♪
Well, how'd you like a little help?
♪
sync & corrections awaqeded
[DRAMATIC MUSIC]
♪
[WOLF HOWLS]
[TONE CHIMES]
[GASPS]
Nice work, Dr. Wu.
Why does she know me?
She's the new Ms. Goodwin.
And who is Ms. Goodwin?
You said you had patients stacking up.
You know, you gotta
think outside the box,
find a solution.
I'm worried about you.
You can't fix this.
Just leave it alone.
I'm resigning as executive director
effective immediately.
How could you take the deal?
This isn't what it looks like.
I was speaking with a charge nurse.
She'd be willing to take this job.
I look forward to meeting her.
[KOKO TAYLOR'S "WANG DANG DOODLE"]
♪
Tell Automatic Slim ♪
To tell Razor-totin' Jim ♪
To Tell Butcher-knife-totin' Annie ♪
To tell Fast-talking Fanny ♪
We gonna pitch a ball ♪
Down to that Union Hall ♪
We gonna romp
and tromp till midnight ♪
Why did you step down?
Is this a permanent thing?
Is it true Miranda demoted you?
Listen, I know you're
all eager for answers.
Unfortunately, for legal reasons,
I can't speak of the events
that led me to resigning.
But coming back to nursing
was my decision.
So
let's just get to work.
- [LAUGHTER]
- We missed you.
- Welcome back.
- Welcome back.
Thank you.
You're looking particularly
fly today, Ms. G.
Well, thank you, Dr. Frost.
So, uh, they took this
photograph out of your file.
Didn't know if you
want to take a new pic.
Yeah, this'll do.
- Thank you, Dean.
- Welcome home.
Thanks.
We need to have a word.
Did you really think I wouldn't
notice you on the floor?
Those are scrubs
you're wearing, Sharon,
not camouflage.
The grays would blend in better.
We had a deal.
You are no longer employed here.
The exit agreement I signed stipulated
that I could no longer work here
in an administrative capacity.
It didn't say anything about nursing.
She's right, Miranda.
You really need to
read the fine print.
I don't need a board vote
to dismiss an RN.
No, but you might want to
consult Legal first.
Firing someone without cause might
be frowned upon by the courts,
especially someone
whose gender, racial identity,
and age are legally protected.
Do you know how silly
you look, Sharon?
Scrubs and sneakers
it's beneath you.
Come on, Miranda.
Did you really think
I was gonna sit home
and make quilts while you undermine
the mission of this hospital?
Well, enjoy your little
trip down memory lane.
I will have your walking papers
in hand by the end of the day.
[SPEAKING CANTONESE]
What seems to be the problem?
Mr. Lam's G-tube is clogged
for some unknown reason.
Yeah, normally
we would just replace it.
Because it's brand-new,
Dr. Archer said it
was unsafe to pull just yet.
How are you feeling, Mr. Lam?
He doesn't speak English.
My Google Translate was able
to identify it as Cantonese,
but it froze up after that.
Yeah, and Nancy's at lunch,
and my Chinese
is a little rusty, so
I should call Dr. Archer.
Yeah, and maybe an interpreter.
That'll take too long.
We can solve this.
Either of you have any quarters?
The acid and carbonation
work to break down the food
that's clogging it up.
That's working.
Imagine the effect
on an empty stomach.
But I drink it anyway.
Cool trick.
That's super old-school, right?
I like to call it tried and true.
So you're the infamous Sharon Goodwin.
I'm Dr. Annabelle Wu,
EM resident, fourth year.
Feel free to call me Annie,
but in front of the patients,
I'd prefer if you call me Doctor.
That works for me, Dr. Wu.
I heard you basically ran
this place for 20 years.
So what's with the downshift?
Some kind of late-life crisis?
- Something like that.
- Oh.
Ambo's incoming with
multiple vics from an MVC.
Seems like a big rig
did a little damage.
OK, looks like they're
playing our song.
[MACHINE BEEPING]
Guy must've been thrown a
good 10 feet when he was hit.
Looks like his head took
the bulk of the blow.
GCS on the floor. No motor response.
Pupils fixed and dilated.
Mr. Driscoll, if you can
hear me, open your eyes,
- please, sir.
- Geoff, honey,
please open your eyes for the doctor.
Sorry, ma'am, are you his wife?
- Mm-hmm.
- I'm sorry,
I just need some room, please, OK?
Push a gram of Keppra
and start him at 3%.
- And then get him to the scan.
- Gail Gehrig, 61,
complaining of left chest pain.
She might have a broken rib or two.
Go ahead. I got it.
You, come with me.
[TENSE MUSIC]
♪
On my count.
1, 2, 3.
[GRUNTS]
[PANTING]
Hey, Gail, I'm Dr. Wu.
I'm gonna take a listen
to those lungs, OK?
OK.
OK, breath sounds bilateral,
but diffuse wheezes.
Let's get her an albuterol neb.
Ms. Gehrig,
I'm Officer Cobb, Chicago PD.
- Remember?
- Yeah.
When we spoke in the ambo,
you said an oncoming car
crossed the dividing line,
and that's why you swerved?
To avoid a [PANTING]
Head-on collision.
And that's when you struck
Mr. Driscoll?
I'm sorry, I-I did
I didn't see him.
Please please tell me
he's gonna be OK.
The doctors are working with him now.
We're gonna need to get
a blood draw just to check
for any possible intoxication.
Wait, was she drinking?
Were you drinking?
No, I wasn't drinking.
I don't drink,
at least not when I'm
when I'm driving.
I wish I could take your word,
but I still gotta get that blood draw.
Not before we've completed a workup.
Time is a factor.
I'm good whenever.
You see, she's giving you her consent.
OK, if you're not capable
of controlling yourself,
Ms. Driscoll,
I'm gonna have to ask you
to step out of the room.
My husband is in the other
room fighting for his life
because this blue hair
couldn't control her vehicle,
and I am the problem?
Uh, why don't we take
Ms. Gehrig to grab some X-rays
so that Mr. And Mrs. Driscoll
can have some privacy?
You want to stay with
your husband, right?
OK.
OK, let's get this one to imaging.
Thanks for the assist.
Not that I had a choice.
♪
So your CT scans show
some pulmonary contusions
and a couple of broken ribs.
It's probably pretty painful, huh?
Only when I breathe.
Well, we'll get pain service
in to place a serratus block.
And my bigger concern, however,
is the pulmonary fibrosis
I'm seeing.
There's some severe scarring
that we typically see
in patients with
chemical or asbestos exposure.
Was this something you were aware of?
Uh-huh.
I used to roughneck in the Gulf
once upon a time.
OK, that might explain it.
Has anyone ever spoken to you
about a lung transplant?
I haven't had access
to anything but urgent care
for a while now.
They got me puffing on an inhaler,
but I can't say it helps.
Any word on that man I hit?
I'll update you as soon as I can.
- Oh.
- OK?
You were pretty quick
to defuse that situation
in the trauma bay.
Well, it just required
a little diplomacy.
Moving forward, don't suggest
a course of treatment
without consulting me first.
It's sows confusion
as to who's in charge.
So did I hear right that
you two were in your car
when the truck hit it?
Yeah, we were just parked
on the side of the road.
Ooh, that is bad timing.
Were you parking
or about to pull away?
- We just found a spot
- We were just pulling away
Yep, you're right.
It was it was horrible timing.
OK, well, Harper, it looks
like your blood pressure
is a bit elevated.
That's something that you'll
need to monitor very closely
over these last few weeks.
OK.
OK, why don't we grab an ultrasound,
get a better look at that baby, OK?
Blue towel, please.
Ah!
You OK, Matthew?
Looks like you're favoring
that shoulder.
Uh, yeah.
I probably just
tweaked it in the crash.
OK, well, we'll have to
get that looked at too.
Harper, that is, um
that is a pretty crazy rash
you've got there.
I know.
I've heard that it's pretty
common during pregnancy
though, right?
Uh-huh.
What did your OB say about it?
Um
we haven't had a chance to ask yet.
The next appointment is soon, though.
Mm.
- OK.
- [LIGHT KNOCKING]
Sorry, guys,
but I just had it confirmed.
Your car was towed to the impound lot.
What? No.
No, no, no, no, no.
There are some things
that we really need
- to get out of there.
- Yeah.
Write up a list.
I'll talk to my guy,
see what we can do, OK?
Thank you, Doris.
Also, um, can you check
with Dr. Ripley
to see if he can maybe take
a look at Matthew's shoulder?
Yeah, no problem.
OK, thank you.
Well, I have got some good news.
While it looks like mom
has been jostled a bit,
your baby appears just fine.
Oh, is that her there?
Mm-hmm.
See, I told you
everything was gonna be OK.
Did you not hear what the
nurse just said, Matthew?
The car is gone.
Neurology is performing a
clinical brain death exam now
and nuc med's on deck.
Wow.
He wasn't even 40.
I guess it's a reminder
to look both ways
before you cross, I suppose.
Hey, Dean, what do
you think about Dr. Wu?
I mean, she's competent, I suppose.
Why are you asking?
Well, it looks like our patient
needs an expedited placement
on the transplant list.
- The truck driver?
- Yeah, Gail Gehrig.
I don't want Dr. Wu to feel
like I'm stepping on her toes,
but I just don't want this
to fall through the cracks.
I've got a contact over at ODA.
Perhaps you can
reach out to him directly,
emphasize the need?
Yeah, send me the deets, and
I'll call over there right now.
- Thanks, Dean.
- Yeah.
Out of sight, out of mind, I know,
but I still was told the
linens need restocking
in the overflow room.
OK, I'm on it.
We'll do it, Ms. Goodwin.
- We were headed there anyway.
- Thanks, ladies,
but I think I'm capable
of changing some bedding.
[BOTH CHUCKLE]
OK.
Oof.
Buddy, that must really hurt, huh?
Alex's teacher was concerned
when he showed up
to school like that.
Our nurse figured
better safe than sorry.
No, that's attention-worthy for sure.
Yeah, really.
Alex, can you tell me
how this happened?
I was making oatmeal for breakfast.
Let me guess.
Was it apple cinnamon?
No.
Maple brown sugar.
[GRUNTS]
That was my second guess.
So what, you just put the water
into the microwave, and then
I guess it spilled.
It didn't hurt.
Really.
I swear.
Well, that is because
you are so brave.
How did your parents react
when they saw this?
Alex lives with his
grandmother, Joanne.
We already called her,
so she's on her way.
OK.
Well, Alex, we're gonna
get you bandaged up, OK?
Some Silvadene, 4 by 4s, and
a tub of soapy water, Trini.
Thank you.
I just wanna check how far up
this splash got on your arm,
all right, Alex?
Would you mind undoing your shirt?
OK, let me help you.
[TENSE MUSIC]
♪
Alex, can you tell me
what happened here?
Sorry.
I came as soon as I could.
Oh, my God.
♪
You poor thing.
Oh, baby.
♪
Of course, but in the meantime,
is there a particular flavor
of yogurt you prefer?
Anything but strawberry, OK?
OK.
Hey, you sure you
thought this through?
Well, how do you mean? [CHUCKLES]
I mean, you sure you're
ready to change catheters
and run yogurts all day?
You sure you're ready to pay
all that deference again?
- Deference?
- Deference.
Like taking orders from some
clueless teenage resident,
keeping your mouth shut?
Last I checked you were kind of
fond of having the last word.
- I don't know.
- OK.
What's the point
you're trying to make,
that people can't evolve?
People evolve all the time,
but they rarely devolve
unless they don't have a choice.
Not not at our age, anyway.
And what's that supposed to mean?
What's that supposed to mean
is are you sure
Miranda didn't have a little
something to do with this?
Hey, you told me you didn't do
the things she accused you of.
That, at least, you clued me in on.
Daniel, it's more complicated
than that.
OK, how? How's it more complicated?
I can't get into it.
You have got to be kidding me!
Will you keep your voice down?
No, I won't, because
I've had it up to here
with you stonewalling me
like this whole situation
is none of my business.
I have really tried to be
so patient and respectful
of this bizarre boundary you
keep laying down, all right?
But then today without so much
as even a cursory heads-up
you show up in scrubs?
What conclusion am I supposed to draw
except for you lost your job
protecting mine?
Well, guess what.
I'm not OK with that, all right?
I did not make that deal, which
makes this the very definition
of my business.
So when you're finally ready
to tell me
what the hell is going on here,
look, I'll be all ears.
But until then,
I got better things to do.
Daniel.
Daniel.
Dr. Wu wants to increase
your flow of oxygen,
so we're fitting you
with this BiPAP mask, OK?
Mm-hmm.
I'm presuming
the man I hit has passed,
given no one's told me
anything to the contrary?
Mr. Driscoll was
pronounced brain-dead, yes.
I'm sorry, Gail.
I'd I'd ask you
to send my condolences,
but
I'm afraid it might be
not welcomed just yet.
Can I help you?
Uh, no.
I'm just trying to get up
to speed on the truck
crash.
Um, you're I'm sorry.
We haven't met.
I am Mallory Sloan.
- I'm the new
- Me?
- Right.
- Yeah. [CHUCKLES]
Yeah.
Um, this is awkward.
I spoke to your guy at ODA.
Definitely helped.
Gail's placement's been expedited.
- Thank you, Dean.
- Sure.
- That's wonderful news.
- Yeah.
I'm I'm sorry. The ODA?
Yeah, Organ Donors of America.
Gail Gehrig's in need
of a new pair of lungs,
and she's on the transplant list.
So this is the truck driver
we're talking about?
Yeah, that's right.
Oh.
Ms. Goodwin, so the blood
draw came back negative
for alcohol, as she predicted.
Great news.
The traffic cams pretty
much confirmed her story,
and Driscoll was actually
jaywalking at the time.
So chalk it up to bad voodoo.
I'd still like to ask her
a few questions,
if it's all right with you.
[CLEARS THROAT]
Uh, well, actually, Officer Cobb,
the person you should be
speaking to is right here.
Mallory Sloan.
She's the new executive director
of patient and medical services.
Oh.
My apologies, force of habit.
That's fine.
Um, Dr. Archer, would
you like to lead the way?
Sure.
X-ray reveals an old fracture
in the clavicle
with malalignment
and callus formation,
like it was never set right.
Yeah, or never set at all.
And, of course, the kid
insists he never felt it.
But it just feels like
Maybe saying that
to protect his grandma?
Yeah.
She claims she has no idea
how Alex broke his collarbone
or burned his hand,
that he never complained about it.
Huh.
We know what happened with parents?
Dad's gone. No one knows where.
Mom is behind bars on drug charges.
[SIGHS]
You know, my first instinct was
to contact DCFS to investigate,
given the possibility that
what we're seeing here might be abuse.
But you called me instead.
I guess with all this
kid's been through,
I don't want to believe the worst.
Sorry.
How much longer
am I expected to wait here?
I've got three kids that need feeding.
Sorry, we're just waiting
for someone from orthopedics
to come down and look
at Alex's collarbone.
OK. And who's this, then?
Hi, Joanne. I'm I'm Dr. Charles.
Hello.
Dr. Charles is an extremely
qualified psychiatrist
with a lot of experience
in emergency pediatrics.
Emergency?
What's the emergency?
He had a hand that needed bandaging.
Ms. Bly, I hope you can
understand that, you know,
from our perspective,
when a child comes in
with an array of injuries like Alex's,
it's standard procedure
for somebody like me
to come down and say hello,
check out the family dynamic,
make sure everybody is
healthy and safe.
Am I being suspected of abuse?
We are just trying to
figure out why Alex has been
such a magnet for injuries.
He's a six-year-old boy, that's why.
You two better bring an army
if you intend to separate me
from my grandchildren.
You know what?
How about we, um, go someplace quiet
to wait for the orthopedist?
You know, maybe get the kids a snack?
There's even a play area.
I would say,
all in all, you guys, uh
you guys got very lucky given
how your vehicle was struck.
You're both ready for discharge.
But
What's this?
Some kind of intervention?
We know that you're unhoused,
and we just need to make sure
that you have a safe place
to sleep tonight.
I knew I shouldn't have said anything.
Well, we're only asking because you're
so close to delivery.
I don't want you to feel
like we're judging you
But aren't you?
You can't possibly imagine
how hard it is
to find a place to rent.
Do either of you have any
friends that you might be able
to stay with, any any family
that you could go home to?
Home is wherever this one is.
We're gonna figure it out.
- Don't worry about us.
- Yeah.
Well, uh, Matthew, you're
you're showing signs of edema
in your lower legs and malnutrition,
and you both have those
infected bedbug rashes.
And most importantly, Harper,
you're possibly
developing preeclampsia.
These next few weeks
are very critical.
You need as much bed rest
and observation as possible.
What do you expect us to do?
Aren't you kicking us out now?
I do know of a women's shelter
that's not too far from here.
A woman's shelter?
What about Matthew?
Matthew can come visit you,
but he would need to find
a different place to sleep and bathe.
No. No, I'm not going there alone.
I don't feel safe in the shelters.
This shelter is safe and clean.
I can promise you that.
It'd only be temporary,
just until you can deliver safely.
Hmm.
Maybe we should consider it, Harper.
No.
We can't be separated
right now, Matthew.
I need you too much.
You get that, right?
Of course, babe.
I'm not letting you
out of my sight, OK?
[MACHINE BEEPING]
Excuse me, a little help in here.
[TENSE MUSIC]
Ah, she's decompensating.
How you holding up, Gail?
Sat's at 88 and dropping.
We need to intubate.
Get the airway kit
and ready 50 of etomidate
and 100 of succ.
We do that, there's no guarantee
we'll ever be able to wean her off.
Kit, please. I don't wanna
have to ask twice.
She'll lose her spot
on the transplant list
if we intubate, Dean.
OK, we're down to 79.
We gotta make a call now.
♪
All right, let's just bag her
for the time being,
put her on ECMO instead, V-V.
Just call in a perfusionist,
and we'll do the cannulation
in the hybrid OR.
You don't think ECMO's overkill?
We'd be risking a whole host
of complications.
Hey, I'll do the procedure
myself, unless you've
got an objection.
No, we're good.
I guess ECMO it is.
♪
Hey, um, hey, where's Harper?
What do you mean?
Well, I was up in radiology
getting a scan,
and when I got back she was gone.
I can't find her anywhere.
Did you send her away
to get more tests?
No.
OK, this isn't good.
Um, we really need to find her.
OK, Matthew, I'm sure she's OK.
She's probably just using
the restroom or something.
No. OK, you don't understand.
She can't be alone out there, OK?
She really needs looking after.
OK. Um
hey, Doris, let's get the word out.
We got a near-term pregnant
woman missing and in distress.
- Yeah.
- Hey, it's OK.
- We're gonna find her.
- Please.
It's not every day
you find a nurse so fluent
in respiratory intervention.
Well, I've seen so many
over the years,
I've got a pretty good handle
on the pros and cons.
Ah, well, it's obvious
Dr. Archer thinks so.
It's hard to get a word in
edgewise when your attending
only has one ear open.
Well, perhaps you'd benefit by keeping
both ears open as well.
I guess we made the right
call putting Gail on ECMO, hmm?
Oh, you found
a new pair of lungs for her?
Geoff Driscoll's, yeah.
- The man that she ran over?
- That's right.
How did she get priority?
She just got put on the list.
Well, lungs don't travel well.
I guess they prioritized geolocation,
given that they matched.
But now is the time for somebody
to break the good news,
and I feel at this point,
that should be you.
Oh, no, no.
You and Dr. Wu should do that.
I've got some restocking to do anyway.
Don't get too comfortable.
But I am needed back in the ED,
so I'll just text her to reschedule.
OK? Thanks.
[BREATHING HEAVILY]
Hey. Hey, hey.
You all right?
I'm Dr. Frost.
Friends call me Jonathan.
Would you mind if I took a look
at your wristband,
just so I know who I'm talking to?
Yeah? OK.
You're OK.
It's all right.
It's OK.
You're OK.
Harper.
Well, listen, Harper,
sometimes when I am struggling
to catch my breath,
I like to just slow things
down a little bit, all right?
It'll get rid of that tightness
that you're probably feeling
right now on your chest.
Am I right?
OK.
I find it helpful to use
the diaphragm.
Breathe into your belly.
I've obviously not done this
while pregnant,
but I think the theory still holds.
Would you like to try it with me?
Yeah?
All right. Take my hand.
You're OK.
You don't have to say
anything, all right?
We're gonna inhale through
the nose for four long beats,
all right?
1, 2, 3, 4.
Great. Now hold it two seconds.
One, two.
Now release.
[EXHALES]
Slow, controlled.
OK, even longer.
You're doing so great.
All right, let's do it
one more time, all right?
[INHALES]
Some days, like today, I just
I just want my life back.
Alex sounds like a bit of
a handful all by himself.
Oh, no.
Alex is an angel.
I wish his sisters were more like him.
He basically just
takes care of himself.
He dresses himself.
He cleans up after himself. He's
Makes his own breakfast?
How could I not have noticed
that he burned his arm so bad
or that he broke his collarbone?
I mean, that must have been
so painful.
But that's Alex.
I mean, he never complains.
He's so brave.
He wants so badly
to be the man of the house.
Huh.
When you say he never
complains, I mean,
how do you mean?
I don't know.
I mean, when he was a baby,
even when his mom would
take him to get shots,
I mean, he never cried.
- Not a peep.
- Right.
So also physically brave.
Yes.
Absolutely.
Is something wrong, Dr. Charles?
No, not at all.
But, um, you know,
with your permission,
I'd like to run a test on Alex.
For most people, submerging
your hand like this,
it pretty quickly
brings on intense pain.
You know, as the severe cold
constricts our blood vessels
and triggers these dense nerve
endings we have under our skin
called nociceptors.
Yeah.
I'm done with that.
You like that?
Whew.
You really can't feel anything, Alex?
Nope.
I don't understand.
What are you trying to prove?
We think Alex has a condition
known as CIP
Congenital Insensitivity to Pain.
It's a rare disorder that has
prevented his pain receptors
from developing correctly.
Pain, as much as we'd love
to banish it from our lives,
it actually serves as this crucial
biological alarm system.
You know, like telling us
to pull our hand out
of a pot of boiling water.
Or letting you know
that you've broken a bone.
We have to confirm this
via genetic sequencing.
But I don't know, man.
You know, we caught it pretty early,
so I'm optimistic
that Alex is gonna live
a normal, healthy life.
So what happens now?
Well, for starters,
you might want to pull
your hand out of there
before you get frostbite, bud.
Yeah, we don't need
to do that anymore.
Good job, baby.
You good?
- Yep.
- All right.
She has a hard time sometimes
moving through the world.
Like she's a little bit
anxious and OCD, I think.
Confrontational.
She's, like, also super superstitious.
She hangs this, uh,
St. Joseph medallion
wherever we find ourselves,
for protection, you know.
Yeah, I'm familiar.
Yeah.
We had it hanging from
a rear-view mirror.
A lot of good that did.
Well, you did walk away in one piece.
You have a point.
Anyways, thank you for everything.
And, uh, don't worry about us.
We'll figure something out.
I am terrified of what
might happen to that poor girl
on the streets.
Yeah.
Hopefully she delivers before
the weather turns too bad.
OK, don't tell Dean,
but I am half-considering
exaggerating the risk
of her preeclampsia
to get her admitted.
But at least she would get
the care that she needs.
Still only solves half the problem.
Well, any chance that ortho
might authorize an overnight
for a separated shoulder?
What, are we running a hotel now?
Believe me, Ms. Goodwin,
I would never try
and game the system.
This is just purely
frustration talking.
We we got these kids,
and they just
lost whatever home they had
in that car crash.
It's like they can't catch a break.
Pull up their charts.
I might have a solution.
Do you want to thank the doctors
for taking such good care
of you today, Alex?
Thank you.
You're very welcome, buddy.
Thank you, guys. Come here, bubba.
Oh, let's go.
We've been here forever.
- Excuse me, Ms. Bly?
- Yeah.
Hi, I'm Madeline Gastern
with the Department of Children
and Family Services.
Can I talk to you for a minute?
I've got my hands full right now.
That's OK.
You can leave the kids
with Ms. Quinn here.
Madeline, what's going on?
[TENSE MUSIC]
Sorry, did Alex's school contact you?
Because this has all
been straightened out
I'm sorry, but I regret to inform you
that due to the nature
of Alex's injuries,
DCFS will be removing him
from your custody
- Whoa. Whoa, whoa, whoa.
- Until a formal investigation
can be conducted.
Madeline, what
are you doing here right now?
- You don't understand.
- There's no abuse.
The kid's got CIP.
Everything's been straightened out.
Hey, hey, hey!
I'm sorry.
Dan, there's new protocols in place.
I'm just trying to follow them.
What protocols are you talking about?
Madeline.
What are you doing?
Ms. Sloan!
♪
I don't understand.
I get why you want to
keep an eye on Harper,
but why am I being admitted?
Well, technically,
you're both being boarded,
and it's, uh it's
because of those insect bites
you guys suffered.
And I don't know
if you've seen on the news,
but there's been a couple cases
of typhus identified recently
in the Great Lakes region,
uh, spread via flea bites, actually.
Now, it's unlikely
that you have typhus,
but it can't be ruled out completely
without two negative blood
tests seven days apart.
So as a precaution to
the public at large
We're going to need to
hold you both here
until we can safely rule it out.
How long would that take?
[TRILLS LIPS]
Depends on, uh, how busy the lab is.
- Yeah.
- Could take a few days.
Well, maybe even a few weeks.
They've been running behind lately.
It's the only way to know for sure.
I'm sorry for any inconvenience.
No, no, no, no, no.
We we totally get it.
I guess we'll just have to grit
our teeth and grind it out.
Hey, guys.
PD brought this in.
What they could salvage from your car.
- Thanks, Doris.
- Yeah.
[GENTLE MUSIC]
My medallion.
♪
Is it OK if I hang this up here?
Absolutely.
♪
I was afraid of what
things might look like
if you were gone for good.
I guess we don't need
to worry anymore.
♪
I'm just not understanding
the problem.
Tell DCFS to stand down.
And once they open a file,
they have their own internal
process to follow.
Well, how'd the file get
opened in the first place?
DCFS isn't supposed to get
involved unless we notify them.
And neither of us did.
- Did you?
- No.
Well, then who did?
The system did.
What system?
Well, staying in compliance
with reporting guidelines
has been a challenge,
as I'm sure you're both aware.
So now we have an algorithm
to address that.
- An algorithm?
- Come on.
How is an algorithm
supposed to address that?
By taking the decision out of
our hands, by removing as much
subjectivity as possible
from the process
- What are you talking about?
- And, Dr. Charles,
do I need to remind you
about the tens of millions of dollars
this hospital pays per year
in malpractice insurance?
OK, well, you better get ready
to pay a whole lot more, 'cause
that lady is coming for you.
Ms. Sloan, only human beings
can investigate these questions
because subjectivity is so
critical to the entire process.
It's why Dr. Frost and I,
two human beings,
declined to notify DCFS this morning
until we could be absolutely
certain that there
wasn't another explanation.
And what do you know? There was!
- Well, what do you mean?
- The kid has CIP.
That's why he had
so many unreported injuries.
I understand your frustration,
but I still think
having DCFS manage this
- is the most prudent path
- Prudent? How?
If you're right and
nothing worrisome is going on
in that household,
then Alex and his siblings
will be returned to his
grandmother's custody
in ten days.
- Ms. Sloan
- Oh, my God.
You rip this child away
from his grandmother like this,
he'll have emotional scars
that could last him a lifetime.
Dr. Frost, I think you're somewhat
underestimating the resiliency
of a six-year-old.
All due respect, I think
Dr. Frost and I might know
a tiny bit more about the resiliency
of a six-year-old than you do.
It's just a hunch.
Well, like I said,
it is out of our hands.
- I am sorry.
- Out of your hands?
I'm sorry.
Do you want to try
to do the right thing?
Ms. Sloan!
[TENSE MUSIC]
♪
Ms. Goodwin,
they're ready for Gail.
♪
So how long before I'll be
able to drive my truck again?
Your recovery will be
about two to three weeks
between the hospital and rehab.
And soon after that,
you'll hopefully be able
to do a lot more than just drive.
I had to stop swimming in the ocean
'cause I couldn't catch my breath.
Will I be able to do that again?
I can't see any reason why not.
No, that's what I'm saying.
We're just one floor down.
So it would expedite things
if you would just come straight down
after Mr. Driscoll's procurement.
Wait a minute.
My husband's lungs are
going to the truck driver?
There must be
some kind of mistake, right?
I mean, this can't
be allowable, can it?
She's the one who killed my husband!
We all appreciate
the gravity of your loss.
The organ donation process
can feel arbitrary.
But trust me, the system is
designed to be as impartial
Trust you?
Who the hell are you?
Why is this nurse all up in my face?
Security, a little help?
He's gone!
My husband's gone, and now
you're gonna benefit from it.
Does that seem fair to you?
No one's giving my husband
a second chance!
♪
Gail, I'm so sorry.
This was supposed to be
anonymous and discreet.
The donor's family
is not supposed to know
any details about
who's receiving the organs.
She's right.
I I can't do this.
♪
I can't accept those lungs.
[PENSIVE MUSIC]
♪
I know you went above and
beyond to get me those lungs.
I'm sorry I let you down.
Well, I'm not the one
you owe an apology to.
You are awfully hard on yourself.
And that accident today
was just that, an accident.
It wasn't your fault.
You have earned
a second chance at life.
You need to forgive yourself.
[PENSIVE MUSIC]
♪
Come sunrise this morning,
I could feel myself drowsing off.
But the only way I get
that load to Gatlinburg
by the end of the day
is to put Chicago rush hour
in my rear view.
So I leaned on a cup of joe,
maybe two.
♪
That was just a pale substitute.
The truth is, I should
have pulled off the road
and caught some Zs.
So no,
you can't really say
it wasn't my fault.
♪
For a second,
I thought I just might
be able to turn back time.
♪
But who was I fooling?
♪
There is a real chance
that those lungs
won't find a new home
before they become unviable,
for starters, and now
we have a patient on ECMO
indefinitely with no roadmap
of how or when to come off.
Yeah, is this about me
overruling you earlier?
Hey, you are my boss.
I can accept you wanting to go
in a different direction.
But when it is a nurse
who is pointing the way
A nurse?
Sharon. Yes.
All I'm saying is, I'm not sure
you make that call
if she's not chirping in your ear.
OK, that nurse has earned
enough respect
to say whatever the hell she wants.
Do you understand?
In fact, she's earned enough respect
so that going forward,
you will cease referring
to her as Sharon.
It's Ms. Goodwin to you.
No, no.
Dean, she's right.
I was out of line.
No, you are not.
Can we have a moment, please?
Mm-hmm.
Look, Dean,
all day, you, Doris,
pretty much everyone except Dr. Wu
has been treating me with kid gloves
and an overabundance of of regard.
And I will admit I allowed it,
because I felt it was my due.
Because it is your due.
It might have been.
But the only way this is
going to work moving forward,
me wearing scrubs,
is if I'm treated
like any other nurse.
I can't be Ms. Goodwin on that floor.
I can only be Sharon.
So you were right.
I can't stop Sharon
working here as a nurse.
But I can control who runs
the ED moving forward,
and that's no longer going to be you.
Oh, you mean I get to spend
more time with my baby girl?
How dare you?
You're making the wrong enemies, Dean.
Yeah, well,
it's a temp gig anyway.
Besides, Lenox will be back
in a few weeks, right?
Last I heard.
You're right.
He did not last the month.
Keep it.
You'll need it to pay for
that tablet you assassinated.
If there's anything I could
have done to save my job,
to protect this hospital,
don't you think I would have done it?
Well, I wouldn't really know, would I?
You know, yours wasn't the
only job I was trying to save.
I made a mistake, Daniel.
I left my computer open in my office,
and Doris came across it.
She was the one that leaked the
information about Dr. Rabari,
but she was only
trying to protect you.
And you only fell on
your sword to protect her?
Well, like I said, I had no choice.
I have a code, and it doesn't allow me
to turn my back on someone
who did what I should have done.
Huh.
Well, at this point,
there's really only
one thing left for me to say.
And what's that?
Thank you.
From the bottom of my heart.
How did I get so lucky
to have a pal like you?
And Doris.
How?
Will you allow me
to show my appreciation
with a wee dram of middling
whisky, Nurse Goodwin?
[SHARON CHUCKLES]
You know, I really
stepped in it today, Daniel.
Turns out I don't like
not having the last word.
Yeah. [CHUCKLES] Me neither.
It's amazing we're still friends.
[CHUCKLES]
I'm telling you,
I don't know how much longer
I'm gonna last with,
you know, Miranda's little
Stormtrooper stomping around.
- Oh, Mallory?
- Yeah. You saw what happened.
I-it's not tenable.
I'm gonna have to scram
before she turns me
into a frickin' algorithm.
I'm assuming that Miranda
is not playing
on the level, right?
No. I know she's not.
The problem is proving it.
♪
Well, how'd you like a little help?
♪
sync & corrections awaqeded
[DRAMATIC MUSIC]
♪
[WOLF HOWLS]