7th Heaven s08e10 Episode Script
The One Thing
What are the five descriptors of pain? Stethoscope, pen, pad Told you, make a list.
Qual uh, quality, radiation, strength, timing and Orientation manual.
And precipitating factors, PQRST.
Have you seen the ER orientation manual? Right here.
Basically, it says show up at 7:00.
They'll show us the rest.
I haven't had a chance to read it.
I'll fill you in on the subway ride.
Okay, give me seven causes of chest pain.
Have you seen my shoes? The gray ones, the flats? The others kill my feet.
A-angina, myocardial infarction, pericarditis and No, I think they're under the sofa.
GI causes, esophagitis, peptic ulcer Aneurysm, costochondritis.
Ow.
You know, I-I prefer the red fuzzy ones with the four-inch heels.
They go better with my lab coat.
In your dreams.
Why aren't you getting ready? Done deal.
You're kidding, right? You aren't really going to use that thing.
It's a gift from my parents.
You know, one look at that bag, and the bullies will beat you up and steal your lunch money.
I can handle the bullies.
If you carry that thing, I just might help them.
(chuckling) Oh, it's 11:00.
I need to study for a while.
A little late.
Look, I'll cover you tomorrow.
Just make sure you set the alarm for 5:00 a.
m.
(sighs) (thunder crashing) Sarah, wake up.
Sarah, wake up.
Sarah, we're late! Didn't you set the alarm? I can be ready in seven minutes.
We're never gonna make it.
Wait, my-my stethoscope.
Where is it? Under Harrison's.
I was listening for a murmur.
Wait, to your own heart sounds? I think I have a prolapsed mitral valve.
No, you don't.
I think I do.
No, you don't.
When did you decide this? Prolapsed valve? To use your maiden name.
We talked about it.
No, no, no, you mentioned it casually once.
We're late.
(phone ringing) Matt Camden.
Come on.
Matt? Dr.
Sharp? Matt, it's me.
I'm leaving without you.
Wait, who? It's Mom, your mom.
Oh, hi, uh, I'm on my way out.
Is everything okay? It's 3:30 in the morning.
Oh, yeah, I know.
The-the boys woke me up for a glass of water.
Kitchen water, not bathroom water.
So, I thought, since I was down here, I'd I'd try you before you got out of the house.
Sarah gave me your new cell phone number.
Sarah gave you my new cell phone number? You're always saying you don't get your messages.
Hang up.
Let's go.
Are you insane? I don't want them to have my number.
I got this so I wouldn't miss messages from work.
From work, not my family.
I didn't know.
I can call back if this isn't a good time.
We just miss you so much.
Hold on, the boys want to say hi.
Hi, Matt.
Hi, Matt.
How are you? Bye, guys.
You did know.
Okay, maybe I knew, but I am tired of taking messages from your family.
There are a million people in your family, and they tie up the line day and night.
Which is exactly why I got this phone.
(phone ringing) Hello.
7th Heaven When I see their happy faces Smiling back at me 7th Heaven I know there's no greater feeling Than the love of family Where can you go When the world don't treat you right? The answer is home That's the one place that you'll find 7th Heaven Mmm, 7th Heaven 7th Heaven.
(barks) (indistinct quiet conversations) Excuse me, we If you have chest pain or shortness of breath, see the triage nurse.
Otherwise, sign in, fill out these forms and wait to be seen.
No, we're here to start our rotation.
We're medical students.
Medical students? We already have enough of those.
My head's killing me.
Wait your turn, Mr.
Hartman.
Could you direct us to the student orientation? Harry's a regular around here.
Likes the Big D.
The Big D? Demerol.
Do you know where the orientation is? Sorry, no idea.
(sighs) Group of students just went scurrying down the hall after Norton.
That must be it.
Which way? Thank you.
Hey, Doc, when can I get my shot? MAN: It's a classic indication of obstructive lung disease, and it Miss Glass, welcome.
Mr.
Simon here has a long-standing history of asthma.
He presents today with increasing SOB.
SOB? No, it's not an epithet.
Uh, shortness of breath.
Well, thank you for interrupting, Mr Camden.
Why don't you listen to Mr.
Simon's lungs and tell us what you hear.
(clears throat) I've lost my bag.
Your what? My stethoscope-- it was in my black bag.
I must have left it in the subway.
Wow, you have a black bag.
Okay, anyone willing to help out our poor Mr.
Camden? Oh, look.
No one else left theirs on the subway.
On second thought, you may need those.
Uh Nurse Kelly Yes? would you be kind enough to lend our Mr.
Camden here your stethoscope for the day? No.
Don't worry, I'll make sure he gives it back.
Consider it your contribution to medical education.
Find me when you're done, okay? Oh (stammers) Doctors are a lot like boy scouts.
They're expected to be prepared and on time.
Understood, Miss Glass? Mr.
Camden? Mr.
Camden? Uh bilateral expiratory wheezes with rails at the right base.
Brilliant.
(phone ringing) Answer that, will you? Matt Camden.
Hey your mom got up with the twins, and she woke me up, and, uh, I couldn't get back to sleep, so I thought I'd call.
She left your new phone number on the fridge.
How are you? Uh, Dad, I'm really busy.
Take the number off the fridge.
Don't let anyone in the family call me.
That number is for emergencies only.
I have to go.
Write this down, Mr.
Camden.
Turn off phone.
All right, the lab is down the hall.
Time-stamp your requisitions.
Curtains three, four, five.
Psych patients are stored next to bed eight.
Try not to lose anybody.
What's the problem? I can't turn it off.
Why? It won't turn off.
Then, get rid of it.
Trauma rooms one, two, three.
Do we get to work on traumas? No.
Are you getting all this, Mr.
Camden? Main desk, Dr.
Sterling.
This is one of our residents, Dr.
Lisa Sterling.
Dr.
Sterling will assign you your patients.
You're expected to do histories and physicals, draw bloods and gather lab results.
Scut work.
It's all part of your medical training.
I had to do it, Dr.
Sterling did it, and now you get to do it.
And someday, you'll get to make someone else do it.
Not the nurses.
Correct.
Do not slough off your work on the nurses.
They will probably ignore any suggestion you make, so (buzzing) don't make any.
More meetings-- they're burying me.
All right, lunch, one half hour.
There's coffee in the lounge.
Put some money in the Styrofoam cup.
Bye.
Okay.
Blood drawing, room three.
They're like little vampires.
Ouch! Sorry.
STERLING: No, never say sorry.
It's a sign of weakness.
Isn't that from an old John Wayne movie? Is it all right to say ouch? Ouch! How about getting a nurse to do this? Uh, I'll give it a shot.
All right, Mr.
Adams, if Mr.
Camden here can't get it on the first try, then I'll do it myself.
I thought the nurses drew blood.
Do you even remember how? Tourniquet.
Prep the area.
Got it.
Bevel up 20 degrees, immobilize the vein and Hey, you drew first blood.
I hardly felt it.
Good job.
Make sure it gets to the labs.
Hey, Doc, can you get this guy to do all my tests? The rest of you need to practice.
Not on me.
You going to tell them? No.
After our start, I think I need to collect all the brownie points I can.
(phone rings) Is my number still on the refrigerator? Matt? Lucy, do me a favor, tear up that number and throw it away.
Fine, if you don't want to hear from your sister who loves and misses you.
I don't.
Not now.
I'll call you.
(dial tone) Forget it.
I'll call the Transit Authority and see if anyone turned it in.
It's New York.
What do you expect? Okay, Liu, sore throat, curtain three.
Cool, I used to volunteer in the free clinic.
I've down a hundred strep screens.
Turned in what? Matt left his black medical bag on the subway.
Black bag.
Sounds like a lucky break to me.
Okay, Goodman, sprained ankle, curtain two.
I can handle that.
Sinatra 40-year-old.
Exam four.
Constipation.
(doors slam open) BP 90 palp.
Tachy at 130.
Reps 24 and labored.
What's open? Trauma Two.
Gangbanger? Bystander.
CBC, chest film, set up for a thorocostomy.
I need four units of O-Neg for the infuser.
Okay if we watch? Day one.
Lots of time for the gun and knife club.
Get your work done.
Constipation.
Doesn't sound like an ER case, but what the hell, I'm going into GI anyway.
Only place to earn money these days is by doing procedures.
What did you guys get? nursing home patient, altered.
thinks he's Napoleon.
Requesting asylum.
I'll trade you.
I have no idea where to start with this one.
Stick to the basics.
They don't expect much.
You're a med student, not a resident.
If they don't expect much, why didn't you tell them you work part-time as a lab tech? Okay, I'll trade.
You don't think I can handle it? You said you wanted to trade.
Besides, you'd do better with Napoleon.
Why? Oh, hypomanic, delusions of grandeur.
He sounds a little like your father.
Hey, where's Exam Two? Mr.
McNeil, I'm Matt Camden.
Are you a priest? I'm sorry, I couldn't hear you.
Are Are you a priest? He wants to know if you're a priest.
Uh no, I'm a medical student.
I need to ask you a few questions.
Are you a priest? No.
I'm a medical student.
He's confused not deaf.
He's not going to be answering any questions.
Mr.
McNeil, why are you here today? Bless me, Father He can't' bless you, Mr.
McNeil.
He left his holy water on the subway.
Great.
How do I get his history? Well, if I were a smart medical student, I'd try the old chart stored at the desk.
(clears throat) They all look the same, don't they, Mr.
McNeil? You're a very pretty nun.
(laughs) Shh.
Mr.
Levesque? Napoleon Bonaparte.
And what brought you in today, Napoleon? The British.
They're trying to send me to Alba.
I need asylum.
They're stealing all of my money.
They want to put me on a cruise ship.
Cruise ship? Bingo.
Shuffleboard, sundeck.
Exile at sea.
It's that Tony Blair.
They implanted a receiver in my head.
He warned me.
Okay.
How can I help you today? I need a green card! Security! (sighs) (beeping) (line ringing) (phone ringing) (groans softly) Please, God, stop calling me.
Matt, what the heck is wrong with you? I'm working.
I'm at the hospital.
Then why do you keep answering the phone? Because I can't turn it off.
Why not? Because I can't.
Shouldn't you be able to use a cell phone before you're allowed to work with patients? Very funny.
Nice talking to you.
Not so fast.
My wife, your sister, is in tears because of the way you talked to her earlier.
It's Lucy.
She's always in tears.
I have to go.
(dial tone) The Encyclopedia Britannica is smaller.
Volumes three, four, five and six.
Have fun.
LIU: Fever 101, tonsillar exudates, but the strep screen is negative.
Mono exposure? I didn't ask.
Call for labs on Mrs.
Shapiro, and page Surgery to do a consult on Miss Connors in five.
Any questions? No.
Just having a little trouble getting a history.
Doesn't speak English? (phone ringing) Maybe he used to, not anymore.
He's got a fever and his blood pressure is low.
Circling the drain.
(phone ringing) Ruby, isn't there a phone you need to be answering? Just do a basic exam.
I'll help you out as soon as I get a minute.
They sedated Napoleon with Haldol.
Before he conquered Europe, I hope.
I didn't get to finish my H&P.
That already puts me behind.
You've got lots of time.
He'll be a lot calmer after the vitamin H.
Vitamin H? Haldol.
Vitamin H.
There's the problem.
You've worked in a hospital, seen all this before.
I haven't seen it all.
Maybe.
But enough to make it seem easy.
You just don't realize, it's not that easy for the rest of us.
I'm glad to help.
Showing the rest of us up isn't helping.
NORTON: Idiot burocrats.
You call Mr.
Jordan.
He needs to go over this report.
LEVESQUE: You stupid! Yours? Mine.
I think he's calling your name.
Sterling tells me you're the new record holder for blood draws.
Uh, yes, but I've RUBY: Mr.
Jordan's on line one.
Got it.
Making up for your bad start? I'm trying.
Don't try.
Just do it.
Jordan.
(monitor beeping rhythmically) Mm, the prodigal son returns.
Figured him out yet? Who? Mr.
McNeil, your patient.
Too many volumes.
Where's his family, maybe they can fill me in.
KELLY: At home, watching TV I suspect.
He came from a nursing home.
Family probably hasn't seen him in weeks.
(machine beeps three times) His blood pressure is dropping.
Maybe you should go get one of the residents.
I asked Sterling.
She's swamped.
She said she'd come over in a minute.
Temp's 103.
He's septic.
Do you want me to turn off the IV? Um, sure, turn off the IV.
Diabetes, CHF, CAD, dementia, pneumonia.
Where do I start? Can you help me lift him? I can't hear his lungs with this thing? It's a poor craftsman that blames his tools.
His blood pressure is low.
I don't think we should sit him up.
Dr.
Norton expects me to complete my H&P.
It'll only take a second.
Whatever you say, Doctor.
KELLY (straining): Up we go, Mr.
McNeil.
Deep breath, Mr.
McNeil.
I can't hear any breath sounds.
(rapid beeping) His heart rate is dropping.
I don't get a pulse.
He's in V-fib.
What do I do? Grab a crash cart.
Go! Go.
Come on.
Come on, Mr.
McNeil.
What are you doing? My patient stopped breathing.
I need a crash cart.
You are the doctor.
You stay with the patient.
You let the nurse go get the crash cart.
He's breathing on his own.
What happened here? MATT: I set him up to listen to his lungs.
He just stopped breathing.
Did you check the patient's blood pressure before examining him? I was trying to complete the exam.
I didn't check.
(phone ringing) I-I can't get it to turn off.
(ringing continues) (ringing continues) I'm just going to let it keep ringing.
Isn't he kind of busy, being in medical school and all? Too busy to talk to me? Are you kidding? He's not answering.
He'll answer.
(line ringing) Heard you came close to bumping off your first patient.
Mr.
Goodman, have you finished your H&Ps? Just tying to lighten the mood.
Excellent try.
Listen, it's my job to supervise the students.
I should have listened.
I should have jumped in sooner.
I'm sorry.
I thought sorry was a sign of weakness.
Here.
A rash.
Tough one.
You still have three H&Ps to do.
Norton let you off easy.
Just get your work done.
Besides, it's a good case.
Trust me.
Miss, uh Perfect.
I prefer Pam.
Penny Perfect is my stage name.
Are you the doctor? No.
I'm a, uh, I'm a medical student.
Well, almost a doctor.
Good enough.
I see you met Pamela? You know her? Everybody knows her.
She shows up once a month to check out the new single residents and students.
Dr.
Camden, are you coming back? Give him a couple of years, Pamela.
All right, back to work, you guys.
Ann Hudson, altered and nonresponsive.
BP 170/90.
Pulse 110.
Reps 12 and shallow.
Trauma Three.
Chem 20, CBC, tox screen.
Who's this? Her friend, Marie Martin.
Pretty upset, couldn't get much history.
We just went out for a walk.
She fell to the ground.
Ms.
Martin, wait here, I'll be right back.
Come with me.
STERLING: One, two, three.
All right.
What have we got? hypertensive, probable CVA.
BP 190 over 110.
What do you think we should do here, Mr.
Camden? Baseline labs, EKG and a chest film.
Got 'em.
And? Start an IV? Already has one.
Get a CT.
Eventually.
Stick with the basics.
Get a good history.
Exactly.
But she's unconscious.
Keen observation.
Check with the family.
Good.
Any family? There's a friend outside.
Her friend's name is Marie Martin.
Sats are dropping-- 90.
High-flow mask at 100 percent.
Open the intubation kit.
and a Mac Three blade.
Anybody here try intubating before? ALL: No.
I'd like to try.
I've practiced on a CPR head.
Of course you did.
I'd still like to try.
Mr.
Camden, if her sats drop any further, maybe you'll get a chance to show us what you've learned.
But right now, go get some background history from her friend.
Don't worry.
I won't let Miss Glass steal your procedure.
I'll call you if she needs to be tubed.
Go, go, go, Come on.
Ms.
Martin? They made me wait out here.
Is she going to be all right? I-I need to get some information from you Ms.
Martin.
Does Ms.
Hudson have any family? A husband? Children? No.
There's just me.
What happened to her? We're not sure yet.
I'm one of the medical students.
I need to speak to her family.
We've lived next door to each other for over 40 years.
We're both widowed and both our kids stink, so we look after each other.
Except she can't look after my dog because she's allergic.
Well, does she have any medical problems? Uh, high blood pressure? Heart disease? History of a previous stroke? She's had a stroke? Oh, my God.
I want to see her.
Oh Hey, hey, hey.
You should sit down.
I'm okay.
I'm a diabetic.
I just have to eat something.
Mr.
Camden, we're waiting.
Any information for me? No.
I haven't had Med list? Previous history? Uh, no.
Are you the doctor? Is she going to be okay? Are you a family member? Well, no.
Then I'm afraid I can't release that information.
Patient confidentiality.
Ms.
Martin and Ms.
Hudson are lifelong neighbors.
I'm sure it'll be okay.
Not unless there's a signed power of attorney.
Would you excuse us for I have that.
We each have one on account of we look after each other.
I sent you out here to get the medical history.
I was trying, but she was so upset You're going to be a doctor.
You're not going to be a social worker.
So start acting like a doctor.
Nurses do the handholding.
Your job is to focus on taking care of the patient.
Doctor Norton, Ms.
Hudson's sats are dropping.
Ms.
Martin's a diabetic, she hasn't eaten.
Let the nurses take care of it.
Come on, Camden, let's see if your practicing paid off.
I found it.
Please, you've got to let me see her.
I'll bring you in as soon as possible.
Is she going to die? First shot, right in the hole.
Once I saw the cords, like butter.
You're lucky you got to practice beforehand.
Where is that practice head? I'd like to give it a shot.
There's a CPR practice lab up on five, next to hematology lab.
How'd you find it? None of us has ever heard about it.
Yeah.
How did you ever find it way up on the fifth floor, next to the hematology lab? Hey, they took that jumper to the psych unit.
Jumper? You had a jumper? Don't change the subject.
Where'd he jump from? The second floor of the hospital.
And, uh, lunch is over kids.
Let's go.
She dropped her pressure in CT.
Trauma Three is open.
DC the Mannitol, mix up Dopamine, Start her at five micrograms a minute.
It appears she suffered a massive stroke.
Is she awake? No.
Will she wake up? We're going to know a lot more in a day or two.
Is there anything we can do for you? I have to go home.
I have a dog, Spence, I need to feed him.
Mr.
Camden, will you walk Ms.
Martin to the desk and ask one of the nurses to assist her? I'm sorry for the bad news.
I'll take you to the desk.
I'd like to see her.
I'll get you a nurse.
No.
I'd like to see her now.
Please.
I'm sorry.
I'm a little dizzy.
You want to sit down? No.
I'm okay now.
Oh, excuse me.
Go on in.
We'll be right here.
She's such a nice lady.
Yeah.
Thank you for the stethoscope.
I don't think the color suits you.
I'll try to do a better job at coordinating my wardrobe tomorrow.
Bring your own in tomorrow.
Tomorrow.
I don't know.
I'm having trouble getting through today.
Is it like this every day? No.
Today was a good day.
It gets worse.
I wasn't expecting.
What, all this? How could you? You know, I go home every night after taking care of 15 patients.
I come back the next morning, and there's 15 new ones waiting to be seen.
I just want to come in one morning and, you know, find an empty waiting room.
Just so I could say, thank God we fixed them all.
You know? Well, there must be something that makes you come back every morning.
That one thing? What's your one thing, Dr.
Camden? (clattering) She's diaphoretic.
Resps 16.
I got a pulse.
Thready, around a 100.
Yes, I need a doctor in here, now! Hook her up.
Vitals? Tachycardic at 110.
BP 120 over 60.
EKG, Chem 20, tox screen, pulse ox.
Immobilize her neck until we clear it.
I've got a line.
Maybe she vaso-vagaled.
She's diabetic.
Brilliant.
Thank you for informing us, Camden.
Were you hoping we would eventually just figure it out? No, I told you.
When? In the hall, when I was getting her neighbor's history.
Accu-Chek's at 40.
Miss Glass, what's the treatment for hypoglycemia? Glucose IV.
Correct.
Push it.
What what happened? Congratulations, Miss Glass.
Your first medical miracle.
All right, work her up.
Baseline labs, IV of D-5.
Camden get her a food tray.
You know her.
You should work her up.
You saved her.
What about that bothers you? That it wasn't you? Norton wants you to do it.
She's your patient.
I have to get a food tray.
Hi.
Hi.
I'm looking for Reverend Camden.
I think he's upstairs with Annie.
I'll tell him you're here.
Who are you calling? Ruthie is trying to reach Matt.
If he answers, take the phone up to her.
She and Peter are doing homework in her room.
Oh.
(line ringing) No, I can't hold.
They said they'd have the tox screen results 20 minutes ago.
So is Matt in your class? Sorry? Camden.
The two of you are thick as thieves.
We know each other.
That's it? Come on, there's got to be more than that.
He's cute.
He's a little, Type A, but cute.
So you two aren't? What? Together? Hooked up? Livin' in sin? No.
Good.
I mean, I just wanted to know.
Oh, this stupid lab.
They've had me on hold forever.
Take down the tox screen results when they come back on the line.
Hello? Hel Yes, I can hold.
Can we talk? Actually, on the phone here.
Are you on hold? Don't you have a patient? Don't you think we're under enough pressure without turning on each other? Yes, I'm here.
Later, okay? I want to go home.
I have things to do.
You're on a long-acting oral hypoglycemic.
We need to keep you on an IV for the next 24 hours.
What about Spence? I told you I have a dog.
I can't stay here 24 hours.
I don't want to stay in this place.
It's too quiet here.
Well, you may be the first person to ever call this place quiet.
I'm used to it.
Ann's a talker.
All the time, she drives me crazy.
Always talking about finding that "one thing.
" That "one thing"? The one thing that she could really be good at.
The one thing that would make her stand out-- her contribution to life.
She's tried painting.
Writing a novel.
Training for a marathon.
It just seems so very quiet now.
If you want to talk I'll listen.
How about you talk, I'll listen.
Mr.
Camden, rounds at the desk.
I have to go.
Thank you.
I didn't do anything.
Hey, if it's meant to be It's meant to be.
Hi.
Hi.
I was just waiting here for Reverend Camden.
On pizza night? When Lucy and I get together? Nice seeing you.
If Matt answers, will you take that upstairs to Ruthie? (line ringing) (hangs up phone) After which psych was consulted.
Oh, I noted injection sites on his thighs.
I think he's using anabolic steroids.
That's a good observation, but you should have documented that in your physical exam.
Okay.
Mr.
Camden, which three cases did you complete? Pamela Perfect-- rash, Marie Martin-- hypoglycemia.
Mm-hmm.
That's only two.
Someone took over Mr.
McNeil before I could finish the workup.
Aw, that's too bad.
Mr.
Camden, were my instructions unclear? How many H&Ps are you required to perform each day? Three.
Three, not two, not two and a half.
Now, are you having a remarkably bad day or is this the best that you can do? Neither.
Listen to me, all of you.
Up to now, it's been about the theory of medicine, but from here on out, it is about the practice of medicine.
You're here to learn to take care of patients and by necessity, learn to care about them a little less.
That's brilliant.
NORTON: And from now on, the gloves are off.
There's no more excuses.
And Mr.
Camden, I expect your work-- todays and tomorrow's-- to be completed tomorrow at 5:00.
I'm going out with the rest of the gang to celebrate surviving day one.
Not me, thanks.
We don't have any food at the apartment.
I'll find something.
It's 6:00.
You're off the clock.
It's time to start acting like you're one of us.
I never said I wasn't.
No, you just did everything you could to make yourself look better than the rest of us.
I wanted to return this to you.
Oh, you're off already? Nurses do 12.
Nurses get paid.
Not enough.
After today, I think you're probably right.
Anyway, thanks.
Sure.
This may sting a little.
People always say it'll hurt a little when they mean a lot.
Will this leave a scar? I have one.
You know how I got it? (chuckles) One day, my sister and I were racing across the house.
I slipped and I split my head open on the bedpost.
My mom took me to our pediatrician's office-- Dr.
Lindsay.
He sewed up my forehead.
Halfway through, I guess he noticed I was wincing.
He'd forgotten to use a local.
Oh.
I never said a word.
He told me I was his best patient and when I grow up I should be a doctor.
So Dr.
Lindsay got you into all this? No, Dr.
Lindsay didn't make me want to be a doctor.
He made me afraid of doctors.
You want to be a doctor? No, I hate blood.
(laughs) Don't buy into all that Norton stuff.
He's a jerk.
Ah, sounds like you know him pretty well.
Yeah, a little too well.
(winces) I don't know, maybe he's right.
He's not.
Ms.
Martin was asking for you.
She wants to talk.
She likes you, trusts you.
I'm off the clock.
NURSE: Dr.
Norton, stat.
NORTON: She's in V-fib.
Another amp of D-50.
Charge to 300.
NURSE: Sats are 88.
Good air entry bilaterally with bagging.
Mr.
Camden, following up on your patient.
Very laudable.
Clear.
Clear.
Bad timing, though.
Still in V-fib.
Good pulse with CPR.
Accu-check 80.
What happened? The combination of prolonged hypoglycemia and stress seems to have precipitated a cardiac event.
Charge to 300.
Another 75 of lido and clear.
Clear.
Clear.
(shocks) Asystole.
Should we try epi or Pronestyl? Sure, and throw in the kitchen sink.
Okay, another epi.
Are you tired? No.
Her lytes are within normal range.
Oh, great, so she'll die with normal lab results.
Okay, that's it.
Time of death No, the epi needs time to circulate.
Shock her again.
There's nothing left to shock.
One more try.
Come on.
Come on.
Mr.
Camden That shouldn't have happened.
No, it shouldn't have.
She tried to tell us.
We were too busy to listen.
Listen to what? She told us she was a diabetic.
We we should have done something, but we ignored her.
I didn't ignore her, you did.
Y-You told me to let the nurses handle it.
No, I told you to start acting like a doctor.
Nurses listen to what doctors say.
Did you ask any of the nurses to feed her? No.
Well, then, I I think it's obvious where the fault lies.
Wait, fault? You told us we were doctors, not social workers, not to care.
Well, we sure don't have to care about her now.
Hmm.
You've been doing this for what, 15 minutes? And you have the gall to blame me for your mistakes? You arrogant little know-nothing.
Every rotation, there's one of you-- some guy who thinks he's going to set the medical world on fire-- and like clockwork, they screw up every time and they don't have the guts to look in the mirror and say that it's their fault.
Maybe I'm not the only one who needs that look.
You sanctimonious-- I don't have to.
I am the director of this department, your boss, and we do things my way! And the only reason that you're still here is because you've shown a small amount of technical aptitude in the blood draws.
Other than that, you're a walking disaster.
But I am going to make you a doctor in spite of yourself, Mr.
Camden, and if you're unhappy about that, don't bother coming in tomorrow.
Matt, don't.
You're wrong.
I'm warning you, Camden.
Go home while you still have a future.
What, the blood draws? I don't have any special aptitude.
I work part-time as a lab tech.
I already knew how to do it.
I'm just the same as the rest of 'em.
Matt Camden? Somebody said you lost this.
Matt? It's okay, go back to sleep.
(dog whining) Who's that? His name is Spence.
Ms.
Martin's dog.
(sighs) The apartment's tiny, Matt.
We're never here.
We can't dog-sit, even for a couple of days.
We're not.
He's ours now.
What happened? I can't not right now.
How? I went to the Transit Authority lost and found.
All the way downtown? Someone turned it in.
In New York? The clerk couldn't believe it either.
The guy who brought it in said he had a brother in the hospital, thought it would be bad karma not to turn it in, didn't want to mess with someone's destiny.
Are you okay? Wondering if I chose the right thing.
(barks) I'll get 3B to let him out tomorrow.
No, the right "one thing.
" I decided how to spend the rest of my life just because I saw a couple babies being born when I was a teenager.
I decided what to do with the rest of my life when I was a teenager.
(sighs) You're lucky.
Some people go their whole life not knowing what they want to be.
I don't feel lucky.
I'm not sure I was meant to do this.
Maybe you shouldn't mess with your destiny.
(barking) (chuckles) I knew he wasn't ready to come in.
I'll go.
Me and Spence need a little bonding time.
Come with us? We should talk.
I need a little time.
Okay.
Come on, Spence.
(whining) We're going to have to talk about this.
(door opens) (door closes) (phone ringing) Yeah.
I was just going to bed and I was thinking about you.
Everything okay? Everything's fine.
All right, Matt, good night.
I love you.
We all love you.
I love you, too.
Good night.
Qual uh, quality, radiation, strength, timing and Orientation manual.
And precipitating factors, PQRST.
Have you seen the ER orientation manual? Right here.
Basically, it says show up at 7:00.
They'll show us the rest.
I haven't had a chance to read it.
I'll fill you in on the subway ride.
Okay, give me seven causes of chest pain.
Have you seen my shoes? The gray ones, the flats? The others kill my feet.
A-angina, myocardial infarction, pericarditis and No, I think they're under the sofa.
GI causes, esophagitis, peptic ulcer Aneurysm, costochondritis.
Ow.
You know, I-I prefer the red fuzzy ones with the four-inch heels.
They go better with my lab coat.
In your dreams.
Why aren't you getting ready? Done deal.
You're kidding, right? You aren't really going to use that thing.
It's a gift from my parents.
You know, one look at that bag, and the bullies will beat you up and steal your lunch money.
I can handle the bullies.
If you carry that thing, I just might help them.
(chuckling) Oh, it's 11:00.
I need to study for a while.
A little late.
Look, I'll cover you tomorrow.
Just make sure you set the alarm for 5:00 a.
m.
(sighs) (thunder crashing) Sarah, wake up.
Sarah, wake up.
Sarah, we're late! Didn't you set the alarm? I can be ready in seven minutes.
We're never gonna make it.
Wait, my-my stethoscope.
Where is it? Under Harrison's.
I was listening for a murmur.
Wait, to your own heart sounds? I think I have a prolapsed mitral valve.
No, you don't.
I think I do.
No, you don't.
When did you decide this? Prolapsed valve? To use your maiden name.
We talked about it.
No, no, no, you mentioned it casually once.
We're late.
(phone ringing) Matt Camden.
Come on.
Matt? Dr.
Sharp? Matt, it's me.
I'm leaving without you.
Wait, who? It's Mom, your mom.
Oh, hi, uh, I'm on my way out.
Is everything okay? It's 3:30 in the morning.
Oh, yeah, I know.
The-the boys woke me up for a glass of water.
Kitchen water, not bathroom water.
So, I thought, since I was down here, I'd I'd try you before you got out of the house.
Sarah gave me your new cell phone number.
Sarah gave you my new cell phone number? You're always saying you don't get your messages.
Hang up.
Let's go.
Are you insane? I don't want them to have my number.
I got this so I wouldn't miss messages from work.
From work, not my family.
I didn't know.
I can call back if this isn't a good time.
We just miss you so much.
Hold on, the boys want to say hi.
Hi, Matt.
Hi, Matt.
How are you? Bye, guys.
You did know.
Okay, maybe I knew, but I am tired of taking messages from your family.
There are a million people in your family, and they tie up the line day and night.
Which is exactly why I got this phone.
(phone ringing) Hello.
7th Heaven When I see their happy faces Smiling back at me 7th Heaven I know there's no greater feeling Than the love of family Where can you go When the world don't treat you right? The answer is home That's the one place that you'll find 7th Heaven Mmm, 7th Heaven 7th Heaven.
(barks) (indistinct quiet conversations) Excuse me, we If you have chest pain or shortness of breath, see the triage nurse.
Otherwise, sign in, fill out these forms and wait to be seen.
No, we're here to start our rotation.
We're medical students.
Medical students? We already have enough of those.
My head's killing me.
Wait your turn, Mr.
Hartman.
Could you direct us to the student orientation? Harry's a regular around here.
Likes the Big D.
The Big D? Demerol.
Do you know where the orientation is? Sorry, no idea.
(sighs) Group of students just went scurrying down the hall after Norton.
That must be it.
Which way? Thank you.
Hey, Doc, when can I get my shot? MAN: It's a classic indication of obstructive lung disease, and it Miss Glass, welcome.
Mr.
Simon here has a long-standing history of asthma.
He presents today with increasing SOB.
SOB? No, it's not an epithet.
Uh, shortness of breath.
Well, thank you for interrupting, Mr Camden.
Why don't you listen to Mr.
Simon's lungs and tell us what you hear.
(clears throat) I've lost my bag.
Your what? My stethoscope-- it was in my black bag.
I must have left it in the subway.
Wow, you have a black bag.
Okay, anyone willing to help out our poor Mr.
Camden? Oh, look.
No one else left theirs on the subway.
On second thought, you may need those.
Uh Nurse Kelly Yes? would you be kind enough to lend our Mr.
Camden here your stethoscope for the day? No.
Don't worry, I'll make sure he gives it back.
Consider it your contribution to medical education.
Find me when you're done, okay? Oh (stammers) Doctors are a lot like boy scouts.
They're expected to be prepared and on time.
Understood, Miss Glass? Mr.
Camden? Mr.
Camden? Uh bilateral expiratory wheezes with rails at the right base.
Brilliant.
(phone ringing) Answer that, will you? Matt Camden.
Hey your mom got up with the twins, and she woke me up, and, uh, I couldn't get back to sleep, so I thought I'd call.
She left your new phone number on the fridge.
How are you? Uh, Dad, I'm really busy.
Take the number off the fridge.
Don't let anyone in the family call me.
That number is for emergencies only.
I have to go.
Write this down, Mr.
Camden.
Turn off phone.
All right, the lab is down the hall.
Time-stamp your requisitions.
Curtains three, four, five.
Psych patients are stored next to bed eight.
Try not to lose anybody.
What's the problem? I can't turn it off.
Why? It won't turn off.
Then, get rid of it.
Trauma rooms one, two, three.
Do we get to work on traumas? No.
Are you getting all this, Mr.
Camden? Main desk, Dr.
Sterling.
This is one of our residents, Dr.
Lisa Sterling.
Dr.
Sterling will assign you your patients.
You're expected to do histories and physicals, draw bloods and gather lab results.
Scut work.
It's all part of your medical training.
I had to do it, Dr.
Sterling did it, and now you get to do it.
And someday, you'll get to make someone else do it.
Not the nurses.
Correct.
Do not slough off your work on the nurses.
They will probably ignore any suggestion you make, so (buzzing) don't make any.
More meetings-- they're burying me.
All right, lunch, one half hour.
There's coffee in the lounge.
Put some money in the Styrofoam cup.
Bye.
Okay.
Blood drawing, room three.
They're like little vampires.
Ouch! Sorry.
STERLING: No, never say sorry.
It's a sign of weakness.
Isn't that from an old John Wayne movie? Is it all right to say ouch? Ouch! How about getting a nurse to do this? Uh, I'll give it a shot.
All right, Mr.
Adams, if Mr.
Camden here can't get it on the first try, then I'll do it myself.
I thought the nurses drew blood.
Do you even remember how? Tourniquet.
Prep the area.
Got it.
Bevel up 20 degrees, immobilize the vein and Hey, you drew first blood.
I hardly felt it.
Good job.
Make sure it gets to the labs.
Hey, Doc, can you get this guy to do all my tests? The rest of you need to practice.
Not on me.
You going to tell them? No.
After our start, I think I need to collect all the brownie points I can.
(phone rings) Is my number still on the refrigerator? Matt? Lucy, do me a favor, tear up that number and throw it away.
Fine, if you don't want to hear from your sister who loves and misses you.
I don't.
Not now.
I'll call you.
(dial tone) Forget it.
I'll call the Transit Authority and see if anyone turned it in.
It's New York.
What do you expect? Okay, Liu, sore throat, curtain three.
Cool, I used to volunteer in the free clinic.
I've down a hundred strep screens.
Turned in what? Matt left his black medical bag on the subway.
Black bag.
Sounds like a lucky break to me.
Okay, Goodman, sprained ankle, curtain two.
I can handle that.
Sinatra 40-year-old.
Exam four.
Constipation.
(doors slam open) BP 90 palp.
Tachy at 130.
Reps 24 and labored.
What's open? Trauma Two.
Gangbanger? Bystander.
CBC, chest film, set up for a thorocostomy.
I need four units of O-Neg for the infuser.
Okay if we watch? Day one.
Lots of time for the gun and knife club.
Get your work done.
Constipation.
Doesn't sound like an ER case, but what the hell, I'm going into GI anyway.
Only place to earn money these days is by doing procedures.
What did you guys get? nursing home patient, altered.
thinks he's Napoleon.
Requesting asylum.
I'll trade you.
I have no idea where to start with this one.
Stick to the basics.
They don't expect much.
You're a med student, not a resident.
If they don't expect much, why didn't you tell them you work part-time as a lab tech? Okay, I'll trade.
You don't think I can handle it? You said you wanted to trade.
Besides, you'd do better with Napoleon.
Why? Oh, hypomanic, delusions of grandeur.
He sounds a little like your father.
Hey, where's Exam Two? Mr.
McNeil, I'm Matt Camden.
Are you a priest? I'm sorry, I couldn't hear you.
Are Are you a priest? He wants to know if you're a priest.
Uh no, I'm a medical student.
I need to ask you a few questions.
Are you a priest? No.
I'm a medical student.
He's confused not deaf.
He's not going to be answering any questions.
Mr.
McNeil, why are you here today? Bless me, Father He can't' bless you, Mr.
McNeil.
He left his holy water on the subway.
Great.
How do I get his history? Well, if I were a smart medical student, I'd try the old chart stored at the desk.
(clears throat) They all look the same, don't they, Mr.
McNeil? You're a very pretty nun.
(laughs) Shh.
Mr.
Levesque? Napoleon Bonaparte.
And what brought you in today, Napoleon? The British.
They're trying to send me to Alba.
I need asylum.
They're stealing all of my money.
They want to put me on a cruise ship.
Cruise ship? Bingo.
Shuffleboard, sundeck.
Exile at sea.
It's that Tony Blair.
They implanted a receiver in my head.
He warned me.
Okay.
How can I help you today? I need a green card! Security! (sighs) (beeping) (line ringing) (phone ringing) (groans softly) Please, God, stop calling me.
Matt, what the heck is wrong with you? I'm working.
I'm at the hospital.
Then why do you keep answering the phone? Because I can't turn it off.
Why not? Because I can't.
Shouldn't you be able to use a cell phone before you're allowed to work with patients? Very funny.
Nice talking to you.
Not so fast.
My wife, your sister, is in tears because of the way you talked to her earlier.
It's Lucy.
She's always in tears.
I have to go.
(dial tone) The Encyclopedia Britannica is smaller.
Volumes three, four, five and six.
Have fun.
LIU: Fever 101, tonsillar exudates, but the strep screen is negative.
Mono exposure? I didn't ask.
Call for labs on Mrs.
Shapiro, and page Surgery to do a consult on Miss Connors in five.
Any questions? No.
Just having a little trouble getting a history.
Doesn't speak English? (phone ringing) Maybe he used to, not anymore.
He's got a fever and his blood pressure is low.
Circling the drain.
(phone ringing) Ruby, isn't there a phone you need to be answering? Just do a basic exam.
I'll help you out as soon as I get a minute.
They sedated Napoleon with Haldol.
Before he conquered Europe, I hope.
I didn't get to finish my H&P.
That already puts me behind.
You've got lots of time.
He'll be a lot calmer after the vitamin H.
Vitamin H? Haldol.
Vitamin H.
There's the problem.
You've worked in a hospital, seen all this before.
I haven't seen it all.
Maybe.
But enough to make it seem easy.
You just don't realize, it's not that easy for the rest of us.
I'm glad to help.
Showing the rest of us up isn't helping.
NORTON: Idiot burocrats.
You call Mr.
Jordan.
He needs to go over this report.
LEVESQUE: You stupid! Yours? Mine.
I think he's calling your name.
Sterling tells me you're the new record holder for blood draws.
Uh, yes, but I've RUBY: Mr.
Jordan's on line one.
Got it.
Making up for your bad start? I'm trying.
Don't try.
Just do it.
Jordan.
(monitor beeping rhythmically) Mm, the prodigal son returns.
Figured him out yet? Who? Mr.
McNeil, your patient.
Too many volumes.
Where's his family, maybe they can fill me in.
KELLY: At home, watching TV I suspect.
He came from a nursing home.
Family probably hasn't seen him in weeks.
(machine beeps three times) His blood pressure is dropping.
Maybe you should go get one of the residents.
I asked Sterling.
She's swamped.
She said she'd come over in a minute.
Temp's 103.
He's septic.
Do you want me to turn off the IV? Um, sure, turn off the IV.
Diabetes, CHF, CAD, dementia, pneumonia.
Where do I start? Can you help me lift him? I can't hear his lungs with this thing? It's a poor craftsman that blames his tools.
His blood pressure is low.
I don't think we should sit him up.
Dr.
Norton expects me to complete my H&P.
It'll only take a second.
Whatever you say, Doctor.
KELLY (straining): Up we go, Mr.
McNeil.
Deep breath, Mr.
McNeil.
I can't hear any breath sounds.
(rapid beeping) His heart rate is dropping.
I don't get a pulse.
He's in V-fib.
What do I do? Grab a crash cart.
Go! Go.
Come on.
Come on, Mr.
McNeil.
What are you doing? My patient stopped breathing.
I need a crash cart.
You are the doctor.
You stay with the patient.
You let the nurse go get the crash cart.
He's breathing on his own.
What happened here? MATT: I set him up to listen to his lungs.
He just stopped breathing.
Did you check the patient's blood pressure before examining him? I was trying to complete the exam.
I didn't check.
(phone ringing) I-I can't get it to turn off.
(ringing continues) (ringing continues) I'm just going to let it keep ringing.
Isn't he kind of busy, being in medical school and all? Too busy to talk to me? Are you kidding? He's not answering.
He'll answer.
(line ringing) Heard you came close to bumping off your first patient.
Mr.
Goodman, have you finished your H&Ps? Just tying to lighten the mood.
Excellent try.
Listen, it's my job to supervise the students.
I should have listened.
I should have jumped in sooner.
I'm sorry.
I thought sorry was a sign of weakness.
Here.
A rash.
Tough one.
You still have three H&Ps to do.
Norton let you off easy.
Just get your work done.
Besides, it's a good case.
Trust me.
Miss, uh Perfect.
I prefer Pam.
Penny Perfect is my stage name.
Are you the doctor? No.
I'm a, uh, I'm a medical student.
Well, almost a doctor.
Good enough.
I see you met Pamela? You know her? Everybody knows her.
She shows up once a month to check out the new single residents and students.
Dr.
Camden, are you coming back? Give him a couple of years, Pamela.
All right, back to work, you guys.
Ann Hudson, altered and nonresponsive.
BP 170/90.
Pulse 110.
Reps 12 and shallow.
Trauma Three.
Chem 20, CBC, tox screen.
Who's this? Her friend, Marie Martin.
Pretty upset, couldn't get much history.
We just went out for a walk.
She fell to the ground.
Ms.
Martin, wait here, I'll be right back.
Come with me.
STERLING: One, two, three.
All right.
What have we got? hypertensive, probable CVA.
BP 190 over 110.
What do you think we should do here, Mr.
Camden? Baseline labs, EKG and a chest film.
Got 'em.
And? Start an IV? Already has one.
Get a CT.
Eventually.
Stick with the basics.
Get a good history.
Exactly.
But she's unconscious.
Keen observation.
Check with the family.
Good.
Any family? There's a friend outside.
Her friend's name is Marie Martin.
Sats are dropping-- 90.
High-flow mask at 100 percent.
Open the intubation kit.
and a Mac Three blade.
Anybody here try intubating before? ALL: No.
I'd like to try.
I've practiced on a CPR head.
Of course you did.
I'd still like to try.
Mr.
Camden, if her sats drop any further, maybe you'll get a chance to show us what you've learned.
But right now, go get some background history from her friend.
Don't worry.
I won't let Miss Glass steal your procedure.
I'll call you if she needs to be tubed.
Go, go, go, Come on.
Ms.
Martin? They made me wait out here.
Is she going to be all right? I-I need to get some information from you Ms.
Martin.
Does Ms.
Hudson have any family? A husband? Children? No.
There's just me.
What happened to her? We're not sure yet.
I'm one of the medical students.
I need to speak to her family.
We've lived next door to each other for over 40 years.
We're both widowed and both our kids stink, so we look after each other.
Except she can't look after my dog because she's allergic.
Well, does she have any medical problems? Uh, high blood pressure? Heart disease? History of a previous stroke? She's had a stroke? Oh, my God.
I want to see her.
Oh Hey, hey, hey.
You should sit down.
I'm okay.
I'm a diabetic.
I just have to eat something.
Mr.
Camden, we're waiting.
Any information for me? No.
I haven't had Med list? Previous history? Uh, no.
Are you the doctor? Is she going to be okay? Are you a family member? Well, no.
Then I'm afraid I can't release that information.
Patient confidentiality.
Ms.
Martin and Ms.
Hudson are lifelong neighbors.
I'm sure it'll be okay.
Not unless there's a signed power of attorney.
Would you excuse us for I have that.
We each have one on account of we look after each other.
I sent you out here to get the medical history.
I was trying, but she was so upset You're going to be a doctor.
You're not going to be a social worker.
So start acting like a doctor.
Nurses do the handholding.
Your job is to focus on taking care of the patient.
Doctor Norton, Ms.
Hudson's sats are dropping.
Ms.
Martin's a diabetic, she hasn't eaten.
Let the nurses take care of it.
Come on, Camden, let's see if your practicing paid off.
I found it.
Please, you've got to let me see her.
I'll bring you in as soon as possible.
Is she going to die? First shot, right in the hole.
Once I saw the cords, like butter.
You're lucky you got to practice beforehand.
Where is that practice head? I'd like to give it a shot.
There's a CPR practice lab up on five, next to hematology lab.
How'd you find it? None of us has ever heard about it.
Yeah.
How did you ever find it way up on the fifth floor, next to the hematology lab? Hey, they took that jumper to the psych unit.
Jumper? You had a jumper? Don't change the subject.
Where'd he jump from? The second floor of the hospital.
And, uh, lunch is over kids.
Let's go.
She dropped her pressure in CT.
Trauma Three is open.
DC the Mannitol, mix up Dopamine, Start her at five micrograms a minute.
It appears she suffered a massive stroke.
Is she awake? No.
Will she wake up? We're going to know a lot more in a day or two.
Is there anything we can do for you? I have to go home.
I have a dog, Spence, I need to feed him.
Mr.
Camden, will you walk Ms.
Martin to the desk and ask one of the nurses to assist her? I'm sorry for the bad news.
I'll take you to the desk.
I'd like to see her.
I'll get you a nurse.
No.
I'd like to see her now.
Please.
I'm sorry.
I'm a little dizzy.
You want to sit down? No.
I'm okay now.
Oh, excuse me.
Go on in.
We'll be right here.
She's such a nice lady.
Yeah.
Thank you for the stethoscope.
I don't think the color suits you.
I'll try to do a better job at coordinating my wardrobe tomorrow.
Bring your own in tomorrow.
Tomorrow.
I don't know.
I'm having trouble getting through today.
Is it like this every day? No.
Today was a good day.
It gets worse.
I wasn't expecting.
What, all this? How could you? You know, I go home every night after taking care of 15 patients.
I come back the next morning, and there's 15 new ones waiting to be seen.
I just want to come in one morning and, you know, find an empty waiting room.
Just so I could say, thank God we fixed them all.
You know? Well, there must be something that makes you come back every morning.
That one thing? What's your one thing, Dr.
Camden? (clattering) She's diaphoretic.
Resps 16.
I got a pulse.
Thready, around a 100.
Yes, I need a doctor in here, now! Hook her up.
Vitals? Tachycardic at 110.
BP 120 over 60.
EKG, Chem 20, tox screen, pulse ox.
Immobilize her neck until we clear it.
I've got a line.
Maybe she vaso-vagaled.
She's diabetic.
Brilliant.
Thank you for informing us, Camden.
Were you hoping we would eventually just figure it out? No, I told you.
When? In the hall, when I was getting her neighbor's history.
Accu-Chek's at 40.
Miss Glass, what's the treatment for hypoglycemia? Glucose IV.
Correct.
Push it.
What what happened? Congratulations, Miss Glass.
Your first medical miracle.
All right, work her up.
Baseline labs, IV of D-5.
Camden get her a food tray.
You know her.
You should work her up.
You saved her.
What about that bothers you? That it wasn't you? Norton wants you to do it.
She's your patient.
I have to get a food tray.
Hi.
Hi.
I'm looking for Reverend Camden.
I think he's upstairs with Annie.
I'll tell him you're here.
Who are you calling? Ruthie is trying to reach Matt.
If he answers, take the phone up to her.
She and Peter are doing homework in her room.
Oh.
(line ringing) No, I can't hold.
They said they'd have the tox screen results 20 minutes ago.
So is Matt in your class? Sorry? Camden.
The two of you are thick as thieves.
We know each other.
That's it? Come on, there's got to be more than that.
He's cute.
He's a little, Type A, but cute.
So you two aren't? What? Together? Hooked up? Livin' in sin? No.
Good.
I mean, I just wanted to know.
Oh, this stupid lab.
They've had me on hold forever.
Take down the tox screen results when they come back on the line.
Hello? Hel Yes, I can hold.
Can we talk? Actually, on the phone here.
Are you on hold? Don't you have a patient? Don't you think we're under enough pressure without turning on each other? Yes, I'm here.
Later, okay? I want to go home.
I have things to do.
You're on a long-acting oral hypoglycemic.
We need to keep you on an IV for the next 24 hours.
What about Spence? I told you I have a dog.
I can't stay here 24 hours.
I don't want to stay in this place.
It's too quiet here.
Well, you may be the first person to ever call this place quiet.
I'm used to it.
Ann's a talker.
All the time, she drives me crazy.
Always talking about finding that "one thing.
" That "one thing"? The one thing that she could really be good at.
The one thing that would make her stand out-- her contribution to life.
She's tried painting.
Writing a novel.
Training for a marathon.
It just seems so very quiet now.
If you want to talk I'll listen.
How about you talk, I'll listen.
Mr.
Camden, rounds at the desk.
I have to go.
Thank you.
I didn't do anything.
Hey, if it's meant to be It's meant to be.
Hi.
Hi.
I was just waiting here for Reverend Camden.
On pizza night? When Lucy and I get together? Nice seeing you.
If Matt answers, will you take that upstairs to Ruthie? (line ringing) (hangs up phone) After which psych was consulted.
Oh, I noted injection sites on his thighs.
I think he's using anabolic steroids.
That's a good observation, but you should have documented that in your physical exam.
Okay.
Mr.
Camden, which three cases did you complete? Pamela Perfect-- rash, Marie Martin-- hypoglycemia.
Mm-hmm.
That's only two.
Someone took over Mr.
McNeil before I could finish the workup.
Aw, that's too bad.
Mr.
Camden, were my instructions unclear? How many H&Ps are you required to perform each day? Three.
Three, not two, not two and a half.
Now, are you having a remarkably bad day or is this the best that you can do? Neither.
Listen to me, all of you.
Up to now, it's been about the theory of medicine, but from here on out, it is about the practice of medicine.
You're here to learn to take care of patients and by necessity, learn to care about them a little less.
That's brilliant.
NORTON: And from now on, the gloves are off.
There's no more excuses.
And Mr.
Camden, I expect your work-- todays and tomorrow's-- to be completed tomorrow at 5:00.
I'm going out with the rest of the gang to celebrate surviving day one.
Not me, thanks.
We don't have any food at the apartment.
I'll find something.
It's 6:00.
You're off the clock.
It's time to start acting like you're one of us.
I never said I wasn't.
No, you just did everything you could to make yourself look better than the rest of us.
I wanted to return this to you.
Oh, you're off already? Nurses do 12.
Nurses get paid.
Not enough.
After today, I think you're probably right.
Anyway, thanks.
Sure.
This may sting a little.
People always say it'll hurt a little when they mean a lot.
Will this leave a scar? I have one.
You know how I got it? (chuckles) One day, my sister and I were racing across the house.
I slipped and I split my head open on the bedpost.
My mom took me to our pediatrician's office-- Dr.
Lindsay.
He sewed up my forehead.
Halfway through, I guess he noticed I was wincing.
He'd forgotten to use a local.
Oh.
I never said a word.
He told me I was his best patient and when I grow up I should be a doctor.
So Dr.
Lindsay got you into all this? No, Dr.
Lindsay didn't make me want to be a doctor.
He made me afraid of doctors.
You want to be a doctor? No, I hate blood.
(laughs) Don't buy into all that Norton stuff.
He's a jerk.
Ah, sounds like you know him pretty well.
Yeah, a little too well.
(winces) I don't know, maybe he's right.
He's not.
Ms.
Martin was asking for you.
She wants to talk.
She likes you, trusts you.
I'm off the clock.
NURSE: Dr.
Norton, stat.
NORTON: She's in V-fib.
Another amp of D-50.
Charge to 300.
NURSE: Sats are 88.
Good air entry bilaterally with bagging.
Mr.
Camden, following up on your patient.
Very laudable.
Clear.
Clear.
Bad timing, though.
Still in V-fib.
Good pulse with CPR.
Accu-check 80.
What happened? The combination of prolonged hypoglycemia and stress seems to have precipitated a cardiac event.
Charge to 300.
Another 75 of lido and clear.
Clear.
Clear.
(shocks) Asystole.
Should we try epi or Pronestyl? Sure, and throw in the kitchen sink.
Okay, another epi.
Are you tired? No.
Her lytes are within normal range.
Oh, great, so she'll die with normal lab results.
Okay, that's it.
Time of death No, the epi needs time to circulate.
Shock her again.
There's nothing left to shock.
One more try.
Come on.
Come on.
Mr.
Camden That shouldn't have happened.
No, it shouldn't have.
She tried to tell us.
We were too busy to listen.
Listen to what? She told us she was a diabetic.
We we should have done something, but we ignored her.
I didn't ignore her, you did.
Y-You told me to let the nurses handle it.
No, I told you to start acting like a doctor.
Nurses listen to what doctors say.
Did you ask any of the nurses to feed her? No.
Well, then, I I think it's obvious where the fault lies.
Wait, fault? You told us we were doctors, not social workers, not to care.
Well, we sure don't have to care about her now.
Hmm.
You've been doing this for what, 15 minutes? And you have the gall to blame me for your mistakes? You arrogant little know-nothing.
Every rotation, there's one of you-- some guy who thinks he's going to set the medical world on fire-- and like clockwork, they screw up every time and they don't have the guts to look in the mirror and say that it's their fault.
Maybe I'm not the only one who needs that look.
You sanctimonious-- I don't have to.
I am the director of this department, your boss, and we do things my way! And the only reason that you're still here is because you've shown a small amount of technical aptitude in the blood draws.
Other than that, you're a walking disaster.
But I am going to make you a doctor in spite of yourself, Mr.
Camden, and if you're unhappy about that, don't bother coming in tomorrow.
Matt, don't.
You're wrong.
I'm warning you, Camden.
Go home while you still have a future.
What, the blood draws? I don't have any special aptitude.
I work part-time as a lab tech.
I already knew how to do it.
I'm just the same as the rest of 'em.
Matt Camden? Somebody said you lost this.
Matt? It's okay, go back to sleep.
(dog whining) Who's that? His name is Spence.
Ms.
Martin's dog.
(sighs) The apartment's tiny, Matt.
We're never here.
We can't dog-sit, even for a couple of days.
We're not.
He's ours now.
What happened? I can't not right now.
How? I went to the Transit Authority lost and found.
All the way downtown? Someone turned it in.
In New York? The clerk couldn't believe it either.
The guy who brought it in said he had a brother in the hospital, thought it would be bad karma not to turn it in, didn't want to mess with someone's destiny.
Are you okay? Wondering if I chose the right thing.
(barks) I'll get 3B to let him out tomorrow.
No, the right "one thing.
" I decided how to spend the rest of my life just because I saw a couple babies being born when I was a teenager.
I decided what to do with the rest of my life when I was a teenager.
(sighs) You're lucky.
Some people go their whole life not knowing what they want to be.
I don't feel lucky.
I'm not sure I was meant to do this.
Maybe you shouldn't mess with your destiny.
(barking) (chuckles) I knew he wasn't ready to come in.
I'll go.
Me and Spence need a little bonding time.
Come with us? We should talk.
I need a little time.
Okay.
Come on, Spence.
(whining) We're going to have to talk about this.
(door opens) (door closes) (phone ringing) Yeah.
I was just going to bed and I was thinking about you.
Everything okay? Everything's fine.
All right, Matt, good night.
I love you.
We all love you.
I love you, too.
Good night.