Chicago Med (2015) s02e08 Episode Script

Free Will

1 Have you seen this person? - His name is Danny.
- Uh-uh.
- He maybe found a shelter.
- Maybe.
Or he could be riding the train all night to stay warm.
Ethan, if you're trying to make me feel better, - it's not gonna work.
- I'm not.
I'm just saying, we can't look everywhere, and it's time to go to work.
Well, you go ahead.
I'm gonna keep looking.
Um, excuse me.
- Excuse me? - Sarah, Sarah, Sarah.
Lower Wacker is much more popular this time of year.
We'll check it out tonight after our shift.
- Paté, sweet breads.
- You ordered a paté platter - and sweet breads? - Yeah.
Pathologists love organ meats.
You recognize that's weird, right? Ah, I think it's a vitamin D thing.
We don't get much sunshine.
- [laughs] - Have a good day.
- Hey, what's up? - Morning.
Big moving in party tonight, huh? Evite wouldn't lie.
Yeah, well, we'll be there.
So how's it been so far, living together? Only a couple days, but so far so good.
I bet.
Oh, I heard there's a giant Whole Foods across the street.
That's awesome.
Yeah, it is.
Well, I'm really happy for you guys.
- Doctor Manning.
- Mm-hmm? - Treatment 6.
- Got it.
You and Dr.
Shore better be the real deal.
I am bringing a Château Pichon 2005.
Great, wine spritzers.
Don't you dare.
Treatment 1.
Hey, uh, did you get those lab results yet? They just came in.
Want me to come with you? Um, I think I better do this myself.
Okay, just tell her if she needs anything I'm here.
[sniffs and coughs] Don't come too close.
My TB's become active.
The spot on your lung's a half a centimeter larger.
- [sighs] - I'm sorry.
[sighs] I took my meds.
I didn't overexert.
I-I just don't get it.
Thing is, um, that's not all.
- What do you mean? - This - Here, just just read it.
- Come on, Noah.
Just Just read it.
Wait I'm pregnant? I'm pregnant.
Is it just me, or these Santas seem - to come out earlier every year? - Right? The psych nurse station still has their Halloween decorations up? Any Thanksgiving plans? Taking Robin out for some sushi.
Good, so the two of you are spending some time together? Yeah.
Here and there.
Doing great, you know? I mean, such a great kid.
But you know how it is.
You don't really worry about them.
You worry about the people they surround themselves with.
Sounds like someone in particular.
No, not really.
Oh, I guess there's this one guy.
You know, a great great fella.
I mean, we work together.
Terrific surgeon.
But he's got these family issues, man.
Big family issues, and obviously with Robin's family history, it just can all turn into a bit of a powder keg.
Have you spoken to her about this? - No.
- Oh.
So you're just keeping it all to yourself? Didn't I just tell my shrink? Daniel.
I don't know.
I might have said something to they guy.
Nothing intrusive.
Just, I don't know.
- Some friendly advice.
- Advice? Yeah.
Don't make the holidays any more hard than they have to be.
Hey, I know this isn't ideal, but a couple of weeks, we should have your TB back under control.
Yeah, you'll be back in the ED throwing me shade again in no time.
[sighs] But how did this happen? I take birth control.
Uh, my opinion, your TB meds made your birth control less effective, and then becoming pregnant weakened your immune system to let the TB become active.
Oh, God.
No one could have predicted this, April.
In a few months I'll be walking down the aisle with a baby bump.
Yeah, but it's all good.
Right? Yeah.
No, it is, but - what about Tate? - You know Tate.
He'll love it.
He's head over heels for you.
Yeah, right now, but what if I get sick? What if I can't take care of this baby? - April - He didn't sign up for this.
[pager chimes] It's okay.
I'll check on you soon, okay? Jim Vance, 38, end stage kidney failure, suffered a syncopal episode following dialysis.
- Transplant candidate? - Too far down the list.
Hi, Mr.
This is Dr.
Heard you had some trouble today.
Today, Tuesday, last Friday.
Almost every time I get dialysis now.
What happens? My chest, um, it starts to to flutter - Uh-huh.
- I feel really weak.
Um, ventricular Ectopy.
- Yeah.
- Ectopy.
May be IDH.
Intradialytic hypotension.
In some people, dialysis can cause an extreme drop in blood pressure, which prevents enough oxygen from reaching the heart, and over time, that can cause dysrhythmias or even a heart attack.
So tell the transplant people.
Maybe they can move me up the list.
Well, we can try, but I'm sorry to say, heart disease usually moves people down the list, not up.
- But I'm not even 40 yet.
- I hear you, and I promise we're gonna do everything we can to help.
Let's get him on 15 p.
of kayexalate and start him on esmolol to stabilize his rhythm.
Or we could do low-volume dialysis.
We could.
Otherwise we're just treating the symptoms and not the actual problem.
- Yeah.
- Great.
- Okay.
- I'll be back in a few.
- Mm.
- We'll see you.
We don't usually disagree in front of a patient.
I had to say something.
You really think low-volume dialysis will make a difference? I mean, it seems like six of one, - half a dozen the other, no? - I don't know.
Let's find out.
Hey, you bringing Clarke tonight? - Mm-hmm.
- Good.
Pathology party.
Not much to look at.
So how's it going with him? Good.
You know, we're just trying to let it happen.
Not trying to force anything.
- Force anything? - Like moving in together for financial reasons or convenience.
- Mm - No, I wish Will all the best.
- I just think it's weird.
- 36-year-old male, penetrating stab wound to the abdomen.
- You're going to Trauma 1.
- Got it.
What happened? I got jumped in the yard.
Three guys.
Why would they do that? All I do is make friends.
- I need to transfer him.
- Yeah, hold up.
- Okay, he's ready.
- On my count.
One, two, three.
[grunts] Guys, I got a hole in my gut.
I ain't going anywhere.
Left lower quadrant looks clean.
No major vessels, no bowel.
I can't take it.
You need to put me under, you do what you gotta do.
No, I think you got lucky on this one, Mr.
CT abdomen, then bring him back.
We can take care of this one here.
- Okay.
- Okay, Doc.
I trust you, but I gotta ask.
After you're done, am I gonna be able to play the piano? Hey, come on.
Don't leave me hanging here.
Let me guess, you never could play it before? I like you, Doc.
[chuckles] You can stick your fingers in me any time you want.
- How's he doing? - Ah, he'll be fine, though with a nice-looking scar.
Pretty fortunate, considering it was three against one.
That's actually not the case, Dr.
Seems he stabbed himself hoping to score - a holiday from prison.
- What? I guess when you're up against 30 to life for a double homicide, you look for little diversions.
Her name is Karina Goff.
She's 16 years old with a history notable for Williams Syndrome.
Her mom found her passed out on the couch.
Williams Syndrome.
You ever seen it? No, never.
It's a genetic disorder, right? Uh-huh.
It's commonly associated with cardiovascular disease, but even more striking is their personality.
They produce enormous amounts of oxytocin, which is the hormone commonly associated with feelings of trust and the desire to be social.
They're very interesting people.
[indistinct chatter] - Hi, Dr.
Clarke! - Hi, Karina.
Wendy, this is Dr.
Latham and Dr.
Oh, I like your earrings.
- It's a moon and the stars.
- I see that.
So, how we feeling today? Tired.
Still awake enough to donate her entire allowance - to UNICEF this morning.
- [both chuckle] Which is what? The third time this month? Is this the first time she's fainted? Yes.
May I listen to your heart? Mid-systolic ejection murmur over the right second intercostal space.
Aortic stenosis? Probably.
- Let's get an echo.
- Okay.
Can you make me better? - I am gonna try my best.
- [giggles] [chuckles] Okay, dear.
Let the doctor breathe.
- Doctor? - Uh - [all chuckle] - Let us let us run a few tests.
We'll be back with our recommendations.
I thought maybe Sunday we can go to the Field Museum.
- That sounds good.
- DNA Center has an exhibit on the reproductive habits of sharks that's supposed to be great.
I'm sorry.
What were you saying? Danny still hasn't checked in on Facebook, has he? - No.
- He'll turn up.
You don't know that.
He's helpless and alone out there.
And you've been out there every day looking for him.
There's nothing else you can do.
I could have let him stay with me - when he asked.
- No, Reese, you couldn't have.
That's not your responsibility.
He found you when he needed you in the past.
He'll turn up.
I said get out of here.
I just wanna talk to the doctor.
You better get out of my face, man; I'm not playing.
I just wanted to know if you're okay.
- Do I look like I'm okay, man? - Excuse me? Sir, is everything okay in here? Uh, yeah.
I'm Ian.
- Jim's brother.
- [scoffs] Some brother.
Go ahead.
Tell 'em.
- Jim - Go ahead and tell 'em, man! Tell 'em.
I'm a perfect match to donate my kidney.
Right, and he'd rather watch me die than give it to me.
I love my brother.
I'd love to give him my kidney.
What's stopping you? I'm HIV-positive.
But giving him a kidney would be giving him HIV as well.
I'm guessing by his reaction that he doesn't know? Not a clue.
May I ask why don't you tell him? Because Jim is incredibly homophobic.
He thinks homosexuality is disgusting, deviant behavior.
Yeah, well, but right now, he thinks you're willing to let him die.
Well, right now Right now he hates me for what I'm doing, but if I tell him this, he'll hate me for who I am.
I understand.
But just so you know, if you don't tell him soon, it may be too late.
Hey, uh, hello.
- [chuckles] - Hey.
You better put that mask on.
I-I brought you some stuff from home, okay? - Thank you.
- All right.
All right, so, how you feeling? - Sit down.
- Why? What is it? I'm pregnant.
Pregnant? Are you sure? You you're on the pill.
My TB meds screwed things up.
I'm sorry.
I know we didn't plan for this.
I know this changes everything.
We're gonna have a baby.
Oh, you can't see.
Um [both chuckle] Okay.
Now put that back on.
Babe, we slept in the same bed last night.
Put it back on.
[laughs] It's a beautiful thing, honey.
It really is.
[exhales] Ms.
Charles, what brings you to the ED today? Yellow fever? Plague? Eh, just a plain old cough.
Things have not been the same since the swine flu died down.
Well, don't worry.
They'll be another epidemic one day.
Eh, that's what I keep telling myself.
You know, gotta stay positive.
I never figured you for an optimist.
[laughs] Are you kidding me? I still root for the White Sox.
- Wow.
- I do.
- How do you do it? - I would love to tell you.
I don't know.
Maybe over drinks tonight? That sounds great.
Uh I'm just not sure your father would approve.
Wha did he say something to you? No, not not really.
He just mentioned something in passing.
I see.
Goff, hi.
So we got Karina's test results.
The large vessel leaving her heart has become severely congested.
It's making her heart work harder and harder and and decreasing the amount of oxygen that it can deliver.
That's why she's become so tired and listless.
Oh, God.
What do we do? Well, we recommend an operation to either fix the aortic valve or replace it.
- Heart surgery? - Yes.
Hi, Dr.
Rhodes! What're you guys talking about? Dr.
Rhodes was just explaining your test results.
Hey, Karina, why don't we get you back to bed? There you are.
So, based on what I am seeing, I believe you need surgery.
Will that make me better? Well, there are never any guarantees, but, if things go well, then, yes, it will.
Good! Then I wanna do it.
It's not that simple, sweetheart.
We need to think about this.
- Give the doctor and I a minute.
- Okay.
We'll be right back.
I know you think surgery has the best odds, but I also know that Williams patients have a much higher chance of not surviving general anesthesia.
I completely understand, but the fact is, her condition is quite advanced and she did express that she wants the surgery.
She doesn't understand.
She says that just to please you.
Well, she may not be able to make a completely informed decision, but she does know how she feels.
She's under 18.
It's my decision to make.
Shouldn't we at least let her be a part of the conversation? Dr.
Rhodes, Karina is not like your other patients.
I want options.
[clicks tongue] Okay.
Uh, let me talk to Dr.
See if he has any ideas.
What did you tell Connor? Come again? Did you tell him to stay away from me? - No.
- You said something.
- I might have ind - Who I date is not your concern.
You are absolutely right.
[scoffs] You are unbelievable.
I'm sorry.
I was wrong.
If I worry about you, I can't help it.
Okay, well, that's gonna need to stop.
Can't do it.
I'm your dad.
I know I haven't won any awards in that department This is not a referendum on you.
I'm sorry I wasn't there.
I'm sorry I wasn't a father.
Okay, see? That that right there.
Why does it always go back to that? Does it ever occur to you that I have moved on? I didn't.
Not only am I past it, but I really I do not care.
So you can feel as guilty as you want, but you being overinvolved in my life now is not gonna cut it.
[door slams] Hey, Doc.
We gotta stop meeting like this, right? [chuckles softly] Ah, you giving me the silent treatment, huh? Hey, you think I could get a TV in here? You and I could watch a little, uh "Family Feud.
" Not enough time.
I'm stitching you up and then you're leaving, which means you won't be needing those.
Ah, come on.
Why you gotta be like that? Because you're not here on vacation.
Hey, give me a break here.
I'm injured.
By your own hand, I hear.
You wanna play that game? I am extremely depressed, and you know what? That makes me wanna hurt myself.
- Excuse me? - You heard me.
You heard me too.
I am gonna hurt myself! And we all know what that means.
We have no choice.
I'll call Dr.
Charles for a psych consult.
That's right you will.
[alarm blaring] [machines beeping rapidly] He's in v-tach.
Stop the dialysis.
Pulse is thready.
Shortness of breath.
Lost his pulse.
We gotta defibrillate now.
- Bag him.
- Get me the paddles.
- What's going on? - Charge to 200.
He's in cardiac arrest.
Still in v-tach.
Come on.
Charge to 300.
Sinus rhythm.
Jim, can you hear me? He's stable for now.
Jim? I need to talk to you.
I gotta tell you something.
- There she is.
- Thank you.
Yeah, of course.
Hey, uh, is there somewhere we can go talk for a minute? Did you find Danny? [quietly] Um He's he's dead, isn't he? Yes.
I'm so sorry.
[crying] [quietly] Hey.
Hey, you did everything you could.
This is Sarah Reese.
Hi, are you family? A friend? No, I'm his doctor.
I was his doctor.
[inhales sharply] Was he beaten to death? It looks that way.
We won't know for sure until we have the results of the autopsy.
Your sputum cultures just came back.
It turns out you don't have regular TB.
Uh, it's multi-drug resistant.
Okay, so I'm gonna have to be on three or four meds instead of one? Uh, it's not quite that simple.
Uh, it's only susceptible to one drug, but it's completely susceptible, so it'll definitely work, but this medication can cause neural tube defects in a growing fetus.
But not always.
There's just a chance.
Well, there There must be something else.
I they couldn't have tested everything.
They have.
Well, tell them to test it again.
I mean, try something.
There's nothing else to try.
I just placed the order.
The first dose should be up in a little while.
[exhales] I'm sorry, April.
[door opens] [door closes] Spoke to your patient, Mr.
Let me guess, not a suicide risk.
Garden variety sociopath.
He's an opportunist.
Knows all the buzz words.
Not a sincere bone in his body.
Good enough for me.
Let's start discharge paperwork on Treatment 4.
Chalk one up for the good guys.
Hi, Mr.
Your rhythm looks good.
How are you feeling? Disgusted.
Given your latest reaction, I'd like to try something different.
A medication called midodrine to raise your blood pressure, followed by a special course of low-calcium dialysate.
Will it work? To be honest, it's a long shot.
But it's our best option.
Just tell me.
How long have I got? You're experiencing cardiac events with every dialysis, and you need dialysis three days a week, so realistically, it can happen at any time.
We are trying everything we have.
[quietly] Okay.
You wouldn't give me your kidney 'cause of the virus, right? But what if I don't care? Would you give it to me then? - But you'll get infected.
- HIV, it's better than dying.
Would you do it? Yeah.
Of course.
Then let's do that.
I want his kidney.
Vance, you are severely immunocompromised.
If you received an HIV-positive organ, if you contracted HIV in any way, it could immediately progress to AIDS, and that would most likely kill you.
Do it.
Let's just do it.
As your doctor, I strongly Excuse uh, will you excuse us for a moment? Thank you.
We should look into this.
Look into what? Purposely giving someone HIV? He knows the risks.
What does he have? Days? A couple of weeks? That's the thing.
We don't know.
Uh, he could surprise us, and make it long enough to get a healthy kidney.
We could put him on carnitine, try sodium modeling.
That's grasping at straws.
Yes, a transplant is dangerous, but if it works, it could give him years.
It's unethical and illegal.
Even if you found a surgeon willing to do it, the minute anyone found out, our licenses would be revoked.
So we get a special dispensation.
That man is dying in there.
The least we could do is give him a chance.
Natalie I'm sorry.
As the attending physician, I cannot sign off on this.
Then I'll figure it out myself.
I'm gonna call the OR, see if they can bump anybody till tomorrow.
Rhodes, any news? We were actually just about to see you.
Uh, the final reading of the echo showed even more significant disease than we thought.
We need to consider scheduling surgery immediately.
Where's Karina? That patient in there, where did she go? I told her to stay in her room.
Where is she? We'll find out.
Check the ambulance bay.
- You don't know where she is? - Ma'am, just Karina? - [laughing] - Karina? - She's in here.
- [giggles] Sweetie, I need you to step away from that man.
Get away from him! Out of there.
- Mom, it's okay.
- No, it's not okay.
- That man is dangerous.
- But I was just saying hi.
Okay, okay, I know, sweetie.
Can't take my eyes off you for one minute.
It's my fault.
No, that's not true.
Of course it is.
[sniffles] I told him we could remove the chip.
I encouraged him to run away.
You empowered him to make decisions.
That's what good doctors do.
But they were the wrong decisions.
It was the wrong outcome.
And now he's dead.
I mean, who knows.
If I'd have told him to wait, maybe the police would have come and broken up the ring and he'd be free.
[sniffles] I was careless with his life.
Reese you're anything but careless.
Sometimes the best advice, you know, it's just not enough.
Dangerous thing about psychiatry, it can sometimes give those of us who practice it the illusion of control.
But the human brain, it's it is the most complex, mysterious object in the universe.
That means that what we do, it [scoffs] it just doesn't come with any guarantees.
I don't think that makes me feel any better.
I know.
It never does.
[chuckles softly] It must be hard.
It is.
She is such a bright light.
A breath of fresh air.
You should see how people spark up when they see her, and how happy it makes Karina.
It's like she feeds off of it.
If you don't operate I'll be taking that from her.
Do the surgery.
We'll get her upstairs shortly.
[exhales shakily] [exhales] - Dr.
Halstead? - Yeah? Um, April is refusing to take her new medication.
She won't listen to me.
I I just don't know what to do.
You know I'm here to convince you to change your mind.
I'm a nurse.
I stopped listening to doctors a long time ago.
[chuckles softly] I know it doesn't make sense, but there's another life inside of me now.
How can I take a medicine that could endanger it? Hopefully it won't.
I see a lot of hopeful people come in here and we tell them we're doing everything we can.
If I take that medication and something happens to this baby, then I didn't do everything I could.
I can't live with that.
April, you've been put into an impossible situation, and I can't tell you what to do, but if you don't take this medication, there is a very high chance both you and your baby will die.
[sighs] It's unbelievable.
Health and Human Services won't okay that HIV kidney transplant? Won't even consider it.
Our local contact at the FDA.
Deals with compassionate use and experimental drugs.
Might as well try everything.
Thank you.
Looks like our time together's up.
Mm, yeah, you got me, Doc.
Can't put anything over on you.
I sent his prescription ahead to the prison pharmacy.
Yeah, you're a real tough guy, huh? [coughing] Took my best shots.
Bang, bang, bang.
You just deflected 'em like Captain freaking America.
I'm sorry your stay was not satisfactory.
Satisfactory? [coughing] What the hell? Get me a portable chest X-ray, stat.
On it.
Doctor's too smart for a stupid con like me.
- Lungs are clear.
- Doctor.
Come on.
Did he swallow anything? Not that I saw.
[coughing and breathing heavily] Wait, what are those? They look like little stars.
They must have lacerated his esophagus.
Get him up to surgery now.
[coughing and laughing] Wires are in.
Chest is dry.
Let's close the sternum.
Vorspan, was the patient wearing any earrings? No, why? They think she gave 'em to that convict downstairs, and he swallowed them.
You think you've seen everything.
- We'll need wire cutters soon.
- Yes, doctor.
You know they did a study once on oxytocin.
College students exposed to high levels of it just started giving their money away.
Did you see how freely she interacted with that man? Just a total stranger? I've never been good at that.
It's just a symptom of her genetic condition.
But maybe that's not entirely a bad thing.
[exhales] [sighs] Any luck getting someone to approve the transplant? Nope.
Got stonewalled by everybody.
I'm sorry.
[sighs] Time to go tell Jim the bad news.
- I'll come with.
- No.
No, I'll do it.
I'm the one who got his hopes up, so What're you gonna tell him? The truth.
That the one thing he needs most in the world is right in front of him and he can't have it, and he doesn't even have a choice.
- [sighs] - Natalie.
There's still one thing we can do to make this legal.
What're you talking about? He's already said he's willing to deal with HIV infection.
Let's give him the option.
Wait, are you serious? It's his decision.
We'd just be giving him a choice.
You realize the implications of this? I do, but if we wanna save his life, is there any other way? [sighs] Mr.
Vance, I'm afraid that as things stand, there is no possible way you can receive your brother's kidney.
Wait, so there's nothing at all that we can do? No, not as things currently stand.
Even though I know the risk? Even though I wanna do it? That's correct.
It is illegal to give an infected organ to a non-infected recipient.
That's the terrible irony because if you already had HIV, the procedure would be legal.
Now, obviously, we can't give you HIV.
No, but but he can.
And you do have a choice.
[phone ringing] How's he doing? Gonna be off solid food for a while.
Could be a lot of scarring.
We should know more in a few days.
I guess he got his vacation after all.
I just can't believe I let him win.
Really? Does this look like a win to you? He got what he wanted.
So he's a patient that came here to be treated.
That should have been your focus.
Are you saying I should have let him have his way? You know, my grandfather used to say, "Never wrestle with a pig.
" You both get dirty, "but the pig likes it.
" [footsteps approaching] She's gonna be fine.
Back to herself.
"Audentes Fortuna iuvat.
" "Fortune favors the bold.
" Congratulations, Dr.
Good night, Dr.
Hey, Sox fan.
Is it too late for those drinks? What about not upsetting my father? Why stop now? - [both laughing softly] - Okay.
[indistinct chatter] - You need anything? - Uh, no, I'm good.
- Thank you.
- All right.
- Hey.
- Hey.
This is a really great place.
I love the breakfast nook.
- Yeah, thanks.
- Mm-hmm.
Are you feeling good about today? Yeah.
Yeah, I am.
[glass clanging] Hey, everybody.
[chuckles] Um, thank you so much for coming.
Uh, celebrating with the people who know Will and me best, it means a lot, but there is something that most of you may not know about Will.
Uh, he's still got a lot of med school debt [laughter] But he paid part of his way through it by singing at Irish weddings.
- [group chuckles and murmurs] - What? - No, no.
- Come on, come on.
Yeah, you paying half the rent now, buddy.
- Both: Come on.
- No, seriously.
These people are trying to have a good time.
- Everybody wants you to.
- Come on.
- Just one song.
- Okay, Ms.
One song.
She's the boss.
[laughter] That's right.
- Can you hold this? - Yes.
You guys think you're funny, don't you? I know we're funny.
[laughs] [laughs] All right [guitar music playing] Baby It's been a long day, baby Things ain't been goin' my way You know I need you here To ease my mind All of the time Baby The way you move me is crazy It's like you see straight through me Make it easy [laughs] [indistinct chatter on TV] [laughter on TV] [no audio]