Chicago Med (2015) s02e20 Episode Script

Generation Gap

No, I'm not saying that you made it up.
I believe you heard something.
Do you? 'Cause it really doesn't sound like it.
- I'm gonna take the next one.
- No, Dad, no, come.
- We have rats.
- Or we don't.
We've had two exterminators go through everything.
- "We"? - Yes, we, Dad.
We are cohabitating, and we do have rats.
- We'll talk about this later.
- Yes, we will.
[sighs] How about that snow, huh? Springtime in Chicago.
I know what I heard, okay? We just have to get an exterminator who knows what he's doing.
- Hey, Maggie? - Mm-hmm.
I wanna FaceTime with Owen before his nap.
I set an alarm on my phone for an hour from now, but if I get swamped, can you remind me? - Sure.
- He was already asleep when I got home last night and still conked out when I left this morning.
I've hardly seen him lately.
Don't worry I'll remind you.
[moaning] It hurts like hell, I know.
We're gonna get you upstairs and the surgeon will fix the holes the bullet left in your intestines.
- They'll take good care of you.
- [moaning] Dr.
Choi, incoming.
Trauma 2's open.
Elliot Gallagher, 17, got beat up at school.
Multiple facial trauma, chest wall contusions, GCS of 15 with history of loss of consciousness.
Elliot, I'm Dr.
Can you tell us what happened? Those guys, they caught me.
Make sure his parents are notified.
Let's transfer on my count.
Ready? One, two, three.
Elliot, can you take a deep breath for me? [wheezing] Again? - [grunts] - That hurt? - No.
- Good breath sounds.
Let's get him off the board and get a chest X-ray.
Right away.
[groaning] Lungs are up and no broken ribs.
Looks like they're just bruised.
Let's give him 50 of fentanyl for pain.
On it.
Can you turn your head side to side? Chin to chest? Good, c-spine's clear.
Elliot, follow the light for me.
Your right eye doesn't look the same as your left.
I think the orbit's fractured.
Your nose is also broken.
I'm going to quickly realign it.
Pain meds should be working by now.
[groans] Sorry.
Hope they caught the boys who did this.
I deserved it.
You gotta castrate me.
What? I want you to castrate me.
Are his ankles swollen? Just look down and check.
Damn it.
Yeah, all right.
I'm on my way.
- Everything all right? - Not really.
That was my brother.
He's with my dad.
The man's stubborn beyond all belief.
He's had mitral valve regurge for, like, the last ten years.
Oh, man, faulty valves are tricky.
Yeah, and I don't like what Jay's describing.
I gotta get to the L station.
Why doesn't your brother bring him in? Dad hates doctors.
Did I mention he's stubborn? - Well, don't you have a car? - I sold it.
Hey, look, man, waiting for the L train's just gonna slow you down.
Why don't you take mine? Actually, I'd like to take you.
- I'll get my coat.
- All right.
I think about sex all the time.
You're 17.
It's really It's not that unusual.
Sex is for procreation.
That's all.
Oh, so how did you come to that understanding? My parents.
The reason those guys beat me up I was climbing on a dumpster by the girls' gym and was looking in a window to the shower.
It sounds to me like grounds for disciplinary action, maybe, but, I mean, not a beating.
I mean, certainly not castration.
Blonde girls.
It's it's blonde blonde girls.
I follow them.
There's this one girl, Lacey.
She's blonde.
I sit behind her in trig.
One day, I I cut this off.
She didn't notice.
I'm afraid of of what I'm gonna do.
I I was looking up castration online.
They can do it with drugs.
That's what I want chemical castration.
I don't wanna hurt her.
Or anyone.
Elliot is very troubled.
The poor kid is just consumed with sexual thoughts.
Aren't most kids his age? Yeah, but he's been raised to believe that sex is wrong unless it's for procreation.
And repressing his natural urges is triggering aggressive impulses, which he's struggling to control.
- Aggressive? - He fetishizes blondes.
Stalks them.
We're talking about a sexual predator? Not a psychopath.
I mean, he has a conscience.
I mean, I think he could definitely benefit from therapy, but I'm not ruling out those meds.
- Chemical castration, really? - It's temporary, Ethan.
Raping somebody isn't.
We would need the parents' consent.
Manning, a three-year-old with a bilateral lower extremity paresis and gingival lesions in Treatment 4.
Hey, you wanna give me a hand with this? Sure.
Hi, I'm Dr.
Manning, and this is Mr.
Clark, a medical student.
- Hi.
- He's gonna be assisting me.
I'm Amelia.
This is my son, Troy.
Hi, Troy.
I hear you're not feeling well.
Troy is speech-delayed.
He only says a few words.
I'm gonna check you out.
Okay, buddy? When did this start happening? A couple weeks ago, he woke up limping.
When it kept getting worse, I took him in for X-rays, but they didn't show anything.
The doctor wanted him to rest for a week, but it isn't getting any better.
They've been okay at work, but I I gotta get Troy well.
I understand.
This morning, his gums started bleeding.
Hey, let me check your chompers, bud.
- Ulcerations.
- Hmm.
He looks quite thin.
Has his appetite been affected? He's always been a picky eater.
I've got one like that too.
All right, we'll get a copy of his X-rays.
The leg pain and weakness could be coming from a lot of things, so we'll get a CAT scan of his spine and some blood work, and hopefully we'll get some answers.
All right.
- Chocky.
- Not now, sweetie, okay? Chocky, now.
He wants some chocolate milk.
Well, I think we have some of that in the cafeteria.
I'll have some sent in.
We'll check back in a little while.
All right, here are the rest of them.
[doll crying] Why all the dolls? As part of my psych residency, I have to teach high school kids the responsibilities of having a baby, so hopefully they'll exercise a little caution.
The sound circuit is adapted to convert audio data into analog audio output at the speaker.
[laughs] Oh, man, too bad you can't do that with a real baby.
- Okay, can I see it? - Mm-hmm.
Ah, peripheral port is coupled to the micro-controller and connects to the host computer? Uh-huh, so I can monitor how the kids are doing.
- It's ridiculous.
- What? Why? These are cool.
No, I have no maternal instincts.
I have no connection to babies.
I have no intention of having one.
Oh, I'm right there with you.
Good luck.
- Robin? - Oh, hey.
What's looking good? I can't decide.
This is where you grew up, huh? Yep, played a lot of ball on this street.
Everybody knew everybody.
All the grandmas would sit on the front porches.
They were like the original neighborhood watch.
Up there, Mrs.
Riley hated noise.
She used to throw a pot of boiling water out at us.
Caught Jay on the foot one time.
Little different than the Gold Coast, huh? It's nice.
- Hey, Pop.
- What are you doing here? I called him.
Wasted trip.
- I don't need you.
- Are you kidding me? You missed two days of work, and you never miss work.
Pop, this is Connor Rhodes.
He's another doc at the Med.
Told you I don't need this.
Come on, you can barely talk.
I'm gonna take medical advice from someone who wet the bed till he was nine? Never changes.
I gotta get back to the district.
Thanks, Jay.
Don't let the door hit you on the way out.
Halstead, I'm seeing some things that tell me that your heart isn't working very well.
Your fingertips are purple.
You're having a hard time breathing, and your energy seems depleted.
Had this heart thing forever.
It's it's never been a problem.
Do you mind if I have a listen? If it'll get you two off my ass.
Apical holosystolic murmur and the lungs are wet.
In English? It means that your heart has been compensating for the faulty valve for a very long time, and now it can't keep up, so fluid is backing up into your lungs.
It literally means you're drowning in your own blood.
We need to get you to the hospital.
- I'll call an ambulance.
- Like hell you will.
I'll be damned if I'll have neighbors see me hauled out of here in an ambulance.
- Mr.
Halstead - No.
If we're going, I'm driving.
Oh, no, no, we'll drive.
[groans] Ah! I got it.
- I'll call the ambulance.
- No! Just move your asses.
April, I got a patient walking into the ambulance entrance.
- Can you get a wheelchair ready? - Walking in? Uh-huh, it's Dr.
Halstead's dad.
- Hey, you're going to Treatment 6.
- Yep.
Problems getting an ambulance? - No, problem with the patient.
- I don't need that.
- I got it, I got it.
- Okay.
Easy on the bed.
Damn it, I got it.
[groans] All right, let's get him hooked up.
Will, you wanna get him on oxygen? - Yep, Pop - Yeah? on a scale of 1 to 10, how bad's the pain? I've had gas that hurt worse.
All right, T wave inversions, ST depressions.
It looks like he's having a NSTEMI.
Let's give him 81 milligrams of aspirin and a dose of nasal nitro.
Let's get cardiac labs, CBC, CMP, coags, and a chest X-ray.
He's gonna need a formal echo, but, in the meantime, let's take a quick look at the heart with the ultrasound.
Bilateral pleural effusion and congestion.
Yep, you see here? Mitral valve is wide open and the LV is dilated.
Halstead, it's just like we thought.
Your heart is working way too hard to compensate for your bad valve.
First time I've ever heard of hard work being a bad thing.
- You got a fix? - We will.
We're gonna get you an angiogram, and it'll give us a full picture of your heart, and then we're gonna figure out a plan.
Let's get him up to the cath lab.
Don't worry, Pop.
We can beat this.
Who the hell's worried? All right, let's go.
Will? My dad, his heart.
He needs a cath.
Oh, I'm so sorry.
Let me know how it goes.
Natalie? Head lac in Treatment 2.
I'll shoot you the chart.
And don't forget to FaceTime Owen as soon as you're out, okay? Oh, thank you.
- The three-year-old.
- Mm-hmm? Test results are back.
CT was clean, blood work indicates mild anemia.
Mm, nothing to explain the limping or the lesions.
Maybe we're dealing with lead poisoning or some sort of tox? Yeah, um, let's do a tox workup and look for heavy metals, and get a babygram while you're at it.
It could also be abuse.
- Let's not go there yet.
- Can I help you? - It's our son, Elliot.
- They said he was in a fight.
We got here as quick as we could.
- We got a call from his school.
- Okay, Dr.
Choi? - He'll take you to him.
- Dr.
Choi, Stan Gallagher.
- This is my wife, Debbie.
- What happened? Uh, Elliot got into an altercation at school and suffered an orbital blowout fracture.
The eye surgeons want to get him to surgery.
He's right here.
- [gasps] - Oh, my God.
Oh, my poor baby.
Elliot, who did this to you? He's still a little groggy from the pain meds.
Why don't we let him rest while we talk? The bracelets you're wearing have a sensor which registers when you feed, bathe, or diaper the baby.
If you shake the baby to stop its crying, it will shut down and register as being abused.
Are you a real doctor? Sometimes I wonder.
Uh, anyways, uh, recent studies have shown that talking, reading and singing to babies is crucial for early brain development, 80% of which occurs during the first three years of life.
These dolls record the amount of time you spend doing these activities, so, obviously, the more, the better.
Need anything, Dr.
Reese? Uh, no, I'm fine, Mr.
[sighs] Any questions? I don't get it.
We're supposed to be talking to a doll? [laughter] Or reading or singing, mm-hmm.
Any other questions? What operating system are the dolls on? I don't know, and, really, why is that relevant? I have PE today.
What should I do with the doll then? That is a problem you will have to deal with.
The point of this is to understand the impact having a baby would have on your life.
I will see you all at the end of the day to check on your dolls.
So a kid got beat up.
What does he need a psychiatrist for? Well, Elliot was caught peeping on girls - in the shower at school.
- Oh, my God.
Wait till I get him home.
But much more troubling are some violent impulses that, so far, he hasn't acted upon.
And there is something we can do.
Elliot wants us to give him a medication that would turn off his testosterone.
This would significantly decrease his sex drive and make it much easier for him to control these impulses, but we do need your permission to do it.
"Turn off his testosterone"? What exactly are you talking about? The medical term is chemical castration.
- What? - It's completely reversible.
The idea would be to combine it with traditional therapy with the hope of ultimately weaning him off the medication.
No, no way.
Elliot could very well be on the verge of acting out on some very disturbing impulses, including rape.
He would never do anything like that.
You people are sick.
Again, this was your son's idea.
Elliot is torn up about this.
He's scared he may not be able to stop himself.
This is ridiculous.
Fix his eye, and we're taking him home.
- Where's your dad? - The restroom.
He shouldn't be up after his cath.
He couldn't use a bedpan? Practically threw it at my head.
[coughing] [groans] [coughing] - I'm here if you need me.
- I won't.
So, Mr.
Halstead, the results of your cardiac cath show that your heart has been under stress for so long from the mitral valve regurgitation that it's basically giving up.
This is why I told you to get it checked regularly.
If we knew about the regurge, we could've gotten ahead of this.
Yeah, so what? I'll fix it now.
Well, there's another issue, unfortunately.
Your left anterior descending artery is 80% blocked.
Now, that is the largest artery.
It supplies half the heart with blood.
The question is "Am I done?" I can do a surgical replacement of the valve, and, while I'm in there, do a bypass for the blocked artery.
Are you talking open heart surgery? It would involve opening your chest, yes.
Now, if you wanted to go non-surgical, a cardiologist could place a clip on the mitral valve to try and control the regurge and do angioplasty to open up the blocked artery.
Do you have a good cardiologist? We do, but I I strongly recommend that you let me operate.
The long-term results of surgery are much better.
Mm-hmm, exactly.
I'm going non-surgical.
- Pop - Hey, if you don't like it, you don't have to be here.
I'll set it up.
Now, you know I should be cracking his chest, right? So why did you give in? Hey, you're the one who gave him the non-surgical option.
No, I laid out his choices, Will.
- I pushed for the surgery.
- Not hard enough.
You're his son.
You should be the one trying to convince him.
He won't listen to me.
My dad considers me something of a disappointment.
Oh, yeah, he didn't even want me to go to college.
Says a real man goes right to work.
He doesn't give a damn what I have to say.
So why don't you get Jay to try to talk to him? It won't help.
No, Jay and him have their own history.
Everything's coming back normal.
Maybe we're dealing with some sort of weird vasculitis.
Henoch-Schonlein purpura or Kawasaki disease? Or possibly an infectious disease or rickettsia - like Rocky Mountain Fever - [splattering] - Chocky, now! - It's okay, baby.
We'll get you some chocky.
Uh, the chocolate milk never came? No, the cafeteria was out, and he won't drink the plain.
Well, you can't fault a kid for knowing what he likes, right? Is there something else that he likes? Graham crackers.
When I get home at night, all he wants is chocolate milk and graham crackers.
It's hard not to give in when it's late, and I'm tired.
Let me go see what I can find.
Uh, you said he's picky at night.
Is he better during the day? I'm pretty sure he eats other things.
Pretty sure? He has a couple sitters.
The neighbor's kid, the woman upstairs.
It's possible they're not as firm as they ought to be.
I can't afford daycare.
I understand.
I'm gonna send a nurse in to draw blood for one more test.
and Mrs.
Gallagher, I need to get Elliot up to pre-op holding.
The eye surgeon will be calling for him any minute.
We'll be in the waiting room.
I'm guessing your parents told you they wouldn't approve the chemical castration.
No, but my mom read me Thessalonians 4:3.
God's will is for you to be holy, so stay away from sexual sin and immorality.
Both Dr.
Charles and I tried, but since you're still a minor Yeah, I figured.
All right, whatever.
Look, I'll talk to Dr.
Charles and see if we can come up with some other options.
All right, numbers look good.
Breathing great.
Feel like I could pitch nine innings.
It's what every team wants a 60-something starter with a bum ticker.
At least nobody had to cut my chest open to fix it.
Admit it, kid, I was right.
You got that fancy degree, but I'm still the one calling the shots.
I didn't say this course of treatment wouldn't work.
I was more concerned with the long-term.
That right? 'Cause to me it looks like you're back-pedaling so much you're gonna start sweating.
Oh, believe me, that is the last you'll hear about it.
Well, since you made me miss the end of the game, let's, uh, see if I can find some highlights.
I guess I should start with an apology.
And for the foreseeable future The cleanest, whitest white.
[knocking] Yeah? Hey, Dr.
Charles, you you got a second? - Uh, yeah, kind of.
- Okay.
I'm worried about Robin.
She she's not acting like herself.
She is, uh, she's convinced that there's rats in my condo, but I haven't seen them or heard them, and no exterminator can find them.
Rats can be pretty clever.
Not that clever.
And, aside from that, lately I there are times when I find Robin just staring off into space.
Well, I mean, that's not that odd.
I mean, I do that all the time.
- It must be a family trait.
- I think it's more than that.
How so? Like I said, she's not acting like herself.
I I just feel like there's something off with her.
Well, I mean, there is that new living situation.
Cohabitation can be awful stressful.
Charles, I hope you realize that I wouldn't have come here if I didn't think this was important.
And you know what? I appreciate that, but I was supposed to be on a conference call, like, two minutes ago, so can we pick this up later? Yeah, all right, you bet.
- Well, thank you for your time.
- Thank you.
[door slams] - Did you find anything? - We did.
Based on Troy's limited diet, we checked his vitamin C levels.
The results show a significant deficiency.
Well below normal.
Troy has scurvy.
It's what's causing his symptoms.
I don't understand.
Scurvy? Isn't that something sailors used to get? It was, historically, but anybody with prolonged dietary deficiencies is susceptible.
Well, how is that possible? We were surprised too.
It's not something we see.
It's been all but eradicated in developed countries because it's easily preventable with a balanced diet.
You mean he's sick because of what he eats? More like what he doesn't eat.
It's a parent's job, Ms.
Bohlen, to make sure their children get nutritious foods.
- Excuse me? - This never should have happened.
You should have been monitoring Troy's diet.
That's easy for you to say.
You know nothing about my life.
I work two jobs to support my son.
I am gone from 6:00 a.
to 8:00 at night.
You have no right to judge.
I would do anything to protect him.
Excuse me.
Please explain the course of treatment.
Halstead, I'm Sharon Goodwin, executive director of patient and medical services.
I thought I should say hello.
Well, how you doing? Well, better question is, how are you doing? Oh, other than a lack of sports channels in this place, I'm feeling pretty all right.
You know, we think quite highly of your son around here.
Oh, kid's got you snowed, huh? You know, you look a little pale.
Are you sure you're feeling okay? I'm fine.
Page Dr.
I'm concerned about your breathing.
I'm gonna increase your oxygen.
- What happened? - He's throwing runs of PVCs.
Give him the ultrasound.
How you feeling, Mr.
Halstead? Like I just told her, I'm feeling fine.
I don't think you're doing as well as you say you are.
Why don't we have a look, huh? Half the mitral valve clip came off.
It's flopping around.
We need to get you to surgery.
Can you fix it? Like before? No, we can't.
We need to operate, and quickly.
If the other half comes loose, the clip could end up in your brain or somewhere else you definitely don't want it.
Wait This is not up for discussion, Mr.
No, just just don't tell Will.
I don't wanna have to hear him crowing.
We won't, but I'm afraid he's going to find out anyway.
Yeah, yeah, okay.
Sorry, hold on.
Hey, what's up? I can't find my wallet.
Oh, let me get it.
My coffee, her yogurt.
Come on, go sit down.
I think someone stole it.
Oh, my God, now I'm going to have to cancel my credit cards and get a new driver's license.
[sighs] - That it? - Oh, thank God.
Ah, the old side pocket.
Is everything okay, honey? Damn it, Dad, I know that look.
You're trying to shrink me.
- We're just talking.
- We're having some coffee No, we're not just talking.
You never just talk to me.
- It is always a psych evaluation.
- Robin, come on.
Just because you are a head case, Dad, does not mean that I am.
Stop looking for things that aren't there.
Thank you for your participation.
Thank you for your participation.
Thank you for your participation.
Thank you.
Uh, Marla, would you hang back a sec? - Uh, sure.
- Yeah, okay.
- Your score, very impressive.
- Thanks.
You fed it regularly at two-hour intervals and verbally interacted a total of six hours.
You said more was better.
Uh, how did you have time to do anything else? Uh, multi-tasking.
You hacked your doll.
What? No.
Okay, just because I am 26, don't think I am some old fool.
This score is impossible.
Yeah, I hacked it.
[sighs] Don't worry, Mr.
We're gonna get that mitral valve fixed.
Damn it.
The kid was right.
Not so much a kid anymore, is he? No.
Did you know he put himself through college? I told him told him it was a waste of time and damned if I was gonna pay for it.
Well, I'm sure you're very proud of him.
That doesn't even begin to say it.
He made something of his life.
He's a better man than I am.
I don't think he feels that way, sir.
And I'm sure that he wouldn't want you to either.
We need to get started, Mr.
Halstead, are you ready? Yeah.
I spoke to the surgeon.
Everything went great.
Once the dressing is off, your vision should be back to normal.
I'll be back in a bit to check on you.
I went off on that boy's mom.
Oh? - But it was really about me.
- Mm.
I wasn't mad at her.
I was mad at myself.
Am I a horrible mother? Yes, you are.
Nat, you're just having working mom's guilt.
Relax, man, Dad's too stubborn to die.
Any word? Not yet.
I heard you were there when he went back into failure.
- Mm-hmm.
- Thanks for jumping in.
Well, it's good to flex the nursing muscles every now and then.
He did great.
Brand new mitral valve is fully functioning.
Shouldn't give him any more problems.
Told you.
- Thanks, man.
- You got it.
- Nice work, Dr.
- Thank you.
Well, I'm gonna head back to the house 'cause he's probably gonna need some stuff.
- Mm-hmm.
- All right? - See you, Jay.
- Yeah.
Thanks, Connor.
If my dad hadn't pulled through Yeah.
I gotta say, man, what you guys have? It's pretty great.
Are you serious? All we do is fight.
Yeah, well, me and my dad we barely even talk.
That doesn't sound too bad to me.
Take my word for it, Will.
You got a good thing going.
Elliot? [knocking] Elliot? [door slams] Elliot, what are you doing? She looked cold.
Step away from her.
Elliot, open the door.
Page security! Elliot! [screams] - Elliot? - [screaming] [screaming] I need a gurney with soft restraints - and some ABD pads.
- [screaming] Get me some ice and 50 mics fentanyl IV now, and page Urology.
[sobbing] Just relax, Elliot, Elliot, Elliot.
- Just relax, buddy.
- [hyperventilating] The procedure to repair the testicles is complicated, but the urologist is optimistic.
How did this happen? What did we do? You know, in my experience, there's actually very little to be gained from looking backwards.
The important thing to focus on is "what do you do now?" Hey.
I just saw Natalie.
She told me your dad's in the hospital.
Yeah, mitral valve and blockage.
He should be awake now.
I'm headed up.
Will, I'm glad he's doing well, but how come I had to hear it from Natalie and not you? Yeah, sorry.
It's been a little crazy.
You had time to tell her.
Listen, why don't you come with me? If Dad's up for it, I'll introduce you.
No, just let me know how he's doing.
I will.
[knocking] - Yeah? - Am I interrupting? Actually, I'm glad you're here.
I have something to show you.
Proof that we have got rats.
I picked up some of their droppings.
I don't understand.
They were they were here.
They were here! Weren't they? Honey, I'm saying this as a dad, not a shrink.
I would just feel a whole lot better if we could get somebody to, you know, take a take a look at you.
What do you say? Okay.
So did you flunk her? - No, I couldn't.
- Mm.
She was overwhelmed.
She's taking all these AP courses and doing all that extracurricular stuff that you gotta do - to get into a good college.
- Man, I hear you.
Math Club? - A lot of better ways to spend my time.
- Mm-hmm.
And the thing is, I did it too.
I hacked my doll when I was in high school 'cause I was overwhelmed.
I mean, to tell you the truth, Noah, the real reason I don't wanna have kids is it's too hard.
I How is anybody supposed to do it all? Nah, you'd be good at it.
Why do you say that? I watched you.
You're like that girl, cagey, resourceful.
You can't hack a real baby, Noah.
Yeah, you're right, all right.
And what do you mean, you watched me? You know.
- Hey.
- Hey.
I heard your dad's doing well.
Yeah, I'm sure he's making the nurses miserable.
They can handle it.
- I better get up there.
- Okay.
We're waiting for a bed, then we'll transfer Troy upstairs.
We're gonna get you feeling better soon, okay, buddy? It takes a few weeks to get back to normal, but his prognosis is good.
He should have a full recovery.
You waiting for a thank you? One of our social workers is gonna come in and talk to you about nutrition, help you with Troy's diet.
[scoffs] And I'm sorry.
I know it isn't easy holding everything together.
And, to tell you the truth, every day, I worry if I'm doing right by my kid, so.
All right.
Hang in there, champ.
Hey, Pop, how you feeling? Like I took one on the chin.
You kind of did.
Maybe now, if something's cooked in bacon grease, you'll think twice? You know, in fact, we need to have a talk about all the junk food you eat.
And the beer.
What? I mean it.
When we get home, there're gonna be some changes.
Thanks, kid.
I love you.
Love you too.
Who is that? Can you say hi? - Can you say hi? - Hi.
- Can you say hi? - Yes, oh.