Chicago Med (2015) s03e08 Episode Script
Lemons and Lemonade
1 [THE KILLERS' "THE MAN".]
I'm the man Come 'round No-no-nothing can break You can't break me down I got gas in the tank I got money in the bank I got news for you, baby, you're looking at the man I got skin in the game I don't feel no pain I got news for you, baby, you're looking at the man [DRAMATIC MUSIC.]
Thanks.
Wow, some showy new wheels.
Not cheap.
What are we talking? 125? In the neighborhood.
Not one I've ever lived in.
Morning.
Good morning.
Nice looking.
But is she attracted to you or the car? I'm gonna go find out.
Catch up to you later.
- Hi.
- Hi.
- Connor.
- Lisette.
That's it.
You got this.
Nice job, little man.
I think you got a future architect here.
Or a demolitions expert.
[BABBLES.]
Oh, I get a turn.
Thank you.
Oh, is that good? You like that? Told ya.
We'll just have to rebuild it again, now won't we? Ow! What happened? I have no idea.
Are you okay? - [BABBLES.]
- Yeah.
"Patton.
" "The Evil Dead.
" "The Dirty Dozen.
" "Texas Chainsaw Massacre.
" Come on, all your favorite movies can't be slasher films.
Better than World War II flicks.
They're classics.
What can I get you? Chai tea latte, almond milk, no water, no foam, extra hot.
You got it.
Black coffee.
It is mystifying how little we have in common.
Luckily, opposites attract.
Works for me.
Got a chai tea latte, no water, no foam, almond milk, extra hot.
- Thank you.
- Really? Hers comes out first? He'll pay.
Catch you later.
[DISTANT SIREN WAILING.]
I need a doctor, please! - What's wrong? Are you hurt? - Not me, a woman, two blocks over, she's on the ground, isn't moving.
Show me.
[DRAMATIC MUSIC.]
Excuse me, excuse me.
Hey, can you hear me? Can you hear me? Who saw what happened? She jogged past me, then she just fell.
I called 911.
- God, is she alive? - Barely.
Can't wait on the paramedics.
I need you.
20-something female went down while jogging.
Barely awake, weak pulse, hypothermic.
Let's get her on the monitors and start a line.
Bolus a liter of warm saline and grab some blankets.
We need to raise her body temp.
She's pretty bundled up.
How long was she exposed to the elements? On the ground.
Two, maybe three minutes.
That's it? And she's hypothermic? Yeah.
Oh, God.
- There's nothing to her.
- Let's get her up.
Okay.
This side.
Hair's brittle and thin, lanugo covering the skin.
Anorexia.
Stethoscope.
BP 88/50, heart rate 50s.
EKG is sinus Brady.
Bilateral crackles.
Her eyes are yellow.
She's jaundiced.
God, I can feel right through her to the bed underneath.
Where am I? Hey, in the hospital.
Can you tell me your name? Allison.
Allison, I'm Dr.
Choi, I'm gonna help you, okay? I'm okay.
I just need to rest.
Let's get a CBC, CMP, LFTs, a chest x-ray and a 12 lead EKG.
Yep, on it.
Morning, I'm Dr.
Halstead.
Asterid.
It looks like you're hurting too.
Need a hit? [CHUCKLING.]
Thanks, but let's get you squared away first.
What happened? I was running up the stairs to the platform to catch the train.
By the time I got to the last step, I was [GRUNTS.]
I was so exhausted, I tripped.
Landed on my arm.
Is it broken? Well, maybe.
We'll get some X-rays.
Lean forward for me.
[WINCING.]
Ah.
You okay? I tweaked my back a few months ago.
Free clinic gave me some anti-inflammatories.
Said they'd help.
They haven't.
I even crushed them up and snorted them.
What? Just kidding.
I'm a stand-up comic, so when I see an opening for a joke, I have to take it.
Well, timing was excellent, I'll give you that.
Where does your back hurt? Uh, it's a sharp pain down here.
Mm-hmm.
More throbbing up here.
The fall made it worse, didn't it? Well, I can't say without a CT, but no bruising or swelling, so that's a good sign.
Hang tight.
The techs will be by soon to take you up to Radiology.
Maggie, which nurse do you have covering Asterid in Treatment Four? You're looking at her.
Double duty again, huh? Yep, twice the work for me, and yet, it's the hospital's bank account that benefits.
You know, trickle up economics.
Absolutely.
Nice shiner.
I haven't seen one of those on you for a while.
This time, it wasn't my fault.
[LAUGHING.]
South side boy.
Somehow, I don't buy it.
What do you need in Four? AP lateral of the left elbow and a CT chest and belly with contrast.
You got it.
Dr.
Reese.
Welcome back.
How are you doing? Great, great, very eager to dive back in.
Fantastic.
Just for the record, easing back in is okay too, but thrilled you're here.
How's therapy been going? Oh, well, it better be going well.
Daily counseling, anger management sessions, meeting with the hospital attorney.
And remember, not intended to be a punishment.
Oh, no, of course not.
It's actually a great way to grow professionally.
Can't hide from it.
It keeps the secrets - in their pockets.
- Wonderful.
20-something woman, agitated and out of control.
PD found her running around in the middle of the I-90 express lanes.
- What's she on? - Nothing we can tell.
No track marks or tweaking signs, but a lot of rambling.
Our insides, holding in Airway's clearly intact.
Obviously has no problem moving four limbs spontaneously.
I'd say my job is done.
She's all yours.
Thank you.
Dr.
Charles, Treatment Three, can't wait.
But now I see how everything is filled with water Oh, man.
Um Go ahead, I've got Jane Doe.
Do a full assessment, and we will staff it later.
Thanks.
You good? I'm good.
Welcome back.
Don't open the box, no.
Open the box, no.
Don't open the box.
Back and forth, on and off.
Allison, how you doing? We're here easy, easy, easy, easy.
Allison, I'm Dr.
Charles.
Shrink.
So, um, something tells me this isn't your first time in an ED.
Not just saline, is it? D5? Well, your blood sugar was 44, so you know, the dextrose Treats hypoglycemia and all that comes with it, I know.
But at 170 calories per liter If I can get 80 per mile, home to lake and back is four, that's 320.
So, is your math working out? Are you gonna be able to burn off those extra calories? [DRAMATIC MUSIC.]
I don't need to be here.
Check my levels, vitamins.
Potassium.
They'll be normal.
What is the go-to trick these days for, you know, gaming those numbers? You guys still sucking on lemons or, I don't know, I heard that guzzling vitamin water is kind of coming into vogue.
I mean, it's none of my business, but I am curious.
How long has it been going on for? Five years? Ten? 15? 15 years? At least 15 years.
I want to go home.
Okay.
[STRAINING.]
Allison, you know, if you can't get out of bed, you know that I can't I can't let you go, right? And you do know what that means.
5,000.
1,000.
4,000.
1,500.
- 3,000.
- Two.
Three.
Fine.
3,000 calories.
And it has to be through your nose.
[HEAVY BREATHING.]
If this goes.
Mm.
Got yourself a deal.
And following the fingers, you can count, the count likes to laugh, and he's just a puppet, sometimes I feel like a puppet, - with someone operating me - I'm Dr.
Reese.
- Can you tell me your name? - Not operating on me.
Because surgery belongs in another part of the hospital.
Each part separated by a floor, a floor made of marble or wood.
Can you tell me how you got here? Cooking things through at a slow heat.
- The temperature cooks evenly - Where do you live? Through me to the core of my eyes and my brain, and none of it will stop.
Watching the whirring, watching the whirring, go, go, go, go, go, go, go.
Foot, foot, left, right, left, right.
Back and forth, on and off, on and off, on and off.
Back and forth, on and off, the switch, the light switch breaking Meds first, talk later? Please.
Uh, let's get her Risperdal M-TAB two milligrams, should calm her down.
All right.
I don't know why I let you talk me out of coming here yesterday.
I'm fine, it's just a really bad cold.
It's our first vacation together.
Emergency room's not on the itinerary.
Temp's 100.
4.
See, Hannah, it's barely a fever.
God forbid he let on that he's sick.
- I've got a stubborn one also.
- Mm.
Me too.
Lymph nodes are enlarged.
All right.
I'm gonna have you open your mouth for me.
He hasn't eaten in three days.
He can barely sip water.
It hurts that bad.
Throat's pretty raw.
Tonsils are swollen.
Yellow exudate.
- What's that? - Pus.
Maybe an infection.
See, we should've come yesterday.
I'll get a rapid strep test.
And let's get a CBC and BMP also.
I'm sorry.
I just wanted the trip to be perfect.
And I just want you to be healthy.
Well, hopefully we can solve both of your problems.
I'll be back shortly.
What, you keeping a secret? - Hey.
- "Your Toddler and You.
" Is this business or pleasure? Both.
I'm looking for ideas on how to get Owen to like me.
What makes you think he doesn't? Oh, I don't know.
[LAUGHING.]
You worry too much.
Hey, Owen's number one in Natalie's life.
If I can't make it work with him, I got no shot with her.
Well, let me break down toddlers for you.
They eat, sleep, poop, and play.
Help 'em out with any one of those things, and you're gold.
Radiologist's report.
Asterid's arm X-ray and CT scans.
- And no fractures? - Mm-hmm.
Just soft tissue swelling.
Let's wrap her elbow up and put it in a sling.
Got it.
Whoa.
What is it? Her CT.
I need Connor and Dr.
Neal in Urology.
I got it.
3,000 calories? It's all she's willing to accept.
Why are you negotiating? Dangerously low albumin, renal insufficiency.
5'6" and less than 70 pounds.
Dr.
Charles, I carried her in, she was nothing.
She needs high-calorie, long-term nutrition.
I agree.
Then what are you doing? Anorexia is actually the most deadly mental illness that there is.
Every instinct she has is telling her to resist this, and I don't want to push her any harder than she'll let us.
- Then let me push her.
- No.
I made a deal, we have to honor it.
Trust me, it's her best shot.
Listen, we get 3,000, and you'll go back for more.
- Of course.
- Dr.
Choi, Allison's parents are here.
Waiting room.
Thanks, Mags.
I'll fill them in and place the feeding tube.
Is she the worst case you've ever seen? Healthy BMI is 18 to 25.
Hers is 11.
If she's going to survive, we can't afford to make any mistakes here.
She's killing herself.
So, um, so catch me up on Jane Doe.
Um, no idea on her.
Maggie is working with PD to get a name.
Tox screen is clean, this isn't drug-induced.
And I'm thinking bipolar mania.
Rapid speech, psychomotor agitation, flight of ideas, plus she hasn't bathed in days.
So, presumably, she went manic and fled wherever she was living? - Mm-hmm.
- You started her on Risperdal? It hasn't made a dent.
I want to double the dose and add a second mood stabilizer.
You ruled out all the possibilities? You know, schizoaffective disorder, temporal lobe epilepsy, delirium, other mood disorders? Why? Mania can be diagnosed through pattern recognition just like I've done, and there's been no clinical indication to keep digging for anything else.
Just humor me, okay, doctor? Look, it's your first day back, before you add any other meds, just check all the boxes, see if you don't think it's necessary.
Physical, neural exam, motor function, head CT, all that stuff, okay? - Okay.
- Okay, good.
I wish there was something I could do.
Hi, guys, Uh, so, Tommy, you do not have strep.
But your body is most likely fighting off a bacterial infection.
So, I'm gonna start you on clindamycin, which is an oral antibiotic.
Whatever the bug, it'll take care of it.
So we can get out of here? Yes, but please, just try to take it easy the next few days.
As cliché as it is, rest is the best medicine.
I won't let him leave the hotel, promise.
Ow! Are you okay? My ankle.
Why don't you let me take a look? [DRAMATIC MUSIC.]
Whoa, that's really red.
- You didn't feel anything? - Uh-uh.
Hot and fluctuant.
- I and D it? - Yeah.
Now, I'm gonna make a small incision, so that we can get a sample, okay? All right, and when I ask you to, I'm gonna have you take a deep breath, and exhale for me, okay? All right, this is gonna hurt a little bit, all right? Just take a deep breath in.
Good.
And another one.
[GRUNTS SOFTLY.]
And again.
Good.
[WINCES.]
One last time.
[SIGHS.]
Great job.
All right, here comes the incision.
Ow! [GASPS.]
[GROANING.]
Oh.
Is that what's in my throat? How did it get in his ankle? Let's just wait and see what the lab says.
Bad news, though, you guys are gonna have to hang out here a little bit longer, I'm sorry.
All right, you need anything, I'll be close by.
Bacteria can travel once it enters the bloodstream, but for a new infection to manifest that fast Yeah, something's definitely going on.
- See you in the lab, okay? - Yeah.
It's cancer? Yeah, it's likely renal cell carcinoma.
The tumor extends from inside your left kidney, into the inferior vena cava, and up into the right atrium of your heart.
You never had a sprained back.
The pain is from ureteral compression.
You were exhausted running up the stairs because the tumor was blocking blood from returning to your heart.
Asterid, you following us? Yeah, I'm just trying to find a joke to cope with all of this.
That's okay.
We'll find the funny after you've beaten this.
Mm-hmm.
Seriously, I'm not dying? No.
No, the cancer is treatable.
The tumor is operable.
Now, to get all of it, I'm gonna have to involve other surgeons, and unfortunately, we will have to remove your left kidney.
But you can live just fine with one.
[DRAMATIC MUSIC.]
I know it's a lot to take all at once.
You don't get it.
I do open Mic night.
Those gigs don't come with health care plans.
And the three jobs that I do have barely cover the rent.
So I can't pay for this.
You don't have to.
The tumor invading your heart is life-threatening, and that means that Medicaid will cover the surgery and the resulting recovery.
It's not gonna cost me anything? No.
We're gonna take care of you.
Allison, I'm gonna put this tube in your nose.
When you feel it in your throat, I need you to swallow.
Allison, you understand? Okay, here we go.
[GAGGING.]
Swallow.
Allison, swallow.
There you go.
It's going in, nice job.
It's going to work this time.
We've tried helping her for years.
Doctors, rehabs.
No matter what we do, she just keeps withering away.
Sometimes, being out of options is what it takes to instill desire to get better.
X-ray.
Tube's in.
I'm gonna turn on the pump now.
[HEAVY BREATHING.]
[CRYING.]
Allison, Allison.
Look at me, look at me.
- Slow breaths.
- I can't.
Yes, you can.
You can do this.
- You're fine, you're - No, no, stop.
- Just relax, just relax.
- Stop it.
I can't do it.
I need it out! Hold on, hold on, hold on.
No, no, no, no, no! [COUGHING.]
We'll try again.
No.
I'm done.
Allison! I said I'm done.
Why don't we give Dr.
Choi a moment to prepare another tube? - Maybe we can - You're not hearing me.
I want my lawyer.
I'm serious.
Get my phone.
I'm calling my lawyer now.
Will, I'll come find you when we're done.
I'm good.
Kidney free? Yep, from everything but the renal vein.
I'm vessel looping the inferior vena cava below it now.
I'm curious.
You score a date tonight? I did.
How's it going on your end? Opening the right atrium.
I can see the bulb of the tumor.
There we go.
Your turn.
All right.
Tumor is one long stalk now.
I'm gonna tease it out as we remove the kidney.
Kidney is detached.
And here we go.
All right.
Got it.
- One piece? No stragglers? - It's whole.
Impressive.
Bet your mojo's gonna last all night long.
Lucky girl.
We will conquer the evil beast that live inside, and I shout them out, out, out, out.
And the winds blow by, and carry my breath into the sky.
God's shouting down and carries my clothes into your head.
And I will conquer the evil beast that live inside Thanks, Trudy.
Dr.
Reese? I just got off the phone with PD.
A woman named Melissa Withers filed a missing persons report about her sister, Jamie.
Description matches your Jane Doe.
Out, out, out, out, out, out, I pray.
And to follow the pages as they turn, thumbing through.
Do you got a phone number for Melissa? For Melissa.
[DRAMATIC MUSIC.]
Déjà vu.
I had pneumonia, right after college.
Spent two weeks in the hospital, Waukesha, Wisconsin.
Let me guess.
Same vending machines? It's amazing.
Cafeteria makes a great smoothie.
No, I-I want to stay close to Tommy.
I'll find something.
Hey, so, the clindamycin is not gonna work.
Bacteria pulled from his ankle: gram-positive cocci.
- A staph infection.
- Yeah.
So, let's switch to IV Vancomycin.
Staph can be a sticky bug.
We need to be more aggressive.
- Okay.
- Thank you.
So we clear to try another feeding tube? Um, no.
We are not.
Apparently, Allison was prepared for this moment.
She's already had papers drawn up to prevent forcible feeding.
Hospital lawyers don't want to fight it.
That's insane.
They'll just let her die? Well, legally, they don't have a move.
Precedent's already been set in the courts.
In each case, the patient's wishes were upheld.
So we go to the parents.
Don't they have a say? Allison's an adult, Ethan.
I mean, ultimately, she decides her own fate.
So, there's nothing we can do? Look, after seven years, anorexia is considered severe and enduring.
This poor lady has been struggling for more than 15.
Her entire being is fixated on gaining control, and holding onto it.
Even if it kills her.
So regardless of the injunction, or her parents love The odds of her recovery are Hey, there.
How you feeling? All things considered, fantastic.
I mean I'm down a kidney, but at least it didn't cost me an arm and a leg.
See, you got your sense of humor back.
Kind of.
Yeah, that was pretty awful, huh? Look, jokes aside, thank you.
Sure.
So, I'm gonna be back to check on you in a couple hours, but before we head out, any questions? Just one.
My right leg is achy.
Around the shin.
Never felt it before.
Maybe a side effect from the anesthesia? Could be.
Let me speak with the anesthesiologist and see what he thinks.
Right now, you just get some rest.
Leg pain? That's not from the anesthesia.
No, but let's not say it out loud without an X-ray.
I'll get it going.
Hannah.
[HEAVY BREATHING.]
Hannah? Oh, my God.
Tommy? Help.
Help! What's happening? Temp's up to 104.
He's tacky.
BP's 94/62.
Septic shock.
First dose of Vanc didn't work.
Bolus a liter of normal saline, and push IV Tylenol.
Tommy, can you open your mouth for me? What are you looking for? Abscesses that weren't there earlier.
Nothing dental or oral.
Help me search his skin.
[SHIVERING.]
Nothing on this side.
Here either.
Get a cooling blanket.
He should be getting better, but he's only getting worse.
It's gonna be okay.
It's okay.
Hey.
Hi.
Tommy's latest labs.
He doesn't have a staph infection.
Vancomycin-Resistant Enterococcus.
- The super bug? - Yeah.
And one that is not easy to get.
VRE's a nosocomial infection.
It lives in hospitals.
I don't think I've ever seen it contracted anywhere else.
Hannah.
She had pneumonia a decade ago.
Was hospitalized for two weeks.
Could've picked it up then, had it ever since.
Asymptomatic carrier.
Intimate relationship, lots of ways she could've passed it on.
Okay, let's start Tommy on IV Linezolid, swab Hannah's nose and throat for the bacteria, confirm she's the source.
- Got it.
- Thank you.
[SOLEMN MUSIC.]
[ELEVATOR BELL DINGS.]
Oh, Dr.
Charles, our Jane Doe is Jamie Walker, an aspiring chef in culinary school.
Huh.
A month ago, she started staying up all night, reading the Bible, and writing a manifesto.
Last week, she dropped out of school and hasn't been seen home in four days.
Now, my original findings, combined with her sudden onset drop, lack in functioning, her decreased need for sleep, her grandiose thinking combined with hyper-religiosity, it is what I thought: bipolar mania.
So, exams, lab results didn't poke any holes? No, I never go to them.
I filled in the blanks with the added history.
Wait, so, you got all that, a detailed, chronological history, from a patient in a manic state? I well, no, it came from collateral.
I found and spoke with her sister, Melissa.
Dr.
Reese, I thought we were checking all the boxes.
You know, doing it by the book? I-I confirmed my diagnosis.
Does it matter how I got there? Yes, when you're on probation, it does.
It does matter how you got there.
Um, you're you're right.
Okay.
So, um so what's the next move, for your patient? I want to admit her to the psych ward.
She hasn't responded to any of her meds.
And what meds would those be? I doubled the Risperdal and added Depakote.
Also without filling you in.
Okay, Well, um, you know, with bipolar, all those meds, should've made some kind of dent, so I'd like to take a look.
The cancer metastasized to her tibia.
Likely months ago.
No discomfort upon admission? It was drowned out by the back pain from her kidney.
Once that was alleviated Her body registered the new problem.
So, did we catch it in time? Let's start Asterid on a high dose bolus of Interleukin-2, see if she responds.
If she doesn't, she may be a candidate for our phase three trial of Pazopanib, a chemotherapy agent.
I'm gonna pull Ortho in, as well.
Excuse me, Dr.
Rhodes, Halstead, may I speak with you? I'm cancelling Asterid's move to Oncology.
- What? - Instead, I'm going to find a bed for her in a safety net hospital.
Med is a premiere cancer center.
- You're gonna transfer her? - I don't have a choice.
She doesn't have insurance, and I know the hospital won't cover the bill her treatments are going to generate.
She has emergency coverage from Medicaid.
Right, but that only pays for procedures related to removal of the tumor.
The bone cancer is new, and not immediately life-threatening.
[SCOFFS.]
We can't throw Asterid out.
A minute clinic misdiagnosed her renal cell carcinoma as a back sprain.
If we put her in the system, she might fall through the cracks again.
You have pulled strings before, you made the numbers work, just do it again.
Do you know what kind of numbers we're talking about here? $100,000? $200,000? What kind of dream world are you living in? [TENSE MUSIC.]
Do you want me to inform the patient? No, we'll do it.
[SIGHS.]
- Sitting in pews - Hi, I'm Dr.
Charles.
Four days ago, we could have somewhat of a conversation, and now, I don't know if she's eaten.
Between her work and school, I thought Jamie was just stressed.
I didn't realize she was having a breakdown.
None of this is on you.
Um, Jamie? I'd like to examine you now.
Would that be all right? Three locked up inside.
Wanted everything for it, everything, everything.
Everything.
So much my arms can't even hold them all Clear, prominent disinhibition.
Hasn't let up since my first exam.
Consistent with bipolar mania.
- Let me go.
- You see this? In her eyes? What? Yellowish brown circles around her irises.
I think they're Kayser-Fleischer rings.
And weeks, days and weeks flipping in the calendar, the bright light burns the trees, leaves, falling, stop falling, too many too many people crowding.
Too many people.
Bright light burns the trees.
Leaves falling.
Entirely too many people.
Um your sister is in culinary school.
Has she ever said anything to you about about copper, using copper pots? Yeah, I think so.
Something about them being the best heat conductors.
I don't know anything about cooking.
Does that mean something to you? Dr.
Reese? - Wilson's disease.
- What's that? It's a genetic disorder, um, where com copper accumulates in the body.
Jamie's use of copper cookware could've accelerated the buildup that led to this manic episode.
If this is Wilson's disease, is there a cure? Um, no, but there is treatment to manage it, and she she would get better.
Oh, thank God.
Dr.
Reese, could I just have a word outside? Thank you.
And twitching.
Wiggle, wriggle, wiggle [DRAMATIC MUSIC.]
So, you couldn't even get close enough to your patient to examine her eyes? She was so agitated - Dr.
Reese.
- Help! [ALARM BLARING.]
No pulse.
V-fib.
Charge to 200.
[DEFIBRILLATOR WHINES.]
- Charged.
- Clear.
[GASPS.]
Oh, my poor baby.
One milligram epi.
Charge to 200 again.
- Epi's in.
Charged.
- Clear.
[ZAPS.]
[MACHINES BEEPING.]
Asystole.
We can't shock her anymore.
Oh, my God.
What's he doing? Come on, come on.
She's suffered enough.
Please, stop.
Time of death 18:21.
We're looking for Dr.
Halstead.
Here to transfer an Asterid Morgan to County.
Right, one sec.
- Will? - Yeah? They're here.
Hey, guys.
Come with me.
I got this from Hannah? How? I don't have a sore throat.
No fever, aches, pains, I'm not sick.
You don't have an active infection, but since your pneumonia, you've been contagious.
For ten years? I work in an office, cross paths with dozens of people every day, not to mention boyfriends before Tommy.
No one else has ever gotten sick.
We're gonna run some tests and find out exactly what it is.
Honey, I am so sorry.
It's not your fault.
You had no idea.
Besides, I'm feeling better.
It means that these antibiotics are working, right? Yes.
Put Hannah on them.
- Yeah.
- Kill whatever bug she's been dragging around for the last ten years.
I'm afraid it's not that simple.
You see, as a carrier, you're colonized with the bacteria.
Which means it lives in too many places in your body for the antibiotic to be effective.
You mean I've got this forever? I'm afraid so.
Then I could give it to Tommy again.
With precautions, the risk of reinfection can be reduced.
This can't be this can't be happening.
We can deal with it.
- Yeah.
- We'll figure it out.
[SOLEMN MUSIC.]
This sucks.
We do everything right and still come up short.
All right, let's go.
Screw this.
Stop, she's not going anywhere.
Sorry, we have transfer orders.
And I am overriding them.
Dr.
Rhodes, what's going on? It's okay, Asterid.
It's just a miscommunication.
I'm gonna take care of it.
Go ahead and put her back.
Whatever you say.
Sign here, so this doesn't come down on us.
Connor, what are you doing? I got this.
Don't worry.
I did my two-week suspension.
I am in therapy.
I am not supposed to be afraid anymore.
I am a psychiatrist.
Rule number one is to connect with your patients, and I could not even look her in the eye.
Look, the good news is that you recognize the problem.
Right? Sarah, nobody learns how to master their fears in two weeks, trust me.
It doesn't happen.
Not even somebody as determined as you are.
Okay.
You know what? Um, when Allison died today, I saw myself, because she could not change.
But I have to I have to.
I just don't know how.
You have to help me, Dr.
Charles.
Of course.
Of course.
Of course I will.
Okay.
Hey, how's it going? They haven't taken their eyes off each other.
Hey, Hannah, here are some pamphlets on universal precautions.
I thought they might be helpful for you and Tommy.
Yeah, uh, I don't need them.
You don't? There's only one thing to do.
Will you give this to Tommy tomorrow? I couldn't tell him myself.
Hannah I love him.
I can't put him at risk.
Dealing with TB, Tate and I, the pressure it put on our relationship I get it.
Uh-huh.
Same here.
Where are you gonna put it? - Right there.
- Right there? Oh, that's gonna be beautiful.
You like it standing up like that? [LAUGHS.]
Oh, I'll take that as a no.
[KNOCKING ON DOOR.]
Oh.
Special delivery.
What did you do? Hey, little man.
Look what I have for ya.
- A car.
- A truck! It is! Is this because of that? I'm reading up on child development.
Emotional modeling, active engagement.
I thought maybe the best way to bond might just be a bribe.
[CHUCKLES.]
Owen, do you like the car? - Yeah.
- Yeah? Want to get in, try it out? Take it for a spin.
- Oh! - Ah.
I'm so sorry.
Are you okay? - Does he hate me? - What? No.
Of course not.
Hey, how could he hate you? I don't know.
[LAUGHS.]
Look, you and I are lucky.
A pair of black eyes, it's nothing.
[CHUCKLES.]
Let's go get you some ice.
Come on.
[DRAMATIC MUSIC.]
- Dr.
Rhodes.
- Excuse me.
A moment.
Asterid's transfer to County I'm sure you can imagine my surprise when I learned it was suddenly unnecessary.
Yeah, it, uh it turns out that the hospital's charitable fund has enough money to cover her costs.
It does now.
It seems a six-figure donation was made a few hours ago anonymously.
- That's good timing, I guess.
- Mm.
Good night.
Dr.
Rhodes, be careful.
Patients are going to keep coming.
And as wealthy as you may be, your checkbook won't be able to keep up.
But it did today.
Good night, Ms.
Goodwin.
I'm the man Come 'round No-no-nothing can break You can't break me down I got gas in the tank I got money in the bank I got news for you, baby, you're looking at the man I got skin in the game I don't feel no pain I got news for you, baby, you're looking at the man [DRAMATIC MUSIC.]
Thanks.
Wow, some showy new wheels.
Not cheap.
What are we talking? 125? In the neighborhood.
Not one I've ever lived in.
Morning.
Good morning.
Nice looking.
But is she attracted to you or the car? I'm gonna go find out.
Catch up to you later.
- Hi.
- Hi.
- Connor.
- Lisette.
That's it.
You got this.
Nice job, little man.
I think you got a future architect here.
Or a demolitions expert.
[BABBLES.]
Oh, I get a turn.
Thank you.
Oh, is that good? You like that? Told ya.
We'll just have to rebuild it again, now won't we? Ow! What happened? I have no idea.
Are you okay? - [BABBLES.]
- Yeah.
"Patton.
" "The Evil Dead.
" "The Dirty Dozen.
" "Texas Chainsaw Massacre.
" Come on, all your favorite movies can't be slasher films.
Better than World War II flicks.
They're classics.
What can I get you? Chai tea latte, almond milk, no water, no foam, extra hot.
You got it.
Black coffee.
It is mystifying how little we have in common.
Luckily, opposites attract.
Works for me.
Got a chai tea latte, no water, no foam, almond milk, extra hot.
- Thank you.
- Really? Hers comes out first? He'll pay.
Catch you later.
[DISTANT SIREN WAILING.]
I need a doctor, please! - What's wrong? Are you hurt? - Not me, a woman, two blocks over, she's on the ground, isn't moving.
Show me.
[DRAMATIC MUSIC.]
Excuse me, excuse me.
Hey, can you hear me? Can you hear me? Who saw what happened? She jogged past me, then she just fell.
I called 911.
- God, is she alive? - Barely.
Can't wait on the paramedics.
I need you.
20-something female went down while jogging.
Barely awake, weak pulse, hypothermic.
Let's get her on the monitors and start a line.
Bolus a liter of warm saline and grab some blankets.
We need to raise her body temp.
She's pretty bundled up.
How long was she exposed to the elements? On the ground.
Two, maybe three minutes.
That's it? And she's hypothermic? Yeah.
Oh, God.
- There's nothing to her.
- Let's get her up.
Okay.
This side.
Hair's brittle and thin, lanugo covering the skin.
Anorexia.
Stethoscope.
BP 88/50, heart rate 50s.
EKG is sinus Brady.
Bilateral crackles.
Her eyes are yellow.
She's jaundiced.
God, I can feel right through her to the bed underneath.
Where am I? Hey, in the hospital.
Can you tell me your name? Allison.
Allison, I'm Dr.
Choi, I'm gonna help you, okay? I'm okay.
I just need to rest.
Let's get a CBC, CMP, LFTs, a chest x-ray and a 12 lead EKG.
Yep, on it.
Morning, I'm Dr.
Halstead.
Asterid.
It looks like you're hurting too.
Need a hit? [CHUCKLING.]
Thanks, but let's get you squared away first.
What happened? I was running up the stairs to the platform to catch the train.
By the time I got to the last step, I was [GRUNTS.]
I was so exhausted, I tripped.
Landed on my arm.
Is it broken? Well, maybe.
We'll get some X-rays.
Lean forward for me.
[WINCING.]
Ah.
You okay? I tweaked my back a few months ago.
Free clinic gave me some anti-inflammatories.
Said they'd help.
They haven't.
I even crushed them up and snorted them.
What? Just kidding.
I'm a stand-up comic, so when I see an opening for a joke, I have to take it.
Well, timing was excellent, I'll give you that.
Where does your back hurt? Uh, it's a sharp pain down here.
Mm-hmm.
More throbbing up here.
The fall made it worse, didn't it? Well, I can't say without a CT, but no bruising or swelling, so that's a good sign.
Hang tight.
The techs will be by soon to take you up to Radiology.
Maggie, which nurse do you have covering Asterid in Treatment Four? You're looking at her.
Double duty again, huh? Yep, twice the work for me, and yet, it's the hospital's bank account that benefits.
You know, trickle up economics.
Absolutely.
Nice shiner.
I haven't seen one of those on you for a while.
This time, it wasn't my fault.
[LAUGHING.]
South side boy.
Somehow, I don't buy it.
What do you need in Four? AP lateral of the left elbow and a CT chest and belly with contrast.
You got it.
Dr.
Reese.
Welcome back.
How are you doing? Great, great, very eager to dive back in.
Fantastic.
Just for the record, easing back in is okay too, but thrilled you're here.
How's therapy been going? Oh, well, it better be going well.
Daily counseling, anger management sessions, meeting with the hospital attorney.
And remember, not intended to be a punishment.
Oh, no, of course not.
It's actually a great way to grow professionally.
Can't hide from it.
It keeps the secrets - in their pockets.
- Wonderful.
20-something woman, agitated and out of control.
PD found her running around in the middle of the I-90 express lanes.
- What's she on? - Nothing we can tell.
No track marks or tweaking signs, but a lot of rambling.
Our insides, holding in Airway's clearly intact.
Obviously has no problem moving four limbs spontaneously.
I'd say my job is done.
She's all yours.
Thank you.
Dr.
Charles, Treatment Three, can't wait.
But now I see how everything is filled with water Oh, man.
Um Go ahead, I've got Jane Doe.
Do a full assessment, and we will staff it later.
Thanks.
You good? I'm good.
Welcome back.
Don't open the box, no.
Open the box, no.
Don't open the box.
Back and forth, on and off.
Allison, how you doing? We're here easy, easy, easy, easy.
Allison, I'm Dr.
Charles.
Shrink.
So, um, something tells me this isn't your first time in an ED.
Not just saline, is it? D5? Well, your blood sugar was 44, so you know, the dextrose Treats hypoglycemia and all that comes with it, I know.
But at 170 calories per liter If I can get 80 per mile, home to lake and back is four, that's 320.
So, is your math working out? Are you gonna be able to burn off those extra calories? [DRAMATIC MUSIC.]
I don't need to be here.
Check my levels, vitamins.
Potassium.
They'll be normal.
What is the go-to trick these days for, you know, gaming those numbers? You guys still sucking on lemons or, I don't know, I heard that guzzling vitamin water is kind of coming into vogue.
I mean, it's none of my business, but I am curious.
How long has it been going on for? Five years? Ten? 15? 15 years? At least 15 years.
I want to go home.
Okay.
[STRAINING.]
Allison, you know, if you can't get out of bed, you know that I can't I can't let you go, right? And you do know what that means.
5,000.
1,000.
4,000.
1,500.
- 3,000.
- Two.
Three.
Fine.
3,000 calories.
And it has to be through your nose.
[HEAVY BREATHING.]
If this goes.
Mm.
Got yourself a deal.
And following the fingers, you can count, the count likes to laugh, and he's just a puppet, sometimes I feel like a puppet, - with someone operating me - I'm Dr.
Reese.
- Can you tell me your name? - Not operating on me.
Because surgery belongs in another part of the hospital.
Each part separated by a floor, a floor made of marble or wood.
Can you tell me how you got here? Cooking things through at a slow heat.
- The temperature cooks evenly - Where do you live? Through me to the core of my eyes and my brain, and none of it will stop.
Watching the whirring, watching the whirring, go, go, go, go, go, go, go.
Foot, foot, left, right, left, right.
Back and forth, on and off, on and off, on and off.
Back and forth, on and off, the switch, the light switch breaking Meds first, talk later? Please.
Uh, let's get her Risperdal M-TAB two milligrams, should calm her down.
All right.
I don't know why I let you talk me out of coming here yesterday.
I'm fine, it's just a really bad cold.
It's our first vacation together.
Emergency room's not on the itinerary.
Temp's 100.
4.
See, Hannah, it's barely a fever.
God forbid he let on that he's sick.
- I've got a stubborn one also.
- Mm.
Me too.
Lymph nodes are enlarged.
All right.
I'm gonna have you open your mouth for me.
He hasn't eaten in three days.
He can barely sip water.
It hurts that bad.
Throat's pretty raw.
Tonsils are swollen.
Yellow exudate.
- What's that? - Pus.
Maybe an infection.
See, we should've come yesterday.
I'll get a rapid strep test.
And let's get a CBC and BMP also.
I'm sorry.
I just wanted the trip to be perfect.
And I just want you to be healthy.
Well, hopefully we can solve both of your problems.
I'll be back shortly.
What, you keeping a secret? - Hey.
- "Your Toddler and You.
" Is this business or pleasure? Both.
I'm looking for ideas on how to get Owen to like me.
What makes you think he doesn't? Oh, I don't know.
[LAUGHING.]
You worry too much.
Hey, Owen's number one in Natalie's life.
If I can't make it work with him, I got no shot with her.
Well, let me break down toddlers for you.
They eat, sleep, poop, and play.
Help 'em out with any one of those things, and you're gold.
Radiologist's report.
Asterid's arm X-ray and CT scans.
- And no fractures? - Mm-hmm.
Just soft tissue swelling.
Let's wrap her elbow up and put it in a sling.
Got it.
Whoa.
What is it? Her CT.
I need Connor and Dr.
Neal in Urology.
I got it.
3,000 calories? It's all she's willing to accept.
Why are you negotiating? Dangerously low albumin, renal insufficiency.
5'6" and less than 70 pounds.
Dr.
Charles, I carried her in, she was nothing.
She needs high-calorie, long-term nutrition.
I agree.
Then what are you doing? Anorexia is actually the most deadly mental illness that there is.
Every instinct she has is telling her to resist this, and I don't want to push her any harder than she'll let us.
- Then let me push her.
- No.
I made a deal, we have to honor it.
Trust me, it's her best shot.
Listen, we get 3,000, and you'll go back for more.
- Of course.
- Dr.
Choi, Allison's parents are here.
Waiting room.
Thanks, Mags.
I'll fill them in and place the feeding tube.
Is she the worst case you've ever seen? Healthy BMI is 18 to 25.
Hers is 11.
If she's going to survive, we can't afford to make any mistakes here.
She's killing herself.
So, um, so catch me up on Jane Doe.
Um, no idea on her.
Maggie is working with PD to get a name.
Tox screen is clean, this isn't drug-induced.
And I'm thinking bipolar mania.
Rapid speech, psychomotor agitation, flight of ideas, plus she hasn't bathed in days.
So, presumably, she went manic and fled wherever she was living? - Mm-hmm.
- You started her on Risperdal? It hasn't made a dent.
I want to double the dose and add a second mood stabilizer.
You ruled out all the possibilities? You know, schizoaffective disorder, temporal lobe epilepsy, delirium, other mood disorders? Why? Mania can be diagnosed through pattern recognition just like I've done, and there's been no clinical indication to keep digging for anything else.
Just humor me, okay, doctor? Look, it's your first day back, before you add any other meds, just check all the boxes, see if you don't think it's necessary.
Physical, neural exam, motor function, head CT, all that stuff, okay? - Okay.
- Okay, good.
I wish there was something I could do.
Hi, guys, Uh, so, Tommy, you do not have strep.
But your body is most likely fighting off a bacterial infection.
So, I'm gonna start you on clindamycin, which is an oral antibiotic.
Whatever the bug, it'll take care of it.
So we can get out of here? Yes, but please, just try to take it easy the next few days.
As cliché as it is, rest is the best medicine.
I won't let him leave the hotel, promise.
Ow! Are you okay? My ankle.
Why don't you let me take a look? [DRAMATIC MUSIC.]
Whoa, that's really red.
- You didn't feel anything? - Uh-uh.
Hot and fluctuant.
- I and D it? - Yeah.
Now, I'm gonna make a small incision, so that we can get a sample, okay? All right, and when I ask you to, I'm gonna have you take a deep breath, and exhale for me, okay? All right, this is gonna hurt a little bit, all right? Just take a deep breath in.
Good.
And another one.
[GRUNTS SOFTLY.]
And again.
Good.
[WINCES.]
One last time.
[SIGHS.]
Great job.
All right, here comes the incision.
Ow! [GASPS.]
[GROANING.]
Oh.
Is that what's in my throat? How did it get in his ankle? Let's just wait and see what the lab says.
Bad news, though, you guys are gonna have to hang out here a little bit longer, I'm sorry.
All right, you need anything, I'll be close by.
Bacteria can travel once it enters the bloodstream, but for a new infection to manifest that fast Yeah, something's definitely going on.
- See you in the lab, okay? - Yeah.
It's cancer? Yeah, it's likely renal cell carcinoma.
The tumor extends from inside your left kidney, into the inferior vena cava, and up into the right atrium of your heart.
You never had a sprained back.
The pain is from ureteral compression.
You were exhausted running up the stairs because the tumor was blocking blood from returning to your heart.
Asterid, you following us? Yeah, I'm just trying to find a joke to cope with all of this.
That's okay.
We'll find the funny after you've beaten this.
Mm-hmm.
Seriously, I'm not dying? No.
No, the cancer is treatable.
The tumor is operable.
Now, to get all of it, I'm gonna have to involve other surgeons, and unfortunately, we will have to remove your left kidney.
But you can live just fine with one.
[DRAMATIC MUSIC.]
I know it's a lot to take all at once.
You don't get it.
I do open Mic night.
Those gigs don't come with health care plans.
And the three jobs that I do have barely cover the rent.
So I can't pay for this.
You don't have to.
The tumor invading your heart is life-threatening, and that means that Medicaid will cover the surgery and the resulting recovery.
It's not gonna cost me anything? No.
We're gonna take care of you.
Allison, I'm gonna put this tube in your nose.
When you feel it in your throat, I need you to swallow.
Allison, you understand? Okay, here we go.
[GAGGING.]
Swallow.
Allison, swallow.
There you go.
It's going in, nice job.
It's going to work this time.
We've tried helping her for years.
Doctors, rehabs.
No matter what we do, she just keeps withering away.
Sometimes, being out of options is what it takes to instill desire to get better.
X-ray.
Tube's in.
I'm gonna turn on the pump now.
[HEAVY BREATHING.]
[CRYING.]
Allison, Allison.
Look at me, look at me.
- Slow breaths.
- I can't.
Yes, you can.
You can do this.
- You're fine, you're - No, no, stop.
- Just relax, just relax.
- Stop it.
I can't do it.
I need it out! Hold on, hold on, hold on.
No, no, no, no, no! [COUGHING.]
We'll try again.
No.
I'm done.
Allison! I said I'm done.
Why don't we give Dr.
Choi a moment to prepare another tube? - Maybe we can - You're not hearing me.
I want my lawyer.
I'm serious.
Get my phone.
I'm calling my lawyer now.
Will, I'll come find you when we're done.
I'm good.
Kidney free? Yep, from everything but the renal vein.
I'm vessel looping the inferior vena cava below it now.
I'm curious.
You score a date tonight? I did.
How's it going on your end? Opening the right atrium.
I can see the bulb of the tumor.
There we go.
Your turn.
All right.
Tumor is one long stalk now.
I'm gonna tease it out as we remove the kidney.
Kidney is detached.
And here we go.
All right.
Got it.
- One piece? No stragglers? - It's whole.
Impressive.
Bet your mojo's gonna last all night long.
Lucky girl.
We will conquer the evil beast that live inside, and I shout them out, out, out, out.
And the winds blow by, and carry my breath into the sky.
God's shouting down and carries my clothes into your head.
And I will conquer the evil beast that live inside Thanks, Trudy.
Dr.
Reese? I just got off the phone with PD.
A woman named Melissa Withers filed a missing persons report about her sister, Jamie.
Description matches your Jane Doe.
Out, out, out, out, out, out, I pray.
And to follow the pages as they turn, thumbing through.
Do you got a phone number for Melissa? For Melissa.
[DRAMATIC MUSIC.]
Déjà vu.
I had pneumonia, right after college.
Spent two weeks in the hospital, Waukesha, Wisconsin.
Let me guess.
Same vending machines? It's amazing.
Cafeteria makes a great smoothie.
No, I-I want to stay close to Tommy.
I'll find something.
Hey, so, the clindamycin is not gonna work.
Bacteria pulled from his ankle: gram-positive cocci.
- A staph infection.
- Yeah.
So, let's switch to IV Vancomycin.
Staph can be a sticky bug.
We need to be more aggressive.
- Okay.
- Thank you.
So we clear to try another feeding tube? Um, no.
We are not.
Apparently, Allison was prepared for this moment.
She's already had papers drawn up to prevent forcible feeding.
Hospital lawyers don't want to fight it.
That's insane.
They'll just let her die? Well, legally, they don't have a move.
Precedent's already been set in the courts.
In each case, the patient's wishes were upheld.
So we go to the parents.
Don't they have a say? Allison's an adult, Ethan.
I mean, ultimately, she decides her own fate.
So, there's nothing we can do? Look, after seven years, anorexia is considered severe and enduring.
This poor lady has been struggling for more than 15.
Her entire being is fixated on gaining control, and holding onto it.
Even if it kills her.
So regardless of the injunction, or her parents love The odds of her recovery are Hey, there.
How you feeling? All things considered, fantastic.
I mean I'm down a kidney, but at least it didn't cost me an arm and a leg.
See, you got your sense of humor back.
Kind of.
Yeah, that was pretty awful, huh? Look, jokes aside, thank you.
Sure.
So, I'm gonna be back to check on you in a couple hours, but before we head out, any questions? Just one.
My right leg is achy.
Around the shin.
Never felt it before.
Maybe a side effect from the anesthesia? Could be.
Let me speak with the anesthesiologist and see what he thinks.
Right now, you just get some rest.
Leg pain? That's not from the anesthesia.
No, but let's not say it out loud without an X-ray.
I'll get it going.
Hannah.
[HEAVY BREATHING.]
Hannah? Oh, my God.
Tommy? Help.
Help! What's happening? Temp's up to 104.
He's tacky.
BP's 94/62.
Septic shock.
First dose of Vanc didn't work.
Bolus a liter of normal saline, and push IV Tylenol.
Tommy, can you open your mouth for me? What are you looking for? Abscesses that weren't there earlier.
Nothing dental or oral.
Help me search his skin.
[SHIVERING.]
Nothing on this side.
Here either.
Get a cooling blanket.
He should be getting better, but he's only getting worse.
It's gonna be okay.
It's okay.
Hey.
Hi.
Tommy's latest labs.
He doesn't have a staph infection.
Vancomycin-Resistant Enterococcus.
- The super bug? - Yeah.
And one that is not easy to get.
VRE's a nosocomial infection.
It lives in hospitals.
I don't think I've ever seen it contracted anywhere else.
Hannah.
She had pneumonia a decade ago.
Was hospitalized for two weeks.
Could've picked it up then, had it ever since.
Asymptomatic carrier.
Intimate relationship, lots of ways she could've passed it on.
Okay, let's start Tommy on IV Linezolid, swab Hannah's nose and throat for the bacteria, confirm she's the source.
- Got it.
- Thank you.
[SOLEMN MUSIC.]
[ELEVATOR BELL DINGS.]
Oh, Dr.
Charles, our Jane Doe is Jamie Walker, an aspiring chef in culinary school.
Huh.
A month ago, she started staying up all night, reading the Bible, and writing a manifesto.
Last week, she dropped out of school and hasn't been seen home in four days.
Now, my original findings, combined with her sudden onset drop, lack in functioning, her decreased need for sleep, her grandiose thinking combined with hyper-religiosity, it is what I thought: bipolar mania.
So, exams, lab results didn't poke any holes? No, I never go to them.
I filled in the blanks with the added history.
Wait, so, you got all that, a detailed, chronological history, from a patient in a manic state? I well, no, it came from collateral.
I found and spoke with her sister, Melissa.
Dr.
Reese, I thought we were checking all the boxes.
You know, doing it by the book? I-I confirmed my diagnosis.
Does it matter how I got there? Yes, when you're on probation, it does.
It does matter how you got there.
Um, you're you're right.
Okay.
So, um so what's the next move, for your patient? I want to admit her to the psych ward.
She hasn't responded to any of her meds.
And what meds would those be? I doubled the Risperdal and added Depakote.
Also without filling you in.
Okay, Well, um, you know, with bipolar, all those meds, should've made some kind of dent, so I'd like to take a look.
The cancer metastasized to her tibia.
Likely months ago.
No discomfort upon admission? It was drowned out by the back pain from her kidney.
Once that was alleviated Her body registered the new problem.
So, did we catch it in time? Let's start Asterid on a high dose bolus of Interleukin-2, see if she responds.
If she doesn't, she may be a candidate for our phase three trial of Pazopanib, a chemotherapy agent.
I'm gonna pull Ortho in, as well.
Excuse me, Dr.
Rhodes, Halstead, may I speak with you? I'm cancelling Asterid's move to Oncology.
- What? - Instead, I'm going to find a bed for her in a safety net hospital.
Med is a premiere cancer center.
- You're gonna transfer her? - I don't have a choice.
She doesn't have insurance, and I know the hospital won't cover the bill her treatments are going to generate.
She has emergency coverage from Medicaid.
Right, but that only pays for procedures related to removal of the tumor.
The bone cancer is new, and not immediately life-threatening.
[SCOFFS.]
We can't throw Asterid out.
A minute clinic misdiagnosed her renal cell carcinoma as a back sprain.
If we put her in the system, she might fall through the cracks again.
You have pulled strings before, you made the numbers work, just do it again.
Do you know what kind of numbers we're talking about here? $100,000? $200,000? What kind of dream world are you living in? [TENSE MUSIC.]
Do you want me to inform the patient? No, we'll do it.
[SIGHS.]
- Sitting in pews - Hi, I'm Dr.
Charles.
Four days ago, we could have somewhat of a conversation, and now, I don't know if she's eaten.
Between her work and school, I thought Jamie was just stressed.
I didn't realize she was having a breakdown.
None of this is on you.
Um, Jamie? I'd like to examine you now.
Would that be all right? Three locked up inside.
Wanted everything for it, everything, everything.
Everything.
So much my arms can't even hold them all Clear, prominent disinhibition.
Hasn't let up since my first exam.
Consistent with bipolar mania.
- Let me go.
- You see this? In her eyes? What? Yellowish brown circles around her irises.
I think they're Kayser-Fleischer rings.
And weeks, days and weeks flipping in the calendar, the bright light burns the trees, leaves, falling, stop falling, too many too many people crowding.
Too many people.
Bright light burns the trees.
Leaves falling.
Entirely too many people.
Um your sister is in culinary school.
Has she ever said anything to you about about copper, using copper pots? Yeah, I think so.
Something about them being the best heat conductors.
I don't know anything about cooking.
Does that mean something to you? Dr.
Reese? - Wilson's disease.
- What's that? It's a genetic disorder, um, where com copper accumulates in the body.
Jamie's use of copper cookware could've accelerated the buildup that led to this manic episode.
If this is Wilson's disease, is there a cure? Um, no, but there is treatment to manage it, and she she would get better.
Oh, thank God.
Dr.
Reese, could I just have a word outside? Thank you.
And twitching.
Wiggle, wriggle, wiggle [DRAMATIC MUSIC.]
So, you couldn't even get close enough to your patient to examine her eyes? She was so agitated - Dr.
Reese.
- Help! [ALARM BLARING.]
No pulse.
V-fib.
Charge to 200.
[DEFIBRILLATOR WHINES.]
- Charged.
- Clear.
[GASPS.]
Oh, my poor baby.
One milligram epi.
Charge to 200 again.
- Epi's in.
Charged.
- Clear.
[ZAPS.]
[MACHINES BEEPING.]
Asystole.
We can't shock her anymore.
Oh, my God.
What's he doing? Come on, come on.
She's suffered enough.
Please, stop.
Time of death 18:21.
We're looking for Dr.
Halstead.
Here to transfer an Asterid Morgan to County.
Right, one sec.
- Will? - Yeah? They're here.
Hey, guys.
Come with me.
I got this from Hannah? How? I don't have a sore throat.
No fever, aches, pains, I'm not sick.
You don't have an active infection, but since your pneumonia, you've been contagious.
For ten years? I work in an office, cross paths with dozens of people every day, not to mention boyfriends before Tommy.
No one else has ever gotten sick.
We're gonna run some tests and find out exactly what it is.
Honey, I am so sorry.
It's not your fault.
You had no idea.
Besides, I'm feeling better.
It means that these antibiotics are working, right? Yes.
Put Hannah on them.
- Yeah.
- Kill whatever bug she's been dragging around for the last ten years.
I'm afraid it's not that simple.
You see, as a carrier, you're colonized with the bacteria.
Which means it lives in too many places in your body for the antibiotic to be effective.
You mean I've got this forever? I'm afraid so.
Then I could give it to Tommy again.
With precautions, the risk of reinfection can be reduced.
This can't be this can't be happening.
We can deal with it.
- Yeah.
- We'll figure it out.
[SOLEMN MUSIC.]
This sucks.
We do everything right and still come up short.
All right, let's go.
Screw this.
Stop, she's not going anywhere.
Sorry, we have transfer orders.
And I am overriding them.
Dr.
Rhodes, what's going on? It's okay, Asterid.
It's just a miscommunication.
I'm gonna take care of it.
Go ahead and put her back.
Whatever you say.
Sign here, so this doesn't come down on us.
Connor, what are you doing? I got this.
Don't worry.
I did my two-week suspension.
I am in therapy.
I am not supposed to be afraid anymore.
I am a psychiatrist.
Rule number one is to connect with your patients, and I could not even look her in the eye.
Look, the good news is that you recognize the problem.
Right? Sarah, nobody learns how to master their fears in two weeks, trust me.
It doesn't happen.
Not even somebody as determined as you are.
Okay.
You know what? Um, when Allison died today, I saw myself, because she could not change.
But I have to I have to.
I just don't know how.
You have to help me, Dr.
Charles.
Of course.
Of course.
Of course I will.
Okay.
Hey, how's it going? They haven't taken their eyes off each other.
Hey, Hannah, here are some pamphlets on universal precautions.
I thought they might be helpful for you and Tommy.
Yeah, uh, I don't need them.
You don't? There's only one thing to do.
Will you give this to Tommy tomorrow? I couldn't tell him myself.
Hannah I love him.
I can't put him at risk.
Dealing with TB, Tate and I, the pressure it put on our relationship I get it.
Uh-huh.
Same here.
Where are you gonna put it? - Right there.
- Right there? Oh, that's gonna be beautiful.
You like it standing up like that? [LAUGHS.]
Oh, I'll take that as a no.
[KNOCKING ON DOOR.]
Oh.
Special delivery.
What did you do? Hey, little man.
Look what I have for ya.
- A car.
- A truck! It is! Is this because of that? I'm reading up on child development.
Emotional modeling, active engagement.
I thought maybe the best way to bond might just be a bribe.
[CHUCKLES.]
Owen, do you like the car? - Yeah.
- Yeah? Want to get in, try it out? Take it for a spin.
- Oh! - Ah.
I'm so sorry.
Are you okay? - Does he hate me? - What? No.
Of course not.
Hey, how could he hate you? I don't know.
[LAUGHS.]
Look, you and I are lucky.
A pair of black eyes, it's nothing.
[CHUCKLES.]
Let's go get you some ice.
Come on.
[DRAMATIC MUSIC.]
- Dr.
Rhodes.
- Excuse me.
A moment.
Asterid's transfer to County I'm sure you can imagine my surprise when I learned it was suddenly unnecessary.
Yeah, it, uh it turns out that the hospital's charitable fund has enough money to cover her costs.
It does now.
It seems a six-figure donation was made a few hours ago anonymously.
- That's good timing, I guess.
- Mm.
Good night.
Dr.
Rhodes, be careful.
Patients are going to keep coming.
And as wealthy as you may be, your checkbook won't be able to keep up.
But it did today.
Good night, Ms.
Goodwin.