Chicago Med (2015) s03e16 Episode Script
An Inconvenient Truth
1 Ehi.
Look like you could use an aspirin.
What time did you make it home from Molly's last night? - I didn't.
- Oh.
Walk of shame? I mean, I've been there.
Dr.
Rhodes, I need you.
I'm not on Trauma today, Maggie.
Not a Trauma.
Robert Haywood, Dr.
Reese's dad, CFD just arrived with a STEMI alert.
Yeah.
[TENSE MUSIC.]
Courtney, you're going to T Two.
Robert Haywood, 58-year-old male with known history of heart failure, CAD, and Ischemic cardiomyopathy.
Yeah, he's my patient.
Heart rate, 95.
BP, 88 over 44.
New onset angina unrelieved with nitro and aspirin in the field.
EKG shows ST elevations.
It feels like someone's squeezing.
I know, Bob, you're having a heart attack.
Just try to stay calm, okay? All right, everybody, on my count.
One, two, three.
There we go.
[ELEVATOR DINGS.]
Maggie, you paged.
[SIGHS.]
It's your dad.
- The ambo just brought him in.
- What? Irregular heartbeat.
He's in a-fib.
- [GROANS.]
- Four of morphine, esmolol drip, and an aspirin.
Rapid ventricular rate, 210.
He's in SVT and hypotensive.
We need to cardiovert.
- Give me the paddles.
- [PADDLES WHIR.]
All right, 5 of valium.
- Charge to 75 joules.
- Charged.
Sync and clear.
[GROANS.]
Back to sinus rhythm.
Rate, 88.
All right, Maggie, call the cath lab.
- Tell 'em we're on our way up.
- I got you.
- Ready? - Wait.
All right.
Let's go.
Come on, Sarah, you can ride up with us.
Sarah? We stented your right coronary artery, and we placed a balloon pump.
Now, your ejection fraction is low, so I'm afraid that you're gonna have to stay in the ICU Until a heart becomes available.
Mm-hmm.
It's just as I predicted.
Though, I'll admit, I didn't expect to end up here so soon.
You are at the highest status on the transplant list.
But only for 30 days.
If I don't get a heart by then [CHUCKLES.]
Ah, we'll we'll cross that bridge when we get there? Took the words right out of my mouth, Bob.
I'll see you soon, all right? All right.
Oh, Dr.
Rhodes, do you know if, uh, Sarah's here today? Uh, I'm not sure about that, but I can check on it for you.
Hey.
I heard about your dad.
I'm sorry.
If you need to talk or I don't.
But thanks.
Dr.
Sexton, heads up.
- This is Henry Lee.
- How are you doing, Mr.
Lee? You're going to Treatment Two.
Congestive heart failure and metastatic stage four non-small-cell lung cancer.
Stopped chemo last month.
All right, Mr.
Lee.
Hey, Henry.
There's my girl.
You two know each other? Old friends.
Henry used to come into the ED once a month for his heart meds.
Been missing you around here, man.
Okay, where does it hurt, Mr.
Lee? Faster to tell you where it doesn't hurt.
Give 5 of morphine IV.
Bibasilar crackles.
Add 20 of Lasix and order a chest X-ray.
Henry has a history of malignant pleural effusions.
Every time they drain my lungs, suckers just heal right back up.
Okay, well, we can put in a drainage tube.
No, no, no more procedures.
No needles, no tubes.
I'm done with all that.
Yes, sir.
[SOLEMN MUSIC.]
Henry's cancer's everywhere.
Hey, does he have any family? Not that I know of.
His wife is deceased.
I'm pretty sure he lives alone.
Okay, well, we'll have to transfer him to a hospice facility.
I'm sorry, April.
Choi, Halstead, walk with me.
CFD's inbound with two teenage boys burned in a house fire, one of which is Carter Singleton the Third.
Singleton? Yes, as in the soon-to-be-constructed Singleton Center for Diagnostic Radiology.
Huge donors, and Goodwin's godson, so - VIP.
Yeah.
- Yeah.
You're going to Treatment Six.
Desmond? 16-year-old male, 22% second-degree burns.
BP, 120 over 82.
Heart rate, 110.
- A friend's right behind.
- Bo? Where's Bo? Bo Williams, 17 years old.
85% third degree burns.
Couldn't get a BP, but palpable radial pulse of 112.
Kids a real hero.
When we got there, he was giving his buddy CPR on the lawn.
Okay, gently, one, two, three.
[SCREAMS, SOBS.]
- 100 of fentanyl for the pain.
- Yes.
- Thank you, Desmond.
- Yep.
[WHEEZING, GROANING.]
[TENSE MUSIC.]
All right, lungs are clear.
Where'd you learn to do CPR? - Boy Scouts.
- Carter, I'm here.
Is Bo gonna be okay? He's with Dr.
Choi, one of the best.
He's taking very good care of him.
[YELLS, GROANS.]
Groin line's in.
I'm having trouble bagging him.
- His chest is cooked.
- He needs a chest escharotomy.
- Scalpel? - You're gonna do it here? No choice.
His chest can't expand.
Gotta release the skin tension.
Ms.
Goodwin? [GASPS.]
Oh, my God, Carter! Lydia, careful.
Sharon, is he gonna be okay? Carter suffered second-degree burns.
They're gonna be painful to the touch for a while.
Dr.
Halstead, Lydia and Maurice Singleton.
Son, uh, how How did this happen? Is Bo all right? Were you with Bo? That boy is nothing but trouble.
That's not true, Mom.
You know you are not allowed to go over to his house.
Lydia, just lighten up a little bit, please.
Uh, Maria, wash the burns with soap and water, apply Silvadene cream, and I'll be back to help dress him.
Thank you, Dr.
Halstead.
Here, please.
That kid's in pretty bad shape.
Have you notified his parents? They were visiting some friends over in Lake Geneva.
Driving back now.
That's terrible news to come home to.
Yeah.
All right.
[ELEVATOR DINGS.]
- Hey.
- Hey.
So, sidelined for the conjoined twins surgery, and now you're doing procedures before your morning coffee? - I like the fight in you.
- I'm a glutton for punishment.
Latham made his choice clear.
You know, it's not over until the first incision.
Start playing nice, maybe you'll be holding the scalpel.
Are you all of a sudden rooting for my success? Not at all, I just hate winning by default.
[PHONES CHIME.]
Bruce Hammond, 34.
Blunt trauma to the chest following a high-speed car accident.
Negative echo, but a small left hemothorax and a sternal fracture.
CT's negative for aortic injury.
Yes, but Radiology read that there might be a small pericardial effusion.
Since he's got a hemothorax, let's put a chest tube in and see what comes out, and if he needs surgery, we can do a high left thoracotomy.
Hold on.
Is that a blush of contrast over the right atrium? If there's a hole in his heart, he needs a median sternotomy.
Good eye, Dr.
Bekker.
If it is a blush, we can't afford to ignore it.
I don't know, opening him up is highly aggressive, and we don't know whether the contrast is inside or outside of his heart.
If the majority is in favor of sternotomy - I'll follow.
- Excellent.
Dr.
Bekker, you'll lead.
Dr.
Rhodes, you'll assist.
Mm-hmm.
- [DOOR OPENS.]
- Oh, don't look so pained.
I think you just earned yourself some good will.
When did Emma's pain start? About an hour ago, halfway through ballet class.
I wasn't sure if I should bring her in, but her mom would have my head if something happened to her.
[GROANS.]
I was worried that it might be appendicitis.
No, appendicitis would be pain on her right side, but I would like to get an ultrasound.
You know, when I was young, I wanted to take ballet, but unfortunately, I was born with two left feet, so I went with violin instead.
Well, I don't really like dance, but my mommy did ballet when she was young, so she makes me go.
Oh.
[CHUCKLES.]
Right now, I'm gonna put this on your stomach, so I can see what's inside, okay? All right.
Monique, can you increase the depth? I can't see her uterus and ovaries.
It's already all the way up, Dr.
Manning.
[SOFT MUSIC.]
All right, let's start a line.
Give her 1 milligram of morphine for the pain.
And let me know as soon as her mom gets here.
I'd like to speak with her.
Is Emma gonna be okay? Yes, but it's a good thing that you brought her in.
All right, Emma, I'm gonna be back soon, okay? - Okay.
- Okay.
- Thank you.
- Thank you.
Hey, Dr.
Charles, you got a sec? I've got a case I'd like to run by you.
- What you got? - My patient, Emma, nine, she presented with abdominal pain on the left side, so I did a quick bedside scan to check her ovaries.
It's actually testicular torsion.
- Testicular torsion? - Yes.
The ultrasound showed an absence of uterus and ovaries, - but she has undescended testes.
- Huh.
Nothing about this in her chart? No, I doubt the family has any idea.
Okay page Pediatric Urology.
- We need to get a plan together.
- Okay, thank you.
I suspect Emma has 17-beta HSD3 deficiency.
It's caused by a genetic mutation.
Emma's testes aren't able to carry out the final step of testosterone synthesis.
So, just to be clear, genetically, she's male? She almost certainly has XY chromosomes, yes.
As far as the testicular torsion, what's required? We need to untwist the testis and then fixate it via orchiopexy.
So we'll be able to save the testicle? With surgery, yes, otherwise it'll die from lack of blood flow in six, maybe eight hours tops.
Okay, thank you, Dr.
Rios.
We'll share the news with her mother and get surgical consent.
This news could change Emma's whole sense of identity.
It is a lot for this family to process.
You know, my experience in situations like this is that the children are often surprisingly open-minded and resilient.
What's the story? Well, Carter said that Bo was cooking up BHL.
Uh, butane hash oil.
You blast marijuana with enough butane, and you get pure THC.
Lengths kids will go to to get high these days.
Exactly.
Uh, Carter said he heard screams from the other room, so he ran in, he tried to pat out the flames on Bo.
Then his sweatshirt caught fire, but he dropped and rolled.
Guessing from Bo's burns, he didn't do the same.
Yeah, Carter said Bo panicked and ran.
Can I talk to him? He's nonresponsive and on a ventilator, but I'll you know.
Hey, Will.
Dr.
Frisch.
I think after last night, you can call me Maia.
Lunch? I'm buying.
Uh, pretty slammed today.
Another time.
[CLEARS THROAT.]
I take it you and Nat are on the outs still? As far as I know.
Careful.
She'll come around.
Mr.
Lee, this stage in your life can bring a lot of painful emotions and memories up.
I can help to talk about what you're feeling, any concerns you're having, fears, regrets.
Henry, what is it? What's wrong? Where's my shirt? [SOFT, SOMBER MUSIC.]
My boy Jackson.
You have a son? When he was little, he was my shadow but as he got older, we started butting heads.
Didn't care too much for all my rules.
Rough neighborhood where we lived.
Sounds like you were just trying to protect him.
But maybe I was too hard on him.
His mom passed about ten years ago.
After the funeral, we had words.
Said some ugly things to each other.
Haven't spoken since.
Do you have his phone number? Any idea where he lives? Last I heard, he was up in Wilmette or maybe Skokie? Can't remember.
Should've reached out sooner.
It's not too late.
We'll find him.
We will do our best, Mr.
Lee.
Don't you think you're overpromising? How do you know we'll be able to track this guy down? I'm not letting Henry die alone.
Ruptured atrial appendage.
Median sternotomy was the right call.
Ah, it was a coin toss.
Could've gone the other way.
Still, pulling someone through that kind of blunt trauma, it's impressive.
You should write it up.
I know I said play nice, but don't go soft on me.
- That's no fun.
- Hold on There are only 244 instruments here.
There are supposed to be 245.
Dr.
Rhodes, stop closing.
Everyone search your areas.
Check your trays, the drape pockets, - look in the basins, everywhere.
- It has to be here somewhere.
[TENSE MUSIC.]
Somebody talk to me, anybody! We counted three times already.
Instrument's in the chest.
Get a tech in here to get a chest X-ray, and page Dr.
Latham now! I don't understand.
How could her doctors have missed this for so long? Why don't we go somewhere more private? Your daughter is in excellent hands, trust me.
Here, right this way.
So, because Emma's genitals are typically female, there was no reason to suspect that she had the condition.
If the testicular torsion hadn't caused Emma's pain today, it's very likely she wouldn't have been diagnosed until she reached puberty.
What happens during puberty? When Emma turns 12 or 13, uh, the testes will start to make testosterone.
She may develop typically male attributes: um, body and facial hair, an Adam's apple, - her voice may deepen.
- What? No, that can't happen.
You have to take them out.
The only thing that is medically necessary right now is to alleviate Emma's pain by untwisting the testis.
But Emma would have to have another surgery down the line, right? I mean, she'd have to have them taken out.
She's a girl.
Children with Emma's condition often identify as male after puberty.
No, that's not That's not gonna happen.
I want you to take them out.
To perform an irreversible procedure of this nature, we would need to inform Emma and get her assent.
Her assent? She's nine.
She won't understand, and even if she does, - it'll traumatize her.
- We fully appreciate how completely overwhelming this is right now.
Really, we do.
But the truth is is that the evolving thinking among medical ethicists is that children should be afforded gender autonomy, regardless of their age.
You know what, I just wanna be with my daughter right now.
Of course.
[SOLEMN MUSIC.]
- What the hell is that? - No idea.
Not an instrument I recognize.
But it is a foreign body, and we can't pinpoint where it is.
It could be in the pleural cavity, the pericardium.
We're going to have to reopen the sternotomy.
Clearly.
How could a careless oversight like this occur? We use the same instruments, the same routine every single time.
How could both of you miss it? Is is the patient's skin fully closed? No.
A few staples away.
[SIGHS.]
If the skin isn't closed, then the incident isn't a sentinel event.
Going back in won't be considered a second operation.
You both narrowly escaped an investigation by the hospital and a report to IDPH.
I want you in my office as soon as you retrieve the foreign body, and I wanna know who's responsible.
[INHALES SHARPLY, EXHALES.]
Don't beat yourself up.
It's only your second strike.
You know this could just as easily be your instrument, right? Lucky it's an easy fix.
You better not have been smoking with Bo.
I wasn't, Mom.
I told you already.
[GROANING.]
Bo almost ended up in juvie last year, but the judge agreed to give him another shot.
Now, you would've thought he would've learned his lesson Mom, just shut up, okay? - Whoa, whoa, whoa - Excuse me? Don't talk to your mother like that.
What is with you? [BEEPING.]
What's going on? - Sats are dropping.
- What's wrong with Bo? Take him off the vent and start bagging.
He's bradying down.
Heart rate's 30.
Milligram of Epi.
- No pulse.
PEA.
- Another milligram of Epi.
Asystole.
He's gone.
No.
No! No! No! - Son - Bo, please! - Carter - Carter Carter - No, just go save him, please! - Sweetie Please, Bo, come on, man! - Bo! - Carter Bo, come on, man! [SOBBING, SCREAMING.]
- That poor family.
- Yeah.
It's strange.
Bo's parents said he'd been doing so well.
They'd been regularly drug-testing him.
He'd been clean for months.
Guess he just fell off the wagon.
Did you get a tox screen on Bo? No, why? Do me a favor and get one.
I'm gonna get one on Carter.
Jackson Lee.
No? Okay.
All right, thank you, bye.
Hey, any news? Not yet.
I think I found his Linkedln profile, though.
Just trying to track down a phone number or an email address.
I have a friend over at the DMV.
Send me what you have on Jackson.
- I'll see what he can do.
- Thanks, Maggie.
- Yeah.
- Need some help in here.
Okay.
Sats down to 90.
CO2's at 65 on the ABG.
Okay, Mr.
Lee, you have DNI and DNR orders on your chart.
Now, I need to confirm that you do not want us to intubate you or perform CPR should your heart stop.
[TENSE MUSIC.]
Okay.
Then we're gonna make you feel comfortable.
Start a morphine drip and give 4 of Ativan.
[SOLEMN MUSIC.]
Okay.
No holes in the right pleura.
Or the left.
It must be in the pericardium.
Give me more suction.
[TUBES HISSING.]
Instrument's not there.
It's in the heart.
We're going to have to reopen the atriotomy.
That's going to require putting him back on bypass.
You're increasing his risk of air embolism and stroke.
We're aware, Marty, but we don't have a choice.
Your quick fix just got a lot more complicated.
Hi.
You feeling better, Emma? My mommy says I'll need an operation.
Yes, that's what my friend, Dr.
Charles, and I - came to talk to you about.
- Hi, Emma.
So, you remember when I took a picture of your belly earlier? Well, it showed me that you have something inside of you.
Something that only boys have, honey, not girls.
That part inside of you, it may cause you to change a little on the outside in a few years.
It'll make you look like a boy.
Ms.
Paulson, would you mind giving us a moment to explain? Please? So, Emma most people who look like girls on the outside feel like girls on the inside, but sometimes, a person who looks like a girl on the outside feels like a boy on the inside, and you know what O okay, stop, stop, you You're just confusing her.
Of course Emma feels like a girl.
Sweetie, the part inside of you, it's what's hurting you right now, so Mommy wants the doctors to take it out so that you'll be safe.
- Mrs.
Paulson - Wait, will it hurt? No, not at all, sweetie.
You'll be asleep the whole time.
And when you wake up, we can get chocolate sundaes.
So it's okay if they take them out? Mm-hmm.
Ms.
Paulson, can we speak to you outside for a moment? [DISQUIETING MUSIC.]
Okay, you heard her.
You have her assent.
Take them out.
It was not an informed decision.
Well, Emma's nine years old.
She didn't understand half of what you were saying.
Again, regardless of her age, it's very important that we at least try and explain the situation to Emma, so we can give her a chance to tell us how she feels.
I I know how she feels.
I know my child, and I won't let you manipulate her.
We were not trying to manipulate her.
Why don't we take a beat, let Dr.
Manning and I put our heads together, and see if we can come up with a course of action that everybody's comfortable with, okay? [TENSE MUSIC.]
I take it things didn't go well.
Emma's mom coerced her into having her testes removed.
Yeah, we gotta get Goodwin involved to see if we can convene an emergency ethics panel.
We have three hours tops until the testicle dies.
We better move fast.
Given the placement and orientation of the handprints on Carter's back, there's no way they're his own.
Okay? So? So Carter told my brother, Jay, that he tried to slap out the flames on Bo.
I haven't said anything to Jay.
So, you think Carter may have started the fire and is blaming Bo? Carter tested positive for THC.
[BROODING MUSIC.]
Bo was clean.
Thank you, Dr.
Halstead.
What you up to? I'm trying to write a budget for this research grant application, but Excel formulas hate me.
Well, I don't know if you know this, but I am kinda a math whiz.
I am, I can take a stab at it, if you wanna go see your dad.
I don't.
I I I don't want to talk about him, and I don't wanna see him.
Okay? Yeah.
Noah I know you Sextons are as thick as thieves, but not every family's like that.
[PHONE BUZZING.]
April? [SOLEMN MUSIC.]
Your son is coming, Henry.
Jackson's coming.
Thank you.
My angel.
Metzenbaum and DeBakey Forceps.
[TENSE MUSIC.]
Reopening the atriotomy now.
I'll need better visualization.
Suction.
Ah-ha.
There it is.
Stuck in the ostia of the pulmonary vein.
What is it? It's the tip of a suction catheter.
You were the only one on suction.
[DISQUIETING MUSIC.]
Then hold on.
Cardiac suction catheters don't have detachable tips.
At one point, Dr.
Bekker had to suction an area herself.
I handed her a catheter from a trauma tray.
I think it's yours.
Well, we're going to need to take it out, aren't we? Stone forceps.
Forceps.
Got it.
His BP is dropping.
The vessel tore.
He's bleeding out.
Quick, get me some 5-0 Prolene and a long needle driver.
Careful you don't ligate the vein.
If you narrow it, he could lose part of his lung.
Why don't you stop backseat driving and help me save his life? You okay? Yes.
No.
My patient's mom is trying to force an invasive surgery on her.
Unless the ethics committee intervenes, I don't think I'm gonna be able to stop it.
I mean, I know I shouldn't be unloading on you.
I'm I know we're I'm sorry.
No, it's okay.
Case sounds tough.
Sorry, Nat but I know you'll figure it out.
Yeah.
You look exhausted.
Are you okay? Uh, yeah.
Had a tough time sleeping last night.
Anyway, good luck.
Finished repairing the pulmonary vein laceration.
BP any better, Marty? Talk to me.
Vitals are stable.
Dr.
Rhodes, close the atriotomy, take the patient off bypass, and staple him up.
Uh, wait a second, you're the lead here.
You have to decide how you want him closed.
Wires or plates and screws for the sternum? Don't you remember how we closed him last time? Do it again.
[DOOR CLOSES.]
[DISQUIETING MUSIC.]
I don't know who the hell you think you are, but that stunt you just pulled, leaving me there to clean up your mess? I'm sorry.
[INHALES SHARPLY.]
I'm sorry.
[SOBBING.]
Come on, Ava, you don't have to worry about your reputation, okay? This isn't some reflection of your surgical skill.
This is just it it's human error.
It could happen to anybody.
You really think it's my reputation I'm worried about? Bruce Bruce almost died today, because of my stupid mistake.
He didn't Hey, listen to me.
Ava, he didn't.
He didn't, okay? He's in recovery because of what you did.
Oh [SNIFFLES.]
What if he has deficits? [SOBBING.]
I could never forgive myself.
Involuntary manslaughter's a class three felony.
Carries a potential jail sentence.
It certainly doesn't help matters if Carter lied during his statement.
Why are we discussing charges when we should be talking to the police? I'm sorry but whatever the consequences are, Carter needs to face them.
You're right.
Thank you, gentlemen, for filling us in.
We'll handle it from here.
- [DOOR CLOSES.]
- Look, Sharon CFD and CPD will conduct their own very thorough investigation, and it is in the hospital's best interest and frankly yours to not put yourself in the middle.
But I am in the middle, Peter.
Carter's my godson.
I've known this boy since he was in diapers.
He's not some master manipulator.
If he lied, it's because he was scared.
Beside the fact that the Singleton's are your friends, they are also major donors to this hospital, and there is a multimillion dollar relationship at stake here.
So if the kid is gonna get in trouble, please, let PD be the bad guys.
Any word from the ethics committee? No way.
No way they're gonna allow this.
Because, technically, they have both Judy and Emma's consent, and because testicular torsion is a medical emergency, the hospital feels obligated to act.
But the assent was coerced.
Yeah, but coercion's very difficult to prove, and the truth is that in the majority of these cases, the court's do side with the parents.
The board's worried about a negligence suit.
- [GAGS.]
- What? Oh, no.
Oh.
[TENSE MUSIC.]
Help.
Someone, help.
Uh, what what what what's What's wrong with her? The testicle must be more ischemic.
- Not getting enough blood flow.
- [GROANING.]
We can't wait any longer.
Prep this patient for surgery now.
Mommy, I'm scared.
I don't want them to hurt me.
No, no, no, honey, they won't hurt you, I promise.
Judy, I know you love your daughter, and I know you're afraid of what the future might hold, but Emma trusts you, she counts on you.
I just I don't want anything to happen to my little girl.
- She's all that I have.
- You're not gonna lose her.
No matter what gender Emma identifies with, she's still gonna be your child, the same kid who loves chocolate sundaes - and hates ballet.
- She told you? That's the exciting part: having our kids show us who they are in their own time.
Mommy? Mommy? Don't take them out.
- Are you sure? - Yes, I'm sure.
Hey, Maggie, any word from Henry's son? I thought he was just driving down from Wilmette.
His phone keeps on going to voicemail.
Maybe he changed his mind about coming.
How can he let his father die alone? We don't know the whole story, April, what went on between them.
Some things are hard to get over.
I never should have gotten Henry's hopes up.
- I have to tell him.
- I'll go with you.
[SOLEMN MUSIC.]
Henry? Henry Jackson - Son - Henry, I'm sorry I'm here.
[POIGNANT MUSIC.]
I'm right here.
You came? Yeah.
My boy.
My boy.
The evidence is substantial, and it's in Carter's best interest to come clean to the police on his own.
A jury will look favorably on that.
A jury? Oh, God.
No.
Sharon, I am begging you, - please do not say anything.
- Lydia This will not bring Bo back, and it will ruin Carter's life.
- Grace? - I had to talk to you.
When we got here, Dr.
Choi told us what, uh, Carter did.
Grace, I He said when the paramedics found the boys, that Carter was performing CPR on Bo.
I'm so sorry, Lydia.
I'm so sorry that Bo got Carter into this mess.
I'm so sorry.
Hey, Will thank you for earlier.
I didn't do anything.
Well, that's the point.
You just listened.
I appreciate it.
All right.
Well, I'm always here to lend an ear anytime you need.
How 'bout tonight? Oysters at Shaw's? - Sure.
- Okay.
Hey.
You know the last time we were in a hospital room together? [CHUCKLES.]
The day you were born.
- You were there? - Mm-hmm, yeah.
I was holding you when you opened your eyes for the first time.
You know, they say it takes about a week for a newborn to focus on objects, but I swear, you looked right at me.
And that was it.
I was hooked.
You know, Carter, you're my godson.
I only want what's best for you.
And if there's anything else you need to tell the police, baby, now is the time.
You [SOLEMN MUSIC.]
You're gonna carry this day with you for the rest of your life, and holding a secret on top of that it'll be too much, baby.
It'll break you, Carter.
It'll break you.
Yes, he's hanging in.
Yeah, I'll Let let let me call you back, Miles, thanks, bye.
What is he doing here? Carter asked to speak with Detective Halstead again.
What did you say to him? I'm sorry, Lydia.
You're sorry? [SOLEMN MUSIC.]
That was the right thing to do, Ms.
Goodwin.
Yeah, I think that's debatable.
When the Singletons pull their funding, which I imagine they're going to do, you're gonna have to answer to the board.
I'm prepared to do that.
Noah what you did in there You think I was wrong for letting him think his son was there.
No.
No, I don't.
I think it was really kind.
I'm sorry I snapped at you earlier.
No, you don't you don't have to apologize.
That's No, I do.
I do.
You were just being a friend.
When I said I didn't wanna see my dad, the truth is I don't want to want to see him.
Does that make sense? - Um - It's okay.
It doesn't make sense to me either.
- Night, Noah.
- Night.
- How's the patient? - Just waking up.
But his vitals are stable and he's neurologically intact.
Ah.
I suppose you know what I'm going to ask next.
It was my instrument, Dr.
Latham.
I take full responsibility.
No, it was my instrument.
My fault.
- That's not true.
- Yes, it is.
Ah.
[CHUCKLES.]
[EXHALES.]
My rabbi used to say, "Klieg, Klieg, Klieg, du bist a nar.
" Ah.
"You are smart, smart, smart, but, eh, not so smart.
" You both are my most promising fellows, but now I am no longer certain that either of you should be my second for the conjoined twins surgery.
[EXHALES SHARPLY.]
I'll be watching you both very closely going forward.
- You didn't have to do that.
- I know.
- I can take my lumps.
- Never said you couldn't.
I guess we're both in the doghouse now.
Plenty of room for two.
Don't worry, you get used to it.
Builds character.
[LAIDBACK MUSIC PLAYING.]
Here you are, sir.
Oh, hey.
I ordered us half a dozen of Henderson Bay oysters.
What do you want to drink? - Uh, excuse me - Wait, Nat If there's any chance we're moving forward here, there's something I gotta tell you.
What is it? Last night after work, I grabbed a drink.
I met someone at the bar.
It was nothing.
It was just high school stuff.
- High school stuff? - It didn't go beyond kissing.
[SOLEMN MUSIC.]
Well, not much.
And I I thought of you.
I put the brakes on.
I actually fell asleep on her couch.
Were you thinking of me when you went home with her? Nat, you've been so distant the past two weeks, I didn't know if things would turn around between us You know, when I asked for a break, it was never about wanting anyone else.
I don't want anyone else.
It meant nothing, I swear.
Nat, I'm so s
Look like you could use an aspirin.
What time did you make it home from Molly's last night? - I didn't.
- Oh.
Walk of shame? I mean, I've been there.
Dr.
Rhodes, I need you.
I'm not on Trauma today, Maggie.
Not a Trauma.
Robert Haywood, Dr.
Reese's dad, CFD just arrived with a STEMI alert.
Yeah.
[TENSE MUSIC.]
Courtney, you're going to T Two.
Robert Haywood, 58-year-old male with known history of heart failure, CAD, and Ischemic cardiomyopathy.
Yeah, he's my patient.
Heart rate, 95.
BP, 88 over 44.
New onset angina unrelieved with nitro and aspirin in the field.
EKG shows ST elevations.
It feels like someone's squeezing.
I know, Bob, you're having a heart attack.
Just try to stay calm, okay? All right, everybody, on my count.
One, two, three.
There we go.
[ELEVATOR DINGS.]
Maggie, you paged.
[SIGHS.]
It's your dad.
- The ambo just brought him in.
- What? Irregular heartbeat.
He's in a-fib.
- [GROANS.]
- Four of morphine, esmolol drip, and an aspirin.
Rapid ventricular rate, 210.
He's in SVT and hypotensive.
We need to cardiovert.
- Give me the paddles.
- [PADDLES WHIR.]
All right, 5 of valium.
- Charge to 75 joules.
- Charged.
Sync and clear.
[GROANS.]
Back to sinus rhythm.
Rate, 88.
All right, Maggie, call the cath lab.
- Tell 'em we're on our way up.
- I got you.
- Ready? - Wait.
All right.
Let's go.
Come on, Sarah, you can ride up with us.
Sarah? We stented your right coronary artery, and we placed a balloon pump.
Now, your ejection fraction is low, so I'm afraid that you're gonna have to stay in the ICU Until a heart becomes available.
Mm-hmm.
It's just as I predicted.
Though, I'll admit, I didn't expect to end up here so soon.
You are at the highest status on the transplant list.
But only for 30 days.
If I don't get a heart by then [CHUCKLES.]
Ah, we'll we'll cross that bridge when we get there? Took the words right out of my mouth, Bob.
I'll see you soon, all right? All right.
Oh, Dr.
Rhodes, do you know if, uh, Sarah's here today? Uh, I'm not sure about that, but I can check on it for you.
Hey.
I heard about your dad.
I'm sorry.
If you need to talk or I don't.
But thanks.
Dr.
Sexton, heads up.
- This is Henry Lee.
- How are you doing, Mr.
Lee? You're going to Treatment Two.
Congestive heart failure and metastatic stage four non-small-cell lung cancer.
Stopped chemo last month.
All right, Mr.
Lee.
Hey, Henry.
There's my girl.
You two know each other? Old friends.
Henry used to come into the ED once a month for his heart meds.
Been missing you around here, man.
Okay, where does it hurt, Mr.
Lee? Faster to tell you where it doesn't hurt.
Give 5 of morphine IV.
Bibasilar crackles.
Add 20 of Lasix and order a chest X-ray.
Henry has a history of malignant pleural effusions.
Every time they drain my lungs, suckers just heal right back up.
Okay, well, we can put in a drainage tube.
No, no, no more procedures.
No needles, no tubes.
I'm done with all that.
Yes, sir.
[SOLEMN MUSIC.]
Henry's cancer's everywhere.
Hey, does he have any family? Not that I know of.
His wife is deceased.
I'm pretty sure he lives alone.
Okay, well, we'll have to transfer him to a hospice facility.
I'm sorry, April.
Choi, Halstead, walk with me.
CFD's inbound with two teenage boys burned in a house fire, one of which is Carter Singleton the Third.
Singleton? Yes, as in the soon-to-be-constructed Singleton Center for Diagnostic Radiology.
Huge donors, and Goodwin's godson, so - VIP.
Yeah.
- Yeah.
You're going to Treatment Six.
Desmond? 16-year-old male, 22% second-degree burns.
BP, 120 over 82.
Heart rate, 110.
- A friend's right behind.
- Bo? Where's Bo? Bo Williams, 17 years old.
85% third degree burns.
Couldn't get a BP, but palpable radial pulse of 112.
Kids a real hero.
When we got there, he was giving his buddy CPR on the lawn.
Okay, gently, one, two, three.
[SCREAMS, SOBS.]
- 100 of fentanyl for the pain.
- Yes.
- Thank you, Desmond.
- Yep.
[WHEEZING, GROANING.]
[TENSE MUSIC.]
All right, lungs are clear.
Where'd you learn to do CPR? - Boy Scouts.
- Carter, I'm here.
Is Bo gonna be okay? He's with Dr.
Choi, one of the best.
He's taking very good care of him.
[YELLS, GROANS.]
Groin line's in.
I'm having trouble bagging him.
- His chest is cooked.
- He needs a chest escharotomy.
- Scalpel? - You're gonna do it here? No choice.
His chest can't expand.
Gotta release the skin tension.
Ms.
Goodwin? [GASPS.]
Oh, my God, Carter! Lydia, careful.
Sharon, is he gonna be okay? Carter suffered second-degree burns.
They're gonna be painful to the touch for a while.
Dr.
Halstead, Lydia and Maurice Singleton.
Son, uh, how How did this happen? Is Bo all right? Were you with Bo? That boy is nothing but trouble.
That's not true, Mom.
You know you are not allowed to go over to his house.
Lydia, just lighten up a little bit, please.
Uh, Maria, wash the burns with soap and water, apply Silvadene cream, and I'll be back to help dress him.
Thank you, Dr.
Halstead.
Here, please.
That kid's in pretty bad shape.
Have you notified his parents? They were visiting some friends over in Lake Geneva.
Driving back now.
That's terrible news to come home to.
Yeah.
All right.
[ELEVATOR DINGS.]
- Hey.
- Hey.
So, sidelined for the conjoined twins surgery, and now you're doing procedures before your morning coffee? - I like the fight in you.
- I'm a glutton for punishment.
Latham made his choice clear.
You know, it's not over until the first incision.
Start playing nice, maybe you'll be holding the scalpel.
Are you all of a sudden rooting for my success? Not at all, I just hate winning by default.
[PHONES CHIME.]
Bruce Hammond, 34.
Blunt trauma to the chest following a high-speed car accident.
Negative echo, but a small left hemothorax and a sternal fracture.
CT's negative for aortic injury.
Yes, but Radiology read that there might be a small pericardial effusion.
Since he's got a hemothorax, let's put a chest tube in and see what comes out, and if he needs surgery, we can do a high left thoracotomy.
Hold on.
Is that a blush of contrast over the right atrium? If there's a hole in his heart, he needs a median sternotomy.
Good eye, Dr.
Bekker.
If it is a blush, we can't afford to ignore it.
I don't know, opening him up is highly aggressive, and we don't know whether the contrast is inside or outside of his heart.
If the majority is in favor of sternotomy - I'll follow.
- Excellent.
Dr.
Bekker, you'll lead.
Dr.
Rhodes, you'll assist.
Mm-hmm.
- [DOOR OPENS.]
- Oh, don't look so pained.
I think you just earned yourself some good will.
When did Emma's pain start? About an hour ago, halfway through ballet class.
I wasn't sure if I should bring her in, but her mom would have my head if something happened to her.
[GROANS.]
I was worried that it might be appendicitis.
No, appendicitis would be pain on her right side, but I would like to get an ultrasound.
You know, when I was young, I wanted to take ballet, but unfortunately, I was born with two left feet, so I went with violin instead.
Well, I don't really like dance, but my mommy did ballet when she was young, so she makes me go.
Oh.
[CHUCKLES.]
Right now, I'm gonna put this on your stomach, so I can see what's inside, okay? All right.
Monique, can you increase the depth? I can't see her uterus and ovaries.
It's already all the way up, Dr.
Manning.
[SOFT MUSIC.]
All right, let's start a line.
Give her 1 milligram of morphine for the pain.
And let me know as soon as her mom gets here.
I'd like to speak with her.
Is Emma gonna be okay? Yes, but it's a good thing that you brought her in.
All right, Emma, I'm gonna be back soon, okay? - Okay.
- Okay.
- Thank you.
- Thank you.
Hey, Dr.
Charles, you got a sec? I've got a case I'd like to run by you.
- What you got? - My patient, Emma, nine, she presented with abdominal pain on the left side, so I did a quick bedside scan to check her ovaries.
It's actually testicular torsion.
- Testicular torsion? - Yes.
The ultrasound showed an absence of uterus and ovaries, - but she has undescended testes.
- Huh.
Nothing about this in her chart? No, I doubt the family has any idea.
Okay page Pediatric Urology.
- We need to get a plan together.
- Okay, thank you.
I suspect Emma has 17-beta HSD3 deficiency.
It's caused by a genetic mutation.
Emma's testes aren't able to carry out the final step of testosterone synthesis.
So, just to be clear, genetically, she's male? She almost certainly has XY chromosomes, yes.
As far as the testicular torsion, what's required? We need to untwist the testis and then fixate it via orchiopexy.
So we'll be able to save the testicle? With surgery, yes, otherwise it'll die from lack of blood flow in six, maybe eight hours tops.
Okay, thank you, Dr.
Rios.
We'll share the news with her mother and get surgical consent.
This news could change Emma's whole sense of identity.
It is a lot for this family to process.
You know, my experience in situations like this is that the children are often surprisingly open-minded and resilient.
What's the story? Well, Carter said that Bo was cooking up BHL.
Uh, butane hash oil.
You blast marijuana with enough butane, and you get pure THC.
Lengths kids will go to to get high these days.
Exactly.
Uh, Carter said he heard screams from the other room, so he ran in, he tried to pat out the flames on Bo.
Then his sweatshirt caught fire, but he dropped and rolled.
Guessing from Bo's burns, he didn't do the same.
Yeah, Carter said Bo panicked and ran.
Can I talk to him? He's nonresponsive and on a ventilator, but I'll you know.
Hey, Will.
Dr.
Frisch.
I think after last night, you can call me Maia.
Lunch? I'm buying.
Uh, pretty slammed today.
Another time.
[CLEARS THROAT.]
I take it you and Nat are on the outs still? As far as I know.
Careful.
She'll come around.
Mr.
Lee, this stage in your life can bring a lot of painful emotions and memories up.
I can help to talk about what you're feeling, any concerns you're having, fears, regrets.
Henry, what is it? What's wrong? Where's my shirt? [SOFT, SOMBER MUSIC.]
My boy Jackson.
You have a son? When he was little, he was my shadow but as he got older, we started butting heads.
Didn't care too much for all my rules.
Rough neighborhood where we lived.
Sounds like you were just trying to protect him.
But maybe I was too hard on him.
His mom passed about ten years ago.
After the funeral, we had words.
Said some ugly things to each other.
Haven't spoken since.
Do you have his phone number? Any idea where he lives? Last I heard, he was up in Wilmette or maybe Skokie? Can't remember.
Should've reached out sooner.
It's not too late.
We'll find him.
We will do our best, Mr.
Lee.
Don't you think you're overpromising? How do you know we'll be able to track this guy down? I'm not letting Henry die alone.
Ruptured atrial appendage.
Median sternotomy was the right call.
Ah, it was a coin toss.
Could've gone the other way.
Still, pulling someone through that kind of blunt trauma, it's impressive.
You should write it up.
I know I said play nice, but don't go soft on me.
- That's no fun.
- Hold on There are only 244 instruments here.
There are supposed to be 245.
Dr.
Rhodes, stop closing.
Everyone search your areas.
Check your trays, the drape pockets, - look in the basins, everywhere.
- It has to be here somewhere.
[TENSE MUSIC.]
Somebody talk to me, anybody! We counted three times already.
Instrument's in the chest.
Get a tech in here to get a chest X-ray, and page Dr.
Latham now! I don't understand.
How could her doctors have missed this for so long? Why don't we go somewhere more private? Your daughter is in excellent hands, trust me.
Here, right this way.
So, because Emma's genitals are typically female, there was no reason to suspect that she had the condition.
If the testicular torsion hadn't caused Emma's pain today, it's very likely she wouldn't have been diagnosed until she reached puberty.
What happens during puberty? When Emma turns 12 or 13, uh, the testes will start to make testosterone.
She may develop typically male attributes: um, body and facial hair, an Adam's apple, - her voice may deepen.
- What? No, that can't happen.
You have to take them out.
The only thing that is medically necessary right now is to alleviate Emma's pain by untwisting the testis.
But Emma would have to have another surgery down the line, right? I mean, she'd have to have them taken out.
She's a girl.
Children with Emma's condition often identify as male after puberty.
No, that's not That's not gonna happen.
I want you to take them out.
To perform an irreversible procedure of this nature, we would need to inform Emma and get her assent.
Her assent? She's nine.
She won't understand, and even if she does, - it'll traumatize her.
- We fully appreciate how completely overwhelming this is right now.
Really, we do.
But the truth is is that the evolving thinking among medical ethicists is that children should be afforded gender autonomy, regardless of their age.
You know what, I just wanna be with my daughter right now.
Of course.
[SOLEMN MUSIC.]
- What the hell is that? - No idea.
Not an instrument I recognize.
But it is a foreign body, and we can't pinpoint where it is.
It could be in the pleural cavity, the pericardium.
We're going to have to reopen the sternotomy.
Clearly.
How could a careless oversight like this occur? We use the same instruments, the same routine every single time.
How could both of you miss it? Is is the patient's skin fully closed? No.
A few staples away.
[SIGHS.]
If the skin isn't closed, then the incident isn't a sentinel event.
Going back in won't be considered a second operation.
You both narrowly escaped an investigation by the hospital and a report to IDPH.
I want you in my office as soon as you retrieve the foreign body, and I wanna know who's responsible.
[INHALES SHARPLY, EXHALES.]
Don't beat yourself up.
It's only your second strike.
You know this could just as easily be your instrument, right? Lucky it's an easy fix.
You better not have been smoking with Bo.
I wasn't, Mom.
I told you already.
[GROANING.]
Bo almost ended up in juvie last year, but the judge agreed to give him another shot.
Now, you would've thought he would've learned his lesson Mom, just shut up, okay? - Whoa, whoa, whoa - Excuse me? Don't talk to your mother like that.
What is with you? [BEEPING.]
What's going on? - Sats are dropping.
- What's wrong with Bo? Take him off the vent and start bagging.
He's bradying down.
Heart rate's 30.
Milligram of Epi.
- No pulse.
PEA.
- Another milligram of Epi.
Asystole.
He's gone.
No.
No! No! No! - Son - Bo, please! - Carter - Carter Carter - No, just go save him, please! - Sweetie Please, Bo, come on, man! - Bo! - Carter Bo, come on, man! [SOBBING, SCREAMING.]
- That poor family.
- Yeah.
It's strange.
Bo's parents said he'd been doing so well.
They'd been regularly drug-testing him.
He'd been clean for months.
Guess he just fell off the wagon.
Did you get a tox screen on Bo? No, why? Do me a favor and get one.
I'm gonna get one on Carter.
Jackson Lee.
No? Okay.
All right, thank you, bye.
Hey, any news? Not yet.
I think I found his Linkedln profile, though.
Just trying to track down a phone number or an email address.
I have a friend over at the DMV.
Send me what you have on Jackson.
- I'll see what he can do.
- Thanks, Maggie.
- Yeah.
- Need some help in here.
Okay.
Sats down to 90.
CO2's at 65 on the ABG.
Okay, Mr.
Lee, you have DNI and DNR orders on your chart.
Now, I need to confirm that you do not want us to intubate you or perform CPR should your heart stop.
[TENSE MUSIC.]
Okay.
Then we're gonna make you feel comfortable.
Start a morphine drip and give 4 of Ativan.
[SOLEMN MUSIC.]
Okay.
No holes in the right pleura.
Or the left.
It must be in the pericardium.
Give me more suction.
[TUBES HISSING.]
Instrument's not there.
It's in the heart.
We're going to have to reopen the atriotomy.
That's going to require putting him back on bypass.
You're increasing his risk of air embolism and stroke.
We're aware, Marty, but we don't have a choice.
Your quick fix just got a lot more complicated.
Hi.
You feeling better, Emma? My mommy says I'll need an operation.
Yes, that's what my friend, Dr.
Charles, and I - came to talk to you about.
- Hi, Emma.
So, you remember when I took a picture of your belly earlier? Well, it showed me that you have something inside of you.
Something that only boys have, honey, not girls.
That part inside of you, it may cause you to change a little on the outside in a few years.
It'll make you look like a boy.
Ms.
Paulson, would you mind giving us a moment to explain? Please? So, Emma most people who look like girls on the outside feel like girls on the inside, but sometimes, a person who looks like a girl on the outside feels like a boy on the inside, and you know what O okay, stop, stop, you You're just confusing her.
Of course Emma feels like a girl.
Sweetie, the part inside of you, it's what's hurting you right now, so Mommy wants the doctors to take it out so that you'll be safe.
- Mrs.
Paulson - Wait, will it hurt? No, not at all, sweetie.
You'll be asleep the whole time.
And when you wake up, we can get chocolate sundaes.
So it's okay if they take them out? Mm-hmm.
Ms.
Paulson, can we speak to you outside for a moment? [DISQUIETING MUSIC.]
Okay, you heard her.
You have her assent.
Take them out.
It was not an informed decision.
Well, Emma's nine years old.
She didn't understand half of what you were saying.
Again, regardless of her age, it's very important that we at least try and explain the situation to Emma, so we can give her a chance to tell us how she feels.
I I know how she feels.
I know my child, and I won't let you manipulate her.
We were not trying to manipulate her.
Why don't we take a beat, let Dr.
Manning and I put our heads together, and see if we can come up with a course of action that everybody's comfortable with, okay? [TENSE MUSIC.]
I take it things didn't go well.
Emma's mom coerced her into having her testes removed.
Yeah, we gotta get Goodwin involved to see if we can convene an emergency ethics panel.
We have three hours tops until the testicle dies.
We better move fast.
Given the placement and orientation of the handprints on Carter's back, there's no way they're his own.
Okay? So? So Carter told my brother, Jay, that he tried to slap out the flames on Bo.
I haven't said anything to Jay.
So, you think Carter may have started the fire and is blaming Bo? Carter tested positive for THC.
[BROODING MUSIC.]
Bo was clean.
Thank you, Dr.
Halstead.
What you up to? I'm trying to write a budget for this research grant application, but Excel formulas hate me.
Well, I don't know if you know this, but I am kinda a math whiz.
I am, I can take a stab at it, if you wanna go see your dad.
I don't.
I I I don't want to talk about him, and I don't wanna see him.
Okay? Yeah.
Noah I know you Sextons are as thick as thieves, but not every family's like that.
[PHONE BUZZING.]
April? [SOLEMN MUSIC.]
Your son is coming, Henry.
Jackson's coming.
Thank you.
My angel.
Metzenbaum and DeBakey Forceps.
[TENSE MUSIC.]
Reopening the atriotomy now.
I'll need better visualization.
Suction.
Ah-ha.
There it is.
Stuck in the ostia of the pulmonary vein.
What is it? It's the tip of a suction catheter.
You were the only one on suction.
[DISQUIETING MUSIC.]
Then hold on.
Cardiac suction catheters don't have detachable tips.
At one point, Dr.
Bekker had to suction an area herself.
I handed her a catheter from a trauma tray.
I think it's yours.
Well, we're going to need to take it out, aren't we? Stone forceps.
Forceps.
Got it.
His BP is dropping.
The vessel tore.
He's bleeding out.
Quick, get me some 5-0 Prolene and a long needle driver.
Careful you don't ligate the vein.
If you narrow it, he could lose part of his lung.
Why don't you stop backseat driving and help me save his life? You okay? Yes.
No.
My patient's mom is trying to force an invasive surgery on her.
Unless the ethics committee intervenes, I don't think I'm gonna be able to stop it.
I mean, I know I shouldn't be unloading on you.
I'm I know we're I'm sorry.
No, it's okay.
Case sounds tough.
Sorry, Nat but I know you'll figure it out.
Yeah.
You look exhausted.
Are you okay? Uh, yeah.
Had a tough time sleeping last night.
Anyway, good luck.
Finished repairing the pulmonary vein laceration.
BP any better, Marty? Talk to me.
Vitals are stable.
Dr.
Rhodes, close the atriotomy, take the patient off bypass, and staple him up.
Uh, wait a second, you're the lead here.
You have to decide how you want him closed.
Wires or plates and screws for the sternum? Don't you remember how we closed him last time? Do it again.
[DOOR CLOSES.]
[DISQUIETING MUSIC.]
I don't know who the hell you think you are, but that stunt you just pulled, leaving me there to clean up your mess? I'm sorry.
[INHALES SHARPLY.]
I'm sorry.
[SOBBING.]
Come on, Ava, you don't have to worry about your reputation, okay? This isn't some reflection of your surgical skill.
This is just it it's human error.
It could happen to anybody.
You really think it's my reputation I'm worried about? Bruce Bruce almost died today, because of my stupid mistake.
He didn't Hey, listen to me.
Ava, he didn't.
He didn't, okay? He's in recovery because of what you did.
Oh [SNIFFLES.]
What if he has deficits? [SOBBING.]
I could never forgive myself.
Involuntary manslaughter's a class three felony.
Carries a potential jail sentence.
It certainly doesn't help matters if Carter lied during his statement.
Why are we discussing charges when we should be talking to the police? I'm sorry but whatever the consequences are, Carter needs to face them.
You're right.
Thank you, gentlemen, for filling us in.
We'll handle it from here.
- [DOOR CLOSES.]
- Look, Sharon CFD and CPD will conduct their own very thorough investigation, and it is in the hospital's best interest and frankly yours to not put yourself in the middle.
But I am in the middle, Peter.
Carter's my godson.
I've known this boy since he was in diapers.
He's not some master manipulator.
If he lied, it's because he was scared.
Beside the fact that the Singleton's are your friends, they are also major donors to this hospital, and there is a multimillion dollar relationship at stake here.
So if the kid is gonna get in trouble, please, let PD be the bad guys.
Any word from the ethics committee? No way.
No way they're gonna allow this.
Because, technically, they have both Judy and Emma's consent, and because testicular torsion is a medical emergency, the hospital feels obligated to act.
But the assent was coerced.
Yeah, but coercion's very difficult to prove, and the truth is that in the majority of these cases, the court's do side with the parents.
The board's worried about a negligence suit.
- [GAGS.]
- What? Oh, no.
Oh.
[TENSE MUSIC.]
Help.
Someone, help.
Uh, what what what what's What's wrong with her? The testicle must be more ischemic.
- Not getting enough blood flow.
- [GROANING.]
We can't wait any longer.
Prep this patient for surgery now.
Mommy, I'm scared.
I don't want them to hurt me.
No, no, no, honey, they won't hurt you, I promise.
Judy, I know you love your daughter, and I know you're afraid of what the future might hold, but Emma trusts you, she counts on you.
I just I don't want anything to happen to my little girl.
- She's all that I have.
- You're not gonna lose her.
No matter what gender Emma identifies with, she's still gonna be your child, the same kid who loves chocolate sundaes - and hates ballet.
- She told you? That's the exciting part: having our kids show us who they are in their own time.
Mommy? Mommy? Don't take them out.
- Are you sure? - Yes, I'm sure.
Hey, Maggie, any word from Henry's son? I thought he was just driving down from Wilmette.
His phone keeps on going to voicemail.
Maybe he changed his mind about coming.
How can he let his father die alone? We don't know the whole story, April, what went on between them.
Some things are hard to get over.
I never should have gotten Henry's hopes up.
- I have to tell him.
- I'll go with you.
[SOLEMN MUSIC.]
Henry? Henry Jackson - Son - Henry, I'm sorry I'm here.
[POIGNANT MUSIC.]
I'm right here.
You came? Yeah.
My boy.
My boy.
The evidence is substantial, and it's in Carter's best interest to come clean to the police on his own.
A jury will look favorably on that.
A jury? Oh, God.
No.
Sharon, I am begging you, - please do not say anything.
- Lydia This will not bring Bo back, and it will ruin Carter's life.
- Grace? - I had to talk to you.
When we got here, Dr.
Choi told us what, uh, Carter did.
Grace, I He said when the paramedics found the boys, that Carter was performing CPR on Bo.
I'm so sorry, Lydia.
I'm so sorry that Bo got Carter into this mess.
I'm so sorry.
Hey, Will thank you for earlier.
I didn't do anything.
Well, that's the point.
You just listened.
I appreciate it.
All right.
Well, I'm always here to lend an ear anytime you need.
How 'bout tonight? Oysters at Shaw's? - Sure.
- Okay.
Hey.
You know the last time we were in a hospital room together? [CHUCKLES.]
The day you were born.
- You were there? - Mm-hmm, yeah.
I was holding you when you opened your eyes for the first time.
You know, they say it takes about a week for a newborn to focus on objects, but I swear, you looked right at me.
And that was it.
I was hooked.
You know, Carter, you're my godson.
I only want what's best for you.
And if there's anything else you need to tell the police, baby, now is the time.
You [SOLEMN MUSIC.]
You're gonna carry this day with you for the rest of your life, and holding a secret on top of that it'll be too much, baby.
It'll break you, Carter.
It'll break you.
Yes, he's hanging in.
Yeah, I'll Let let let me call you back, Miles, thanks, bye.
What is he doing here? Carter asked to speak with Detective Halstead again.
What did you say to him? I'm sorry, Lydia.
You're sorry? [SOLEMN MUSIC.]
That was the right thing to do, Ms.
Goodwin.
Yeah, I think that's debatable.
When the Singletons pull their funding, which I imagine they're going to do, you're gonna have to answer to the board.
I'm prepared to do that.
Noah what you did in there You think I was wrong for letting him think his son was there.
No.
No, I don't.
I think it was really kind.
I'm sorry I snapped at you earlier.
No, you don't you don't have to apologize.
That's No, I do.
I do.
You were just being a friend.
When I said I didn't wanna see my dad, the truth is I don't want to want to see him.
Does that make sense? - Um - It's okay.
It doesn't make sense to me either.
- Night, Noah.
- Night.
- How's the patient? - Just waking up.
But his vitals are stable and he's neurologically intact.
Ah.
I suppose you know what I'm going to ask next.
It was my instrument, Dr.
Latham.
I take full responsibility.
No, it was my instrument.
My fault.
- That's not true.
- Yes, it is.
Ah.
[CHUCKLES.]
[EXHALES.]
My rabbi used to say, "Klieg, Klieg, Klieg, du bist a nar.
" Ah.
"You are smart, smart, smart, but, eh, not so smart.
" You both are my most promising fellows, but now I am no longer certain that either of you should be my second for the conjoined twins surgery.
[EXHALES SHARPLY.]
I'll be watching you both very closely going forward.
- You didn't have to do that.
- I know.
- I can take my lumps.
- Never said you couldn't.
I guess we're both in the doghouse now.
Plenty of room for two.
Don't worry, you get used to it.
Builds character.
[LAIDBACK MUSIC PLAYING.]
Here you are, sir.
Oh, hey.
I ordered us half a dozen of Henderson Bay oysters.
What do you want to drink? - Uh, excuse me - Wait, Nat If there's any chance we're moving forward here, there's something I gotta tell you.
What is it? Last night after work, I grabbed a drink.
I met someone at the bar.
It was nothing.
It was just high school stuff.
- High school stuff? - It didn't go beyond kissing.
[SOLEMN MUSIC.]
Well, not much.
And I I thought of you.
I put the brakes on.
I actually fell asleep on her couch.
Were you thinking of me when you went home with her? Nat, you've been so distant the past two weeks, I didn't know if things would turn around between us You know, when I asked for a break, it was never about wanting anyone else.
I don't want anyone else.
It meant nothing, I swear.
Nat, I'm so s