Chicago Med (2015) s04e12 Episode Script

The Things We Do

1 [HELICOPTER BLADES WHIRRING.]
Touching down at Med in eight minutes.
Sounds good.
Hey, Daniel.
- What's up? - [CHUCKLING.]
How was your weekend? I actually went out on a date.
Nice! With that guy you met at that The jazz club? At Andy's? Nope, I met him online.
Online? I thought I'd give it a shot.
Wow.
I don't know, man.
Placing the deepest core of my innermost self in the hands of an algorithm? Not sure I'm there yet.
Well, where else am I gonna meet anybody? Are you gonna go out with him again? Uh-uh, but I'm gonna keep trying.
[ELEVATOR DINGING.]
NICU wants to know how he's looking.
Uh, he's tolerating the ECMO and his vitals are good.
All right, we'll be there in about two minutes.
[CLANGING.]
- What's going on? - Power's gone.
What do you mean the power's gone? We lost an engine.
We're gonna have to land.
[BEEPING.]
Brace yourself.
[BLADES WHIRRING, BEEPING CONTINUES.]
[SUSPENSEFUL MUSIC.]
Hold on tight! [CRASHING.]
[PANTING.]
- Are you guys okay? [PANTING.]
Yeah, uh Cody's foot is jammed and, uh, I think I dislocated my shoulder.
- You? - My leg's stuck, but I'm okay.
You guys just sit tight.
I'm gonna call for help.
Okay.
This is November Hotel 6-3-2-0-1.
We've made an emergency landing in Townsend Quarry.
Looks like we've got a bent airframe.
We're gonna need assistance evacuating the aircraft.
[BEEPING.]
His sats are down to 94.
His oxygenator is not working.
He won't make it to the hospital.
Call Med we need to get a new oxygenator out here fast.
- This is November Hotel - Ah! Vicki and I just hung around the apartment, nothing big.
You okay? Yeah, I've been crashing on my brother's couch.
It's like a pile of rocks.
You're still not back with Nat? What's going on? Uh, she kicked me out.
You got to ask her.
Dr.
Manning's helicopter just went down hard outside of the city.
Is Natalie hurt? Nothing serious, dislocated shoulder.
The patient's okay, but they're stuck.
The oxygenator on the ECMO is damaged.
We need to get a new one out to her now.
Okay, Dr.
Choi, grab an ambulance.
- No, I'll go.
- No.
I just put a patient in five.
Let Choi do it.
- No way, I'm going.
- And I'll cover for him.
- Thanks.
- Suit yourself.
- [KNOCKING.]
- Mr.
Green? Hi, I'm Dr.
Choi.
Yeah, it's Bruce.
This is Carol and Jesse.
Nice to meet you.
So what seems to be the problem? [SIGHING.]
My belly is killing me, man.
He's been throwing up a lot.
- It's getting worse.
- [GROANING.]
My mouth is dry.
Hey, Jesse, could you grab my water bottle? [SOMBER MUSIC.]
Thanks, bud.
What happened to you? Broke my arm.
That's a bummer.
You know, I think Monique might have some cool stickers to put on your cast.
Want to go take a look? Sure.
Nice.
I'll run some tests, but everything I'm seeing points to liver failure.
Any history of hepatitis? No.
How about alcohol abuse? Couple of drinks here and there.
How many drinks is a couple? I don't know, two or three while I'm watching the game.
- Honey - Carol, we I'd like to take some blood and get a CT, then go from there.
We can discuss this more once I have the results.
Okay.
Dr.
Choi? He drinks more than he says he does.
It's a problem.
Look, we'll do everything we can for him, but he won't get any better unless he stops drinking.
I tried.
Nothing works.
Let me have one of our psychiatrists talk to him.
He might be able to help.
[SIGHING.]
Thank you.
Sure.
What, no coffee today? All that vanilla syrup is going to go to waste.
What are you going to do? Connor, what's going on? Nothing.
Well, it's not nothing.
You've been distant and aloof for weeks.
Can you please tell me what's going on? There's nothing to tell.
I'm fine.
Dr.
Rhodes, Dr.
Bekker, your patient's here.
We're in Trauma 2.
- Thank you.
- I've got Barbara Duncan, Down syndrome, 21 weeks pregnant, passed out and is stable now on five liters O2.
This is her mother, Kathy.
Hi.
Hey, Barbara, I'm Dr.
Rhodes, I'm gonna take good care of you, okay? - Okay.
- Good.
All right, let's transfer on my count.
One, two, three! There we go.
So what happened? I got dizzy.
She fainted in art class.
This is the second time this week.
I have a baby in me.
Congratulations.
I'm gonna be a great mom, just like my mom.
I am certain that you will.
So I spoke with Barbara's cardiologist.
He said that she has a congenital heart defect? Tetralogy of Fallot.
It wasn't that severe, so they decided not to repair it.
Oh, it's it's possible the extra load from pregnancy is starting to cause too much strain.
Well, her lungs are wet.
So, Barbara, we would like to run some tests to figure out what's wrong.
Is that okay? Sure.
Good deal.
We will check on you soon.
Doctor, is she gonna need surgery? It's possible, but we need to wait and see her test results first.
Fine, just let me know as soon as you can in case I have to make arrangements or bring in special equipment to the house.
Look, I I know that this is all a lot, so is there anybody else that we can call? Maybe the baby's father? He took off.
It's just the two of us.
Excuse me.
[SOLEMN MUSIC.]
Ethan, I, uh, I just talked to the Greens.
Any luck? Well, he doesn't seem to think he has a problem.
I think the wife's been trying to get through, but Yeah, but what can she do? She's a victim in this too.
Yeah, family dynamics can be crucial when it comes to recovery.
You just don't tend to get results by maintaining the status quo.
In my experience, something pretty drastic has to happen to get the drinker to realize they hit rock bottom and start looking for a solution.
Dr.
Charles, he's got portal hypertension, esophageal varices, and LFTs through the roof.
This is rock bottom.
You'd think.
[SOLEMN MUSIC.]
[SIREN WAILING.]
Hey, guys, I need to get this oxygenator down there.
Oh, it's gonna be a minute.
We gotta get our extrication equipment down first.
Natalie's got a dislocated shoulder and her patient's in trouble.
All right, we'll send it down in the basket.
- No, I'm going too.
- Doc, come on.
We don't even have our guys down there yet.
I have to get to Natalie.
Send me down now.
[SUSPENSEFUL MUSIC.]
[SUSPENSEFUL MUSIC.]
- You okay? - I'm fine.
- How's the boy? - Sats are down to 82.
What about your shoulder? It's all right.
I'm fine.
[CRACKING.]
[GROANING.]
- Got it? - Yeah.
[GROANING, PANTING.]
[GROANING.]
- Wait, stop.
- Ah! Let me see if I can pry open another window.
I told you I'm fine.
Natalie, just hold on.
You don't have to be a hero.
Ow.
Come on.
What, do you want to damage the nerves? I don't need your medical advice, Will.
[PANTING.]
Mr.
Flores, can you tell me how long you've been in pain? Uh, just since last night.
Usually her cooking wears off by the morning.
- [CHUCKLES.]
- Okay.
Have, uh, you ever had pain like this before? Uh, no.
Any history of abdominal conditions or surgeries? No.
[GROANING.]
Okay, based on your positive McBurney's sign and rebound tenderness, I suspect you have a routine case of appendicitis.
Do you have any allergies? Uh, not that I know of.
Then we're going to order some tests and call Surgery.
- Surgery? - Mm-hmm, yes.
If necessary, an appendectomy is a very simple procedure.
You'd most likely be out of the hospital by tomorrow.
Okay.
[GROANING.]
Here you go.
- Oh, thank you.
- Yeah.
Um, I like to keep notes on all my cases.
[CHUCKLING.]
Tell radiology we need a C with contrast, stat.
Nah, keep it.
Turns out people don't hire a flooring company 'cause you give 'em free pens.
[CHUCKLING.]
Who knew? Yeah, that does seem unlikely.
[CHUCKLING.]
And for the pain? I think it's time to take it back.
- Ibuprofen 600.
- Okay.
Would you excuse me for a second? Of course.
Oh, yeah, snack time.
Yeah.
I would stay away from those apple slices.
They don't change them out that much.
Okay, thanks.
[GROANING.]
Whoa, I got you.
I got you.
That's an excellent cast.
What did you do to your arm? I broke it.
What, bear attack? Motorcycle? Oh, it was nothing.
I just you know, I fell.
[SOMBER MUSIC.]
From my treehouse.
[WHIRRING.]
[BEEPING.]
Oh, excellent choice.
So, um, what happened? Uh, what, rainy day? Rotten plank? Oh, I you know, I was just playing around.
I got to get back to my mom and dad.
So, Barbara, your tests are showing that you are in heart failure and we have every reason to expect that it will get worse as the pregnancy progresses.
How much worse? It's impossible to say, but the odds of you having a life-threatening event are quite high.
So she needs the surgery.
That would be my recommendation, yes, but you should know, the surgery is long and difficult and it could pose a risk to the baby.
It's gonna hurt my baby? It's possible.
And, unfortunately if it does, your baby is too small to survive on its own.
- He'll die? - He may.
No, I don't want the surgery.
Barbie, I don't think they're saying that we have a choice.
- Yes, we do.
- Honey You don't want to take care of this baby.
Barbara Oh, you think it's going to be a problem like me.
I know this is difficult and painful, but you have to let me handle this.
No, this is my decision! You're not capable of making this decision! [SOBBING.]
[SOLEMN MUSIC.]
[SNIFFLING.]
Look, why don't you two take some time? You can think about it and we will come back in just a bit.
[SIGHING.]
Excuse me.
I have Barbara's medical power of attorney.
Do the surgery.
Ms.
Duncan, I really think that the two of you should If she doesn't have the surgery, she could die.
Do the surgery.
I'll go put her on the schedule.
No, you won't.
You heard her mother, she has power of attorney.
I heard my patient and she doesn't want it.
Got it.
- Are you okay? - Yeah, thanks.
- Hey, Cruz.
- Yeah.
Help me try and get this kid out.
- On my way.
- How's Cody doing? His sats are improving, but the battery is running low on the ECMO.
Well, looks like they should have him out soon.
Let me reduce your shoulder.
No, we'll do it when we get back.
We still have to get him out of here, back to the ambulance, and all the way to Med.
You're gonna need your arm.
Fine.
[HISSING.]
[GROANING.]
No, I um, I think you're a little too high on the forearm.
Natalie, I've done this before.
Yeah, I know, but this is the arm that I You broke in college when Lisa Gates ran into you with her bike.
I know.
All right, you're gonna feel this.
- Just be still.
- Okay, but I still think [CRACKING.]
Ow.
There, try it out.
[PANTING.]
It's good.
Thank you.
I'm gonna go check on Cody.
Dr.
Choi? Is my dad gonna die? [SIGHS.]
We're doing everything we can to help him get better.
So he might? Give us a chance.
We still have some things we can try.
[SIGHS.]
[SOLEMN MUSIC.]
Doc, that thing for me? Once we drain the fluid from your abdomen, it'll be easier to breathe.
And then what happens? We'll start you on a diuretic.
Then have you evaluated for an intrahepatic porto-systemic shunt That sounds serious.
It is, but here's the thing If you keep drinking, none of it will work.
Come on, Doc, I told you You'll lose your mental status first.
Confusion, memory loss.
That's when your kidneys start to fail.
Your lungs fill with fluid.
Then it's either heart failure, infection, or coma.
Probably two, three months tops.
Okay, I get it, it's It's your job to scare me.
My job is to try to keep you alive and, from what I can tell, you have a lot to live for.
But it's up to you whether you want to do that or not.
Let me know when the drainage stops.
Bruce.
Okay, you're right.
Clearly, I drink too much.
She's always telling me that.
[SNIFFLING.]
Oh, that's it.
I'm done.
Quitting doesn't mean just saying it.
It means going through detox, A.
A.
Doc, I got a boy I love, my wife.
I am telling you I have taken my last drink.
[SOLEMN MUSIC.]
Okay, let's get you stabilized.
Then I'll have a social worker come down to go over the next steps.
Thank you.
[BEEPING.]
A code in radiology? Let's go.
[DRAMATIC MUSIC.]
[STRAINING.]
Did he get contrast? Just a minute ago.
Okay, it's an allergic reaction.
His throat's swelling.
.
3 milligrams of epi IM.
Okay, Pete, just relax.
Try and take a deep breath.
Epi's in.
I need to intubate.
Laryngoscope and ET tube.
He said he didn't have any allergies.
Look, you don't always know until they happen.
[SUSPENSEFUL MUSIC.]
Tube's in.
Start bagging.
- [BEEPING.]
- He's in V-fib.
Grab the paddles.
Curry, run the code.
- What? No, I - Curry! [BEEPING.]
Okay, um Ch charge to 200.
[RIPPING.]
[CHARGING.]
Clear? [ZAPPING.]
Still in V-fib.
Giving an amp of epi.
Again.
[CHARGING.]
- Charging to 200.
- Clear! [ZAPPING.]
Charge it again.
April, 200.
It's over.
- What? - Call it.
[FLATLINING.]
[SCOFFING.]
Time of death, 13:06.
And this young woman with Down syndrome is 25? Yes, she is an adult and does not want the surgery.
Barbara has a life-threatening condition.
She needs this procedure.
And what happens if she doesn't get it? We will put her on medication.
We'll have her get weekly checkups from her cardiologist.
And she'll likely still die from heart failure.
Barbara's mother has spent her entire life caring for her daughter.
Everything she's done, she has done for her.
We need to trust her judgment.
We need to let people make their own decisions, not have them made against their will.
I understand your concerns, Dr.
Rhodes, but the patient's mother does have legal decision-making power.
I don't see any choice but to authorize the surgery.
Thank you.
Okay.
We should give Barbara some credit for knowing what she wants.
What is going on with you? I want to honor my patient's wishes.
No, we've had professional disagreements before.
This is different.
This feels personal.
All right.
My father told me his version of how he came to donate the money for the Hybrid OR.
Yeah, he said I slept with him.
He's lying.
He said that you were the instigator, that you seduced him.
It sounded like he was telling the truth.
Patient is out and we're on the move.
Copy that, squad three.
We'll notify Chicago Med.
I knew you didn't want to go, but how's therapy going? Only gone once, but Dr.
Moore seems fine.
Good.
Well, I mean, I'm glad you like her.
She spent a lot of time waiting for me to say something, but I didn't know what I was supposed to talk about.
What happened, happened.
- [ALARM BEEPING.]
- Dr.
Manning! His sats and heart rate are tanking! [DRAMATIC MUSIC.]
No breath sounds on the left.
The bag must've blown out the lung.
- We need a chest tube.
- No, he's too anticoagulated.
A chest tube might cause a major bleed.
I'm doing a needle.
Wait, a needle is only temporary.
He's still gonna need a tube.
We can deal with that when we get there.
- He needs decompression now.
- Natalie You know what? You're right.
Let's do a needle.
[BEEPING.]
Sats are back in the 80s.
Breath sounds are better.
Let's get him out of here.
Barbara, I'm very sorry but we do have to take you up to surgery now.
No, I don't want to go.
Everything is only getting worse.
I'm afraid we don't have a choice.
But my baby! We're going to do everything that we can to make sure that your baby is safe.
You said you can't! You said my baby might die! Mom, make them stop! Sweetie, it's going to be okay.
Dr.
Rhodes? We're taking her up to surgery now.
[CLICKING.]
They're gonna kill my baby! - Everything's gonna be okay.
- It's my baby, Mom! No, I don't wanna go! No! No, no! You still haven't told her about her husband.
Uh, no, I was I was I was just about to.
Is this the first patient you've lost? Yeah.
You want to go over what you should say? No, no, I'm fine.
We had a lecture on this in second year.
- Why don't I come with you? - Okay.
I got worried.
It was taking so long.
Mrs.
Flores, I'm afraid there was a complication.
"Complication"? Your husband had an allergic reaction and stopped breathing.
We tried to save him, but his heart went into an arrhythmia and he he died.
What? Ventricular fibrillation.
He he died.
That doesn't make any sense.
You you said that that it was just his appendix and it was a simple procedure! Yes, but this was a a contrast reaction which had nothing to do with - He can't be dead! - I'm afraid he is.
His his heart went into a fatal arrhythmia.
That's not true! He's not dead! [SOBBING.]
Mrs.
Flores.
Mrs.
Flores, it is true.
We did everything that we could, but your husband is gone.
I am so sorry.
- No.
- I am so sorry.
No! So sorry.
[SOBBING.]
Oh, God.
No.
Help! We need help! He's been throwing up.
[RETCHING.]
Activate the MTP and get me an NG tube.
He's bleeding! Please! He has enlarged vessels in his esophagus.
They must've torn from the vomiting.
All right, Bruce, this is gonna be uncomfortable, but I need you to swallow for me, okay? [SCREAMING.]
Hang on, Mr.
Green.
This'll only take a second.
[RETCHING.]
Have you been drinking? Have you been drinking this whole time? - [GROANING.]
- Call GI.
We gotta send him upstairs for ligation.
How could you? You're killing yourself! Bruce, we can't stop the bleeding.
We have to send you upstairs for a procedure.
Let's go! This is what you get! - [COUGHING.]
- This is what you get! [RETCHING.]
The procedure could take awhile.
I'll bring you to a room where you can wait.
- It's fine.
- [BOTTLE THUDDING.]
- Bastard.
- [SIGHING.]
Where's Jesse? Jesse? Where is he? Jesse! Hank, have you seen her son? Broken arm? [DRAMATIC MUSIC.]
I didn't see him.
Where did he go? Let's check the waiting room.
You've seen a kid with a cast? Yeah, he was going towards the elevators.
Call security right now.
[SIRENS WAILING IN DISTANCE.]
[SOMBER MUSIC.]
Stay there.
Ooh, it's cold out here.
Leave me alone.
Jesse, I want you to know that I I really I really understand how hard this all is for you.
You've been put in a really tough situation.
I know it sucks.
[SIGHS.]
You know I got this hunch maybe you didn't fall out of your treehouse.
That maybe you jumped because you just want all the pain to go away.
You didn't want to feel all those Those helpless feelings anymore.
I get that.
I think that probably your dad feels that way when he wants to drink.
You might think that your dad acts the way he does 'cause he doesn't care about you.
Nothing could be further from the truth.
You your dad drinks 'cause he's trying to get away from From the difficult feelings, and not wanting to feel those feelings, I mean, it's the most normal thing in the world.
Yeah.
Thing is, it turns out that the only way to make them go away is to talk about them.
Yeah, talking about them, it can make bad feelings go away and it also helps you understand them better if they come back.
You know, so if you're up for it, I'd be really interested to talk about that stuff with you, if you want.
I mean, think about it.
In the meantime what I really want to do, I want to get you back inside so your mom and dad know that you're safe.
They're really worried about you.
You know why? It's just they love you so much.
So what do you say? Do you wanna go back inside? Ms.
Duncan? Sharon Goodwin, Director of Patient Services.
I wanted to return your legal documents.
Have you heard anything? Is Barbara okay? I'm sorry.
I don't have any news yet, but could I get someone to bring something for you from the cafeteria? A sandwich or some coffee? I'm not hungry.
Thank you.
Yeah, I'm sure this isn't easy.
If the baby dies, I don't think Barbara will ever forgive me.
Do you have children, Miss Goodwin? I do, three, but they're all grown.
With Barbara, it's like having a child who never grows up.
Don't get me wrong.
I wouldn't trade it for the world.
It's just the possibility of having another one.
It's a lot.
[CHUCKLING.]
.
I mean, the baby doesn't have Down syndrome, it's not that.
It's just I'm not 30 anymore and You don't feel up to it.
So I keep asking myself, when I pushed so hard for this surgery Did you do it for your daughter or yourself? Now, come.
[SOBBING.]
[SOLEMN MUSIC.]
- Scalpel and Debakeys? - Scalpel and Debakeys.
- [BEEPING.]
- Marty? Fetal heart rate is down to 115.
Can you get it back up? Transfusing her.
We're down to 109.
We're going to lose the fetus.
Where are we at on the bypass? 4 liters.
Crank it up to 6.
Wait, what are you doing? The fetus needs more blood.
Connor, our priority is to save the patient, not the fetus.
We can save both.
If you flood too much blood to Barbara's brain, she could have permanent neurological damage.
It could put her into a coma.
Fetal heart rate's down to 86.
Connor, it's too dangerous.
Dr.
Rhodes? It's what Barbara wants.
Turn the bypass up to 6.
[DRAMATIC MUSIC.]
Curry, write some admissions orders for Mr.
Bane in 6.
Okay.
[SIGHS.]
[SNIFFLING.]
[SOBBING.]
I'm so sorry, Will For the way things got between us.
Yeah.
You went through something terrible and I never even asked you what it was like to have your life in danger.
I can't even imagine.
You know, when I was in that room, afraid I was going to die, all I could think was I'd never see you again.
[SIGHS.]
I can't believe it.
My baby My baby tried to kill himself.
We're going to keep Jesse here for a few days if that's all right.
You know, see how he does, come up with a treatment plan for him.
But then what? After we get home, I already missed this once.
The signs aren't always so apparent.
You got to take it easy on yourself.
It's not like you haven't had other stuff going on.
Oh, God.
[SOBBING.]
How do I help him? You you wanna communicate with him.
Talk to him, listen, have honest conversations about what's going on in your family.
I think for Jesse, just knowing that you're there, it'll go a very long way.
[SOBS.]
- You ready? - Yeah.
Jesse Hey, Mom.
[SIGHS.]
We're gonna get through this.
I promise.
Mrs.
Green, uh, we heard your husband's procedure went well.
I'm leaving him.
We're gonna go stay with my sister.
Okay.
Bruce says he'll go to rehab, that he'll stop drinking, but I cannot risk Jesse's life on the chance that he doesn't.
And if he can stay sober for three months, I'll go back to him.
[SOMBER MUSIC.]
It takes a lot of courage to make a sacrifice like that.
Yeah.
Maybe now that'll finally get his attention.
Let's hope so.
Dr.
Rhodes, she's waking up.
Barbie, it's me, Mom.
- Barbie? - Mom? Barbara, do you know where you are? - Hospital? - Mm-hmm.
How is my baby? Why don't we find out? Can you help me out there? All right.
Good, and there he is.
Look at him.
Look at his little hand.
Mom, isn't he cute? He's beautiful.
We're going to have a beautiful baby.
Looks like the fever's starting to break.
He should be off ECMO soon.
[SIGHING.]
Good.
Have a good night.
Will? I want you to come back home.
To me.
You do? The thing is, you have to get rid of your gun.
I'm sorry, but that's just how it has to be.
Okay.
I'll take it to the police station tonight and, uh, turn it in.
[SIGHS.]
[SIGHS.]
- April.
- Have a good night.
April April.
We should talk about that kiss.
I'm sorry that happened.
I know you're with Vicki now.
There's nothing for us to talk about.
I cannot believe that you are even considering taking your father's word over mine.
Ava, every step of the way, you have lied to me.
About going to my dad, about knowing that he cut the check.
How am I supposed to believe anything that you have to say? Because I care about you and he doesn't! He never has.
Your whole life, he's tried to keep you under his thumb.
He's attempted to undermine everything you do.
He's trying to drive a wedge between us.
He said that he liked your perfume.
That it smelled like lilacs.
It does.
So what? I was standing over him.
I was I was showing him the prospectus.
That doesn't mean anything.
"The ends justify the means.
" Those were your words.
Connor I did not sleep with your father.
I wish I could believe you.
Daniel, it's late.
You still doing notes? Yeah, just cleaning a couple of things up.
What are you doing? Nothing.
What are you doing? Let me see.
A dating profile? Really? I thought you didn't trust algorithms.
I don't.
Ah, you're just scared.
I am.
So what changed? I don't know.
I witnessed this real act of courage today, love even.
Maybe it made me a little braver.
What can I say? Hope springs eternal.
[CHUCKLES.]
"Tell us about yourself.
" What am I supposed to say? "Jazz, walks on the beach"? You don't like jazz.
You like hip-hop.
- I like everything.
- Come on.
I got all night.
Let's do this.
- Oh, man.
- [LAUGHS.]
[TENSE MUSIC.]

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