Chicago Med (2015) s05e13 Episode Script
Pain Is for the Living
1 You have to work out whatever feelings you're having about Dr.
Marcel.
Fast.
Give me a Narcan inhaler.
You overdosed, but you're gonna be all right.
You're letting this get way too personal, Will.
It's never a good idea.
For God's sake, isn't it personal? You lost a brother to drugs.
Enough! I met you this morning.
I'm gonna try to turn things around.
Good.
Hey.
Hi.
I love you.
- Easy.
- Oh, God, sorry.
It's only me.
I wasn't expecting that.
Hey, I know work's not the place for ambush affection, but I couldn't help myself.
I won't hold it against you.
What's up? I haven't seen a smile this big since Navy beat Army.
Just thinking about being a dad.
Birthday parties, coaching teams.
It's a decade down the road.
We are three weeks into IVF.
You know what they say.
"You blink and the kids are grown.
" - Hey.
- What up? Pelicans covered the spread.
How many rings do the Pelicans have? Go Bulls.
Yeah, we'll see.
I'm a horrible person, aren't I? No, you're human.
What can I do to help? You got a time machine? - Hey, you.
- Hey.
Date last night.
Spill it.
It was nice.
He was polite, handsome, smart, but I don't think so.
Huh, well, polite, smart, and handsome.
- Sounds awful.
- All right.
The real reason, he's a psych professor.
I mean, the way he looked at me, I just couldn't shake the feeling that I was being analyzed.
This is the fourth first date without even considering a second.
Well, I'm glad you're counting, Mom.
It doesn't matter because none of those guys were gonna work out anyways.
Wow.
ESP.
Say, do you know when the Saints are gonna win another Super Bowl? All right, well, let me know if you get another vision.
All I'm saying is the right second date is out there and I'll know it when I meet him.
Help, please! My son! I got him.
Where am I going? - Trauma 1.
- Help my husband and son! Help, help, help, help, help! Help him.
I-I didn't know what to do.
Ow, ow! Bruising on his neck.
Protect it and bag him.
Hold C-spine.
What's his name? - Jamie.
- Jamie? Hey, Jamie, can you hear me? Okay, okay, take it easy.
You're okay.
Take it easy.
- What happened? - It was an accident.
Um, I choked him out.
I had to.
- It all happened so fast.
I didn't realize.
I just wanted it to stop.
Jamie was screaming, Dylan was crying, and Gordon.
I want you to take a deep breath, okay? Take a deep breath.
All right.
Have a seat.
Sit down.
Okay.
And, um I, uh, I just want you to tell me Tell me what happened.
Okay.
So I was driving, talking with Bella, my wife.
The, um, the boys were in the back.
Jamie was playing with his iPad.
Dylan grabbed it from him, but wouldn't give it back.
Jamie can't control his anger.
He started punching Dylan, got out of his seat belt, got on top of him.
He kept pounding.
Bella couldn't pull him off.
I could hear Jamie's fists cracking against Dylan's face.
He was screaming for help, so I pulled over.
Just threw myself on top of Jamie.
I wrapped my arms around him and held him as tight as I could.
When he gets like this, the bear hugs are the only thing that bring him back.
- Bring him back? - From his dark place.
Uh-huh.
Okay.
Will you, um, will you excuse me for a moment, Gordon? We're gonna take care of you little, man, okay? All right.
Ordered a CT.
But I'm almost positive there's a bilateral mandible fracture.
Gonna need surgery to wire it shut.
Man, Ethan.
Kid's only six years old.
Jamie? He's stable but tormented.
Dad choked him out.
Probably so he couldn't defend his little brother.
Sometimes I hate the ED.
Jamie, how are you doing? I'm Dr.
Charles.
Um, would you mind if I looked at your hands? Fifth metacarpal is broken on each hand.
That's really gotta hurt.
Um, look, we're gonna get you completely fixed up.
Okay? It was nice to meet you.
This is not child abuse.
Thanks, man.
You know, one of the volunteers works at a rehab center.
If you'd like, she can tell you about their program.
Yeah.
Sure.
Maybe another time.
If you change your mind, we're here.
- Will.
- Yeah? You have been here for hours.
Go home, get some rest.
Yeah, I could use some sleep before I start my shift.
Ah, damn it.
It starts in a half hour.
Uh, okay.
All right.
That woman over there, her name's Susan.
When she comes down, she's gonna be hungry.
- I stashed some protein bars - I know, I saw.
The electrolyte drinks too.
Get to work.
I'll be back later, you call me if you need anything.
That's the cry, that one.
It's not "I'm hungry" or "I'm tired.
" It's new.
Okay.
I know, I know, Axel.
You're in pain and my touching you is only making it worse.
Any changes in his sleep pattern? No.
Every baby book I read said put your child on a schedule and stick to it.
Been there.
My son's almost four.
I know, I know.
Almost finished.
Okay.
What about diet? I had to start using formula.
Just not enough hours in the day to pump, work, nurse, do laundry, pump again.
Single mom? Yeah, me too.
- Dad still in the picture? - No, but I'm okay with it.
Well, I'm not seeing anything out of the ordinary.
I mean, the switch from breast milk to formula could be upsetting Axel's stomach.
Have you noticed any diarrhea since the change? Here and there.
But this cry has been consistent for the last month.
I'll test for allergies, but infants and crying Don't say colic.
I've been to three pediatricians.
They all diagnosed colic and sent me home.
No.
Something else is going on.
Run tests, X-Rays, scans.
Just please, figure it out.
Okay, well, why don't we start with some basic labs and go from there? Is that okay? Sure.
Thank you.
I'll send a nurse in to get started.
Thank you.
Hey, Jamie, you hungry? Thirsty? I know your casts are bulky.
I can help you.
I'll leave the tray right here just in case.
Hi.
Nice to meet you.
They're talking about me.
About what I did to my little brother.
I didn't mean to hurt him.
I'm so sorry.
It's okay.
Okay, okay.
Well, after two miscarriages and five failed IVF attempts, we'd had enough heartbreak.
We adopted Jamie when he was a few days old.
Best day of our lives.
Do you know anything about his birth parents? Nothing really.
Mom was young, in foster care.
We don't know anything about dad.
Well, Jamie's 11 now, so how old was he when he first started acting out? As an infant, he didn't like being held.
- Was always fidgety.
- Hmm, how about as a toddler? Sitting still, taking turns, following directions, they were all a challenge.
When did Jamie's behavior start becoming aggressive? Elementary school.
Fights with classmates and teachers.
We're homeschooling now.
And your other son, Dylan, is he adopted as well? - Yeah.
- Mm-hmm.
It was initially Jamie's idea.
He wanted to be a big brother.
And in the beginning, Dylan's presence seemed to calm Jamie.
He would push his stroller, feed him his bottle, let him climb all over him.
They are so were so close.
I'm assuming that Jamie's been evaluated by a psychiatrist.
Several.
They all just head to the diagnosis.
Intermittent explosive disorder, comorbid ADHD, disruptive mood dysregulation disorder.
Tell me, what meds is he on right now? Risperidone, valproic acid, lithium, Adderall, Tenex.
They all work for a bit, but then He always ends up in his dark place.
Yeah.
Mr.
and Mrs.
Shaw, Dylan's out of surgery.
I'll take you to recovery.
Look, what I'd like to do is admit Jamie for a five day hold.
That'll give us a chance to assess the situation and come up with some treatment options for you.
Anything.
Please, just help him.
Yeah.
Shh.
He's out.
Cried himself to sleep.
What'd the tests say? The labs were normal.
But the babygram revealed a mild bowel distention.
There are no obstructions.
However, the stool in Axel's diaper was watery.
That suggests a GI issue.
Okay.
What do you do for that? Endoscopy.
So under a general anesthesia, a surgeon will guide a camera down Axel's throat into his GI tract to search for abnormalities.
And if necessary, we'll do a colonoscopy as well.
Mm.
Can I be there? I wouldn't recommend that.
I mean, seeing the scope inside Axel, it might be upsetting.
- No, I really wanna be there.
- Are you sure? Because I can't overstate how distressing this procedure can be for a parent to watch.
I mean, seeing your child on the table, unconscious I'll be okay.
All right.
Techs will be by shortly to bring up Axel.
I'll be there as well.
- Signed.
- Thank you.
Hey, Doris.
Julia, the mom in Treatment III, did you get a read? I like her.
I wish all parents would handle the ED that smoothly.
You don't think she's too composed? I mean, her son is clearly in distress and she hasn't even broken a sweat.
Oh, there's that Manning ESP again.
Okay.
She asked me to run more tests on her baby than necessary, and now she wants to be front row when he gets scoped.
You don't think that's a little odd? Uh, if you say so.
Call Dr.
Frisch.
I wanna put Axel on today's schedule for an endoscopy.
She's busy.
Omphalocele repair.
Gonna be locked away all day.
But I'm free to take care of it right now if you'd like.
Okay.
Thanks.
Meet you upstairs.
Ms.
Doris? - Thank you.
- Sure.
- Nurse April.
- Dr.
Marcel.
Okay, stomach and esophagus appear normal.
Let's reset for a colonoscopy.
Julia, are you okay? You don't have to keep watching, you know.
No, I'm okay.
It's just I have a scrape on my stomach.
I forgot to change the bandage and it's beginning to slide around.
Why don't I have a nurse change that out for you when we're back in the ED? Oh, okay.
Yeah.
- Thanks.
- Yeah.
Somehow I keep scraping myself right there.
I don't know how.
Mom brain, I guess.
Ooh, ooh.
Right there.
Okay.
Sharp or dull pain, Chloe? I think both.
Is that even possible? Unfortunately.
How long have you been feeling off? I don't know.
A couple weeks? Three months.
She downplays everything.
We just got married.
I figured the pain was just nervous energy, but the wedding's behind us now and I still feel "blah.
" Any constipation? Bloating? She hasn't pooped in a week.
So Chloe, I'm gonna need to take a closer look to see what's going on.
We'll get some X-rays, a pelvic and a rectal.
Just keeping the sexy flowing, aren't I? Till death do us part.
Well, a nurse will come in and get things going.
Congratulations, Mr.
and Mrs.
James.
- Crockett.
- Yeah? Perfect timing.
Single vehicle accident landing now.
Massive trauma.
I'll have Baghdad ready.
Got it.
- What do you got? - Lucy Seaver, 20.
GCS 3.
Intubated in the field.
Bilateral femur fractures and traction splints.
SATS 100% on oxygen.
Okay, Lucy, don't be afraid.
You're in the ED.
We're gonna take good care of you.
Parents should be here any second.
They were on the scene.
They were in the car behind Lucy.
- They saw the crash? - And the aftermath.
Lucy's car was so mangled, it took us 20 minutes to extricate her and get her in the ambo.
Okay, all right.
Here we go.
On my count.
One, two, three.
All right.
Good breath sounds bilaterally.
- Belly's hard as a rock.
- BP's 70s.
Two of plasma, two of blood on the transfuser.
Trigger the MTP.
Let's fast her.
Ton of soft tissue damage.
Glass everywhere.
All right, no, scrap the X-ray.
No time.
Give me that wand.
Fast is positive.
Yeah, I gotta get into her belly.
All right, let's go.
Let's open up the Hybrid OR! - All right.
- Oh, my God.
- Get her prepped, all right? - Lucy! Let's get her on the move.
All right.
Mr.
and Mrs.
Seaver, if you will.
Your daughter's been seriously injured.
She needs immediate surgery to control internal bleeding.
It's fixable? She's gonna live? We will do everything we can.
Huh.
So, uh, so what is your favorite sport? Football, I guess.
- Bears fan? - My dad likes them.
- I like the Chiefs.
- Oh, really? - Oh, how'd that happen? - The quarterback.
I saw a video of him throw the ball out of the stadium.
- That was cool.
- I saw that clip too.
And you're right.
It was cool.
You know, I was wondering if we could talk a bit about about what happens.
You know, about how it feels when you start to get upset.
I don't know.
Kind of It's fuzzy.
Fuzzy.
So kind of like, um, like a dream? I guess.
And and when it happens, I mean, what does it, uh, what does it feel like? I mean, like, you know, in here? I mean, do you feel anything in your body? Feels like I'm gonna explode.
Wow.
I'm sorry.
That must be really scary.
Do you want to take a little break? I want this off.
It's sticking to me.
- I can't stand it.
- Okay, okay.
Don't touch me! Don't touch me! I hate you! I hate you! Let go! Stop it! Go away! Stop it! - Go away! - Two of Haldol! Go away! Stop it, no! No, I don't want meds! Stop! Stop it, no! Stop! No! I don't want meds, stop! Stop it! I wish I could tell you exactly what happened in there, what triggered Jamie, but honestly, I can't.
I have reviewed his medical records, I've spoken with several of his doctors, and what is clear to me is that your son is struggling with multiple impulse control and mood regulation disorders.
So what do we do? We just want to help him.
Well, it's the hospital's recommendation that Jamie be admitted to a residential facility where he can receive sustained clinical care as well as supportive therapy.
- A residential facility? - Mm-hmm.
Yeah.
Mrs.
Shaw, Jamie is 11.
Puberty is fast approaching.
And that surge of hormones is just gonna undoubtedly exacerbate his conditions.
It'll just make him more difficult to treat in general.
You know, find the right balance of meds.
And a specialized setting like this will have the behavioral resources Jamie needs for the future.
And it'll be a safe place for him right now.
- Anything for our son.
- All right.
I'll take care of all the arrangements.
Okay.
Looking good.
Four tears in the small bowel mesentery tied off.
Liver's packed and hemostatic.
Pressure's no good.
We maxed out on pressors? Yeah, and I've given ten units of blood and ten of plasma.
- She's still bleeding somewhere.
- I don't Hematoma on the pelvis.
Bigger than my first look and growing.
Gotta assume the pelvis is shattered and bleeding.
Okay, team, new deal.
Preperitoneal packs.
Let's go.
Hey, Chloe.
How you feeling? Like a stuffed turkey.
X-Rays show your bowel is FOS.
- Full of - Stool.
The pelvic suggests your uterus is enlarged.
So I suspect a fibroid is sitting on the uterus, putting pressure on the rectum.
You were right.
The last few weeks, she was scouring the web with her symptoms, and fibroid fit the bill.
Yeah, we're trying to have a baby.
Internet says fibroids hinder the ability to conceive.
Not all fibroids are created equal.
Hey, I'm gonna order a pelvic ultrasound and a gyne consult.
I'll check back soon.
And no more Googling, okay? Doctor's orders.
How's it going with your six-month-old? Dead end.
Nothing's jumping out in any of the labs and the endoscopy and colonoscopy report.
I'm starting to wonder if it's really baby Axel who's the one that's sick.
What do you mean? The mom, she's just She's got this air about her, this nonchalance that screams, "Yeah, my baby's in the ED, but it's just another day.
" Well, it wouldn't be the first time we see a parent pretend their child was sick to get attention.
Yeah, unfortunately.
- Have you seen Dr.
Charles? - He's upstairs.
- I'll page him for you.
- Thanks.
Yeah.
Dr.
Manning, it's Julia.
There's something you need to see.
You know, I had my appendix taken out when I was in 10th grade.
All right.
Well, let's take a look.
Oh, my God.
This is a fistula.
Basically a tunnel between your small bowel and your skin.
The green fluid is leaking from your intestines.
- Seriously? - Mm-hmm.
I've been getting these scrapes for years.
They heal up.
It's been my intestines oozing out? The tissue sample taken during Axel's endoscopy, I'd like it biopsied.
Biopsy? You're testing for cancer? No.
Something new.
And now I'm thinking you may have it as well.
The test that I ran on your son, I'd like to run on you as well.
Okay.
All right.
Pelvis is packed.
Bleeding's under control.
Call ICU and tell them Lucy's coming up to rewarm.
Something's wrong.
Pressure's still in the toilet.
- 74 over 38, falling.
- What? - She's peri-arrest.
- She's still bleeding? The abdomen is dry.
Pelvis is contained.
I mean, we're hemostatic, Marty.
She's bradying down.
- No pulse.
- Come on.
Milligram of EPI.
EPI's in.
Pulse check? Go.
Still nothing.
Come on, Lucy.
Hold compressions.
Be good.
- Asystole.
- Come on.
Come on, Lucy.
Come on.
Damn it.
Time of death, 16:17.
Okay, everyone, clear the room, please.
I'd like a moment alone with my patient.
What's going on? There's room for Jamie at Meyerbrook, which is the only residential facility capable of handling his needs.
Unfortunately, neither his private insurance nor state Medicaid is gonna cover the cost.
What about an individual care grant from the state? I already looked into it.
It's no help.
Yeah, the grant's so underfunded, it wouldn't come close to what's needed.
So what's plan B? Well, you know, I'm gonna just try and use the five-day hold to normalize his meds as best I can.
And I do know a brilliant guy who specializes in these kind of disorders I want to refer him to.
An outpatient service? Jamie pummeled Dylan over an iPad.
The kid's jaw's wired shut.
He's only six years old.
He's going to invade his brother's space again.
And when that happens, and Jamie loses his temper, I'm worried he could kill Dylan.
I don't like it either, Ethan, but I mean, you know, I can't hold him here forever.
I get it, but we have an obligation to protect Dylan.
And he needs our help just as much as Jamie.
Dr.
Halstead, the gyne attending on-call came down a few minutes ago.
- She's with Chloe right now.
- Great, thanks.
If you feel comfortable with that.
Yeah.
Dr.
Hannah Asher, gynecology.
- Will Halstead.
- It's nice to meet you.
Yeah.
Likewise.
I was just explaining to Chloe and David that I reviewed her pelvic ultrasound.
Considering the location and size of the fibroid, I believe removing it surgically is the best course of treatment.
A myomectomy? By who, when? Me.
Today.
Chloe, David, you should know this surgery can be risky.
Yes, I've explained the pros and cons, Dr.
Halstead.
Was clear that while this is a big operation, it's also a common one.
Nevertheless, complications could rise.
So I would suggest non-surgical options.
Hormone therapy will shrink the fibroid.
Well, that's what Dr.
Asher said.
But to ensure that it doesn't grow back, Chloe would have to go on the pill.
We're anxious to start a family.
The pill takes that off the table.
In the short term, yes.
But not permanently.
Actually, it kind of does.
I'm 41, Dr.
Halstead.
Our window for getting pregnant is already closing.
If I choose hormones, I might as well slam it shut.
We appreciate your passion, Dr.
Halstead.
But surgery is the best for us.
I'll get that started.
It was so nice meeting both of you.
Doctor.
Excuse me just a moment.
Doctor Asher? Doctor.
Hmm? - You can't perform this surgery.
- Hmm? I mean, you shouldn't even be working.
Look, thank you for your help last week, but I'm better now.
I'm over that hump.
So heroin addiction is like a cold? What, you just get over it? What I saw at that injection site Was me having a bad day.
- A bad day? - Mm-hmm.
You You OD'd.
For all I know, you're high right now.
Right.
But how many all-nighters you pull over there since I saw you last, huh? Three? Four? Maybe I should be the one worried about your judgment.
Don't twist this.
I'm not an addict about to operate.
You step into that OR, you put Chloe's life in jeopardy.
I would never risk the well-being of a patient.
Not that it is any of your business, I'm sober now.
I'd expect an addict to say that.
Chloe is in good hands with me.
Axel has Crohn's disease? But he's only six months old.
Well, it's rare in children, let alone infants, but not unheard of.
Isn't Crohn's a diet thing? I mean, Axel's barely started on solids.
Well, diet aggravates Crohn's, but it's not the cause.
Genetics is.
Crohn's tends to cluster in families.
Whoa, my test results Show that you have Crohn's as well.
The fistula is just evidence of the severity.
This doesn't make sense.
If I've got Crohn's badly enough to burn a hole in my skin, shouldn't it bother me? Well, fistulas themselves are painless, but yes, a Crohn's flare-up is excruciating.
You should be in pain.
Agony.
Yeah, well, I don't feel a thing.
This is weirding you out, isn't it? It's definitely unusual.
Or actually, maybe it's maybe it's rare.
Let me ask you a question.
What emotion are you feeling right now? I'm not sure what you mean.
Well, I just told you that you and your son have an inflammatory bowel disease.
What are you feeling? Stress? Anxiety? Fear? Confusion, that's for sure.
You know, I'd like to run one more test.
- Okay? - Okay.
Okay.
Bea, it's taking too long.
Check with Dr.
Asher.
Again? I've already gone in there twice for you, Dr.
Halstead.
Please, I'm treating Chloe in the ED.
I just want to make sure Dr.
Asher's got everything under control.
- Fine.
- Thank you.
Dr.
Asher said, "Go away.
" Nope, staying right here.
Hey, I got your page.
You have a new plan to help Jamie? Yeah.
Yep, I do.
So, Mr.
and Mrs.
Shaw, I have given this a tremendous amount of thought.
I've consulted with With numerous colleagues, with social workers, with our Executive Director of Patient Services.
Jamie needs to be at the Meyerbrook Residential Facility.
So the insurance companies, they agreed to pay? No.
Both your private insurance and Medicaid won't budge.
Then I'm confused.
There is a way to force Medicaid to cover Meyerbrook's cost in full.
It's called a psychiatric lockout.
But it will require you to surrender Jamie to this hospital.
Surrender? I don't understand.
If you were to leave Jamie here and refuse to come back, Child Protective Services would have to take custody of him.
Then, as a ward of the state, legally, Illinois would have to provide him with the mental health services that he needs.
- Meyerbrook? - This is insane.
- We're not doing this.
- So there's no other way? I'm so sorry, but there just isn't.
We would absolutely find a way for you to maintain contact with Jamie, but you also need to know that legally, you won't have any say in his care.
We're still his parents.
This doesn't change that.
Nothing changes that.
No.
No, no, no.
We're not abandoning our son.
Mrs.
Shaw, you will not be abandoning him.
This this won't be forever.
Jamie needs us to do this.
When? I cannot imagine how agonizing this decision must be.
But the sooner Jamie starts to heal, the sooner you all can look forward to becoming a family again.
Bella.
It's to save him.
Everything is going to be okay.
Hey, buddy.
It's gonna be okay, buddy.
Right now, it's the best thing.
You'll be better, and so you're just gonna stay with the doctors.
- You're okay, baby.
- No, no.
Please.
I'll be better.
- I didn't mean to! - It's okay.
Please, I want to go home.
I want to go home.
Please, Mom.
Dr.
Marcel? Lucy's parents are still in the waiting room.
- You haven't told them - She should be alive.
Well, it's been over an hour.
They need to know that their daughter has passed.
I won't speak to them until I can explain how she died.
Why I couldn't save her.
Can you give me some light? Right here.
Every other injury was either a tear or a rip in the skin.
This one's a hole.
Something embedded inside.
More shrapnel from the windshield? It doesn't really feel like glass.
Can you, uh, swing that X-Ray machine around? Go ahead.
That's a bullet.
Lucy was shot? Lucy was shot? How? She was driving down the highway alone in the car.
The steep angle of entry shows that the bullet struck from above and launched into Lucy's pelvis.
It severed her external iliac artery.
- Shot from above? - Yes.
Now, the police will run ballistics.
But they believe, and science backs it up, that someone, somewhere in the city, fired a gun into the air.
And when that bullet came down, it struck Lucy.
Someone.
Somewhere.
And now our daughter is dead? I'm so sorry.
The nurse will come to take you to see Lucy.
Excuse me.
Hey, the additional blood work you ordered on Axel's mom.
Oh, wow.
This whole time, my take on Julia has been off.
Way off.
We love fun We're going out and having some We love fun You know we're gonna have a ton Never heard that song before.
"We Love Fun" by The Bouncing Souls.
I don't know any real lullabies.
Julia, all day, I've been troubled by your demeanor because you didn't seem worried about Axel.
But now I know you really aren't worried.
And I suspect you've never felt anxious, depressed, or even afraid your entire life, have you? No, not really.
Same goes for physical pain, doesn't it? Kind of feels like this is a trick question or something.
No.
Okay.
So when I had my son, labor was a beast.
Intense pressure, cramps, spasms.
But you didn't feel any of that, did you? Nope.
Whole thing just kind of tingled.
But I've always had an extremely high pain tolerance.
I know.
There's something wrong with me, right? My friends have been saying it forever.
Wait, is there something wrong with me? No.
No, but there is something missing from you.
So we all have what's called a FAAHP1 pseudogene.
Your preliminary blood work shows that you have a rare microdeletion which affects your insensitivity to pain.
When I was a kid, my dad would say everyone else were wimps.
That we were a hardy breed, that pain was just a word.
Well, microdeletion is a genetic thing.
So it's likely that your father and other family members have it as well.
Julia? What's wrong? I passed Axel the gene for Crohn's, but not the one so he won't be tortured by it.
And if I didn't know when I hurt myself, I wouldn't have known when I hurt my son.
I probably made the bath too hot.
- Didn't dress him warm enough - Hey.
You knew it wasn't colic.
You knew to bring your son into the ED.
You may not feel everything he feels, but you're his mother.
You'll always know what he needs.
Uh, keep going.
Grab her husband.
I'll meet you in recovery.
Wonderful.
You're still here.
- Is Chloe okay? - Yeah, she's fine.
Operation was flawless.
This time.
How about you and I keep our distance from one another? Yeah, fine.
Just as soon as you stop treating patients and seek treatment for your addiction.
Screw you, Halstead.
In that case, I'm going to submit a letter to the hospital's Chief Medical Officer.
And that decision will be made for you.
That's a stupid idea.
You out me, I out your own involvement in a not-quite-legal injection site.
So if I go down, so do you.
So if you want to report me, have at it, cowboy.
- Hey.
- Hey.
Heard you had a rough one today.
- You all right? - Yeah.
The little boy and his mom.
Your, uh, ESP pan out? Not even close.
- I'll see you tomorrow.
- Night.
Hey.
Today sucked.
Yes, it did.
We just don't have enough psychiatric resources for kids.
And unfortunately, the Shaws won't be the last family to face a lockout.
But Jamie will get the help he needs.
And that's a good thing.
Hey, buddy.
Come on, let's go.
Marcel.
Fast.
Give me a Narcan inhaler.
You overdosed, but you're gonna be all right.
You're letting this get way too personal, Will.
It's never a good idea.
For God's sake, isn't it personal? You lost a brother to drugs.
Enough! I met you this morning.
I'm gonna try to turn things around.
Good.
Hey.
Hi.
I love you.
- Easy.
- Oh, God, sorry.
It's only me.
I wasn't expecting that.
Hey, I know work's not the place for ambush affection, but I couldn't help myself.
I won't hold it against you.
What's up? I haven't seen a smile this big since Navy beat Army.
Just thinking about being a dad.
Birthday parties, coaching teams.
It's a decade down the road.
We are three weeks into IVF.
You know what they say.
"You blink and the kids are grown.
" - Hey.
- What up? Pelicans covered the spread.
How many rings do the Pelicans have? Go Bulls.
Yeah, we'll see.
I'm a horrible person, aren't I? No, you're human.
What can I do to help? You got a time machine? - Hey, you.
- Hey.
Date last night.
Spill it.
It was nice.
He was polite, handsome, smart, but I don't think so.
Huh, well, polite, smart, and handsome.
- Sounds awful.
- All right.
The real reason, he's a psych professor.
I mean, the way he looked at me, I just couldn't shake the feeling that I was being analyzed.
This is the fourth first date without even considering a second.
Well, I'm glad you're counting, Mom.
It doesn't matter because none of those guys were gonna work out anyways.
Wow.
ESP.
Say, do you know when the Saints are gonna win another Super Bowl? All right, well, let me know if you get another vision.
All I'm saying is the right second date is out there and I'll know it when I meet him.
Help, please! My son! I got him.
Where am I going? - Trauma 1.
- Help my husband and son! Help, help, help, help, help! Help him.
I-I didn't know what to do.
Ow, ow! Bruising on his neck.
Protect it and bag him.
Hold C-spine.
What's his name? - Jamie.
- Jamie? Hey, Jamie, can you hear me? Okay, okay, take it easy.
You're okay.
Take it easy.
- What happened? - It was an accident.
Um, I choked him out.
I had to.
- It all happened so fast.
I didn't realize.
I just wanted it to stop.
Jamie was screaming, Dylan was crying, and Gordon.
I want you to take a deep breath, okay? Take a deep breath.
All right.
Have a seat.
Sit down.
Okay.
And, um I, uh, I just want you to tell me Tell me what happened.
Okay.
So I was driving, talking with Bella, my wife.
The, um, the boys were in the back.
Jamie was playing with his iPad.
Dylan grabbed it from him, but wouldn't give it back.
Jamie can't control his anger.
He started punching Dylan, got out of his seat belt, got on top of him.
He kept pounding.
Bella couldn't pull him off.
I could hear Jamie's fists cracking against Dylan's face.
He was screaming for help, so I pulled over.
Just threw myself on top of Jamie.
I wrapped my arms around him and held him as tight as I could.
When he gets like this, the bear hugs are the only thing that bring him back.
- Bring him back? - From his dark place.
Uh-huh.
Okay.
Will you, um, will you excuse me for a moment, Gordon? We're gonna take care of you little, man, okay? All right.
Ordered a CT.
But I'm almost positive there's a bilateral mandible fracture.
Gonna need surgery to wire it shut.
Man, Ethan.
Kid's only six years old.
Jamie? He's stable but tormented.
Dad choked him out.
Probably so he couldn't defend his little brother.
Sometimes I hate the ED.
Jamie, how are you doing? I'm Dr.
Charles.
Um, would you mind if I looked at your hands? Fifth metacarpal is broken on each hand.
That's really gotta hurt.
Um, look, we're gonna get you completely fixed up.
Okay? It was nice to meet you.
This is not child abuse.
Thanks, man.
You know, one of the volunteers works at a rehab center.
If you'd like, she can tell you about their program.
Yeah.
Sure.
Maybe another time.
If you change your mind, we're here.
- Will.
- Yeah? You have been here for hours.
Go home, get some rest.
Yeah, I could use some sleep before I start my shift.
Ah, damn it.
It starts in a half hour.
Uh, okay.
All right.
That woman over there, her name's Susan.
When she comes down, she's gonna be hungry.
- I stashed some protein bars - I know, I saw.
The electrolyte drinks too.
Get to work.
I'll be back later, you call me if you need anything.
That's the cry, that one.
It's not "I'm hungry" or "I'm tired.
" It's new.
Okay.
I know, I know, Axel.
You're in pain and my touching you is only making it worse.
Any changes in his sleep pattern? No.
Every baby book I read said put your child on a schedule and stick to it.
Been there.
My son's almost four.
I know, I know.
Almost finished.
Okay.
What about diet? I had to start using formula.
Just not enough hours in the day to pump, work, nurse, do laundry, pump again.
Single mom? Yeah, me too.
- Dad still in the picture? - No, but I'm okay with it.
Well, I'm not seeing anything out of the ordinary.
I mean, the switch from breast milk to formula could be upsetting Axel's stomach.
Have you noticed any diarrhea since the change? Here and there.
But this cry has been consistent for the last month.
I'll test for allergies, but infants and crying Don't say colic.
I've been to three pediatricians.
They all diagnosed colic and sent me home.
No.
Something else is going on.
Run tests, X-Rays, scans.
Just please, figure it out.
Okay, well, why don't we start with some basic labs and go from there? Is that okay? Sure.
Thank you.
I'll send a nurse in to get started.
Thank you.
Hey, Jamie, you hungry? Thirsty? I know your casts are bulky.
I can help you.
I'll leave the tray right here just in case.
Hi.
Nice to meet you.
They're talking about me.
About what I did to my little brother.
I didn't mean to hurt him.
I'm so sorry.
It's okay.
Okay, okay.
Well, after two miscarriages and five failed IVF attempts, we'd had enough heartbreak.
We adopted Jamie when he was a few days old.
Best day of our lives.
Do you know anything about his birth parents? Nothing really.
Mom was young, in foster care.
We don't know anything about dad.
Well, Jamie's 11 now, so how old was he when he first started acting out? As an infant, he didn't like being held.
- Was always fidgety.
- Hmm, how about as a toddler? Sitting still, taking turns, following directions, they were all a challenge.
When did Jamie's behavior start becoming aggressive? Elementary school.
Fights with classmates and teachers.
We're homeschooling now.
And your other son, Dylan, is he adopted as well? - Yeah.
- Mm-hmm.
It was initially Jamie's idea.
He wanted to be a big brother.
And in the beginning, Dylan's presence seemed to calm Jamie.
He would push his stroller, feed him his bottle, let him climb all over him.
They are so were so close.
I'm assuming that Jamie's been evaluated by a psychiatrist.
Several.
They all just head to the diagnosis.
Intermittent explosive disorder, comorbid ADHD, disruptive mood dysregulation disorder.
Tell me, what meds is he on right now? Risperidone, valproic acid, lithium, Adderall, Tenex.
They all work for a bit, but then He always ends up in his dark place.
Yeah.
Mr.
and Mrs.
Shaw, Dylan's out of surgery.
I'll take you to recovery.
Look, what I'd like to do is admit Jamie for a five day hold.
That'll give us a chance to assess the situation and come up with some treatment options for you.
Anything.
Please, just help him.
Yeah.
Shh.
He's out.
Cried himself to sleep.
What'd the tests say? The labs were normal.
But the babygram revealed a mild bowel distention.
There are no obstructions.
However, the stool in Axel's diaper was watery.
That suggests a GI issue.
Okay.
What do you do for that? Endoscopy.
So under a general anesthesia, a surgeon will guide a camera down Axel's throat into his GI tract to search for abnormalities.
And if necessary, we'll do a colonoscopy as well.
Mm.
Can I be there? I wouldn't recommend that.
I mean, seeing the scope inside Axel, it might be upsetting.
- No, I really wanna be there.
- Are you sure? Because I can't overstate how distressing this procedure can be for a parent to watch.
I mean, seeing your child on the table, unconscious I'll be okay.
All right.
Techs will be by shortly to bring up Axel.
I'll be there as well.
- Signed.
- Thank you.
Hey, Doris.
Julia, the mom in Treatment III, did you get a read? I like her.
I wish all parents would handle the ED that smoothly.
You don't think she's too composed? I mean, her son is clearly in distress and she hasn't even broken a sweat.
Oh, there's that Manning ESP again.
Okay.
She asked me to run more tests on her baby than necessary, and now she wants to be front row when he gets scoped.
You don't think that's a little odd? Uh, if you say so.
Call Dr.
Frisch.
I wanna put Axel on today's schedule for an endoscopy.
She's busy.
Omphalocele repair.
Gonna be locked away all day.
But I'm free to take care of it right now if you'd like.
Okay.
Thanks.
Meet you upstairs.
Ms.
Doris? - Thank you.
- Sure.
- Nurse April.
- Dr.
Marcel.
Okay, stomach and esophagus appear normal.
Let's reset for a colonoscopy.
Julia, are you okay? You don't have to keep watching, you know.
No, I'm okay.
It's just I have a scrape on my stomach.
I forgot to change the bandage and it's beginning to slide around.
Why don't I have a nurse change that out for you when we're back in the ED? Oh, okay.
Yeah.
- Thanks.
- Yeah.
Somehow I keep scraping myself right there.
I don't know how.
Mom brain, I guess.
Ooh, ooh.
Right there.
Okay.
Sharp or dull pain, Chloe? I think both.
Is that even possible? Unfortunately.
How long have you been feeling off? I don't know.
A couple weeks? Three months.
She downplays everything.
We just got married.
I figured the pain was just nervous energy, but the wedding's behind us now and I still feel "blah.
" Any constipation? Bloating? She hasn't pooped in a week.
So Chloe, I'm gonna need to take a closer look to see what's going on.
We'll get some X-rays, a pelvic and a rectal.
Just keeping the sexy flowing, aren't I? Till death do us part.
Well, a nurse will come in and get things going.
Congratulations, Mr.
and Mrs.
James.
- Crockett.
- Yeah? Perfect timing.
Single vehicle accident landing now.
Massive trauma.
I'll have Baghdad ready.
Got it.
- What do you got? - Lucy Seaver, 20.
GCS 3.
Intubated in the field.
Bilateral femur fractures and traction splints.
SATS 100% on oxygen.
Okay, Lucy, don't be afraid.
You're in the ED.
We're gonna take good care of you.
Parents should be here any second.
They were on the scene.
They were in the car behind Lucy.
- They saw the crash? - And the aftermath.
Lucy's car was so mangled, it took us 20 minutes to extricate her and get her in the ambo.
Okay, all right.
Here we go.
On my count.
One, two, three.
All right.
Good breath sounds bilaterally.
- Belly's hard as a rock.
- BP's 70s.
Two of plasma, two of blood on the transfuser.
Trigger the MTP.
Let's fast her.
Ton of soft tissue damage.
Glass everywhere.
All right, no, scrap the X-ray.
No time.
Give me that wand.
Fast is positive.
Yeah, I gotta get into her belly.
All right, let's go.
Let's open up the Hybrid OR! - All right.
- Oh, my God.
- Get her prepped, all right? - Lucy! Let's get her on the move.
All right.
Mr.
and Mrs.
Seaver, if you will.
Your daughter's been seriously injured.
She needs immediate surgery to control internal bleeding.
It's fixable? She's gonna live? We will do everything we can.
Huh.
So, uh, so what is your favorite sport? Football, I guess.
- Bears fan? - My dad likes them.
- I like the Chiefs.
- Oh, really? - Oh, how'd that happen? - The quarterback.
I saw a video of him throw the ball out of the stadium.
- That was cool.
- I saw that clip too.
And you're right.
It was cool.
You know, I was wondering if we could talk a bit about about what happens.
You know, about how it feels when you start to get upset.
I don't know.
Kind of It's fuzzy.
Fuzzy.
So kind of like, um, like a dream? I guess.
And and when it happens, I mean, what does it, uh, what does it feel like? I mean, like, you know, in here? I mean, do you feel anything in your body? Feels like I'm gonna explode.
Wow.
I'm sorry.
That must be really scary.
Do you want to take a little break? I want this off.
It's sticking to me.
- I can't stand it.
- Okay, okay.
Don't touch me! Don't touch me! I hate you! I hate you! Let go! Stop it! Go away! Stop it! - Go away! - Two of Haldol! Go away! Stop it, no! No, I don't want meds! Stop! Stop it, no! Stop! No! I don't want meds, stop! Stop it! I wish I could tell you exactly what happened in there, what triggered Jamie, but honestly, I can't.
I have reviewed his medical records, I've spoken with several of his doctors, and what is clear to me is that your son is struggling with multiple impulse control and mood regulation disorders.
So what do we do? We just want to help him.
Well, it's the hospital's recommendation that Jamie be admitted to a residential facility where he can receive sustained clinical care as well as supportive therapy.
- A residential facility? - Mm-hmm.
Yeah.
Mrs.
Shaw, Jamie is 11.
Puberty is fast approaching.
And that surge of hormones is just gonna undoubtedly exacerbate his conditions.
It'll just make him more difficult to treat in general.
You know, find the right balance of meds.
And a specialized setting like this will have the behavioral resources Jamie needs for the future.
And it'll be a safe place for him right now.
- Anything for our son.
- All right.
I'll take care of all the arrangements.
Okay.
Looking good.
Four tears in the small bowel mesentery tied off.
Liver's packed and hemostatic.
Pressure's no good.
We maxed out on pressors? Yeah, and I've given ten units of blood and ten of plasma.
- She's still bleeding somewhere.
- I don't Hematoma on the pelvis.
Bigger than my first look and growing.
Gotta assume the pelvis is shattered and bleeding.
Okay, team, new deal.
Preperitoneal packs.
Let's go.
Hey, Chloe.
How you feeling? Like a stuffed turkey.
X-Rays show your bowel is FOS.
- Full of - Stool.
The pelvic suggests your uterus is enlarged.
So I suspect a fibroid is sitting on the uterus, putting pressure on the rectum.
You were right.
The last few weeks, she was scouring the web with her symptoms, and fibroid fit the bill.
Yeah, we're trying to have a baby.
Internet says fibroids hinder the ability to conceive.
Not all fibroids are created equal.
Hey, I'm gonna order a pelvic ultrasound and a gyne consult.
I'll check back soon.
And no more Googling, okay? Doctor's orders.
How's it going with your six-month-old? Dead end.
Nothing's jumping out in any of the labs and the endoscopy and colonoscopy report.
I'm starting to wonder if it's really baby Axel who's the one that's sick.
What do you mean? The mom, she's just She's got this air about her, this nonchalance that screams, "Yeah, my baby's in the ED, but it's just another day.
" Well, it wouldn't be the first time we see a parent pretend their child was sick to get attention.
Yeah, unfortunately.
- Have you seen Dr.
Charles? - He's upstairs.
- I'll page him for you.
- Thanks.
Yeah.
Dr.
Manning, it's Julia.
There's something you need to see.
You know, I had my appendix taken out when I was in 10th grade.
All right.
Well, let's take a look.
Oh, my God.
This is a fistula.
Basically a tunnel between your small bowel and your skin.
The green fluid is leaking from your intestines.
- Seriously? - Mm-hmm.
I've been getting these scrapes for years.
They heal up.
It's been my intestines oozing out? The tissue sample taken during Axel's endoscopy, I'd like it biopsied.
Biopsy? You're testing for cancer? No.
Something new.
And now I'm thinking you may have it as well.
The test that I ran on your son, I'd like to run on you as well.
Okay.
All right.
Pelvis is packed.
Bleeding's under control.
Call ICU and tell them Lucy's coming up to rewarm.
Something's wrong.
Pressure's still in the toilet.
- 74 over 38, falling.
- What? - She's peri-arrest.
- She's still bleeding? The abdomen is dry.
Pelvis is contained.
I mean, we're hemostatic, Marty.
She's bradying down.
- No pulse.
- Come on.
Milligram of EPI.
EPI's in.
Pulse check? Go.
Still nothing.
Come on, Lucy.
Hold compressions.
Be good.
- Asystole.
- Come on.
Come on, Lucy.
Come on.
Damn it.
Time of death, 16:17.
Okay, everyone, clear the room, please.
I'd like a moment alone with my patient.
What's going on? There's room for Jamie at Meyerbrook, which is the only residential facility capable of handling his needs.
Unfortunately, neither his private insurance nor state Medicaid is gonna cover the cost.
What about an individual care grant from the state? I already looked into it.
It's no help.
Yeah, the grant's so underfunded, it wouldn't come close to what's needed.
So what's plan B? Well, you know, I'm gonna just try and use the five-day hold to normalize his meds as best I can.
And I do know a brilliant guy who specializes in these kind of disorders I want to refer him to.
An outpatient service? Jamie pummeled Dylan over an iPad.
The kid's jaw's wired shut.
He's only six years old.
He's going to invade his brother's space again.
And when that happens, and Jamie loses his temper, I'm worried he could kill Dylan.
I don't like it either, Ethan, but I mean, you know, I can't hold him here forever.
I get it, but we have an obligation to protect Dylan.
And he needs our help just as much as Jamie.
Dr.
Halstead, the gyne attending on-call came down a few minutes ago.
- She's with Chloe right now.
- Great, thanks.
If you feel comfortable with that.
Yeah.
Dr.
Hannah Asher, gynecology.
- Will Halstead.
- It's nice to meet you.
Yeah.
Likewise.
I was just explaining to Chloe and David that I reviewed her pelvic ultrasound.
Considering the location and size of the fibroid, I believe removing it surgically is the best course of treatment.
A myomectomy? By who, when? Me.
Today.
Chloe, David, you should know this surgery can be risky.
Yes, I've explained the pros and cons, Dr.
Halstead.
Was clear that while this is a big operation, it's also a common one.
Nevertheless, complications could rise.
So I would suggest non-surgical options.
Hormone therapy will shrink the fibroid.
Well, that's what Dr.
Asher said.
But to ensure that it doesn't grow back, Chloe would have to go on the pill.
We're anxious to start a family.
The pill takes that off the table.
In the short term, yes.
But not permanently.
Actually, it kind of does.
I'm 41, Dr.
Halstead.
Our window for getting pregnant is already closing.
If I choose hormones, I might as well slam it shut.
We appreciate your passion, Dr.
Halstead.
But surgery is the best for us.
I'll get that started.
It was so nice meeting both of you.
Doctor.
Excuse me just a moment.
Doctor Asher? Doctor.
Hmm? - You can't perform this surgery.
- Hmm? I mean, you shouldn't even be working.
Look, thank you for your help last week, but I'm better now.
I'm over that hump.
So heroin addiction is like a cold? What, you just get over it? What I saw at that injection site Was me having a bad day.
- A bad day? - Mm-hmm.
You You OD'd.
For all I know, you're high right now.
Right.
But how many all-nighters you pull over there since I saw you last, huh? Three? Four? Maybe I should be the one worried about your judgment.
Don't twist this.
I'm not an addict about to operate.
You step into that OR, you put Chloe's life in jeopardy.
I would never risk the well-being of a patient.
Not that it is any of your business, I'm sober now.
I'd expect an addict to say that.
Chloe is in good hands with me.
Axel has Crohn's disease? But he's only six months old.
Well, it's rare in children, let alone infants, but not unheard of.
Isn't Crohn's a diet thing? I mean, Axel's barely started on solids.
Well, diet aggravates Crohn's, but it's not the cause.
Genetics is.
Crohn's tends to cluster in families.
Whoa, my test results Show that you have Crohn's as well.
The fistula is just evidence of the severity.
This doesn't make sense.
If I've got Crohn's badly enough to burn a hole in my skin, shouldn't it bother me? Well, fistulas themselves are painless, but yes, a Crohn's flare-up is excruciating.
You should be in pain.
Agony.
Yeah, well, I don't feel a thing.
This is weirding you out, isn't it? It's definitely unusual.
Or actually, maybe it's maybe it's rare.
Let me ask you a question.
What emotion are you feeling right now? I'm not sure what you mean.
Well, I just told you that you and your son have an inflammatory bowel disease.
What are you feeling? Stress? Anxiety? Fear? Confusion, that's for sure.
You know, I'd like to run one more test.
- Okay? - Okay.
Okay.
Bea, it's taking too long.
Check with Dr.
Asher.
Again? I've already gone in there twice for you, Dr.
Halstead.
Please, I'm treating Chloe in the ED.
I just want to make sure Dr.
Asher's got everything under control.
- Fine.
- Thank you.
Dr.
Asher said, "Go away.
" Nope, staying right here.
Hey, I got your page.
You have a new plan to help Jamie? Yeah.
Yep, I do.
So, Mr.
and Mrs.
Shaw, I have given this a tremendous amount of thought.
I've consulted with With numerous colleagues, with social workers, with our Executive Director of Patient Services.
Jamie needs to be at the Meyerbrook Residential Facility.
So the insurance companies, they agreed to pay? No.
Both your private insurance and Medicaid won't budge.
Then I'm confused.
There is a way to force Medicaid to cover Meyerbrook's cost in full.
It's called a psychiatric lockout.
But it will require you to surrender Jamie to this hospital.
Surrender? I don't understand.
If you were to leave Jamie here and refuse to come back, Child Protective Services would have to take custody of him.
Then, as a ward of the state, legally, Illinois would have to provide him with the mental health services that he needs.
- Meyerbrook? - This is insane.
- We're not doing this.
- So there's no other way? I'm so sorry, but there just isn't.
We would absolutely find a way for you to maintain contact with Jamie, but you also need to know that legally, you won't have any say in his care.
We're still his parents.
This doesn't change that.
Nothing changes that.
No.
No, no, no.
We're not abandoning our son.
Mrs.
Shaw, you will not be abandoning him.
This this won't be forever.
Jamie needs us to do this.
When? I cannot imagine how agonizing this decision must be.
But the sooner Jamie starts to heal, the sooner you all can look forward to becoming a family again.
Bella.
It's to save him.
Everything is going to be okay.
Hey, buddy.
It's gonna be okay, buddy.
Right now, it's the best thing.
You'll be better, and so you're just gonna stay with the doctors.
- You're okay, baby.
- No, no.
Please.
I'll be better.
- I didn't mean to! - It's okay.
Please, I want to go home.
I want to go home.
Please, Mom.
Dr.
Marcel? Lucy's parents are still in the waiting room.
- You haven't told them - She should be alive.
Well, it's been over an hour.
They need to know that their daughter has passed.
I won't speak to them until I can explain how she died.
Why I couldn't save her.
Can you give me some light? Right here.
Every other injury was either a tear or a rip in the skin.
This one's a hole.
Something embedded inside.
More shrapnel from the windshield? It doesn't really feel like glass.
Can you, uh, swing that X-Ray machine around? Go ahead.
That's a bullet.
Lucy was shot? Lucy was shot? How? She was driving down the highway alone in the car.
The steep angle of entry shows that the bullet struck from above and launched into Lucy's pelvis.
It severed her external iliac artery.
- Shot from above? - Yes.
Now, the police will run ballistics.
But they believe, and science backs it up, that someone, somewhere in the city, fired a gun into the air.
And when that bullet came down, it struck Lucy.
Someone.
Somewhere.
And now our daughter is dead? I'm so sorry.
The nurse will come to take you to see Lucy.
Excuse me.
Hey, the additional blood work you ordered on Axel's mom.
Oh, wow.
This whole time, my take on Julia has been off.
Way off.
We love fun We're going out and having some We love fun You know we're gonna have a ton Never heard that song before.
"We Love Fun" by The Bouncing Souls.
I don't know any real lullabies.
Julia, all day, I've been troubled by your demeanor because you didn't seem worried about Axel.
But now I know you really aren't worried.
And I suspect you've never felt anxious, depressed, or even afraid your entire life, have you? No, not really.
Same goes for physical pain, doesn't it? Kind of feels like this is a trick question or something.
No.
Okay.
So when I had my son, labor was a beast.
Intense pressure, cramps, spasms.
But you didn't feel any of that, did you? Nope.
Whole thing just kind of tingled.
But I've always had an extremely high pain tolerance.
I know.
There's something wrong with me, right? My friends have been saying it forever.
Wait, is there something wrong with me? No.
No, but there is something missing from you.
So we all have what's called a FAAHP1 pseudogene.
Your preliminary blood work shows that you have a rare microdeletion which affects your insensitivity to pain.
When I was a kid, my dad would say everyone else were wimps.
That we were a hardy breed, that pain was just a word.
Well, microdeletion is a genetic thing.
So it's likely that your father and other family members have it as well.
Julia? What's wrong? I passed Axel the gene for Crohn's, but not the one so he won't be tortured by it.
And if I didn't know when I hurt myself, I wouldn't have known when I hurt my son.
I probably made the bath too hot.
- Didn't dress him warm enough - Hey.
You knew it wasn't colic.
You knew to bring your son into the ED.
You may not feel everything he feels, but you're his mother.
You'll always know what he needs.
Uh, keep going.
Grab her husband.
I'll meet you in recovery.
Wonderful.
You're still here.
- Is Chloe okay? - Yeah, she's fine.
Operation was flawless.
This time.
How about you and I keep our distance from one another? Yeah, fine.
Just as soon as you stop treating patients and seek treatment for your addiction.
Screw you, Halstead.
In that case, I'm going to submit a letter to the hospital's Chief Medical Officer.
And that decision will be made for you.
That's a stupid idea.
You out me, I out your own involvement in a not-quite-legal injection site.
So if I go down, so do you.
So if you want to report me, have at it, cowboy.
- Hey.
- Hey.
Heard you had a rough one today.
- You all right? - Yeah.
The little boy and his mom.
Your, uh, ESP pan out? Not even close.
- I'll see you tomorrow.
- Night.
Hey.
Today sucked.
Yes, it did.
We just don't have enough psychiatric resources for kids.
And unfortunately, the Shaws won't be the last family to face a lockout.
But Jamie will get the help he needs.
And that's a good thing.
Hey, buddy.
Come on, let's go.