Chicago Med (2015) s06e03 Episode Script

1 Your new chief is Dr.
Ethan Choi.
We're ready to try that med for an oral heart failure medication.
Dr.
Virani, would you be willing to talk about that offer? Talking about myself is not really my thing.
I consider myself more of a stoic.
Big on hiding emotion.
That you? Mom's moving us to Arizona.
Hasn't happened yet.
We're gonna figure it out.
I know your heart's in this COVID battle, but you can't go it alone.
They are sick, and they are alone.
I'm not abandoning them.
I don't know what I'm gonna do at lunch every day without talking to your kids on FaceTime.
Oh, don't you worry.
I'll make sure Annie still sends you her recipes.
Good.
You take care of yourself, Mr.
Booker.
You too.
Thank you so much for everything.
Hey.
Dr.
Manning.
You look so what's the word? - Decontaminated.
- Oh, why, thank you! And I'm sensing a temperature on you of, what? 98.
4? .
5? Oh, as a matter of fact, you're wrong.
98.
7.
Oh.
Yes, I tend to run a little hot.
Oh, I'm sure you do.
And what was that? With Crockett? Nothing.
- Oh, no.
- Hmm? Ben and I have never exchanged temperatures.
Stop it.
Grab your earbuds.
You are on Telemedicine.
What? No.
Sorry, everybody's gotta clock in their hours.
Ugh, I hate working through a computer screen.
It's so impersonal.
Well, just break the ice.
Ask them for their temperature.
Oh, my God.
Dr.
Choi, I just got off with the Board.
They're concerned about your projections for next month.
I understand, but with Norris shutting its ED, we had to ramp up for the influx of patients.
And I'm sure you're doing everything you can, but with the losses we sustained from treating COVID, - they're watching every penny.
- I get it.
I can try to reassess some protocols, maybe find a few more beds.
Maybe you should look at how you're allocating your staff.
Look, I know this isn't easy, but if Norris' ED can go under, it could happen to us.
Yes, ma'am.
- Hey.
- Hey.
Anna got her algebra test back.
- A-minus.
- Wow, great.
- Mm-hmm, I know.
- Why does that sound like a lead into something much less pleasant? The transfer to Arizona came through.
I start in a month.
So you already took it? I thought we were gonna talk about this.
I can't pass this up.
You can't just take Anna a thousand miles away without discussing it with me.
There's a direct flight.
You can come see her on the weekends.
Susan, it's a direct violation of our divorce agreement.
We really want to end up in court over this? I know this is hard and you guys have gotten so close, but Look, I'm sorry, but they need me down there in the ED.
We're just gonna have to pick this up later, okay? But I just Hey, what's so important? I'm sorry to do this, but I have to bring you back down to the ED.
Is this about my safety again? That's part of it.
You've been in the COVID ward for over a month, and we've had a couple nurses test positive.
All the more reason for me to stay here.
It isn't just that.
I have to balance my staff between wards.
Please, I need you downstairs.
You know how important this is to me.
- Of course I do.
- We just discharged another patient this morning.
I am helping people get through this.
Look, I understand, and it isn't forever.
- You can't do this.
- I can and I have to.
I expect you down there in an hour.
- Dr.
Choi? Patients are backing up into the lobby.
What do you want me to do? Get Doris to double up on room turnover.
April.
Dr.
Charles, I have a young woman in 6 who needs IV antibiotics, but is a little anxious about needles, and I need to move things along.
Think you and April could give it a try? Yeah, sure.
Whatever you say, Chief.
Thanks.
- Everything all right? - No.
Ethan yanked me off the COVID ward.
- Oh.
- Despite knowing how I feel.
You want to talk about it? There's nothing to talk about.
Hi, I'm April.
I'm gonna start your IV.
How are you doing? I'm Dr.
Charles.
You must be Lisa.
Yes.
Very nice to meet you, sir.
Wow, that is quite an infection you have there Well, listen, you don't need to worry.
Everybody in here has been tested negative for COVID, just like you.
Okay? You mind if I have a seat? - Okay.
- So in my experience, the trick to this whole business is to talk about movies.
My favorite movie happens to be "Amadeus.
" How about you? Uh, I don't know.
Okay, um well, then, how about books? You been you been reading anything good recently? Ah I don't really read.
I work as a babysitter.
So you must like kids then? Just breathe.
Yes, I take care of a boy and a girl, Tommy and Bridget.
They're brother and sister, ages eight and 10.
Got it.
So is that "Bridget" with a D or a T? 'Cause, you know, the Irish They spell it kinda weird.
- Is it in? - Yep, all done.
Lisa, somebody's gonna be back to check up on you in a second, okay? Nice to meet you, Lisa.
That was odd.
It was odd.
But, you know, I mean, come on.
Hospitals can be scary places, especially these days.
But I tell you what, give me a heads-up when her labs come in, okay? I might want to talk to her again.
- Okay.
- Thank you.
We see a lot of heart failure here.
With some hard work, I think we could fill this trial in a matter of weeks, not months.
I like your enthusiasm.
Well, I mean, I saw the phase 2 results.
Ejection fraction is up an average of 40%? This drug could be a game changer.
Morning, Mags.
Morning.
We're starting the clinical trial today.
- Okay.
- Let me know if we get any heart failure patients.
Oh, you're in luck.
We got one in 5 right now.
Well, I'll let you know how it goes.
- Great.
- All right.
Mags, I'd like you with me on this one.
All right.
Mr.
Esquivel? Am I saying that right? Si.
I'm Dr.
Halstead.
How're you feeling? Hard to breathe.
- Tired.
- Mm-hmm.
Yeah, he's got a right-sided effusion.
Gonna need a tap.
Sir, it says you've been here before for heart failure.
I have? Yes.
And looks like it's gotten a bit worse.
Are you taking your medication? - Blue ones, white ones.
- Good.
But they may not be working well enough.
Here's the thing.
I'm actually involved in testing a brand-new heart failure drug, and based on what I'm seeing, I think you could be an excellent candidate.
- More pills? - Just one.
And it would help your heart pump better.
Now, it is experimental, and we don't have a ton of data on it, but what we do have is extremely encouraging.
It will make me better? I can't make any promises, but in this trial, three out of the four patients get the medication.
As long as you are one of them, we should see results pretty quickly.
What do you say? Wanna give it a try? Okay.
Yeah? I just want to make sure you understand what I'm proposing.
Whatever you say, doc.
All right.
I'll be back in a minute with the paperwork, and we'll get you going.
Set him up for a thoracentesis, and I'll get you the list of labs for the trial.
Yeah, but Are you sure he understood? He didn't seem all there.
He seemed cognizant enough to me.
I asked him twice.
Yeah, but you said it yourself.
It's possible that he gets into the control group.
- He might not even get the drug.
- Right.
But the control group gets the standard of care regardless, and after 12 weeks, everyone gets put on the drug anyways.
He's making a good choice.
Baghdad? Got a 28-year-old female paramedic with a knife wound in the right flank.
123/70, heart rate 82, respiration's 26.
COVID negative.
Lanik, Marcel, you're up.
Doris? - Yep.
- I'll help.
Just keep doing it that way, okay? Check her belly for fluid.
Megan? What happened? I was on call, and a guy jumped out of nowhere.
Okay.
All right, we're gonna help you out.
Here we go, on my count.
One, two, three.
Okay, let's have a look.
How bad is it? I've seen worse.
You two know each other? Yeah, we've crossed paths.
Usually over a Sazerac.
Or three.
You know, if you really wanted to see me again, you could have just called.
Oh, don't.
- Easy.
- It hurts.
Oh, he always could make me laugh.
He's a funny guy.
Okay, no free fluid.
Good.
Doris, type and cross for 6 and 6.
Hang two uncrossed units and call up for an abdomen CT.
- Uh-huh.
- Am I gonna need surgery? It depends if it got the kidney.
We'll see what the scans say.
If you can do it without surgery My wedding's in two weeks.
You're getting married? That's fantastic.
I'm happy for you.
Yeah.
Yeah, no, it is.
Could have been this one if he wasn't so hard to land.
Well, all right.
We're gonna take good care of you, all right? Okay.
In the meantime, lay off the street fighting.
- I'll draw up some labs.
- That's okay, Trauma's got it.
You don't get out of Telemedicine that easy.
You two seem to know each other pretty well.
Yeah, we had some good times.
Lucky for her, she was smart enough to get away.
Tell me, are there any women in Chicago you have not had a Sazerac with? There's still a few on my list.
Hmm.
Is this done yet? Almost.
Before you go, Dr.
Choi would like to give you a supplement.
- Why? - Your lab work revealed you have an extreme vitamin D deficiency.
We get our vitamin D from the sun.
You not been leaving the house too much? I do, to play with the kids I babysit.
Right, of course.
Thomas and Brittany? Yes.
Or is it Bridget? Bridget.
Yeah, Bridget.
Right, of course.
So you got a nice park you take 'em to? Where do you go? Different places.
Can you do this fast? I need to get back soon.
Yeah, of course we can.
You got a long drive today? Where do you live, just if you don't mind me asking? I don't know.
Just hang in there, Lisa.
We'll get you out of here soon.
That poor girl is so scared.
It doesn't seem like just a needle phobia.
Did she have any ID when she came in, or emergency contact info? - Nope.
- What are you thinking? Well, she is extremely fearful, but also, she repeats her backstory like she's on some kind of robotic tape loop.
What do you mean? Look, she doesn't spend a lot of time outside, clearly.
She could have been abducted.
Maybe.
Or she could have just been in quarantine and scared of hospitals.
Well, you could be right, but I really do think we should look into it.
Okay.
Do what you can, but she wants to leave, so as soon as her bag runs, I gotta let her go.
- Ethan.
- You're talking about getting PD down here, interviewing her, you know, checking out her story.
Then we could take a picture.
Have them run it through the missing persons registry.
It's not ethical to take a picture of her - without her consent.
- I'll figure it out.
But if taking a picture could save this woman's life, that's what I'm gonna do.
Okay, so tell me how long have you been feeling nauseous for? A few days, but it's getting worse, and my heart's been beating really fast.
Do you have any history of diabetes, heart or stomach issues? I don't think so, but I haven't seen a doctor since Dr.
Kelson retired.
So have you ever had these symptoms before? A few times.
My cousin thinks I have an ulcer.
What do you think? Well, I don't really want to speculate based on such limited history, so I do think it's best that you come in for some blood work.
Oh, I can't do that.
We're still in a pandemic.
The hospital is actually very safe.
We're taking every precaution.
I'm sure, but I'm of an age that I understand, but, you know, with your symptoms, I really do think it's best that you come in.
I can't.
I'm so sorry.
Okay, you know what? I will write you up some anti-nausea medication for the pharmacy to deliver to you, but in the meantime, if your symptoms do get worse, I really need you to call me back immediately, okay? Oh, I will.
All right, thank you.
Bye.
Any luck? PD ran Lisa's photo, and they didn't get a match.
I mean, it is possible it never got reported, which happens more than you think.
What I don't get is if she was being held captive, why would they let her come here alone? Well, her captor might believe that she's been so well conditioned that she'd just come right back.
- Like brainwashed? - Yeah, I mean, think about it.
If your only reality is what the people who are controlling you say it is, you know, you wouldn't dream defying it.
Lisa's IV is finished, and she's asking to leave.
Ethan, she might be in trouble.
We can't just send her back out there.
- Did PD make an ID? - She's not in the system.
Then I can't leave her here.
Hey, I gotta tell ya, I just My gut's telling me that's not the right move yet.
Can I go now? We are done with your medical treatment, but the hospital is a safe place, and it's our job to protect you, which means that if you are feeling harmed or I want to leave.
Lisa, if anybody is holding you against your will Just let me go! Okay.
Here's your discharge paperwork.
Just sign at the bottom.
What do I do with this? Why don't you, um why don't you let us print that out for you, okay? Be right back.
Okay, look.
IPad's been around for how long? What, like 10 years? - Something like that.
- Yeah.
She had no idea what this was.
Listen, we've been looking all along for a missing adult, and maybe what we should have been looking for is a missing child.
Wait, what are you talking about? What if she was abducted years ago? - When she was a kid? - It'd be totally possible.
She hasn't indicated that she's in trouble, and she's not asking for our help.
We have no grounds to keep her.
She could be in danger.
- I don't understand why you just - I'm sorry.
Buddy.
I understand the kind of pressure you're under.
Really, I do.
Bu are you sure this is how you want to run your ED? Give us an hour.
Okay, all set.
- Good.
- Dad? Are you okay? Marí? Estoy bien.
What happened? Hi, I'm Dr.
Halstead.
Your father just had a flare of pulmonary edema.
Caused him some trouble breathing, but he's doing okay now.
Oh, God, it keeps getting worse.
Yeah, you know, fortunately I was able to sign him up for a brand-new clinical trial.
I think it's really gonna help.
What, like an experiment? I wouldn't characterize it like that.
It's an opportunity for a new medication, and he said he wants it.
He can't make a decision like that.
You know, there's not much to decide, really.
He takes a pill a day and comes in twice a week - so we can check his blood - Twice a week? I'm his sole caretaker, and I work.
There's no way.
His cardiologist said he should be evaluated for something called an LVAD.
Hmm, that's a surgical procedure.
Given his age and ventricular insufficiency, I do not think he'd be a good candidate.
He's already taken the first dose of medication.
If we can just give it a little time I'm sorry, we're not interested.
If you could please call someone down and have him evaluated for the LVAD, I'd appreciate it.
- Ms.
Esquivel, please - Doctor.
That's what we want.
Okay, I will I will give them a call.
Megan's still here.
Does that mean her kidney wasn't involved? Well, there's a laceration on the inferior pole, but IR was able to embolize it.
The blush looks pretty large.
You sure that'll cover it? I I think it will.
And you got Lanik to agree not to operate? Well, it took a little convincing.
By someone working very hard to carry out his special friend's wishes? Oh, you nailed me.
I'm a helpless pushover, man.
Oh, really, though, don't you think you're being a little conservative? If her pressure drops, then you'll be taking an unstable patient into surgery.
I'm sorry, have we met? 'Cause Dr.
Natalie Manning doesn't usually advocate for surgery.
But thank you.
Always appreciate a colleague's input.
Anytime.
Always.
This is impossible.
We're never gonna find her.
Ethan should never have taken me off the COVID ward.
At least there I felt like I was doing something, having an impact.
You felt felt a real purpose.
Yeah.
I can see how that would be hard, leaving that behind.
But I've known you for a long time, and it seems to me, you make yourself pretty damn useful wherever you are.
Yeah, but this was different.
I felt like I was finally I don't know.
I found myself.
Who I am.
Yeah.
And Ethan took that away from me.
Have you found a match? Well, it's tricky, you know? 'Cause we have no idea what she looked like when she was a kid.
Send me her pic.
I I found a face app that can de-age it.
If she was abducted, it might help us find a match.
It's a long shot, but She looks familiar.
Wait, that's K Kelly, um Kelly Bissett, from Wheaton.
Disappeared a bunch of years ago.
It was all over the news.
Kelly Bissett.
Wheaton, Illinois.
That's her.
April, make sure she doesn't leave.
I'll call PD.
- Dr.
Marcel? - Yeah? Her pressure's dropping.
Hey.
How're you feeling? Kinda light-headed.
Let's have a look.
That's a problem.
What is it? - There's blood in her Foley.
- Call upstairs.
We gotta get her up to the O.
R.
now.
Wait, what's what's going on? Your kidney's still bleeding.
There could be serious damage.
What are you gonna do? We might have to remove it.
I'm sorry, Megan.
Okay.
Do whatever you have to do.
Ms.
Webb.
Dr.
Manning, how are you? I'm fine, but how are you? Well, you told me to call if I had more symptoms.
Right.
My hands are kind of tingly and numb and it feels weird moving my arms.
How long has this been going on for? About an hour.
Is it something bad? I don't know, but I do really need you to come in now.
Oh, no, please.
Can you just ask me a few more questions? I'm gonna need more information than that.
Run tests.
You know, this is an odd combination of symptoms.
I want to make sure I'm not missing anything.
Well, maybe if we just gave it a little more time.
Why don't I do some more research on this and I will give you a call back, okay? But if this gets worse, I need you to promise me that you'll come in.
But you'll definitely call me back? Absolutely.
Okay? - Thank you.
- Of course, bye.
Good news.
Your father's sats are looking better.
Okay, but cardiology still hasn't come by.
Have you heard anything? Yeah, I apprised them of the situation, but I did tell them to hold off on coming down.
Wait, what? Why? I wanted to see if he would improve, and he did.
His ejection fraction is up 4%, his heart I made it very clear what I wanted.
I know, I know.
I wanted to get his echo results in How much do they pay him for this trial? - Maria.
- Forget it.
I'm calling his cardiologist.
No, no, no, please.
Hey, you're making a big mistake.
Dr.
Halstead? - Trina, come here.
- Ms.
Esquivel? - Please, just - Dr.
Halstead.
What are you doing? She was very clear about what she wants! She doesn't understand.
If an LVAD goes poorly, he could end up stranded on ECMO.
That's a death sentence, Maggie.
Are you sure that this trial is not clouding your judgement? Yes, this trial's the best shot we have - at saving Ruben's life.
- Dr.
Halstead? No, no, no, stop.
I'm taking him to see Dr.
Foster Papá! Maria, get out of here.
He's in arrest.
Code blue.
Pulseless V-tach, paddles.
Oh, my God! Paddles! Charging to 200.
This is your fault! Charged.
Clear.
- Papá.
- Pulse, Maggie.
- Papá.
- No pulse.
Compressions.
Charging to 200.
Please, Papá.
Charge, clear.
Pulse is back.
- Is he alive? - Yes.
He's stable, but unconscious, and at this point, we're gonna have to intubate and then move him up to the ICU.
Maria! It's okay.
Hey, we're trying to help him.
We are.
Claims she's not the missing girl.
She's adamant.
Well, not surprising.
Been terrorized over the last 12 years into completely erasing her former identity.
It's not gonna be so easy to just break right through that.
Just look at her eyes.
It's her, you can see that.
It could be.
But without a statement or physical evidence, the detectives will have to get a warrant to check her DNA.
It's gonna take a while.
Thanks.
So now what do we do? Well, we gotta find her family.
And then what? Lisa? I've been here too long.
I have to go.
Lisa, we can help you.
No, no, no.
I have to go.
Get out of my way! - Security.
- She's on a hold.
- Miss.
- What? No, what's going on? I have to go! No! Let me go! Take it easy! Please! - Lisa, it's gonna be okay.
- No! No! Mrs.
Bissett? I'm Dan Charles.
You're the doctor who called? Yes, and this is April Sexton.
- Hello.
- I just want you to know that we get tested at the hospital every day - and we're both negative.
- It's all right.
I'm tested weekly myself, and I work from home.
It's so cold.
Please, come in.
Thank you.
I don't know why I've agreed to see you.
My daughter's gone.
Whoever's in your hospital isn't her.
How can you be so sure? Because I've been dealing with them for years these imposters.
Some want money, some want attention.
Actually, she's not even claiming to be your daughter.
What? Then why are you even here? Well, she does present as somebody who's been in captivity for many years.
So just some crazy person? Not really.
And there's a photo we'd like to show you.
I don't want to see any more pictures! Please, just take a look.
Please? That's not Kelly.
My Kelly had birthmarks, she had a scar on her hand where she had a bike accident.
It would be so helpful if you came with us to the hospital and saw her with your own eyes.
I'm not doing this again.
I can't take it.
My daughter is gone.
May I? The pictures have faded.
Mrs.
Bissett, I wish you'd reconsider.
We know how painful this must be for you, which is why we wouldn't be here No! I'm done chasing ghosts.
We're sorry to have bothered you.
Will, you cannot go in there.
Ruben still has runs of V-tach.
Has a cardiologist seen him? No, they're backed up.
He needs a stellate ganglion block right now.
Ruben's daughter had you taken off the case.
- Ms.
Esquivel - Will.
You are not his doctor anymore! I understand, but this is an emergency.
Your father is in a dangerous arrhythmia.
I want to do what's called a stellate ganglion block.
Inject a small anesthetic into nerves in his neck Is this a part of your trial? No, it's not.
But if it works, it will help convert his heart back into a safe rhythm.
- It would save his life.
- I don't trust you.
- No! - Maria? Dr.
Halstead is one of the best doctors that we have here.
Please don't.
I've had enough! Maria if he thinks this is the best treatment for your father, so do I.
Do you really trust him? I do.
Fine.
Do it.
Okay.
Thank you.
Okay, now, when I inject you need to stay completely still.
If I'm even a millimeter off, I could hit the carotid.
All right.
There's the carotid.
Okay.
Let's go.
Can you see anything? Not yet.
Angle it a little down.
A little more.
What is that? He's having a run of V-tach.
Do you want the amiodarone? No, we got this.
Keep going.
What's happening? Dr.
Halstead? Angle it up.
Ay, Papá.
He's in V-tach.
He's gonna arrest.
No, keep going.
A little more.
Pressure's dropping.
Do something.
Save him.
Okay, Maria.
Almost there.
Keep going, a little more.
Stop right there.
I'm going in.
Do not move.
Got it.
Pushing bupivacaine.
Don't move.
All in.
Normal sinus rhythm.
Okay, coming out.
Don't move.
Out.
- How'd it go with the mom? - We struck out.
Poor thing could barely look at the picture.
Please.
You have to let me go.
Someone took you from your home.
They took your family, your childhood, everything you had.
But what no one can ever take from you is who you are.
This is yours, isn't it? Are you Kelly Bissett? It's okay.
It's okay.
It's okay.
It's okay.
It's so nice to hear from you, Dr.
Manning.
I have been searching for possible diagnoses, but without being able to examine you, I just can't narrow it down.
I'm sorry.
Even if I wanted to come in, I couldn't.
My son used to drive me, but he moved to Colorado a few months ago.
Barely calls.
And never Zooms.
I understand.
If anything changes or gets worse Oh, actually, there is one more symptom.
My urine is red.
I mean, it's really red, like the color of wine.
Hang on one second.
Ms.
Webb, have you ever heard of something called ALAD porphyria? I don't think so.
It's a very rare genetic disease.
Only 10 cases reported ever.
And your symptoms match the diagnosis.
- Really? - To a T.
But if you actually had it, you would look a lot more ill.
Oh.
"Urine the color of wine.
" That's exactly how it's described in the literature.
I'm sorry to do this, but I have to ask.
Do you really have these symptoms? Or are you just reading about porphyria online? The nausea was real.
But I tried to call my son to ask him, but he didn't have time.
So I started looking up possible causes, and No.
I don't have the symptoms.
I'm I'm sorry I wasted your time.
Ms.
Webb? Yes? I miss my son too.
He's five.
I had to move out because of the pandemic.
Oh, I'm so sorry.
What's his name? Owen.
You wanna see a picture of him? Yes, I do.
Here he is.
He's adorable! Mm-hmm.
Mine is Richard.
He goes by Rick Mr.
Esquivel, how are you feeling? - Good.
- Great.
Yeah, your rhythm is stable and your pressure's up.
Hopefully, you won't have to stay with us much longer.
Take care.
Dr.
Halstead? I appreciate everything you've done.
So if you think your clinical trial is the best thing for my father, I'd like to keep him in it.
Thank you, and I wish he could, but the ganglion block disqualified him.
You know, maybe down the road we can revisit it again, but for now, I'm just glad he's doing doing better.
You knew all along.
The block was gonna disqualify him.
It's what he needed.
Here's the sad irony.
All his numbers were up.
Yeah.
Ejection fraction, heart function.
Maggie, I think this drug works.
Yeah.
I shouldn't have questioned you today.
Eh.
My bad.
It's okay.
You happy? Yeah.
Yeah, I am.
Good.
So you think I'll be able to walk down the aisle? Oh, yeah.
Just promise me no big dips during your first dance, yeah? Okay.
Megan? I got the first flight back.
Are you okay? Hi, sweetie.
I'm fine.
I was crazy worried.
Oh, God, I'm so glad you're here.
Me too.
I'm okay.
I just gotta take it slow.
Nice work.
Thanks.
She's right through here.
And you're sure it's really her? Absolutely positive.
Mom? April, I Good work today.
Thanks.
Hey.
Hey.
Tell me something.
Why do you do it? The one-night stands? They all end up the same.
How's that? With you alone.
Or maybe that's the point.