ER s01e03 Episode Script

Day One

Susan? Susan? Susan! You have to get up.
What time is it? lt's a baby.
A baby.
ln respiratory arrest.
One-year-old found unresponsive.
Couldn't get an lV.
-What'd you find? -No spontaneous resps.
She's cyanotic, faint pulse at 200.
We scooped and ran.
What happened? -She stopped breathing.
-Has she been sick? Any medication? -Any recent trauma? -No.
Nothing! Let's see if we can find a vein-- Can't get a rhythm.
Sinus track 1 80.
Come on.
Magill forceps.
Where are you? An earring.
-Hyperventilate her.
Blood sugar? -Twenty.
l need an 1 8-gauge spinal.
l'll go in interosseus.
Will she be all right? l'll need dextrose.
ls she gonna be okay? Dextrose is in.
-Okay, got it? -Got it.
Get a blood gas, chest film, CBC and Chem-7.
She's gonna be fine.
An infant in arrest and you didn't wake me? An extra hour's sleep, you should thank me.
-l know, but-- -We didn't need you for the baby.
Now we need you.
-For what? -German tourists.
They got food poisoning at a Hofbrau House on 46th.
Guten Morgen.
Das ist Dr.
Guten Morgen, Herr Doctor.
They need stool guaiacs.
Rectals? One, you gotta rule out Ml.
Two, that baby Lewis saved.
Three, some old guy who sticks his hand up his shirt.
Four, chest pains.
Five, a kid with an allergic reaction.
Where's the guy with the hand? Morning.
Hey, Timmy.
What's up? We got four coming in on a chopper, two critical.
-How soon? -Five to ten.
-Hey, Timmy.
Hold, please.
l got a chest pain in Exam Room 4.
Night shift ran an x-ray and EKG.
You know, l really need a cup of coffee.
Cream, no sugar.
Thank you.
-Wanna help with a chest pain? -Yes.
Be right back.
Zambano, l'm Dr.
This is John Carter.
ln order to evaluate pain, start with P.
So start.
Provoking/palliating, right? What brought on your pain? lt started in the shower.
Could you describe it? lt's like somebody's squeezing my chest.
Well, good.
Does the pain move anywhere? Neck, back? No.
What is he, a beginner? This is a teaching hospital, Mr.
Your EKG's normal, and your history of angina l don't think we need to be concerned.
Carter will keep an eye on you while we wait for the enzyme results.
lt's been eight weeks.
You mean you haven't even been out there yet? -Thought about it, just haven't done it.
-You and Hathaway were so close.
lt's not gonna get any easier, Doug.
Just go! Let's go! Two majors, two minors.
Passenger space intrusion.
Guy ran a red light.
T-boned a car at 50 mph.
Head, neck, chest, pelvic and hip injury.
She's had 3 liters.
-GCN? -Point-one-one.
Pressure's 50 over 30, pulse 1 20.
All right, okay.
Let's go.
Hurry up.
Let's go! What else you got? Head, neck and abdominal pain.
Pressure's 65.
Pulse 1 50 and thready.
GCS 4-6-5.
She's got a scalp laceration and a deformed humerus fracture.
Let's get her downstairs right away.
All right? Take her into 2.
Doug, take the little girl into 1 .
Mommy! All right, do this on my count.
And one, two, three, go! Type and cross-match 6 units packed-cell CBC.
Let's get the O-neg moving, now.
l need a chest tube tray.
Let's move.
This isn't a museum, we got work to do.
-Who else is on the floor? -Everybody's working.
Call the O.
and let's see who they can spare.
Mommy! -Type and cross-match four units.
She's still 50 palp.
Pulse is 1 80.
Sweetheart, tell me where else it hurts, okay? Concentrate, all right? -You hear me? -Mommy! Okay, you hear me? Tell me where it hurts.
Does it hurt here? How about here? -Spleen.
-We gotta get her to the O.
, now! Stay really still, okay? Mommy! This the guy who hit them? -ls he gonna be all right? -Yep.
Too bad.
We'll need blood alcohol.
-Bet it's over .
20 -.
35, easy.
Let's get a tox screen and a CT of his head.
We have to rule out head trauma.
-Has he done this before? -Five times.
Ring, we called Orthopedics.
They'll be down to look at your leg.
My wife and daughter okay? We're working on them right now.
l didn't even see him.
The light changed, Janet screamed, and there he was.
We're working on your family.
-How many more do we have? -Three.
l have to check on a patient.
l'll be right back.
Still feeling okay? How much longer am l gonna have to wait? Just a couple more minutes.
We are very busy today.
But you're feeling all right otherwise? Mr.
Zambano? Mr.
Zambano? Hey! l need some help in here! Clear! -What the hell you doing? -Sorry.
-You need help? -l'm here.
-Vital signs stable? -Yes.
Sir, you're gonna be just fine.
Pressure's 80 over 50.
Pulse 1 20.
They ready for her upstairs? All right, let's go.
Get Ortho to the O.
We're taking you to another part of the hospital to make you better.
-Where's Mommy? -We're taking care of her too.
And your daddy will be there when you wake up.
Here you go, Doug.
-She gonna make it? -Ruptured spleen.
How's the father? Orthopods are doing his leg.
The driver's sleeping like a baby.
Not a scratch on him.
How's the mother? Maybe.
lt's 8 weeks since she attempted suicide.
You two were close.
You and Hathaway shared a lot of things.
l stopped by.
A couple of times.
Never got out of the car.
Take her some flowers.
You don't have to stay long.
You want me to go with you? l'm off Sundays.
l don't know.
l don't know.
l'll drive.
lt's me.
lt's not your fault, Doug.
You gotta forgive yourself sooner or later.
Pop! Pop! Just like that, he shoot me.
For cigarettes! Give him a gram of ancef lV.
No older than my grandson.
Twelve, maybe.
With a little gun.
CBC chest and shoulder films.
Little man.
Little gun.
Fifteen years l am selling liquor out of the same store.
Robbed seven times, never hurt.
Nothing! Now l get shot by sixth grader with baby gun.
Patient in 2 with abdominal pain and one in Trauma with a stab wound.
Gregor, you're lucky.
The bullet went straight through.
l'm gonna send you up to O.
They'll explore the wound for serious damage remove any dead tissue and debris.
Work up the patient in 2, focus H and P.
l'll be there in ten minutes.
-Ten minutes? -Or less.
You like cognac? l can get you a good cognac.
Smooth as silk.
-That won't be necessary.
-Cigars, then? Cuban, maybe? No, no, no.
That's fine.
Thank you, though.
l don't smoke.
You have nine minutes.
Good doctor, eh? He's the best.
He has a low-grade fever, slight cough postural hypotension, and he's dehydrated.
-l have to go home.
-l know.
You told us your first name.
Do you remember your last name? -l have to go home.
-Victor, lie still.
Why don't you lie back? We might need some restraints.
l have to feed my dog.
Give him D5, NS.
Do a head CT, non-contrast.
Get Psych Services down here for a consult.
Do a GGF-1 .
A GGF-1 ? Grandpa's Got a Fever.
CBC, Chem-7, chest x-ray, UA and blood cultures.
Give it to me quick.
vascular disease manifested by claudication of the left calf.
He's 1 0 days post-op from Mercy General after an aorto-bifemoral bypass.
Normal post-op course until six hours ago when he experienced lower left quadrant pain without palliative or provoking factors.
Other than a large Mexican dinner.
-Meds? -30cc's Milk of Magnesia, constipation.
Mother's maiden name? He's joking.
Good morning, Mr.
l'm Dr.
-You have abdominal pain? -l called my doctor.
He isn't here yet.
Joe Arndt.
You know Joe? No, l don't.
ls it sensitive here? No rebound or guarding.
Leg is warm.
Cap refill is normal.
My leg is fine, my stomach hurts.
Carter, what would you do? With his history of constipation and the type of pain l'd order a CBC Chem-7, UA amylase and a KUB.
-lf they're normal? -l'd discharge him.
Let him see his physician.
You just cost this hospital a $2-million settlement.
You could have a thrombosis with extension into the mesenteric arteries.
What's a thrombosis? lt's a blood clot.
They replaced an artery in your leg.
Sometimes a clot forms in the artery.
l'd like to rule it out.
Get him an arteriogram.
Can't we wait for my doctor? l don't think that'd be wise.
Notify Radiology and get them on it right away.
The mother's still in surgery.
The blood alcohol came back at .
435 What about the drug screen? lt was negative.
There's no justice, is there? Not much.
He's dehydrated and has a slight respiratory infection.
He's still confused and agitated.
Sir, sir.
l have two dogs and-- Two? That's great, sir.
-Did you run a CAT scan? -Diffuse atrophy.
Nothing new or focal.
l'm out of here.
-That's it? -What were you expecting? l thought he'd be admitted to Psych Services.
But he's got an infection.
He's senile and he needs psych support.
So now you're a psychiatrist? l can recognize senile dementia when l see it.
He's not medically cleared to my service.
He has a respiratory infection and he's dehydrated.
What he needs is antibiotics and lV hydration.
l'll buff him up, start the antibiotics and pull the lV.
Give him 2.
5 Haldol and have Social Services do a follow-up.
l don't have a bed for him.
He needs our help.
You want me turning away homicidal psychotics because your patient's got one of my beds? Find him a medical bed or release him.
l'm not admitting him.
End of discussion.
You fell asleep? Oak Street Beach.
You fell asleep in the sun? Can you sit down? l don't think so.
Maybe we should lean him against the gurney.
l passed.
The bar? l am so proud of you! This is heartwarming but can l get some help here? -Can you take vital signs? -Sure thing.
What are you doing? Remember the back seat of your Celica? Remember the trip to Hawaii? You gotta get accepted to the bar more often.
Timmy, where's the car accident? Hi, Mr.
l'm Dr.
ls my daughter out of surgery? Not yet, but don't worry.
She's gonna be okay.
We had to repair her spleen.
l need to talk to you about your wife.
She's got a spinal fracture and massive internal bleeding.
She has what's called DlC.
Her blood won't clot as a result of the trauma.
She's going to die.
Ring did you and your wife ever discuss organ donation? He needs to be admitted.
-On what grounds? -Change of mental status.
He's senile, that's nothing new.
Give him antibiotics, send him home.
He has no one to make sure he takes his meds to feed him, use the bathroom-- That's what Social Services are for.
-They can't see him today.
-What about Psych? Cvetic won't admit him.
He can be treated as an outpatient.
We don't have the beds.
lf Cvetic won't take him, he's out.
Thank you, Timmy.
Emergency alarm's going off.
Malik, grab the crash cart.
Susan, we got a mayday.
l can't find my earring.
Your hand was on the emergency call button the entire time? Oh, man.
l miss all the good stuff.
l'm never gonna live this down.
This is great.
Everybody thought you were some kind of a saint.
l was gonna call you ''Mahatma.
'' What'll happen when Wertz hears? You were with your wife.
Lucky you.
l'm chief resident.
l'm supposed to set a good example.
lt's a big hospital.
Maybe Wertz won't even hear about it.
Hey, Mark.
How's it hanging? l'm a dead man.
Carter! Doctor, time to get up.
Clear! l've got a rash.
l need a doctor.
-Are you a doctor? -Me? She's got a rash.
-Can you help me? -Sure.
l can try.
Pressure's 70 over 50.
Pulse is 1 20, resps 32.
Temperature's 1 02.
Pulse ox is only 85 percent.
-You her husband? -Yes.
Franks, this is Dr.
What kind of medications is she on? l tried to get her to see our doctor for weeks but she wouldn't go.
Lasix, Dig, KCl lsordil, nitro, captopril, Antivert Darvocet, Timaptic.
We need a chest film, EKG, CBC Chem-7, Dig level, UA blood cultures times two, blood gases and hydrate her with a ls she gonna be all right? We may have to make a difficult choice in the next few hours.
We're dealing with impending respiratory failure.
Please do everything you can.
We'll get blood gases first and then take it from there, okay? Okay.
So you're in your third year of medical school.
Must be hard.
lt's pretty demanding.
Must be very hard.
Afternoon, Dr.
Hi, Dr.
Poison ivy.
Pretty nasty case.
Saw lots of this when l did my Dermatology rotation.
You don't mind if l observe, do you, doctor? He's doing fine on his own.
l'm sure he is.
Medrol Dosepak and antihistamine will clear this right up.
Remember the summer when Jerry broke his arm up at the lake? And you were so worried.
l told you that boys will be boys.
But you pampered him.
lt's remarkable he turned out as well as he did.
lsn't it? Mr.
Franks? l'm troubled with the results of your wife's blood gases.
How old is she? Eighty-six.
Our options are limited.
Her condition is terminal.
lf we put her on a respirator, we may not be able to wean her off.
We'd be prolonging her life in a vegetative state.
Or we can make her comfortable.
Give her fluids, antibiotics let nature run its course.
You mean let her die.
She'd die in peace.
Put her on the respirator.
Franks, are you sure that's what she'd want? We'll hold off until we get another blood gas.
Hopefully she'll improve with nebulizer treatments.
She has 1 3 grandchildren.
Did you know that? No, sir.
l didn't know that.
l just thought you should know.
So you're finally up.
What time is it? Seven-thirty.
Boy, l must've really tied one on this time.
-l'll go get you a doctor.
Damn it! Did l get busted again? -You don't remember? -No, not much.
Am l hurt or something? The policeman went for coffee.
He'll be right back.
l must've really screwed up this time, didn't l? You hit a family.
The mother's dead, and the daughter's in lntensive Care.
You ordered an angiogram? They haven't gotten to it.
Radiology's backed up.
Thank God for small favors.
No concern about a thrombosis? His urine came back positive.
l think his pain is related to a urinary tract infection.
He had a Foley catheter in surgery.
You don't think it's serious, Joe? l'll write you a prescription and send you home.
That's what he said.
Excuse me, doctor.
May l have a word with you, please? l really think you might want to reconsider.
What are you, a third-year resident? Second year.
Surgical resident.
The next time you wanna practice overly aggressive procedures do it on one of your indigent patients.
They won't know you're showing off for students.
We'll have you out in five minutes.
Joe, that's great.
Thanks so much.
Right in the middle of the reception she starts puking her guts out.
Honey, l'm sorry.
l just-- Oh, God! There she goes again.
Compazine, 1 0 milligrams l.
CBC and Chem-7.
What did she eat? l don't think she ate until the reception.
Did you, honey? Everybody had the same buffet at Gerber's.
You're holding your reception at Gerber's Hofbrau House on 46th? That's where those German tourists ate.
How many guests at your wedding? Couple of hundred.
l'll get more emesis basins.
She's become a little more lucid.
Have her blood gases improved? PCO-2's up to 70.
She's tiring.
She's getting better.
Your wife was dehydrated, Mr.
She woke because we gave her fluids.
Her respiratory problem is worsening.
l'm very tired.
l know, dear.
Are you in any pain? l'm dying, aren't l, doctor? No, you're gonna be fine.
You are not gonna be able to continue breathing on your own for very much longer.
Do you want us to put you on a machine to help you breathe? Yes.
She does.
l'm asking your wife, Mr.
-For how long? -l don't know.
We've already discussed this! l don't want you to go.
Oh, l know.
lt's okay, darling.
A couple of hundred? But not everybody had the potato salad.
Only about 60 are sick.
Connie! Thank God! l've never been so glad to see anybody in my whole life.
Good night, everybody! Just keep your head down.
We'll be with you soon.
Not everybody gets Compazine.
D5, NS lVs if they look like they need it, okay? Yeah, l'm holding.
-What was that? -Accordions.
Their wedding reception's in our waiting room.
'Night! Dr.
l need you.
They found him walking down the middle of Halsted, naked.
He was still wearing his hospital bracelet.
Hey, Victor.
My dogs.
l have to feed my dogs.
l know you do.
Should l get Cvetic? No.
l want you to take him to Psych Services, now.
What if they won't accept him? Then l'll sign him into Cvetic's service.
How you holding up? l'll make it, l'm off in three hours.
You on tonight? No.
Talk to Doug about Hathaway.
lt's been two months.
l did.
l even offered to drive him out there.
Why is he acting like this? They were together two years.
He feels guilty.
He thinks it's his fault.
l guess things are better with you and Jennifer, huh? She passed her bar.
She was excited.
So were you, from what l could see.
So what happens next? She gets a job? She's looking.
What the hell do you think you're doing? Do not admit a patient to my service without a consult.
He needs psychiatric help.
-Not in my opinion.
-He was found naked on Halsted.
-He's senile, not psychotic! -He needs care.
-Admit him to your service.
-Wertz wouldn't let me.
Don't ever do that to me again.
Benton? l'm sorry about what happened with the thrombosis patient.
l think you were right.
ls that so? He should've had the angiogram.
l'll be sure to notify the New England Journal of Medicine.
Doug Ross needs you.
What's up? Mrs.
Franks died.
For you're the lover I've been waiting for The mate that fate had me created for And every time your lips meet mine Darling, down and down I go Round and round I go In a spin Loving the spin I'm in Under That Old Black Magic called love -She asleep? -Finally.
l'm proud of you, counselor.
Never thought l'd make it, huh? l knew you'd make it.
l miss you.
l miss you too.
We have to make love more often.
The look on your face! lt was a little embarrassing.
We could pick up where we left off.
What if Rachel wakes up? We could stay out here.
ln the yard? lf Mrs.
Navrocki sees us? What if she did, huh? l have to be back in the hospital in two hours, Jen.
l'm sorry.
You're never gonna leave, are you? The hospital.
l don't know.
l need you, Mark.
l love you.
-How did you get-- -Let's go.
-Where? -Your place.
l live with my folks.
My place, then.
What are we there for, if we can't keep a 75-year-old man from wandering around the North Side naked? l just get so frustrated sometimes, you know.
l just wanna scream.
You can't solve all the world's problems.
That's what Wertz said.
Well, he's very wise.
Listen, you have to be very careful how you deal with consults.
You can get yourself in real trouble.
l just wanna make a difference.
Yeah, well, you also wanna have a career.
And not everybody's gonna be as understanding as l was.
Yeah, you're real understanding.
That's one of my best qualities.
Well, one of them.
Hello, Helen.
Can l come in? No, you can't.
Go away.
Who is it, Mama? l asked him to leave.
lt's okay, Mama.
You look beautiful.
How've you been? Okay.
l just came by to see you.
Say hi.
lt's good to see you.
Take care.
Benton? -What is it? -EMTs are on their way.
They think it's a ruptured bowel.
What's the pulse? Pulse is 1 40.
Pressure 60 over 40.
We've been pumping in fluids.
He's had 1 500cc's.
Abdomen's rigid, extremely tender.
Says he was here today with a thrombosis.
Let's get a CBC.
Type and cross six units.
Let's drop an NG.
Call the O.
, tell them to prep for an exploratory lap.
All right, people, come on! We've done this before.
Camacho, l got him.
Let's get him in close.
Listen, don't worry.
Everything will be fine.
All right, we've done it before.
Here we go.
One, two, three! Let's go! All right, clear.
Let's move, people! Here we go.
All right, l need to drop an NG.
Let's get a chest x-ray and abdominal.
Make it a portable.
Let's move!