ER s01e04 Episode Script

Going Home

Carol? Yes, Mama.
Are you all right? Just woke up early, that's all.
Go back to bed.
l'll wake you when l leave.
You don't have to go today.
l want to.
lf you're not ready, no one will mind.
l know.
But l am ready, Mama.
lt's all right.
Don't worry.
Go on.
Go back to bed.
Mesenteric arteries.
Who is it? The problem now of course is To simply hold your horses To rush would be a crime 'Cause Nice and Easy does it Nice and Easy does it Nice and Easy does it every time -Gotta teach it who's boss.
-Have we--? Excuse me.
-Carol Hathaway.
l met you my first day.
Oh, my last.
Or so l thought.
-Hey, Wendy.
-Welcome back.
How are you? -Great.
Got a slow Monday for me? -Like always.
It's gonna be so easy to fall.
Whose patient is this? -No, but l can name that tune.
-Can you find out? l'm on my way to Radiology, but l'll be back in ten.
That's fine.
That's fine.
Greene, is this your patient? No, this is my patient.
How you doing, Mr.
Resnick? l'm having an enema, how do you think l'm doing? The problem now of course is To simply hold your horses Room 4 is Mrs.
Yakamoto's CC, lingering cough and a runny nose.
No doubt because the kid has a cold.
l'll take baby Huey first.
Mark, have you seen Carol? You're almost done, Mr.
This is the third time you've asked me this morning.
-The answer is still no.
-We need to be a little sensitive.
-First day back? -First day back.
l'm here to unload that new shipment of barbiturates.
-You didn't kill your sense of humor.
-Just a few brain cells.
Hi, Jerry.
Jerry, you're killing me.
Nothing you haven't tried.
-Don't start.
Don't start what? Dr.
Ross asked us to be a little sensitive today.
Ah, there she is.
Whose patient is this? Carol, welcome back.
Where did you find her? Who is she? Cops brought her in.
Found her riding the El about 4 a.
She had no l.
, wouldn't talk.
Oh, yeah? Well, she sings.
Really? Sorry, Dr.
Who's gonna take Madame X here? l got a laceration in the Suture room.
Abdominal pain, Room 1 .
l will in a minute, but Dr.
Jones wants these x-rays right away.
l'll get it.
We're on the road to romance, That's safe to say So let's make all the stops Along the way.
All right.
Any congestion, vomiting, diarrhea? He just doesn't seem right.
Have you or your wife been sick recently? Do you have any other kids, or a babysitter? We never left him with a babysitter.
We'll get some blood tests and do some fever control to get his temperature down and see how he does.
Okay? He looks a little lethargic.
Let's get a CBC, blood culture, chest, ear and throat swabs.
And hope that we don't have to do a lumbar puncture or we're looking at a Valium drip for Dad.
-By the way, have you seen--? -No, but l'll remember to be sensitive.
lf you ever wanna take a few minutes and talk about it.
See you around.
-Lab results on Mr.
Newton? -Not back yet.
l hope you don't mind our joking with you earlier.
You don't think attempted suicide is something to joke about? Don't worry.
lt's fine.
-lf you ever wanna talk.
Boy, am l happy to see you! Because l don't have to be charge nurse anymore.
Welcome back.
Thanks a lot.
l have the perfect first-day-back patient for you.
Where did they drop Arthur? Other side of Curtain Area 3.
-Our Arthur? -Yeah.
So how's it going? Couldn't wait for this day.
Now l'll be glad when it's over.
-l feel like everyone's watching me.
-Everyone is.
But no one wants you to fail if that's what you're worried about.
My shrink wanted me to consider working in a doctor's office instead of the ER.
-Dermatology's good.
-l don't think so.
Maybe this was too soon to dive back in.
lt's Monday, it'll be easy.
Kids who fake being sick to stay out of school a few people who partied too hard this weekend, and Arthur.
Gosh, it is good to be back.
All the familiar faces.
Arthur! Get up! Come on, let's go.
Ma'am? Are you okay? l mean, l can see that you're not okay.
lf l could just get your name for the.
Your first name? Or your-- lt's okay, actually.
l don't need your name.
Hey now.
Would you like a drink? l know l would like a drink.
Gunshot wound's on its way.
Now! Malik, find Benton, clear Trauma 1 and notify the O.
Lydia, draw CBC, get the lab to cross and type 6 units whole blood.
Find how much O-neg's around.
He's a bleeder.
Got another one.
79-year-old male, probable heart attack.
-EMTs are here in two minutes.
-Call Lewis and the cardiologist on call.
-Sick kids? Weekend partiers? -Welcome home.
He's in shock.
Keep those lVs wide open.
All right, people.
Showtime! Let's move.
He's not breathing.
Get the intubation tray.
No breath sounds, hyperresonant on the left side.
He's got a tension pneumo.
Let's get a chest tube tray now.
Seven and a half.
-Where's X-ray? -l'll get it.
Check with Susan.
See if she needs help.
-They need X-ray, Trauma 1 .
-He's coming.
Welcome back.
-l could use some company.
-Timmy, find Pam.
-What've you got? -Heart attack symptoms.
Substernal chest pain radiating down left arm with diaphoresis.
Had nitro spray times two without relief and 5 mg morphine.
-Vitals? -BP's down 90 over 50.
Respiration 24.
He was in sinus rhythm then went into this.
Okay, on three.
One, two, three.
Flannigan, how's your pain now? Better.
Kayson's my cardiologist.
Someone was going to call him.
Okay, let's check on Dr.
Get an EKG, chest, CBC, Chem-7, enzyme and coag panel.
BP's 90 over 55, pulse is racing at 1 80.
What's his rhythm? lf it's V-tach, we need to shock him.
-You wanna do it? -No, he seems quite stable.
Let's try adenosine.
6 mg lV push.
Heart rate's dropping.
BP's down.
Down to 50 palp.
Damn! Get the external pacemaker.
-Where's the pacer? -ln the drawer.
Carol, stay put.
We need you in here.
Take this to Susan in 4.
-How's his belly? -Rigid.
-Lavage time? -Got it.
Anesthesia? l'd say his buddies already took care of it for us.
Heart rate's low.
Give him another milligram of atropine.
-Pacemaker's capturing.
-ls the dopamine running? Yes.
Sure you don't wanna intubate him? l'd have to paralyze him, which l won't considering his low BP.
Keep bagging.
This guy's blood gas stinks.
Did you reach Kayson? He's being paged.
Can't wait.
Get the Pavulon, Versed and sux, and a dose of TPA.
-Vitals? -BP's 50 over 30.
Respiration 36.
-Pulse 1 40.
-Let's take a look.
His ST wave is way up.
Acute Ml.
We're in trouble.
You wanna inject TPA? Hand me his old chart.
No contraindications to TPA, but l don't want him to bleed.
-How's his pressure? -90 over 60.
We gotta go with it.
5000 units heparin and TPA, 1 0 mg push.
Keep him on the monitor.
-BP? -Still 90 over 60.
He's in v-fib.
Crash cart! -Two hundred? -Yes.
Clear again.
l'm Dr.
What have we got? He's having an inferior wall Ml.
l just started TPA.
He should go to the lab for angioplasty.
-l felt drug therapy was indicated.
-And angioplasty wasn't? -No.
But since-- -l favor a more aggressive approach.
That's one opinion.
l chose drugs.
Lewis, Mr.
Flannigan is my patient.
You're a resident.
All decision concerning his care will be made by me.
Call the cath lab.
Tell them we're coming.
Vitals? Blood pressure is 1 1 0 over 70.
Pulse is 90.
Pacemaker captured, that's a start.
Prep another milligram atropine.
Keep bagging.
Come on, let's go.
l'll go to the blood bank.
How's that Ml? Kayson seems to have it under control.
You wanna grab some coffee? That was good work in there.
You may have doubts about being back, but none of us do.
-Have you seen Morgenstern? -No.
-Have you seen Susan? -Am l the hall monitor? No.
l need you in Exam 4.
Cheung, early 30s, eye and cheek swollen.
Facial lacerations.
Bruised ribs.
Don't know how it happened.
Doesn't speak English, but her son does.
Travel my way, take the highway That's the best Madame X? She doesn't answer to that, but yes.
At least she's good.
It winds from Chicago to L.
You are absolutely wrong.
-l'm not wrong.
-lt was a bad call.
Admit it, Div.
Anybody could've made it.
You don't pick a guy off first with the winning run on third.
There were two outs.
McDowell had it all sewed up.
Till he threw it in the dugout.
What do you need? This is Madame X.
l did a physical but had trouble with the psych exam.
And the mental status questions? Tried.
Half the time she screamed, the other half she was in tears.
Let's see what we can do.
She fell down the stairs.
-At your house? -Yeah.
-Did you see her fall, Frank? -Yeah.
And you live at 31 1 West McArthur apartment A? Apartment A, that would be on the third floor, right? No, we live on the first floor.
Where were the stairs? Will you help her? Yes, we will.
Malik, why don't you take Frank out? Come on, l'll show you how to get free stuff from the candy machine.
-X-rays? -Yes.
Left orbit, chest and ribs.
What do you bet we find a few healed fractures? My dad once saw Benny Goodman play at the old Monroe Theater.
-On 33rd Street? -Yep.
l used to sing there during the war.
All those boys in uniform.
He was one of them.
Who knows, maybe you even danced with him.
l never thought to talk about music.
l don't know music.
Neither does he.
Are you ready to try some of those questions? -Like on Jeopardy!? -Yeah.
Can you tell me where you are? What is a jail? No, you're not in jail.
The cops brought me in here.
Okay, l'll give you that one.
What year is it? What is 1 948? -And who's the President? -Harry Truman.
Who is Harry Truman? Here's a different kind of question: lf you found a sealed letter with a stamp on it lying in the street, what would you do? l would.
lt's okay, forget it.
We'll try another one.
Can you tell me the difference between a child and a dwarf? l am a child, but l'm not a dwarf.
Very good.
-Walk with me.
Are you glad to be back? -Glad to be anywhere.
-How's your family handling this? All right.
They were afraid it was their fault.
-How're you holding up? -Okay.
Hoping to slip back without everyone making a big deal.
lt is a big deal.
People should be concerned.
Your family, the staff.
But everyone felt you were ready to return.
-Thank you.
-You're welcome.
Now go work too hard.
Hypothyroidism, Cushing's syndrome hepatolenticular degeneration, vascular disease? When you hear hoofs, think horses, not zebras.
Think Alzheimer's.
lt explains the mood swings, memory loss, confusion.
What should l do? Find her family.
She just wandered off.
l asked you to check her, not to become her physician.
l see Malik taught you his trick.
l know sometimes it's scary to tell the truth.
Especially about stuff that happens at home.
When your mom and dad argue, you don't wanna take sides, right? Telling the truth isn't taking sides it's just saying what happened.
And if we knew what really happened to your mom we might be able to help her more.
She didn't fall down the stairs, did she? Here you go.
Don't worry, Frank.
Your mom's gonna be fine, all right? Just fine.
Going to lunch? The cafeteria has taken a real dive since you left.
lt's got all this low-fat health food junk.
lt's a major drag.
l can't really do this.
Do what? Go to lunch? l'm not asking you out.
l'm not saying that we should see each other again.
l'm sorry l'm late.
l had a knee arthroscopy on this kid.
Captain of the school football team.
His folks are worried about his scholarship, but.
You know John Taglieri.
-Hi, John.
-How's Pediatrics? -You must have a lot of worried parents.
-All of them.
Maybe we should go.
But not the cafeteria.
No burgers, no fries.
That place is worthless.
lt was really good seeing you again.
That's a really funny story.
l'll have to remember that one, Mr.
Can l see you for a minute? Excuse me.
You were supposed to be in Radiology 20 minutes ago.
Look, he can talk about his mother, father, brother, sister, dog.
Your job is to stay focused on his medical problems.
Bird touching down in two.
Boating accident.
These chopper jockies move fast.
Stay close, pay attention.
Don't go near the rear blade and don't fall off the roof.
You're not being a lot of help.
l've surrendered.
You haven't decided for six months.
l've narrowed it down to either the Cherokee, Explorer -Montero, Trooper or Pathfinder.
-What, no 4Runner? Susan, Mark, l'm gonna switch this week's M and M to this afternoon.
l want Dr.
Kayson to come.
He can't on Friday.
l want you to present your morning's heart case.
Excellent teaching case.
All part of the process.
l'll see you at five.
Oh, God! He didn't crump, did he? No.
l gave him TPA, Kayson wanted angioplasty.
Hate to get into it again.
''l'm sure it'll be an excellent teaching case, Susan.
'' Follow me.
Stay close, all right? Don't get in the way, whatever you do.
Stay on me.
Come on, come on.
Go! -What've we got? -1 6-year-old girl.
Jet Ski accident.
Boyfriend tried to outrun a whaler.
Altered LOC from head trauma.
What are her vitals? Four-inch scalp laceration.
Bleeding controlled with pressure.
-Go! Move! -Left arm and right leg with fracture.
Vitals 60 over 40, pulse 1 40 and thready.
Pupils PERRL.
GCS 343.
Skin is pale and cool.
-How long was she in the water? -3 minutes.
Started CPR.
She stayed unconscious.
Was there any respiratory effort? Carter, move! Go on, get the door! Huey's test results have failed to show a source of infection.
What does that mean? lt doesn't mean anything.
But we need to rule out meningitis.
So l would like to do a lumbar puncture.
-Lumbar puncture? -A spinal tap.
Spinal tap? -Who wants to fill me in? -Dr.
She's 1 6.
lt was an accident on the lake.
She's hypotensive.
She was underwater 5 minutes.
Three minutes.
Multiple trauma, hypotension, tachycardia, GCS 343.
Multiple extremity fractures.
Neuro and vascular, intact.
Thank you, Dr.
We'll take it from here.
Let's move, people.
Tell X-ray we need a cross table C-spine and.
Chem-7, CBC, type and cross-match Call O.
and inform them.
The bathroom is over here if you want to wash your face.
-Malik will show you where you can wait.
-Thank you.
Heard you had a crasher.
Trials of fatherhood.
You talk to Carol yet? l tried to.
Taglieri showed up.
Are you surprised? They've been going out for a while.
-You didn't expect her to pine for you? -No, l didn't.
Just hoped she would? Nobody likes being replaced.
Glad l did it first.
Although for the life of me, l can't remember why.
Maybe it's just because you're stupid, childish, immature.
l get the point.
We'll have someone do your stitches soon, okay? -Thank you.
-Your blood test came back.
You didn't tell me you have leukemia.
You asked what l came in for.
This cut.
l feel stupid slipping in the kitchen.
Supposed to slip in the bathtub.
You didn't slip, Mrs.
Packer, you fainted.
Your white blood cell and platelet count is very low.
You have aplastic anemia.
lf someone could just sew me up.
You need to be admitted to the hospital for a blood transfusion.
That's just not possible.
Not today.
Without transfusion of blood, you're susceptible to infection, bleeding -possibly even a heart attack.
-l know all about it.
l've had this for quite some time.
And time is something l don't have a great deal of anymore.
l'd rather not spend it in a hospital.
Now if l could just get a few stitches.
We'll have someone in here in a minute.
Thank you.
l know.
l know.
All right.
You're a very brave boy.
All finished.
Carter, next time you can do the lumbar.
Come here, buddy.
Here we go.
l know.
l know.
lt's all over.
Susan needs you to do some stitches by the nurse's desk.
There you go.
-Have you seen Mark? -No, sorry.
Hanging in? -We still having coffee later? -Yeah, sure.
That ought to do it.
You okay? You're gonna be okay.
You're gonna be okay.
You know, when l think of all the great ones Ella Fitzgerald is probably my favorite.
l mean, she's amazing.
And the music there's nothing like that music today.
No, there isn't.
Do you wanna sing? Life begins and spirits rise And they become memories That vaporize And the vapor becomes The dreams we devise And while we are dreaming Time Flies And while we are dreaming Time Flies Excuse me.
My breasts hurt.
Carter, please.
And your name again? Proserpina, daughter of Ceres, who was whisked away into the dank underworld by Pluto, who not only had his way with her but also forced her to eat three red, ripe, dripping pomegranate seeds.
And to think you could have missed all this.
All right Miss ''Pina,'' let's start with a Social Security number.
Did Jennifer come for lunch? No.
She had a job interview with Pitman, Pitman and Staufenowski.
What a mouthful.
l'd hate be the receptionist.
l'm gonna meet her for dinner.
Don't leave before the session.
l need all my friends with Kayson.
l won't miss your interrogation.
-Got a minute? -Don't be late.
That boy, Frank wants to talk to you.
-About his mother? -Didn't say, but that's a good guess.
He's scared to death.
-Shot again? -Never have l seen such a thing.
-l've become a magnet.
-Your name? -lvan Gregor.
He owns a liquor store.
-They're bad shots.
Little punks! l should buy a gun.
Never wanted one around, but what l am supposed to do? Calm down.
All right, let's get him in here.
Call Radiology.
Let's get a left hip tib-fib x-ray, right away.
Go find Carter.
He keeps disappearing.
We'll do this on my count and we'll do it right.
Liz, l don't think that we should-- Remember that thing you did the other night? That thing in the car or in the kitchen? That thing on the stairs.
That's nothing compared to.
l don't think we have any uneven parallel bars.
You know what they say in med school: ''S-1 , S-2, S-3, S-4 keep the pelvis off the floor.
'' Patient: Gregor, lvan.
Medical record 6955.
AP and lateral views: left tibia and fibula.
Please reconsider.
We can start immediately.
You'd only have to be here one night.
That doesn't seem very long to either of you to me it is an eternity.
We wanna give you more time.
You've given me a wonderful afternoon.
lt's not every day l get to hear Mary Cavanaugh sing in person.
Mary Cavanaugh? My husband and l saw her perform in San Francisco, on our honeymoon in 1 948.
l appreciate your concern, but l have to go.
We need a wheelchair! And has your father hit her before? Has your father ever hit you? Does your father know that you two are here? He's coming to pick us up.
l guess l shouldn't have told.
No, no, no.
You did the right thing.
We're gonna try to get some people to help you, okay? Why don't you go see your mom? Call Social Services and Children and Family Services.
See if anyone can come up with a shelter for them.
Let me know when they're here.
l don't think l've ever seen such an old little boy.
So you elected not to cardiovert? -He seemed stable.
-Hypotensive with chest pain? -The pain was controlled.
Let's continue, please.
Could be a wide, complex tachycardia.
Was that a consideration? -l felt it was rate related.
-Which it wasn't.
Heart rate dropped.
EKG shows an acute inferior wall Ml.
Why the delay in intubation? You had the bad gases.
l thought bagging would help.
When l got the gases back, l tubed him.
So you recommended drug therapy.
TPA? l do angioplasty with my Mls.
The TPA messed everything up.
He had no contraindications, and time is heart muscle.
-l was on my way! -l didn't know.
People, please.
This is just a teaching session.
What was the outcome? Did the angiocath and it was a mess.
He bled like a stuck pig.
Before l got to the angioplasty his heart rhythm went haywire.
Shocked him and he revived.
EKG became normal.
The artery opened.
So you never did angioplasty? -l could hardly-- -And the TPA worked? Dr.
Benton, what would you do? Angioplasty.
Langworthy? Angioplasty.
Greene? Angioplasty.
Just because we're friends doesn't mean we'll always agree.
l'm getting dragged over the coals, you stroll in late, don't say a word.
l missed the first half.
How was l supposed to comment? Didn't stop you commenting in the end.
Why do l feel like a traitor? You know, it wasn't personal.
l'm dying out there and you're siding with the slicers and dicers.
Benton and Langworthy are surgeons.
They only want to cut people open.
That may be an exaggeration.
The patient was fine with a dose of TPA versus a $ 1 0,000 surgery.
My decision was valid, you should've backed me up.
You seen the chart on the sliced finger in the Suture Room? Yep.
Did Proserpina find you? Who? Oh, Liz.
-Seems like an interesting girl.
-Yes, she is.
l knew a girl like that once.
Freshman year of college.
''Penicillin'' was her middle name.
No meningitis.
He's got no infection.
Continue to monitor his temperature.
And have his doctor check the blood cultures tomorrow.
Thank you.
Wanna get some coffee? l'm not sure now is a good time.
We'll go outside and watch them polish up the ambulances.
Okay, l'll just be a few minutes.
Lewis was so persistent l had to agree to a transfusion.
We're just worried about you.
l'll miss my granddaughter's christening tonight.
8:00 service.
Your family could reschedule it.
Why should they? l'm not going to die on them.
Not today.
l've had a lot of time to think about dying.
Can't say l recommend it.
A nice fat stroke would have suited me better.
But each morning l wake up l think of as a gift.
And there's this feeling l have.
l don't know when it's going to happen.
But l know when it's not.
l'm not going to die today.
l am going to a christening.
Father showed up ten minutes ago, very determined to leave.
Cheung, l'm Dr.
Like to go and talk this through? There is no need, but thank you.
l want to get my family home.
This mother and son need to get to a shelter.
They've gotta want to go.
Frank told me that his father hit her.
Look at her face.
She denies it.
My son was very upset when his mother fell.
You understand.
Please ask your mother again for me, will you? -Get Children and Family Services.
-Not unless he's been beaten.
How can you say such a thing? Has your father ever hit you? Did your father hit your mom? No.
Thank you for your concern.
l don't think so.
l'll get it.
Who was Jimmy Dorsey? Glen Miller.
-l got Duke Ellington, didn't l? -Big deal.
What're we doing here? We're waiting.
Your granddaughter's here.
You're going home.
That's right.
-My granddaughter's here.
Did you meet? -Yes.
l'm going home.
Can you come? l'm very busy today, but some other time.
Are we all set? Thanks again, and l'm sorry about this.
She usually doesn't wander so far.
lt's okay, really.
Don't worry.
She's really great.
Love you, love you, love you.
l love you too.
Let's take it Nice and Easy It's gonna be so easy Come on, Ellen.
Come on, come on.
Hey baby, what's your hurry? Relax and don't you worry We're gonna fall in love Thanks.
-Good first day? -Yeah, so far.
That's good.
Listen, l was hoping that-- l know that you're seeing Taglieri, but.
l was thinking you and l could see each other again.
l would've tried suicide earlier if it was such a turn on for you.
-l'm serious.
-No, you're not.
You're standing there like a puppy because you feel guilty.
No, l don't.
l mean l do, but that's not what this is about.
lt is.
You think you had something to do with my swallowing the pills.
Well, you didn't.
There were actually more depressing events in my life than you.
Tell me about them.
l wanna know.
lt's a combination of things, you know.
Too much stuff starts piling up, you feel trapped.
l spend a lot of time talking about all this stuff with my shrink, so.
l have a lot of work to do.
Look, Carol.
You really wanna be with Taglieri? He was there before this happened, and when it happened.
What we had is it worth another chance? You thought what we had didn't work.
l don't suppose we could talk you out of this? l told you l'd be in first thing in the morning for the rest of my transfusion.
l can't miss one minute of one thing.
Not one minute, one hour, one day.
When l was your age l never thought of such things.
l do.
Life might be giving up on me, but l'm not giving up on it.
-Then we'll see you tomorrow morning? -Yes, you will.
ls she leaving again? She's going to a christening.
Come quick! Mark's hurt.
Surprise! We wanted to give something to let you know how glad we are that you're back.
Eight weeks ago, you grabbed our attention.
So if you feel like you need to do that again we'd like you to put this on instead.
Speech! To say l feel lucky would be kind of an understatement.
What you all did to save me was like a gift.
l've promised myself to remember that every day, so thank you.