ER s01e06 Episode Script

Into That Good Night

Doug? Come on! We're busy again.
l'm on double shift.
So am l, and you wanted a long weekend.
Now get up.
l was having a terrific dream.
l was beating my high-school football coach.
Carter! Med students don't sleep at 4:00 p.
Get up, Carter.
Woman with a headache, thinks it's a brain tumor.
A kid with gum in his eye, and an old lady who wants her hand held.
-l'm hungry.
-Cookies at the desk.
Repeat H and H ordered for abdominal pain in 2.
-Good morning, Susan.
-lt's afternoon.
l knew that.
Your brain's rotted.
At your age, Ryne Sandberg retired.
At my age, Mozart was dead.
Jen, l can't get out.
l've got two residents on double shifts.
l'll be home before Rachel goes to bed.
-Tell Mark to go see his wife.
-Go see her.
Why can't you tell me over the phone? Hang on.
Jen, it's Doug.
Can you hold on a second? We can survive without you.
l'll meet you there, all right? Bye.
Thank you.
l know you can survive without me.
Rescue's bringing in two victims, motor-vehicle collision, one major.
-How soon? -Now.
-Where's Benton? -Am l his travel agent? Ask his student.
Read about diseases, you think you have them.
Find Benton, head-on vehicle.
Two victims on the way.
TC, seven months OB, vitals stable.
Second victim behind her.
What's your name, ma'am? -Sally Niemeyer.
-How far along are you? Almost seven months.
Second one coming in.
Chest trauma, vitals stable.
Air bag didn't open.
Name's Suarez, gangbanger, stole a car, hit the pregnant lady.
Miss Suarez, is there any pain? CBC, type and cross, and hold four units.
Hook her up to a fetal monitor.
Now, please.
-Your baby has a steady heartbeat.
-l'm gonna have a boy.
Get a K & B, call OB for ultrasound.
Does this hurt? Do you have pain in your head? No.
That girl, she just ran right into me, didn't even stop.
What about me, man? Push down with your hand.
Push again.
That's good.
Push down on your foot, like on a gas pedal.
You're doing great.
All right, gently.
What? You're in labor.
Two centimeters dilated, 40% effaced.
Can somebody call my husband? -Want to stop it? -l want to buy time for the kid's lungs.
What if it's 34 weeks? lt doesn't feel like 34 weeks.
We need ultrasound.
l don't know.
lt's too early.
We gotta try.
Will my baby be okay? Let's stop the labor.
Bolus her six grams magnesium sulfate.
Get a fetal lung profile.
Where's OB? What about me? ls my baby okay? lt's okay.
lt's okay.
That's incredible! lt's terrific.
l still can't believe it.
Why didn't you tell me on the phone? lt's in Milwaukee.
lt's only two hours away.
And a federal clerkship.
l never dreamed l had a chance.
l thought you wanted to be a state's attorney.
They haven't made an offer.
The judge had a clerk.
The guy bagged out at the last minute.
lt's a great break for you.
You deserve it.
You deserve it.
There's lots of hospitals there.
l don't know about chief residents, but.
We could live here, and you could take the train.
Four hours a day on a train? When will l have time to sleep? l'll never get to see Rachel.
l'll make some phone calls.
See what they got up there.
l've made a lot of compromises, Mark.
Doug, they're not stopping.
Contractions two minutes apart.
Doug? l don't like this.
We're gonna have major lung trouble.
-Fetal heart rate? -1 35 and dropping.
We got 1 28.
Late decelerations.
-Fetal distress may be acidotic.
-What's wrong? ls my baby okay? We're taking care of your baby.
Her water's broken.
All right, we can't stop this.
Let's go for delivery.
Call OB.
Tell them we're on the way.
Call Neonatal, tell them to expect a preemie, 28 weeks.
Tell Third Floor to send a team to 5.
Niemeyer, you're gonna deliver your baby right now.
-Let's clear that, please! -You got it? Here you go.
How's Jennifer? She got a great job in Milwaukee.
Can she do it by phone? l don't think that's what the federal judge has in mind.
Milwaukee? Don't ask.
l don't know.
Miss Suarez, you hit a pregnant woman.
We're not too happy about that, but we'll take care of you.
Now, you have to tell us the truth.
-Did you take any drugs today? -No.
Do any cocaine, maybe a little crack? No! Yeah, right.
CBC, tox screen and let's get a chest film.
Look at this board! Don't worry, it'll get quieter.
Don't say the ''Q'' word.
You'll start a stampede.
-Take the kid in 1 .
-All right.
-She deliver? -Right out of the elevator.
The baby's in Neonatal, lungs are bad, hyaline membrane.
Good night.
Mom's okay.
Good night, Billy.
Ross? Can l talk to you? Sure, if you can keep me awake.
lf a patient has a burning sensation, does he necessarily have--? A sexually transmitted disease? Probably.
You have to do a culture.
Ever do that? No.
First you gotta do a chlamydia prep.
Then you have to do a Gram's stain for gonorrhea.
Stick this bad boy in about a quarter of an inch, and spin it around about ten times.
Ten times? Who's the lucky girl? Liz.
The girl with the rash.
Old hospital saying, Carter: Don't dip your pen in company ink.
l hope you used a condom.
We got a Code 3 from Rescue 63, full arrest.
They're on their way in now.
Can l take her? Not until her tests are back.
She's breathing, ain't she? She stole the car and hit a pregnant lady.
For all l know, she could have an aortic rupture.
You want her to die in jail? Frankly, doc? l wouldn't lose sleep.
Neither would l.
But l'm liable.
You're not.
Mom, listen.
l can barely hear you.
Got a heart.
Where to? Trauma 2.
Last door on your right.
-Susan, we need you.
-l gotta go.
l'm really okay.
Are you doctors? l'm Dr.
l thought he was in full arrest.
l was, until they fried my chest hairs.
Let's get a CBC, Chem-7, blood gas and coag panel.
On my count.
One, two three.
He was in fib.
Shocked him once, converted fast.
He had a 1 00 milligrams of lidocaine.
How did it feel? Any pain? l don't remember.
l passed out.
Can we get a monitor? Do you have a history of heart problems, Mr.
Gasner? Nothing a transplant wouldn't cure.
l was up for a good one.
A kid in a motorcycle accident.
lt went to Minneapolis.
Who's your cardiologist? Mike Dickey.
Great guy.
He's at St.
Luke's in Cleveland.
l'm in town for the builders' convention.
My wife said l shouldn't travel.
But how could l miss 2,000 construction guys in one.
l don't get a pulse.
Gasner? What? He's not in fib.
Give him an amp of epi.
Come on.
Come on back.
l'll call for his history.
l just pass out.
Start a dopamine drip, 400 in 250 D5W, 1 0 drops a minute.
My chest feels like someone sat on it.
That happens sometimes.
l know.
Give her something.
She can't breathe.
That's it.
Keep taking deep breaths.
Blood gases are back.
Not good.
PO-2's 70.
Are you taking any medications? lt's never been this bad.
Hand-held nebs, albuterol 2.
5 milligrams.
Peak flow, pre and post.
Give her Solumedrol Can l talk to you outside for a second? Sandy, this is Lydia.
She'll take care of you.
You're gonna be fine, okay? Just keep breathing.
Keep breathing.
Your daughter's having a serious asthma attack.
ls she allergic to anything? l don't think so.
Do you have any pets? This cat, a stray.
Sandy found her.
She just loves her.
You have to get rid of the cat.
We need to do some tests.
lt'll take about two hours, okay? Gasner, G-A-S-N-E-R, first name Samuel.
Can you fax us his chart? Are you a doctor? They said my wife was here.
What's your name? Niemeyer.
She's pregnant.
ls she all right? Jerry.
l'll take you up to Neonatal.
Neo-what? You had a baby.
Thanks, Jerry.
Greene, with an ''E'' at the end.
He's chief resident.
l got a little tired.
Built 1 5 houses this year.
l wanted to design them, but l just build them.
Could you stop talking for a second? Old inferior wall Ml, low voltage consistent with severe myopathy.
l've been through this.
l know what it says.
lt's nothing new.
Am l gonna make it tonight? l ask every time.
He's in fib.
-Two hundred.
Another 50 of lidocaine.
Start a drip.
Two grams at 500.
l don't usually do that.
Could somebody please call my wife? That's a big boggy heart.
Suppose we get a transplant.
ls it too late? He's been defibrillated twice.
He in cardiogenic shock.
Keeps going in and out.
Can't be much muscle there.
Jerry, call Cardiology for an echo.
Wake up Dr.
Flint, get him here from Lake Forest.
Call the transplant coordinator, see if they got any hearts around.
And your wife called.
Great! l missed calling Rachel.
Get ahold of the Gasner family? l'm trying every ten minutes.
Gasner doesn't think he'll make it through the night.
Ross, peak flow's gone from 1 90 to 300.
-How's her gases? -Much better.
Sandy, you are doing great.
She'll need an appointment with your doctor.
She's also going to need an inhaler at home and prednisone.
Fill this thing out tonight.
Hospital pharmacy is open 24 hours and it's on the first floor.
There you go.
l thought you were off at 1 0.
-l'm on all night.
How about you? -l'm on a double.
-Thank you.
Why is Mark getting messages from University Hospital in Milwaukee? His wife wants to move.
She got a job there.
ls he gonna do it? l hope not.
l can't imagine he'd be happy there.
He ever go home? He's waiting for that gang girl's recovery.
What's he doing? Practicing one-handed knots.
He'd do it with his teeth if he could.
No, you can't wear a glove on your teeth.
What are you listening to? Snoop Doggy Dog.
Trends in Cardiac Surgery, Volume Two.
Blood pressure's falling, 80 over 60.
Add a dobutamine drip, 250 in 250, You feel crummy waiting around for a kid to smash up his car so you can get his heart.
We're getting great pictures.
Frame one for me, will you? How's your heart? lt's in pretty good shape.
Want to lend it to me for the weekend? You got better things to do with it.
Do them all.
You never know when you'll get the chance.
Left ventricle, please.
You got kids, doc? A daughter.
She's five.
My girl's nine.
Her age l shouldn't really travel.
l miss too much of her life.
What can l say? l love the job.
How you doing? To tell you the truth, l felt a hell of a lot better yesterday.
What's your wife do, doc? She's a lawyer.
You guys must have your hands full.
Did l get any tests back? -On who? -A patient.
Does the patient have a name? Yeah.
lt's Car-tere.
l'll watch out for them.
Don't tell anybody the results.
''Secret'' is my middle name.
Gasner, Samuel.
We called in.
Look, we'll take any heart.
Anything? Type A blood, negative T-cell cross-match, okay? Keep us posted.
We need a heart.
Thank you.
He's getting weaker.
l can't pull a heart out of thin air.
Gunshot wound to the foot.
The liquor store guy again, asking for you.
lvan? What does he do, wear a sign that says ''shoot me''? lvan, lvan, lvan.
Who did it this time? Me, l did it.
-l thought you didn't have a gun.
-l bought a little Glock.
Oh, God, it hurts! Let's get a gram of ancef, and That last BP was a little high, All right, 1 0 Procardia sublingual.
Russia's crazy.
You need vodka to get good doctor.
God bless America.
God didn't bless your neighborhood.
l was showing the gun to Nicky, the dry cleaner, and bang! Off went half your toe.
Will l lose it? You already did.
Let's go.
Still can't find a donor.
There's one, but the blood type is AB.
How hard is it to find a type A? The patient has advanced dilated cardiomyopathy with severe mitral regurgitation and an ejection fraction of less than 1 0%.
This is not the best news l've heard all day.
So, Steve, do you have an opinion? Dr.
Kayson and l agree on little, but we're both happy not to be Mr.
What if we put him on a heart-lung bypass while we look for another donor? l'd say the stress alone would kill him in a couple of hours.
Put the transplant team on call.
We'll put him on the table in 20 minutes.
Gasner's wife will be here around three.
Somebody's going to have to tell them.
Have the desk beep me when she gets here.
Hey, Carter! Bend over! There we go.
l'm cooking now.
All right, hold still.
What is he doing? l lost a bet.
He's my backboard.
Mark? l'm on a roll here.
Here we go.
And the shot! You ruined my concentration.
Ross? Baby in 4.
Seven inches taller l would've been a contender.
-Any luck with that heart? -No.
l heard your wife got a job in Milwaukee.
Yeah, she's clerking for a federal judge.
That sounds exciting.
lt is.
You gonna leave the hospital? l don't know.
l thought you were off.
Yeah, l am.
l just thought l'd stick around.
You ever have one like Mr.
Gasner before, one that took so long? No.
You look like hell, Carter.
Yeah, l'm just waiting for Ben-- Dr.
Benton to leave.
You need some sleep.
That hurt.
You've taken a bad fall, Mrs.
l'll get some x-rays.
No x-rays.
They'll hurt my baby.
How long have you been pregnant? Six months now.
Your baby'll be protected.
We'll shield you with lead and we'll use a low dose.
As long as you promise not to hurt my baby.
l promise.
Lydia take Mrs.
Fadem to Radiology.
And be careful of her pregnancy.
Right away.
-Her what? -Pregnancy.
You worry too much.
Kayson hates me.
He's a cardiologist.
He's on my review board.
l'll need his recommendation.
Why would you want it? The man loses so many patients, he gets endorsements from funeral homes.
When l was your age l worried about what every attending thought of me too.
Forget it.
You're a good doctor.
You're better than my ex, and l actually married her.
A lot of subjects interest me, and believe me, your ex-wife tops my list.
That's me.
My knife-wielding psychotic must be up from his nap.
Your wife's on her way.
She'll be a wreck.
He's not putting out fluids.
One-sixty of Lasix.
Hey, doc? Do l look stupid? Why don't you tell me? You versus God.
We know who wins.
l don't think of it that way.
You don't have to.
l'm the one on the table.
We looked at your echo.
And if we don't find a donor heart you probably won't make it through the night.
lt's two in the morning.
l'm dying.
So please call me Sam.
This is no time to be formal.
Don't forget to check on lvan.
Can l take the girl now? The gangbanger? Aortic rupture.
l forgot to tell you, she died in recovery.
l'll see you at seven.
? -Good night.
Why bother driving home? Three hours sleep.
l've got to come back here.
This is nuts.
Quinn, Daniel.
Hypotensive, comatose.
Fraternity kid, drinking all night.
Ever see anybody intubated? No.
Get Respiratory in here.
Start a second line.
D50, one amp, 2 mg Narcan.
Pam, get an EKG.
Quinn, do you hear me? -Daniel? -Respiratory's on the way.
He's cyanotic.
Add dopamine.
Hyperventilate him.
The line's in, Susan.
BP 70 over 40 and falling.
Get a CBC, blood alcohol, Chem-7 and tox screen.
Tube him.
Blood sat's 80.
Do a dextrose stick.
Okay, Carter, pay attention.
This is where it counts.
Visualize the cords.
You don't want to miss the trachea and end up in his esophagus.
lt's in.
Bag him.
Listen to the lungs to make sure the tube's in place.
Glucose is normal.
BP is steady, 80 over 65.
Draw a blood gas now.
Doug? They called from Neonatal if you want to look at the preemie.
He's gonna be okay.
God smiled on him.
Since when do you believe in God? l've been contemplating my insignificance in the universe.
l thought you were its center.
Not always.
l'm looking for Dr.
He's in the emergency room.
Yeah, l'm Dr.
Thank you very much.
You're welcome.
Who are you? l'm Randy Niemeyer.
My wife, my baby.
They said you took her up.
My boy's gonna be okay.
l'm just on my way up to see your baby.
You want to? We're hydrating like crazy and his blood pressure's not moving.
Order LFTs, BUN and creatinine.
His friend's here.
He says the guy didn't have that much to drink.
And the Cubs are a shoo-in for the pennant.
Elliot, this is Dr.
How much did Mr.
Quinn drink? We were playing this game, Whale's Tales.
You say numbers.
lf you can't remember them, you drink.
How much did Mr.
Quinn drink? Listen, his father's an assistant dean.
lf he finds out about-- What was he drinking and how much? Beer.
Beer and shots of tequila.
He must've had 1 5, 20 shots.
-Did he do any drugs? -No.
-Will he be all right? -l hope so.
Blood alcohol's back, .
Call Dialysis.
Let them know we're on the way.
Let's move him.
Gasner? -l'm Elaine Gasner.
This is Sarah.
Hi, Sarah.
l'm Dr.
Sit down, honey.
Where's my husband? Can l see him? He's sleeping.
l need to tell you about his condition.
His heart muscle is badly deteriorated.
They said he could get a transplant.
lf there was one available.
There isn't one tonight.
He can wait till they find one.
Your husband's heart is failing.
Unless we find a heart donor in the next couple of hours, l don't believe he'll make it through the night.
l'm sorry.
Sam? Mark.
Your wife and daughter are here.
l was thinking.
Did you hear the one about the guy on the country road? Flat tire.
Doesn't have a jack.
Never mind.
You think you can avoid it.
lt all counts.
Decisions you don't make.
The real joke is l'm still gonna die.
l guess l'm getting ready for it.
l'm not ready.
Damn it, l'm not! l don't want to leave them.
Sarah needs me.
Could you please have my wife bring Sarah in? Sure.
Don't say it.
What? That l should be grateful to be alive.
That's not what l was thinking.
What were you thinking? l don't know.
ls there any chance? Type A, negative cross-match.
Forty-three years old.
He can handle the surgery.
lt just seems that marriage should be easier.
l never heard it called easy.
Sometimes l think we did it just to make our parents happy.
-You're good at making people happy.
-Not this week.
What? How soon will you know? A 1 9-year-old flatline EEG.
Can't find the parents to sign a release.
What'll you do about Milwaukee? l could be a junior resident at a suburban hospital.
That'd do wonders for your career.
lt all counts.
What? Nothing.
Your dialysis kid's coming around.
Well, can you keep trying? l need that heart.
Can you do me a favor and get a hotel for Mrs.
Gasner and her daughter? Sure.
You okay, Dr.
Greene? l'm fine, Jerry.
Ross? Lydia, what is a seven letter word for ''dumb,'' beginning with an ''M''? ''Moronic.
'' Your asthma patient's back.
-She tried to sleep-- -Where's the inhaler? l didn't get it.
She's having another attack.
l told you to fill out that prescription tonight.
She could've died.
You understand that? The medicine costs $30.
l don't have the money.
Medicaid don't come for another week.
l'll be back.
Do we have a spare inhaler? Just the one.
lf he's that bad, he should come in.
-What about Proventil samples? -Nope.
We can't diagnose over the phone.
lf that's what you want to do.
Thank you.
-Prednisone, any of that? -Plenty.
On the top shelf.
lt'll take more to get her through the week.
You seem very interested.
She must be pretty.
She's 1 2.
l'll see what else l can turn up.
Jerry, l don't get it.
l sent that Gram stain ages ago, and it's not back yet? -Who was that for again? -Mine.
For me.
Oh, yes.
lt came in about three.
Where is it, Jerry? Bulletin board.
Excuse me.
You gotta do something.
l feel like l'm gonna throw up.
We wouldn't want that.
Not here in the hall.
Come with me.
Hi, John.
Hi, Puppy.
You're up pretty late.
l fell asleep on the plane.
Did you have fun with Grandma? She gave me a present.
Blood sat's 80 percent.
-What did you get? -Fifteen liters O-2.
A diary.
Grandma made the cover herself.
Grandma likes to make things for you.
My mom says my dad's gonna die.
Yes, he is.
Why can't you fix him? We can't fix everything.
l can breathe now.
We don't have an inhaler.
Take the prednisone every day and visit the clinic in the morning.
Tomorrow? l can't go tomorrow.
lt's important.
l gotta go to work.
lt's my second week.
Ross? There's a kid throwing up in 3.
You're gonna have to take off work.
-l can't.
-She has to have the medication.
lt has to be done, okay? So do it.
l know, Elaine.
l know.
l forgot a long time ago.
l was always sure of you.
You never let me down.
Sam! Please.
l have to tell him one more thing.
You have to make him hear me.
Forever, honey.
Sarah'll be fine.
Remind her l love her.
Quinn? Daniel? l'm Dr.
You're on dialysis because you drank too much.
Would you blink if you understand me? We'll be taking that tube out of your windpipe soon.
Your kidneys are functioning.
Your liver's fine.
And you lost a few million brain cells, but you can spare them.
Blink if you will never do this again.
Playing one-on-one against yourself is the easy way.
Here you go.
Here you go.
Come on.
Get by me.
l'm the short guy.
You said you could've been a contender.
You distracted me.
-That's the game.
-What do you want? Can l borrow forty bucks? -For what? -l gotta run an errand.
Go home, Mark.
This'll get your daughter through the next 3 weeks.
Make sure she uses the inhaler.
Bring her back if she's not feeling better.
You bought this yourself? l'll get her to the clinic.
l promise.
Thank you.
You're welcome.
Honey? What time is it? Seven-thirty.
l was just thinking about Milwaukee.
And l know it'll be hard.
That's okay.
Don't worry about it.
But if you want me to go l'll go.
l'll go.
No, you'd hate it.
lt's not a big deal.
lt's only two hours away.
l love you.
l love you too.
Daddy, you're home! Hi, sweetheart.
Come on in.
Come here.
l'm so glad to see you.
Daddy, what's wrong? Nothing's wrong.
Nothing's wrong.
Nothing's wrong.