ER s01e13 Episode Script

Happy New Year

Bob, who's in? Dr.
There's a guy in the street.
Gunshot wounds.
Blood everywhere.
All right.
You heard the doctor.
Here we go.
We got a GSW.
lt's on the street.
We're gonna need some hands out there.
Clear Trauma 1 .
A patient's gonna strangle on Christmas lights.
-He's between the cars.
-l see him.
Okay, l can see him.
All right, he's still breathing.
l got a pulse.
We gotta get him out of here.
Lift him up.
All right.
Easy! Watch his head.
Joe, you got him? Bag him.
Connie, notify the O.
, get Benton and order eight units O-neg.
Bob, call Security.
We got a gangbanger here.
Gangbanger? Dial 4-3-2 and say, ''Help!'' Open the Trauma Care Unit! ln winter, l wish they'd dump the bodies inside.
Yeah, pretty inconsiderate of them.
Trauma 2, call the blood bank.
We need eight units of O-neg.
And l need a page on Benton.
Get his clothes off.
Gary, can you grab that? Abdomen, chest, neck, legs.
Pulse 1 60 and thready.
Decreased breath sounds hyperresonant on the right.
l'll decompress.
Fourteen gauge? Get your souvenirs here.
l'll get it out of here.
Let's intubate him.
Carter, jump in here.
Me? You've seen 50 of these by now, right? Advance the blade to the epiglottis, then lift.
-l can't see a thing in here.
-Okay, l'll suction.
Visualize the vocal cords, and pass the tube through them.
Stay away from that esophagus.
-You got it.
-Nice work, Carter.
's waiting.
What've we got? Tube's in.
Let's go! Gunshot wounds to the neck, chest, abdomen and legs.
Gave two liters of saline, needs a thoracotomy and laparotomy.
Clear that elevator! -l'd like to follow through the O.
-There'll be enough bodies there.
-l haven't been there yet.
-l'll take him from here.
l'm the one who found him.
Well, you probably saved his life.
Let's go.
We got a dead shovel in 2 and a paper cut in the Suture Room.
Paper cut? The guy says his newspaper jumped up and attacked him.
We're waiting for psych.
lsn't it comforting to know that 1 995 won't be any different than 1 994? Excuse me.
Carter? Can you call the medical examiner to pick up the dead shovel in 2? What's a dead shovel? Fat man shoveling snow.
Heart palpitations and a fractured femur.
She's waiting on the orthopods.
Excuse me.
Excuse me.
l've been here for hours now, and l feel absolutely fine.
Davies is the mitral prolapse with resolved SVT.
Yeah, resolved and forgotten.
Where's Dr.
Lewis? She'll be with you as soon as she can.
l hope so.
l have a 7-year-old at home with the mumps.
So do l.
Gets on your nerves, doesn't it? Thank you.
You can do it.
l can do it.
Just swing on.
You mean hang on? l can't do it, Bob.
l can't do it! Yes.
Yes, you can! You okay? New Year's revolution.
l quit smoking.
-She had a menthol.
-Menthols don't count.
My resolution was to quit doing scut work.
After l take these to the lab.
He failed.
Why can't l? -ls Dr.
Benton back from surgery yet? -Been and gone! Thank you.
This is gross! -Shut up, Stewey! -No, you! You started it.
Now stop it! Let the doctor do his work! Perhaps Binky wants to wait outside.
You know, Mrs.
Bimley, Stewey's eye is gonna be just fine.
A word of caution: Keep all the guns, even the paint guns, away from the kids.
Well, obviously.
Do you think l'm an idiot? Come on, Stewey, let's go! Binky! l got a bumsicle for you.
Freeze-dried at the backdoor.
-Let's clear Trauma 1 .
-Got to go.
Welcome back.
l found him on 43rd Street.
Gilbert McCabe.
Legs frozen to the sidewalk.
l was just sleeping.
l feel fine.
Put me down.
You can't even stand up.
We had to chip the ice with a tire iron.
They woke me up is what they did.
McCabe, my name's Dr.
This is Dr.
We're gonna check you over.
l don't want some colored woman working on me.
Like l said, '95 is gonna be just like '94.
l said, put me down.
What are you, deaf? -Dr.
-l'm very busy, Dr.
This'll just take a minute.
l've got a patient with-- You'll have to wait.
l've got a patient coming out of surgery.
Davies, everything checks out okay.
Your heart rate's normalized.
We need to increase your verapamil.
So l can go? Not until the attending cardiologist gives the okay.
Don't worry, you'll have time for your daughter's mumps.
They last a good seven days.
You have to take them off.
The hell l do.
-You need Carter? -Not if you do.
Bowel disimpaction in 1 .
-How was surgery? -Which surgery? -The gang kid from this morning.
-He died 1 0 minutes in.
This is my surgical rotation.
-Your ER surgical rotation.
-l haven't stepped foot in an O.
You always treat students like this? Dr.
Benton, l hate to complain, but all l do is scut work.
l did it for my surgical resident.
We all did.
And you'll do it until you can do it in your sleep.
You are a medical student.
You're here to make my life easier.
Yeah, l'm also here to learn.
And have you? Learned? Glove up and dig in.
And don't take all day.
-Can you feel anything here? -Keep it where l can see it.
-Are you feeling anything here? -Where? -How about that? You feel that? -No.
And don't touch those pants.
-Now? -No, nothing hurts.
And don't get into those pockets.
l got all my money in those pockets.
What do you keep poking for? My feet feel fine.
lt's just that they're a little heavy.
Like a chunk of wood.
And l wanna take those shoes with me.
Do you hear me? Connie, set up a morphine drip and a gram of Ancef, and a tetanus booster.
l don't want any drugs.
Heparin, 5000 units.
You have severe frostbite in your feet and legs.
lce crystals in the tissues.
We need to warm them up quickly in a whirlpool bath.
You mean like a Jacuzzi? Yeah, like a Jacuzzi.
We'll see if there's any tissue damage and decide if we need surgery.
Oh, no, l won't need that! That's a perfectly good pair of hoofers.
Just need a little warming up, that's all.
Tell them l'm taking my clothes with me.
l don't want some bonehead stealing them.
Davies is 38 years old known history of recurrent, easily controlled SVT.
You should've released her hours ago.
l tried to talk to you on your way to recovery.
You should've come to me a long time before that.
Hey, Susie! Not now, Chloe.
l did try to find you.
l gotta tell you something.
Hey, are you one of Susie's teachers? Here's your release.
Next time, Dr.
Lewis, try harder.
Oh, Mrs.
Davies needs you.
-Stop coming by.
-Let me tell you something.
-lt can't wait until tonight? -l won't be here tonight.
Ronnie and l are moving to Texas.
l've come to say goodbye.
Susan, are you coming? What are you gonna do? l don't know, learn how to cook chili.
This isn't funny.
You and Ronnie are moving to Texas.
You're not even sure he can get a job.
l told you, he's got an uncle that works in a refinery.
-Where are you going to live? -l always figure that stuff out.
You're pregnant.
lt's a little different this time.
This is crazy! l don't think you should go.
You want me, Ronnie and the baby to stay with you? You don't even want me to have the baby.
l just think that you should-- l want to, and l'm going to.
At least stay in Chicago.
l'll talk to Mom and Dad-- l don't want that! l don't want to stay with people that always think l'm doing the wrong thing.
l am gonna love this baby, Susan, so much.
And l want everyone else to love it too.
You gonna eat that? l'll send you a postcard from the Alamo, okay? Chloe, wait! You don't even have a winter coat.
l'll wear it.
l'll wear it all the time.
Give him a liter of Ringer's the first hour, 1 6 line.
Start a Foley.
BP's 70 over 40.
Resps shallow at 28.
Full thickness burns to both legs.
Check who's covering plastics.
-We need more sterile saline.
-Lydia's coming with it.
-Third degrees to the scalp and face.
-Chest and abdomen burns are minor.
-Burn Unit's notified, Mark.
-Thanks, Lydia.
Pulse ox is 85.
-Any other firemen hurt? -No.
Give him 1 0 of morphine.
Want me to get rid of them? No, no.
Let them stay.
José, you're missing my point.
We are not a pizza joint, and we do not deliver.
Okay, sure.
Take your business elsewhere.
-Guy wants us to make house calls.
-How quaint.
You have, Dr.
Ross, won the Pick Three Lotto.
We got a runny nose in 1 , a cough and a sore throat in 4 and babies having babies over at Curtain Number 2.
Babies it is.
-Sure thing.
So how was New Year's Eve? Sorry l didn't make it.
Neither did we.
Walt and l fell out by 1 0:30.
So what does he think about your new job? He's happy.
Kids me about it all the time.
Says working for Parks and Recs is like being an urban forest ranger.
Yeah, but l bet Mom's proud, right? That's what we need to talk about, Peter.
Walt and l saw this really nice place across from Bryn Mawr Park.
She'd have her own room, people to spend time with her, nurses to look after her.
What are you talking about? l don't think we can keep caring for her.
Since the stroke, she's been in and out.
She needs constant looking after.
l don't know constant.
You wouldn't know constant, because you're never around.
With this new job, l'm not able to do it anymore and l don't want the kids to take on that responsibility.
Steven's in basketball, Joanie's doing plays.
l can't ask them to give it up.
Why? Because that's what you did when you were looking after me.
When Mom went back to work, we didn't have much choice, did we? l do have a choice about my own kids.
Jackie there's gotta be something else.
What about Mrs.
Lukey? -She's only 3 years younger than Mom.
-She looked after that old man.
She lives across the street.
She can come over and spend the days.
l'll make the arrangements to pay for it.
Since when do you have extra money? Let me worry about that.
ls this a done deal just because you say so? Where have you been for the past 6 years while Walt and l worried about it? l can't put her in a home.
You won't have to.
lt's our decision.
All of ours.
lt can't always be about what you want, Peter.
l'm gonna miss my bus.
Doc what's the story? How's our boy? lt's not great, guys.
He's got full-thickness burns to 60% of his body.
He needs to go up to the O.
for débridement and then to the Burn Unit.
But he'll make it? l'll know more in about 1 2 hours.
Okay, thanks, Doc.
Greene, can l talk to you? Yeah, can l borrow your pen? l don't know if this is appropriate.
l'm not sure Dr.
Benton's interested in supervising me.
l'm fairly certain that he's not.
So the warm, fuzzy demeanor's not getting through to you? Yes, that would be accurate.
l had a ton of residents like Benton.
l think Benton had a ton of residents like Benton.
He's not the worst one you'll get.
My advice? Get used to it.
Lydia, l need some help with those teenagers.
She can't.
She's on her way to Radiology.
She's quitting smoking.
She's chewing nicotine gum.
The whole pack? You okay? l've never seen anything like that.
l just started three weeks ago.
Maybe l shouldn't be doing this.
l didn't think it would scare me like this.
You need to get some rest.
Go home, okay? Get some sleep.
The EKGs are normal? That's right.
So are your blood tests, chest x-rays and enzymes.
No damage to the heart muscle.
So what was this pain then? Probably muscular.
You take all this time just to tell me l pulled a muscle? So l take that anti-inflammatory again? Again? A couple of months ago, my wife made me clean the garage.
Threw my back out.
Two months ago? That's what l said.
Oh, they gave you Feldene.
Your pain's stopped.
You don't need to take it.
So l'm out of here.
l can't discharge you exactly yet.
What's the deal? You said l was fine.
l've got three customers this afternoon.
l'll run your tests by the cardiologist on call.
Then we can sign you out.
-Have you seen Mark? -Down one.
lt's okay, she's a nurse.
Chopper's setting down in two minutes with an MVA.
-Get Benton for it.
-He's still at lunch.
Here's your pap tray.
Thank you, Dr.
He's your man.
Right this way.
Paramedics are bringing in an MVA.
l need you to bring him down.
By myself? Excellent! lt's 34 degrees out.
You might want to get your coat.
My coat.
Carter, is there some kind of emergency? All right, come on.
All right.
What've we got? MVA.
School bus versus two-door.
Blunt abdominal trauma.
Twenty-five years old.
Pulse 1 50 and thready.
BP 50 palp.
-Go! Go! -Couldn't intubate.
Scooped and flew.
All right.
We'll take it.
Cap refill's slow.
-Sinus tach at 1 50.
-Run a strip.
What've we got? MVA.
Blunt trauma to the abdomen.
Let's intubate.
l got it.
You help intubate.
l'll get X-ray down here.
Okay, Mr.
Carter, he's all yours.
Connie, can l get a 7.
5? Jim, it's Lily in the ER.
We need portable x-rays in Trauma 2.
C-spine abdominal series to start.
-Okay, thanks.
-Got some towels over here.
He's got a lot of secretions in here.
l need some suction.
Where's the O-neg? On its way.
Advance the blade.
Visualize the vocal cords.
Pass through the tube.
-How much fluid has he had? -2 liters in the field.
This'll make 4.
-l got it.
-Give me a suction cath.
-Respirator? -No, we'll bag him.
His abdomen's rigid.
Peritoneal lavage? Would you like to do that also, Mr.
Carter? -No, you can do that one.
-Why, thank you.
Don't bother, Peter.
l got a team scrubbing up.
Move him upstairs.
Give me the bullet.
MVA, 25 years old.
Brought in pale and diaphoretic.
Pulse is 1 50, BP is 50 palp.
Resp's 25.
Blunt abdominal trauma, probable ruptured spleen.
Thank you all.
We'll take it from here.
Watch the line.
-Watch that strap.
-We're clear.
Excuse us, people.
Morgenstern and l have a gallbladder at 8 p.
Scrub in by 7:30.
We have made contact.
l repeat, we have made contact.
-lt was you who was looking for him, right? -Yeah.
-l'm on my way to the lab.
-Then sign out Mr.
Vennerbeck now.
A 38-year-old admitted with non-radiating left chest pain reproducible with movement.
Tenderness left sternal border.
Resolved without treatment.
-EKG's normal? -Yes.
-Enzymes, chest x-ray? -Normal.
-Dizzy? Palpitations? -No.
-Diaphoretic? -No.
-Hyperlipidemia? -No.
-History of chest pain? -No, but-- Risk factors? None, but slightly elevated blood pressure.
Doesn't sound cardiac.
Have him see his doctor.
-Thank you, Dr.
-Thank you, Dr.
You're free and clear.
You need to see your own doctor for a stress test.
Missed two appointments, and you tell me to see my own doctor.
Sorry it took so long.
We wanted to be thorough.
Sure, sure.
Thanks, okay? -l'll send a nurse in.
When l was a resident, l was always worried about people's approval.
The attending, the patients.
Maybe because l was a woman.
A black woman.
Life was a lot easier once l got over it.
Don't let the patients get to you, Dr.
We treat them as soon as we can.
Don't apologize for how long it takes.
We're a busy hospital, not a restaurant.
-Gaby started it.
-l did not! -You did too! -Did not.
Ladies, you're sisters.
We can work this out.
Sally didn't want the name Emily.
lt's Grandma's name.
l always wanted it.
You know, there are plenty of other names.
You don't even know if it's a girl! -Besides, l deliver a week earlier.
-Not if l have it induced! Coming through.
Connie-- Get out of the way! Connie, get a CBC and a Chem-7.
Get FHTs with a Doppler, and call OB.
Susan, are you bored? Looking for something to do? Come on.
Her name's Tarita.
She's 1 9 years old.
She's complaining of abdominal pains.
She needs Narcan and an amp of glucose.
Hook up the suction to a Yankaur.
We need an amp of glucose.
Narcan given.
Where's that Doppler? BP's 70 over 30.
Resp's shallow at 8.
Crank up the lV.
She's somnolent.
Pupils pinpoint.
What's she on? Boyfriend says pills and cocaine.
-Let's get a tox screen.
-She needs an amp of D-50 too.
We'll help you, Tarita.
When is your due date? l don't know! Lie back, it'll be fine.
l don't know.
lt's coming.
She's fully dilated.
A 1 00% effaced.
Membrane's ruptured.
Get her to OB.
l'll notify an lCU unit.
Elderly couple's coming in.
Both comatose.
ETA's 2 minutes.
Benton's in surgery.
Hicks is on her way.
Please hurry, it's coming! lt's coming.
-Just don't push.
Don't push! -Take short breaths.
Screw you.
Short breaths like you're blowing out a candle.
-A foot's coming out, and it's blue.
-Back her up, and take her in here.
Come on, people.
Excuse us! Make way! Call OB.
Tell them to get down here right away.
Can't get worse than a cocaine-toxic footling breech.
Yes, it can.
Umbilical cord's prolapsed.
-Grab the monitors.
Where're the leads? -ln the crash cart.
Pull in a dynamap.
-Are they gonna be okay? -Who are you? l live next door.
Their cat wanted in.
When l knocked, nobody answered.
Her skin is cherry red under the nails.
O-2 at 1 5 liters.
Call Respiratory in here, stat.
lt's probably carbon monoxide poisoning.
Carol, do a sodium hydroxide test.
Get a couple of test tubes from the rack.
Did they use any heaters? They got those little ones.
lt's not oil, but-- -Kerosene.
-That's it.
We need a portable x-ray.
They'll be okay? They lived next door to me all of my life.
They're like my grandparents.
CO's present, both samples.
Get the oxygen hooked up here.
What kind of lab test you want? -Turn the warmer on.
-Who's on in NlCU? Dizon was here earlier.
You son of a bitch, it hurts.
-Turn the warmer on.
-Good, l got the other leg.
lt's out.
The baby usually rotates to the spine anterior position.
Shoulder blades are free.
Okay, now rotate it sideways.
Sweep the arms down over the chest.
-What are you doing? -Okay, here we go.
He's tremulous.
Keep breathing.
My baby.
l'll stick a butterfly in the scalp vein.
Get me a heel stick glucose.
Blood sugar's 25.
-Any vaginal tears? -Not too bad.
Let me get some cord blood.
Give him six milligrams of Susan, didn't you just release a patient named Vennerbeck? Honey, everything will be okay.
l just know it.
-What happened? -l don't understand.
Severe substernal chest pain radiating down the left arm.
He's had five morphine-- He's got a new holosystolic murmur with a thrill.
Give me an ET tube 7.
-Why did you let him go? -Start a 400 milligram dopamine drip.
Will somebody please tell me what is going on? with chest pain.
Holosystolic murmur.
Hypotensive with a possible ventricular septal rupture.
Give me 40 milligrams Lasix lV push.
Doctor, please.
Tell me what is going on! Let's get him upstairs.
Call the cath lab to prep for intra-aortic balloon.
Go! Come on, go! All right.
That'll be all, Dr.
All right.
Vennerbeck, l'm Dr.
We need to take certain emergency measures to stabilize your husband.
Maryanski, l'm sorry it's not the news that you wanted to hear.
No, l want this baby.
ls it your husband? He doesn't want to have the baby? Ms.
Maryanski this is something that the two of you, as a couple, really should discuss.
He's infertile! Well in that case that, yeah, would be.
These are the maxillary sinuses.
Opacification on the affected side is a subtle clue that the inferior wall of the orbit is fractured.
lf this isn't a good time.
Sorry, it's been a long day.
Actually, l'm scrubbing with Dr.
Benton on a gallbladder in 7 minutes.
Well, if l know Dr.
Benton, he'll be early.
Better get out of here.
Remember these three things: Cystic duct, common duct, liver.
Get out of here.
They're asleep.
You scared me.
Their blood gases have normalized.
Their CO levels are down.
They're gonna be fine.
They're on a 23:59 hold.
Well, l just wanted to check on them before l head out.
Babcock owned a bakery.
Started it the year they were married.
He still makes a three-tiered cake every June 1 4th on their anniversary.
They got lucky today.
l think maybe they've been lucky every day.
Don't butt in backwards.
You're not sterile yet.
Turn on the faucet with your knee.
Pop open a brush packet.
Come on, get it open.
Now, get your hands wet, starting with your fingernails.
Scrub your fingers 1 0 times.
Front, side back, webbing.
Like this? Yeah, sort of.
Then scrub the palm 1 0 times.
Back of the hands down the arm front, side back, up to the elbows.
Then rinse so that the water runs down your arms not your hands.
You got it? Yeah, l think so.
Remember, 1 0 times.
And hurry up.
--5, 6, 7, 8, 9, 1 0.
Good, just pull it right back.
Sometimes l like to pull the thing back and hold it.
Get it out of your way.
-There you go.
-All right.
Let it spring right back.
So you saw a piano showroom? Yeah, a piano showroom, right on the Expressway.
Drove right by it.
lt's-- Let's Bovie this bleeder.
What's so strange about that? l've been driving that same route home every night for six years and l never even saw it until last night.
But there it was on the Eisenhower, right off Central.
Well, l guess that is strange.
Now divide the anterior rectus fascia.
Yeah, let's Hoover that puppy.
Good, good.
Shirley, is it hot in here? No, Dr.
l think it must be the change of life.
Pianos on the Expressway? Thank you, Shirley.
You may go now.
Let's zap that guy, will you? Mr.
Glad you could join us.
Tonsil clamp.
Peter, divide the rectus, then grab the posterior rectus sheath.
Straight arms.
Very good.
Right hand.
Right hand.
Sorry, l thought you meant your right hand.
No, your right hand.
Left hand.
Grab it.
We'll straighten it up.
Still with us, Carter? Yeah, right here.
You're done.
Okay, there's the fundus.
Okay, grab it.
What is it, Carter? Where should l stand? Not right there.
And don't touch my shoulder.
You just contaminated yourself.
Shirley, will you take him out? Want to play a round of foreign capitals? You know, l hate this game.
Yes! Doug! Yes! Doug! No! No, no, no! Don't move.
What was your name again? Someday l'm gonna believe that line out of you.
What are you talking about? Can you remember the names of all the women you've slept with? No.
So someday you'll forget mine.
Now you're assuming that we won't last.
Well yeah.
Where are you going? l've got that conference in the morning.
We treated this older couple today.
They were married 48 years.
-They seemed pretty happy about it.
-That's them, not us.
How do you know? How did they know? Because if it were us, we wouldn't be doing this.
We'd both be married have daughters in Girl Scouts be renting The Lion King.
We'd never have met, because we'd already be committed to somebody else.
Don't you want that? Not now.
Not with me? Same thing.
Then why don't l want it? Because you are afraid.
-Most men are afraid.
-Of what? Responsibility, aging, death diminished sexual capacity.
See you.
lceland? Reykjavik.
Don't move.
Okay, pack off the colon, duodenum and stomach.
Perhaps your student should step a little closer.
Yeah, l guess you're right.
We're all packed off here.
Peel it like a pear.
Grab at the ampulla, and dissect Calot's triangle.
Can you tell us what defines Calot's triangle? The cystic duct, the common duct and the liver? Hold this retractor, will you? Let's get a little Bovie here.
Have you ever noticed the piano showroom on the Eisenhower Expressway? And so then she blurts out, ''He's infertile.
'' Susan, that's my best story of the new year.
Sorry, it's just been another incredibly hateful day with Kayson.
Well, you buy into it.
You can't let him ride you like that.
l put salt on them.
Shouldn't eat salt.
-What are you doing? -l need more Tabasco.
-You haven't tasted them yet.
-Don't need to.
-But if you haven't tasted them-- -You have a problem with this? No.
Absolutely not.
Saw Chloe wandering around the halls today.
She was so calm l hardly recognized her.
Thanks, Mark.
Sorry, that was stupid.
They're moving to Texas.
Ronnie will dig for oil, and she'll have his baby.
Assuming it is his baby.
Why don't they stay here? -l told her to get an abortion.
-Why'd you do that? -Because l think she should.
-That's not very supportive.
Supportive of what? My sister's fantasy of having a child? She thinks it's like having a pet.
A little puppy who will follow her and love her forever who won't care that she's an alcoholic and abuses drugs that she gets diseases from sleeping with every guy on the corner.
This baby may turn her around.
You don't know.
Like the one we delivered this afternoon? -Maybe.
l don't know.
-Well, l do.
No, you don't.
That's the point.
None of us do.
Chloe and the baby will have a chance.
Who are you to decide? l'm her sister.
l pick up the pieces.
lt's still her choice.
l would support it if she'd ever taken any responsibility for her life before taking on another.
l love her, but she can't even part her hair.
So do l think she should bring a child into this world? No, l do not.
Kayson? Vennerbeck is dead, Dr.
Oh, God.
l've reviewed his file.
He shouldn't have been released.
You approved it.
l didn't have all the information.
What information? Two months ago he had back pain.
The diagnosis was musculoskeletal.
lt was atypical angina, and you should've told me.
-You didn't ask for his medical history.
-Do l have to ask for everything? What are you suggesting? l am suggesting this case was more complicated than you thought.
That your experience was not sufficient to either determine that or to present it to those who could.
l presented what you asked for.
But not the entire picture! And because of that, a man is dead.
And his wife is consulting their attorney.
Morgenstern is aware of this situation.
And l have requested a full case review.
Susan, EMT's pulling up.
Woman in respiratory arrest.