ER s05e13 Episode Script

Choosing Joi

Previously on ER: I've been having a problem with Dr.
Why didn't Genetics suggest this medication? It's brand-new, part of a clinical trial.
Do I need to fill any of this out? I wouldn't.
He's not a candidate for the study.
Breaking research protocol could damage funding.
- So you agree with them? - I see their point.
Doug, don't walk away.
Doug? Jerry, have you seen Doug? He dropped off some charts.
He went up top for coffee.
- "Up top"? - As in keep your coat on.
I missed you this morning.
I tried not to wake you.
One of us should get more than four hours of sleep.
- I love you.
You know that? - Yes, I do.
Doug, what's going on? You all right? I'm not going to jump if that's what your afraid of.
That's good.
I'm attached here, so you'll take me too.
- All this just about helping a kid.
- All what? - You and me getting into it.
- Hey, it's over and done.
- It's not over for Mark and IKerry.
- Now, you don't know that.
They don't want to make a big deal out of this.
- They have to do something.
- Why? To prove they never wanted a Pediatric Attending in the first place.
- That's not fair.
- No.
You put the patient first.
And that's what we're supposed to do, isn't it? You're good to me.
You know that? Yeah, I know that.
Largely, it's been innuendo.
The slightly inappropriate phrase at the slightly inappropriate moment.
You might not consider it sexual harassment.
If you could give me some specifics.
The more ridiculous one was when he spoke of "sniffing my tail pipe.
" - Excuse me? - Well, I'd just parked.
And he said words to the effect that had he known it was my car he would have "sniffed my tail pipe.
" When I asked him what he was talking about he said, "Oh, I thought we were talking about sex.
" But you weren't? No, of course not.
I was coming in to do a gastroplasty.
Did he ever give you any reason for terminating your fellowship? I was led to believe that he didn't have to give me a reason.
But he didn't sponsor anyone else and funding didn't stop? No.
Why do you think he did it? Well, I suppose he could've been punishing me.
We went out to lunch once.
He laid his heart on his sleeve, said he found me attractive and asked if we might go out together on a date.
And how long after that did the fellowship end? A matter of weeks.
We don't know for sure if the two are related, do we? - That will be for others to decide.
- What others? If a full investigation goes forward.
- How will that be determined? - Dr.
I ordered up a high-cholesterol breakfast.
Three eggs, pigs in a blanket.
May I join you? - Unfortunately, we just finished.
- Drains to pull, that sort of thing.
Well, then I guess I'll have to administer CPR on myself.
I've been sitting for three days.
I'd rather walk.
I'd rather you sit.
We're going in here.
Carol, I got us a customer.
With a cough.
- Who're you calling a son of a bitch? - No, it means "shortness of breath.
" Okay.
Let's get you seated on the gurney, and take off this coat.
No, it's cold in here.
We promise to return your coat - Just give me some medicine.
- You need to help us Oh, Sparky.
Get back up here.
Animals aren't allowed.
Give me some medicine and I'll get out of your way.
Why don't you let Malik take care of Sparky while I examine you, okay? - Are you a dog person? - Yeah, sure.
- Okay.
Any fever? - Hey, Sparky.
- Coughing up yellow or green sputum? - No.
All right.
This might be a little cold.
I hear a few crackles.
I'd like a chest x-ray.
Make sure you don't have pneumonia.
- Alice, you're a smoker? - Well, yeah.
Breaks up the boredom on the road.
I drove from Albuquerque.
- Why? - I don't know.
If I'd known it was this cold, I'd have gone straight to Miami.
How much is this x-ray? I don't have insurance or money.
Alice, we're a county hospital.
If you can't pay, it's subsidized.
Do you have any family in Chicago you'd like us to call? Don't know a soul in Chicago.
You stay here, keep an eye on Sparky, and Malik and I will be right back.
I'll order a portable x-ray.
Good idea.
Radiology won't want to deal with Sparky.
Carol, Medical Records just sent these charts up for review.
- We sent them last week.
- Then why'd they come back? Just like they said, for review by the Interim Chief.
That's you again, right? Thank you for straightening that out, Malik.
No problem.
Richard Tuggle, 35.
Complains of 20 minutes of heavy chest pain with nausea and diaphoresis.
Felt okay this morning.
- Coming through! - I'm sorry.
I'll come back later.
No problem.
BP's 140/88.
Pulse 90.
Chest pain was relieved by two sprays of nitro.
CBC, Chem-20, cardiac enzymes.
Here, help him out of that.
- Have you had pain like this before? - Never.
- Any history of heart disease? - No.
- High blood pressure? Diabetes? - No.
I'm really healthy.
- When you're free, Doug's waiting.
- I'll be there soon.
Pulse ox is 99 on two liters.
- You weren't out shoveling snow? - No.
I work at home.
So, what is it? Did I have a heart attack? Well, you're a little young for that.
We'll do some blood work and monitor your heart.
We'll figure it out.
- I hear an ejection murmur.
- I hope not.
Carter? - What are you doing? - Dr.
Meet Dudzik, Hilzig and Strauss.
Patient/doctor class.
Need something? I was hoping you could give me some time.
But Never mind.
Where's your student? Miss IKnight? - Surgery rotation.
- Right.
Never mind.
You don't want coffee? No, I'm not having any trouble staying awake.
What's the verdict? No big verdict.
We agreed to keep this quiet so that we don't jeopardize hospital funding.
But Mark and I want some assurance this won't happen again.
So anytime you want to prescribe schedule-two narcotics: Morphine, Demerol, Dilaudid, Fentanyl, we want to cosign the order.
- That's it? - That's it.
Well, if it'll settle things down, I'll agree to do it.
Believe me or not, I don't have some compulsion for breaking the rules.
Sometimes they get in the way of helping a patient.
If you'd seen the pain this kid was in, you would've done the same thing.
Doug, we have seen that kind of pain.
Ross, Carol needs you in Curtain 3.
Thanks, Jerry.
His contractures have been so severe.
Worse than anything with Michael.
His seizures have increased.
Joi, come sit.
Julian wants to admit him.
But I just can't do that.
- Roger Julian? - He's a doctor up in Genetics.
- I know him.
- Joi spoke to him this morning.
Michael, my oldest, was in the ICU his whole last week hooked up to all those tubes.
I know Ricky doesn't have much time.
But I just can't do that to him.
- Can we keep Ricky here? - Please, I just want to take him home.
I'm gonna talk to Roger.
But I think we should arrange for PCA Patient-Controlled Analgesia.
We would hook Ricky up to an IV that would deliver pain medication at home.
Now, obviously, you'll have to control it.
Will it be stronger medicine than what you gave me before? Dilaudid or Fentanyl.
I'll do whatever it takes, Dr.
Ross, just so I can keep him at home.
I know he probably won't know the difference, but you know.
It's okay.
We'll let you know as soon as we can set it up.
Okay? All right.
I'll go find Roger.
You set up an IV.
- All right? - Yep.
Getting near the end.
If the survival rate's the same why not do a lumpectomy and save the breast? Because with a modified radical mastectomy you can save the patient.
Although a lumpectomy can get around the tumor.
- And then you do radiation therapy.
- And there can be severe side effects.
There can be with removing a breast.
I'm not discounting the psychological impact.
Actually, I think you are just a bit.
You'll see most male surgeons find it relatively easy to lop off a breast.
That's clich Á, don't you think? Yeah, because it's true.
It's a personal decision this woman must make.
She's gonna worry about her sexuality, her self-image.
Listen, a patient comes in here with cancer, I say we cut it out.
See? You think of her in terms of being a patient, not as a woman.
You know what? It's not that complicated.
Let's forget it.
You don't want it to be complicated.
Just cut to the chase, so to speak.
Well, isn't this a scrub fest? Mind if I borrow your intern? I gotta do an appy.
No, not at all.
I've only got a biopsy.
Lucy, you're with me.
Appreciate it.
You need my assistance on an appendectomy? Of course not, but I'd love the company.
How was breakfast? It was coffee, actually.
Women never seem to eat breakfast anymore.
Now it's just coffee or maybe a muffin.
Why? Are they worried about their weight, a reputation for eating like a horse.
I really couldn't say.
Can you say what people are talking about with IKerry Weaver over coffee? You can stop playing games, Robert.
I know what's going on.
I know someone's accused you.
But if IKerry digs and decides she's determined to dig up something you know, that's how people get hurt.
Well, that's true.
I mean, for instance, what if it came out that you were sleeping with Peter Benton while you were his intern and he was your supervisor in a position to evaluate you which, I'm sure you're aware, is a very big no-no.
Come on.
Peter and I were together before I was his intern.
And you made Anspaugh aware of that, right? That's grounds for dismissal.
Not for you, of course.
But for Peter, Dr.
Benton, which would be a shame considering how much work he's put into getting where he is.
You wouldn't dare.
Well, I wouldn't like myself very much if I did that, would I? Anyway, it's not really in my hands, is it? The films are back on Alice Presley.
She's antsy to go.
- I said I'd find meat for Sparky.
- Thanks, Malik.
- Hey, Steve.
- Nurse Hathaway, always a pleasure.
I've kept these up so you can see for yourself.
As you can see for yourself, there is no evidence of pneumonia.
There's a raise in bronchovesicular markings which may be smoking induced.
Although, it's more likely she simply has the flu.
Not unlike half the techs in our department.
What we have here is essentially a normal chest film.
I'd like a V/Q scan.
What makes you think she has a PE? She's a smoker, hypoxic, and been driving for 18 hours putting her at risk for blood clots.
- What's her heart rate? - 85.
- Respiratory rate? - 20.
- Any calf tenderness? - Not really.
Nothing you've said suggests pulmonary embolism.
She has pleuritic chest pain.
So does everyone with bronchitis.
Look, I know there isn't any hard evidence.
It's just a feeling I have.
Unfortunately, I cannot authorize an $800 test based on intuition.
The patient has a cough and no insurance, I might add.
So that's what this is about? Payment? No.
Although, the hospital does like to cover its expenses.
I'll pay for it.
- Your checkbook is my command.
- Thanks, Steve.
One V/Q scan coming up.
We got a couple more hackers.
I'll stick them into Exam 2.
No, no.
It's not ready yet.
- Yes, it is.
Your patient left.
- Alice Presley? Is she nuts? She talked about walking her Sparky.
Oh, God! I promised Anspaugh I'd review charts for him.
Am I a sucker or what? Hey, you don't have to agree with me.
- Hey, you okay? - Yes.
It's slippery.
I'm fine.
Good luck, Mark.
How's he doing? - Pain-free, normal sinus, no ectopy.
- Which is all good, right? Yes, but I got some of your blood work back.
And I'm concerned because your cholesterol is 465.
- That doesn't sound good.
- It's not.
Do you have a family history of high cholesterol? Did your father or any male relative have heart trouble in their 30s? I don't know.
Some inherited conditions run in families and can cause high lipid levels.
So you might want to check because they can put you at risk for a heart attack at an early age.
I can't check.
I was adopted.
I haven't a clue about any medical history.
I'd like to admit you so we can start you on a cholesterol-Iowering agent and do a complete workup.
Alice! Wait! Wait! You need to stay for one more test.
I really can't.
Miami calls.
You don't want to get stuck on the road sick.
You don't understand.
I can't leave the pups in the cold.
You can bring Sparky in.
I won't tell.
No, you really don't understand.
It's not just Sparky.
I didn't start out to collect them or anything.
It just happened.
Jules, we did our Residencies together.
The old school tie won't work.
I hated my Residency.
There you go.
So did I.
Ricky can't control his analgesia, but the mother's willing to.
Up in Genetics we prefer to admit these end-stage kids.
We're not experienced in home care.
We do it with cancer kids.
They send them home.
Maybe Oncology can help you.
I don't have time.
This kid's in bad shape, he needs it.
- Doug, look - Jules, come on.
I'll talk to the team about it.
- We meet the day after tomorrow.
- Ricky doesn't have until then.
I'm sorry.
- Ouch.
You're poking too hard.
- Strauss, stop your whining.
These are the anterior chains and these are the posterior.
As you examine, ask yourself: "Do the nodes feel like BB's, like peas or sourballs?" - I got two BB's.
- I got one BB and one sourball.
Quit goofing.
It doesn't feel like a BB.
It's not a pea.
It can be tough to estimate the size at first.
BB and a pea, right? You had any night sweats? Any weight loss? Jeez, what is this? - Have you? - No, I feel fine.
- Noticed enlarged nodes elsewhere? - You're kidding, right? No.
I'm sure it's nothing to worry about.
I might get another doctor to look.
- Maybe do a biopsy.
- A biopsy? I'm Mark Greene.
I'm sorry, I don't know your name.
Mobalage Ekabo.
You've done something to your back.
Let me take a look.
No, it's been like this for a long time.
I'm all right.
It might be a slipped disc.
Let me take a look.
Come on.
It won't take long.
Sit down right here.
Did you start here recently? It's been several months.
Really? I haven't seen you around much.
I worked on other floors.
Well, glad to have you down here.
Thank you.
I closed the curtain for privacy.
You can take your shirt off now.
No, please.
Stop, please.
Stop it, please.
Stop! - I'm not doing anything.
- Stop it now! - Stop it! - It's okay.
- Stop it! - It's okay.
Stop it! All right?! Malik, need help? No, I'm cool.
I'm just going in here.
How'd you do? It's all good.
I hope they like Cheese Sliders.
- We ain't breaking the rules? - No.
Sneaking dogs in and feeding them cheeseburgers Did you say cheeseburgers? That's their favorite.
Shut the door! Please don't ask.
I need to talk to you outside.
Malik, you okay in here? Oh, he's doing great.
The pups love him.
All right.
I'll be right back.
And after they eat, that's usually when they need to go outside.
Make a little poop.
Genetics bailed.
We can't get a PCA for a couple of days.
Maybe I can arrange it through the clinic, call a home health care agency.
Jerry, did you find out about that guy Mobalage? No.
Housekeeping hasn't called back yet.
What happened? He flipped out.
I hadn't started the exam.
You know, Rachel called.
She said she's going with the purple frames.
Poor Rachel.
She found out that she needs glasses.
She couldn't see the blackboard.
I hated when that happened.
I felt like such an 8-year-old geek.
It happened to me at 9.
Same age as Rachel.
Fiercely bad eyesight on my side of the family.
You must've had fiercely red hair on your side.
I hope that's the worst thing I pass on from my gene pool.
It's not like she'll go bald Jerry, weren't you gonna check those labs for Mrs.
Bolpec? Yes, I was.
I am.
You owe her, Jerry.
Where's Carter? Suture.
Malik, where are you? I'll help you in a few minutes.
I got it.
On my second call.
One of the agencies I used with PCA on a cancer patient a few months ago.
Joi's health insurance will cover it.
Did you tell her about it? No, I think you should.
Joi, looks like we're able to provide that pain medication we talked about.
Now? Today? A home health care agency will deliver the machine to your house.
The machine will be set to deliver an amount of Dilaudid every hour.
- When do I push the button? - Whenever you feel he's in pain.
- How do I know how much to give? - You won't have to worry.
There's only one booster dose within a two-hour period.
Then the machine will automatically lock out any additional dose.
Ross will write a prescription.
A medi-van will take you home.
Thank you.
Thank you both so much.
I just wish we could do more.
- It started snowing again! - Yeah, about an hour ago.
Listen, IKerry, I've been thinking.
I don't feel comfortable with what I told you.
None of us are at ease with the situation.
What I mean to say is, I don't feel there was any harassment involved.
That's not our decision.
When the full committee hears the testimony I won't be testifying.
If I'm not convinced, then I shouldn't put it forth into an official record.
Did something happen today? No.
There's just no relevance to the incidents I mentioned.
That being the case, I think it's only right that I withdraw my statement.
I'm really sorry.
Sorry that I wasted your time.
I hope you understand.
- Ready to go in here? - Yep.
Labs are all okay.
Upon physical exam, no significant findings in the head or neck other than the enlarged node in the right submaxillary area.
You want to do the honors, Carter? I've actually never done a neck biopsy.
Okay, well, here's your chance.
- You ready there, Mr.
Strauss? - Yeah.
So this V/Q thing was positive? Yes.
Which means that small blood clots have traveled from your legs.
If this isn't treated, a larger blood clot could lodge in your lung.
That sounds bad.
I'll have to get myself back soon to get that treated.
Alice, you need to be admitted today.
You need to stay for a few days so your blood can be anticoagulated.
My dogs.
I can't I don't know what we're gonna do, but we'll think of something.
- Jerry! - Damn it, Jerry! Go! Go! - Go get them, Jerry! - You gotta get them.
Oh, God! Hey, Mark? Ricky Abbott, the kid with ALD.
He's back and in pretty bad shape.
I arranged a home PCA.
I need you to sign off on the Dilaudid.
He's a Genetics patient, right? - He's down here now.
- I can't sign off on that.
- He's not on our service.
- I thought it'd be easier.
Yeah, maybe.
But that's their deal.
You'll have to have Genetics sign off on it.
I should have thought of that in the first place, huh? - Hey.
- Hey, did you have a breakout? Yeah, something like that.
- Hey, you're on.
All set.
- Okay, thanks.
I'll give it to her after I get rid of this guy.
- Jerry? - Sorry, Dr.
I was looking for you.
I am very sorry.
I can pay for the curtain.
I don't care about the curtain.
Are you okay? I won't cause any trouble, and I'd like to keep my job.
You didn't cause any trouble, and no one's gonna take your job.
Thank you very much.
I do think that you have a pain in your back.
I'd like to help you if I can.
I think my back is fine.
But there's something.
I'm hoping you can give it to me.
- What's that? - I believe it's called Viagra.
That's medication used for impotence.
I am impotent.
- IKerry? - Robert.
- May I sit down? - Certainly.
I'd offer you something, but we don't have Did you speak with Dr.
Corday today? She assisted me on an appy.
Is that when you spoke to her about Maggie Doyle's harassment inquiry? - Why would I do that? - To stop it from going forward.
I'm eager for it to go ahead.
I look forward to being vindicated.
Well, then you're gonna be disappointed because the investigation's been closed.
Really? We'll have to go back to our humdrum lives then, won't we? Of course, all the testimony has been typed up.
I've got it in a file.
And the thing that really sticks out is that bad evaluation you gave Dr.
She's received such positive remarks on her other rotations.
You think that perhaps I was a little bit hasty and that if I spent a little more time on it Yes.
I'm thinking that if you took that time right now you might write something very different.
Which you'd be interested in reading.
Oh, absolutely.
I imagine I'd want to put it in that file.
So, Mobalage, where are you from? Nigeria.
That's a ways away from here.
How do you like Chicago? Okay.
My wife does not like the cold.
She works here in the cafeteria.
Well, that must be nice for both of you.
Watch my finger.
To come to the same place for work.
We need to pull the gown down now.
All right? The burns seem to be well-healed.
They're not a problem.
Had them for a while? - You want to tell me how it happened? - No.
I need to examine below the waist now.
I understand.
- You're in early.
- I have no life.
Weaver, Sam Broder called back.
- He'll meet you at Doc Magoo's.
- Thanks.
- That sounds like a life.
Hot date? - At Doc Magoo's? - Even Dr.
Weaver has standards.
- Thanks, Jerry.
I think.
Greene? Path report's back on that med student, Strauss.
- Better let him know.
- Sent that kid up to the O.
- Hey, you have a minute? - Yeah.
I wanted to fill you in on something.
Let's go in the lounge.
I need to talk to you about the pathology report.
- You guys mind hanging outside? - No, they can stay.
I already know it's crappy news.
The biopsy shows Hodgkin's disease, which is a form of lymphoma.
Oh, man.
Understand that it's very treatable with radiation therapy.
Your chance of surviving is very high.
Look, could I just? Could I have a few minutes here, please? Yeah.
I'll check back.
I contacted a pet rescue group that can take the dogs tomorrow.
I need you to take two home tonight.
- I can't do that, Carol.
I have cats.
- You have cats? Yeah, what's wrong with cats? Sorry, Carol.
Well, I'm a dog person.
I'll take two and one of Jerry's.
I want the little one.
No, no, no.
Sparky is my man.
Hey, Sparky! I'll take two of the big ones.
- AI's sick of little dogs.
- What's up with that? I'll take the Airedale if no one wants him.
Joi Abbott's on the phone for you.
Work it out amongst yourselves.
Give me two, any two.
I don't care.
Tie their leashes to my locker.
- Hey, Sparky.
- Thank you, guys.
Hi, Joi.
It's Carol Hathaway.
Wait, wait.
Joi, what's wrong? Did they hook it up? Can you tell if it's working properly? Joi? Joi.
You need to calm down and just take your time, all right? Just take your time.
The initial lab tests don't reveal anything like diabetes which may be related to erectile dysfunction.
I understand.
You're not on any medications that have that side effect? No.
If it was psychological, you could still have a spontaneous early-morning or midsleep erection.
I do not.
I think it's caused by trauma.
If you were in an accident or maybe even beaten If your pelvis had been broken internal bleeding could have compressed the arteries and veins affecting the blood supply to and from the penis.
If that is the case? A urologist would probably want to do a vascular bypass operation to try to restore normal function.
I think you should see a urologist.
- Where's Dr.
Romano? - I last saw him in the lounge.
- Was it you? - Sorry.
There were a couple of names I gave Dr.
One didn't have anything concrete and the other backed out.
Was that you, Elizabeth? Did you decide to protect your own place in the food chain? Stay in the club? Yes, I did.
- I'm sorry, Maggie.
- Sorry my ass.
- Then they hooked it up wrong.
- It's hooked up right.
She doesn't know whether to give him a shot or not.
- Lf she thinks he needs it.
- She can't tell.
If in doubt, she should give it to him.
It's not gonna matter that much.
I don't think he'll make it through the night.
I told her we'd go over.
Why? She knows how to work the machine.
What are we gonna do? She's all alone, Doug.
She's really scared.
I don't know what good it'll do for us to be there watching her son die.
I know.
I don't know.
It probably won't do any good.
I just I really want to be there.
I'll probably be home pretty late.
Mobalage, they told me you were here.
I didn't know what was wrong.
IKobe, this is Dr.
Greene, this is my wife, IKobe.
- Nice to meet you.
- How do you do? I strained my back and Dr.
Greene was kind enough to take a look at it and give me some pain medication.
Yeah, it'll be better in a couple of days.
Thank you.
Sometimes he tries to do too much at his job.
He works too hard.
Yes, I know.
I'll be fine.
Thank you again.
You're welcome.
You're the only man sitting alone.
I'm hoping you're Sam Broder, right? - Dr.
Nice to meet you.
- Call me IKerry.
My office says you've made a few appointments and always canceled them at the last minute.
- You'd think I was the dentist.
- I'm sorry.
That's all right.
It's pretty common.
Deciding to track down your birth parents isn't something to do lightly.
- I've done that whole Internet thing.
- Most people start there.
I do this for a living.
My company handled several hundred cases last year.
Sounds like a good living.
I need your full name, date of birth, place of birth and the names of your adoptive parents.
I'm glad you could step in on such short notice.
I'm always happy to get a 16-year-old up get him back out there kissing the girls, making them cry.
So how's this Interim Chief thing working out? Oh, miserably.
Between my surgical duties and all the administrative crap down there It's a shame IKerry Weaver wasn't able to continue.
Plus, you're Chief of Staff.
I tackle that part of my job around midnight.
Didn't it work out well when Morgenstern handled surgery in the ER? He did have it down.
Well, Donald, I feel I'd be remiss if I didn't offer up my services.
To be Interim Chief of the ER? "Acting Chief" has a bit more je ne sais quois.
I don't care if you call yourself God if you're willing to take that on.
- We'd still be conducting a search.
- Yeah.
Well, as long as you need me.
I needed you today.
- Well, how does tomorrow sound? - Like a stroke of luck.
Sorry it's only instant.
I used to grind the beans.
Don't worry about it.
Anything is fine.
I'll get it.