ER s06e05 Episode Script

Truth & Consequences

Previously on E.
- Seems like you're settling in well, eh? - Oh, everybody is been terrific.
- You're a resident? - Yeah.
Well, one thing you still need to learn is that every patient in here is somebody's boyfriend, girlfriend, father, mother, son It went well.
Within the next couple of weeks we can begin reconstruction.
Meg, are you smoking? I'm just really stressed.
Lucy, I've been treating trauma patients for thirty years.
I think I know what I ordered.
- We're gonna let you take Carlos.
- Really? - Somebody ought to give this guy a talking-to! - That's not your job.
- The hell it isn't, man.
- Look, you don't know the details.
I know enough! Sorry boss, I didn't realize it was you.
Beluchi, as a New York resident, you should know enough to wear a helmet.
I got a hard head.
I've been hit three times.
Never got anything worse than road rash.
You always been on County? - Gosh.
Going on ten years.
- Damn! Killers of entire families don't get ten years.
It's not a prison, Dave.
I don't know about that.
Weaver sure acts like a warden.
And what's with the leg? She crash her Harley? I don't know.
I never asked.
Wanna lift? - On your bike? - Yeah.
Never ride double before? Not since I was eight and had a banana seat.
- A what? - Forget it, before your time.
Thanks anyway.
Suit yourself.
See you in the trenches.
Watch out! You're such a good boy.
Daddy's home.
There you go.
- Hi.
- Sorry I'm late.
I got held up.
Better get going.
How's my buddy? Say good bye to Mommy, Carlos.
"Bye, Mommy.
Daddy and I are gonna watch some ESPN.
" - Ok, the med schedule is- - On the fridge.
Don't forget to wear gloves when you change him- Jeanie, don't worry.
We'll be fine.
- Love you.
- Love you too.
Have a good day.
- We can't treat this.
Try the V.
- No, no, no! I've got to get to work and I can't cross the kids safely if I can't hold up my sign.
- Why can't you hold it in that hand.
- That's my whistle hand.
Problem solved.
Randy, can you help this gentleman, please? - Is your bike in the lounge again? - No.
- You know there's a rack in the ambulance bay? - I know.
Take curtain one.
Severe abdominal pain.
Hi, Jesse.
I'm doctor Dave.
- I don't feel too well.
- What's the problem? That's colorful.
- Lucy, meet Jesse.
- Not my patient.
I gotta get my bike out of the lounge.
Hey, isn't that your bike? Hey! That's gonna leave a mark.
- So cute.
- How's Reggie like being a father? - He's loving it.
- Who took Mr.
Opotoski's chart? Every time I turn around, one of the nurses takes my chart.
- You left this in the suture room.
- I wasn't in the suture room.
- You're welcome.
- Dr.
A grateful patient gave me two Blackhawks tickets.
Interested? Trauma on ice.
Who could say no? - What do we got here? - Guy slashed with a knife.
Looks clean and superficial.
Check this out.
It's Dermabond.
Pretty nifty stuff.
- Like Super Glue.
- Army had that in the '60s.
- Come on.
- Yeah, really.
FDA took 30 years to approve it for civilians.
Update his tetanus.
Did you see a dog bite victim? - Is there a problem? - This chart is illegible.
It should be.
Didn't you learn that in Med School? - You were a student? - All right.
- Admit it.
You can't even read that.
- That's for security purposes.
- Why not use a computer? - A computer crashes.
My notes don't.
- I'll help with the computer.
- Great idea.
- Can't teach an old dog new tricks.
- You're not old.
Just stubborn.
- Hi.
- Hello.
- Elaine.
- John.
- Dr.
Lawrence, meet Elaine Nichols.
- Nice to meet you.
- Do you have a minute, John? - Would you excuse us? - Hey, Dr.
- Dr.
You know Weaver, right? - She ever tell you about her leg? - No.
Why? Just curious.
Don't look at me.
Ask Carter.
He lived with her.
Really? I'm doing everything by the book.
I even gave up caffeine.
- Are you getting plenty of rest? - I'm trying.
I'm really sorry about the cafeteria thing, but I got a new job at the Big-T Pharmacy.
I gave them your name as a reference, if that's okay.
I've told them I've known you a couple of years.
In case they call.
But I doubt they will.
Something wrong with my eyes? Are you taking any medications? - Just prenatal vitamins.
- Good.
Okay, I'll be back.
Why don't you take a break? I'll cover.
- Can you have this tox screened? - Sure thing.
Taking a breather? My breathing's fine, but my ankles are about to explode.
- Maybe I'll wrap them in duct tape.
- Don't think that's recommended.
- Is this our MVA? - Yeah, Benjamin Hearn, 16, with CF.
- Car accident, trauma to right side.
- How you feeling? - Hurts to breathe.
- Tachy at 130, BP's 110 over 72.
Did you take his temperature? Okay.
Call me if you need me.
Okay, there's no sign of a fracture.
Did his blood work come back? - Jeanie? - Yeah? - Blood work? - It isn't back yet.
Is everything okay? You seem distracted.
Carlos was a bit off this morning.
Reggie's is still getting used to the dad rutine.
- Why don't you call him? - I did.
Everything's fine.
I just hate being away from him.
What do we got? Rib fractures, possible liver laceration.
When were you last hospitalized for cystic fybrosis? About a year ago.
Guarding right quadrant.
Let's get a CBC type and cross a four chest and a C-spine.
Let's get ultrasound.
And let's get genetics down here for a pre-op consult.
- Carol? - I think I'm having a contraction.
- Why don't you step out.
- No.
It's gone.
I'm fine, it must have been a Braxton Hicks.
Carol, I want you to go sit down and if you have another one you're going on the monitor.
Soft, mild tenderness.
No rebound.
Let's get a tox screen CBC chem 7, liver panel and a lead test.
Coming up.
So, Jesse how much paint did you eat? I don't know.
Half a tube, maybe.
Do you do this very often? Just this once.
I had pretty a bad day.
You depressed? Creatively challenged.
- So you're an artist? - No.
Francis Bacon, William Blake.
Those guys were artists.
- I'm actually feeling pretty good now- - No.
We need to run some tests and I want to check the toxicity of the paint you ingested.
You must think I'm pretty stupid.
Creatively challenged.
Julian, Genetics.
This your CF patient? He needs a laparotomy.
I'd like you to sign off on anesthesia.
- What are his sats? - 97 percent.
- His x-ray? - No fluids.
Give me five minutes.
Set up for spirometry.
- His father's here.
- Okay.
- Peter, you got this? - Yeah, go.
Any more contractions? You should go home and get off your feet for a while.
I'm fine, Mark.
As long as these guys would stop using my bladder as a socker ball.
You should try to slow things down a little.
- I don't need you worrying about me.
- Somebody's got to worry about you.
I've gotta pee.
Ultrasound showed a tear in Benjamin's liver.
Is he gonna be okay? He has an excelent chance of survival, but he's gonna need surgery to repair the damage.
Should we donate blood? No, we'll have to operate immediately.
We'll see if we can use his own blood.
If he does require a transfusion, I can assure you our supply has been screened.
No, I don't want Benjamin getting blood from some stranger.
Would you screen Mr.
Hearn and his son? They want to de designated donors to Benjamin Hearn.
You want to follow me? Sorry I didn't return your calls.
And I apologize for standing you up.
That's okay.
I guess I just needed time to sort things out.
And have you? I think so.
You don't have to worry about me anymore, John.
I'll be okay.
And your follow-up? I'm seeing a plastic surgeon on Wednesday.
And after that I'm thinking about going to Europe.
For how long? I don't know.
Couple months.
Just do a little soul searching.
So this is goodbye? This is thank you.
For everything.
Will you give me a call when you get back? I'll send you a postcard.
Hey, Carter.
- You lived with Weaver? - In her basement.
In her basement? - She was my landlady.
- Okay.
So when your landlady was collecting rent you must have seen her leg, right? Go away, Dave.
- Come on.
Hey, Lucy.
- Don't talk to me.
Why's everyone so grumpy? Unit contacting County General.
Rescue 43 at multi-victim incident.
How many can you take? - Two and eight.
- Two major, eight minor.
Prep Trauma 1 and 2.
Kidney failure, liver damage, your red blood cells could explode.
Okay, you made your point.
I won't eat any more paint.
What about the cocaine? Your urine tested positive.
Okay, so on occasion I I have used some mind-expanding chemicals.
I'm not the first artist to do so.
But you've been using the last few days.
- I want to put you in rehab.
- Thanks, but I'm cool.
I've been under lots of stress, my work sucks.
Maybe it's because you're using cocaine.
You came here for help, so let me help you.
- Can you paint in these programs? - Probably.
- What do you think? - I can't promise anything.
- I'll check it out.
- Great.
Explosion in a science class.
We took two major, eight minor.
Feeling generous? Victor Sutherland, 52-year-old teacher.
Respiratory distress, BP 90 over 60.
Pulse 1-20.
- What? - Hazmat said it was chlorine gas.
- Don't speak.
- Lungs are wet.
- Tube him.
- Any others? He's the worst.
Triage the others and watch the residents.
- What's this? - Ken Kranics, 17.
Blunt head trauma with LOC.
Respiratory rate of four.
BP 124/86.
Get a head CT, call neurosurgery.
Call me if you need me.
- What's going on? - Science room explosion.
There's a dozen more.
Looks like partial thickness burns.
She's wheezy.
abdominal injury.
BP 95/65.
Pulse 110.
We gave her a liter.
- Pull it out.
- We will.
Hang in there.
We need an ultrasound before we go to O.
Trauma 1.
- We've got a Colles' fracture here.
- That's a grade-one open fracture.
- Do I set it for reduction? - Only if there's dorsal angulation.
- You want something for the pain? - No, I'm okay.
- Stop it! - You have to let me irrigate.
- How we doing here? - Glass injuries to eyes.
Should I give this guy mannitol? I see papilledema- - What do you mean? - Head trauma.
He hasn't blown a pupil.
GCS is nine and disc margins are blurred.
- Has he blown a pupil? - No they're equal and reactive.
Hold off.
Wait for the head CT.
- You were saying? - What? - Thin cuts? - Through the orbits.
Optho consult.
- I can't see anything.
- You're in good hands, son.
Janet Gunderson, 17, chest hit the edge of a desk.
- Pleuritic pain.
Pulse 100, BP 132/74.
- What's open? - Try Curtain 3.
- Chest x-ray and an EKG.
We got a finger amputation.
- Is the finger on ice? - His friend lost it.
Give him a gram of Ancef and call the reimplantation service.
Ten of lidocaine.
I'll do a wrist block.
- We could use you.
- For who? The girls with the hand and facial burns.
- What is that? - Antibiotic ointment.
- Did you call the burn team? - Yes, 8% body area.
Is Vancomycin okay for my patient? - Which one? - Hand injury.
- The finger? - No, the wrist.
You said Ancef, but he's allergic.
- Fine.
What room is he in? - Exam 4.
Should I give steroids? - Steriods? - Yeah.
For the wheezing.
I wouldn't.
Why not? It's not good.
Don't do it.
Trust me.
How you doing? All I did was puke.
- You weren't in the explosion? - Is that what happened? Sounds crazy.
Haleh, you got the drug key? Ten of morphine.
Coming through! Coming through! We need you, doctor.
I'm in.
Bag him.
- What's up? - I could use a hand.
His lungs are full of fluid.
Pulmonary edema from the chlorine.
Still hypotensive after decompression.
- 32 French right here.
- Check the belly.
- Can we get ultrasound? - It's tied up.
I'll do a DPL.
Lawrence, my EKG? My patient has a chest fracture.
I'm afraid of tamponade.
- Do a cardiac echo.
- But- Just do the damn echo! - What's this? - Peritoneal lavage kit.
It's a percutaneous kit.
Use the Seldinger technique.
- I'll do an open lavage.
- The kit works well.
Where's the drug box? Just get me a scalpel some towel clips, a pair of rakes and a - A hemostat? - Yeah.
Come on.
Hurry up.
It's fairly easy to use, Gabe.
You just spread the guide-wire- These are unreliable.
You hit the preperitoneal space.
- I think if you tried- - I said no, damn it! I do an open technique.
It's standard.
And that's what I'm gonna do.
This is crap! The finger amputation is ready for his wrist block.
You seem to have everything under control, Kerry.
Another patient needs me.
I'm sorry.
That was unprofessional and uncalled for.
- Do you want to talk about it? - There's nothing to talk about.
It's been awhile since I've had multiple casualties.
You should have asked for help.
You had your hands full.
I was overloaded, that's all.
It happens to the best of us.
Do you remember that time you were third year, I think.
A double-decker bus hit a bridge and sheared off the top.
- That was insane.
- It was a little hectic.
A little hectic? Three gurneys in every space.
Everybody lost it.
But you kept your cool.
I don't know if I should be telling you this What is it, Gabe? There were times when you drove me nuts.
It was like having ten other students.
You asked more questions than I thought was humanly possible.
But it payed off.
I'm proud of you, Kerry.
Chief of Emergency Medicine.
You were great in there.
- Damn, I was a good teacher.
- And still are, according to Carter.
I think you're wrong about these kits, but I'll use them.
It's your ER now.
For the record my way may be older, but it's faster and better.
Kind of like me.
Are you taking any pain medication? - No.
Why? - You tested positive for opiates.
- What? - You're taking drugs, which means - your baby is taking drugs.
- I'm not using drugs.
If you're sharing needles, you're putting the baby at risk for- - I'm not sharing needles.
- But you are using.
- I know you care about your baby.
- I do.
I do care.
Do you want to hurt it? - Then you have to stop.
- I'm hardly using - just so I don't get sick.
- You can't use at all! Let me put you into a detox program.
I'll see what I can do.
You're putting him on a psych hold? It's voluntary.
I'll call down when a bed opens.
- Did I pass? - Yep.
You'll go up within the hour.
They won't let me paint.
I'm sorry.
They said I could sketch.
Thanks for helping me.
I really needed it.
- Dr.
- Carol.
I have an expectant mother in need of a rehab bed.
I just gave our last bed to a guy in Exam 1.
- She's pregnant.
- I'm sorry.
A space might open up soon, though.
Can he sign up for an outpatient program? This is about an unborn child.
- Let's see what we got.
Where is she? - In here.
- How's it going? - Have you spoken to Ben? No.
Is he doing okay? You know what? Let's talk in here.
- Is something wrong with Ben? - No, he'll be fine.
It's just that when I screened your blood, you tested HIV positive.
You should have told me.
I didn't know for sure.
Until now.
I'm sorry.
I figured this would happen.
You didn't practice safe sex? Apparently not.
I could send you to a clinic.
You could start treatment.
- Are you going to tell my parents? - No.
Family support is important in dealing with HIV.
Support? Are you kidding? My old man would disown me.
I tried telling them.
The whole: "I've got this friend who's gay.
" He freaked.
He said if I brought a fag to his house he would kick my ass.
It would be easier if your family knew the truth.
Forget it.
Every family has its secrets anyway.
Right? - Can you see a possible CVA? - Not now.
Ask Carter.
- You took my spot.
- What? - In detox.
- Meyers made him an outpatient.
- After you convinced him.
- We needed the spot for a pregnant- - But you're a nurse- - What? You're a med student! - I'm sure he'll be admitted soon.
- That's easy for you to say.
Did you find Lawrence? - Yep.
- And? And what? He had a meltdown.
- That's a little melodramatic.
- I don't know.
He's not the first to lose his temper in the heat of the moment.
- Over a lavage kit? - You know what? He's been doing this for 30 years.
He doesn't like the newer equipment.
- I know you two are close.
- What are you trying to say? - He's acting a bit strange.
- Yeah, he's eccentric.
But he's a great doctor.
- Don't be defensive.
- I'm not.
You don't like that I hired Gabe.
I did, so deal with it.
I repaired Ben's liver.
He's fine.
- Any complications? - We gave him some blood, but I expect a full recovery.
He got our blood, right? Just yours.
I couldn't use Aaron's.
- Why not? - It wasn't a good match.
But we have the same type.
But Aaron's had different antigens that could have caused a reaction.
- I'm sorry.
- It's okay.
The important thing is - Ben's gonna be all right.
- Yeah.
Everyone's been here for hours.
Where were you hiding? I wasn't hiding.
I just didn't think it was so bad.
How's my teacher, Mr.
Sutherland? I haven't heard.
What experiment were you doing? The wrong one.
What does that mean? Nothing.
What happened today, Howie? If you have any information, you should let me know.
It might help us treat Mr.
Do you promise to keep this secret? Doctor/patient confidentiality and all that? I can promise you'll feel better if you tell me the truth.
The right eye will be fine.
But glass sliced through the left eyeball and displaced the lens.
- When can they fix that? - It will be a difficult job.
- Can I see? - I don't think that- Jeez-! Dad? What is it? What's wrong? We just have to wait for the specialist.
- Is it okay? - Mr.
Perez, will you come with me? - Where's he going? - He needs to - They can't fix that.
- I'm not a specialist.
- The optho- - He's gonna be blind.
- We don't know that- - He has a scholarship.
- I understand.
- The first to go to college.
- He's worked very hard- - Mr.
Perez, please.
It's important that you're here for your son.
He needs you.
- Everything okay? - Everything's fine.
It's Reggie.
Says it's urgent.
Reggie? For how long? Okay, I will.
- Is everything okay? - Carlos is sick.
I need to go.
- You do.
Go on.
- Thanks.
- Did they bring in Howie MacMurtry? - Why? Tell her.
He caused the explosion.
The jocks talked me into it.
I switched the chemicals.
It was supposed to be a small, exothermic reaction.
A little smoke and a few bubbles, that's all.
But Mr.
Sutherland changed the experiment.
This wasn't supposed to happen.
- It was just a joke.
- You son of a bitch! - Sir? - My son is blind because of you.
Nathan and his friends told me to do it.
- You'll have to leave.
- You're a liar! - Get out of the way.
- Security! It was an accident! - Get off of him! Get up! - Get away! - You okay? - Yeah.
- He's not breathing.
- Do we intubate? Let's get him to the bed.
Go, go, go, go, go! Get me a number 8 ET tube.
I need suction.
- Thanks for pulling him off.
- Just get the tube in.
Is he okay? Let's get him on a pulse ox.
All right.
I'm in.
Let's bag him.
- No breath sounds.
- Not pinking up.
Intubation was good, I saw the cords.
- He's blowing up.
- Subcutaneous emphysema.
You broke his larynx? - Let's prep him for a crike.
- It could be below the cricoid.
- Let's trach him.
- What about the tube? - Pull it out.
- Pulse ox at 81.
Heart rate's down to 50.
Amp of atropine.
Carter, blow some oxygen down there.
- I'm not seeing his chest rise.
- Pulse ox 76.
- Run of five.
- Get a crash cart.
I'm in.
Bag him.
I'm getting breath sounds.
- Pulse ox up to 85.
- That was a nice save.
I spoke to the plastic surgeon and he said your burns shouldn't scar too badly.
Well, um I'll check in later.
If you need anything, hit the buzzer.
I'm gonna have scars.
The new skin may have irregular pigmentation.
But it's only temporary.
How temporary? Six months to a year.
The plastic surgeon will know more.
I might look like this for a year? No, no.
Um it will take up to a year, but you may heal much faster.
Okay? How much faster? I don't know.
It'll get a little better each day.
- You were lucky, Quinn.
- You think this is lucky? I look like a hideous freak.
You look like like a girl who was lucky enough to survive a dangerous accident.
I'd rather be dead than look like this.
- You okay? - Peachy.
You did the right thing.
I think Mr.
Perez might feel differently.
I saw it.
We need to talk.
Howie, you all right? Yeah.
- How's Mr.
Perez? - He's gonna be okay.
But not Mr.
Sutherland, huh? I don't know.
A lot of kids thought he was a geek.
He'd mess up the experiments sometimes, but he did it on purpose just to make class a little more fun.
He was a really good teacher.
He might recover, right? Like a long shot or something? Like one in a million? Yeah.
I told him.
I told my father I was HIV positive.
Good for you.
He kicked me out.
You know, he might just need a little time.
He said I'm not his son.
I'm sorry.
At least he knows the truth.
Screw him if he can't handle it.
It might be a few days before I can get you into detox.
- Should have made reservations.
- You can be an outpatient.
- Whatever.
- You need help.
I need a real job.
I watched you here today.
You, the doctors, the cops, paramedics.
Everybody's doing something important and I eat paint.
- You need to talk to someone.
- I don't need a shrink.
See you around.
- Can you speak to one of my patients? - Go away, Dave.
You fixed that last guy good.
Real good.
This one's different.
I got a teenage girl who burned her face.
She's really depressed - and nothing I say is helping.
- Really? About the hockey game, I'm afraid I'm gonna have to cancel.
- Everything all right? - Yeah.
Something came up.
So I can see.
- What? - Moods swings, haggard brow.
Inability to concentrate.
All signs of woman problems.
- It's that obvious? - If you've been married enough.
And I met her today.
I don't forget a pretty face.
- You got any professional advice? - What? From me? I'll diagnose any disease but I can't figure out women.
That's what makes them so irresistible.
But I do know life's too short to waste on regret.
I'll see you tomorrow.
- Dr.
- Yeah.
- I got your films.
- Anyone seen the pregnant woman in 3? - No, sorry.
- I think she left.
She was supposed to go to detox.
How's he doing? Chest is clear.
Setting at 98 on two liters.
I'd give him albuterol and I'll stop by tomorrow.
- I had a question about DNA testing.
- What about it? Sometimes we get single moms who have questions about DNA testing.
Can we do anything here? Yeah, we've got a kit you can use.
Just call my office.
He said my skin would be discolored.
The new skin will be sensitive to UV rays.
So you have to use lots of sunscreen.
- So much for my tan next summer.
- Your skin will look younger for it.
There will come a day when younger is better.
Trust me.
What about my hair? It'll be thinner.
But it will grow back.
- How long does that take? - Does it grow fast? - No.
- Well, you might have to wear a wig.
You could go blond.
It's true what they say.
Just be patient.
And if you have any questions call me or Dr.
Okay? Thank you.
Wow, you're good.
- Thanks.
- I mean really good.
You're welcome, Dave.
- Chief.
- You wanted to see me? No? I heard you had a question about my leg.
Me? No, not me.
I had a patient with a bad ankle.
Someone must have misunderstood.
I see.
Well if you do ever want to know, you should just ask.
No problem.
But it's none of my business, right? No.
No, it's not.
If it isn't the lean, Greene fighting machine.
- It was an accident.
- That you caused.
- Self-defense.
- Oh? - He attacked Carter.
- Carter didn't crush his throat.
- I want a formal apology to Mr.
- Fine.
Something else? I didn't bring this on.
I'll try to do damage control but his family will be coming in.
They want a sacrificial lamb and right now, you are looking pretty woolly.
ER? Hey, Jeanie.
How's Carlos? Good.
No, Kerry left already.
Mark? Yeah.
He's right here, honey.
Jeanie, it's Mark.
Sorry I had to rush out.
He's better, he's just a little wheezy.
Tell Kerry I'll be late tomorrow.
Thanks, Mark.
Gotta go.
Hey, you.
Hey, big boy.
How's my favorite little man? How's my favorite little man? - John.
- Hi.
What are you doing here? Can I come in? If you want me to leave, just say so.
I don't want your sympathy.
I know.
- Gabe? - Hey, Kerry.
Is everything all right? - I think somebody stole my car.
- What? I never leave it unlocked.
Maybe I did.
I left the house in such a hurry.
- Are you sure you' re on this level? - What? - Did you park on this level? - Yeah.
Every day I park on four so I can get a space.
This is three.
What an idiot.
After a while they all look the same.
I swear, I'd forget my head if it wasn't attached.
Do you want me to help? No, thanks.
I'll see you tomorrow.
- Okay, good night, Gabe.
- Good night.