ER s06e15 Episode Script

E.
R.
E.
R.
6x15 "BE PATIENT" Is he standing on the frozen lake or in a hut? It beats me.
- What kind of fish do they catch? - Yo! Morning.
- He rides that in the winter? - Damn.
Malucci.
- What? - Conference with Romano.
He admitted a patient.
I forgot my notes.
That'll teach you to sleep over.
See you later.
You should get a U-lock.
Somebody's gonna leave you with no ride.
Tired of scolding me for not having a helmet? Dr.
Dave, I'd never want to get between you and brain-death.
Abdominal pain, possible ischemic bowel, needs a consult.
- Mr.
Wyatt's x-rays.
- Good.
Could you finish here? - What's left? - Mr.
Kechevsky, rule out MI.
If someone has the enzyme results, I would like to follow up.
- Can you handle that? - Yes.
- That's it? - Yep.
All right.
ER.
Yeah, hang on a second.
Abby, it's for you.
- I answer phones.
- Just helping.
And I appreciate it.
Yes, I did call.
Three days ago.
I need to talk to you about the late payments.
What? You'll just have to sell them.
I don't care how you do it, just make the payments.
Just make the payments.
Bye.
- My soon-to-be ex-husband.
- Sounds bad.
He's taken a flyer on stocks with my money.
- Ow! Maybe they'll go up.
- I'll never see the cash.
I'm leaving before I fall over.
Until next time, ladies.
- Bye.
- Men.
Morning.
I forgot some notes.
You look tired.
Were you watching Charlie Rose? Not exactly.
Morning, Elizabeth.
David came over for breakfast.
In boxers and slippers? My slippers.
I hope you don't mind.
I thought you were ice fishing.
- I didn't make it.
- I can see that.
- Goodbye, Elizabeth.
- See you.
- Can I freshen your cup? - I practically drank the whole pot.
So are you amused? Bemused? - Shocked? Chagrined? - That's a start.
- I suppose you think at my age- - Mother.
Please.
Do you really think this is a good idea? - I'm old, but I'm not dead.
- His wife is.
Recently.
- Then bloody well good for him- - Mother! Is it so difficult to imagine two people being attracted to each other? Were you using protection? There are diseases.
- He's diseased? - That's not the point.
- You really want to discuss this? - No! He's my boyfriend's father.
You always worried what people think.
- I did not! - Yes, you did.
How would you know? Did the nanny tell you? Yes, Elizabeth.
You were so neglected.
Don't pretend to know me.
I know you better than you think.
I'm just trying to say this could get very complicated.
Why are you afraid relationships will go bad? Perhaps because ours hasn't exactly gone right.
I have to go.
No fair doing paperwork now.
- I'm not on yet.
- Just making us look bad? I'm doing reviews for Carter and Lucy.
- Sorry.
Need my help? - I've got it.
I've got an object up the nose and a hemorrhoids case for you.
I'll be right there.
The CPK was normal.
Good.
Good.
Discharge him, Abby.
Yeah.
He should follow up with Cardiology.
No, I have the night shift all week.
I'll see you tomorrow.
Okay.
Bye.
Laura! Stop! - It hurts.
- I know.
I'm a doctor, I'll help you.
Look at me.
Try to breathe slow and easy.
Now, tell me your name and where it hurts.
- Laura.
My leg.
- Keep your head still.
Do you remove nose piercings? I put a new stud in the old hole.
Inject two cc's of air into the foley and pull it back gently.
Bless you.
- Thanks.
- You're welcome.
- Can I go? - In a minute.
Hemorrhoids next? Do the initial work-up, then find me or Mark.
- You gonna use that thing on me? - We'll see.
- I'm Abby.
- Ron Perth.
I feel kind of stupid coming in.
I didn't expect to feel great.
I'm still bleeding, from the- You know, hemorrhoids.
- They were banded just last week? - Yeah.
- You're pale.
How much bleeding? - Not much.
I fly to Denver at 5 for my girlfriend's birthday.
Could you give me a cream to shrink it down? Sorry.
- I was taking her dancing.
- Just dinner might be better.
- Need a hand? - Yeah.
Could you order a CBC, Chem-7 and coags and prep for anoscopy.
- Is that what I think? - I'll be gentle.
Oh, man.
Where's my mom? Somebody get my mom! She's coming, Laura.
I need to cut open your pants now.
- Oh, my God! Is she okay? - Yes.
I'm Dr.
Kovac.
I called 911.
Be careful.
Her leg is broken and maybe a rib.
- Mom, it hurts! - Can't you do something? - Get that lady's broom.
- I'll get it.
- What are you doing? - Splinting her leg.
- Why? - I need to check for artery damage.
We We heard you can't tell anybody anything we say.
That depends on what you tell me.
It's about Sex? If there's no abuse and the guys are under 18 then I can't tell anyone.
- You can't tell our parents? - No.
- You promise? - What is it? I can't help if you don't tell me what it is.
We might have caught something.
What do you think it is? We heard syphilis was going around school.
I see.
Why don't you girls come with me, okay? - Okay.
- Okay.
- It hurts! - What is it? - I'm worried she's bleeding internally.
- Oh, no.
- Where's the ambulance? - It's coming.
Let's just drive her.
It's okay.
It's gonna be okay.
Sir! You, the plumber.
I need your help.
Can you make room for this girl? - Put her in the van? - She needs to get to the hospital.
Okay, let's go.
- In his underwear? My father? - I can't believe it.
- What did you say? - What could I say? I tried to talk to her about it, but we just argued.
- It's not funny.
- It beats ice fishing.
- Don't you find it bizarre? - It's not such a bad thing.
Are they going to keep on doing it? He's coming in this afternoon.
I'll talk to him.
Yeah, thanks.
I can't breathe.
Her rib could've punctured a lung.
Look right.
Now to the left.
- Laura? Laura? - Oh, my God! - No breath sounds.
- What is it? She has a tension pneumothorax.
An air leak is keeping her heart from beating.
We have to use this needle to relieve the pressure.
Oh, my God! - Why is she bleeding? - I might've nicked an artery.
Push where the blood's coming out.
Something wrong? - These pads are soaked.
- Just keep pressing them.
Come on, damn it.
I'm coming in with a major trauma.
Clear a room and get four units of O-neg.
Go faster.
We need to be there now! Auto versus 10-year-old girl.
Trauma to lower chest - and fractured left femur.
- Hang on! - We need a chest tube right away.
- Pulse is thready.
- Need any help? - No.
Got it.
She was stable, then I lost her pulse.
And I may have nicked her intercostal.
- What happened? - The van hit a bump.
- Why not wait for the ambulance? - I waited seven minutes.
Paramedics arrived two minutes after you left.
You'll have to wait.
Trauma panel.
Type and cross for 4.
Two large-bore IVs, prep the chest.
BP's 80, palp pulse 110.
- Where's my mom? - She's outside.
How are you doing? - I'll give you something for the pain.
- Lidocaine.
- I need ultrasound.
- Let's move.
- Luka, we got it from here.
- I'll stay.
- Get X-ray up here.
- Pulse ox 92.
Let's intubate.
6½ ET tube.
I'm in, hook me up.
- Chest full of blood.
- You did hit the artery.
Call the O.
R.
, hold a room.
Looks like more than a nick.
- We got a liter out.
- Pressure's 50.
- She's unresponsive.
- Prep for a right-sided thoracotomy.
- Not much longer.
- Is Terri okay? She's fine.
She's sitting in Chairs.
There's cervical bleeding.
It might be dysplasia.
- Is that syphilis? Dysplasia? - There's no sign of syphilis.
We'll wait for the blood test.
- You can get dressed.
- So I can go? No.
Your HIV test won't take long.
- Am I all right? - Let's see what the test says.
The other girl looks okay, but do a stat pap smear on this one.
Let's get you dressed.
- Well, Mr.
Perth.
- Ron, please.
- Your blood count's normal.
- Good, right? Right, but it takes a while for a crit to show a blood loss.
But I feel okay.
I'd hate to have you bleed out at 35,000 feet.
- You want another test.
- Yeah.
I'm going to draw some blood which is tagged with a radionuclide which I reinject by IV.
Then I trace for bleeding.
- As long as I won't glow in the dark.
- It's quick, I promise.
- Is it really the thought that counts? - About what? My girlfriend's birthday.
I was considering jewelry.
- But if I go there, I've got to go big.
- I don't know.
- My husband gave me a surprise picnic.
- Romantic.
Cheap.
- Hello.
- Hi.
- Dr.
Weaver, Mr.
Perth.
- How's he doing? - I'm doing a nuclear medicine scan.
- We don't do those very often.
- CBC and lytes come back? - Yeah, they're normal.
- Can we talk a minute? - Sure.
Hold that.
The belly's benign, there's no evidence of a bleed.
Why do the test? - His skin is pale, his eyes are dull- - Not diagnostic of a bleed.
I don't think the scan is necessary.
You should discharge him.
- Is there a problem? - No.
I just have to get this to the lab.
- More suction.
- Got it.
- Can you stick-tie the bleeder? - No.
- Keith needle.
- What are you doing? Kennedy maneuver.
Transmural hemostatic suture.
- Hang another unit.
- And autotransfuse.
I tie the superior and inferior and tie them tight.
- Dry as a bone.
Nice.
- New seizure in 2.
I'll get this.
You okay? - Check the BP.
- How about another crit? - Fine.
- Let's go talk to the mother.
- Pressure's crashing.
- Chest is dry.
Check the belly again.
- She must still be bleeding.
- You're right.
Belly's full of blood.
- She blew the capsule.
- Should've checked.
Let's hang two units and move to the O.
R.
now! - What is it? - We're going to surgery.
- This is her mom.
- Come with us.
We'll take it from here.
- I want to stay.
She's my patient.
- No.
Not anymore.
Go and get some sleep.
You think I'm going to sleep? - That's hilarious.
- Oh, my God! We got to go.
Bye.
We were just talking to some friends.
I need to talk to Andrea privately.
- Is she all right? - Could you wait outside? Hey, it's okay.
Thanks.
Andrea, we got your test results.
They found abnormal cells in your pap smear.
You might have cervical cancer.
We need to do a biopsy to make sure.
Cancer? Was it caused by having sex? You get it from an infected partner.
It's human papilloma virus.
- Not everyone with HPV has cancer- - You can't tell my parents.
If you have this, you need to be hospitalized.
You said everything I told you was confidential.
If you're not treated, you'll get sick.
We also have to inform your partner.
I don't know who it is.
I mean, which one.
How many have you had? Not sure.
We have these parties.
- I want to scrub in.
- No.
- Why? - You're not a surgeon.
- I'm not asking to operate.
- I'll call you when I'm done.
Let's go.
She'll be all right.
- Are you coming back down to the ER? - In a minute.
I'll show you where you can wait.
Mrs.
Saltzman was in for shoulder pain.
She had an MRI.
You were right.
Herniated disc.
And Mr.
Blandeleau, chest pain.
Ruled in for an Ml, had angioplasty.
And he's doing okay.
That's it.
- Thanks.
- No problem.
- Are you doing Lucy's cases too? - Told Weaver I didn't mind.
How was the memorial service? Okay.
It was nice.
A little weird.
How's everything else downstairs? Same old thing.
How are you doing? I'm doing fine.
- People drop by here all day.
- I bet.
- Even my grandmother.
- I thought you two didn't talk.
There's nothing like a stab wound to put a spin on things.
Hey, I'm gonna be back to work soon.
- Maybe I'll take up skydiving.
- You do that.
- Get out of here.
I need my rest.
- Okay.
- Need help getting on the bed? - No.
- Catch you tomorrow.
- Yep.
- John- Are you okay? - Yeah, fine.
- Listen, take it easy, okay? - Yeah.
Thanks, Deb.
Dad.
- You're late.
- Three minutes.
I was worried you might have fallen through the ice.
Yeah.
Very funny, Mark.
- Like you don't know.
- Just having fun.
Which is apparently what you were doing.
- Elizabeth wasn't amused.
- I'd say that's accurate.
It was wrong to be at her place.
- Don't worry.
- We'll get a room tonight.
- What? - It'll be easier for everyone.
So it's an ongoing thing? - You think this is a one-night stand? - I don't know.
- What floor's this pulmonologist on? - Fifth.
I like her.
She makes me happy.
Sorry if that makes you unhappy.
- I didn't say that.
- But she'll be gone soon and I'll be back on your sofa.
Then we can both be unhappy.
- How many has she slept with? - I don't know.
Both have been going to sex parties.
My God! At their age? I can't tell her parents.
But she's a minor who needs surgery.
Maybe she'll let me tell them.
I know what you're doing, but this is a public health issue.
At least one of those boys is spreading HPV.
And the girls at those parties need to be examined.
So you also need to call the school.
- Did you see two girls here? - They went out that door.
Damn it! Excuse me? Yeah? I'm Barbara Knight.
I'm looking for Dr.
Greene.
- He was here just a minute ago.
- Or maybe Dr.
Weaver? She was here too.
Right now, I'm all you got.
- I need to find your lounge area.
- People don't usually wait in there.
No, I just need to check my daughter's locker.
- I'm sorry.
Your name? - Barbara Knight.
I'm Lucy's mother.
- I don't have the combination.
- The med school gave it to me.
Thank you.
I've checked into the Ritz-Carlton.
I don't need that.
This is unnecessary.
They have a lovely view.
Now I have a meeting.
Stop it.
At our ages, there's no reason for us to be living together.
You say that as if we ever really lived together.
I love you.
But I swear, at times you can be insufferable.
- Me? I can be insufferable? - What exactly do you blame me for? I don't blame you for anything.
Then stop acting as if you do.
So I wasn't the conventional mother.
- What about your father? - It's not about Dad.
No.
It's about what I couldn't provide.
Fathers aren't blamed for working too much.
Mothers are blamed if they work at all.
Should you have a child sometime, will you give up your work? I don't know.
I don't know if that's gonna happen.
Then I'm sorry I set you such a terrible example.
- Technetium? - Yeah.
- Any signs of bleeding? - No.
Why'd you order a scan that I said was unnecessary? Maybe it's a nursing instinct.
But the guy does not look well.
It's winter.
Nobody looks well.
And medical students don't order tests.
It wastes your time and his money.
Cut him loose.
Abby, if Benton calls, get me.
I'm gonna grab something to eat, okay? - I thought you weren't on.
- I'm not.
- Have you called the police? - What? I'm not done yet.
- Call them now! - Get out of my way! - You're not leaving! - Leave me alone! What's wrong with you?! - Get off! - You left her! - I don't know anything.
- You hit her and left.
- I don't know anything.
- I saw you, and I can identify you! - It was an accident.
- And you just drove off? - I was scared, okay? - So was that little girl! I panicked.
I've had a couple DUIs.
But I wasn't drinking today.
I didn't know what to do.
But you knew enough to run away, huh? - Is she here? Is she all right? - You don't have the right to ask.
Maybe I was just being a hypochondriac.
No, you were right to come in.
And you'd be right to come back.
Well, thanks.
I'll keep an eye on it.
Say, in 15 minutes, if you're feverish or sick to your stomach, get that checked out.
But you just saw me.
It may not be me again, but somebody would - and they'd examine you thoroughly.
- Are you saying I'm not okay? I'm just saying that it's been an awfully bad flu season.
- You wanna take a break? - No, I'm okay.
- That's enough for today.
- Hang on.
- You did great.
I'll get- - I can do it! I just wanna get back to my room.
Dr.
Carter? - What are you doing here? - We need to talk.
- You promised, you bitch! - You need to come in.
- You said there were rules.
- I know, but I can't.
- You lied.
- To both of us.
It is a lot more complicated than that.
Your health is in danger.
And other girls could get infected too.
Now everyone's gonna know everything.
Andrea? Andrea! So we'll have to reschedule the bowel resection for 4:30.
Hello.
Sorry.
I didn't mean to surprise you.
Certainly not twice in one day.
You're here for your appointment? I've already been.
Got poked and prodded and x-rayed.
- Damn doctors.
No offense.
- None taken.
And I'm sorry if my presence offended you this morning.
I was just- Well, you said it.
Surprised.
I didn't mean to make trouble for you two.
Oh, no.
None that wasn't there already.
- And why is there trouble? - Mothers and daughters, I suppose.
You don't own the whole ranch on that one.
Let's save a little corner for fathers and sons.
But I will admit mothers and daughters are worse.
But that's just a woman thing.
The only problem with children is they grow up to be adults.
Yes, eventually we have opinions.
I know.
But do you have to express them? It's a learned response.
I'll give you that.
I suggest the four of us go out sort of bury the hatchet.
Mark thinks it's a great idea.
He doesn't.
He will.
- Abby didn't discharge him? - He's back with abdominal pain.
- BP's 80/60.
- Hang a unit on the infuser.
- What happened? - I began a rectal.
He started gushing.
It's a bleeding tic.
Get four units, call O.
R.
- I already did.
I'm in.
- Okay, hook him up.
Thank God he came back in.
Chicago wasn't her first choice.
She wanted San Francisco.
I took her when she was 8.
One ride on a cable car and it was her city.
Although she grew to love this one.
- You don't need to hear all this.
- No, it's fine.
I really just wanted to stop by and thank you.
Lucy always talked about you how she was first assigned to you.
She had a lot of respect for you.
And you must've taught her a lot.
- She worked with all the residents.
- I know.
But you're the one she used to mention.
But she- She loved her work.
She was better than I ever gave her credit for.
Can I ask you something? Yes.
When you were- Well, when that man stabbed you, what did you think? No I mean, what did it feel like? It happened really fast, and I didn't know what was going on.
But I didn't feel a thing.
No pain? No pain.
Did you get that venogram I ordered two hours ago? I had a CT -guided biopsy.
- You gonna get it? - After my embolization.
- Does that mean tomorrow? - With that attitude.
- Did you read a CT on David Greene? - Who? - My father.
He came in for a scan.
- Check the pile.
That's a big stack.
While you're at it, read a few plain films.
- Or you could work a few more hours.
- Don't start.
- ER guys want wet reads yesterday.
- Here we go.
ICU orders portables for every feeding-tube placement.
You think you have high volume in ER? I get high volume from the hospital.
Hey, Mark? You okay? That's your dad? Yeah.
Wow.
I'm sorry.
- He didn't say where we're going? - Just an address.
It's the "wear jeans" part that's scaring me.
Mother has no jeans.
- I don't know if I want to see her.
- Right.
- I wish we could face them together.
- Yeah.
- Are you all right? - What? - You're down to one-word responses.
- I'm sorry.
I've gotta finish up.
I'll meet you there.
All right.
I'll see you.
- What'd the school say? - They'll help.
But the girls saw me.
They didn't listen this time? No, they ran away.
You did the right thing.
I'm still gonna call Andrea later.
Your hemorrhoid patient's in the O.
R.
They're doing a laparotomy.
- I heard.
Is he gonna be okay? - He should.
He's got a bleeding diverticulum.
It's pretty lucky that he checked himself back in.
- I'm gonna go check on him later.
- Good.
You were right.
There was more wrong with him.
Just a gut feeling.
He could've bled to death if he hadn't come back.
Well, it's a good thing that he felt fluish.
That's exactly what he said: "fluish.
" Mrs.
Williams, Laura came out of surgery very well.
The nurse will take you to see her, if you'd like.
Thank you.
Both of you.
- I was out of line before.
I'm sorry.
- I understand.
- You fixed her hepatic vein? - Atrial-caval shunt.
She should be fine.
You saved her life.
I'm not so sure.
You had to open her chest to fix my mistake.
We had to do it anyway.
The liver was life-threatening.
If you waited, she might not have made it.
It's impossible to know.
Listen to me.
You made a call.
It took a lot of guts.
- What have you got? - Andrea Parks.
O.
D.
No suicide note, but lots of bottles in the cabinet.
- Any narcotics? - No.
She's lethargic, but arousable.
- When did she take the pills? - An hour or two ago.
- What kind of drugs? - Leave me alone! - Poly-drug.
- What'd you take? - You know her? - From this morning.
Cervical cancer.
- CBT, blood and urine tox screen.
- On my count.
One, two, three.
- We'll pump her stomach.
- She may not need lavage.
- Did you get the pills? - I had them- - We need them.
- Maybe you should leave.
- Did you send- - You're running this? Pulse ox is 96 on two liters.
It could be Tricyclics.
- So tonight's the jazz club.
- It's a good spot.
Good group is playing.
Cleo knows it too.
- What's that mean? - Nothing.
You're right on schedule.
All right, give it to me.
First, there was probably coffee in the cafeteria.
Then dinner in a nice but well-lit restaurant.
Then, maybe a sporting event.
And tonight's jazz.
We all know what happens after the jazz.
When did your brain lose its filter? I think you took it out in the O.
R.
last week.
- Here.
Let me help you.
- I got it! - Damn it! - Carter.
Carter.
Carter.
It's all right.
It's all right.
You okay? I lied to Lucy's mother.
I said it wasn't painful to have a knife shoved into your gut.
She's tachy at 120.
- You know what she took? - She was on the floor.
- Was it from your cabinet? - My parents'.
- What was there? - I don't know.
Tylenol, aspirin- - Anything prescription? - My dad takes pain pills.
- Do you know what they're called? - Diaza - Diazepam? - Sats down to 81.
- Barely responsive.
- Lost gag reflex.
- Let's intubate.
- I'll bag her.
- She could vomit.
- Antidepressants? - No.
- Are you sure? - History of seizures? - No.
- Push flumazenil.
- She's hypoxic.
Intubate.
Give the flumazenil a chance.
We have to protect her airway.
All right, good.
It worked.
What am I doing here? Terri found you.
Do you remember taking pills? - What? - You'll be okay, Andrea.
Oh, God, Andrea! What did you do? Let's give her charcoal now.
It's an interesting game.
- Don't worry, you'll get it.
- A martini would help.
That should do the trick.
Loosen you up.
- You want anything? - No, thanks.
- What's keeping Mark? - He'll be here.
I hope.
- Do you know how to keep score? - Not a clue.
- But you're learning American games? - One by one.
At least I'm trying.
I think that's rather adventurous of you.
That meeting I was running off to earlier I missed it.
- First time that's happened.
- I think it was.
Just couldn't be bothered to go.
- Went and sat by the lake instead.
- I bet that was freezing.
The only thing colder was the conversation we had this afternoon.
Elizabeth, I know I'm not the mother you wish you'd had.
- That's not exactly true.
- I keep hoping that you'll forgive me.
The problem is you never wanted forgiveness.
There's the rub.
Mark's dad says children shouldn't have opinions.
Yes? Well, he's absolutely right.
- I'll take over, Connie.
- Sure, thanks.
- How are you doing? - Okay.
I had to tell the school so other students could get tested.
But I haven't told your parents.
Or Terri's.
- You haven't? - I was hoping you would.
If it happened to one of them, wouldn't you want to know? - That was ugly.
- Am I penalized? - It's just a little dent.
- What? There's not a little dent.
I'm kidding.
Hey, hey, Mark.
- What kept you? - Oh, nothing.
- Hi.
- Sit down.
Have a drink.
- My ball's stuck.
- You broke it.
- Press the button.
- We'll work you in next.
No problem.
Boys against girls wouldn't be fair.
Neither one of them is any good at all.
And I'll be back on the sofa.
Isabelle's going back to Elizabeth's tonight.
- Sure.
- Grab a ball.
- No, you're too far to the right.
- But last time it went left.
- You see those marks? - The arrows? Aim for the one on the right.
And pull the ball all the way back.
And don't drop it.
Just let it roll on the floor.
- Wrist straight.
- That's an awful lot.
I'll show you.
- I never knew he was a surgery intern.
- He was good, smart.
He'd spend all of his time talking to patients.
One time Morgenstern made him hold a retractor for four hours.
Carter never broke a sweat.
He'll be all right, Peter.
Tickets.
You sure you wanna go in there? We're not gonna be able to talk.
Let's go get some coffee.
Come on.
- You're gonna disappoint Carter.
- What? - Nothing.
- What? Nothing.
What? Nothing.
That was fun tonight.
Yeah, it was.
Dad, I need to talk to you.
Sure.
I saw your scan today.
You have lung cancer which has spread to your liver.
Yeah.
That's what the doctors in San Diego said too.
How long have you known? For a while.
Why didn't you tell me? You remember old Rear Admiral Norris? How could I forget him? He was missing a thumb.
He scared me to death as a kid.
He had cancer.
Every time I laid eyes on him, I thought: "Poor old bastard, he's got cancer.
" Hell, he lived another 12 years.
But still, every time I saw him I didn't want it to define me, Mark.
I didn't wanna see it in people's eyes.
I didn't want to see it at all.
And I'm scared.