ER s07e05 Episode Script

Flight of Fancy

Previously on E.
I was hoping you'd give me the joy and honor of being your husband.
- I can't find a decent position.
- Stay local, or you give up custody.
I am willing to offer you a per diem position.
- Per diem? - Yeah.
Give me the purse! Stop! Luka, stop! Stop it! E.
7x05 "FIGHT OF FANCY" What can I tell you? I'm short-staffed, okay? I can't go on a transport.
Conni, can you clear this TIA in 6? - She's waiting for her daughter.
- That's what Chairs are for.
And give a gram of Unasyn to the dog bite in 4.
Mark, they need you at the MICN.
Try Mercy Air.
Maybe they can pick him up.
Paramedics have a guy with chest pain.
Won't get in the ambulance.
Well, explain the risks and make sure he signs out AMA.
What are his vitals? - He's refusing to sign the form.
- Mark, you gave my patient cefoxitin? - Who? - Bovard.
Hold on.
Listen, he needed antibiotics.
- Yeah.
Cefotetan's a better drug.
- Peter, I'm a little busy.
That's not my problem.
You should have called me.
- Did you get through? - No answer.
I stat-paged him twice.
Well, try his cell phone.
Any response to Lasix? Mark, the AMA.
Get him on the radio and try and convince him.
What about a nitro drip? I need you to buff up a recurrent bowel obstruction I have on the way.
What are we? Jiffy Lube? I need a sugar-tong splint in 3.
Kovac still MIA? - Kovac missed his shift? - I'm sure he's on his way.
- Where's Kerry? - It's her day off.
- She's at a chrysanthemum show.
- Great, she's off playing Martha Stewart.
Hold on.
Just a sec.
I'm sorry.
I've got a helicopter transport.
We're gonna have to call in backup.
Why don't you wait until 8:30? He's never late.
- Peter, what's this? - Hot appy.
's ready.
I'll take him.
Greene needs your help here.
- Trauma coming in? - No.
You're gonna cover the whole ER.
- What? - Yep.
This'll get you started.
Diarrhea, ear pain and weak and dizzy all over.
Wait a minute.
"Weak and dizzy" wasn't part of our per-diem agreement.
Sure it is.
Per diem means "per my discretion.
" Okay.
I'm on my way.
I haven't done primary care since med school.
Don't worry, Peter.
You just gotta cover until Kovac gets here.
When's that? I hope soon.
Andrazak in 4, check his lytes in an hour.
And look at a post-reduction shoulder film on Quintano.
- How long's your flight? - I don't know.
- Where you going? - Grass Creek, Indiana.
The wedding coordinator's coming at noon.
- I know.
- Mark, we canceled her once already.
Go ahead and talk to her.
You can handle it.
I don't want to.
I want you to share in kinds of invitations, menus, flowers - I know.
I'm stuck.
I'm sorry.
- Well, at least try to get back on time.
I'll call you.
- Have a safe flight! - What? Nothing! Lifeguard Five-Seven-David.
Landing-pad zone is clear.
All right, I've got the earache.
That's a Pedes case.
Well, Romano has me seeing everything today.
And that's a complete waste of your brilliance.
I've apologized.
If you can't accept it, let's call a truce so we can work.
You are amazing.
First, you dump me.
Then you expect me- - I did not dump you.
- Then what do you call it? You were going to move to Philadelphia without saying a word.
But I didn't, did I? I stayed here, and I took this damn per diem job.
And I'm supposed to believe you did that for me? That's what I thought.
I'm Dr.
So, Jason How long has he been sick? It started last week with an earache.
And then he had a fever.
- Okay.
- Now he's coughing.
- Let's take a look here.
- You don't think he's got pneumonia? - One thing at a time.
- Get away from me! Jason.
Be nice.
The doctor wants to help you.
I said, be nice.
All right, Jason.
Look, this isn't gonna hurt, okay? - Just be still.
Here we go.
- No! I wanna go home! It's okay.
It's not gonna hurt.
Jason! That's right, Jason.
Go to Mommy.
Why don't you put him on your lap and give him a nice big hug? And if Jason's real still, I'm going to give him a sticker.
- How are his sats? - Up to 98.
- His ejection fraction's less than 10%.
- Mr.
Coggins? - Call me Tom.
- I'm Mark Greene.
We're gonna lie you down to load you on.
I'm gonna miss the scenery.
- What's his BP? -90/70.
It's always that low.
There's not much heart muscle.
Can you keep trying Janet? Sure, Tom.
That's my fiancée.
She's flying in from Montreal today.
Let me know if you feel dizzy or get short of breath.
I'm okay as long as I lie still.
Bright side is, I get bumped up on the transplant list, right? - Gordon, how are we for oxygen? - Four E cylinders, all full.
Ready? Let's go.
One, two, three.
Full trauma panel.
Type and cross for eight.
Get the bypass team on standby.
- Somebody stabbed him? - No.
He tripped near a pencil sharpener.
Our office manager wanted to pull it out.
But I wouldn't let him.
Decreased breath sounds.
Set me up with a chest tube.
- I'll do it.
- No, I'll do it.
Excuse me.
This is a teaching hospital.
Go find another patient to learn on.
- Pulse ox down to 91.
- Okay.
Let's get one percent with epi.
Peter, heard you had a good one.
And indeed you do.
- He needs a CT.
Let me get a 10 blade.
- Don't bother.
I'll throw the tube in and take him to the OR.
Don't worry.
You are in excellent hands.
- It's okay.
I've got this.
- This is a surgical case.
You are an ER doctor today.
Remember? There's a guy puking out in the hall.
Go see what you can do.
Excuse me.
I need a 32 French tube, some 0 silk and Xeroforms Sir, are you okay? - What does it look like? - Can we get some Compazine here? Sir, you're gonna have to aim for the basin.
- I heard it.
But I didn't believe it.
- Carter, get me some gloves.
Peter Benton, ER Attending.
Has kind of a nice ring to it.
- You want this? - Oh, no.
No, no.
Looks like you're doing just fine.
Trent? I'm Dr.
What happened to your hand? I have this stupid art class.
We were carving some duck decoy.
The most exciting thing that we ever did, I think, was macramé.
- How many stitches do you think? - How many do you want? - Enough to get me out of art class.
- Ten ought to do it.
- Dr.
Carter, can you step out a second? - After I suture this.
It's important.
I'll be right back.
Don't pick your nose.
- What? - His grandmother wants to talk with you.
- Well, just bring her in.
- No.
She asked to see you alone.
I'm Dr.
I'm sorry.
I came as soon as I could.
Is Trent all right? Just a few stitches.
He'll be good as new.
Doctor, there's something you need to know.
Trent's mother died of AIDS when he was 2.
He tested HIV-positive.
- You need to be careful.
- He didn't say anything.
He doesn't know.
We never told him.
- What? - We just wanted him to be normal like other kids.
- What about the medications? - He thinks he has a vitamin deficiency.
- And your doctor plays along with that? - Well, he understands.
Trent needs to know.
When he's older.
When he can better understand.
Your grandson could be sexually active.
- He's not.
I've asked him.
- Are you sure he's telling the truth? Doctor, I know my grandson.
You don't.
Larson, I have a legal right to tell Trent that he's HIV-positive.
- You have no right to interfere.
- HIV is a sexually transmitted disease.
And if he's having unprotected sex, he could be putting others at risk.
- Well, I think we better leave.
- Well, he can't leave.
- Let me by.
- Chris? - Let me by! - Could you escort Mrs.
Larson to Chairs? - This way, ma'am.
- Don't touch me.
Don't do this.
Pulse ox 94 on two liters.
What's your hurry? You keep checking your watch every 10 seconds.
- I'm just charting.
- I don't think so.
- You late for something? - I'm supposed to meet my fiancée.
- You got a lunch date? - We're meeting the wedding planner.
You're taking the plunge.
It's a great feeling.
What's your fiancée's name again? Janet.
I'm calling the ER.
See if they can get ahold of her, and she can meet us there.
That'd be great.
Hi, Randi? It's Mark Greene up in the helicopter.
Who's around? Dr.
Corday's right here.
It's Dr.
I need to speak to him right away.
- Is everything all right? - Dr.
Dietrich? This is Dr.
Carter at County.
I repaired a laceration on your patient, Trent Larson.
- I'll try and get ahold of her.
- No, he's a great kid.
Listen, if I was to get a needle-stick, is there anything I should know? - Did you get in touch with that hotel? - There's still no answer.
Could you call the manager and see if they can send somebody up there? Detective? You keep coming by, I'm gonna have to get you a badge and a gun.
So, is there anything? Dr.
Kovac, now, you know the minute there's anything new, I'm gonna call you.
We take photos for the medical record.
I thought it might help.
His morgue photo's already on the police bulletin.
Maybe you could go back to where it happened, show this around? We've done our interviews, doc.
No one knows him.
What about fingerprints? Have a seat.
Have a seat, doc.
Look, I understand how you feel, okay? But the fact is, you're probably better off if no one IDs this guy.
No one's gonna come crawling out of the woodwork with a wrongful death suit.
I don't care.
I just need to know who he was.
Take my advice, doc.
You were defending yourself.
Dedicate yourself to believing that.
- All right.
Keep that clean and dry.
- All right.
Hey, Dr.
Carter, is my grandmother here yet? Yeah.
But first we need to talk.
Why? It's just a cut.
Yeah, actually, I need to ask you something.
All right.
It's about your mother.
How much do you remember about her? - Nothing.
- You sure? Yeah.
She's dead.
She was a loser.
A heroin addict.
She died of AIDS.
And she had the virus when she was pregnant with you.
And the virus can pass from the mother to the baby.
Wait a second.
So - I have AIDS? - No.
You have HIV.
And you're healthy because you've been taking medication.
No, no.
See, I just take a bunch of vitamins.
That's it.
You've been taking medication to combat the virus.
They're just vitamins, man.
Your grandmother told me.
And I confirmed it with your doctor.
Why wouldn't she tell me?! I think she wanted to protect you.
But you need to know.
So my whole life everybody's lied to me.
I'm not lying to you.
How much longer do you think? Gordon, what's our ETA? Well, there's the Kankakee River.
About 20 minutes.
You all right? It's all right.
Just a little chest pain.
I'll be okay.
Nitro spray.
Open your mouth, under your tongue.
On a scale of one to 10, how bad is the pain? Big-time ST elevation on the monitor.
Find the tenecteplase.
I'll do the heparin.
- What's going on? - You're having a heart attack.
But we're giving you clot-busting medicine.
Pulse ox down to 82.
You want to intubate? Not if I don't have to.
Let's get him on a mask.
- Maybe we should land.
- No.
Doctor Greene Dr.
Greene, you'll get me there, right? Yeah.
I'll get you there.
Do you have a girlfriend? Because if you've slept with anybody, they'll have to be tested.
It's important, Trent.
You have to use condoms.
- Can I go now? - Yeah.
Yep, your grandmother's waiting.
So a case manager's gonna phone you tomorrow, see how you're doing.
And you've got an appointment next week with the teen HIV center.
And you can always reach me here.
The ER always knows where to find me.
- All right.
- All right? Trent? Thank you, doctor.
Hog Butcher for the World Tool Maker, Stacker of Wheat Player with Railroads City of the Big Shoulders You know Sandburg's poetry.
Just that one.
After teaching English for 10 years, I know them all.
- It looks like you' re feeling better.
- ST segments are back down.
Hello? Yeah, we're about five minutes out.
That's good.
Hold on.
Janet's on her way in.
Thank you.
Listen, we're gonna need a gurney and- What the hell's that? The main rotor.
I got metal fragments in the gearbox.
- What's wrong? - Mark! Mark, are you there? Mark? Mayday, mayday.
This is Lifeguard Nine-Seven-Kilo on emergency descent.
- Cinch him in tight.
- I'm gonna shut down for auto rotation.
No, no.
We're gonna make it.
Mark? Can you hear me? - What's going on? - I don't know.
There were horns, shouting.
Now there's nothing.
Mark! VFR position.
Industrial area.
Scrap yard near 95th and Commercial.
When I get enough rotor speed, I'll pull on the pitch to cushion our landing.
- We're falling.
- Hang in there, Tom.
Here we go.
Everybody out.
Get out now! - Take the monitor.
- Got it.
Pumps are down.
- Let's go.
Move away.
- Airway kit.
- You get the feet? - All set.
- Let's go together.
- All right.
We gotta move.
- How far? - Just keep going.
I'll tell you when.
- You all right? - Got it.
Yeah, yeah.
Let's go.
Come on! - Tom, how are you doing there? - Sats are down to 78.
- All right.
I gotta tube him.
- All right.
This is far enough.
This will shield us if the fuel tank blows.
Give me four of Versed, - All right.
- Tom Tom, we gotta stick a tube down your throat, help you breathe.
- Do they know where we are? - Yeah, I called it in.
They'll find us.
I'm giving some medicine to relax you, Tom.
- Got it.
- Do they know anything? ATC's got a mayday call with location.
EMS and Fire are rolling.
- Injuries? - They didn't say.
- Well, call them back, damn it! - What's going on? - Mark's chopper went down.
- What? - They crashed? - An emergency landing.
We don't know that.
We don't know anything.
Call Dispatch.
- They don't know anything more.
- I don't care! I can't have this place fall apart.
Get on with CDO and keep us posted.
- How are we doing? - We've got 19 patients waiting.
Malucci, grab some charts.
Abby, start some IVs for anyone who needs one.
Get Carter to order x-rays from triage.
All right, let's move, people.
- Where the hell is Kovac? - We're still trying.
- Very nice.
- Appreciate it.
- You play here a lot? - Yeah.
I work here and the Navy pier.
- What about at night? - Sometimes for the after-dinner crowd.
Have you ever seen this man? No.
I would remember a guy like that.
You don't seem like a cop.
I'm a doctor.
Try the tour-boat ticket guy.
He's here all the time.
- I did.
- Sorry I can't help you.
Good breath sounds.
Keep him on high-flow oxygen.
Fifteen more minutes and the tank's dry.
- Where's EMS? - Sound close.
They can't see us.
They're gonna have to call in a police chopper.
We can't wait.
You have any flares? I have a Verry pistol in the chopper.
But I can barely walk.
- I'll get it.
- Left side, behind the pilot seat.
Luka, it's Abby.
Could you call me when you get this message? I've been trying to reach you everywhere, and I'm getting a little worried.
- Abby? - Call me.
Miss Skye here complains of abdominal pain.
It's not really my abdomen.
- I can't believe I'm actually embarrassed.
- Well, we see everything here.
I got a roll of money stuck up my "birth canal.
" Look, could you hurry up? I got a cab waiting with the meter running.
Okay? Dr.
Benton, we need you right now.
Six-month baby, respiratory distress.
- Abby? - Just hold on one second.
Temp's 103.
Coarse crackles bilaterally.
- Pulse ox is only 75.
- All right.
Let's take a look.
Sounds like pneumonia.
Let's get a pediatric intubation tray.
We got a line.
I'll draw a CBC and blood culture.
Damn! I don't even do pediatric intubations.
Where's Cleo? - She took a kid to PICU.
- Get her down here now.
- What size tube? - We use two and a half in Delivery.
I think I need something bigger.
Three, three and a half? I don't know.
Got the labs.
He's clamped down.
I can't get the blade in.
- Paralyze him.
- What's the dose? - You need his weight.
- He's vomiting.
- Pulse ox is dropping.
- What do we have? Difficult intubation.
I can't dose without a weight.
That's what the Broselow tape is for.
We're in the red zone.
Premedicate with.
17 of atropine, 14 of lido.
Bag him.
Keep some cricoid pressure.
- I couldn't see the cords.
- You had the wrong blade and tube.
- Thanks for coming.
- Drugs are on board.
He's loose.
- Okay.
Here we go.
- Dr.
Benton? - Hold on.
Hold on.
- Okay I'm in.
Bag him.
Benton, do you want to close to paramedic traffic? I've got this.
Hang 400 of ceftriaxone.
Settings will be volume at 90 cc's No monitor beds, and we're boarding five ICU patients.
All right.
Close to paramedics.
You sure you want to do that? We've been getting a lot of bad press.
- What would you do? - I don't know.
- South Side wants to send a patient.
- We're closed to transfers.
It's just a backache.
Their x-ray machine's down.
- Fine! Fine! Fine! Send him! - So? Do we close? Don't ask me.
They don't pay me enough.
Paramedics found them on the South Side.
No casualties, thank God! Well? Well? Thank you.
- Trent? - Hey.
They told us to wait because you were busy.
Is she a friend of yours? - She's my girlfriend.
- Your girlfriend? - You said you didn't have one.
- I brought her here.
You gotta be honest with me.
Is she the only one? Yes.
The only one.
I've kissed other girls.
Is that a problem? - No sex with anyone else? - No.
And you didn't use condoms? I love her, man.
All right.
Let's run some tests.
We'll see where we are.
- You want to ride up front? - No.
I'm staying with Tom.
- Nearest facility's Oakdale Community.
- No.
We're going to County.
Dispatch doesn't want us to leave our attachment area.
- It's all right.
I'll take responsibility.
- Easy now.
- Roy, the doctor says we go to County.
- Can't.
County's closed.
- What? - They just closed.
ER saturation.
That's okay.
I'm an Attending there.
They'll take us.
Let's go.
- Patch me through to the ambulance? - Dr.
Corday, surgical consult in 4.
I'll be there.
Just give me the number.
- Excuse me.
I'm looking for Dr.
- Are you Janet? - Yeah.
- Elizabeth Corday.
- We expect them very soon.
- How's Tom doing? Quite well.
Apparently, no one was hurt in the landing.
- What landing? - Something minor with the helicopter.
So how long have you two been engaged? Three years.
So he's not in the helicopter? No.
In an ambulance.
My goodness, three years! That seems like a long time.
Right after he gave me the ring, he got the flu.
Then the virus went to his heart.
We spend a lot of time in hospitals.
- Have you seen the hernia yet? - In a minute.
- No, no.
- EKG on a new chest-pain patient.
- Let me see.
- A guy on a backboard for two hours.
- When are you gonna clear his neck? - When I can.
- Want me to call Weaver in? - No.
- Are you ever gonna sew me up? - We're busy.
Just wait there.
- What's this? - A second board.
We're backed up.
Four patients just left without being seen.
I know the solution.
We see them, and have them wait in Chairs.
Come on! Are you crazy? We need monitoring, IVs, medication.
You doctors order too many tests.
You should be keeping things moving.
- Stroke patient needs a monitored bed.
- We don't have them.
Tell him - We'll put him in the hall.
- None of my nurses have even had lunch.
Ambulance dropped off a stab wound to the belly.
All right, all right.
That's it.
That's it.
Get me the phone.
- Heart rate is 40 after two of atropine.
- Amp of epi.
He needs a pacemaker.
We should be in a hospital right now.
Any hospital.
- Rescue 82.
- BP is down to 60 palp.
- Open up the dopamine.
- It's for you.
Okay, we're almost there.
He can't talk right now.
- He's out.
I can't feel a pulse.
- I gotta go.
Starting chest compressions.
We could've been at Oakdale 10 minutes ago.
I'm going on record you overrode policy.
- There's gonna be an incident report.
- Shut up.
Get back to work.
Hang in there, Tom.
You're gonna make it.
Janet's there.
She's waiting for you.
- How long has he been down? - He never arrested.
- Needs help maintaining a pulse.
- You look exhausted.
- He wouldn't let us relieve him.
- I'll take over.
- We're coming through here! - What's wrong? This is Janet Wei, his fiancée.
Tom had a heart attack.
He needs a pacemaker.
You can take his hand.
- It's me.
I'm here.
Can you hear me? - Keep talking to him.
- It's Janet.
He's squeezing my hand.
- What's his BP? Seventy systolic on 20 mics of dopamine.
- What about an intra-aortic balloon? - Not a bad idea.
- We need the room! - Everything's backed up! - We're closed to paramedics.
- Get that patient out! - Wait! The rapid infuser! - Oh, my God! - Clamp the central line! - Turn it off! - I'm trying! - Get Housekeeping in here! - We need another two units of blood.
- What the hell's going on? I just got back from transport.
I left Benton in charge.
Mortimer goes to X-ray.
Put the rectal bleed in Exam 3.
A patient says her tongue is too smooth.
Tell her to get a life.
Smooth tongue could be a sign of anemia, iron deficiency.
I can't leave without this place going to hell.
- I've never seen it this busy.
- It's like this every day.
I just heard from the Trib.
Tell me we're not closed to trauma.
- We're not.
As of now, we're open.
- We can't see another critical patient.
Get me the nursing supervisor.
I want every stable patient moved out of ICU.
I was under the impression you could manage the ER.
I was the only Attending.
Kovac never showed.
- He didn't show?! - He might have switched a shift.
In 20 years, I have never been late.
I guess you work on a different standard.
Peter, based on your performance, maybe you're not the guy for the per diem.
- Dr.
Carter? - Yeah? Lab results on Emma Miller.
- Man! - That's tough.
Fifteen years old.
Pacer is capturing well.
Setting the rate at 80.
- I got your transducer here.
- How are you doing? Passing a 40-cc balloon.
I need to check position with fluoro.
Janet, why don't you come talk to me outside? This pump should bring his blood pressure up.
Will he live long enough to get the heart transplant? I don't know.
I want to marry him.
I don't know if he's gonna be able to leave the hospital.
- Can we do it here? - We could try and arrange it.
I think if we got married it might help.
- What if they made a mistake? - I wouldn't tell you if I wasn't certain.
But I don't feel sick.
You should do the test again.
Emma, if you start taking medication right now, you could stay healthy.
I know what happens.
Everybody dies.
That's not true.
That's not Look at Trent.
He's had HIV his whole life.
Look at him.
- I wish we'd never had sex.
- Emma, I didn't know.
I swear.
Carter, tell her.
This is a lot.
This is a lot for you to handle.
And you're both gonna need some help.
So, before you go, I would like you both to talk to a counselor.
Hold on, you two.
Hold on.
I'll leave you two alone for a little while.
But before you do anything, talk it over.
Come on - Why is Mr.
Chang still here? - He's waiting for a second CBC.
Do another HemoCue.
If it's over 11, send him home.
- Torelli's cardiac enzymes.
- Great.
All right.
She's out of here.
Clears up another monitored bed.
You know, Romano was out of line.
When isn't he? It's wrong to throw you in and expect you to swim.
Nobody masters ER management on their first day.
- What's this? - Back pain.
Collapsed at triage.
Both trauma rooms are full.
Let's take him to Curtain 2.
Go! - I need a central line kit now! - BP's 60 palp.
Could be a ruptured aneurysm.
CBC, coags, type and cross for eight, four units of O-neg.
Let's prep the neck.
I feel a pulsatile mass.
Hey, Malik, is there any history on this guy? I need a trauma kit.
This is a triple-lumen CVP.
"History of hypertension and high cholesterol.
" He needs an NG and a Foley.
I need the SonoSite.
Benton accepted this patient from an urgent-care center.
- What? And he's been waiting in Chairs? - For two hours.
I can't find the subclavian.
Put him in Trendelenburg.
- They said it was just a back sprain.
- The doctor told you that? - I didn't exactly talk to the doctor.
- Great.
And now he's bleeding out.
- Take a deep breath.
- M.
is 78 with a pump.
Is that good or bad? Took you out of heart failure and off your breathing tube.
Sats are up to 99.
Get him on five liters, nasal cannula.
Conni, grab a blood-gas kit.
Where's Janet? She's trying to get a clerk from city hall to come issue a marriage license.
That's crazy.
- People in love do crazy things.
- I wanted to wait for a transplant so I could chase her down the aisle.
I didn't want her to marry a cripple.
You get a heart, she won't.
If one's available, if the tissues match, how long can I last on this pump? Couple weeks.
Pretty lousy odds.
They were worse when you were having a heart attack in the chopper.
- You see any Zephiran? - Yeah.
Top shelf.
Hey, I heard about your teenagers.
They're so young.
It's pretty rough.
- Are you okay? - Yeah.
I think so.
Do you want to take a break? I'm gonna plug in two new patients.
I'll come find you.
- Talk to Kovac? - Not yet.
- Dr.
Kovac? - Yeah? We finished the autopsy.
I can review some of the pertinent findings.
There were multiple contusions to the occipital cortex with herniation through the foramen magnum.
And if you'll take a look here, you'll see numerous fractures consistent with repetitive blunt trauma.
I know how he died.
Well, I can tell you that he was a smoker based on the lung findings.
Also, he probably once lived in central California.
There were foci of pulmonary fibrosis consistent with coccidioidomycosis.
It's endemic to the San Joaquin Valley.
That's an agricultural area.
Maybe he grew up on a farm.
Well, I don't know.
There's grease under the fingernails and a biker-club tattoo.
He could be just a drifter.
But we'll probably never know.
Happens all the time.
Not such a smart idea to take your Razor down a flight of stairs, huh? - Were you wearing a helmet? - Yeah.
What do you think I am? Stupid? Well, we'll see after the x-ray.
Right wrist film, something for the pain.
A half a It happened so fast.
We were fighting.
He ran into the street.
A car hit him.
They're doing everything they can.
- Dr.
Carter? - What's the rhythm? - V-fib.
- Charge to 360.
Oh, God! Trent.
- What's our down time? - Twenty minutes.
Never had a pulse.
- Don't let him die.
- Still V-fib.
- Hey, doc.
- Thanks for coming down.
What do you need? Thirty-one-year-old patient, end-stage heart failure.
He may not make it.
- What denomination? - I don't know.
Can he speak? For last rites, I need to know.
He and his fiancée want to get married.
- Tonight? - We can't move him.
We gotta do it here.
- Were you able to get a license? - I tried.
But city hall's closing.
- You don't have a marriage license? - Can you do it anyway? A marriage isn't legally binding without a license.
How about tomorrow? Okay.
He may not make it until tomorrow.
Can't you help them? They want your blessing.
They have very little time.
Well, as long as everyone understands it won't hold up in court.
- Are you ready to tie the knot? - Come on.
Let's go talk to Tom.
- Dr.
Kovac, did you trade your shift? - No.
Where have you been? They couldn't reach you.
You didn't answer your page.
What's the problem? That I had to come in today and cover for you.
- I thought I was on tonight.
- No.
You were on today.
Then I'm sorry.
There must have been some mistake.
There was no one with enough experience to cover you.
We almost lost two patients.
- Luka, this is grounds for dismissal.
- Fine, Kerry.
Fire me.
I know that you've been through a lot.
If you need to take time off, tell me.
But you can't miss any more shifts.
- I can work tonight.
- We don't need you.
You should go home.
Go on.
- Luka, wait.
- What? Wait a minute.
Don't walk away.
- Where have you been? - Abby, please.
I want to help.
Just talk to me.
There is nothing to say, okay? To have and to hold, to love and to cherish as long as you both shall live.
"The union of husband and wife in heart, body and mind is intended by God for their mutual joy.
For the health and comfort given one another in prosperity and adversity.
And when it is God's will, for the procreation of children.
" You can stay as long as you want, okay? - Emma, I am so sorry.
- Get out of here.
- Emma - It's your fault.
By the power vested in me, I pronounce you husband and wife.
Go ahead and kiss your bride, Tom.
- Congratulations.
- Congratulations.
I'm gonna break all the rules and allow you to have one sip of champagne.
Well, since this is the honeymoon suite, you're entitled to a little privacy.
- We're very grateful.
Thank you.
- Yeah.
For everything.
Nice folks.
Tell them to get a license, and I'll do it again.
No charge.
So, what about our wedding coordinator? I totally forgot to call and cancel.
She'll be furious.
Blame it on me.
I mean, it was a medical emergency.
- The hell with her! - Excuse me? This is all so silly.
I don't want a rose-entwined arbor with trained doves.
I don't want champagne served out of crystal flutes.
I understand.
- Who cares about a bloody ice sculpture? - Not me.
I just want to get married in a simple ceremony.
I don't know.
I was looking forward to those doves.
So I spoke to the O.
The aneurysm repair's going well.
- I'm glad to hear it.
- Yeah.
I think it's best for now if you just see patients.
Well, if that's what you want.
You're an excellent surgeon.
But ER management is not the best use of your skills.
Leave that to us.
Hello, Mrs.
I'm Dr.
So I understand you have a pain in your hip.
That's right.
And I've been lying here for three hours.
Well, I'm very sorry about that.
Pardon me for asking, but are you an intern? No, no.
I'm a faculty physician.
Your mother must be very proud.
Yeah, she was.
So how long have you had this pain? Before we get much further I'd like to say that I would be more at ease with another doctor.
- Excuse me? - You look like a fine young man.
But I've always had white doctors.
I've always felt more comfortable that way.
So you're saying that you only want to see a white doctor? If it's all right with you.
That's fine.
You'll just have to wait another three hours.
- What happened to him? - I don't know.
- Hey, have you seen Abby? - I saw her punch out.
- Hey, Carter.
You got a minute? - Actually, I'm just on my way out.
Carter, wait.
John, you had a bad day.
We all have bad days.
Look at me.
You have to make tough choices, do what you think is right and accept the outcome.
- I shouldn't have told him.
- You had to.
I'll see you tomorrow.
Hey I'm off in 20 minutes.
You wanna get some dinner? - I got an AA meeting at 9:00.
- You'll make it.
Can I join you? It's a counter, Peter.
You can sit anywhere.
So you survived.
- Weaver said I was incompetent.
- Really? Well, that's what she implied.
The per diem job is just temporary until you get back into Surgery.
But I needed to show them that I could run the ER.
Why? It has no bearing on your surgical career.
But it reflects on me, you know? I should've been able to handle it.
- You can't be perfect at everything.
- Yeah, but, Cleo I can learn a job if I can do it well.
So do you feel better having said this to a sympathetic ear? Yeah.
Yeah, I guess so.
You know, I've had some problems, and I haven't had anyone to talk to.
Are you ever going to be there for me? Because you sure as hell haven't been.
Who is it? It's me.
Can I come in, please? Sure.
- Abby- - You don't have to talk.