ER s07e14 Episode Script

A Walk in the Woods

E.
R.
Previously on E.
R.
How much of your brain did they cut out? He has a mild expressive aphasia.
- It's temporary.
- I don't like it.
- This is just gonna be between us, right? - Of course.
The only reason you gave me that job is because I'm black.
Lupus is very serious.
I know what it does, Dr.
Kovac.
I even know I'm gonna die from it.
I need information about evaluating a physician who's possibly cognitively impaired.
E.
R.
7x14 "A WALK IN THE WOODS" You asleep? Cleo? Cleo? You asleep? It's snowing outside.
What time is it? Almost 6.
You know, I was thinking I have to be in at 7.
The alarm's going off in 10 minutes.
I'll be quick.
The hell you will.
- You feel it? - No.
There.
It's really moving.
How long has she been going on like this? On and off all night.
Go back to sleep.
I keep thinking about that movie.
Alien, you know? It's moving around under his skin and then, all of a sudden, it breaks its way through with its teeth.
Amanda, stop it.
You're scaring your mother.
Amanda.
So the baby's a girl today.
Or Matthew, after my grandfather.
I can't decide.
Last day? Last day.
What? It's okay.
Hi.
Did I wake you? I was trying to let you sleep.
I should probably get home anyway.
You should bring a few things over.
I could clear out some closet space for you.
- Are you sure you can spare it? - I can find a couple of inches somewhere, maybe.
I need to dry my hair.
Are you gonna watch me again? Are you okay? And you? Penny for your thoughts.
- Pardon? - It means It means, "What are you thinking about? " Nothing, really.
I was thinking about the bishop.
Making love with me makes you think of a priest with lupus? You watch me when we make love.
You're beautiful.
What was her name? Who? Your wife.
Daniella.
Did you love her very much? Yeah.
I'm glad.
E.
R.
Carter, 4-year-old boy's coming in from preschool.
Fever, trouble breathing.
Sixty-two's pulling in.
Okey-dokey.
Hey, Frank.
Is Dr.
Greene here yet? No.
Said he was coming in late.
Weaver's upstairs at some big administrative powwow.
Probably suggesting the installation of pay toilets in the bathrooms.
Is Kovac here? He's got a dead shovel they're trying to bring back.
It's just you and me, then, with this 4-year-old.
I can take it.
- Welcome back! - Thanks.
- How are you feeling? - Pretty good.
- Want me to tag along with you? - No.
I've got it.
Eight weeks.
Could be some cobwebs.
Thanks, anyway.
- Call me if she gets into any trouble.
- Okay.
You look great.
I still have a few pounds to drop.
- Can't tell.
- I should have gotten a coat.
- Grab one.
- No, I'm all right.
Zack Woodman, 4 years old.
Post grand mal seizure at preschool.
We were finishing crafts, and he started shaking and wet his pants.
- You his mother? - No.
Preschool teacher.
Feels like he's burning up.
BP's 100/60.
Pulse, 120.
- Does he have a history of epilepsy? - Not that I know of.
- Zack, open your eyes.
Zack- - Excuse me.
Can somebody help me? - Are you hurt? - It's not me.
He's in the car.
He's very weak.
I don't think he can walk on his own.
Abby? - What's wrong? - He's having trouble breathing.
- Has he been ill? - Yes.
When did this start? I don't know.
A couple hours ago, I guess.
- Hi.
- Hello.
- Can you walk? - I don't think so.
I need a septic workup, CBC, blood and urine cultures, chest x-ray.
- Temp's 105.
- Sorry.
- The bishop's back.
- I need a weight.
Blue zone, 20 kilos.
- Pulse ox, 82.
- Put him on a mask, 10 liters.
Do you want to do a spinal tap? He could have meningitis.
Or a febrile seizure, and he's gonna wake up.
- Why don't I get an LP tray? - I want to wait a few minutes.
Give 900 of cefotaxime after the cultures.
Well, I love what you've done with the place.
Very Teutonic.
No trappings of success to interfere with your performing your new duties.
I requisitioned some furniture but the form's on your desk waiting for your signature.
Well, you should see my in-box.
Must be 18 inches deep.
- Are those admissions folders? - Yeah.
I thought I'd familiarize myself with them.
Don't bother.
Kids are gonna toss out clich├ęs about wanting to help people.
You could ask their favorite color, or if they like cheese.
Doesn't matter.
Step outside a minute, would you? He showed up whining about not getting an interview.
You should shake his hand, since this falls under your purview before you have Security toss him out.
Hey.
That's your man.
- Dean Benton? - Dr.
Benton.
William White.
Thanks for finding time to see me.
Yeah.
Well, what can I do for you? I got this letter.
I applied to the medical school.
But I didn't get an interview.
Teacher doesn't have a signed emergency consent form.
- He's still not waking up.
- How long? - Forty minutes.
- Zack? Zack, can you hear me? - He needs an LP.
- We don't have parental consent.
Get another doc to sign off the chart with you.
Okay.
Get the tray set up.
- Frank, where's Carter? - In 4.
Granny took a fall.
Can I see you for a moment? Sure.
I've got that 4-year-old with febrile seizure.
He's still altered.
I wanna do a spinal tap.
The preschool doesn't have an emergency consent.
Haven't been able to contact a parent.
- Any other signs? - X-ray looks like viral pneumonia.
I can't assess for a stiff neck, but there is photophobia.
Where do you want me to sign? Oxygen saturation's only 78.
- What should it be? - Hundred.
Seventy-eight sounds like a passing grade.
Barely.
Put him up to four liters.
CBC, blood cultures, ABG, sed rate and a portable chest.
Hang a gram of cefotaxime in case it's pneumonia.
Pneumonia? I don't even feel like I have a fever.
The steroids prevent you from having fevers.
And push 125 of Solu-Medrol.
You're giving me more steroids? You could have a flare of the lupus with inflammation in the lung.
There's also a chance that you are throwing blood clots.
Lupus makes your blood coagulate more easily.
Have you called your own doctor? No.
- I'll call him.
- No.
Why? Because you think I'm easier to manipulate? I'm not nearly as Machiavellian as you imagine me to be.
I came here because I prefer your care.
How's it going? Easy tap when they're unconscious.
Looks pretty clear.
- Cute kid.
What's his name? - Zack.
Cell count, glucose, protein, Gram's stain and culture.
He's got those shoes that light up when you walk.
How do they do that? - Want to roll him back over? - What is that? - What? - That.
You didn't tell me he had a macular rash.
It wasn't there half an hour ago.
- It must be a viral exanthem.
- It could be measles.
- Measles? - Yeah.
Fever, altered mental status, pneumonia.
More likely, he has a virus with pneumonia and had a febrile seizure from the high temperature.
That is a classic measles rash.
Abby, can you hand me a tongue depressor? - Have you ever seen measles? - No.
You? Of course not.
Nobody's seen measles.
Can you? He's got Koplik spots on the buccal mucosa.
What? Or he bit the inside of his mouth when he was seizing.
There's a Nelson's in the lounge.
Can you grab it, please? Now.
- Is Zack all right? - This is Mrs.
Woodman.
I was in court.
I have to turn off my cell in session.
My God! I'm Dr.
Chen.
Your son had a seizure and a high temperature.
We've done a spinal tap to rule out meningitis.
- Are Zack's immunizations up-to-date? - No.
Has he had the MMR? He hasn't had any immunizations.
None of our children have.
- I got it.
- Abby, put a mask on Zack.
What's the matter? - What's happening? - Get him into the Laminar Flow Room.
Call the school.
Don't let anybody leave.
What's the matter with my son? - Your son has measles.
- That's not too bad, right? One in 500 kids die from measles.
Frank, I'm taking the Luiz kid up now.
Please send along the films when you find them again, will you? Yes, ma'am.
- Hi.
- Hey.
- So how'd it go? - Fine.
Fine? That's it? I laid down, they shot a couple billion more rads into my skull, and then I left.
And that's it.
Hopefully, my irradiated head won't screw up any navigational equipment on our next flight.
All right, all right.
I have to go.
- Lunch? - If I can.
Come find me.
Okay.
So did I hear right? You're done? Radiation treatment.
Just two more weeks of immune therapy.
- Dr.
Greene? - Yeah? That's great.
Did they give you the tumor back? When they took it out, did they give it back to you? Because my uncle Al, he's got his on a mantle in a jar.
Guy over there wants to talk to you.
You know, Dave, I don't really want a tumor on my mantle.
Hi.
Dr.
Greene.
Can I help you? Robert Wilson.
Is there some place we could talk? - Actually, I'm on duty.
- It'd be better if we had some privacy.
- I'm sorry, Mr - Dr.
Wilson.
Dr.
Wilson.
What is it? I work for the Illinois Department of Professional Regulation.
We've been asked to evaluate your competency to continue practicing medicine.
- Where in the hell did he catch measles? - Europe, I think.
Mom was in Paris two weeks ago, took the whole family.
She some fringe lunatic thinks immunizations are a conspiracy between doctors and drug companies? I don't think so.
Find out if there are other kids at home where the child's been, who he's had contact with over the last week.
How is he? They won't let me back there.
We moved him to a room with special ventilation so he doesn't contaminate the rest of the ER.
- Is he awake? - He's still unconscious.
He has pneumonia.
And, in all likelihood, encephalitis.
- What's that? - Inflammation around the brain.
- Did you call the preschool? - Yes.
All the children are there.
Make sure they've all been immunized.
Their parents, their siblings, anyone they've been in contact with.
There's a phone at the desk.
Tell Frank that Dr.
Carter said you could use it.
Please.
You have other children? A daughter.
I called my husband.
He's coming with her.
And she hasn't been immunized either? No.
Is Zack gonna be okay? Well, he's in grave condition with a highly contagious disease.
I'm not an irresponsible parent.
I read all the literature on the Internet, the parenting magazines.
- I discussed it with my pediatrician.
- He didn't recommend the MMR? Zack's immune system could have been weakened from vaccinations.
The immune system is strengthened by vaccines.
- Kids are exposed to foreign antigens.
- Vaccines aren't completely safe.
- I'm sorry- - They aren't, and you know it.
The connection between vaccinations and autism- There is no connection.
Dr.
Carter, Zack dropped his sats.
He's at 75 at 100 percent.
He's getting cyanotic.
I've already started the atropine.
Etomidate and sux.
I need a 5-0 uncuffed ET and a number 2 curved blade.
What's going on? There's so much lung damage that oxygen can't get into his bloodstream.
- What are you doing? - Trying to get him more oxygen.
He needs a machine to breathe? If we don't intubate him, he's gonna die.
- I'll do it.
- I got it.
Not on your first day back.
Step out.
- What? - Step out! Give me some suction.
- He's throwing PVCs.
- Oh, my God! Come on.
- Okay, I got it.
- Good breath sounds bilaterally.
Pulse ox up to 88.
Tidal volume of 150, AC of 14.
Let's keep him on 100 percent with three of PEEP.
- He's okay now? - Yeah, sure.
He's great.
Is that the bishop's? - He says he's feeling better.
- The oxygen and the medication.
So he'll be able to perform the ordination this afternoon? What? That's where we were headed when he became ill in the car.
A kid that he baptized at his first parish is being ordained as a priest today.
Where do you think you're going? I feel much better.
Your ABG shows an oxygen level of 58.
And your sed rate is 84.
Eighty-four.
Is that good? No, it's not good! It's an indication of active lupus! Stop buttoning that damn shirt.
Is Joe still outside? I think I'm gonna need help getting into these pants.
You need to be admitted to the ICU for IV Cytoxan.
Only a couple of hours.
If the inflammation in your lungs continues you won't get enough oxygen to stay alive.
If I skip the reception, I can be back here by 6.
You'll be dead by 6! - It's in God's hands.
- God could give a damn! Is there something I should sign so I can go? - You're kidding! Stephanie? - She just up and moved to Seattle.
- I thought she was living with Deborah.
- No.
She met a stewardess.
Another stewardess! Hey, we were just looking for you.
This is Christy.
Christy, Kerry.
- Hi.
- Hello.
- Christy and I were having coffee.
- I insisted that she bring me here.
I'm sorry, but a bunch of us were beginning to question your existence.
We were thinking about having dinner tonight.
You game? I can't get off in time.
But thank you for asking.
I checked your schedule.
You get off at 6.
Don't worry.
Nobody bites.
Chief, can I get you to sign off on this LOL? Head CT's clear.
-7:30? - Okay.
- Great.
We'll see you then.
- Bye.
That Legaspi's girlfriend? I heard she's gay.
I don't know.
What I wouldn't pay to drop in on that little party, huh? You turned me in? A guy from the medical board's questioning my competency.
- Don't walk away! - I'm not.
I don't wanna have this conversation in the lobby.
He wants to see my medical records.
He's planning on interviewing the staff to see if I'm fit to practice medicine.
He can pull my license! I'm concerned about your personality changes since the surgery.
I tried to talk to you, but you've chosen to ignore me.
- So you call in the licensing board-? - Keep your voice down.
They cut a tumor out of my head.
I'm sorry if I seem a little different to you.
I wouldn't come back to work if I couldn't do the job.
- What about the aphasia? - It's getting better.
If you couldn't think of the name of the drug you wanted ordered the nurses ask questions while the patient dies? - Nobody's dying! - You've been insensitive and argumentative.
- I have not! - You have been shooting from the hip.
I'm not the only one who's expressed concern.
For the safety of the patients I felt I had to call the board for an objective assessment.
I want you to pass, so we can all get back to work confident in your abilities.
Okay? Rich people think if poor kids are immunized, then they don't have to be.
I thought it stopped snowing.
If everybody stops getting vaccines then smallpox will be back, polio, measles.
Then they'll be lined up begging us to stick a needle into little Annie's arm.
Fifty-year-old male with non-Hodgkin's lymphoma.
Persistent nausea and vomiting despite Compazine.
BP's 88/58.
Pulse, 130.
Mucous membranes very dry.
Gave a liter of saline en route.
He only finished the chemotherapy last week.
Is the cancer back? No.
He's probably having a reaction to the chemo.
- How's the boy? - Which one? The kid with the febrile seizure.
- You brought him in? - Couple hours ago.
- They didn't call you? - About? Measles.
You drove an immunosuppressed patient in the same rig? - What does that mean? - Nobody told us! I'll need a CBC and a Chem-20.
Watch your step.
Excuse me.
I need to review a file of an applicant who wasn't given an interview.
And you are? Peter Benton.
I'm the new director of diversity.
- Lucky you.
This year? - Yeah.
It'd be in the reject pile.
What's the name? White.
William White.
We had over 3000 applications for 150 spots.
Big pile.
Director of diversity, huh? That position's a little quixotic around here these days.
My David wouldn't be with Morgan Stanley without affirmative action.
William Jackson White.
Thank you.
Excuse me.
Do you keep files of past candidates that were accepted? I need to compare them.
Compare to last year's acceptances.
They're over there by graduating year.
Student Affairs.
Fax it over.
I'll be looking for it.
Student Affairs.
What are you doing out here? Just getting some air.
What's the matter? - How's your bishop? - He just left.
That's good, right? He's having an acute lupus flare.
He left AMA.
So go get him.
Take some oxygen, make sure he's okay.
He knew what he was doing.
I'm not his keeper.
- So this is you, huh? - Yep.
Could use a little something.
What is that back there? My room with a view.
Cafeteria kitchen.
Vending machine only had turkey and egg salad.
No veggie.
Thank you.
Hear about our measles kid downstairs? Four years old, parents didn't vaccinate.
- What's all this? - Med school applications.
Thinking about starting over? Is this your file? This black kid applied and didn't get an interview.
I went to Records to find out why and found that.
- Yeah? Anything interesting? - Yeah.
My file wasn't with the rest.
It was in the back with three others filed under AA.
Affirmative Action.
- That surprised you? - Hell, yeah! Look, my grades were good.
My MCAT scores were competitive.
Yeah, but when I compared it to the other applicants that were accepted that year, I shouldn't have gotten in.
You're an excellent physician.
They were right to let you in.
Yeah? This is the kid's file that didn't even get an interview this year.
William White.
His grades, his MCAT scores, they're better than mine were.
Bishop Stewart? Damn it! I'm okay.
How long have you been having trouble breathing? I'm just gathering my strength.
You have to go to the hospital.
It's pretty, isn't it? The snow.
So much beauty.
Where's the phone? I need to call an ambulance.
No.
Please, I only need a minute.
You're dying.
Evidently.
As I was sitting here, I was reminded of the night I chose to become a priest.
I'd been struggling with it for a long time.
Several years.
Anyway, that night, I couldn't sleep.
So I got up and went out for a walk in the woods behind my father's house.
It was snowing like it is now.
I don't have any idea how long I walked.
At a certain point, I suddenly realized I didn't know which way to go.
I'd gotten lost.
I was frightened.
As I looked up into that dark night he came to me.
I saw all those millions of snowflakes drifting down toward me.
So still.
So peaceful.
Perfect.
And I was filled with the love of our Lord Jesus Christ.
Like pouring wine into an empty glass.
I'm afraid I may have wasted my life.
For some reason, I never accomplished the things I should have.
What God wanted of me.
And now I'm frightened.
I'm afraid of dying.
There.
I said it.
I am afraid to die.
You have to go to the hospital.
The Lord is my shepherd, I shall not want.
He maketh me to lie down in green pastures.
He leadeth me beside the still waters.
Is he all right? - No.
- Yes.
The procession is forming.
What should I tell them? Tell them I think I have to skip the processional.
When did you lose your faith? I've found with most people, it comes and goes.
Like intimacy in a relationship.
Sometimes it's so strong, a passion, rapture.
And then at other times it's impossible, distant, lost.
But that's not God.
That's us.
We put up our own barriers with our egos and our pain.
He's always there.
No matter what.
Bach.
I love Bach.
Well that's my cue.
So, Kevin, why do you want to be a doctor? I've given that question a great deal of thought.
I think it all boils down to one thing: I really want to help people.
My dad died of lung cancer and I was 12.
I vowed I would work for a cure.
My research in molecular biology has been very rewarding.
We'll see gene therapy in our lifetime.
I'm a people person.
The bottom line is, I really want to help people.
I volunteered for the Pediatrics ward.
I'm very empathetic.
When I saw my kitty suffering like that, I knew that I had a calling.
To help people in their time of need.
You have to combine humanistic skills- With a passion for making a difference.
I really just wanna help people.
- I just wanna help people.
- I wanna help people.
Help people.
How dare you? Damn it, Kerry! They sawed off half his skull.
They inserted high-dosage chemotherapy wafers into the empty cavity.
It caused temporary swelling right next to Broca's.
Of course he had a little aphasia.
But that was six weeks ago.
The swelling's gone down, and he's back to normal.
If anything, I find his honesty rather refreshing.
We could all do with more candor here.
Candidly speaking then, are you sure that you can be objective about this? Of course I'm not objective! I've been with him every moment, and I can tell you he's making remarkable progress and is no danger to anyone.
Except perhaps easily threatened, minor demigods.
He may be endangering patients.
I'm not unsympathetic to his circumstances but I have larger responsibilities.
It's despicable, and you should be ashamed of yourself.
I hope that you end up with a possibly fatal illness one day so that I can do absolutely nothing to help you.
What was that about? Some days I really hate this job.
Well, you, me and everyone else around here.
Are you ready? - Dinner? - Right.
Yes.
I just have to drop this off.
- You still got that leg lac in Sutures.
- I'm on it.
- Get there by Easter, would you, please?! - Yeah, yeah.
- Hey, Malik? - Yeah? Is this the measles kid's post-intubation film? Why didn't it go to the PICU with him? - I'll take it up.
- No, I'll do it.
I want to check on him anyway.
Phi Beta Kappa, Yale.
GPA's 3.
95.
MCATs in the 97th percentile.
- Yeah, sure.
- Peter? And Carpenter.
University of Georgia.
Was this the geek in the Smashing Pumpkins T-shirt, with the lisp? - Sarah.
Redhead, glasses.
- Yeah.
Right.
GPA, 3.
79.
Ninety-fourth percentile on the MCATs.
- Finalist for the Falsberg Science Award.
- Whatever that is.
We've got better.
Peter? No.
That's it.
We are recommending two to the full committee, rejecting 14.
Great.
I still might make it home in time for SportsCenter.
There is another candidate I'd like to discuss.
- William White.
- Who? His MCAT scores were only in the 91st percentile but his GPA was 3.
80, and he was class president.
- I don't see him on the list.
- We didn't grant him an interview.
I met with him today.
He asked me to reconsider his application.
Oh, no.
Is this that whiner I told you to get rid of? - Where did he go to school? - University of Illinois, Chicago.
My gardener could have gotten a 3.
8 at the U of I and his head was run over by a truck as a kid.
I went to the University of Illinois.
His MCATs are well below our admission standards.
MCATs don't predict how good a doctor you'll be.
Just what you do the first years of school.
- This kid is bright.
He's dedicated- - He's black.
- Yeah, he's black.
- Affirmative action's against the law.
We didn't interview one black or Latino candidate today.
We have a colorblind policy.
If he was good enough, he would've been here.
Minority kids don't have the same access to academic opportunities.
You want to address that by advancing underqualified applicants at the expense of our integrity and theirs? I want him to have an interview.
Clear.
- Still V-fib.
- What happened? Hypoxia, bradyed down to 20, then he arrested.
- Another round of epi.
- He's on PEEP? Maxed out, and his PO-2's only 39 on 100 percent oxygen.
- Charge to 50.
- Clear! Asystole.
- How long has he been down? - Forty minutes.
He's had two rounds of atropine? Lidocaine, amiodarone and dopamine.
You got any other ideas? Hold compressions.
Vicki is dating guys now, and Carol is getting married to one.
Both of these women marched in every gay-pride parade for the past 15 years.
- I don't get it.
- I do.
You get society's blessing, your family's- Survivor benefits, tax breaks.
And all you gotta do is lay there a few times a week.
I'm sorry.
We're not usually this bad.
- It's okay.
- Hey do you realize that everyone at this table has slept with Kim? - Oh, my God! - Cut it out, you guys.
I bet she brought a U-Haul on your second date, right? I don't understand.
It's a lesbian joke.
A bad one.
Do you want another drink? Actually, I gotta go.
I have an early shift tomorrow.
- Kerry- - It was really It was really nice to meet you both.
- Wait.
Are you upset? - No.
Well, why are you leaving, then? I don't belong here.
I don't belong here.
I dated Christy in college.
Kate and I dated for maybe a month- It's not that.
This isn't me.
I mean, my experience, the jokes, your friends.
I'm I care about you.
I'm not interested in adopting a lifestyle.
Wow, I can't believe you just said that.
I'll call you later.
Just drive.
Dr.
Kovac.
I was helping him off with his dolman.
He was very short of breath, and he just collapsed.
Oh, God! Bishop Stewart, can you hear me? Call 911.
Tell them we have a man with impending respiratory arrest.
Mark? Mark, you home? Mark? Mark.
Are you okay? He recommended formal competency testing.
Psychiatrists, neuropsychologists, MRI, personality tests It's gonna take five days.
I'm so sorry.
The good times just keep coming.
Luka? What are you doing? I couldn't find a forest.
What? You brought Bishop Stewart back in? How's he doing? He's dying.
He might surprise you.
We get enough miracles around here.
Why not one more? I'm freezing.
- Ready to go home? - Yeah.