ER s09e02 Episode Script

Dead Again

Previously on E.
- The surgery went well.
- So they say.
You were lucky.
Is that what I think it is? I was going through a religious phase.
It's not America.
You may have to adjust your approach somewhat.
Okay, then, he's all yours.
Watch the pericolic gutter.
He's had some adhesions from an appendectomy.
We're going home.
Q-101 time is 8:30 under partly cloudy skies.
We'll be back with the news on the hour after this 30-minute music mix.
You realize you've been in there for 20 minutes? You miss me or am I wasting water? Both.
How much longer are you gonna be? Your shift doesn't start for two hours.
There's an 8:00 meeting near here.
You gonna go? I was thinking about it.
Hello? Something wrong? Carter? What are you doing? We really can't help you anymore, sir.
I'm not a junkie.
The stuff just finds me, you know? How convenient.
I need another room for Mr.
He says Exam 3 is full of ectoplasm.
- Did you cut yourself shaving? - What? Never mind.
- Dr.
Carter - Mrs.
Breeland, you need to stay in bed.
Otherwise, we might be tempted to put somebody else in it.
Okay, I think we’re getting there.
Board number two is for the patients in the halls.
We have heat exhaustion, barbecue-smoke inhalation, and boils.
All up for grabs.
- I love my job.
- No, you don't.
Why are you dressed like that if you can't prescribe nothing? The smell of fresh med students in the morning.
What is it about them? They all seem so - Gullible? Immature? Vapid? - I was going to say sweet.
Bee sting in 1 is asking for you.
Have them start the orientation manuals.
I'll be with them soon.
- Carter, MVA, two minutes.
- But not to hold their breath.
Carter, so there's a trauma coming in.
Why don't you take the bee sting in 1, the wrist fracture in 4 and the burning rash in 2? Care to give me a hand? - Help me! - Why not? - Help me! - Hey! That's just been mopped, damn it! You don't talk if you're having a real seizure.
- Remember that for next time.
- Come on, man! - Think it's always this crazy here? - Probably.
They need to bring you back to the VA hospital, sir.
- I don't understand.
- Your driver will explain.
You guys suck, you know that? - Don't bother.
We don't have any beds.
- So, what else is new? - No, I'm serious.
Try Mercy.
- They' re refusing patients too.
- Then try Rush.
We' re filled.
- I've been bounced all over town with this guy.
I'm out of gas and so is he.
If I don't get him into a bed his UTI's turning into urosepsis.
I got to make water! Yo, doc! - You are one sadistic bitch.
- Now give me your middle finger.
I would if I could.
Any emergency meetings get scheduled? Just one, about this spate of ER closures in the area.
I've advised the board that preliminary figures show an increase in our patient load by 34 percent.
- Who'd you take to La Scala's? - Sorry? Which board member's ass are you kissing? - Now the ring finger.
- Robert, I simply compiled a report.
- Nerve regeneration's a millimeter a week.
- I'm not kissing ass.
It's not my dominant hand.
In fact, I only agreed to take on your responsibilities out of necessity.
I'll be in my office in two weeks - and back in the OR in two months.
- I hope you are.
Thought about upping your Vicodin? Ibuprofen.
I want to stay clear-headed.
- That's enough for today.
- No, keep going.
Sorry, have another patient.
Don't get comfortable, Kerry.
- Is there anything else? - Just your continued support.
- Elizabeth, how are you doing? - Fine.
Well, we'll catch up downstairs.
- I heard rumors.
- All true, I'm afraid.
The one face I missed seeing in Recovery.
I'm so sorry, Robert.
What, about my arm or about not being there? - How are you healing? - Hurts like a son of a bitch.
You? Any sensory function yet? Nope.
It's a motorcycle accident.
I have to go.
I'm sorry.
- Dr.
How was London? - Good.
Timed your trip right.
Missed the pox scare we had.
- So I hear.
- How's Ella? - Fine.
- Is it nice to be back? I'm off to the ER.
I'll let you know.
Well, good luck.
- Bite me, panty smellers! - Ma'am, you need to calm down! Die, you sucking pervert! Dr.
Corday, hi.
We need some Haldol here! - You think that's necessary? - Yes! Doctor C, looking good.
Thanks, Malik.
So, what's the GCS on this motorcycle trauma? - Sorry, I didn't do the ride.
- Oh.
Well, have the X-ray tech - come down for portables.
- You got it.
- Hold the CT till we eyeball the patient.
- Hey, welcome back.
So do you know any of the specifics? Sixteen-year-old girl, motorcycle versus utility pole, no helmet.
Carter's bringing her in.
- What's a chick doing on a motorcycle? - What's anyone doing on a motorcycle? Have the rapid infuser primed and ready, draw her up 100 of fent four of Ativan.
Make sure the airway drugs are out of the box.
- It's like you never left.
- Yeah.
Vital sign.
- We need some O-neg.
- She got a rhythm? - P.
to agonal before arrival.
- Decreased breath sounds.
Intubated for agonal resps.
Didn't know you were back.
- When did she lose her pulse? - Never had one.
- Everybody.
On my count.
One- - Hold transfer and compressions! - Asystole! - Abdomen's distended.
Pelvic instability.
Suction on high.
I need a Yankauer.
That's easily two liters.
All right, amp of epi.
Don't bother.
Obvious C-spine fracture.
She's not even a good organ donor now.
- Is her family here? - Trying to locate them.
- We can talk to them - It's fine.
Just let me know when they arrive.
if it'd be easier for you.
I could pull the trigger right now if I wanted to.
Because it's all right here.
Welcome back, Elizabeth.
Do you have time for a consult? As it turns out, yes.
What's he have? Belly pain? Only because he swallowed a handful of nitroglycerin.
No sudden moves unless you want me to blow! Milo has right upper quadrant tenderness with rebound.
I'm a human time bomb.
He needs to be cleared before we move him upstairs.
- I could go off.
- He could get hypotensive.
Are you scared? I'd be scared.
No! Give him two liters of saline - and monitor him for a few hours.
- Thank you.
Gallant hasn't turfed a case to Psych all day.
- You wanted the consult.
- Dr.
- Yeah? - We' re to capacity? Every bed, every day since Mission Hospital closed.
I thought it was just St.
It doesn't help Weaver's been gone so much.
- She's gunning for Romano's job.
- It keeps her very busy.
- Dr.
- Mr.
Guess you're still itchy? Yeah.
But there's- You need to give drugs a chance to work and quit scratching.
I think the guy next to me stopped breathing.
Great! Got a gang shootout here.
Couple DOA's at the scene.
Another rig's coming behind me.
- Where was she hit? - In the neck.
- BP's 100/76, pulse stable at 100.
- Through and through? - Saw one hole but it wasn't leaking air.
- You need a hand? - Possible SCI.
- Where is he? Ricky? - What's her name? - Alma.
Hang in there, Alma.
We' re gonna try to find him for you.
- Set up a cross-table lateral of the neck.
- Carter.
Still got med students waiting.
Want me to jump on that? Better idea.
You talk to them.
Newbies, huh? You don't wanna work here.
- Haleh, get that dead body out of here.
- And take it where? - Someplace else.
- How much O2? - Five liters by nasal cannula.
- You hurt anywhere else? They shot him! Oh, please, God, don't let him be hurt! We' re gonna find out for you, but you gotta help us.
- Do you have pain anywhere else? - I don't know.
I can't tell.
- How about your legs? - No.
I can't feel them.
Gallant, need a hand here.
We' re talking smithereens here! Have you ever seen smithereens? I'm on Psych rotation.
I really shouldn't be helping you.
- Haleh, this is a dead body.
- You ought to go to med school.
Can't take her to the morgue yet.
We' re waiting on family.
Why am I not exploding? No movement below the umbilicus.
What's wrong with me? Why can't I feel anything? You might have bruising to your spinal cord.
I need 30 mgs per kilo of methylprednisolone, IV bolus.
- Where the hell's X-ray? - Behind you.
Start with the chest.
- Please.
I need Ricky.
- Stay with us, Alma.
Entry wound, left mid-sternocleidomastoid with a large hematoma.
There's blood behind the ear as well.
Be nice to hear about that ultrasound.
Morrison's is dry.
The pericolic gutters look good.
- Bladder is- - Shooting.
Wait! Wait.
She's pregnant.
- What? - Looks like about 11 weeks.
Fetal heart rate is 140.
Baby appears healthy and intact.
I need Ricky.
It's my arm, man.
It hurts like a Do something already! BP's steady at 120.
But he's been like this the whole time.
Ricky, you need to calm down.
- Did you give him anything? - Wouldn't hold still long enough.
Good breath sounds.
Full trauma panel, chest and AP pelvis.
He's a regular customer.
Through and through to the right triceps.
You were lucky.
Yeah? You should see the other guys.
No fracture or deformity.
So, what? Just go back and forth shooting each other till all of you are dead? - An eye for an eye, man.
- Yeah.
Meanwhile his girl gets shot.
- They got Alma too? - She was hit in the neck and it's pretty serious.
- Where you going, dog? - Let me go! - Calm down! - I'm gonna kill those bitches! You already did! Repeat hemogram and update tetanus.
Keep your hand there and don't take it off until you get upstairs.
- Dr.
Corday, when you have a chance? - Be right there.
Make sure the blood bank sends type-specific straight to the OR.
Have the anesthesiologist call me with any questions.
- Are you the one? - A neurosurgeon will perform it.
He'll talk with you shortly.
- I'm sorry? - Don't let me die.
You' re one cold-hearted bitch, you know that? I don't have any damn pity for you, whore! I'm talking to you, pissface! Don't you dare turn your back on me, you stuck-up little ass-shaker! Where the hell do you think you' re going?! Pardon me.
Coming through.
Watch your back, sweetie.
Excuse me.
- Doc, I'm gonna miss the season- - Keep your cup on.
I should have been off two hours ago.
You still here? Can't leave till my patient gets a bed.
Them's the rules.
- Don't sound upset about it.
- Up to level 12.
Turn that off, disturbs the patients.
- Frank, what'd I miss? - County HHS needs to talk to you.
- Ditto, Human Resources.
- Anything from Dr.
Romano? He called half an hour ago, an hour before that.
Somebody from Dr.
Rydell's office called to confirm your appointment- Frank, 2 needs a janitor.
What the hell is this? Why is Stella Willits still on the board? I called to have her admitted to Psych hours ago.
- I haven't evaluated her yet.
- Save yourself the trouble.
She's nuts.
She's a frequent flyer with a history of bogus medical complaints.
With all due respect, I'd like to determine that myself.
The ER doesn't have time or manpower to deal with hypochondriacs.
That's what you' re for.
Get her off my board.
- It's part- - I said, get rid of her.
Gotta give you that.
- How are those medical students coming? - Fine.
I gave them three volumes of Rosen.
Carter, Urology on two.
Think you can come up with something a bit more interactive? Yeah.
Sam Polivy's back with a ureteral stone.
Abby? Those labs back on Melinda Harrell? - Let me check.
- Hi, I'm Erin Harkins.
- I'm on the phone.
- You're busy.
We get it.
Can we get an approximate time orientation will begin? Doctor? Don't tell me you're keeping med students waiting.
- Check with Pratt.
- I'm checking with you.
- Intractable pain and hydronephrosis.
- Dr.
Carter? I cannot admit him to Eight West.
There are no beds.
I'm Dr.
Weaver, Chief of Emergency Medicine.
I will give you a brief tour of the ambulance bay, after which our Chief Resident will give you his attention.
Because, as you'll learn, it's his primary responsibility.
Come on.
- Sorry.
What was that? - Demolition-site accident downtown.
- At least a dozen injuries.
- ETA? - Now.
- I gotta call you back.
Paramedics can transport using standing field protocols- - We've got multiples.
- Wait here.
- Who's on first? - Sick one.
Frank Chambers.
Forty years old, severe chest trauma when a walkway fell.
Wrecking-ball crane collapsed.
BP, 80 systolic, but headed the wrong way.
Tachy 120, denies LOC.
Crepitus on right side.
Page Surgery.
- Mr.
Chambers, can you talk? - Hurts too much.
He thought his ribs were broken.
- You are? - His secretary.
Sustained a facial lac and chest pain but refused treatment.
- You need to be examined.
- After.
He's decreased on the left.
- Let's hear it.
- I've heard it since Michigan Avenue.
Ken Ambrose, 34, tib-fib fracture with dislocation.
had to lift a flower shop off his leg.
Not a shop.
It's a kiosk! - Abdomen's soft, non-tender.
- Vitals normal, tachy at 120 with a liter in.
- Gave him ten of MS.
- Don't touch! It hurts! Okay, bear with us.
We'll give you something.
- Oh, God! I see a light.
- You're not dying.
It's just your ankle.
Oh, God! - You're supposed to help me! - Watch where you're going! - You ran into me! - Haleh? Where's the trauma? Throw a rock, honey.
Blunt chest in 2.
You look wonderful, by the way.
- Eighty-five pounds and counting.
- Good for you.
You cut your hair? - BP's falling, 70 systolic.
- Keep squeezing that bag.
- Where are we? - Flail and crepitus.
Needs a tube.
- Who has an angio cath? - Right here.
How can I help? Given there's only one, I don't see how you can.
- What is that? What are you doing? - It's a tube to help him breathe.
He has a collapsed lung, this will re-inflate it.
I need a thoracostomy tray.
All right, let's see how much air he's got in here.
Oh, God! That any better, Mr.
Chambers? Sats 88.
He's not talking anymore.
Why is he not talking? Because he can't.
Let's Betadine the whole chest just in case.
- You need any help? - Yes.
With his wife.
She's bleeding.
- I'm not his wife.
- Then you shouldn't be here.
- Where's the rapid infuser? - Got it.
We need that blood.
Let's get her on a monitor.
She refused treatment for chest pain at the scene.
I'm Dr.
Come with me.
- No.
Somebody needs to be with him.
- Okay, I'm in.
- Hook me up.
- Let us take care of him and Dr.
Kovac will take care of you.
What are you doing down there? Lewis, what are you doing up there? This guy's got no DP pulse.
It's called a trauma assessment.
Lungs clear, chest tones normal.
- Got the Doppler.
- Give it to me.
- Sweet Jesus! - Explains no pulse.
Okay, let's get a CBC, chem seven, dip a urine, chest and pelvis x-rays.
Chen, give me your hands.
- What are you doing? - Hold tight.
Ken! Have you ever been to Hawaii before? - Well, pretend that you' re there now.
- Pratt, wait! I can't believe you! I feel better.
I feel totally better! I feel totally sick.
Why would you reduce an ankle with no pain meds? No pulse is no blood is dead tissue.
In other words, I just saved your foot.
Thank you.
You' re wonderful.
- Subclavian's in.
Is that the film? - Five hundred cc's are out the chest tube.
- He's holding his pressure.
- No pneumothorax.
Looks like a widened mediastinum and loss of the AP window.
Hard to tell.
The pulmonary contusion is impressive.
One of us should go with him to CT.
Not unless you' re ready to crack the chest.
Flail chest, pulmonary contusions, and labile hypotension.
Could also be from a splenic fracture.
Carter, I'd like an aortagram.
Better yet, a TEE.
The fact he's still alive argues against aortic injury.
- Page me with the result, okay? - Elizabeth, I think there's more to discuss.
Kerry, I'm a trauma surgeon.
The last time I checked, you weren't chief of staff.
Keep me apprised of his condition.
- Okay, the last one.
- Can I go see him now? No.
We have to make sure you didn't bruise your heart or damage your lungs.
- They' re not doing anything.
- Probably just waiting to go up to surgery.
I'm sure he's stable.
I told Mr.
Chambers we were 10 minutes late.
It's a trick I use to get him to meetings on time.
- You don't call him by his first name? - He's kind of formal.
How long have you been working for him? Two years.
Six days a week, 10 hours a day.
Probably spend more time with him than his wife does.
They' re really happy though.
I mean, she's lucky to have him.
- He's a good man.
- Luka no fragments in the x-ray.
Ready to irrigate? Yeah.
Put Polysporin on the wound.
Where'd you get that one? A lowlife stuck me in the back with a switchblade.
An inch to the left and you would have lost a kidney.
Guy that did it to me got snuffed with a sawed-off.
Dude was bite-size.
That's funny? - Whatever, bitch.
- Hey, watch your mouth.
Are you almost done, man? Why? You in a hurry to go to jail? We can check on Alma.
She's probably in Recovery by now.
- That means she's okay, then? - No.
She could wind up paralyzed.
- Like, all over or just her legs? - They' re not sure yet.
Well, better if they just killed her, you know? An hour ago you were ready for revenge.
Yeah, that was personal.
It was about my name, honor.
- But paralyzed? That blows.
- Just dress the wound with Adaptic.
Hey, Luka.
- Piece of work, huh? - Yeah.
And she's pregnant.
- Who? - The girl.
Says it's his baby.
You want to tell him? No.
Do you? Not really.
I'm Michael Gallant from Psychiatry.
Stella Willits from Ohio.
Nice shiner.
I understand you have quite a few medical complaints.
- I'll need to ask you a few questions.
- Knock yourself out, hon.
Had any recent weight gain? I've been thinking about going on the Zone.
- How about dry skin? - Like the Sahara.
Give me this.
"Intolerance to cold.
" Yes.
"Arthritis, sore muscles, constipation.
" Yes, yes, and yes.
" Fatigue.
" Well, I have been kind of low-energy lately.
You have some delayed relaxation from the deep-tendon reflexes.
What about depression? - Me? - Yeah.
No, I'm glass-half-full, I'm silver-lining girl.
I'm an optimist.
Listen, I'll be back to finish.
I guess I do get a little blue sometimes.
Get this gurney out of the way.
If you haven't talked to anyone, you need to go back to the nurse in Triage.
Your food poisoning in Exam 4's been here for 11 hours- - Waiting on a consult.
- From the Naked Chef? He ate bad shrimp.
- Can I get something for my skin? - Yeah, sun block.
Can I talk about Stella Willits? - If you' re admitting her to Psych.
- She may have a reason- Just got word on Mr.
Aortic dissection.
I'm taking him up to Surgery now - unless you have objections.
- No.
Would it be possible for us to speak in private first? - Of course.
- Dr.
Weaver? - Later.
- Yeah, but I need I wanted to talk to you about what happened earlier.
Oh, for God's sake! Who left a cadaver in here? Sasha's a bit of a bad penny.
She keeps being moved while they try to locate her family.
I don't mind if you don't mind.
I'm concerned that you might be taking on too much too soon particularly in the area of trauma.
Based on? What I saw earlier.
A pronounced inability to work with others.
A lack of professional respect.
You' re joking, right? Look, it's stressful, no question.
Copping an attitude with me and my staff is not gonna make a trauma go any easier.
Kerry, I saw a dissected aorta.
In fact, it only adds to the intense pressure that we' re all feeling.
Given my position, I didn't think it necessary to seek your approval.
We all have our sensitivities.
Quite frankly, if anyone has an attitude here, it's you.
- But we can't let them interfere- - No! It's you, with your insistence on being kowtowed to at every bloody opportunity! Oh, my God! Excuse me.
I want some milk, I'm thirsty.
His landlord found him in his apartment crying, hyperventilating.
- Apparently, his girlfriend left him.
- The term would be " mommy.
" - What? - Mommy.
Well, he appears to be an Aby.
You know, an adult baby? It's a fetish in which the baby is taken care of in every way by a " mommy" or a "daddy.
" You're familiar with this condition? It's not really a condition.
It's more like a form of relaxation.
- Are you kidding me? - No, it says right here: "Abies like to relinquish control, get away from their stressful lives.
" - Mr.
Dwyer, what do you do for a living? - Shoe sales.
A foot fetish too.
This is an issue for the Psych Department.
No offense.
I am not so sure about that.
Dwyer, when's the last time someone changed you? This morning.
More than likely, he suffers from a diaper rash, which is a medical ailment to be treated by the ER.
- When are you done with this rotation? - Next week.
Remind me to give you some serious scut work.
"To Dr.
Pratt, thanks from a grateful patient.
Ken, the kiosk man.
" Amazing.
Too bad this guy didn't run a hot-dog stand.
I'm here for allergies.
These things are pushing me over the edge.
Can you get rid of them? Or give them to someone a little more deserving.
Who saved flower boy's foot and moved more patients than anybody today? Me, that's who.
You' re gonna miss me too, because I'm out of here.
- Banker's hours, Pratt? - Only if they work doubles.
Hey, Carter.
What's up with your boss? Is it true she was crying earlier? - Weaver? - Yeah.
Bad breakup or something? - Been pretty moody lately.
- Lately? I'm sorry! I think this man needs immediate attention! - You gotta help my pops! - What happened? They came in the ambulance entrance.
- I saw he was diaphoretic.
- Not asking you.
We were playing ball.
He grabbed his chest.
- When did the pain start? - An hour ago.
- Thought it would go away! - You have pain anywhere else? - Scale of 1-10, how's your pain? - Forty.
- How you feel? - Talk to the elephant on my chest.
- It could- - Excuse me.
You mind? - What are your names? - I'm Pete and he's Derek.
Can you take Pete and Derek to the TV room.
One, Pratt! Okay, here.
Come on.
Is there any way that we can wait in the doctors' lounge? As soon as you' re a doctor.
- Tombstones in two, three and F.
- Better with the spray under your tongue? No.
What do you mean by "tombstones? " It's a non-medical way of describing the line tracings on an EKG.
It's not good news, Mr.
It looks like you' re having a heart attack.
- Aspirin? - Already gave him 80.
Push five of Metoprolol, titrate morphine, start heparin and nitro drips.
- Call Cards and cath lab.
- What's going on? What's he gonna do? There's a blocked vessel.
We open it with a balloon to stop your attack.
We need your permission.
It's called angioplasty.
- Sign for me.
- Cath lab will be ready in 30 minutes.
- He's a hot MI.
- They' re finishing a pacer.
While they' re messing around, he's killing heart cells.
- It'll give us time to medicate.
- V-tach.
- Like I said.
- Charge paddles to 200.
- No pulse.
Starting compressions.
- Abby, open an intubation tray.
Let's get Cardiology in here! And, clear.
The doctors there will give you antibiotics.
Make sure to get that wound checked in two days.
- Right.
- So he's good to go? - Later, I guess.
- She's pregnant.
- Who? - Your girlfriend.
I told you, man, she's not my girlfriend! Well, whoever she is to you, she's carrying your baby.
- Why don't you care? - Why do you? Three-sixty again.
- Still fib.
- Resuming compressions.
- Is this my consult? - Acute inferior Ml.
Refractory V-fib despite lidocaine and procainamide.
Want to go TNK? Isn't gonna make it to the cath lab.
I've been pounding on him.
He'll bleed out with thrombolytics.
- Who's talking? - Pratt, first-year Resident.
Then shut up.
CPR as a contra-indication to thrombolytics has been debunked.
It's a myth.
- Forty of Tenecteplase, IV push.
- Charging to 360, and clear.
A boatload from Lake Michigan just came with alcohol poisoning.
- Kids? - Worse.
The 10-year-old was the only one sober enough to dock.
Do you think it's too late to go into Dermatology? - Excuse me, doctor? - Yes? I had a message that said my daughter was in a motorcycle accident.
Her name is Sasha, Sasha Huffner.
I'll check on her for you.
- Thanks.
- Wait right there.
- Susan, did you order a urine tox screen-? - Check my orders.
Elizabeth? - This guy with the ringworm, he's- - Can you hang on a second? Elizabeth.
And an abdominal CT with contrast and two grams of cefotetan.
- Can we talk? - I'm on my way to the OR - with a bowel obstruction, if it can wait.
- Sasha Huffner's father's here.
- Your first patient, the DOA.
- Right, right.
Look, if you want, I can tell him for you.
Why would I want that? You' re on your way to surgery.
- It's depressing.
- What's his name? - Paul.
He's standing over- - I'll find him.
Hold compressions.
- Fine V-fib.
- Resuming compressions.
How long has it been? Forty-two minutes.
Okay, that's it.
Call it.
You can stop now.
Time of death is 7: 11.
- Wife here? - She's on her way.
- You should still wait.
- Can't lie to them now.
Want to turn off that monitor? - Whoa! He's in V-tach.
- What? I can shock that.
They pronounced him.
Yeah, well, now he's got a good rhythm.
Two hundred.
Still V-tach.
That's enough, Pratt.
- Bag him.
Do it! - No! He's dead! Three hundred.
Oh, my God.
Sinus tach.
I said, bag him.
We did everything that we could.
We had three doctors working on him for over an hour.
We gave him medicine and we shocked his heart, but it didn't do any good.
- Why not? - Because his heart was very, very sick.
And it was too sick to save.
I shouldn't have made him play ball.
- I mean, he said he was tired.
- No, no.
It's not your fault.
It's not your fault.
Your dad had a problem nobody knew about.
Not you, not your mom, and not even him.
You gave him the best possible chance he had by getting him to the hospital.
He can't be dead.
I'm sorry, Pete, he is dead.
And it's very sad.
And it's very unexpected.
And it's okay to cry.
It's just a sign of how much you loved your dad.
Do you guys want to see him? You can say goodbye? Yeah.
You need to know your dad's gonna have a lot of tubes attached to him.
And it might be a little scary.
- It's okay.
- Ready? Keep the lidocaine at two milligrams per minute and page the CCU team.
- What are you doing? - I got him back.
What the hell's going on? BP's 90 palp.
He's back.
- He's alive? - He's not dead.
Daddy's alive! - Mr.
Huffner? - Yes.
I'm Dr.
I'm a surgeon here at County and I was your daughter's physician this morning.
Did you operate on her? Is she all right? I mean, where is she? Can I see her? I'm afraid your daughter died this morning.
She came in essentially DOA with massive internal injuries from a motorcycle accident.
My God.
Someone can take you to see the body.
We've kept it in the department for your benefit.
And afterwards you can make arrangements with the morgue.
A nurse can give you information about grief counseling.
She's my little baby.
Is she gone? I'm sorry.
Nobody walks out of a hospital after 40 minutes of CPR.
There was improvement.
From V-fib to V-tach.
He's either dead or should be dead.
Which means your Resident is cruel, stupid, or both! He saw a shockable rhythm in the setting of thrombolytics.
It could take 30 minutes for TNK to open the coronary artery.
- Are you defending this? - He made a split-second decision.
He was acting in the interest of his patient.
Well, he was wrong.
And now we have a vegetable with a pulse on our hands.
Well, our names are on the chart, not yours.
Pratt and I will take full responsibility for any negative outcome.
Oh, you bet your ass you will.
Hey, I just want to say thanks for backing me up like that.
A Chief Resident and a cardiologist with more than 25 years of experience pronounce a man dead.
And you decide to resurrect him.
- Yes.
But just like you said- - Think I defended you because I like you? Or I approve of the way you practice medicine? You are my responsibility.
You are my job.
And I'm doing mine.
If you wanted to shock, you could have paged me.
I could have been here in a second and we could have discussed it.
Instead, you go off! Without regard for authority or the best interest of your patient.
Now, that's not true.
The guy's got kids.
He's got a wife.
I was trying to save him- You brought the man back, Pratt, because you felt like it! Because you wanted to see if you could.
Why's he still sleeping? He didn't get enough oxygen to the brain.
So we have to wait and see if he wakes up.
You know, there's a chance he might not.
Why's that? He's just taking a nap is all.
Pete, your dad's still pretty sick.
But you saved his life.
Hey, you guys hungry? Come on.
Let's go down to the cafeteria.
I'll get you something to eat.
All right? I'll take you where the doctors eat.
My daddy doesn't like doctors, but I bet he'd like you.
You tired? There's gotta be a better word for it.
Enervated, asthenic, atonic? - Pooped? - Bingo.
Does that mean you want to stay home tonight? Not necessarily.
Anything particular come to mind? You keep working that spot, I'll do whatever you want.
You know, I do need my sock drawer organized.
Can you help me? They told me my husband was back here.
He had a heart attack.
Royston? Even though we got his heart beating again the neurologic tests showed that there's a lack of basic brain function.
- What that means is that- - I know what it means.
How long can he last like this? Indefinitely.
Did your husband leave any instructions? Did he ever express his wishes about what should be done in a situation like this? He's 42 years old.
Then I need to ask you, if his heart stops beating again do you want heroic measures taken to save his life? Or do you want to sign a Do Not Resuscitate order? Is that the right thing to do? I can't make that decision for you.
Is it the right thing to do? Yes.
- I want to thank you, Dr.
- There's no need, Mrs.
No need.
I just get, I don't know, panicky in public places.
You know, that's why you need to keep taking your Klonopin.
- Well, I hope I wasn't too much trouble.
- Oh, not at all.
Not at all.
You want to explain why Stella's still here? - I'm waiting on some lab work.
- Who said you could order labs? - No one.
I thought- - You' re here to assess psychiatric problems, not do a medical workup.
I realize that.
I think she is really sick.
- You looking for these? - What? - Her TSH level is over a hundred.
- Stella? Well, she's hypothyroid, which explains all of her symptoms.
Depression, fatigue- But not the fact that she's a con artist and a hypochondriac.
Until your rotation is over, you are not a member of this ER.
Stop doing our work, start doing the work of your current department.
- Yes, ma'am.
- But good catch.
You off soon? In a few minutes, yeah.
Do me a favor.
Discharge Stella before you leave.
I feel like crap.
I'm going home.
We sent the labs out this morning.
- She's been here for 24 hours- - Something's wrong with my dad! Hey, Pratt! Can you get in here? Mama, what's wrong? Mrs.
Royston, did you sign the DNR? You gotta help my dad.
He's in arrest.
Royston, did you sign the DNR? What's a DNR? It means that your dad is too sick for us to try to help him.
- Why can't she? - Because he's already gone, baby.
No, he's not! No, he's not.
He saved him.
- He said he was gonna be okay.
- Derek, we tried.
- Why are you letting him die? - Baby, please You gotta help.
Mama, tell them to do something, please.
Why are you doing this? Asystole.
Why? Daddy? Rominger's not an appy.
Twenty-five, male, periumbilical to the lower right quadrant.
He's a poster boy.
You can bring him back in 12 hours.
Oh, Dr.
Lewis asked that you take a look at the cholecystitis.
Page the next shift.
- Do you want to take a call from Neuro? - If it's urgent.
You forgot to sign off.
So how are you feeling? It's about the GSW you handled earlier.
Alma Salazar.
I'm fine.
- You wanted to know her status.
- What is it? You gonna tell me? She's a quad.
You' re not gonna wake him up? - No.
- Didn't you two come in together? Yeah.
I'm sure he can find his way home without me.
- You need a lift then? - No, thanks.
Have a good night.
Oh, man.
Oh, man! I don't know.
This is the craziest movie! Hey, yo.
What's all this? Pay-per-view.
Want some pizza? - Yo, Biz.
Let me talk to you for a minute.
- Yo, I'm watching a movie, man.
If I gotta come there, I'm gonna smack fire at you.
Come here, man! Let me talk to you for a minute.
Come on, man! Hurry up! Come here, man.
What's your problem? I thought I told you, man, don't come here again! Stay away from him! You understand that? - Yo, I'm saying, now you his mama, yo? - What? Yo, man, chill out! - You hear what I'm saying? - Why you tripping? Don't play with me, man.
All right, that's it! The party's over! Everybody out! Come on, man, get up! You, too, get up! All y'all! Get up and get out! Yo, my man, are you stupid? - Come on.
Come on.
- What you doing, G? Get out.
Close the door behind you.
What's wrong, G? Yo, I'll holler at y'all later? All right.
- Those are my friends, G! - Yeah? Well, this is my house.
It's mine too.
Oh, yeah? Oh, what? You pay rent? Come on.
Watch out, man.
Does that mean I can't have no friends? Just be quiet.
I'm tired.
You tired, all right.
Grouchy too.
You know those guys are just using you, right? Yo, dog.
How they blow up a whole town like that without killing anybody? They don't.
And if you shot the gun that close, he'd blow his eardrums out too.
Yo, G.
It's just a movie, man.
You ain't got to take it so seriously.
Yeah, whatever.
But she's hot, though.
Most definitely.
You right about that, G.
Yo, you still want some pizza? Hey, Sleeping Beauty.
- How long have I been in there? - Since before my shift started.
Is Abby here? Nope.
But she left you a Post-it.
And you still have a med student waiting for you.
Look, I'm sorry.
The day just kind of got away from me.
- Why don't we try again tomorrow? - No.
No, I don't think so.
I have been here for 16 hours.
I have been ignored and yelled at, and called " honey, " and "sweetie, " and " bitch" twice.
I don't smell good.
And all I've had to eat is gummi bears and Diet Coke.
I'm not leaving until I get what I came for.
This is the Admit area.
This is the center of the ER universe, where you pick up your patients' charts order labs, spend the bulk of your life for the next three months.
- How do you know who's next? - You check that chart rack.
We see people in the order they arrive unless the nurse feels they' re of high acuity.
- Then they' re moved ahead.
- Do you get to suture? If you' re supervised by an Attending