ER s09e18 Episode Script

Finders Keepers

Previously on E.
R.
- I'll take him up myself.
- Dr.
Romano, your arm.
Damn it! I'm fine.
Let's just- Let's go.
Let's roll.
- We’re going to Las Vegas tonight.
- Are you ready? I've asked Robert to consider sharing the chief of staff position with you.
I'd rather cut off my good arm.
Fine.
Congratulations, Kerry.
You've just become chief of staff.
That was a gift.
From a grateful patient? Grateful girlfriend.
I have meetings with department heads later.
Otherwise, I would have waited.
Oh, yeah.
Of course.
I'll have all this sent to your home by week's end.
- Dr.
Weaver? - Yeah? - Maintenance is here.
- Send him in.
What happened to Brenda? I had to let her go.
She seemed unwilling to make the transition.
Centered, right above the backs of the chairs and at museum level.
Oh, museum level.
Always hated the impressionists.
Look, it's a lateral move, Robert.
- All that sugarcoating of the truth.
- Believe me, it wasn't my idea.
Dr.
Anspaugh thought it might be a good interim step.
That's strange, because this power play smacks of a certain estrogen-based - malice I've grown all too familiar with.
- You know I wish you'd try to appreciate the fact that we're trying to do you a favor here.
What you're doing is bending me over and driving it up the chocolate highway.
Let's be honest.
You're a one-handed surgeon, Robert.
Not to mention a Human Resources nightmare and a lousy administrator who's burned more bridges than you've ever built.
You're lucky to have options at all.
- Oh, you're suggesting I have some.
- Yes, you do.
You have three.
It's this it's teaching or it's out.
- Dr.
Romano, can I get your address-? - Bite me, nancy.
I have some billing givebacks - that need to be signed.
- Not my job.
- Cardio admin's on line one.
- Take a message.
What do I tell them? That I don't work here anymore.
- Check the line.
- BP's dropping.
Pulse ox is down.
- What are you doing? - I'm taking her to X-ray.
That's what orderlies are for.
Go help someone drain an abscess.
- Yeah, but I got- - You're a med student.
Hey, green card, I want all your performance evals by day's end.
- Why? - Something to read on the can.
Why do you think? You're on my hit list.
- Who supplies the scrubs? - Allied.
Switch to Lindeman's.
They hug booty better.
The hell are you looking at? Oh, hey, everybody.
Great news, piñata out in the parking lot.
- They're here for their kid.
- They need to stop having kids.
- Clear them out or you're fired.
- What? - Let me rephrase that.
You're fired.
- You can't fire nurses.
- I just did.
Hey, pituitary boy.
- Talking to me? I lost my arm, not my olfactory nerve.
Sic Security on the bum taking a crap there and get a list of every staff member's salary, including yours.
- What was that all about? - Meet the new boss.
Get rid of this coffee machine in here! You losers can pay for your own java.
Times like this, I wish I practiced in Florida.
It's too humid.
Plus, you'd miss me.
- Well, I wouldn't miss the wind chill.
- Dr.
Chen.
How many candles? Hey, I said no cake.
- Happy birthday, Jing-Mei.
- Like you even knew.
Yes, I did.
And I got you something.
Really? I figured if you aren't busy later, I would take you over to The Grotto.
Maybe get some champagne afterwards.
- You thought this through, didn't you? - Yes.
Why wouldn't I? How you doing? Jewelry and personal accessories, all at discount rates.
No, thanks.
Ladies love stuffed animals.
- Five bucks.
- Don't make me hurt you.
This is America.
If you can't sell crap, we're not a free society.
Come on, get out of my way.
I should be back by 6.
She woke up early, so make sure she takes a nap, okay? Hey, you like the sign I put up? Yeah.
Yeah, it's sweet.
Okay, my darling.
Bye-bye.
Hey, kids love stuffed animals.
- Five bucks for this little cutie.
- No, thank you.
- It comes in pink.
I got dolls too.
- Just go.
Go, go.
My foot! My foot! Told Haleh she was fired, said it was a management tool.
Always fire someone the first day.
Lets them know who's boss.
He can call himself king as long as I get severance.
Hey, Abby.
Can you park Mrs.
Strohm here in Exam 1? No.
We lost another exam room.
We'll park her in the hall.
- Weaver never had an office.
- He'll take the lounge if we're not careful.
- And put our lockers where? - Triage? Oh, that's great.
So now our personal stuff can get stolen too.
Too late.
Brand-new leather gloves, right out of my locker.
Real leather? - Yeah, why? - Animals died to make them.
Right.
And we should all wear canvas shoes.
- Oh, God! - Could use a little help here.
- What happened? - Corday's nanny ran over his foot.
- With her freaking minivan.
I'm crippled.
- How did this become your problem? Elizabeth decided it was an ER case.
- It's typical.
We got any open beds? - Yeah, if he's a paying customer.
- Otherwise, the hall.
For anyone late - Park him here.
I'm now in charge.
Say goodbye to the warm fuzzies of the Weaver era hello to the age of efficiency and cost effectiveness.
Tardiness will result in a docked paycheck and/or letter to file.
Once get to work on time you will treat, street and do so quickly.
Any questions? Didn't think so.
Medevac, two minutes out.
Auto versus ped.
Kovac and Carter.
Keep dispositions under 20 minutes.
Doctors Lewis, Chen and Pratt, clear the board.
You get me a breakfast burrito, extra cheese, hold the salsa.
- " Please"? - Get your love at home.
Should be interesting.
Romano in charge.
Seen any movies lately? Nope.
Try that sushi place at Navy Pier yet? No.
It's good.
Long time now that you've been together.
A year? Almost.
That's nice.
Josh Rushing, 37.
Found down along old Route 10 outside of Pembroke.
- Long way from County.
- Busy day.
We go where they tell us.
Scalp lac, multiple contusions.
Probable hit-and-run.
He's suffering from exposure.
Been down a while.
Homeless? After a couple days out, everybody looks homeless.
Is Susan Lewis working today? Yeah, why? Jackknifed rig on the Dan Ryan with an SUV trapped underneath.
Damn it, we gotta go.
Okay, on my count.
One, two, three.
CBC, lytes, BUN and creatin.
Let's get an Accu-Chek.
Wallet says he's from Indiana.
What's he doing walking the back roads of Illinois? - Got a clavicle deformity on the left.
- Maybe he was exercising.
Eighteen in the right AC with a liter up.
Accu-Chek is 96.
- Not in loafers.
- Pretty isolated out that way.
- Lucky they found him at all.
- What do we got? We got a possible car versus pedestrian.
Vitals stable but unresponsive.
This is why I went to school, to practice veterinary medicine.
- On the monitor.
Systolic, 96.
- SonoSite.
- He doesn't need a chest tube.
- I'll be the judge.
Dr.
Kovac, a call for you on line one.
- Not during a trauma.
- Who is it? It's a collect person-to-person from Zagreb.
No blood in Morrison's.
- Your dad? - No free fluid, no - Someone named Gordana.
- pericardial effusion.
Catch.
May I? Hello.
Don't ever call this number again.
- Why did you do that? - Hey, you wanna talk to folks at home - dial 10-10-Call-the-Third-World.
- Okay.
C-spine, chest and pelvis to start.
He needs a rectal.
Oh, I took the liberty of checking the union manual.
You can't fire nurses.
They have their own administration.
You lodge a complaint with their manager.
Fine.
Tell Hally, or whatever, that she can stay.
She already went home.
Then have her come back.
Make sure she deducts for the time she was gone.
And give me bullet points on who I can pink-slip and for what reasons.
There are six unions on the floor.
That's 12 volumes of material.
Fine.
Do yours last.
Dr.
Lewis.
So, what's the story here? Sammy got ahold of Dad's nail gun.
- Who knew he'd use it as a weapon? - He's 7, everything's a weapon.
- This the nail-gun injury? - Yeah.
Well, Dr.
Corday's got this now.
Apparently, Sammy didn't think it was loaded.
No.
I knew.
Well, the puncture appears to have glanced off the rib.
You'll be fine.
- DT and a gram of Ancef? - Yeah.
And a Psych consult for the son, perhaps.
- How's it going down here? - Wanna hear something scary? I miss Weaver.
Fresh pot.
Enjoy it while you can.
- How you doing? - Very well, thanks.
New digs, new challenges, crappy coffee.
Interest you in a cup? I'll pass.
Smart woman.
Look, I think it's awful, just to let you know.
A waste, really, of your- Of your skills, your talent.
But I'm sure it'll be temporary.
Yeah.
Anything I can to do help? You could shoot me now.
BP's stable, 120/78.
And the tox screen's back.
No drugs or alcohol in his system.
Crit's 50.
Hemo concentrated.
Neuro exam looks non-focal.
I don't know.
On his own, no car, out in the middle of nowhere - Think he was robbed? - Still had his wallet with him.
Maybe he got dumped.
- I don't know.
- Maybe his wife knows.
He's wearing a wedding ring.
They're trying to find her.
Hundred of thiamine, just in case.
- Did you know about it? - What? - The Romano coup d'état.
- No idea.
- Does it mean anything? - We're screwed.
Push the admin meeting to 4 and tell the alderman I'm out of the office.
- Dr.
Weaver.
- John, I have to turn over a number of outstanding projects.
Residents time study.
QA of our portable-ultrasound training.
I'd be really grateful if you'd see them through.
- Sure.
- Excellent.
So how long is Romano gonna be down here? - You think it's not permanent? - Because whoever runs the department needs communication and clinical skills.
He is He's an experienced physician.
- His background is entirely surgical.
- John you have to be associate professor before being department head.
I don't want his job, Kerry, I just don't wanna have to do two of them.
All right.
Which one of you smartasses stole my crutch? You have any plans for tonight? Oh, me and this guy named TiVo, we're gonna curl up in front of the TV.
You? Everything okay? Woman I went to med school with has a patient who's very sick.
Young boy.
Is he terminal? Post-shunt tetrology with pulmonary atresia.
He's outgrowing the shunts.
He needs unifoc and complete repair.
- That's a pretty specialized procedure.
- Yup.
So special it can't be done there.
Nicky Broomer, fell while running.
Shoulder dislocation and rib fractures.
Vitals normal except for pulse of 120.
- This guy's a runner? - He's a junkie.
- He gets chased by the cops regularly.
- He fell on the sidewalk.
It was wet.
- Are you high now, Nicky? - No.
And he's staying that way.
Mint condition, the entire lot.
The sky's the limit, as far as markup.
It's yours for only 30 bucks.
Hey, I thought you said you couldn't walk, your foot hurt so bad.
I hopped.
- I'm on the phone here.
- Take two Tylenol every four hours and get a real job.
- Hey, it's at 3:00.
- What? - Cake for Chen.
- Oh, right, right.
- What do you think? Flowers or candy? - It's gotta be something she can wear.
Let's see who's losing the dispo race.
Why, that would be Dr.
Pratt, who will now be punished for his indolent ways.
Lower-back pain in 2 and an unknown intestinal disturbance in 4.
Chop-chop.
In second-to-last place we have Dr.
Lewis.
That's to be expected from one who ovulates.
She gets the maggot infestation in 2.
Of course, we have Mr.
Gallant, who's doing Cadillac workups on Yugo patients.
How are you, hon? Don't tell me.
Don't tell me.
It says right here, " My blood pressure is high.
" Well, hell, so is mine.
But rather than go to a busy ER, I stay home and take my medication.
- Have you tried that? - She's diabetic.
Her EKG is- Is unnecessary.
Give her a sublingual nifedipine and send her to clinic.
- Yeah, but that's not a- - You filling a special-needs quota here? Do you need me to say it slowly in your people's language? Sublingual nifedipine.
When you're done with her, pick up six more.
She's your patient, not mother.
They letting anyone with a check into med school these days? - Gallant is one of our best students.
- Doesn't bode well for future medicine.
Maybe when he gets his license, we'll be dead.
Typically, as Chief Resident, I assign the med students their cases.
When? Every other Tuesday? Any patient here over six hours is your failure, not mine.
Treat, turf or dispo.
You don't have a background in emergency medicine.
It isn't that simple.
- Feast or famine.
- Hey, you're back.
- Another chopper beat us.
Susan around? - Yeah.
Okay.
Your screaming isn't making our job any easier.
This is hard for him.
- Settle down, okay? - It hurts like a son of a bitch.
It's going to continue to hurt unless we pull your arm out.
- Please help me.
- Radial pulse is strong.
We should just give him more Versed or fent.
- Yes, yes! - We already did.
Should be unconscious.
- Why is he still screaming? - I don't know.
- His ribs are broken.
- That, and he's going through withdrawal.
- I can't take it, baby.
- Hey, Susan.
What? - I got a guy here says he's your husband.
- What's he look like? Tall, dark hair, flight nurse.
Yeah, that's him.
- You were in Vegas for, like, two days.
- And three nights.
We met on the plane on the way over, hung out all weekend.
Were you sober at any point? Sunday night, we wanted burgers.
So we took a cab to this drive-through.
Turns out to be a mini-chapel.
So you figured, "What the hell.
Let's get married.
" I know.
It was impulsive.
Impulsive? - Okay, it was really, really stupid.
- Susan.
I'm getting it annulled, anyway.
Haven't seen him since the wedding night.
My flight left the next morning.
He stayed a week.
- He could have married six other women.
- Do you remember his name, at least? Chuck Martin, I think.
Good luck.
Hey, stranger.
- Hey.
- Look, nifedipine is contraindicated.
I'm not bottoming out her pressure and stroking her out.
I know.
He's the one that needs to be educated about this.
And he wants to hear that from a med student.
- Obviously, he needs to prove- - Go talk to him.
If there's a problem, I'll take care of it.
- Got a lot of people scared.
- Not you? - I still need to pay my rent.
- Romano's bark is worse than his bite.
Easy for you to say.
You can walk away if you want to.
- I can't stand it.
- So Susan got married? - Can't call her indecisive.
- Can call her crazy.
When are you people gonna do something? - So I spoke to an attorney.
- Yeah, me too.
- He said annulling it should be fairly easy.
- That's what my guy said.
- I have to admit, I was a little worried.
- Why? Well, you know - it was consummated.
- Oh, yeah.
Right.
- A few times, as I remember.
- More than a few times.
- The cabana? - Right, right.
Right.
But since we never lived together, I figured it shouldn't be a problem.
- Did you tell anyone? - Like who, my mom? She'd kick my ass - if I deprived her of a wedding.
- Same with mine.
- I figured it wasn't anyone's business.
- Exactly.
- And pretty tough to explain too.
- Please, who are you telling? - You kind of had to have been there.
- Yeah.
It made sense at the time.
Guess you have to get back to work.
Yeah.
- So play hooky.
- Let's go.
- Morales, you don't write, you don't call- - No time to radio.
Twenty-four-year-old female passed out.
No trauma, no seizure.
- What? You were shopping? - We were registering.
- She's pregnant.
- Don't tell me.
You were gonna say that.
- BP's 100/60.
Sats are good.
- Do you remember falling, Debra? I remember feeling weak.
I haven't been eating.
Okay.
Start a second line and put up another liter.
- Morning sickness? - Oh, bad.
My first wife had three kids, she never even burped.
Maybe I'm not cut out for this.
- What have we got? - Debra Strickland.
Pregnant, syncope.
- Eighteen weeks.
- Hi, Debra.
- Any cramping or spotting? - No.
Okay.
Let's spin a crit, check her glucose and dip a urine to start.
That hurts? And my belly.
It never did before.
How about when I do this? - Yeah.
- Abby, can you see if Linda Woo is here? - I'll check.
- Finally get a surgical candidate? - Oh, God.
I need an operation? - Not necessarily.
- Stripe in Morrison's.
- Yup.
Probably blood, judging from her hypotension.
Probe over the kidney.
It is.
Doesn't look like it.
It's not.
- Surgery's here.
- What do you have for me? An 18-week IUP with hypotension, intraperitoneal fluid and renal mass.
Obvious ex-lap for tissue diagnosis and staging.
Who are you? Dr.
Robert Romano, head of surgery a week ago.
Who the hell are you? This is Dr.
Woo.
She started yesterday.
Do you have any medical problems or allergies? Are you deaf? - Let me page Corday.
- I'll do it.
BP is dropping, 86/62.
Any moron can see she needs surgical intervention for hemostasis.
I'm sorry, what's your position here? Your practical and intellectual superior with 20 years of surgical experience versus the two years of ass-wiping you call residency.
- Take her up.
- Done.
He was diagnosed at birth.
But access to any kind of care has been limited at best.
- He's been revised? - Twice.
The last time, five years ago.
And the surgical team that performed it in Croatia has disbanded since then.
And there's nothing else in Europe? Nothing they can afford.
County's pediatric thoracic group does unifocalization, free of charge.
Yes.
But he's not a citizen.
Neither are we.
But we are here.
Even if you get a surgical team to donate services, who's gonna pick up the tab? With some PR, charitable contributions could cover it.
But Kerry would still have to sign off on it.
Are you on good terms with her? - Not really.
- Well, neither am I.
- Leave it with me.
I'll see what I can do.
- Thanks.
- Where's Dr.
Woo? - She left.
You need to teach them to have thicker skin.
- She cried a little.
Pratt's consoling her.
- Oh, dear.
Right.
- Intraperitoneal fluid and a mass.
- Pregnant with profound hypotension.
My guess, renal-cell CA.
Necrotic mass obscuring and deforming the capsule of the kidney.
Bleeding across the peritoneum, more likely metastases.
She'll need surgery.
- Hello.
- I'd like a CT of the abdomen if I can.
And have OB involved as well.
She's stable now.
Why don't we get a third consult.
Maybe ask the janitor what he thinks.
I'm down here less than a day, already I'm starting to hate surgeons.
Is something wrong with the baby? No.
The baby's quite healthy, actually.
- Dr.
Romano, you have a minute? - Less than.
It's about my high-blood-pressure patient.
I should've pointed it out to you.
Use of sublingual nifedipine is no longer indicated because of case fatalities.
I never said nifedipine.
I said metropolol.
Works fine for hypertension.
- You said nifedipine.
You said it more th- - Listen.
I'm the doctor.
You're not.
- Seems that if it is your intention to run- - My intention is to serve my time without having affirmative-action imbeciles like you make me regret ever having gone into medicine.
Minute's up.
- Hey, where are my bullet points? - Right.
Well, you can't fire medical students.
But failing them is bad because they have to repeat the rotation.
- I'd suggest a marginal pass.
- What else? - You can, however, fire care partners.
- The hell's a care partner? It's like a non-union orderly.
Hey, you.
What's your name? - Jim.
- Yeah.
You pay union dues, Jim? - No.
- Good.
You're fired.
- I need something.
- That is putting me on edge.
- Was worse when his girlfriend was here.
- Tell Lewis to gag, sedate or kill him.
- She's on break.
- Is there a prerequisite for working here? You have to be a know-nothing drag-ass who doesn't wear a watch? I suspected Weaver would kill her mother to get out of here.
Now I know why.
Only the chief of emergency medicine is concerned with clearing the board.
- You gotta help me.
- Hands off, lowlife.
All right, you.
Where are your parents? I don't have any.
They died in a car crash last year.
- Bummer.
What's your problem? - I need it bad.
I need something real bad.
- Let me guess - Could you move him to Exam 4? - My pleasure.
Come on.
- Jerry.
Wait.
Just one more paragraph in the lab-tech union manual.
Make sure that I see all Romano's patients before anyone gets dispo'd? - Sure.
- Thank you.
- Thank you.
- Doesn't mean you don't work with him.
Okay, where were we? I reached for the soap, down I went, landed right on my rump.
Well, that's not good.
Any loss of consciousness? No.
Just loss of dignity.
- I know, I know.
I'm late, I'm late.
- I had to move Nicky.
- He was driving everybody crazy.
- Thank you.
I sent up labs on your hyperemesis patient.
- Dispo'd your no-longer-itchy rash guy.
- Was I gone that long? You take Sandra, we'll call it even.
I gotta check on a patient.
- Done.
- Slip and fall in the shower.
Possible wrist fracture.
Congratulations.
- On what? - Your newlywed status.
- Lucky.
- Excuse me? I've been looking for Mr.
Right for The last time it happened, they kept me.
You done? I think so.
What happened to your arm? Are you incapable of keeping your mouth shut? - Were you born that way or something? - None of your beeswax.
Breathe deep.
Hey, what do you do for soft asthma? A couple of nebs and some prednisone? You're asking a nurse? Yeah, what you said.
Only, I take an adult dose now.
What he said, I said.
Then discharge with follow-up.
Okay that took all of eight minutes.
See, people? It can be done.
What can be done? Oh, BS'ing your way through a shift, I suppose.
Listen, I didn't mean to be nosy before.
I was just making little talk.
- Small talk.
- Dr.
Kovac, exposure guy is coming to.
- Any word on his wife? - They're still trying to get ahold of her.
Mr.
Rushing? Mr.
Rushing, can you understand me? - Yeah.
- Do you know what happened to you? Car - crashed.
- Your car? Where are they? Who? My kids.
We were driving walked to get help.
- Oh, my God.
- Go get the police.
His kids are still out there somewhere.
- So how long have you been married? - Two years.
Some people think the age difference is a problem, but I can't keep up with him.
We're gonna minimize the exposure to protect the baby.
- Our little accident, Bill likes to call him.
- Oh, you're having a boy? Just a guess.
Will you be able to tell? - No, not with this.
- Oh, good.
I wanna be surprised.
You have to lie very still.
And there's an intercom in case you wanna talk.
CT abdo-pelvis with - and without.
- Fine cuts right through the kidney.
When we shoot the rest of the dye in, you may continue - to feel a warm, tingling sensation.
- Okay.
There it is.
Smaller masses in the abdominal cavity too.
Hey, I'm just the tech.
Hematoma and fluid from where the main tumor bled.
- She's gonna need a nephrectomy.
- Yeah, like now.
I guess Romano was right about one thing today.
Is it almost over? What are their names? Sally and Tim.
Do you know how badly they were hurt? It was dark.
I just remember crying.
BP's stable, 128/80.
Pulse is 106.
They were so scared.
- Luka? - Another liter of warm saline.
Do you recall where it happened? - Do you recall when it happened? - No.
They're dead, aren't they? - We're trying to find them.
- I'm gonna start calling some of this in.
- He's near the six-hour mark.
Stable? - Just finishing up a Heimlich.
Which is the cheesy ER way of dealing with a pneumothorax.
I did it so he could stay here in case his family is found.
Turf him to Medicine, let them hold hands and sing there.
- His kids could be seriously hurt.
- But he's not, get him out of the room.
- Look- - Mandatory therapy making you soft? Do us both a favor.
Stop seeing your shrink.
I mean, I don't believe in it.
And frankly, if you're that screwed up, quit.
Where the hell have you been? Get back to work.
Hey, welcome back.
Right.
X-ray's backed up and she's complaining of a headache.
Get her to Curtain 3 and give her Tylenol.
You could use a lunch tray by now.
What I could use is a husband.
Does yours have a brother? Damn.
Hey, Kippy, my man.
What's happening? - Foot still hurts.
I should sue you clowns.
- I'm in a rush.
What you got for ladies? Stuffed animals.
No, man.
I need something that a lady can wear.
Got some handmade jewelry, some perfume, tie-dyed T-shirt.
Wait, I got some new items in.
How much? - What's this doing here? - We have cake when there's a birthday.
A woman pops a kid out, what difference does the day make? No more official or unofficial birthday recognitions.
Oh, you can't be serious.
Singing, blowing out candles, eating.
By the time it's done - everybody's had a break with pay.
- It fosters community.
And lethargy, by the looks of it.
Sandra Haycox.
What about her? - Broken wrist.
Cast her and cast her off.
- She's complaining of a headache now.
Have her take a number and get back in line.
One complaint per visit.
Hey, who ate my cake? - Nana, Nana! - What happened? Eight-year-old, front-seat passenger in single-car MVA.
Airbag deployed.
- Pretty hard, from the looks of it.
- May have a ruptured globe.
- Why was she sitting in the front seat? - Ask Grandma.
The tumor outgrew its blood supply.
Then part of it died, ruptured and bled.
That's why you passed out.
It could rupture again at any moment.
So it's important that we remove it and the kidney as soon as possible.
What kind of a tumor is it? We don't know.
And we won't know until we get a pathology report.
Do you think it's cancer? Let's take this one step at a time.
My mother died of cancer.
- And if that's what this is, I should know.
- Debra- I should know.
It appears likely to be renal-cell carcinoma, yes.
And if it's as aggressive as it seems, it's possible that you would require chemo and radiation therapy following surgery.
Unfortunately, chemotherapy is unadvisable while pregnant.
You said it was aggressive.
- Yes, but- - Take it out.
Take everything.
Are you saying you wish to terminate as well? Just- Just do it all at once.
Typically, those procedures would be done separately.
If you had surgery and waited until the baby was born- I want the chemo.
- Honey- - I want it now.
We're gonna leave you alone to talk.
I guess she figures she can try again if she beats the cancer.
Three weeks, the fetus is viable outside the womb.
She could fight it then.
She doesn't wanna take that chance.
She's young.
She's scared.
Yeah.
PH is still over nine.
Pilar, how many fingers do I have? Think the blindness is temporary? I've seen alkali keratitis go both ways, but this doesn't look good.
- How's Grandma? - She needs an immobilizer for her knee.
Otherwise, she's fine.
What a difference height makes, huh? Why would anyone put their kid in the front seat? She begged me to.
She's my only grandchild.
I just wanted to make her happy.
Could you grab a couple of Morgan Lenses from the eye-exam room? - Yeah, sure.
- Okay, this isn't going down - as one of my better days.
- I think that applies to all of us.
Wait a minute.
Why is it quiet all of a sudden? - Unbelievable.
- It was too hard to watch.
So you went out and scored? - You weren't doing anything.
I had to.
- You want Narcan? Put him on a monitor.
At least someone's happy.
Of course, it would be pro bono.
You looked at our budget? Every time we open our doors we're pro bono.
We're in a deep deficit, Elizabeth.
I could contact surgeons and specialists, ask them to donate their services.
Which would account for 25 percent of the total cost.
Forget about Medicaid.
The boy's not even a citizen.
That might interest the media.
Look at the separation of the Guatemalan conjoined twins.
I don't think a Croatian kid needing a tet repair is gonna get the same draw.
Kerry, he's 9 years old.
He'll die without it.
And we're just not able to help right now.
I'm sorry.
Kerry, can I ask you something? Are you as concerned about Robert as I am? More precisely, his mental health.
He seems broken by this assignment.
He's a cockroach.
He'll refuse to evolve and yet survive us all.
- Talk to me about Residents.
- You need documentation.
But you have a more powerful weapon in scheduling.
They don't pull 16 shifts a month or work more than three nights in a row you can book them for every weekend, holiday or playoff night you want.
- Good stuff.
- Thank you.
How come the delinquent hasn't been dispo'd yet? That was on my list of things to do.
You didn't give Eddie enough prednisone with his albuterol.
Let me get something straight.
You overrode my orders? Yeah.
Before he can leave, he needs to be able to walk and hold normal sats, which he can't.
- You screwed up.
- No, I did not.
- Maybe you haven't been listening.
- There's basic medical treatments - There's people here who can help- - You don't question my judgment.
And you sure as hell don't get too comfortable here, Dr.
Carter! This is my ER now! That stands for one thing: Everyone's replaceable! Even you.
I need to know what to tell the guy.
All right.
- That better be a local call.
- It's a police matter.
- They haven't found the car? - We checked every road, bridge, river - within five miles.
- Why not 10 or 15? - He can't have walked that far.
- He was getting help for his children.
- He could have walked 100 miles.
- What can I say - we already covered a lot of territory.
- Search teams? It's 40 degrees there.
Look, we're doing all we can.
- Luka, where's Dr.
Romano? - I don't know and I don't care.
- Hey, Chuny.
How's it going? - Don't even.
- John.
- I thought you were long gone.
Yeah.
I just wanted to check and see how Robert was doing.
As expected.
He was abysmal.
He has no patient rapport, stunted interpersonal skills and he's hostile.
- Qualities consistent with surgeons.
- He doesn't know what he's doing.
He almost killed a patient by prescribing antiquated treatment.
But obviously you stopped him from doing so.
- I can't stay on top of the guy 24/7.
- We're shifting him to administrative.
- You gonna chain him to his desk? - The ER may not be the best fit for him but it's all the man has.
Just make it work.
Or better yet, work around him.
- Okay.
- Excuse me.
I'm Diana Rushing.
I got a message saying my husband's here.
Dr.
Kovac.
He treated your husband.
- What is it? - It's Rushing's wife.
- I'll take you to him.
- Is he okay? I've been worried sick.
I'm from Indiana.
He's stable, but he's obviously very upset.
When did you see them last? He left home four days ago.
Who's "them "? Your husband and your children.
What children? He said he was with them in the car when he crashed.
We don't have children.
Her caretaker says she's complained of white discharge.
- She have her period yet? - She says she's a real woman.
- I'm Dr.
Lewis.
How are you feeling? - Good.
We're gonna do a test on your private parts, okay? Set up for a pelvic.
It's probably a simple yeast infection.
Sandra how's your headache? Did the acetaminophen help? Sandra? Sandra? I need a crash cart.
- She came in with a broken wrist.
- She did.
- What happened? - I don't know.
Pulseless and apneic.
V- fib.
Charging to 200.
And clear.
Unit number six going up.
Tumor mass has invaded the renal artery wall and sections of the vena cava.
- You want me to call? - Won't tell me anything I don't know.
Stage IVB, by the size and the spread of it.
Take the kidney.
Dr.
Corday, call on line one.
If it's Path, put it on speaker.
Pedicle clamp in place.
- Metz to divide the vessels.
- Dr.
Corday? Yes, Dr.
Meechum.
What are your findings? Fuhrman grade IV with a sarcomatoid pattern and a high mitotic picture.
Sorry.
Thank you.
Done.
Steel bowl.
It's bad, I take it.
Irresectable.
We'd be doing her a favor if she bled to death.
Her chance of survival is less than Get her husband up here.
I want to speak to him.
Charge again to 360 and clear.
Asystole.
It's been 20 minutes.
Try another amp of epi.
And clear.
No pressure, no pulse.
A headache, a fall, possibly jogged an aneurysm she already had.
No way you could have known about it.
No way she could have known about it.
Yeah, I'm sure she wasn't planning on dying today.
He's depressed.
That, combined with aspects of dissociative disorder allowed him to create this weird negative amnesia.
Was it a psychotic break? Not per se.
But he definitely needs inpatient psych care.
When he talked about them, he made them sound so real.
To him, they are.
Right now, anyway.
But they won't always be.
With the right meds, it'll all fade away.
Cervical motion tenderness.
PID? Yup.
Mindy, do you have a boyfriend? You're pretty young to be having sex much less unprotected sex.
You need to tell him to use condoms.
What are those? That's not a good sign.
Can you tell me his name so we can make sure he gets checked? He cleans floors.
He says he loves me.
Four hundred of cefixime and a gram of azithro.
We're just gonna help you get dressed, okay? Oh, man.
You want me to call the facility? Call the police first.
This has been one of the worst days of my life.
- Careful, don't jinx yourself.
- Goodnight, everyone.
- Happy birthday, Dr.
Chen.
- Oh, thanks.
- Hey, my gloves.
- What? Camel-colored with lambskin.
Are those mine? - No.
- No, no.
Greg just gave them to me.
- They were in my locker this morning.
- So? I bought those out on the street.
You bought these on the street? - Yeah, from Kippy.
But it's a long story.
- Oh, my God! - I'm sorry.
- Listen, I'm sorry.
I mean, what do you-? I can't believe you bought my birthday present on the street.
It was a good deal.
They're genuine leather.
If I were you, I'd put them under a Wood's lamp.
Nice.
- Hey.
- Hey.
- What are you doing here? - We're not supposed to see each other but I figured if your day was as bad as mine, you could use some company.
Well, 8-year-old blinded by an air bag, woman keels over of an aneurysm junkie shooting up in the ER and a Down's syndrome girl with the clap.
Family of four trapped in a burning vehicle, one kid survived.
18 months old.
You win.
What'd you get? Oh, the burger and fries we never got.
Knit one, purl two.
If you take much longer, you're gonna be sewing scabs.
If I go faster, the edges don't evert well.
I love watching med students suture.
It reminds me how good I am.
Was.
- What did you say? - He said, "Was.
" Loose stools in Exam 4.
Knock yourself out.
Almost there.
Skin stapler will be next.
- Cut, please.
- Pressure's steady at 110/68.
He's here.
Mr.
Strickland I'm afraid we've discovered a highly malignant and inoperable cancer.
Oh, God.
- Stapler ready.
- Your wife's chance of survival even with the most aggressive form of chemotherapy, is extremely poor.
But not impossible? The one sure thing is that she will survive long enough to deliver your baby if she doesn't seek treatment.
But for that to happen, you'd have to reverse her decision.
- OB's here.
- How close are we? Almost closed.
Mr.
Strickland if you wish to overrule her decision, you need to do it quickly.
The GYN team here is standing by to perform an abortion.
I want her to live.
Your wife is going to die.
She's gonna fight this.
Do you understand this baby has a chance? - I can't, I just can't.
- Dr.
Corday? - Dr.
Corday? - Mr.
Strickland? Let's get her draped.
Start with the sterile spec.
Another? Yeah.
And stop skimping on the peanuts.
Hey, how about putting something on for those of us in the room without hairy knuckles.
Something wrong with this show? Yeah.
It only appeals to adults making less than 20 grand a year.
Thirty grand.
Oh, car wash gave you a raise.
Good for you.
I'm a copier tech.
Well, that explains the dirty fingernails but not why you enjoy watching half-naked chunky trunks pull tractors with their teeth.
Must be a sort of homoerotic thing for you.