ER s10e10 Episode Script


Previously on E.
Got a medical transport plane in Kinshasa waiting to take you back.
10x10 "MAKEMBA" - Getting bad out there? - Yes.
- Merry Christmas Eve, huh? - If you say so.
- You're late.
- Yeah.
I had to walk from La Salle.
My bus crashed into a UPS truck.
Weak and dizzy in 6.
LOL with bloody stool in 2.
There's a kid who swallowed a Christmas tree ornament in 5.
- Work him up, send him to Kovac.
- My shoes are wet.
- Happy holidays, everybody.
- Where's she going? Home to wait for the ghost of Christmas past to show up.
- Thanks, Michael.
- I was afraid you'd already have it.
No, it's great.
- A kid swallowed an ornament? - Yeah.
Mom's worried about the wire hanging-hook thing.
Take a couple of minutes.
The old lady with the bloody stool can wait for you to change your shoes.
- Thanks.
- Did you get your trinket from Carter? - What? - His Third World care package.
Gone-native junk for everybody.
Kovac got some kind of voodoo mask.
I think it's Bangala.
Yeah, they use it to slaughter farm animals in some kind of satanic ritual.
Oh, here.
Go ahead.
It won't bite.
You ever send that box of stuff to Africa, Frank? Toys for Third World tots? Went out last week.
What'd you get? A box.
A tribal shaman's box.
Medicine men use it to store their potions.
Merry Christmas, everybody! Welcome to Calcutta.
Come on, that's it.
- Hey, what is that? - A little bit of Sikh rap.
A little Sikh rap.
- Are you ready to go? - No, keep dancing.
She's good.
Okay, I'll be back for the H & P's.
- This one? - Yes.
Don't you shake it.
Oh, God.
Are you a paper saver? Mebendazole.
How romantic.
Open it.
You like it? That is beautiful.
It was my father's.
I want you to have it.
Come on, try it on.
It suits you.
Thank you.
So, what'd you get me? It had better be good.
- I hope you won't be disappointed.
- Come on.
It's kind of sentimental.
They were mine when I was little.
- Thank you.
- There's more.
I want you to come back to the States with me.
I want our baby to be born in America.
Well, back to work.
You really don't like the Dixie Chicks? Everybody likes the Dixie Chicks.
- Everybody? - Everybody with any taste.
He's weak on the right.
Toxoplasmosis? - We got a CT? - No.
So treat with sulfadiazine, pyrimethamine, colonic acid.
- Spinal tap? - No.
We have to save the taps for the patients who really need them.
And he doesn't? If he doesn't improve in a week we'll tap him then.
Hey, you looking for me? - How's our Belgian dermatologist? - Oh, suffering from first-day shock.
He'll be all right.
- So are you coming tonight? - Yeah.
Nine? - Coming alone? - No.
- What? - I think it's great.
It's nothing serious.
Nine, then.
Oh, come on.
It is not that simple.
Imperialism is imperialism.
No matter whether the conqueror claims that the conquered will be better off.
Again? "The conqueror brings with him the seeds of his own destruction.
" Heiner Muller.
Müller, right.
Americans are like sheep.
I don't understand why they aren't rioting in the streets of Palm Springs or "Atlana"- Atlanta! Two T's.
And nobody riots in Palm Springs.
They're too busy playing golf.
Democracy has been a positive force for change throughout the world.
Hiroshima, Chile, le Vietnam? Hungary, Poland, Romania.
Coca-Cola, Marlboro.
What I would give for a Quarter Pounder.
That's what I'm talking about.
American commercialism is ruining music, film, indigenous culture around the world.
Listen, from what I've heard of French rock 'n' roll you are well on your way to ruining French music all on your own.
I thought this was supposed to be a celebration.
I don't so much mind American intervention in Iraq.
The Baathists were rapists and murderers.
Hear, hear.
But I do mind America callously dismissing legitimate international concerns just trampling 50 years of carefully crafted diplomacy in pursuit of its own political and economic interests.
Makemba Likasu, Dr.
John Carter.
Kem works with the Ministry of Health.
And her friend, Peter.
I have no idea what he does.
What do you do? Ministry of Finance.
Kem's setting up an ARV demonstration project for AIDS patients.
That's great.
Has everybody ordered already? I love this song.
Come on, Walter! Let's dance.
Come on, Walter.
So, what project you working on? I'm starting a small HIV-AIDS program with money from the Global Fund.
- Anti-retroviral therapy.
- Really? - Triple cocktail here.
- Your skepticism is well-founded.
We have our doubters.
Well, can you afford to treat millions of patients, right? Meds cost $15,000 a year per person.
We can't even get IV antibiotics here.
My point exactly.
We're not using American drugs.
Another example of American commercial self-interest.
I mean, blocking the use of generics.
After the WTO ruled that poor countries could ignore drug patents India developed a generic.
It only costs $200 a year per patient.
Money we also don't have.
What is your alternative, Peter? Just to watch 30 million Africans die in the next 10 years? If we can demonstrate that these programs work then we can appeal to the U.
, to rich countries, to our own governments.
I think I just heard someone playing our song.
Imperialist Yankee dollars to the rescue again.
It's nice to know we're still needed for something.
Oh, Peter, stop pouting.
Let's dance.
It's Bastille Day, you know? Vive la révolution.
I won't be forced to say nice things about the French? No.
He's not improving.
- When did we start him on sulfadiazine? - Ten days ago.
Now do we do a spinal tap? Yeah.
Is this his wife? - Yes.
- Tell her we need some additional tests.
I speak English.
I'm sorry.
Your husband is not getting better.
So we need to do some additional tests.
- He's very sick? - Yes.
He will die soon? Not immediately.
But, yes.
- How pregnant are you? - Six months.
Do you know why your husband is dying? AIDS.
And have you been tested? No.
The children? It only takes a few minutes.
Why? Is there anything you can do to help us if we are sick? If you are HIV-positive we can give you medicine to try and keep you from passing it along to your baby.
- Yes? - Yes.
Dad's dying, end stage.
He's probably got a couple of weeks.
Mom's pregnant.
She's got two kids.
One's 18 months, the other's 5.
All the tests came back positive.
- You get a CD4 count? - She's stage 3.
They've been in the refugee camp.
She had to flee the fighting in Bukavu last March.
Has she been to a VCT center? VCT? - Counseling, community support.
- She doesn't need counseling.
She needs antiretroviral drugs.
- You wanna get her into my pilot program.
- She's a teacher.
She'll be the sole support for her family.
I'd think that would make her a candidate.
I can only enroll 10 patients a month.
We're only funded for 200 participants.
Total? How long is your waiting list? The selection committee is very particular.
How long? We take patients with TLC's under 1200.
They have to live close to the clinic.
They have to participate for five years and show consistency in taking previous drug regimens.
If they fulfill all these they're included in a list that I present to the committee monthly.
They, then, select 10 to get the ARV drugs.
We have six fully occupied AIDS wards in this hospital, Dr.
Every patient in every ward wants to be in my program.
Who would you like me to exclude so I can take your mother from Bukavu? Your AIDS drugs finally came.
The pharmacy needs you to sign your credit card slip.
Twelve hundred bucks.
Carter's paying me back.
Carter needs antiretroviral? He get a stick or something? - No.
- Well, say hello to him for me, will you? - Why don't you write a note, stick it in.
- Okay.
Leave a little for somebody else.
- You're Kovac, right? - Med student needs you down the hall.
Call a pickup for me, will you, Frank? You get used to the heat.
It's the food.
That's another matter.
It can't be any hotter than Sudan.
Thank you, Charles.
- So you've volunteered before? - Yeah.
Every year for the last eight.
- What is that? - Lasagna.
Made with potatoes? Excellent.
Halloween candy? Anything chocolate? - Who's Elizabeth? - She is a friend from work.
Friend? Is she blond? She's a redhead actually.
Are you in private practice back in the States? Yeah.
I spent 15 years at Women and Children's, OB ward.
Oh, yeah? I have a patient eight months pregnant, HIV-positive.
Husband's end-stage.
She's got kids that are HIV-positive.
- Take a look? - Sure.
How about now? - How's her CD4 count? -175.
But that should come up with the ARV's.
Good heartbeat, Mommy.
And the ARV's cut the transmission rate down to three or four percent.
So if she uses formula, that cuts it down to one percent.
- Are you living in the refugee camp? - Yes.
- And are you still breastfeeding? - Yes.
Celine, you can't breastfeed your new baby.
You could pass the virus along in your milk.
We'll get you formula, which is great stuff.
And that will help keep your baby strong.
- My milk can make my baby sick? - Absolutely.
Doctor, can I speak with you a moment? You're doing great, Mommy.
Listen, she's gonna have to breastfeed.
We get the formula in the UNICEF packs.
It's powdered.
You mix it with water.
She's gonna have to get that water from a lake or a river.
There's a 50 percent chance her baby's gonna die from dysentery or cholera.
The three percent chance of contracting HIV from breast milk, it's a bargain.
We'll get her bottled water.
Eight times a day for six months? A year? Two years? - It's possible.
- Maybe.
But it's not practical.
What do you expect?! Of course they're going to start blowing things up.
Nationalism, tribalism.
You didn't figure it out with Vietnam? - No.
We're slow learners.
- Now you come begging Europe for help.
Soldiers, money.
But not as partners, no.
You just want us to legitimize your misadventures.
- What can I say? I voted for the other guy.
- Is it always like this? The conversation is turning into something of a perennial.
If America is going to insist on bombing- Enough.
- If they're going- - They get it! We all get it! Come on, let's dance.
Come on.
- Dance? - Sure.
Where's your friend? From the Red Cross? ICRC, food convoy to Goma.
- And yours? - Peter? He's at a conference in Nairobi.
Something about currency fluctuations in the capital market.
- How's your AIDS study coming? - Fully enrolled.
All 200.
Really? Great.
- What about your adherence rate? - One hundred percent.
We have this combination pill.
So patients only have to take two a day.
Really? In America, the patients have to take seven.
Where are you from? I've been trying to place your accent.
My father was Congolese.
My mother's French.
They met when he was in school in Paris.
- Where were you raised? - London, mostly.
But my mother remarried.
Moba in the summers with my dad.
- What about you? - I was born and raised in Chicago, Illinois.
The Windy City.
Have you ever been to America? No.
But I've seen it in the movies.
You wanna dance? I am terrible.
So am I.
All right.
What's your most embarrassing moment? No, no.
Not a chance.
- Come on.
I just told you mine.
- It wasn't embarrassing so much as stupid.
Come on.
Give it up.
It involved a lack of clothing.
- Thank God.
- Looks like we closed the place.
What? You're not gonna tell me about how you got naked? What happened-? What happened to your patient? The mother, HIV and the kids? Celine? Oh, she's doing great.
- You got her to a VCT center? - No.
I got her on ARV's.
- Anti-retroviral drugs? - Yeah.
Her CD4 is over 400.
Where'd you get the drugs? I had a friend of mine write a prescription back home and ship them over.
- You smuggled them in? - No, no.
I used FedEx.
What? What? She's doing great.
Drugs entering the country have to be registered and approved by the Ministry of Health.
You didn't have the resources to include her.
- AZT? 3TC? - Yeah.
And Nelfinavir.
And that costs you $1000 a month? Twelve hundred.
Where'd she get the money? - I paid for it.
- Yourself? I could treat four patients for a year with what you're spending on your patient every month.
It took me two years to get all the approvals necessary to import the drugs arrange the funding and staff.
And you're jeopardizing it by pulling out your checkbook and sending them.
- How am I jeopardizing your work? - It's not sustainable.
What happens to that poor woman when you leave? You gonna keep shipping her thousands of dollars of drugs for the rest of her life? I was planning on it, yeah.
And who's gonna monitor her progress, make sure she remains compliant? What if one of her kids gets sick and she decides to split her meds with the child? It happens! Or if she moves back to Kivu? Is your Mr.
FedEx gonna chase all over the Congo tracking down your one patient? What happens to your patients when your funding ends? You cannot start a patient on drugs without guaranteeing you can maintain a supply.
- What? And you can guarantee a supply? - Yes.
I'm trying to show my government that ARV therapy works here.
And when they see our success, they'll realize we can save millions of lives.
I'm just trying to save one.
One's not enough! You want me to walk you home? This is mild jaundice.
Three Fansidar tablets and tell her if she's not feeling better, just come back.
John, Ms.
Likasu is here from the Ministry of Health.
- She was looking for your HIV patient.
- Celine? She was quite insistent.
Did you tell her where she was? She went to Angelique.
They're already on the ward.
- What's going on? - You shipped in drugs.
- Okay, sure.
- Okay.
Okay, what? What? I'm enrolling Celine in my pilot program.
- I thought you were full.
- Yeah, I was.
Thanks, Angelique.
So, what happened? I met this rich American who can afford to commit $15,000 a year to my study for the next five years.
- You can afford that, can't you? - Yeah, sure.
So that means I have funding for 40 additional participants and your patient seemed like the start.
What about her two kids? Don't push your luck, doctor.
Thank you.
I looked in the records room and it's not there.
Well, happy Thanksgiving to you too, jack-off.
- Hey, did Detroit win? - I have no freaking idea.
- What about Dallas? - Don't make me come and smack you.
- Are those from Christmas? - Last year? - The year before.
- Which one's Dr.
Greene? I'll need a massive amount of caffeine if I'm gonna make it to sunrise.
Here you go, Abby.
Shred it.
Look at this one.
That's definitely 2001.
- The Secret Santa party.
- Anybody hear from Carter? - He sent us a postcard a month ago.
- Put that in the lounge.
How's he doing? I don't know.
Why did you come back? Well, you were raised in Paris, London? After you got your degree, why did you come back to the Congo? My father was killed.
So I came back to settle his affairs.
How was he killed? He was on his way from Manono to Kabitena.
And his car was ambushed by rebels and CLF soldiers.
I'm so sorry.
He was an engineer.
And he worked 30 years trying to upgrade the water supply in Kivu and Katanga.
But he was a Banyamulenge driving in a Mai Mai area.
So they pulled him from his car and shot him in the head.
He believed in the goodness of people.
I came back for him.
- Here he is.
- Hey.
Need a helmet? Probably.
What's the matter? Celine didn't show up at the clinic this morning for her testing.
So when was the last time she came in? Two weeks ago, just after her husband died.
- And her lymphocyte count was still good? - Yep.
It was excellent.
Something must have happened.
She knows she's supposed to be monitored.
So how are we gonna find her? - She'll be with people from her village.
- How are we gonna find them? We ask.
When did you first notice he was sick? - A week ago.
- Has he been coughing? Yes.
But nothing is coming out.
Any shortness of breath? He cannot run.
He gets very tired.
I know I was supposed to come to the clinic.
But I wanted to wait till he was feeling much better.
I have been taking my medicine every day.
Start him on high dose trimethoprim sulfa.
Twenty milligrams per kilo per day, divided Q six hours.
Ten milligrams twice a day.
How are we set for oxygen? - Not good.
- Hold off on the O2 for now.
- Is it the AIDS? - He has pneumocystis pneumonia.
It's an infection that can take hold if the immune system is weakened.
Will he get better? I hope so.
We're gonna give him medicine, see how he does.
He looks so small and sick.
I only slept with my husband.
No one else, ever.
How bad? Well, if he gets through the pneumonia, he's gonna need ARV's.
- Do you have the pediatric suspensions? - No.
We could grind up the adult tablets.
- Figure out the dosage for a 5-year-old.
- No.
- The little boy's gonna die.
- Yeah.
You can just stand there, not do anything? - You can let that happen-? - What?! I am doing something.
I'm proving drug therapy works so we can save 1000 little boys, - Then help me save this one! - Don't you yell at me.
You go home.
You yell at your president.
You yell at your government.
You tell them that we need real money.
Not just these empty promises.
You tell them 6000 people are dying out here every- - Damn it! - They have to do something about it.
- How are you? - Great.
Still mad? I wasn't mad.
Well, Charles tells me that you're gonna take a C-140 flight into Kinshasa to get a couple more tons of rice.
No, it's MONUC's plane.
I'm just along for the ride.
It occurred to me that I might be able to talk you into picking up a few things.
- Like what? - Oh, Christmas decorations.
You know, tree, lights, ornaments, tinsel.
Tinsel? Santa suit, snow globes, that sort of thing.
Oh, and a couple of cylinders of oxygen.
- Oxygen? - You know, if you can find any.
I made a list.
- Hey.
- Hey.
- What are you doing? - Just wrapping a few Christmas presents for some friends back home.
- Hope you didn't pay too much for it.
- No, it was cheap.
Fifty bucks.
What? I'm just kidding.
It was three.
- How was your day? - Endless.
Who's Abby? She's, you know, a friend.
Really? I hope she still is.
Why? You jealous? A bit.
I think I might be pregnant.
What? How? When did? Oh, yeah.
You angry? No.
You're upset? No.
You? I thought I would be, but It's strange.
I think I might be happy.
- Do you want to have our baby? - I don't know.
Do you? You first.
I've got my program.
And we barely know each other.
It's been, what, six hours? Six weeks.
Oh, God.
I'm really in trouble.
- Getting bad out there? - Yes.
- Merry Christmas Eve, huh? - If you say so.
- Hey, Greg.
- Hey, Valerie.
- How are you doing? - Good.
- Just waiting for the holidays.
- Yeah, me too.
Except I got to work.
Too bad.
- You waiting for Mike? - Yeah.
He's supposed to be off in a couple minutes.
All right then, merry Christmas.
- Merry Christmas, everybody! - Hey, what the hell is that? Come on, that's it.
- Hey, what is that? - A little bit of Sikh rap.
A little Sikh rap.
- Are you ready to go? - No, keep dancing.
She's good.
I found six tanks.
The pilot couldn't handle the extra weight.
He only let me bring on these three.
Bilateral interstitial infiltrates and a high LDH? Yeah.
We've got him on IV Bactrim and steroids.
Pulse ox on O2 is only 78.
Is he not getting any better? He should be resting more comfortably now with the oxygen.
How about the other stuff? Dumped them in the hallway.
Yeah? Decorations? Ornaments? That kind of thing? Someone offered to sell me a fruitcake.
You like fruitcake? You didn't get any, like, decorations, or tinsel or garland? Hey, I did the best I could do.
- All right.
- What's that? - Oh, it's fantastic.
- Where did you get all this stuff? American embassy.
A bunch of their old junk in the basement.
- Friends back home sent all this? - Yeah.
The ER staff where I worked.
I asked everybody to get one gift, nothing over $20.
And looks like everybody chipped in.
How are we gonna know what to give whom? They were supposed- Yeah, they wrote on the back, see? Appropriate age, boy, girl.
A few in here for the adults too.
Package in here for you, John.
This one's heavy.
John is that some kind of doll? What'd you get? It is a card from work that everybody signed.
What's "Martin, Hall and Jacobs? " That is a law firm back home.
It's marked "Urgent.
" Oh, my God.
What? - Dr.
Romano died.
- Was he a friend? No.
No, not really.
It's beautiful, isn't it? Yeah.
It really is.
Merry Christmas.
Merry Christmas.
- Okay.
3-year-old boy.
-3-year-old- - Do you want another? -3-year-old boy.
You know what? Keep going.
I'll be right back.
He hasn't woken up this morning.
His oxygen level is too low.
Will he ever wake up? No, I don't think so.
I brought some presents for your kids from the party.
This is for your little girl.
This is for the baby.
And this is for Lamia.
Shall I open it for him? It's a truck.
Thank you.
Merry Christmas.
Merry Christmas.
They were mine when I was little.
- Thank you.
- There's more.
I want you to come back to the States with me.
I want our baby to be born in America.
I have to go back.
That package, the envelope from the law firm you asked me about? I used to get them every few months.
Then every few weeks.
Now it's every few days.
It's just something that I have to take care of.
Are you in some kind of trouble? No.
No, it's nothing like that.
My grandmother died nine months ago, and I have to settle her estate.
It's just some financial things that I have to deal with.
I kind of ran away after she died.
Ran away from what? Myself.
It's hard to explain.
I wasn't happy.
Something was missing in my life.
I can't leave.
My work is here.
It's my life, you know? I know.
I don't expect you to leave forever.
Come for a couple weeks, a month, two.
Meet my friends.
See my life there.
I give the best prenatal care.
Your program's up and running.
You got a great staff.
They'll be okay without you for a while.
How long do you have to stay? I don't know.
But we'll figure it out together.
What was missing in my life isn't missing anymore.