ER s10e13 Episode Script

Get Carter

10x13 "GET CARTER" Oh, look.
Here they are.
- Hey.
- Hi.
Good morning, Ella.
- Hi.
- Happy birthday, Sydney.
- You ready for your party? - She's been ready for a month.
We’re going to the aquarium, and then we’re having a puppy party.
- It seemed like a good idea at the time.
- I put her present in Ella's backpack.
- Thanks.
- You’re awful brave taking this on alone.
- Hey, you’re welcome to come with us.
- Yeah, Mommy.
Come with us, please? Oh, Ella.
I have to work in the hospital.
I'd come if I could, but I have to do a pancreaticojejunostomy at 9.
- No problem.
- I'll come another time.
I promise.
- You have fun at the party.
- Okay.
Thanks, Dave.
I'll pick her up around 6.
- They'll be into their sugar rush by then.
- Marvelous.
All right, girls.
Love you.
- Bye.
- Bye.
Do you think I could talk to the Infectious Disease department? It would be great to compare adherence statistics for HIV patients in Chicago.
- I could arrange that.
- And it would be helpful if I could spend time in your clinical lab.
Though the chances of us getting one are remote I'd love to take a look at the current-generation flow cytometer.
Hand-counting lymphocytes under a microscope is the best I can do now.
I gotta check with Dr.
- Frank, have you seen Dr.
Weaver? - Try the lounge.
Be right back.
Breakfast pirogi? His dedication to the staff and patients will be hard to - Kerry.
Didn't mean to interrupt.
- You didn't.
- Have you seen Dr.
Lewis? - No.
I just got on.
Would you mind if Kem observed today? Yeah.
She has her Master's degree in public health.
That's no reason to punish her.
Give the poor woman a credit card, Carter.
Let her have some fun.
I tried that.
She would like to speak to the Public Health nurses see how we track communicable diseases.
Maybe she can motivate some of these slackers.
- Frank, where's Lewis? - Got me.
Okay, I want everybody in the lobby at 9 for the dedication.
What dedication? They’re renaming the hospital Romano Memorial.
- Not kidding.
- Where's Kem? Do the patients with sexually transmitted infections get routine HIV testing? Sometimes.
Depends on the doctor.
- Do you refer them to your STI clinic? - I don't think we have one.
- You talked to Dr.
Weaver? - Yeah.
She said everything's fine.
Kem's gonna be hanging out today.
Why? Morning, folks.
- Ride-along? - Yep.
Interns have to do paramedic ride-alongs twice a year.
- Lets them see real medicine.
- Yeah, right.
You might want a couple steroids before lifting this one, doc.
a flight of stairs complains of back and diffuse abdominal pain.
Frank, did any labs come back on the Gorham kid? - Frank? You all right? - I think I'm having a heart attack.
- Are you kidding? - Do I look like I'm kidding? Okay, here.
Here, sit down.
Sit down.
I need some nitro over here.
That feels a lot better.
You know, I bet it was just those breakfast pirogis.
- Hey, check you out, Mr.
- What, you have a deportation hearing? Have another pirogi, Frank.
Luka, could use a set of hands here.
- I'm not on.
- Just for the transfer.
- Where's Dr.
Lewis? - Did you check the on-call room? - She was sleeping.
- Are you kidding? She didn't feel well.
Do you need something? Yeah.
I need someone to run the department.
- Can't help you there.
- Hey, Susan.
The Medical Executive Committee has authorized a nationwide search to look for Romano's replacement.
Until we can find a suitable candidate, we'd like you to step in.
Kerry, thank you for the vote of confidence, but I I'll pass.
I'm going home.
- It's an extra 3 grand a month.
- Do med students qualify? - I'm sorry, but I'm just not interested.
- Why not? I'm pregnant.
Cleanup on aisle five.
I'll phone upstairs as soon as I'm done here.
Please let me sit up.
I can't catch my breath.
You got too much weight on your chest.
We need to get an x-ray of your neck.
No, you don't.
We can use the NEXUS criteria.
If he's alert and sober without any focal neural deficits distracting injury or neck pain, then he's low risk for a C-spine fracture.
- Any pain in here, sir? - No.
- What are you doing here today? - I'm giving a lecture to students on clinical decision-making without the use of ancillary tests.
Look towards me.
Now look at Dr.
- Any pain there? - No.
- That's cool.
- Our health-care system requires us to diagnose with a minimum of tests.
Maybe Kem can sit in on your lecture.
She's doing a little recon in the hospital today.
- I never taught in a classroom.
- Oh, you're a natural.
Okay, his neck's clear.
Let's sit him up.
Ready? One, two, three, go.
HemoCue's 12.
Trauma labs drawn.
This is exactly what I'm talking about.
All he needs is a CBC and UA.
Abdominal pain meets trauma guidelines.
I'm sending a panel.
There's no rebound or guarding.
He doesn't need LFTs, amylase.
Doesn't need to be typed and crossed.
Nurses follow protocols.
- They're unnecessary.
- You know what? Save the lectures for your med students.
The nurses don't want to hear it.
Weaver says to get your butts in the lobby pronto.
Robert Romano was a fixture in this hospital for years.
His dedication to the staff and patients will be hard to forget.
And his generosity continues even now.
- Hey, how you doing? - Very good, thank you.
A significant portion of Dr.
Romano's estate was left to this hospital to further our service of this community.
And to that end, I am pleased to announce the creation of the Robert Romano Center for Gay, Lesbian, Bisexual and Transgendered Healthcare.
This new facility will provide the latest in health services to those patients and their families.
- She didn't.
- Oh, yes, she did.
All right, that's it.
Back to work.
Pratt, you missed your appointment - with Bob Harris in Risk Management.
- I was busy.
I got you another appointment in 30 minutes.
Don't be late.
Is it just me, or do the eyes seem to follow you? Was Romano's prosthetic arm destroyed in the accident? - Why? - Because if it wasn't it's gonna hunt Dr.
Weaver down and strangle her.
- He wasn't a big supporter of gay rights? - No.
Not really.
That's too creepy.
Did I miss the dedication? More like post-mortem payback.
Oh, my God.
All right, looks clear to me.
What do you think? I think we should discuss it over dinner.
- Really? - You like Moroccan? - I'll eat just about anything.
- Pratt! Approximately 20-year-old male, feet versus tree at 30 miles per hour.
Was he thrown from a car? This thing is frozen.
His buddies wrapped him up, tied him to a toboggan and sent him down a hill.
He bounced off the tree and wound up in a creek.
I can palpate a decent carotid, but we can't get his arm out for a BP.
- It looks like bilateral foot fracture.
- We may have a spinal injury.
- Maybe we should get Carter.
- What's wrong with you? Come find me later.
Get 10 liters of warm irrigation solution so we can throw off this blanket.
And let's cut off this tape so we can do a proper assessment.
I hate this time of year.
We must get 30 slip-and-fall calls a week.
Right, Bardelli? - At least.
- Here's an idea.
If it's icy, and you're old, don't go outside.
Save yourself a broken hip.
I told you what would happen if you didn't listen.
You call 911 for paramedics? - Feel like a threat? - Screw you! Hello? Someone hurt in there? Stop it! You're hurting me.
Stop! I'll call the police.
Hold on.
What are we doing? We need to get in.
- Not till the police get here.
- What if he's hurting her? We wait for the cops.
EMT got shot last year going in without backup.
- Open the door! - Leave me alone! Just shut up! Just shut up for five minutes! You enter two pages of demographics for every patient that walks in? - Yes.
- What do you do with the information? That's really up to the Public Health geeks.
Do you use it to track down patients who leave without being seen? You have to ask one of the docs.
So how many people leave without seeing a doctor? Look, lady, I just work here.
What kind of training do you need for this job? Dr.
Weaver, do you know how many patients leave without medical attention? How about calling off this grand inquisition? - Somewhere around 5 percent.
- Some of us are trying to work here.
I just got off the phone with Dr.
Someone's gonna phone me back about letting you take a tour of the lab.
That's great.
You wanna catch Luka's lecture? I'll just have you paged.
Luka didn't seem too keen on the idea.
- He's shy.
He'll appreciate the interest.
- Kerry are we truly to believe that Robert left a substantial donation to establish a gay and lesbian centre? Gay, Lesbian, Bisexual and Transgendered.
Whatever the hell that means.
The actual designation was left to the discretion of the board.
This is the one area where we felt that County was truly lacking.
Revenge is a dish best served cold.
Morales, the police are here, man.
Come on.
Just relax, man.
Listen, there's a woman inside.
It sounds like she's being killed.
This is the police department.
Open the door.
- Get out of here! - This is my apartment! - Back up.
- Back up.
Stop! Sit down, sir! Sit down! - She tripped.
- Ma'am, are you okay? - He pushed me.
- She's drunk.
She tripped.
- Sit down now, sir! - You're the drunk, you liar.
- You better take a look at her.
- I'm gonna kill you.
- Quiet down.
- I swear to God I'll kill you.
- Enough of that.
- It's all your fault.
Patients with peripheral vertigo do not require CT scanning.
What clinical test will diagnose BPPV? Anyone? Sheila? - Could you repeat that last part? - Come on, guys.
Positional test for vertigo.
Rectal temp is 87.
- I think he's coming around.
- What's your name? - Doug.
- You want to tell me what happened? Talk to me.
Hockey initiation.
- I'm cold.
- We're working on that.
Pleural lavage with bilateral chest tubes? - No, let's do external rewarming.
- He's groggy and under 89 degrees.
- That's criteria for active rewarming.
- He's progressing.
Get a warming blanket, heated IV fluids, and heated 02.
- What happen to him? - Doug's friends took him sledding and he wound up swimming.
Temp, - Rest of the vitals? - BP is good, 112/78.
Pulse, 106.
Sinus tach on the monitor.
- Films? - Bilateral calcaneal fractures.
And a compression fracture of L5.
Doug, can you wiggle your toes? Can you wiggle your toes, Doug? Let's get an MRI to rule out spinal-cord injury.
Lumbar compression fractures almost never have cord involvement.
- He can't move his toes.
- It's from the frostbite.
Try some warm-water immersion.
DTRs are 2 plus and equal.
- How's the rectal temp? - Pretty normal.
Sacral nerves are intact.
S2, 3, 4 keeps the poop off the floor.
- Sensory loss in his toes.
- The distribution of a dermatome.
Warm up the toes and reassess.
- I can't feel my toes.
- We're warming them up, Doug.
No, I can't feel anything.
What's happening? You broke both your heels and a vertebrae.
- What, my back's broken? - It's a compression fracture.
- Your legs took most of the impact.
- So am I paralyzed? - We're still waiting.
- No, am I paralyzed? Just tell me.
- Get the MRI.
- Look, can you call my dad? - Can somebody call my dad? - But Dr.
Carter said- Just do it.
Pratt, you're a hard man to track down.
Bob Harris.
I'm with the Risk Management department.
- I can't talk now.
- I realize you're busy.
I need you to write up your recollections of a case regarding an MVA patient, Martin Brodie.
He suffered from- Ankylosing spondylitis.
The disease turned the guy's neck into a breadstick.
Were the injuries from the car accident exacerbated by his condition? He came in having trouble breathing.
I tried to help.
- And there were complications.
- Look, I snapped the guy's neck.
Now he's a quadriplegic.
The insurance settlement on this one is gonna be in the millions.
Do you have any idea how much 24/7 nursing care in a state facility costs? Martin Brodie's a 19-year-old boy looking at what? Forty, 50 more years of total paralysis.
Have your notes on my desk by 9 a.
See you, bitch.
- Pupils equal and reactive.
- I hope he rots in jail.
Pulse, 105.
BP, 118/82 with decent sats around 94 percent.
Smells like her blood alcohol's the same.
From what I can tell, these lacerations are superficial and both her lungs are up.
Is there any chest pain? Belly pain? - Hey, Amy, stay with us.
- Where did he go? - He's been arrested.
- Listen, she's gonna need a head CT.
Keep her on the monitor, stand by with a tube in case she starts to go south.
Do you hear something? Sounds like a kid crying.
Wait! Wait, wait! It's just a kid.
It's just a kid.
Drop the gun, son.
I thought you were my dad.
With a normal neurologic exam and a Glasgow Coma Score of 15 you do not need a head CT, and you save $2000 in health-care costs.
We do about10 unnecessary scans a day.
The costs to procure and maintain the CT scanner are relatively fixed, am I right? Yeah.
So if you eliminated half the scans wouldn't that then double the costs of the tests you did do? I mean, there'd be no real savings in health-care dollars and the patient would be billed twice as much.
Wouldn't the real solution be to have several hospitals share one scanner? Did you send Mrs.
Wintermute to Radiology? - No.
I sent her home.
- What about her abdominal pain? It was more discomfort than pain.
Her husband's been off work with a workers' comp claim.
Her son moved home with his daughter - while going through a divorce.
- What, you get her whole family history? Half the people that come in here just wanna talk to somebody.
How's your son doing? Fine.
He hasn't given himself a thoracotomy.
That's good news.
- He'll probably end up a brain surgeon.
- Yeah.
Or a grave robber.
You're a glass-half-full kind of guy, huh? - Hey, how's the teaching going? - Ask Kem.
She seems to be doing most of the talking.
- Yeah.
She can be a little inquisitive.
- Yeah.
I'll talk to her.
Don't these patients have primary-care doctors? There's a three-month wait to be seen at the clinic.
Hello, Mrs.
I'm Neela.
I don't speak good English.
Can you tell me what's wrong? Why you're here? - My children are sick.
- You don't sound very well yourself.
She's from Haiti.
Do you recognize that? - Pneumonitis? - It sounds like pertussis.
- Whooping cough, really? - Hey, there you are.
John, I think this woman has pertussis.
Is that possible? Yeah.
We get the odd case.
In Chicago? - How's the lecture going? - Interesting.
Luka's an excellent teacher.
I should get back, but I think Neela needs a translator.
I think we can probably manage that.
Farina is ready to give you a tour of the Infectious Disease department.
- What about the lecture? - I think he'll understand.
Hey, Neela, can you take Kem up to five west? - Certainly.
- If you see Luka, tell him I'm sorry - I missed the rest of his lecture.
- Find me when you're done.
Check out that woman.
- Is that the domestic? - Yeah.
Superficial lacs, maybe a broken arm.
We got a kid too.
He almost shot Gallant's head off.
So how are you liking Chicago? It's very nice.
- How long have you been here? - I've been in America for seven years.
Chicago for the last three.
Do you like it? I still feel like I'm getting settled in, but it's quite pleasant for a big city, really.
- Although it's not quite London.
- No.
Or Paris.
It's much more agreeable in the summer.
- A tad warmer too.
- That is good to know.
- And the people are friendly enough.
- Yeah.
They're larger than I expected, the people.
They're quite fond of their giant portions here.
Big Gulp, supersize, monster fries, all that.
I saw a woman drinking a bucket of coffee this morning.
Actually, that's quite common.
- Is this a Med-Surg admit? - Yep.
- Let's run in a gram of Ancef too.
- No.
I just wanna go home.
I'll see what we can do.
How are we doing over here? That's okay, Rudy.
Carter's one of the good guys.
He's gonna help out you and your mom.
- Physically, he's fine.
- How are you? My ears are still ringing, but I'm cool.
- Did you call DCFS? - Yeah.
Rudy, I'll be back in a little bit to check in on you and your mom, okay? Vitals Q 30 minutes and CBC in an hour and set up a suture set with 4-0 nylon.
- Thanks.
- Doug, how are you feeling? - Better.
- Good.
- Where is he coming from? - MRI.
- I said he didn't need that.
- Pratt thought otherwise.
Look, it's not my job to make sure your residents listen to you.
I'm getting tired of doctors thinking that we work for them - or that they can tell us what to do.
- The patients think it works that way.
- I'm staying out of this conversation.
- What's with Kovac and his holier-than-thou healing hand? I'm getting sick of that.
Oh, I don't know.
Those healing hands have their good points.
Right, Abby? - Did you go out with Kovac? - Briefly, yeah.
- And Carter? - Yep.
- Abby's the ER slut.
- I went out with two doctors in the five years that I've worked here.
Hey, Abby.
Are we still on for tonight? - Yeah.
- Great.
We're studying.
And you shouldn't talk, Chuny.
Kovac gets around.
Our goal is to get all of our triple-combination-therapy patients to an undetectable viral load.
I'd be ecstatic just to be able to follow CD4 counts.
Would it be possible for me to visit the AIDS ward? It would if we had one.
Fifteen years ago we had an entire floor of AIDS patients.
Now the few inpatients we care for are on the general medical service.
We had a gentleman earlier in the week with Kaposi's but he was discharged yesterday.
It is so different from what I deal with.
I see thousands of deaths from opportunistic infections.
Well, you're welcome to observe in the outpatient clinic.
These are your AIDS patients? Breath sounds diminished on the left, I think.
He has a scar over his fifth rib.
From a chest tube.
That's right.
Some quack stuck one in me last year.
- You're not gonna do that, are you? - Not if we can help it.
Did you send the human toboggan for an MRI? - I was trying- - I told you it was unnecessary.
The guy started freaking out.
He was worried about paralysis.
- And you? - I was trying to be thorough.
So was I.
Next time you disagree with my orders, come and talk to me about it.
- Okay? - Okay.
You ready to present this? Neela.
Morgan is 64.
He has Wegener's granulomatosis which is an inflammation of the respiratory tract.
- Vitals are in the normal range.
- He's only satting at 92? - He's not taking any deep breaths.
- Because it hurts like hell.
- I told you that already.
- Sounds like pleural effusion.
- Yeah.
He needs to do a thoracentesis.
- I've already paged Pulmonology.
That's good.
As long as Mr.
Morgan doesn't mind gasping for air until sometime tomorrow.
Tomorrow? I could be dead by then.
He's had a number of bronchoscopies.
They put his lung down last year doing a thoracentesis and had to put in a chest tube.
- He'll be better off if they do it upstairs.
- He will? - Yeah.
- Or you will? You send a guy for an MRI he doesn't need because you're worried about paralysis.
Now you don't want a thoracentesis.
- So? - So sounds to me like you're still a little gun-shy from: Breaking that kid's neck.
The man has tons of scar tissue around his lung.
Besides, a thoracentesis down here only opens him up for a risk of infection.
I'll do it.
Neela, would you set me up for a thoracentesis, please? Betadine the chest.
Load up a syringe with 1 percent of lido.
I got this.
- I really don't mind doing it.
- I said, I got this.
We're gonna sit you up and drain some of the fluid - out of your lungs so you can breathe.
- It's about time.
- Does this guy know what he's doing? - You are in good hands.
- Yeah.
- And I'll be back in a little bit.
- I've been looking all over for you.
- Hey, you back already? - You should come and see this patient.
- Okay.
How did it go with Dr.
Farina? He was very nice and generous with his time and his data.
But I'm still 10 years away from the results he's getting.
Are you finished with Mr.
Yarrow? Leg lac in 2? Yeah, he's good.
Just wash out the wound give him a tetanus shot, - Anything else? - That should do it.
- Have you ever heard of Echo Free? - Let me guess.
Something that Kovac does instead of pain meds.
It's a club on LaSalle.
My friend deejays there.
A bunch of us are going tonight if you don't mind hanging around with nurses.
I don't think I'd be much good tonight.
I'm having a bad day.
All the more reason to go out with us.
Nurses make people feel better all the time.
- Hey, Pratt.
Pick up line six.
- Hey, take a message.
It's Dr.
She's calling from Shoo Goo Kin Doo - Okay.
- Somewhere in China.
I have to take this.
Hey, what's up? What? When? - What room is Mr.
Yardley in? - I'm sorry.
Listen, it's not your fault, Jing-Mei.
You know that.
A pulseless foot? You paged a surgeon? You just stay focused on getting your father better.
Lawson came and got him.
- No, no.
I was talking to somebody else.
- Who? The radiologist took him down for an angiogram and wound up giving him angioplasty and putting in a stint.
He's good.
- Yeah, I know.
- That's wonderful.
Someone could have called to tell me I didn't need to come.
Pratt, Mr.
Morgan's dropped his pressure, 86/66.
All right, look, I've gotta take this.
Here, talk to Dr.
Her mother just died.
All right.
Let's get Bordetella PCR, pertussis serologies and a culture.
- Did you get all that? - She has another kid? Eighteen-month-old.
He's at home with her sick mother.
Well, they both need to come in.
They're both probably infected.
The grandmother won't come.
She doesn't trust American doctors.
That's a problem.
Can't treat them unless they come in.
- What if we go there? - This is America.
We don't make house calls.
What? You know what.
I'm not leaving the hospital.
Do you see how many patients I have? Okay, I mean it.
Stop it.
Gallant, I need you guys to make a run for me.
I'd like to stick around with Rudy here.
Just until DCFS shows up.
- After that, then.
- Carter! Pratt needs you in Exam 3.
- Sats, 78.
- It's a tension pneumo.
- Sixteen-gauge Angiocath and Betadine.
- He's not breathing.
- Should I bag him? - It'll make the pneumo worse.
Open a chest-tube tray.
Size 8.
5 gloves.
Heart rate's dropping.
- Do you want a crash cart? - All right, slow down.
- I know what the problem is.
- Treat it.
No pulse.
- He's not breathing.
- Okay, bag him.
I knew this was gonna happen.
I wanted Pulmonology to do it.
It takes a minute for the lung to re-expand.
- Chest tube is definitive.
- Pressure's 94/62.
Coming up.
- Ten blade.
- He's waking up.
- Let's run in the fluids.
- I've got a femoral pulse.
- Curved Kelly.
- Pressure's up.
Sats, 82 and rising.
Twenty-eight French.
- Here, you want to sew this? - Sure.
Where you going? This guy's good.
I've got other patients.
- Dr.
- I'll be back.
- Hey, have you seen Pratt? - Nope.
- What about Kem? - I haven't seen her either.
Maybe they're together.
You need to keep better track of your woman, Carter.
- Hey, Chuny.
Have you seen Pratt? - Sorry.
- We have rules too, you know.
- What are you talking about? - What the hell's going on? - The paramedics needed a translator.
- You took her with you? - She's persuasive.
- She's febrile.
- She's also diabetic.
Weak pulse and was already pretty out of it when we found her.
She was still talking when we found her.
- I can't believe you would go out there.
- Temp, 40.
Accu-Chek, 252.
A full set of labs.
Pertussis PCR and culture and blood culture.
- Sounds good.
How long's she had that? - Several months.
Several months.
She said people in the building are sick.
You exposed yourself to them? Has she been coughing up anything? - Ectopy.
- Ma'am? Run in a liter wide open.
Get a 12-lead on her.
BP's dropping, 92/56.
She's septic and hypotensive.
Let's mix up some dopamine, titrate to a systolic of 90 3.
375 of Zosyn and 150 of gent.
Pertussis is not a risk to my pregnancy.
- It could be TB.
- What am I exposed to back home? Why don't you go ask Mrs.
Lemonier if her mother has any advance directives? You sure you two aren't married? Need a portable x-ray.
Get him in! Pratt! - I need another set of hands.
- I got a nasty head lac.
Get a med student to do it.
You need to sit down and roll up your sleeve, Louie.
If you don't take your Epo shot, you're gonna get sick again.
Do you want to end up in the hosp-? Hey, hey.
Help! Security! Hey, Louie.
Put her down, or I'm gonna call your mother.
- Now say you're sorry.
- Sorry.
- She didn't give me any gum.
- Well, that's no reason to pick her up.
Sit down and behave yourself.
- You okay? - Yeah.
Louie's a lifter.
He likes to pick things up, including nurses.
You have to give him gum before a shot.
Now you tell me.
Listen, about earlier, I don't want you to get the wrong idea about Luka.
- He's a good guy.
- I'm not looking for anything right now.
I just thought you should know.
Thank you.
But independence works pretty good for me.
Although I wouldn't mind some regular sex.
No kidding.
I'd settle for irregular sex.
Can you help my husband? - What's the problem? - It's my leg.
- Did you fall? - No, no.
I think she shot me.
Mom's sleeping off her bender.
She got about 30 stitches.
Her head CT was negative.
Surgery wants to watch her overnight.
BP's 110/78 after three liters.
And her crit's 41.
If they discharge her in the morning why don't we keep the kid with her? DCFS won't let us do that.
They'll wanna place him into foster care.
- It's only one night.
- Then we need to admit him.
- What? - He's looking a little dehydrated.
Complaining of abdominal pain.
Observe him overnight for a rule-out appy.
Look, if he was your kid? I'll start a chart.
Hey, Rudy.
I got good news.
You and your mom can spend the night at my hospital tonight.
- You hungry? Anything I can get you? - They took my gun.
Police took your father's gun because it's dangerous.
You could hurt yourself or somebody else.
How am I gonna protect my mom? Look, buddy, your dad he's going to jail for what he did.
Okay? You don't have to be worried about him now.
He'll get out.
He always does.
He turns off the lights so I can't see him hitting my mom or find the phone.
But I can always hear him.
- Yo, Mike.
- Yeah, in a minute.
We gotta roll, man.
Look, I'll be back, okay? I promise.
Everything'll be okay.
No cardiac motion, no effusion or tamponade.
Resume CPR.
- Zosyn is up.
Another liter up.
- Another round of epi and atropine.
Could be massive PE or Ml.
Hypovolemia possible.
Hypoxia possible.
No pneumo, hypothermia or tamponade.
All right.
Holding CPR.
- V-tach.
I'll shock her.
- Charge to 360.
V- fib.
- She's flatline.
- Wanna pace her? You ran it.
You call it.
Time of death, 5:48.
I'm very sorry, ma'am.
Maybe if she'd come in two weeks earlier, we could have - You ran a good code.
- Didn't help her any.
Carter, Abby needs you in here.
Two liters in.
Pressure's up to 120 systolic.
- Gram of Ancef.
Update his tetanus.
- What's up? You tell me.
GSW with no exit wound, I can't find the bullet.
Pelvic and chest films are clear.
Maybe it migrated to the foot.
I checked.
But let's get a foot and a tib-fib.
- I didn't even want a gun in the house.
- Now I know why.
It was an accident.
I didn't wanna use it.
First HemoCue is 12.
Frequent PVCs on the monitor.
Repeat the HemoCue in 30 minutes.
- Sir, do you have any heart problems? - No.
- Do you use cocaine or crystal meth? - No, no.
Bullet's in the right ventricle.
- Are you kidding me? - What is it? Did you find it? Bullet traveled up your femoral vein into the inferior vena cava into your heart.
- What is that? - Run of six, 100 of lidocaine.
- Can you get it out? - He'll need an operation.
- On his heart? - The bullet is irritating his heart.
Right? Yeah.
Let's page Corday and Cardiothoracic just to be safe.
And rebolus 50 of lido in five.
Help me roll him on his right side.
- Will that help it to come out? - No.
That should keep the bullet from entering his lungs.
- Is that bad? - Don't want that to happen.
You put a bullet in my heart? I shot you in the leg.
It was an accident.
- You got this? - Yep.
- Paramedics ran over our ball.
- Yeah.
Well, it happens.
So seven is my record.
- What? - We lost seven patients in one shift my second year of residency.
That supposed to cheer me up? You know, when you first got here, you were - dangerous, reckless and arrogant.
- Is this your idea of a pep talk? Hey, we all get our confidence rattled.
If you don't, you should worry.
It means you've stopped caring.
Believe me, you could do a lot more harm playing it safe.
So we're damned if we do, damned if we don't.
What do you want me to tell you? That everything's gonna be okay? That you're gonna get so good that nothing bad is ever gonna happen again? Forget it.
This is what we do.
If we're successful in our jobs, then patients live.
And if we're not sometimes they die.
Or wind up paralyzed.
Did you do what you thought was best? Was there a chance that you might have been right? Afterwards, did you tell the kid what had happened? - Yeah.
- Then quit feeling sorry for yourself.
You're a good doctor.
Start acting like it.
How's the daughter? Better than I would be if I'd just seen my mother die.
- Are you angry with me? - No.
But I didn't expect you to be doing paramedic ride-alongs.
Did you even eat lunch today? - I'll grab something.
- You need to eat properly.
- You treat the woman with pertussis? - Yeah.
Why? I think you'd better get out here.
I don't know what they're saying.
Who are "they"? They're Mrs.
Lemonier's neighbors.
I told everyone in the building they needed to be examined, possibly inoculated.
You did? - Now you're angry.
- I'm not angry.
Get everybody into Triage and round up as much pertussis vaccine as you can.
- Can I help? - Yeah.
- I love you.
- Yeah, yeah.
John, where's the man with the bullet in his heart? - He's gone.
- What, he's dead? - No, no.
They took him upstairs.
- Who? - Dr.
- Who the hell is this Dr.
Lawson? He's the new invasive radiologist.
I was supposed to pick my daughter up.
I stayed late because I was paged.
He wanted to do it so you didn't have to.
What are you doing? - You must be Dr.
- That's right.
You got involved in this case how? I was downstairs.
I saw his chest x-ray.
Well, I was the consulting surgeon.
This is the second patient of mine you've poached today.
Got it.
Advancing the guide sheath and moving south.
If there are options in treatment, we should present them to the patient so that he can hear the risks and benefits of both procedures.
I'm sorry.
I thought you'd appreciate having two fewer procedures to do today.
The bullet's in the femoral vein.
You can have your patient back now.
- What? - You can take him to the OR.
For a cutdown.
It's nice to finally meet you, Dr.
I look forward to working together again soon.
Good night.
- Hey, Dr.
- Hey.
Hey, I just wanted to thank you.
You saved my life.
Not really.
I came in here a few hours ago with a broken back, and now I'm going home.
You have a compression fracture of your vertebrae.
Yeah, I know.
But I'm not paralyzed.
Thank you.
You're the best.
Mom, can you hear me? Mom, wake up.
- Mom.
- Hey, little man.
- What's happening? - My mom won't wake up.
It's all my fault.
No, it's not.
The doctors just gave her something so she could sleep.
I couldn't protect her.
- That's not your job.
- Yes, it is.
She doesn't have anybody else to do it.
Well, it says here you do a great job of taking care of your mom.
Then why is she in the hospital? Well, you know, sometimes things happen that we have no control of.
Bad things.
Even when we do our best.
But I think your mom's lucky to have somebody like you looking out for her.
Your arm may hurt and may feel a little achy.
But it'll pass.
If it doesn't, you need to come back to the hospital.
- Hey, Luka, you busy? - No.
You mind helping me examine patients? They all may have been exposed to pertussis.
- Why not.
- You don't mind? No.
This at least I'm good at.
- Hey, Kem enjoyed your lecture.
- Yeah, she's the only one.
I don't think I got through to any of the others.
Maybe it's the accent.
What the hell is this? These people may be infected with whooping cough.
Then they should be seeing their primary-care physician.
From what I've seen, you are their primary-care physician.
- Kem.
- If you don't give them medical care they won't seek treatment, and you'll have an epidemic on your hands.
- What Kem is trying to say is- - She doesn't need you interpreting.
She's making herself perfectly clear.
You got your work cut out for you.
All right, do it, but do it quickly.
From now on, no one is going to Africa.
I'm tired of this Dr.
Schweitzer routine.
- Did I say something wrong? - Not at all.
Eighteen-year-old Peter Spratt, took a hockey puck to the face.
Looks like a mandible fracture.
He swallowed teeth and blood.
- Okay, I got this.
- He's not moving enough air.
- His jaw is too busted to intubate.
- Let's get a 7-0 ET tube and Surgilube.
- I'm going nasal.
- Pratt? It's okay.
Kovac showed me.
Tachy at 112, sats are 92 and dropping.
Apparently, somebody's been listening to you.
I'm sorry I'm a little late.
No worries.
They're just watching a movie.
Hi, Ella.
Okay, time to go.
Put your shoes on.
It's almost over.
- How are the puppies? - Messy.
But the kids had fun.
- You want a piece of cake? - No.
I haven't had dinner.
In that case, how about a slice of pizza? I'll even throw in a glass of wine.
All right, then.
So how was your pancake-juju thing? - My what? - Your surgery.
The operation you were doing this morning.
Pancreaticojejunostomy? - You made that up, didn't you? - Nope.
Come on, admit it.
You have the perfect job for getting out of things.
Who's gonna argue with a surgeon? "I'm really sorry.
I'd love to help you move, but I have to separate a pair of Guatemalan twins who are joined at the testes.
" Actually, a pancreaticojejunostomy is a replumbing of the upper GI tract.
That sounds painful.
Can you get that from working out? - Because my shoulder's been killing me.
- I believe that's called old age.
After I go to all the trouble of making you this nice dinner.
- Cheers.
- Cheers.
Happy birthday.
Hey, Rudy.
- How you doing, man? - Okay.
You hungry? I went and picked us up some burgers and French fries because I am starving.
I also got you this.
All right, take it.
So you don't ever have to worry about the lights going out.
- Busy.
- No kidding.
- How was your day? - It sucked.
Yours? Same.
About this morning- - Forget it.
- No.
I know sometimes I can be overzealous.
- Is that-? Is that the word? - Don't know.
Is that Croatian for "jerk"? I'm sorry.
I didn't want to take my frustrations out on you.
Sometimes I just feel very passionate.
John! - Want a bite? - No.
What are you doing? - I thought we were going to dinner.
- We are.
I'm just famished.
- I needed something to hold me over.
- All this? I couldn't decide.
There was too much to choose from.
- I got Twinkies, Ho Hos, MoonPies.
- This is all junk food.
I know.
But it tastes so good.
I must be getting cravings.
All I can think about is chocolate.
And sex.
- But I am so happy.
Are you happy? - Yeah.
Thanks for letting me come to the hospital today.
I love to watch you work.
- You were such a stud.
- Oh, stop it.
It's all I could do to keep my hands off you.
- That's it.
No more sugar for you.
- Can I come tomorrow? - No.
- Why not? Because Dr.
Weaver said she'd fire me if you did.
- She didn't? - Actually, she did.
- I should talk to her.
- No, please don't.
What, did I do something wrong? Did I get in the way? Did I ask too many questions? I asked too many questions.
- Did I ask too many questions? - How many chocolate bars did you eat?