ER s11e01 Episode Script

One for the Road

E.
R.
Previously on E.
R.
- Where did you match? - University of Michigan, Ann Arbor.
Are you withdrawing from this residency program? Your Honor? I love my son.
You'll be notified of my decision.
- Alex and I have to leave.
- What? Sorry.
I don't wanna go! We have to say goodbye to our son now.
Can't get in touch with my mom.
Phone ain't working.
You need a ride? Hey, jack-off! Pay attention to the road! - What's your problem, man? Get out of here.
- Pay attention to this.
- Oh, nice.
- All right, we're out of here.
- See you, suckers! - Feel that Hemi power, baby.
It's a beautiful thing.
Slow down.
There.
Everybody happy now? E.
R.
11x01 "ONE FOR THE ROAD" Greg.
Son of a bitch.
- He's shooting at us.
- Get down.
- Come on.
Hold on.
- We gotta get out of here.
Hold on! Where is he? Let's go, hold on.
We gotta get away from him! - Get away from him! - There he is.
Watch out! Damn it.
Get away from him! Oh, my leg! - You hit? - Yes.
I'm shot.
Where is he? Oh, God.
Greg.
Greg, I think I broke a rib.
Somebody help me, please.
All right, man.
I'll be right there, man.
Don't worry.
- Where are we? - We're in the river.
- Can you get out of that seat belt? - No.
It hurts.
I can't move.
Come on.
We got to get out.
Elgin, come on, man.
We got to get out.
I can't feel my legs.
Here, take my hand.
Come on, take it.
I'll pull you out.
I can't.
Come on, man.
Squeeze my hand.
Squeeze it.
I really can't.
Greg, I can't get this belt off.
Kid might have cervical cord injury.
Okay.
I'm gonna call for- Oh, my leg! Hello? Yes, please, help us.
We're in a car that crashed into the Chicago River near Franklin.
- All right, ma'am.
- It's wet.
I'm getting wet.
- Hey.
- Hello? Yeah, there's three of us in here.
Critically injured.
- All right.
- Please hurry.
We're sinking.
Underwater.
I don't want to die, man.
All right.
I'm coming, man.
It's getting deeper.
I'll be right there, Elgin.
Don't worry.
Okay, come on.
Duck under this.
- I can't.
- Yes, you can.
Come on, baby.
You have to.
Come on.
Come on.
Come on.
Yes.
Get under there.
- Good job.
Good job.
Good job.
- Okay.
Okay.
- Doc.
- What? How come I can't move? Looks like you hurt your neck.
It might be broken.
What's happening? The engine takes the front down first.
- Oh, God.
- I'm coming, man.
- Oh, God.
- All right.
It's not fair.
Every intern gets a vacation, and I'm stuck with the last overnight.
Maybe it's because you called in sick, like, 50 times.
I have Epstein-Barr.
Not my fault they haven't found a cure.
Damn shame.
That we have to listen to you whine all night.
- Who's the Attending? - Schedule says Lewis but she's on maternity leave.
Maybe it'll be somebody who'll let me out early.
Kovac or Carter.
Just as long as it is not- - Morris! - Bingo.
Fifteen minutes in, you haven't picked up a patient.
I was doing sign-outs.
From who? Colonel Sanders? Go.
- Where's Carter? - Finishing up a lac.
- Kovac? - Left a couple hours ago.
- In the middle of his shift? - Said he had to go.
Nice suit.
Job interview? - Ready? One, two, three, up.
- Okay, Elgin, try not to move your head.
- I'm cold.
- Look, Elgin, we gotta swim out of here.
- I don't think I can.
- I'll stay with you, all right? Greg Jing-Mei, you'll be fine.
Look, when I open up this window you push out, and I'll pull Elgin out behind you, all right? All right, I got his neck.
All right, everybody hold their breath, okay? Deep breath.
- Damn it.
- What's wrong? Power windows.
- I need to pee.
- We'll be at the motel soon.
Hey, you're gonna like Louisville.
They have the Kentucky Derby the Ohio River, hushpuppies.
Can I go in the bushes? Here we go.
Have you ever been? - What? - Louisville.
Have you ever been there? Hey, it doesn't look half bad.
Hey, look, they even have a pool.
- It's stuck.
- We're sinking.
Wait for the water pressure to equalize.
- What? - Physics class.
When the water gets high enough, you'll be able to open the door.
You gotta wait, man.
You gotta wait.
- What was that? - Bottom of the river.
Now what? Now I guess we wait.
Hello? Hello? - Hello? - Can you beat that? Look at this, Mom, I'm fully dressed.
- Hello? - I don't understand a word of it.
Hi.
Can I get a room, please? - And just the two of you? - Yeah.
- How many nights? - Just one.
Passing through.
- You folks on vacation? - No.
You'd better call the police.
She's kidnapping me.
Alex, cut it out.
- Kids.
- I have not.
I want you to get ready to open the door and push out to the surface.
I'll pull out Elgin after you.
- Greg, I don't think I- - Just do it.
Just do it.
All right, Elgin, listen.
Take a deep breath and blow it out on the way up, all right? - Okay.
- All right, go, Jing-Mei.
Go, baby, go.
- All right, big man, you ready? - Yeah.
All right, take a deep breath.
Deep breath.
- Hey! Hey! Hey! - Victim on the surface! Victim on surface! Starboard side! Two o'clock! Oh, please! Help me! Grab the ring, ma'am.
- Is there anybody else in the car? - Two more! Over here! Over here! We got somebody down here! Come on.
Right here.
Where's Elgin? I couldn't get him out.
He got stuck on the door.
I got somebody else down there.
I got to go back down and get him.
Divers will get him, sir.
He's paralyzed.
He can't move.
We don't need anymore victims.
Get in the boat.
Get in the damn boat! - Gored by a deer antler, sent to Ortho.
- You call Animal Control? No, he fell when he hung it on his mantle.
Woman got her glaucoma drops mixed up with her Super Glue.
Nice of you to grace us with your presence.
- Family emergency.
I'm back now.
- Don't need you now.
Go home.
I owe you a couple of hours.
Next time you leave in the middle of a shift, don't bother coming back.
Frank, call the nurse in Admin.
Tell them Sam won't be working tomorrow or any other day.
Family emergency.
He doesn't even have a family.
Is that it? - You have another court date? - Yeah.
- How'd that go? - Okay.
- She's lying.
- I am not.
- Good luck, huh? - She's a drug dealer.
Tiffany James, foreign body in the vagina.
Tucked her stash up there when we busted her.
- I can fish it out.
- You'll do no such thing.
- You having any pelvic or abdominal pain? - I feel fine.
Not a medical emergency.
- So I can leave? - Sit your ass back down.
Doing a pelvic exam without consent is assault.
This guy said he would.
Hey, Luka.
Is something going on with Sam? She left.
- She left? She left to go where? - I have no idea.
Did she take Alex? - Is she coming back? - I don't know.
I don't think so.
- You okay? - Yeah.
Say goodbye to Kem for me, will you? Frank, I need an x-ray in 2.
Haven't you heard? New interns start tomorrow.
It's my last nursing shift.
I'm finally getting out of here.
You ready for it? - Had the doctor up my Xanax.
- Abby.
I thought you were in Michigan.
- You get kicked out already? - County.
Meet me on Two-Bravo.
- Got time to grab coffee? - No.
I have to sleep.
- I'm back on at 6.
What's going on? - I may have thrown away my career.
Doc.
I don't care what your captain says, we do not do strip searches.
Give me a break.
The jail nurse won't do pelvics.
That's your problem, not mine.
Multi-victim TC.
How many criticals can we take? - Three.
What is it? - Auto versus pole and pedestrians.
Another car in the river.
- Who's still on? - You and Morris.
Carter left, and you sent Kovac home.
- Abby, can you stay? - No, I- Good.
Somebody go find Morris.
He's probably hiding in the bathroom again staring at Maxim.
Did they get Elgin out? I'll be right behind you, okay? - They need to get a collar on you, doc.
- Fine.
- They're not bagging him? - You need a collar.
- Is he alive? - I don't know.
Confirming recovery of a third body.
Stand by.
Why aren't they doing CPR? PB 49, any vitals on that third victim? Not at this time.
I'm sorry.
- So you just left? - After I spoke to the director.
Excuse me.
Where do we sign in? He was at a birthday party.
Always has to be the joker.
- What'd you put up there? - LEDs.
He was supposed to wear them on his clothes.
Triage nurse, straight ahead.
You were only there a couple hours.
Give it more time.
Auto versus utility pole.
Decent vitals, probably dislocated hip.
- Give me something for the pain.
- Reduce the hip.
Ten of MS, slow IV push.
Pedestrian with lacs from jumping out of the way.
- I can take him.
- Lily, put him in 3.
- I can still suture.
- You're no longer a student.
You're not covered to practice here.
You wanna stay, you observe.
Car flew into the river.
Probable broken ribs, tachycardia, GSW to the left leg.
- Jing-Mei.
- Oh, God.
- What happened? - Road rage.
A guy shot at us.
- The abdomen okay? - Pleuritic chest pain.
- Get me off this damn backboard.
- Pratt was the driver.
You start with Pratt, I'll stay with Jing-Mei.
Show me a C-spine! - This is so stupid.
I'm fine.
- Bad scalp lac.
- And combative.
- I'm not combative.
I'm just pissed off that you tied me down.
Come on.
Get back in there.
Morris, move him to Suture.
- Got it.
- Let's go! We need the room.
- Dr.
Chen? - That's the guy.
That's the guy that shot at us.
- I want to sign out AMA.
- You can't.
You're a trauma patient - with a head injury.
- One, two, three.
First-day labs, C-spine, chest and pelvis, and a head CT.
- Will you stop it? I don't need all that.
- It's getting harder to breathe.
- Pulse ox is 89.
- Up her to 5 liters.
- How's she doing? - Probable sternal fracture.
Don't wait.
If there's decreased breath sounds, put in a tube.
Open your mouth.
- Is the pain on the left or the right side? - Keep your mouth open.
- You weren't supposed to do anything.
- No one cares if I kill a resident.
- I'm feeling dizzy.
- BP's 90 palp.
- She could have tamponade! - Shut up, Pratt! - Hello? Can I get a doctor? - What? What is it? What? Flaccid paralysis of arms and legs.
Divers fished him out of the river.
- Is that Elgin? - Elgin Gibbs.
- Is he alive? - He has a pulse.
Elgin was with you? - Abby, check him out.
- You're a doctor? - Internship starts tomorrow.
- I just advanced your residency start date.
Now you're an intern.
What, you want an engraved invitation? Go, go, go! Hey, and keep your eye on him.
Make sure he doesn't get up.
Both toes are up-going.
Solu-Medrol, 30 per kilo bolus.
- Abby, what do we have? - Cervical-cord injury.
Starting steroids.
- Who's the resident on the case? - That would be me.
Early bird catches the worm.
Fine cuts through the C-spine.
Set up for Gardner-Wells tongs.
Good alignment.
No fractures.
You can take him off the board.
- About time.
- How are you doing, Greg? I'm fine.
GCS is 15, abdomen is benign.
How's Elgin, spinal-cord injury kid.
No blood in the belly.
Four of morphine, sew him up.
- I'll get Morris to do it.
- Morris? No, I'll do it myself.
- PVC's.
- Hundred of lido, open the crash cart.
Could be accumulating blood in the pericardium.
Need a stat echo.
Run a liter of saline.
How did this happen? Some kind of hit and run.
They caught the guy.
- Any muffled heart sounds? - Pratt- Check for pulsus paradoxus.
Back off, or I'll check your rectal temp with my crutch.
Somebody has to call my house.
My dad's nurse.
Her name's Marie.
- Both lungs are up.
- I was supposed to take over at 9.
- She needs to stay.
- Mediastinum appears normal.
GSW to the left leg.
She barely has pedal pulses.
- Did I transect the artery? - Order an angiogram.
- We need to check compartment pressure.
- Okay, she's bradying down.
- Amp of atropine.
- Dr.
Weaver, Abby needs you now.
- For Elgin? - Prep the entire leg.
Open a cutdown tray.
- Some guy named Eduardo, line two.
- What? Says he's Sandy Lopez's brother.
Sounds upset.
- Wait, wait.
Is Henry okay? - Who? - My son.
- He didn't say.
Well, go find out.
- We're getting search warrant.
- Good or you.
How much longer is it going to be? He dropped pressure.
Ordered 2 units of O-neg.
- Dr.
Weaver, I have some questions.
- Kind of busy here.
Henry's fine, but this Eduardo still wants to talk to you.
- Decreased breath sounds on the left.
- I agree.
You don't work here anymore.
He wants to meet as soon as possible.
Says it's important.
- Take a message.
- BP's only 80.
- What's the HemoCue? -11.
3.
Okay.
Good breath sounds, spinal shock.
Dopamine at 10 mics.
- No chest tube? - No.
Recheck the HemoCue.
- It needs time to equilibrate.
- He's not bleeding.
I'll be with Chen.
I should try and call his mother.
- What size suture are you using? -4-0 nylon.
Morris, I shave my melon, man.
Go with the 5-0, minimize the scar.
- Compartment pressure's 42.
- I've lost the pulse.
- Kerry, Abby's doing a thoracotomy.
- What? Who's getting a thoracotomy? Elgin? - Aorta's clamped.
More suction.
- Are you out of your mind? - He was coding.
- I told you he didn't need a chest tube.
- He had 3 liters of blood in his chest.
- What? - You want the Cell Saver? - Yes.
Mrs.
Gibbs, this is Neela at the hospital.
Your son Elgin was in a car accident tonight.
It's pretty serious.
When you get this, come to the emergency room, ask for me.
It was the machine.
Last one.
Beautifully averted and well approximated.
You are a lightweight when it comes to morphine.
- CT's ready.
- Okay.
Greg, time to wake up.
Greg.
Greg, come on.
Crap.
He's got a blown pupil.
Intubation tray, 20 of etomidate, 100 of sux.
- Should I get Weaver? - Get the head down.
As soon as we tube him, I want 80 of mannitol.
I need suction and an end-tidal CO2 detector.
Here we go.
Charge to 30 again.
Charged.
Asystole.
- How much O-neg has he had? - Eight units.
- Ruptured proximal aorta.
- FFP, platelets.
- What about a side-biting clamp? - There's nothing left to bite.
Are you done? Hold compressions.
- Pratt's herniating.
- What? We need to close his chest.
His mother's coming.
I don't want her to have to see him like this.
Keep head at 30 degrees, M.
A.
P.
in the 90s.
- Hyperventilate? - A PCO2 at 30.
- Morris.
- Epidural bleed.
Mannitol on board.
- He was awake.
- Presentation with a lucid interval.
- Skull fracture.
- Tore his middle meningeal artery.
Abby, call the OR.
Tell them we need an ICP monitor.
Hello? Hey, you ready? Sorry.
I got stuck with a sick kid.
Called the restaurant.
They'll take us at 9:30.
Let me throw on a shirt, I'll be ready to go.
Maybe we could just stay home, watch a movie? Sure.
How does Thai food sound? The takeout menus are in the kitchentop drawer, yeah? Good news is the pupil went down with mannitol.
The bad news is Greg needs surgery, and he might have long-term brain damage.
- So it's wait and see? - Yeah.
So, what happened in Michigan? Can we maybe talk about it tomorrow? Sure.
You should go home and get some rest.
- Go on.
I can finish this.
- I'll stay.
- You start in a few hours.
- Think I started tonight.
Go, really.
I'm okay.
You don't have privileges here anymore.
I don't think I'm gonna be sued for missing a suture on a dead boy's chest.
Go.
I'll wait for his mother.
We'll talk tomorrow? Hi, this is Sam.
Leave a message after the beep.
Bye.
- Has he woken up yet? - Not as of 6 a.
m.
With all the trauma, the board's a mess.
PICU can take the baby up after change of shift.
Two more messages from that Eduardo guy.
He's persistent.
- Where do you want the fresh meat? - Interns? - Right there.
- Hey, Ray Barnett.
- Luka Kovac.
- Hey.
- Are you Dr.
Weaver? - Yeah.
Sorry.
Been up all night.
- You could've fooled me.
- Howard Ritzke.
Orientation's in second-floor auditorium at 8 a.
m.
with the new house staff.
And the elevator's that way, right? Thank you.
- We come back here at what time? - When you're through.
Here's the labs on the baby.
- Out of here.
- That explains it.
All right, gotta go.
Got an appointment.
Sorry.
My alarm didn't go off.
How are Pratt and Chen? - Surgical ICU.
They're both stable.
- Good.
- Did the other interns go upstairs already? - They did.
- But you've been excused.
- What? I have a few pass-ons for you from last night.
I don't have to go to orientation? You have an ID.
You know where the bathrooms are.
All you need's a lab coat.
Welcome to County, Dr.
Lockhart.
Excuse me.
Are you a doctor? Yes, I am.
Sara's stool tested positive for botulism toxin.
- What? - Will she get better? It can take a month.
A month on the breathing machine? She needs oxygen and tube feedings until her muscles recover.
How could she get botulism? - Spores can be present in honey- - Doesn't get that stuff.
I cook and purée everything for her myself by hand.
- Honey? - What? Damn it, Jeffrey, you don't give honey to a baby.
- How am I supposed to know? - It was in the book.
You never read it? - Why don't we all just-? - You gave me four books.
I do the diapers, the bottles, the cleaning, the shopping.
- Excuse me.
Know about a warrant? - We're not doing it.
It was one book.
I told you which book- Hey, it's not like I wanna be doing this.
You know what? The reason I am working is because you lost another job because you can't control your temper! Good luck.
I've been up all night to get that warrant.
Yeah, but where does it say that we have to do the search? Wait, you want me to go back and get a court order to compel you to search? We start doing searches, word will get out, people are gonna be afraid to come.
Who? Drug-dealing hookers? Fine, I'll get the order.
You refuse that, I'll arrest you.
How long do those batteries last? This guy's spitting up blood.
Hi, I'm Ab- I'm Dr.
Lockhart.
- George Pisoni, history of oral malignancy.
- Cancer of the tonsil.
- Been going like this all night.
- CBC, PT, PTT, type and cross.
Bayonets, gel foam and some Cetacaine.
- Can you stop the bleeding? - Going to do the best I can.
- Open up.
- Yankauer's ready.
It's just a little numbing spray.
Nice coat.
It's a mess in there.
Two operations, lots of radiation.
Here.
This should help it clot.
Sorry.
Maybe you'd be more comfortable holding it yourself? Okay.
You're bleeding over a large area.
So we may need to put a breathing tube in your throat to protect your airway.
- No.
- HemoCue's 8.
5.
You might also need a transfusion.
No, thanks.
I have an advance directive.
But if we don't stop this, you could bleed to death.
I guess maybe today's the day.
Alex.
Alex, come on.
I could've been dead.
You wouldn't have noticed.
Leave now, we can make it halfway to Florida.
- I don't wanna go.
- You can swim in the ocean.
So what? All right, how about Cousin Fran's in Atlanta? - Her place smells.
- Fine.
Where do you wanna go? - Back to Chicago.
- Isn't an option.
Come on.
- We don't have time for this.
- No.
- Well, you wanna stay here? - Yeah.
- Really? Right here? - Yes.
- And I can't change your mind? - Nope.
Okay.
We'll stay here.
We'll stay right here in this pool for the rest of our lives.
I found another treatment option.
Will it cure my cancer? Nebulized epinephrine.
It's like a vapor.
You inhale it.
And sometimes it constricts the blood vessels and stops the bleeding.
- How long will it last? - It's just temporary.
Are you sure? Yes.
Yes.
I'm getting tired.
As your blood count drifts down, you get sleepy.
Will it hurt? If it does we'll give you morphine.
Okay.
Will you stay with me? - Will you stay with me a while? - Sure.
Abby, paramedics have a new chest pain and a febrile seizure.
I'll be here, George.
Make sure you get everything you need.
Thank you, Haleh.
And I'll be back, Mr.
Pisoni, okay? Greg? Greg? Yeah, you're intubated.
You had an epidural bleed.
Excuse me? Can he get a pen and paper? Hey, welcome back.
"I have a shift at 8 a.
m.
" Well, you're late.
It's already noon.
Gellin's D-dimer is positive and the spinal tap on Gomez looks like viral meningitis.
- The coat suits you.
- Thank you.
- Kovac, you expecting a collect call? - Nope.
Area code 502.
- Wanna grab some breakfast? - No.
I'm too busy.
Do you live here now? I slept in the call room.
I gave up my apartment.
- Have you been up to see them? - Jing-Mei's okay.
Greg hasn't woken up yet.
It's only been a couple hours.
Now, whatever happens, stay calm, be professional and respectful.
We can appeal if we don't like the decision.
Kerry, did you get my messages? I don't think there's anything else for us to talk about.
- Mr.
Lopez, I don't think it's appropriate- - Please, a minute.
We've all agreed to let the court decide this matter.
You work so much.
My parents are retired.
- They're home all the time for Henry.
- Please, Mr.
Lopez.
- Dr.
Weaver is aware of your concerns.
- No, please, Kerry, two minutes.
Please, two minutes.
Mr.
and Mrs.
Lopez, you have now agreed that a full order of legal and physical custody will be granted to Dr.
Weaver for Henry and you will continue in your current role as caregiver - during Dr.
Weaver's working hours? - Yes, Your Honor.
With visitation rights on holidays as specified.
Yes.
- We just want to be a part of Henry's life.
- Thank you.
Thank you.
Thank you.
Sounds better.
Sixty of prednisone.
- Films on Rowland.
- Okay.
- Set me up for a sugar-tong splint.
- Repeat EKG on Harper.
- Bolus 5000 of heparin.
- And we can't get an IV on Grant.
Okay, I'll do a central line.
- You met the new interns? - No.
It's about time.
Put them to work.
Actually, Luka wanted you to see a few more patients with them first.
- Why can't he take them around? - He left hours ago.
Again? Luka! Luka! How about here? It's okay.
Is there a prayer? I don't know.
We should say something.
We miss you.
And you'll always be in our hearts.
I want you to stay.
I can't.
I can't.
Please? I want us to be together.
I wanna marry you.
- Think I could eat? - I'll order you a tray.
- Been here almost 18 hours.
- I'm aware of that.
You've held up a bed, woken up two judges and now the head of Public Health is coming to do your exam.
- Really? - Really.
He's driving from Lake Forest just for you.
He's really happy about it too.
He says he hasn't done a pelvic in about So you can wait here another hour for the old guy to get here and give you what I'm sure will be a painless and gentle exam or you can let me do it right now.
Hey.
Signed, sealed, delivered, she's all yours.
- You did the exam? - No.
It was more like self-service.
- Sign a death certificate.
- Who? Tonsil guy finally bled out.
George? - When? - About an hour ago.
- Well, why didn't you come and find me? - He was DNR.
You were busy.
- But you were with him? - Yeah.
- He was comfortable? - Yeah.
Is now a good time? - If you're too busy I'll just come back.
- It's fine.
- Where's the Marcaine? - Drug lockup, middle cabinet.
- Right.
And the drug lockup-? - Behind you.
Thank you.
- Who's that? - It's one of the other new interns.
Okay, what happened? I told my residency director I didn't wanna do an internship.
- In Michigan? - Anywhere.
What? - What did he say? - To think about it.
- Lucky he didn't fire you.
- Would make life simpler.
- Diarrhea boy's at it again.
- Okay.
You can't get licensed without an internship.
- So? - So you can't practice medicine.
- Right.
- That's crazy.
It's one more year.
- I don't wanna do it.
- Eight years of school.
You're so close.
What are you gonna do? Throw your future? I'm not sure it's the future I want.
- Abby? - I'm coming.
Let's get something to eat later.
What are you doing, Sam? This is what I do.
You knew that.
I don't stay in one place that long.
So how long are you gonna keep doing that? - As long as I have to.
- You can't keep running away.
Sure I can.
- This isn't just about Steve? - I'm sorry.
Sometimes there's a little collateral damage.
- I have to do this for Alex.
- From what I can tell, it's not working.
Well, he's 10.
He doesn't know what's working.
Is this the life you want for him? For yourself? I don't know what else to do.
Go to your car, follow me back to Chicago.
You don't have to do this alone.
I'm here.
You can trust me.
That is not something I'm good at.
Why not give it a try? Can't be any worse than this, can it? Come on.
We should get going.
I don't wanna miss my flight.
When are you coming back? I'm not sure.
Well, my schedule is flexible.
I can come and visit in a few weeks.
Can we talk about it when I get back? Sure.
I'll just need a bit of time, you know? I've gotta rest.
Get back into work.
You didn't answer my question.
It's okay.
I love you.
You don't have to answer me now.
I'm just not ready.
Well, will you think about it? Promise me that? I just don't know what to think about anything.
It just all happened so fast.
And felt so right, didn't it? Well, it is right.
Just give me a bit more time, okay? I love you too.
I love you so much.