ER s12e02 Episode Script

Nobody's Baby

E.
R.
Previously on E.
R.
- Don't go away mad, Jake.
- But do go away.
I don't wanna have any more kids.
I'm done.
You're responsible for everything the intern does but question the history, they get testy on you.
Sounds like you had a great day.
You told me to step it up.
Yeah, but your job isn't to just move the meat.
You're a Resident now.
- Your name is Charlie Pratt? - Chaz, who is it? - Is there a problem? - Are you Charlie? Yeah, I'm Charlie.
E.
R.
12x02 "NOBODY'S BABY" Is Alex still here? No, he just left.
Why? You were up early.
Yep.
Everything okay? Oh, I just couldn't sleep.
I've been thinking about- Hello? This is Sam.
Yes, I did.
Uh-huh.
When? Okay.
Sure.
If I come by in 20 minutes, is someone still gonna be there? Great.
Okay.
Thank you.
Sorry.
What were you saying? My father's been bugging me to visit him.
I haven't been home in a long time and I have some vacation coming up so I was thinking about making a trip back to Croatia.
It would only be for a couple weeks.
It might be good for us if we spend some time apart.
Alex and you can hang out and - You know- - I already started looking for a new place.
- New place? - For me and Alex.
What, you're moving out? You said it'd be good for us to spend time apart.
That's not what I meant.
Well, I was gonna tell you.
I just think that it's - I need to think things out by myself.
- Where are you going now? - I'm looking at an apartment before work.
- So, what, that's it? - We don't talk about this? - Never seemed to do us any good before.
Oh, did he really? Oh, my God.
You gotta tell me later.
Okay.
I gotta go.
Bye.
Let's go.
Wait! Hey.
Hey.
Can you hold the doors? Hey! Can you hold the door-? Thank you.
- Hey.
- Hi.
- Good morning.
- Well, maybe for you.
I was up half the night writing a paper on paintball injuries for Morris.
Are they talking about us? Can we help you? We were just wondering where you got your shoes.
They look very comfortable.
They match your backpack.
Just ignore them.
They're on a bulimia high.
I don't understand what she said, but it was like- - Ah! - Oh, my God! - Oh, my foot! - Are you okay? - Can you stand on it? - No! - Call 911.
- Should we check her out? No.
- Don't touch me.
- Try not to move.
I'm a doctor.
You may have broken your ankle.
If you're a doctor, I want a second opinion.
Okay.
Dr.
Lockhart, would you care to give a second opinion? Sure.
Your ankle may be broken, and you're a bitch.
All three of them are a liability.
Look at them.
Huddled together like prairie dogs.
This is the best we have to work with? - Should've made me chief long ago.
- And why's that? For one, I'd be a little pickier in choosing our residents.
- What are you talking about? - Abby, Ray, Neela.
No brain, no courage, no heart.
- They need a trip to see the Wizard.
- Who's the wizard? You? That's why they pay me the big bucks.
Officer on deck.
Me.
I'm the chief.
- Yeah, Chief Pain-In-The-Ass.
- Ha-ha.
Oh, Abby, if only you were as talented as you are funny.
At least I'm funny.
If making jokes at the expense of those with Native American heritage is humorous to you Yeah.
I happen to be one-sixteenth Choctaw Indian.
Hey, Jake sent us a postcard from San Francisco.
Right on.
- How's he doing, Abby? Great.
I think he really likes it there.
Yeah.
Not according to this.
Guys, you know our new interns.
Clemons, Munson and Babinski.
Abby, Neela and Ray.
They'll show you the ropes.
I'm Dr.
Morris, but everybody calls me chief, because? Anyone? No? Well, I'm the chief resident.
You present to the residents, they to Pratt and me.
- They present to the attending.
- That's a lot of presenting.
Dr.
Kovac, you got a patient in the cath lab? - Yeah, why? - I think he might have died.
If you'll step over to the board I'll show you how I like things done here.
This applies to you as well.
I'm implementing changes.
I'd like to stick an implement in his eye.
- Pick a number, 1-10.
- Why? - Neela? - Seven.
- Four? - So close, it was six.
- Neela chooses, Munson or Babinski.
- Babinski! - Wait a minute.
- Who's up? - Clemons, you're with me.
- I am? I trust you, girl.
Just don't let me down.
Claire Jansen, 24.
Unrestrained driver.
Rear-ended at moderate velocity.
Term pregnancy.
Good vitals.
Definitely having contractions.
Fetal heart rate looks good, 160.
Okay.
Any pain when I push? - Not now.
- HemoCue, 14.
1.
- Pretty normal.
- I don't think you're bleeding internally.
I should hope not.
Yeah, I think my water broke.
- Premature rupture of membranes.
- Is that bad? No, but there's a good chance you could be having your baby today.
Oh, I wanted to have another home birth.
- This is your second pregnancy? - Yeah.
Zoe's 2.
This one's a boy.
- You want me to call your husband? - No, there's no such creature.
But you could call Toni Stillman.
She's my friend.
- She needs to be here.
- Ray? Twenty-four-year-old.
G- Two P-One, 39 weeks.
Prommed after a TC.
Normal vitals and crit.
Ultrasound and send her up to OB for sterile spec exam.
Do you have a minute? Uh, no.
Not really.
I got to get labs off, do a cathed UA.
Assist Ray with the pelvic and find an ultrasound.
Can you do some of this? Me? No, she can't.
Sorry, Inez.
This is Dr.
Kovac.
I'm helping her get the lay of the land.
- When you're finished? - Sure.
It might be a while.
- Welcome to County, Inez.
- Thank you.
Sit tight, Claire.
You're doing great.
We'll have you upstairs before you get comfortable.
I feel it'll be several hours before I'm comfortable.
- Okay.
Clemons, what's next? A bimanual exam? - Not before the ultrasound.
- Why not? Third trimester.
You rule out previa before the exam.
Most important thing to remember in the ER is if you don't get it, just fake it.
Not enough time to ask all the questions and patients don't wanna see you scratching your head.
So in the meantime, can you go get me some Nitrazine paper? Come on.
Go, go.
Excuse me.
Dr.
Barnett wanted me to get some Nitrazine paper.
- But I don't know what it is.
- You didn't ask? He said if I didn't know something- Listen, number one rule of the ER is if you don't know something, ask.
Okay? You're not gonna learn this stuff by yourself and that's why we're here.
What do I do with the-? Dr.
Rasgotra, can you tell me how to use a Nitrazine paper? Not until I finish suturing a very fidgety 6-year-old.
You're an intern now.
If you don't know something- - I know, fake it.
- What? No, of course not.
- I already asked- - Look things up yourself.
When someone gives you the answer, you forget five minutes later.
Read it and it sticks.
Your primary responsibility, educate yourself.
No one else is gonna do it for you.
Thank you.
- How's it going? - Fine.
Great.
- Do you have any questions? - No.
Terrific.
Uh - Anything to present? - I'll let you know.
Okay.
Can I make a suggestion? Unless your patient has situs inversus, her heart should be on the left.
- Just came back from the girl in 4? - Yeah.
Looks like she's gonna need amphotericin B.
- Your intern picked up histoplasmosis? - Yeah.
He just doesn't know it yet.
How's he doing? - I don't think he likes me.
- Everybody likes you.
Not this guy.
He's acting like I killed his dog or something.
Probably he's just nervous.
I don't think I'll be real great at teaching the interns.
Yes, you will.
You did a great job with Jake.
- Too bad he didn't match here.
- Yeah, too bad.
Dr.
Pratt, can you get on the MICN.
Paramedics need you to pronounce a GSW in the field.
Sure.
Abby! Got one.
Munson, we're up! Unidentified kid.
Looks about 10.
Found down at the food court at City Center Mall.
- Munson! - Still hypotensive after 500 cc's.
- Mental status waxing and waning.
- Hi, I'm Dr.
Lockhart.
Can you tell me your name? - He alone? - His buddies split when we got there.
Sats only 92.
What's your plan? - CBC.
Chem-7.
Tox screen? - And? - Head CT? - And? - Try to find next of kin? - ABG.
LFT's.
Oxygen.
Normal saline, activated charcoal.
Let's go.
- Don't worry.
You'll get the hang of it.
- I know.
Okay, 57.
I concur.
We can pronounce.
What's the status on number two? All right, sounds good.
We'll be waiting for you.
County clear.
- Dr.
Pratt.
- Yeah? Guy out there says he knows you.
- Which guy? - Sitting next to the old lady.
He a friend of yours? - Not really.
- So you want me to bring him in or no? No.
He can wait.
This is Dr.
Pratt.
I need this Trauma Room in a couple minutes.
How are we doing in here? I don't know about you, but I'm having contractions.
Nitrazine is positive.
Which means your water did break.
- Follow it caudad.
- Okay.
Is everything okay? Looks like a breech presentation.
Dr.
Barnett, can I get your advice on something? This doesn't feel any different from my last pregnancy.
The baby's been active.
You're doing good, Claire.
The baby's heart rate is right on target.
Dr.
Pratt, could you come and take look at this, please? Doctor Pratt.
What is it? It looks like you've delivered the feet.
But that's okay, right? I have a friend who delivered breech and her baby was okay.
Page OB and get them down here right now.
Don't worry.
I'll take good care of you and your baby.
Dr.
Kovac, this is Toni Stillman.
She's here to check on Claire's condition.
The pregnant MVA.
Somebody said she was in a car accident.
- Yeah, but she was uninjured.
- Thank God.
What about the baby? - A family friend? - She's our gestational surrogate.
She's lived with my husband, Rod, and me for six weeks.
- She's having your child.
- Yes, we had IVF.
She was implanted with our embryo.
So is our baby gonna be okay? I'm afraid I can't tell you that.
Not without Claire's consent.
- She is carrying my baby.
- Sorry, I need the patient's consent.
- We're best friends.
She'll see me.
- Sam.
This is Toni Stillman.
- She's a friend of Claire's.
- Right.
I spoke with you on the phone.
I'm Sam.
Come on in.
She's been asking for you.
- Sam, how's she doing? - Pretty good.
- Uh - When I get a chance, okay? I was so worried about you.
- I'm fine.
- But you shouldn't be driving.
- I can take you anywhere you need to go.
- It was just a tiny fender-bender.
- Sam, you have activated charcoal here? - Yeah.
Bottom shelf.
- There's a guy in the waiting room- - Yeah.
I know him.
Thanks, Malik.
Claire? Claire, are you okay? - What's happening? - Another contraction? - What is-? She's in labor? - Yup.
But are you gonna stop it? Because she's not due for another week.
But she's 39 weeks.
Junior's ready to make an appearance.
- His feet are already popping out.
- Feet? He's breech? - You'll do a C-section? - We're waiting an OB to weigh in.
GSW's two minutes out, Dr.
Pratt.
Come find me when they get here.
You, you're with me.
Go ahead.
I got it.
- Have you been in a GSW Trauma before? - I grew up in the Bronx.
- Dr.
Pratt, can we present? Not now.
I got a trauma rolling in.
Okay.
What's next? Exam 3.
Possible talar fracture.
I should warn you she already took my head off for how long she's had to wait.
Oh, God.
Can this day get any worse? This is Drew Filmore.
We've met.
- Greg.
- You figured me out, huh? Five minutes after you left, I knew it was you.
I can't talk to you right now.
- Looks like you're busy.
- I am.
What do you want? I don't know.
What were you looking for when you came to find me? I guess I just had to see for myself.
And now I have.
- So how do we do this? - We don't.
I'm sorry I bothered you.
I had no idea you were in Chicago.
- I heard you were still in Detroit.
- I'm not in Detroit no more.
I can imagine what you think about me.
There's a lot of things that you probably need me to explain.
No.
I don't need anything from you.
I never have.
I made a mistake going to see you that night, so forget I came by.
Don't come back anymore.
Hold on.
I can understand you're mad, but I can accept some of that.
- Some of it? - Hey.
You have a half-brother and sister and they are your family too.
Now family's important to you.
Single GSW left chest during a carjacking.
Jocelyn's at U of I.
Chaz is a senior at South Geary.
BP 100, systolic.
Decreased breath sounds on the left.
He'll probably get a scholarship from Loyola if he wins at the swim meet.
Entry wound left parasternal.
No exit.
I need intubation tray, 32 French.
Let's notify the O.
R.
I'm sorry I walked away.
Don't make the same mistake I made.
CT's good.
No blood, no mass effect.
- Barbecue's ready.
- What? Charcoal's in.
Resps down to 14.
Shallow but clear.
Another 0.
5 of Narcan.
I'm sorry, can you repeat that? Is that 140 or 114? Uh-uh-uh-uh-uh.
If you do that, we'll have to restrain you, okay? Malik, give him two of Ativan.
Wait a minute.
Are you sure? I thought benzos could cloud the neurological picture.
Yeah.
Fine.
Soft restraints then.
- Narcan's in.
- Come on.
Talk to us, doctor.
- White count is 12.
3 - You guys still in here? I got a GSW to the chest.
I need you out of here now.
- This kid's ready to go to PICU.
- He's not.
He's getting worse.
Head CT's fine, labs, normal.
From ER standpoint, workup's done.
Could have encephalitis.
We should tap him.
- They can do it upstairs.
- Sounds good to me.
Let's go.
Put him in sutures till I can get PICU.
Come on.
- Need a hand? - Not yet.
I'll let you know.
- Did I do something wrong in there? - No.
Am I not handling this patient correctly? Nope.
Are you okay? Sam's moving out.
Why? I've got a feeling it's a communication problem.
Well, if you're not sure, it probably is.
Sorry.
- If you wanna talk about it - No.
And if I wanted to talk about it, Sam probably wouldn't be moving out.
Thanks, Luka.
I always thought it was my fault that things didn't work out between us but now I know it was you.
Hey.
No problem.
She's gonna need a C-section.
Oh, I don't want surgery.
My friend Julia had a breech.
- Probably a frank breech, which is butt- - You've got a footling breech.
If your cervix doesn't dilate enough, the head can get stuck.
Umbilical cord will compress with each contraction jeopardizing the oxygen supply.
- You need to do what's best for the baby.
- What happens if I don't have surgery? We allow the baby to be delivered up to the umbilicus to give the cervix time to dilate.
Then use maneuvers to deliver head and shoulders.
Then let's do that.
That's not a good idea.
Right, with a footling breech, there's a 25 percent chance of major complications.
It's less than 2 percent with a C-section.
That's a 75 percent chance that the baby will be born without any problems.
Okay.
We can wait while the labor proceeds.
But if the baby's heart rate gets too low, you may still need a C-section.
I don't want surgery.
I'll send somebody down as soon as we have a room ready.
Can you please find Toni for me? You know what? I'll get her.
Dr.
Coburn, are you really not gonna consent for surgery? I can't do it against her will.
What if the baby's in trouble midway through labor? - I still can't do it.
- Are you kidding me? What about the intended parents? This is Toni's baby, isn't it? She's the genetic mother and the intended mother but it's still Claire's body, and she has the right to refuse surgery.
- Abby! PICU on line three.
- What? What's the status on that kid brought in from the mall? I'm hoping this is the PICU calling for him.
Why? - His buddies are asking about him.
- Don't let them leave.
Yeah, this is Abby- Dr.
Lockhart.
Okay.
Great.
We'll send him right up.
Thanks.
- Is he okay? - No.
He's not okay.
Did he take something? You guys, you need to tell me if he took something, okay? - I gotta go.
- Hey! Hey! Hey! Chuny! Wait a minute.
Not so fast.
Hold up.
Hold it.
- Hold on.
Let me grab him.
- Let me go.
Settle down, here.
Sit down.
Your friend is very sick.
What's his name? Liam.
- And what did he take? - Nothing.
- No drugs? - No.
Then why did you run away when the paramedics showed up? - We were skipping school.
- Has Liam been sick? - He hasn't been in school much.
- Why not? His parents are getting divorced and he has to go back and forth.
That's why we ditched, so we could hang out.
Does he have any medical disorders? - Like what? - Anything.
His family are vegetarians.
- Was he acting different today? - Not really.
He was kind of bummed maybe.
He ate two jumbo cheeseburgers.
- I thought he was a vegetarian.
- Abby! He's getting worse.
- What's this? - Kid's backpack.
Find out what's in it.
- What's going on? - He seems pretty unresponsive.
Okay, check his gag reflex.
Liam? Liam? Hold it.
Liam? - You gotta wake up, big guy, okay? - He moved his hand a little bit.
- Barely has a gag.
- All right.
This way.
Okay.
You know the VITAMIN mnemonic? - Vitamins? - Yes, for altered mental status.
V is vascular.
Strokes or clots.
We ruled that out with CT.
I is for? Infection.
What, this game's only for interns? Infection.
No pneumonia.
Normal white count.
Urine's clean.
- We're waiting on the cultures.
T? - Trauma.
Toxins.
Utox is negative, doesn't mean he didn't take something we can't test for.
- What am I looking for? - I don't know.
Drugs.
Meds.
- Wait.
- What? It's M.
Sorry.
Sorry.
M.
The M in "VITAMIN " stands for metabolic.
This kid could have a metabolic disease that keeps him on a restricted diet.
- What diet? - His buddy told me that he was a vegetarian.
- What buddy? - Then today, he had two cheeseburgers.
- I'm lost.
- We need to get this guy upstairs, Abby.
No, what we need is an ammonia level.
Go get some ice.
Ammonia has to go to the lab cold.
Run.
- That's my frappuccino.
- They could do this upstairs, Abby.
Yeah.
After they do their assessment, review labs and repeat x-rays.
Meanwhile, his brain is being pickled by whatever metabolite is going in there.
Okay.
Get that to the lab.
Go.
- Hang in there, Liam.
- Good signal.
Fetal heart rate 158.
- Well, that's still good, right? - For the time being.
But if your baby gets in trouble and is deprived of oxygen every second counts.
But that's not happening.
- Not yet.
- Are you trying to scare me? No.
I'm just trying to prepare you for what might happen.
Listen, thousands of C-sections are performed in this country every day.
It's a simple procedure.
I wanna have more kids of my own one day.
Naturally.
And lots of women go on to have vaginal births after having Caesareans.
Excellent variability of the FHR.
Could I consent, but only as a last resort? Only if the baby's in serious danger? Absolutely.
Sam has a consent form right here.
Okay, but only as a last resort.
You need to be made aware of the risks.
- What sort of risks? - Sam.
- Bleeding, infection, paralysis, stroke- - Sam! These are minimal risks.
Can I speak with you outside, please? - I don't want this.
- No, just- Look, think about it, okay? What is going on in there? She needs to be aware of the risks.
That's why it's called informed consent.
- You made it sound like Frankenstein's- - You made it sound like a pedicure.
- It's not your job to explain the proced - No, that's your job.
Look out! - What's going on? - You tell me.
- Jeez.
- How are we on the packed cells? Units five and six, infusing.
What about Kovac? - No, I got this.
- Okay.
What can I do? Nothing.
Internal paddles again, charge to 30.
- You're shocking asystole? - It's fine V-fib.
- Clear.
- How long has she been down? - Resuming compressions.
- Greg.
Hang another unit, charge the paddles.
Shouldn't we save the blood for someone who's got a chance? - Probable great vessel injury.
- She's down too long.
What, now that you're residents, you're experts? - If we restore her volume, we'll be able- - It's time to call it.
- Call it.
- Me? Call it.
Death at 1440.
What's the survival rate in patients who reach this hospital alive after penetrating chest trauma? When you two can answer that, you can start second-guessing me.
You wanna do something, notify her next of kin.
Abby, sats are down to 76.
Can't get a good seal.
He needs a tube.
Get me a miller tube and a 65.
- What? What's wrong? - What's going on? - Hypoventilating at a rate of six.
- Is this the mall kid? - I told you to send him to PICU hours ago.
- Suction.
- Abby.
- I wanna check one more thing.
Great, so you kept him down here just long enough for him to crash.
Tube.
I got some history that suggested further workup.
- You should give it to the team upstairs.
- I'm in.
- Good chest rise.
Equal breath sounds.
Ammonia's back.
Two-fourteen.
You were right.
The kid has a metabolic disorder, some protein intolerance.
Okay.
Run to the pharmacy, see if the sodium phenylbutyrate is ready.
- Sodium what? - It's a nitrogen scavenger.
It'll help bring down ammonia, reverse encephalopathy.
Got it.
The kid's family are strict vegetarians.
His friends told me today he had two cheeseburgers because he was depressed.
Because his parents are getting a divorce.
So it was probably some sort of fast-food rebellion.
Only he can't handle protein.
- Any family members to confirm this? - Chuny's still trying to track them down.
Can you switch him to D10 half at 150 an hour? - You got it.
- Luka? - We got a hot Ml on its way in.
- Be right there.
So lower the ammonia get him out of his catabolic tailspin, he'll wake up, right? Nice pick-up.
Lockhart comes up big.
You call that a jump shot? Hey, Luka.
- I hear your mom's looking at apartments.
- Yeah.
Who knows? Might be even close enough to walk to my place.
It's not.
It's only a few blocks from here.
You know it's not my idea.
Back to work.
We'll still go camping again on your birthday.
- Yeah? - Absolutely.
- Dr.
Rasgoata? - Rasgotra.
- Rasgotra.
- Neela's fine.
Filmore's freaking out about how long she's waited to have her ankle splinted.
Maybe you could help with this one.
How are we doing, Drew? I've been here for six hours.
Is there anybody here who knows what the hell they're doing? - Yes.
- Then what the hell are you waiting for? I've got a national sales conference I'm supposed to be at.
I'm sorry you had to wait.
Sometimes we lose track of time when we're trying to save people's lives.
Is that sarcasm? Because I don't need that.
I'm a customer here.
If I'm not happy with the service or the way I'm treated I will go to your supervisors.
We have a contract.
- I didn't agree to surgery.
- You agreed to consent to all medically necessary procedures associated with the pregnancy.
- What's going on? - This is my husband, Rod.
- Are you the OB? - No.
ER.
She needs a C-section and I have a legal document permitting to do so.
Can we go out to discuss this? If you don't do this it's a breech of contract, you won't get paid.
Look, I just wanna have the baby naturally! I'll get a court order forcing her to get a C-section.
- I don't think you can do that.
- Watch me.
She's endangering our unborn child.
I'm doing everything I can to convince her to get the surgery, but I can't force her.
She's carrying our baby.
We've been trying to have kids for five years.
We spent a fortune on three tries at IVF, and every time I miscarried.
We gave the last of my embryos to Claire.
I'm sorry, but we can't do it like this.
Let me go talk to her again.
Fine.
I'm still getting a court order.
- Ray, she had a late decel.
How low? - Hundred and eight.
- That means? - Get an OB.
- What's happening? - You guys need to wait outside now.
- We're taking her to Labor and Delivery.
- How are we doing? - Are you moving me? Yup, we're going upstairs.
- Inez, go hold an elevator.
- Okay.
Baby's heart rate dropped in the last contraction which could mean a sign of cord compression.
- The baby could be in trouble.
- What's the heart rate now? - One-twelve.
- But that's still okay though, right? - Claire? - We're doing okay.
Fifteen liters by mask.
You need to have a C-section, Claire.
You know that.
You have to trust me.
I know my own body.
- We wanna go with her.
- No! We wanna be there when our baby is born.
No! I don't want them to be there.
Dr.
Pratt, this is Karen Simms.
You treated her mother.
- GSW.
- Oh.
Right.
Thanks, Chuny.
No one will tell me what happened.
I mean, what's GSW? Is that gastro something? Is she okay? - Would you like to sit down? - I Okay.
GSW stands for gunshot wound.
Your mother was shot during a robbery attempt.
She was shot? Yes.
We gave her blood transfusions, emergency surgery Everything we could to save her.
She's dead? I'm afraid that her injuries were too severe.
I'm very sorry.
How did you find me? We found your name in her address book.
Did she say anything? Well, she talked a little when she was brought in but she'd lost a lot of blood and lost consciousness as we were trying to save her.
Would you like to see her? Too late.
We haven't spoken in a long time.
We had a falling out a while back.
We were both waiting for the other one to give in and admit they were wrong.
I guess I win.
I need to push.
No, not yet.
Just breathe, you're doing great.
- FHR's 120.
Where's Pedes? - On their way.
Oh, God, it wasn't this hard the first time.
- Take a rest.
- Umbilicus past the perineum? Yep.
Good news, Claire.
The baby's hips are out.
- You get to push next time.
- Oh, yeah.
Okay.
I told you I could do this.
Sterile towel.
Some gentle traction can help us get to the axilla.
Okay.
Baby's heart rate's below a hundred.
Ninety-seven, 90, 85 We need to put on - What's wrong? He okay? - Baby's heart rate's dangerously low.
The umbilical cord compressed, he's not getting enough oxygen.
- Sixty-eight.
- It should rebound between contractions.
- But we can still do a Caesarean, Claire.
- No.
We can push him back in, in two minutes, start surgery.
- He's almost out.
- But we don't know that.
His head could be entrapped.
Okay.
This is it.
Big push, Claire.
Between two and five minutes of low oxygen could be the difference between a normal and a brain-damaged baby.
Consent to the C-section.
- I'm trying.
I'm really trying.
- Yeah, okay.
The head is stuck.
We need to pull him out with forceps.
Okay.
Sling a towel under his body.
- Hold him up, here.
- Forty-eight on the monitor.
Open the intubation tray.
Okay, Claire.
Once more.
One big push.
Pretty cyanotic.
Clamps and scissors.
Okay, come on, baby, just give us one little cry.
He needs a little stimulation.
No respiratory effort.
Bag him.
No femoral.
Starting compressions.
Three and a half uncuffed.
Can you please tell Rod and Toni that he's out? I'm in.
Epi 0.
04 by ET.
How is he? He doesn't have a pulse and he's not breathing.
- So, what does that tell you? - Okay.
That's it.
You're out of here.
I thought I could do it.
Swimmers, on your board.
Chaz! Let's do this! Set.
- Have you been in to see the baby? - They're still doing tests on him.
It's been over an hour.
It was a hard delivery.
What aren't they telling us? Your son was deprived of oxygen during the birth.
But he's gonna be all right.
We'll know more in a few days.
There's a good chance that he suffered neurologic damage.
Well, did he or didn't he? I think that he probably did.
Come on, let's go.
- Go where? - Home.
But what about our son? I'm not gonna leave him.
Pediatrician will see you, he'll have more answers.
You already gave us the answer.
We didn't pay to have a brain-dead baby.
He is not brain-dead.
- Rod.
- He's not normal.
Which he would have been if you had done the C-section.
We were gonna call him David after Rod's father.
Toni, you still can.
Let's go.
Hey, Liam, how you feeling? Cruddy.
Your parents are on their way.
They were very worried about you.
Good.
I'll send them to the PICU as soon as they get here.
You'll like it up there.
They have video games.
My friend thinks you're a MILF.
Shut up.
- Excuse me? - It's a Mother-I'd-Like-to- Oh.
Well, I'm not a mother.
I'm a doctor.
Guess that makes you a DILF.
Okay.
See you later, Liam.
Stay on your diet and wear your medic alert bracelet.
Am I supposed to pretend I didn't see that? See what? Okay.
Well, come on.
I don't hear from him, he sends the ER a postcard.
You practically chased him out of town with a torch.
- Where's Pratt? - He left.
Must be nice working banker's hours.
No.
This is incomplete.
You didn't document the distal neuro-vascular exam.
Let me see.
Ten millimeter kidney stone.
No.
Urology needs to see this guy prior to discharge.
This looks good.
- Write the CBC and Chem-20 results.
- Lab slips are on the back of the chart.
Not good enough.
Transcribe them to your H and P.
- Since when? - There's a new sheriff in town, ladies.
All right.
Let's see if you can do better than one-for-four, Lockhart.
- You need me to sign off on some charts? - No.
- You said you had stuff for me to sign- - That was Neela.
Aren't those your charts? Could somebody show me how to do a filiform and follower? - Where's Ray? - Still at Labor and Delivery.
Probably stayed upstairs to hit on the OB nurses.
Come on.
I'll show you how to do it.
How's his muscle tone? Well, it's not too good.
Is he over-breathing the vent? No.
Hypoxic brain injury.
The chance for complete neurological recovery is slim.
Has his mother been in to see him? No.
Claire doesn't consider him her child.
And the Stillmans don't want a ventilator baby.
There's nothing else you can do for him.
Little guy's had a rough day.
And I don't think he should spend his first night all alone.
Hey, Chaz.
Yeah, talk to you guys later.
- Bye.
- All right.
Bye, Chaz.
Congratulations, man.
You swam a good race.
Oh, yeah.
Thanks.
I'm Greg.
Yeah, I remember you.
You came to the house a few weeks ago.
Yeah.
So did your dad say anything about me? No.
He didn't? No.
But he's here with my mom and my sister.
If you want- No.
No.
That's cool.
I Actually, I just wanted to introduce myself to you.
Your father and my mother I'm your half-brother.
- Get out of here.
- No, it's true.
I'm just surprised your dad didn't mention it to you.
I've heard family rumors and stuff, but Wow, this is trippy.
Good to meet you, man.
You too.
Come on, Chaz.
I'm starving.
Hey.
Hey.
So you two met.
Yeah.
Good.
Yeah.
That's good.
We're gonna get a bite to eat.
You wanna join us? No, not tonight.
I just Wanted to introduce myself to Chaz.
You know.
Yeah, I'm glad you did too.
Yeah.
- Well, I gotta go.
- Wait, Greg.
Whatever you guys wanna eat is fine with me.
This is my wife, Evelyn.
My daughter, Jocelyn.
This is Greg.
My son.
Nice to meet you, Greg.
Likewise.
Come join us.
I can't.
I gotta get back to the hospital.
Maybe another time.
It was nice meeting all of you.
It was nice meeting you too, Greg.
- Bye.
- Come on, Chaz.
Yeah, hold up.
You know this is hard.
For all of us.
So come on, man.
Give it a chance.
This is your family.
No, this is your family.
Sam? Alex?