ER s12e05 Episode Script
Wake Up
E.
R.
Previously on E.
R.
I saw Charlie Pratt at Ceasefire.
He said he stopped by here last week.
- How'd it go? - Quick.
Did the oncologist you spoke with mention anything about prophylactic surgery? You mean having my breasts removed? There have been advances in reconstructive surgery.
And you need to protect yourself.
Can you promise me that giving up my breasts would protect me? I had my annual PSA screening.
Needle biopsy showed a moderately differentiated prostate cancer.
- I am so sorry.
- Does this hurt, Blaire? - She's in a coma, Inez.
- Not anymore.
- What's the last thing you remember? - Were we in an accident? E.
R.
12x05 "WAKE UP" The reason I'm calling, Dr.
Clemente, is that you were supposed to start today.
So unless your plane went down or you got hit by a bus you'd better get in here as soon as you get this message.
Luka, I need you to wait.
Pratt's running behind.
The new Attending is a no-show.
First day.
He'd wanna make a good impression.
- You never did.
- I have to go.
Page me if he doesn't show up.
Morris, run through the moonlighting list.
See if we can find someone to come in.
- Whoa.
Where are you rushing off to? - Upstairs.
Why? Uh- Never mind.
Last time I reached out to someone, Dubenko tried to make me his concubine.
Hello, my people.
- You're late.
- Not according to me.
According to me, I got 20 patients on the rack.
Chest pain, I need a monitored bed.
Don't have one.
- Is Dr.
Lewis coming in? - Dr.
Lewis is never coming in again.
She took a tenured track position in Iowa City.
- Just like that? - Just like that.
That's why Dr.
Clemente is supposed to be here now.
Who's this Clemente guy, anyway? He was residency director at Jacobi in the Bronx and he did a stint in Newark.
Is he gonna be the new department chief? We're forming a search committee.
The guy must be angling for it, right? - Abby, vomiting blood.
- My favorite.
Ray, nosebleed.
Sorry, I'm on my tox elective.
I was just rolling down here to remind everybody about my gig tonight.
- Oh Pogo Lounge.
- Isn't that a strip club? It's behind the Lava Lounge, which used to be the Aqua Lounge.
Roomie, are you gonna come? That's why I wake up in the morning.
Okay, med students.
Burning urination, seafood allergy.
- We're not really doctors.
- That never stopped Morris.
Roswell and Marshall are premed.
They're working for my grant tracking patient throughput time.
If we don't start moving the meat, they'll be unemployed.
You want me to supervise everyone and take on three new patients? You're an R-4, stop whining.
- Where are you going? - To the Weaver Lounge.
To work on my presentation.
Anything short of a meteor crash, don't bug me.
Pratt.
EKG looks good.
All right.
Where's your pain, sir? It's not a pain.
I just feel something right here.
- BP 124 over 78.
- What's it feel like? It feels really heavy, like a boulder.
I can't breathe, doc.
Say no more.
Sir, would you do me a favor and open up? No, no.
I did two lines of coke last night.
- What? - Yeah, and a bottle of tequila.
- You did? - Yeah, not to mention three Viagra.
- Why didn't you say something? - Aren't you supposed to take my history? - Who are you? - Victor Clemente.
Your new Attending.
And congratulations, doc.
You just killed me.
Usually, Dr.
Pratt is very thorough.
We're getting slammed.
It's okay, death becomes me.
I've got a Q&A upstairs, but maybe I should stay down here.
No, go ahead, take it.
Dr.
Kevorkian and I will hold down the fort.
- Hey, Jerry.
You know where to find me? - Mm-hm.
You sure know how to make an entrance.
I was just trying to get the lay of the land.
You take it too far.
You should have seen me at St.
Mary's.
I took it all the way to a rectal.
She was cuter than you, though.
Look at that.
You guys still using x-ray film? I thought everybody was digital by now.
- Oh, hey.
Nice job shaving my chest hair.
- No problem.
Now, it took 24 minutes to get my vitals.
Twenty-four minutes.
Come on.
I know we can all do better than that.
Yes, we can.
Yes, we can.
It's totally what I think.
Archie Morris, chief resident.
It usually takes me about 10 minutes to figure out who the kiss-ass is.
At least we're breaking records somewhere, huh? Now, the EKG was prompt, but the resident's evaluation was sloppy.
You know we were busy.
It's always busy, it's always chaos, always out of control.
I know you don't have enough hours to spend with every patient.
But our job is efficiency and excellence.
We're marksmen.
We hone in on what's important, hit our target with one shot and move on.
We should call Psych on this guy.
And who are you? Abby Lockhart.
R-2.
Oh, yeah.
Weaver was talking to me about you.
I'd like to say it was all good, but it wasn't.
- Can we start by clearing this stuff? - Okay, in Trauma 1, we have Grease board? God, I haven't seen one of these since the '80s.
That's pretty cool.
Look, unless anybody has any objections, I prefer walking rounds.
We all learn.
Okay? Let's go.
He's kind of hot.
- I thought you had a boyfriend.
- He's at war, and so are my hormones.
Come in.
How are you? This toothbrush feels like a hundred-pound weight.
Well, it's normal after such prolonged bed rest.
Please tell me you brought rocky road and a cheeseburger.
I just came by to test your muscle tone again.
So no fries? Well, at least you're not Dr.
Schulansky.
He brings tours here like I'm a freak from the wild animal park.
He's excited that you're awake.
She's alive.
She's alive.
Squeeze my hand.
Okay.
That feels a little stronger than last week.
Try to lift up your leg.
That's good.
Very good.
Well, it's more than you could do the last time.
That's thanks to three hours a day with Helga, the therapist from hell.
Well, I see you had some visitors.
Yeah, that was my best friend from college.
I haven't seen her since graduation.
I asked her for a joint and she brought me a teddy bear.
Good for her.
The last thing you need is anything interfering with your recovery.
I need, heh, to take the edge off.
Waking up and finding out that your mom's dead, your fiancé's MIA and you've literally slept through your 20s, it's just a little stressful.
Has Dr.
Schulansky said anything about the accident? All I know is you and your mom were driving and there was some kind of traffic collision.
Yeah, that much I remember.
We were on our way for my final fitting for my wedding dress.
It was strapless with a tulle skirt.
I wouldn't even let Jason see it.
- Your fiancé? - Mm-hm.
Have you spoken to him? Oh.
That would fall under the heading of "Scared as hell, don't know how to do that one.
" Lowered tidal volume of 6 cc's per kilo decreased mortality from 40 percent to 31 percent.
You twirl a knob, you're gonna save a life.
Okay? All right, let's go.
Those are cool shoes, man.
Are they Adidas? Get laid, Morris.
Boris Nadinovitz, presenting with fever, lymphadenopathy and night sweats.
No obvious source.
Ya bolen, doctor.
So, what's your diagnostic approach? Skin test for TB and cocci histo? Good, good, good.
Dorsey Watson.
Greg Pratt.
Man, what's it been, like five years? Six.
I was in second year when you graduated.
- Wow.
So, what are you doing here? - I work here.
What's your excuse? I heard you were in Winnetka doing lipo on rich chicks.
Still am, man.
Still am.
But one of my patients got a half-price tummy tuck from a hack, landed upstairs.
Hey, killer, come on.
We got patients to clear.
Let's go.
- I gotta roll, man.
- Hey, do your thing.
- I'll holler at you before I go.
- Definitely.
Be relaxed.
Try to sound calm.
It will be weird for him at first.
You think? - It's ringing.
- Okay, take a deep breath.
What's going on? Oh! Hi.
Is this Jason Clark's house? She's calling her fiancé.
Blaire Collins.
I'm an old friend of his from the Art Institute.
- She's doing great.
- I'm amazed by her progress.
I've been trying to help her for over four years and all of a sudden, this.
Yeah, it's really me.
What were you treating her with? Most recently, an experimental cocktail.
Fluoxetine, Sinemet and dextroamphetamine.
- Is she still on them? - Not anymore.
I know.
It's weird.
She's asked me about what happened, how she got hurt.
Um I think it's better not to talk to her about it yet.
Is there something she shouldn't know? The accident was violent, to say the least.
Blaire and her mother were carjacked.
Her mom was raped.
And shot? Blaire tried to fight and was pistol-whipped.
They would have killed her, but someone pulled up.
Still, she has the right to know.
She's in a fragile state.
Telling her could set her back.
Let's get her healthy first.
She needs to hear this from someone close to her.
- She has no family.
- She'll be told, doctor.
All in good time.
A 22-year-old female presenting with recurring headaches.
- No history of migraine- - Right.
But there is a history of idiopathic intracranial hypertension.
They usually take out a bunch of spinal fluid.
We don't do that anymore.
- We don't? - No.
Now that we know that llH is caused by sagittal sinus thrombosis resulting in a decreased CSF reabsorption at the arachnoid sinuses.
I didn't know that.
- Heparin is the treatment of choice.
- Here you go, doc.
I'm just gonna place a drop in your eye.
Lean back.
She still needs an LP for diagnosis.
Hey, hey, not so fast, not so fast.
Annals of Emergency Medicine, May 2000.
- 2000? - Five? - Nope.
- Three? - Nope.
- Four? Ten points for the winner.
Intraocular pressure correlates with intracranial pressure.
Fifty-four.
Diagnosis made, and you don't get a spinal tap.
Abby, Oncology's on the phone.
If you ever say he's hot again, I'll kneecap you.
Some patient of yours is freaking out.
- In Oncology? - Mm-hm.
- Who is it? - Stephanie Lowenstein.
She's upset because we couldn't do the reconstruction.
- Why not? - They found an enlarged lymph node.
We told her pathology isn't back, but she won't listen.
She says it's all your fault.
She smashed the mirror.
- Stephanie.
- I don't want you here.
- I just wanna help.
- You call this helping? This is not helping.
- Okay, I understand how you feel.
- You have no idea how I feel.
Miss Lowenstein, wait.
You just have to let the doctors get the results back from the tests.
We'll figure out how to proceed.
To do what? To cut me up some more? To hell with your damn tests.
Stephanie, listen to me, please.
Just listen.
- You ruined me.
- I know you're scared.
Is that what I am? Just because they found a node doesn't mean you have cancer.
I need a cab.
Where's a cab? You need to come inside and let us treat you.
I have money.
Where's my stupid book? Listen to me.
Everything you're feeling right now is normal.
- It's just gonna take time.
- I don't have time.
That's not true.
Who's gonna marry someone who could need chemo for 10 years? Someone who could die before the kid goes to high school? If they had trouble making a diagnosis, it may not be cancer.
And if it is, because you had the surgery, they caught it early.
- I don't believe you.
- It's the truth.
You did what you had to do and it was incredibly brave.
- Then why do I feel like this? - Because it's scary.
It's scary, but you don't have to go through this alone.
- Get the hell away from me.
- Stephanie, please.
Just let me take care of those cuts.
Just come inside with me and Stephanie, please.
I've tried all the Internet dating sites.
I rewrote my profile so many times, you would have thought it was my thesis.
What happened to Lou? - I liked Lou.
- Ah.
I don't think he could handle this.
He said he would come back after the surgery, but I never liked Lou.
Guy's a jerk.
It's a good thing you found out early.
I don't wanna freeze my eggs or buy milk on the Internet.
I wanted to breastfeed.
This is a little bit of Neosporin.
Aren't you afraid you'll wind up the auntie? Be forced to adopt some kid from Cambodia? I think Cambodian kids are cute.
You know what I meant.
Stephanie, if all goes well, you'll get the reconstruction.
You'll have an uneventful recovery and a perfectly normal life.
That's doctor talk.
You don't get it.
My mother's sister died of breast cancer.
So did my grandmother.
And you? I have never even had a mammogram.
Tony Dejesus, single stab wound to the neck, vitals stable, good airway.
- Hey, having trouble breathing? No.
Time of arrival, 1442.
- Was this gang-related? - My old lady stabbed me.
- Why did she do that? - Because she's a psycho bitch.
Where are my residents? This is a great case.
Get my residents.
Hey, who are these clowns? We are not putting on a show for you.
What the hell is wrong with you? Get the hell out of here.
The woman who answered Jason's phone was his wife.
Six years is a long time.
Ha.
You know, the thing that's so hard about all of this is that everything has just gone on and I still feel like Jason and I were just finalizing our wedding list yesterday.
I'm sure he stayed by you as long as he could.
He came by twice.
Schulansky told me.
No wonder he wanted us to write our own vows.
He probably planned on omitting the whole "in sickness and in health" part.
Did you want him to spend the rest of his life hoping for something everyone said wouldn't happen? Maybe I can be his mistress.
Which anatomic landmarks define zone two of the neck? The cricoid cartilage to the angle of the mandible.
Very, very, very good.
Because management of zone two injuries is very controversial.
Actually, some people advocate surgical exploration for everything.
I'm pretty sure surgeons would not wanna explore an asymptomatic patient with a superficial wound.
Can you guys hurry up? My old lady's gonna burn my truck.
Maybe next time, you won't double dip at your mom's-in-law.
You seen my wife's mother? - Then don't criticize.
- My bad.
I'm sure you guys are aware of all the indications for immediate exploration.
Right, Dr.
Morris? Airway compromise, severe hemorrhage or expanding hematoma.
- He has none of those.
- Good, so then let me go.
Right, but we can always learn from every case, Dr.
Pratt.
Talk to me about management with neck injuries.
- What? - Brother, keep it short.
Don't go Al Sharpton on his ass.
Duplex scan, endoscopy, gastrograffin swallow which you would only do if he had symptoms.
Well, slow your roll, bro because what proportion of zone two vascular injuries are asymptomatic? Dr.
Rasgotra? With a significant injury, he might have signs of bleeding or a hematoma.
- The guy is stable.
- Maybe, maybe.
But nine in a hundred times, asymptomatic patients have lesions that require surgical repair.
How about that, Dr.
Pratt? How about that? Talk to me now.
You know what? How about I go check on my asthma patient in Curtain 2? There's no asthma patient in Curtain 2.
Yeah, well, maybe he went out for a smoke.
I'll go find him.
Yes, Eve, I did.
I put up the sanitizer.
No, I didn't hand out pens.
I am putting up the poster as we speak.
Yes, that special tape that won't ruin the walls.
Okay, bye-bye.
Don't tell me.
Eve? It's her day off and she still calls in.
Here.
She wants everyone's hands to be sanitized before they touch a patient.
"Scrub or rub"? It sounds kinky.
- We should be so lucky.
- Heh-heh.
I was thinking we could get something to eat.
You know, maybe catch a movie or something.
No, I haven't seen that one yet.
All right, cool.
I'll meet you out front.
Hey.
How are you doing, Greg? What, you're stalking me now? No.
I'm here for a sick friend.
Sure you don't have another illegitimate kid up in there? We need to talk.
What are you doing after work? I've got a date.
With Olivia Evans? Nice girl.
I've known her since she was in high school.
That's great.
What about tomorrow? Maybe we can have dinner.
You like gumbo? I know a great place on King Drive.
And down the street, there's a cat with a pool hall- Listen, we're not eating any gumbo together or playing pool.
All right? Then what would you like to do? I would like for you to leave me alone.
For real.
We're done.
Okay.
You don't wanna have anything to do with me.
- What about your little brother? - Don't use him like that.
- He'd like to get to know you, Greg.
- He just met me.
I don't know what your mother told you about me.
But I have an idea it wasn't everything.
- Come on, man.
- I could explain - but only if you give me the time.
- I do not have the time.
I'm trying here.
Then stop.
Fine.
If you wanna drop it forever, that's your call.
But you'll have to live with it.
Your choice.
I never got the whole marriage talk from my mom.
But the moment that I told her that Jason proposed, she pulled out this trunk.
She had every detail of my wedding planned.
It was crazy.
Oh, my God.
Stop, stop.
She wasn't gonna pressure you.
Yeah.
She wanted it to be special.
Which way is Lake Michigan? That way.
You can see it from the other side of the hospital.
- Can we go? - I shouldn't even have you out.
- Please? - No.
Come on.
What does a girl have to do to get a break with you? I hope Clemente doesn't become chief of the department.
- You liked him.
- I did until I had to present.
Patient doesn't have flesh-eating bacteria now but what symptoms might he have? Is that muscle spasm in the jaw? Acute tetanus? I'm all for teaching, but this guy doesn't stop.
Yeah, he's annoying.
You said you liked his bloody shoes, you wanker.
Just because he's annoying, doesn't mean I can't like his shoes.
- Are you going to Ray's gig? - To hell with Ray.
He's upstairs having a blast.
Jerry, it's Ray.
Save me.
I'm bored stiff.
Try picturing every woman up there naked.
That always works for me.
Oh, come on.
Are there any drug cases down there? Couple of traumas rolling in.
Lola Simon, 7- year-old with crush injury.
BP 70 palp.
- What crushed her? - Your next patient.
- Move your legs for me.
- Seven-year-old girl, no sign of drugs.
Yeah! I'm king of the world! Looks like you forgot how to fly, king.
Tommy Bonetti, stood up on the Tilt-A-Whirl at the St.
Ignatius fair.
- Is he on drugs? - He might have just hit his head.
Sounds like drugs.
I'm on my way down.
- Move away from the light.
- We're trying to take care of you, man.
You look like an alien.
Don't probe me.
Please sedate him.
I have to assess his neural status first.
Taking the HemoCue.
Process the spinal films before you take the rest.
- Hey, I'm rolling out, man.
- What, you scared of a little blood? - Squeeze my hand.
- Systolic's 65.
All right, no fluid in the abdomen.
Pericardium is clear.
Looks like spinal shock with a high thoracic injury.
Am I right? I'm way out of my league, man.
Don't you remember Bartlett's lecture on blunt trauma? Sweetie, listen, I'm gonna poke you.
Tell me when you feel this.
Start dopamine at 5 mics, Sensory level at T4.
How you doing, Lola? - That's a big bug.
- You just killed our mascot.
- Here she goes.
- Log roll.
Keep her on the backboard.
Suction.
Look, some of the old U of I crew's are hooking up at Cherry Red tonight.
You got plans? - Pratt, we need you in here.
- I'm gonna try to roll through.
- Pratt, now.
- Go see what's up.
I'll intubate.
You don't stay still, I'll put this needle through your heart.
- Can we sedate and paralyze? - He took his IV out.
Since when did Alfred E.
Neuman become a doctor? - What about I.
M.
Versed? - Gave him five.
It's not touching him.
- What did he take? - Maybe ice, coke.
Tracheal 140.
- What the hell are you on? - Her in a minute.
I can't find the vein.
- How about Haldol? - No, he could seize.
Morris, let me try the line.
- Dr.
Pratt.
- Go ahead, push the sux.
This guy's unstable as hell.
We can't get a line.
- I'm tied up.
- We need help.
You gotta get Clemente.
- Is there another Attending on? - Clemente's the only one.
No, we can handle this ourselves.
I'll do a femoral cutdown.
- Are you serious? - He needs access.
Pulse keeps going up.
Mix up esmolol, slow down his rate.
- Ten blade.
- We got sugar in here? Oh, wow, we got a trauma.
I didn't know.
Pager's probably not working.
No, my pager's working.
Twenty-foot fall complicated by unknown intoxication.
- What are you guys doing? - A femoral cutdown.
Whoa, whoa, whoa, everybody take a deep breath.
Take a deep breath.
Get my briefcase under admit.
- Banana cheese.
- Yeah, banana cheese.
- What did he take? - He won't say.
Tachy with mydriasis.
My guess is sympathomimetic.
Bad, bad guess.
Skin and membranes are dry.
It's an anticholinergic.
Electrolytes back yet? Right here.
Hyperchloremia.
Anion gap is minus four.
How could that be? Skittles, people, skittles.
Very popular with the kids these days.
It's cold pills with dextromethorphan hydrogen bromide.
The lab analyzer thinks bromide is chloride.
- You get a reversal of the gap.
- Aaah! Anything to calm him down? Two mics of I.
M.
physostigmine.
He still needs access.
- Here you go.
- I'm Rick James, bitch.
Close your eyes.
Go to your happy place, son.
What time did the chem panel come back? He's got weird anatomy.
We couldn't find the subclavian.
There it is, there it is.
Right there.
See, the probe allows us to cannulate the vein under direct visualization.
That's very cool.
- You carry that with you all the time? - It's just a demo.
I ran the phase-three trials.
- Beautiful, beautiful.
- It's like shooting fish in a barrel.
Heart rate's down to 80.
I guess we didn't need the beta blockers, did we? I trust you guys can finish without me.
No problem, boss.
Hey.
Even if you think I'm a pain in the ass it should never get in the way of patient care.
You with me? Good.
Dr.
Lockhart? Hey.
What's up? Well, everything.
And almost twice a day.
Congratulations.
I hear you're getting out today.
If you thought it stunk to work here, try being a patient.
By the way, thanks for the date.
- She told you? - I had to pay her.
- It was supposed to be a freebie.
- Just the first time.
Initially, it kind of turned me off when I learned that she was a professional.
But then when I thought about it, it turned me on.
We're both professionals.
So you didn't need me after all.
Well, I guess not.
Hey.
I don't remember your name.
Abby.
And you're a little late, Lou.
I came to see how Stephanie was doing.
She had her breasts removed.
Pick up a pink ribbon on your way out.
- What? She did? - Yeah, she did.
What are you talking about? Stephanie says you disappeared on her.
She told the nurse not to let me in.
And every time I called, she wouldn't say why she was here and kept going on about how she couldn't handle dating anyone right now.
- Why would she do that? - I don't know.
All I know is I can't stop thinking about her.
And I'm a little worried.
Come on, come on.
Do it, do it, do it.
Dr.
Clemente.
- Oh, damn it.
- Do you have a moment? You should really consider getting one of these.
It might keep you from hacking up the patients.
I'm sorry I didn't call you in earlier.
Bonetti's gone up to the ICU.
We've got to consider preemptive orders.
It was really unprofessional of me.
Nurses transporting patients? What a waste of resources.
- Are you listening to me? - Actually, no.
I lost.
Okay, look.
A femoral cutdown has to be a last-ditch effort in a peri-arrest patient.
- And skittles boy wasn't quite there yet.
- Well, I thought he was.
Oh, you thought he was.
Look, I know.
I was a resident too, I thought I had the keys to the kingdom.
But the great thing is that we can always learn.
That's why I'm here.
Well, sometimes you wanna do it yourself.
Sometimes your ego does, but the patient would rather that I do it.
- Believe me.
- You're right.
You know what? It's not about being right.
Okay, look, I consider you, Pratt, Morris, every resident, every student here an investment in the future.
My dividend comes when something that I've taught you saves a life.
That's it.
You should really consider surgery as an elective.
Well, why do you say that? Because you're quick to cut and you like to use a scalpel more than your brain.
Come in.
- Hi.
- Hey.
I brought you some company.
Lou.
I heard what happened.
Hi.
Come in.
Sit down.
Chocolate.
Hi.
I'd like to schedule an outpatient mammogram.
Sure.
Patient's name? Abby Lockhart.
First you missed morning rounds and now they tell me you're avoiding Poison Control.
No, I got stuck with a consult.
Look, a bunch of Zen monks made tea from this plant in their garden.
Now they have vomiting, diarrhea.
Some are tachycardic, some bradycardic, some hypotensive, some hypertensive.
- Not a clear toxidrome.
- I haven't identified this on the Internet.
I even sent digital photos to the Botany Department, but It's not jimsonweed, not foxglove, not oleander.
Well, maybe it's tabaco gigante.
You know something? You may be right.
I saw this once in Mexico.
It's a tobacco plant.
Your patients have nicotine toxicity.
- Oh.
- Good call.
Thank you.
Dr.
Clemente.
Why are my research assistants sitting in the waiting area? The parking garage is too cold? They're collecting data for me.
The looky-loos were getting in the way of the work.
Then you just tell them to step back.
I didn't wanna overstep.
Maybe that should come from you.
Overstep? You pulled the plug on my study.
Look.
I meant it as more as a time-out kind of thing.
You told them that my study was useless.
Look, I know what happened in Newark.
And I really do not want a repeat here, okay? All right, look.
Bottom line, you hired me to make this place more efficient.
And that's what I am trying to do.
And if and when we start bedside registration is gonna make your study- I don't know, irrelevant? I've got a $ 100,000 grant that says that it won't.
You've got $ 100,000, why don't we go digital? Listen, I run this hospital.
If we start bedside registration, that goes through me.
If you put my students on a time-out, that goes through me.
If you wanna wash the floors differently, that goes through me.
Do I make myself clear? I got one more question for you.
Does my answer go through you? My mom loved seeing the lake.
Look at the water.
At least some things stay the same.
We should really get back.
Have you always been such a worrier? I've always had things to worry about.
Do you think this was God? What? Me waking up.
I don't know.
You think it was science, don't you? I've seen deeply religious people come into the hospital.
Prayer did nothing for them.
And then I've seen plenty of skeptics experience miraculous recoveries.
So you think it was fate? I think I'm glad we're both here able to wonder about it.
Yeah.
How you gonna punk me like that? What's up, little man? You know where Olivia is? - Yeah, she's down the hall.
- Thanks.
I hear you, fellows.
But you sound like a bunch of knuckleheads.
Hey, all I'm saying is, you can't feel nothing with no jimmy on.
Get used to them.
There's no alternative.
Getting a girl pregnant is 18 years of lockdown.
Half your check going to Uncle Sam.
- The other half going to your kid and? - The baby's mama? And what happens if you miss a child support payment? Who's gonna be blowing up your pager? My baby's mama.
Having a kid at your age ain't what you wanna do.
Trust me.
Do you miss Croatia? I have family there.
But there are more opportunities for me here.
I like Chicago.
Except the winter sucks.
Yeah, you can always go inside and warm up.
You know how I keep asking you about the accident? It's because I keep having these flashes that don't add up.
What kind of flashes? I remember being scared.
We had just gotten coffee and I remember seeing my mom's face.
Her eyes were petrified.
And I hear her screams, but her screams are muffled by the radio and there's blood and laughter.
Lots of laughter, and at first I thought it was just a dream but the images are so vivid.
- They're so clear.
- Sit down.
Sit down.
Something else happened that night.
And not knowing what it is is killing me.
But I need the truth.
- Blaire.
- I want to be out - Figure it - Blaire? Come on, Blaire.
Stay with me.
Hey, I need a monitored bed.
- Trauma 1.
What's going on? - Page Schulansky in Neurology.
Hey, I'm Dr.
Clemente.
So, what's the problem? She's not talking.
Get me an Accu-Chek, a HemoCue and a pulse ox.
- She doesn't need that.
- Can we have her friend wait outside? - I'm not her friend.
- This is Dr.
Kovac, one of our Attendings.
Hey, doc.
I'm sorry, I had no clue.
- Ma'am? Ma'am, can you hear me? - Her name's Blaire.
- Can you hear me? - Schulansky's at the VA.
Damn it.
Gaze is fixed to the right.
I need a CBC, chem panel and a head CT.
No, she needs fluoxetine, Sinemet and dextroamphetamine.
I don't know what you're talking about.
Abby, run up to the pharmacy and get the meds.
There's an approach dealing with altered mental status.
This is not a standard patient.
She's been on experimental cocktail.
Abby, fluoxetine, Sinemet and dextroamphetamine.
Abby, please go.
Hey, hey.
I need some help.
Hey.
What's up? Fluoxetine, Sinemet, dextroamphetamine.
Yeah, write it up.
Hey, what are you doing? Are you crazy? You can't go back here.
Crit's fine.
Sodium and potassium are normal.
- I told you that.
- CT is ready.
Okay, let's move her now.
She needs the meds.
We could be missing a brain bleed or a mass effect.
- I know.
- We don't have time to screw around.
The meds woke her up from the coma.
If they did, we'd have coma patients waking up everywhere.
- All I know is they worked for her.
- Got them.
You're not gonna actually let him do this? Are you confident these meds are gonna work? If not, there's gonna be a tall guy in a cheap suit from the state asking questions.
It's worth a try, Kerry.
Right.
Hold the scanner.
I'll give him five minutes.
You know what? Don't sweat it.
Dr.
Kovac, you're the physician of record.
I'm not on the chart when the family sues.
Well, I'm in luck.
There is no family.
And fluoxetine in at 2019.
Let's get her up to CT.
As soon as I get a portable monitor.
Blaire? Blaire? Eyes opening to pain.
- Incomprehensible verbal activity.
- You got a GCS of 2, 2, 4.
- Check her gag.
- Whoa.
She's seizing.
Two mics of Ativan now.
One hundred percent oxygen, non-rebreather.
- She has a history of seizures? - No.
Well, any of the meds you pushed could have caused this.
So could falling drug levels, so could withdrawal.
Another round of Ativan.
Heh.
I really liked that last one.
Is it new? Yeah.
It's called " Blood Wine.
" Oh, "Blood Wine.
" How did you think of that? I cut my finger opening a bottle of merlot.
So you and your friend headed home? I don't know what she's doing.
Do you know what you're doing? - Yeah, I know what I'd like to do.
- Hold that thought.
- I'll settle with the boys.
I'll be back.
- Yo, Ray.
You guys are late.
We were the opening act.
Clemente had us pull journal articles to justify the treatment of every patient.
You wanna get something to eat? - I have plans.
- Do your plans have friends? Let's see.
- Zoe.
- Yes? - This is my boy, Archie.
- What up, ladies? - You guys hungry? - We wanna meet the band.
I play drums.
Yeah, I'm serious.
Like: That's my marching band.
We won the nationals.
Turning into pooh, pooh, pooh, and then we Guys? Ray! Blaire? Blaire, open your eyes.
Maybe she's postictal.
Or the Ativan didn't wear off.
Or I shouldn't have pushed the meds.
You don't know why she had a seizure.
Maybe we overloaded her sinuses.
Luka, there is no way to know why she fell back into this.
Yeah.
I have to go.
Are you okay? The state conservator agreed to admit Blaire to the hospital for two days to see if there's any improvement.
If not, she'll go back to the nursing home.
I could have been a doctor But why poetry? Why I? Why me? Why I? I could have been a lawyer But why poetry? Poetry.
Why? Poetry.
Thank you.
- Where's our waitress? - To hell with her.
What do you want? Uh Light beer.
Lipo doctor's scared of getting handles.
Don't hate.
I look good.
I'll be back.
Excuse me.
Hey, what's up, bro? I'll get two beers, one light.
- You want something? - A conversation would be cool.
- You haven't said anything to me.
- We can barely hear.
You could hear everyone just fine.
What did I do, Greg? - Tell me what I did.
- You should've told me he was in there.
- You want me to survey the building? - Yes, I do.
Look, he's down there helping those kids.
And who sews up those kids once they leave your place? Your father tries to help them before they get to you.
I see.
Charlie Pratt may be a lot of things.
But he's not my father, my dad or my pops.
He's just a guy who got my mom pregnant.
So basically, he made the same mistake he's warning those kids about.
Greg, wait.
Uh- You wanna hate him, I can't stop you, but Charlie's a good guy.
Twenty hours a week with the kids, runs a basketball league - rehab houses for poor people.
- Yeah, see, that's the problem.
I've waited my whole life to spit in my old man's face.
He's not lying in the gutter- - People change, Greg- - He's building houses for people for free.
- No.
No.
- Greg.
Blaire, I hope you can hear me.
On that night, you and your mom were driving.
You stopped at a red light.
Another car pulled up next to you.
There were three men inside.
They pulled a gun and dragged your mom
R.
Previously on E.
R.
I saw Charlie Pratt at Ceasefire.
He said he stopped by here last week.
- How'd it go? - Quick.
Did the oncologist you spoke with mention anything about prophylactic surgery? You mean having my breasts removed? There have been advances in reconstructive surgery.
And you need to protect yourself.
Can you promise me that giving up my breasts would protect me? I had my annual PSA screening.
Needle biopsy showed a moderately differentiated prostate cancer.
- I am so sorry.
- Does this hurt, Blaire? - She's in a coma, Inez.
- Not anymore.
- What's the last thing you remember? - Were we in an accident? E.
R.
12x05 "WAKE UP" The reason I'm calling, Dr.
Clemente, is that you were supposed to start today.
So unless your plane went down or you got hit by a bus you'd better get in here as soon as you get this message.
Luka, I need you to wait.
Pratt's running behind.
The new Attending is a no-show.
First day.
He'd wanna make a good impression.
- You never did.
- I have to go.
Page me if he doesn't show up.
Morris, run through the moonlighting list.
See if we can find someone to come in.
- Whoa.
Where are you rushing off to? - Upstairs.
Why? Uh- Never mind.
Last time I reached out to someone, Dubenko tried to make me his concubine.
Hello, my people.
- You're late.
- Not according to me.
According to me, I got 20 patients on the rack.
Chest pain, I need a monitored bed.
Don't have one.
- Is Dr.
Lewis coming in? - Dr.
Lewis is never coming in again.
She took a tenured track position in Iowa City.
- Just like that? - Just like that.
That's why Dr.
Clemente is supposed to be here now.
Who's this Clemente guy, anyway? He was residency director at Jacobi in the Bronx and he did a stint in Newark.
Is he gonna be the new department chief? We're forming a search committee.
The guy must be angling for it, right? - Abby, vomiting blood.
- My favorite.
Ray, nosebleed.
Sorry, I'm on my tox elective.
I was just rolling down here to remind everybody about my gig tonight.
- Oh Pogo Lounge.
- Isn't that a strip club? It's behind the Lava Lounge, which used to be the Aqua Lounge.
Roomie, are you gonna come? That's why I wake up in the morning.
Okay, med students.
Burning urination, seafood allergy.
- We're not really doctors.
- That never stopped Morris.
Roswell and Marshall are premed.
They're working for my grant tracking patient throughput time.
If we don't start moving the meat, they'll be unemployed.
You want me to supervise everyone and take on three new patients? You're an R-4, stop whining.
- Where are you going? - To the Weaver Lounge.
To work on my presentation.
Anything short of a meteor crash, don't bug me.
Pratt.
EKG looks good.
All right.
Where's your pain, sir? It's not a pain.
I just feel something right here.
- BP 124 over 78.
- What's it feel like? It feels really heavy, like a boulder.
I can't breathe, doc.
Say no more.
Sir, would you do me a favor and open up? No, no.
I did two lines of coke last night.
- What? - Yeah, and a bottle of tequila.
- You did? - Yeah, not to mention three Viagra.
- Why didn't you say something? - Aren't you supposed to take my history? - Who are you? - Victor Clemente.
Your new Attending.
And congratulations, doc.
You just killed me.
Usually, Dr.
Pratt is very thorough.
We're getting slammed.
It's okay, death becomes me.
I've got a Q&A upstairs, but maybe I should stay down here.
No, go ahead, take it.
Dr.
Kevorkian and I will hold down the fort.
- Hey, Jerry.
You know where to find me? - Mm-hm.
You sure know how to make an entrance.
I was just trying to get the lay of the land.
You take it too far.
You should have seen me at St.
Mary's.
I took it all the way to a rectal.
She was cuter than you, though.
Look at that.
You guys still using x-ray film? I thought everybody was digital by now.
- Oh, hey.
Nice job shaving my chest hair.
- No problem.
Now, it took 24 minutes to get my vitals.
Twenty-four minutes.
Come on.
I know we can all do better than that.
Yes, we can.
Yes, we can.
It's totally what I think.
Archie Morris, chief resident.
It usually takes me about 10 minutes to figure out who the kiss-ass is.
At least we're breaking records somewhere, huh? Now, the EKG was prompt, but the resident's evaluation was sloppy.
You know we were busy.
It's always busy, it's always chaos, always out of control.
I know you don't have enough hours to spend with every patient.
But our job is efficiency and excellence.
We're marksmen.
We hone in on what's important, hit our target with one shot and move on.
We should call Psych on this guy.
And who are you? Abby Lockhart.
R-2.
Oh, yeah.
Weaver was talking to me about you.
I'd like to say it was all good, but it wasn't.
- Can we start by clearing this stuff? - Okay, in Trauma 1, we have Grease board? God, I haven't seen one of these since the '80s.
That's pretty cool.
Look, unless anybody has any objections, I prefer walking rounds.
We all learn.
Okay? Let's go.
He's kind of hot.
- I thought you had a boyfriend.
- He's at war, and so are my hormones.
Come in.
How are you? This toothbrush feels like a hundred-pound weight.
Well, it's normal after such prolonged bed rest.
Please tell me you brought rocky road and a cheeseburger.
I just came by to test your muscle tone again.
So no fries? Well, at least you're not Dr.
Schulansky.
He brings tours here like I'm a freak from the wild animal park.
He's excited that you're awake.
She's alive.
She's alive.
Squeeze my hand.
Okay.
That feels a little stronger than last week.
Try to lift up your leg.
That's good.
Very good.
Well, it's more than you could do the last time.
That's thanks to three hours a day with Helga, the therapist from hell.
Well, I see you had some visitors.
Yeah, that was my best friend from college.
I haven't seen her since graduation.
I asked her for a joint and she brought me a teddy bear.
Good for her.
The last thing you need is anything interfering with your recovery.
I need, heh, to take the edge off.
Waking up and finding out that your mom's dead, your fiancé's MIA and you've literally slept through your 20s, it's just a little stressful.
Has Dr.
Schulansky said anything about the accident? All I know is you and your mom were driving and there was some kind of traffic collision.
Yeah, that much I remember.
We were on our way for my final fitting for my wedding dress.
It was strapless with a tulle skirt.
I wouldn't even let Jason see it.
- Your fiancé? - Mm-hm.
Have you spoken to him? Oh.
That would fall under the heading of "Scared as hell, don't know how to do that one.
" Lowered tidal volume of 6 cc's per kilo decreased mortality from 40 percent to 31 percent.
You twirl a knob, you're gonna save a life.
Okay? All right, let's go.
Those are cool shoes, man.
Are they Adidas? Get laid, Morris.
Boris Nadinovitz, presenting with fever, lymphadenopathy and night sweats.
No obvious source.
Ya bolen, doctor.
So, what's your diagnostic approach? Skin test for TB and cocci histo? Good, good, good.
Dorsey Watson.
Greg Pratt.
Man, what's it been, like five years? Six.
I was in second year when you graduated.
- Wow.
So, what are you doing here? - I work here.
What's your excuse? I heard you were in Winnetka doing lipo on rich chicks.
Still am, man.
Still am.
But one of my patients got a half-price tummy tuck from a hack, landed upstairs.
Hey, killer, come on.
We got patients to clear.
Let's go.
- I gotta roll, man.
- Hey, do your thing.
- I'll holler at you before I go.
- Definitely.
Be relaxed.
Try to sound calm.
It will be weird for him at first.
You think? - It's ringing.
- Okay, take a deep breath.
What's going on? Oh! Hi.
Is this Jason Clark's house? She's calling her fiancé.
Blaire Collins.
I'm an old friend of his from the Art Institute.
- She's doing great.
- I'm amazed by her progress.
I've been trying to help her for over four years and all of a sudden, this.
Yeah, it's really me.
What were you treating her with? Most recently, an experimental cocktail.
Fluoxetine, Sinemet and dextroamphetamine.
- Is she still on them? - Not anymore.
I know.
It's weird.
She's asked me about what happened, how she got hurt.
Um I think it's better not to talk to her about it yet.
Is there something she shouldn't know? The accident was violent, to say the least.
Blaire and her mother were carjacked.
Her mom was raped.
And shot? Blaire tried to fight and was pistol-whipped.
They would have killed her, but someone pulled up.
Still, she has the right to know.
She's in a fragile state.
Telling her could set her back.
Let's get her healthy first.
She needs to hear this from someone close to her.
- She has no family.
- She'll be told, doctor.
All in good time.
A 22-year-old female presenting with recurring headaches.
- No history of migraine- - Right.
But there is a history of idiopathic intracranial hypertension.
They usually take out a bunch of spinal fluid.
We don't do that anymore.
- We don't? - No.
Now that we know that llH is caused by sagittal sinus thrombosis resulting in a decreased CSF reabsorption at the arachnoid sinuses.
I didn't know that.
- Heparin is the treatment of choice.
- Here you go, doc.
I'm just gonna place a drop in your eye.
Lean back.
She still needs an LP for diagnosis.
Hey, hey, not so fast, not so fast.
Annals of Emergency Medicine, May 2000.
- 2000? - Five? - Nope.
- Three? - Nope.
- Four? Ten points for the winner.
Intraocular pressure correlates with intracranial pressure.
Fifty-four.
Diagnosis made, and you don't get a spinal tap.
Abby, Oncology's on the phone.
If you ever say he's hot again, I'll kneecap you.
Some patient of yours is freaking out.
- In Oncology? - Mm-hm.
- Who is it? - Stephanie Lowenstein.
She's upset because we couldn't do the reconstruction.
- Why not? - They found an enlarged lymph node.
We told her pathology isn't back, but she won't listen.
She says it's all your fault.
She smashed the mirror.
- Stephanie.
- I don't want you here.
- I just wanna help.
- You call this helping? This is not helping.
- Okay, I understand how you feel.
- You have no idea how I feel.
Miss Lowenstein, wait.
You just have to let the doctors get the results back from the tests.
We'll figure out how to proceed.
To do what? To cut me up some more? To hell with your damn tests.
Stephanie, listen to me, please.
Just listen.
- You ruined me.
- I know you're scared.
Is that what I am? Just because they found a node doesn't mean you have cancer.
I need a cab.
Where's a cab? You need to come inside and let us treat you.
I have money.
Where's my stupid book? Listen to me.
Everything you're feeling right now is normal.
- It's just gonna take time.
- I don't have time.
That's not true.
Who's gonna marry someone who could need chemo for 10 years? Someone who could die before the kid goes to high school? If they had trouble making a diagnosis, it may not be cancer.
And if it is, because you had the surgery, they caught it early.
- I don't believe you.
- It's the truth.
You did what you had to do and it was incredibly brave.
- Then why do I feel like this? - Because it's scary.
It's scary, but you don't have to go through this alone.
- Get the hell away from me.
- Stephanie, please.
Just let me take care of those cuts.
Just come inside with me and Stephanie, please.
I've tried all the Internet dating sites.
I rewrote my profile so many times, you would have thought it was my thesis.
What happened to Lou? - I liked Lou.
- Ah.
I don't think he could handle this.
He said he would come back after the surgery, but I never liked Lou.
Guy's a jerk.
It's a good thing you found out early.
I don't wanna freeze my eggs or buy milk on the Internet.
I wanted to breastfeed.
This is a little bit of Neosporin.
Aren't you afraid you'll wind up the auntie? Be forced to adopt some kid from Cambodia? I think Cambodian kids are cute.
You know what I meant.
Stephanie, if all goes well, you'll get the reconstruction.
You'll have an uneventful recovery and a perfectly normal life.
That's doctor talk.
You don't get it.
My mother's sister died of breast cancer.
So did my grandmother.
And you? I have never even had a mammogram.
Tony Dejesus, single stab wound to the neck, vitals stable, good airway.
- Hey, having trouble breathing? No.
Time of arrival, 1442.
- Was this gang-related? - My old lady stabbed me.
- Why did she do that? - Because she's a psycho bitch.
Where are my residents? This is a great case.
Get my residents.
Hey, who are these clowns? We are not putting on a show for you.
What the hell is wrong with you? Get the hell out of here.
The woman who answered Jason's phone was his wife.
Six years is a long time.
Ha.
You know, the thing that's so hard about all of this is that everything has just gone on and I still feel like Jason and I were just finalizing our wedding list yesterday.
I'm sure he stayed by you as long as he could.
He came by twice.
Schulansky told me.
No wonder he wanted us to write our own vows.
He probably planned on omitting the whole "in sickness and in health" part.
Did you want him to spend the rest of his life hoping for something everyone said wouldn't happen? Maybe I can be his mistress.
Which anatomic landmarks define zone two of the neck? The cricoid cartilage to the angle of the mandible.
Very, very, very good.
Because management of zone two injuries is very controversial.
Actually, some people advocate surgical exploration for everything.
I'm pretty sure surgeons would not wanna explore an asymptomatic patient with a superficial wound.
Can you guys hurry up? My old lady's gonna burn my truck.
Maybe next time, you won't double dip at your mom's-in-law.
You seen my wife's mother? - Then don't criticize.
- My bad.
I'm sure you guys are aware of all the indications for immediate exploration.
Right, Dr.
Morris? Airway compromise, severe hemorrhage or expanding hematoma.
- He has none of those.
- Good, so then let me go.
Right, but we can always learn from every case, Dr.
Pratt.
Talk to me about management with neck injuries.
- What? - Brother, keep it short.
Don't go Al Sharpton on his ass.
Duplex scan, endoscopy, gastrograffin swallow which you would only do if he had symptoms.
Well, slow your roll, bro because what proportion of zone two vascular injuries are asymptomatic? Dr.
Rasgotra? With a significant injury, he might have signs of bleeding or a hematoma.
- The guy is stable.
- Maybe, maybe.
But nine in a hundred times, asymptomatic patients have lesions that require surgical repair.
How about that, Dr.
Pratt? How about that? Talk to me now.
You know what? How about I go check on my asthma patient in Curtain 2? There's no asthma patient in Curtain 2.
Yeah, well, maybe he went out for a smoke.
I'll go find him.
Yes, Eve, I did.
I put up the sanitizer.
No, I didn't hand out pens.
I am putting up the poster as we speak.
Yes, that special tape that won't ruin the walls.
Okay, bye-bye.
Don't tell me.
Eve? It's her day off and she still calls in.
Here.
She wants everyone's hands to be sanitized before they touch a patient.
"Scrub or rub"? It sounds kinky.
- We should be so lucky.
- Heh-heh.
I was thinking we could get something to eat.
You know, maybe catch a movie or something.
No, I haven't seen that one yet.
All right, cool.
I'll meet you out front.
Hey.
How are you doing, Greg? What, you're stalking me now? No.
I'm here for a sick friend.
Sure you don't have another illegitimate kid up in there? We need to talk.
What are you doing after work? I've got a date.
With Olivia Evans? Nice girl.
I've known her since she was in high school.
That's great.
What about tomorrow? Maybe we can have dinner.
You like gumbo? I know a great place on King Drive.
And down the street, there's a cat with a pool hall- Listen, we're not eating any gumbo together or playing pool.
All right? Then what would you like to do? I would like for you to leave me alone.
For real.
We're done.
Okay.
You don't wanna have anything to do with me.
- What about your little brother? - Don't use him like that.
- He'd like to get to know you, Greg.
- He just met me.
I don't know what your mother told you about me.
But I have an idea it wasn't everything.
- Come on, man.
- I could explain - but only if you give me the time.
- I do not have the time.
I'm trying here.
Then stop.
Fine.
If you wanna drop it forever, that's your call.
But you'll have to live with it.
Your choice.
I never got the whole marriage talk from my mom.
But the moment that I told her that Jason proposed, she pulled out this trunk.
She had every detail of my wedding planned.
It was crazy.
Oh, my God.
Stop, stop.
She wasn't gonna pressure you.
Yeah.
She wanted it to be special.
Which way is Lake Michigan? That way.
You can see it from the other side of the hospital.
- Can we go? - I shouldn't even have you out.
- Please? - No.
Come on.
What does a girl have to do to get a break with you? I hope Clemente doesn't become chief of the department.
- You liked him.
- I did until I had to present.
Patient doesn't have flesh-eating bacteria now but what symptoms might he have? Is that muscle spasm in the jaw? Acute tetanus? I'm all for teaching, but this guy doesn't stop.
Yeah, he's annoying.
You said you liked his bloody shoes, you wanker.
Just because he's annoying, doesn't mean I can't like his shoes.
- Are you going to Ray's gig? - To hell with Ray.
He's upstairs having a blast.
Jerry, it's Ray.
Save me.
I'm bored stiff.
Try picturing every woman up there naked.
That always works for me.
Oh, come on.
Are there any drug cases down there? Couple of traumas rolling in.
Lola Simon, 7- year-old with crush injury.
BP 70 palp.
- What crushed her? - Your next patient.
- Move your legs for me.
- Seven-year-old girl, no sign of drugs.
Yeah! I'm king of the world! Looks like you forgot how to fly, king.
Tommy Bonetti, stood up on the Tilt-A-Whirl at the St.
Ignatius fair.
- Is he on drugs? - He might have just hit his head.
Sounds like drugs.
I'm on my way down.
- Move away from the light.
- We're trying to take care of you, man.
You look like an alien.
Don't probe me.
Please sedate him.
I have to assess his neural status first.
Taking the HemoCue.
Process the spinal films before you take the rest.
- Hey, I'm rolling out, man.
- What, you scared of a little blood? - Squeeze my hand.
- Systolic's 65.
All right, no fluid in the abdomen.
Pericardium is clear.
Looks like spinal shock with a high thoracic injury.
Am I right? I'm way out of my league, man.
Don't you remember Bartlett's lecture on blunt trauma? Sweetie, listen, I'm gonna poke you.
Tell me when you feel this.
Start dopamine at 5 mics, Sensory level at T4.
How you doing, Lola? - That's a big bug.
- You just killed our mascot.
- Here she goes.
- Log roll.
Keep her on the backboard.
Suction.
Look, some of the old U of I crew's are hooking up at Cherry Red tonight.
You got plans? - Pratt, we need you in here.
- I'm gonna try to roll through.
- Pratt, now.
- Go see what's up.
I'll intubate.
You don't stay still, I'll put this needle through your heart.
- Can we sedate and paralyze? - He took his IV out.
Since when did Alfred E.
Neuman become a doctor? - What about I.
M.
Versed? - Gave him five.
It's not touching him.
- What did he take? - Maybe ice, coke.
Tracheal 140.
- What the hell are you on? - Her in a minute.
I can't find the vein.
- How about Haldol? - No, he could seize.
Morris, let me try the line.
- Dr.
Pratt.
- Go ahead, push the sux.
This guy's unstable as hell.
We can't get a line.
- I'm tied up.
- We need help.
You gotta get Clemente.
- Is there another Attending on? - Clemente's the only one.
No, we can handle this ourselves.
I'll do a femoral cutdown.
- Are you serious? - He needs access.
Pulse keeps going up.
Mix up esmolol, slow down his rate.
- Ten blade.
- We got sugar in here? Oh, wow, we got a trauma.
I didn't know.
Pager's probably not working.
No, my pager's working.
Twenty-foot fall complicated by unknown intoxication.
- What are you guys doing? - A femoral cutdown.
Whoa, whoa, whoa, everybody take a deep breath.
Take a deep breath.
Get my briefcase under admit.
- Banana cheese.
- Yeah, banana cheese.
- What did he take? - He won't say.
Tachy with mydriasis.
My guess is sympathomimetic.
Bad, bad guess.
Skin and membranes are dry.
It's an anticholinergic.
Electrolytes back yet? Right here.
Hyperchloremia.
Anion gap is minus four.
How could that be? Skittles, people, skittles.
Very popular with the kids these days.
It's cold pills with dextromethorphan hydrogen bromide.
The lab analyzer thinks bromide is chloride.
- You get a reversal of the gap.
- Aaah! Anything to calm him down? Two mics of I.
M.
physostigmine.
He still needs access.
- Here you go.
- I'm Rick James, bitch.
Close your eyes.
Go to your happy place, son.
What time did the chem panel come back? He's got weird anatomy.
We couldn't find the subclavian.
There it is, there it is.
Right there.
See, the probe allows us to cannulate the vein under direct visualization.
That's very cool.
- You carry that with you all the time? - It's just a demo.
I ran the phase-three trials.
- Beautiful, beautiful.
- It's like shooting fish in a barrel.
Heart rate's down to 80.
I guess we didn't need the beta blockers, did we? I trust you guys can finish without me.
No problem, boss.
Hey.
Even if you think I'm a pain in the ass it should never get in the way of patient care.
You with me? Good.
Dr.
Lockhart? Hey.
What's up? Well, everything.
And almost twice a day.
Congratulations.
I hear you're getting out today.
If you thought it stunk to work here, try being a patient.
By the way, thanks for the date.
- She told you? - I had to pay her.
- It was supposed to be a freebie.
- Just the first time.
Initially, it kind of turned me off when I learned that she was a professional.
But then when I thought about it, it turned me on.
We're both professionals.
So you didn't need me after all.
Well, I guess not.
Hey.
I don't remember your name.
Abby.
And you're a little late, Lou.
I came to see how Stephanie was doing.
She had her breasts removed.
Pick up a pink ribbon on your way out.
- What? She did? - Yeah, she did.
What are you talking about? Stephanie says you disappeared on her.
She told the nurse not to let me in.
And every time I called, she wouldn't say why she was here and kept going on about how she couldn't handle dating anyone right now.
- Why would she do that? - I don't know.
All I know is I can't stop thinking about her.
And I'm a little worried.
Come on, come on.
Do it, do it, do it.
Dr.
Clemente.
- Oh, damn it.
- Do you have a moment? You should really consider getting one of these.
It might keep you from hacking up the patients.
I'm sorry I didn't call you in earlier.
Bonetti's gone up to the ICU.
We've got to consider preemptive orders.
It was really unprofessional of me.
Nurses transporting patients? What a waste of resources.
- Are you listening to me? - Actually, no.
I lost.
Okay, look.
A femoral cutdown has to be a last-ditch effort in a peri-arrest patient.
- And skittles boy wasn't quite there yet.
- Well, I thought he was.
Oh, you thought he was.
Look, I know.
I was a resident too, I thought I had the keys to the kingdom.
But the great thing is that we can always learn.
That's why I'm here.
Well, sometimes you wanna do it yourself.
Sometimes your ego does, but the patient would rather that I do it.
- Believe me.
- You're right.
You know what? It's not about being right.
Okay, look, I consider you, Pratt, Morris, every resident, every student here an investment in the future.
My dividend comes when something that I've taught you saves a life.
That's it.
You should really consider surgery as an elective.
Well, why do you say that? Because you're quick to cut and you like to use a scalpel more than your brain.
Come in.
- Hi.
- Hey.
I brought you some company.
Lou.
I heard what happened.
Hi.
Come in.
Sit down.
Chocolate.
Hi.
I'd like to schedule an outpatient mammogram.
Sure.
Patient's name? Abby Lockhart.
First you missed morning rounds and now they tell me you're avoiding Poison Control.
No, I got stuck with a consult.
Look, a bunch of Zen monks made tea from this plant in their garden.
Now they have vomiting, diarrhea.
Some are tachycardic, some bradycardic, some hypotensive, some hypertensive.
- Not a clear toxidrome.
- I haven't identified this on the Internet.
I even sent digital photos to the Botany Department, but It's not jimsonweed, not foxglove, not oleander.
Well, maybe it's tabaco gigante.
You know something? You may be right.
I saw this once in Mexico.
It's a tobacco plant.
Your patients have nicotine toxicity.
- Oh.
- Good call.
Thank you.
Dr.
Clemente.
Why are my research assistants sitting in the waiting area? The parking garage is too cold? They're collecting data for me.
The looky-loos were getting in the way of the work.
Then you just tell them to step back.
I didn't wanna overstep.
Maybe that should come from you.
Overstep? You pulled the plug on my study.
Look.
I meant it as more as a time-out kind of thing.
You told them that my study was useless.
Look, I know what happened in Newark.
And I really do not want a repeat here, okay? All right, look.
Bottom line, you hired me to make this place more efficient.
And that's what I am trying to do.
And if and when we start bedside registration is gonna make your study- I don't know, irrelevant? I've got a $ 100,000 grant that says that it won't.
You've got $ 100,000, why don't we go digital? Listen, I run this hospital.
If we start bedside registration, that goes through me.
If you put my students on a time-out, that goes through me.
If you wanna wash the floors differently, that goes through me.
Do I make myself clear? I got one more question for you.
Does my answer go through you? My mom loved seeing the lake.
Look at the water.
At least some things stay the same.
We should really get back.
Have you always been such a worrier? I've always had things to worry about.
Do you think this was God? What? Me waking up.
I don't know.
You think it was science, don't you? I've seen deeply religious people come into the hospital.
Prayer did nothing for them.
And then I've seen plenty of skeptics experience miraculous recoveries.
So you think it was fate? I think I'm glad we're both here able to wonder about it.
Yeah.
How you gonna punk me like that? What's up, little man? You know where Olivia is? - Yeah, she's down the hall.
- Thanks.
I hear you, fellows.
But you sound like a bunch of knuckleheads.
Hey, all I'm saying is, you can't feel nothing with no jimmy on.
Get used to them.
There's no alternative.
Getting a girl pregnant is 18 years of lockdown.
Half your check going to Uncle Sam.
- The other half going to your kid and? - The baby's mama? And what happens if you miss a child support payment? Who's gonna be blowing up your pager? My baby's mama.
Having a kid at your age ain't what you wanna do.
Trust me.
Do you miss Croatia? I have family there.
But there are more opportunities for me here.
I like Chicago.
Except the winter sucks.
Yeah, you can always go inside and warm up.
You know how I keep asking you about the accident? It's because I keep having these flashes that don't add up.
What kind of flashes? I remember being scared.
We had just gotten coffee and I remember seeing my mom's face.
Her eyes were petrified.
And I hear her screams, but her screams are muffled by the radio and there's blood and laughter.
Lots of laughter, and at first I thought it was just a dream but the images are so vivid.
- They're so clear.
- Sit down.
Sit down.
Something else happened that night.
And not knowing what it is is killing me.
But I need the truth.
- Blaire.
- I want to be out - Figure it - Blaire? Come on, Blaire.
Stay with me.
Hey, I need a monitored bed.
- Trauma 1.
What's going on? - Page Schulansky in Neurology.
Hey, I'm Dr.
Clemente.
So, what's the problem? She's not talking.
Get me an Accu-Chek, a HemoCue and a pulse ox.
- She doesn't need that.
- Can we have her friend wait outside? - I'm not her friend.
- This is Dr.
Kovac, one of our Attendings.
Hey, doc.
I'm sorry, I had no clue.
- Ma'am? Ma'am, can you hear me? - Her name's Blaire.
- Can you hear me? - Schulansky's at the VA.
Damn it.
Gaze is fixed to the right.
I need a CBC, chem panel and a head CT.
No, she needs fluoxetine, Sinemet and dextroamphetamine.
I don't know what you're talking about.
Abby, run up to the pharmacy and get the meds.
There's an approach dealing with altered mental status.
This is not a standard patient.
She's been on experimental cocktail.
Abby, fluoxetine, Sinemet and dextroamphetamine.
Abby, please go.
Hey, hey.
I need some help.
Hey.
What's up? Fluoxetine, Sinemet, dextroamphetamine.
Yeah, write it up.
Hey, what are you doing? Are you crazy? You can't go back here.
Crit's fine.
Sodium and potassium are normal.
- I told you that.
- CT is ready.
Okay, let's move her now.
She needs the meds.
We could be missing a brain bleed or a mass effect.
- I know.
- We don't have time to screw around.
The meds woke her up from the coma.
If they did, we'd have coma patients waking up everywhere.
- All I know is they worked for her.
- Got them.
You're not gonna actually let him do this? Are you confident these meds are gonna work? If not, there's gonna be a tall guy in a cheap suit from the state asking questions.
It's worth a try, Kerry.
Right.
Hold the scanner.
I'll give him five minutes.
You know what? Don't sweat it.
Dr.
Kovac, you're the physician of record.
I'm not on the chart when the family sues.
Well, I'm in luck.
There is no family.
And fluoxetine in at 2019.
Let's get her up to CT.
As soon as I get a portable monitor.
Blaire? Blaire? Eyes opening to pain.
- Incomprehensible verbal activity.
- You got a GCS of 2, 2, 4.
- Check her gag.
- Whoa.
She's seizing.
Two mics of Ativan now.
One hundred percent oxygen, non-rebreather.
- She has a history of seizures? - No.
Well, any of the meds you pushed could have caused this.
So could falling drug levels, so could withdrawal.
Another round of Ativan.
Heh.
I really liked that last one.
Is it new? Yeah.
It's called " Blood Wine.
" Oh, "Blood Wine.
" How did you think of that? I cut my finger opening a bottle of merlot.
So you and your friend headed home? I don't know what she's doing.
Do you know what you're doing? - Yeah, I know what I'd like to do.
- Hold that thought.
- I'll settle with the boys.
I'll be back.
- Yo, Ray.
You guys are late.
We were the opening act.
Clemente had us pull journal articles to justify the treatment of every patient.
You wanna get something to eat? - I have plans.
- Do your plans have friends? Let's see.
- Zoe.
- Yes? - This is my boy, Archie.
- What up, ladies? - You guys hungry? - We wanna meet the band.
I play drums.
Yeah, I'm serious.
Like: That's my marching band.
We won the nationals.
Turning into pooh, pooh, pooh, and then we Guys? Ray! Blaire? Blaire, open your eyes.
Maybe she's postictal.
Or the Ativan didn't wear off.
Or I shouldn't have pushed the meds.
You don't know why she had a seizure.
Maybe we overloaded her sinuses.
Luka, there is no way to know why she fell back into this.
Yeah.
I have to go.
Are you okay? The state conservator agreed to admit Blaire to the hospital for two days to see if there's any improvement.
If not, she'll go back to the nursing home.
I could have been a doctor But why poetry? Why I? Why me? Why I? I could have been a lawyer But why poetry? Poetry.
Why? Poetry.
Thank you.
- Where's our waitress? - To hell with her.
What do you want? Uh Light beer.
Lipo doctor's scared of getting handles.
Don't hate.
I look good.
I'll be back.
Excuse me.
Hey, what's up, bro? I'll get two beers, one light.
- You want something? - A conversation would be cool.
- You haven't said anything to me.
- We can barely hear.
You could hear everyone just fine.
What did I do, Greg? - Tell me what I did.
- You should've told me he was in there.
- You want me to survey the building? - Yes, I do.
Look, he's down there helping those kids.
And who sews up those kids once they leave your place? Your father tries to help them before they get to you.
I see.
Charlie Pratt may be a lot of things.
But he's not my father, my dad or my pops.
He's just a guy who got my mom pregnant.
So basically, he made the same mistake he's warning those kids about.
Greg, wait.
Uh- You wanna hate him, I can't stop you, but Charlie's a good guy.
Twenty hours a week with the kids, runs a basketball league - rehab houses for poor people.
- Yeah, see, that's the problem.
I've waited my whole life to spit in my old man's face.
He's not lying in the gutter- - People change, Greg- - He's building houses for people for free.
- No.
No.
- Greg.
Blaire, I hope you can hear me.
On that night, you and your mom were driving.
You stopped at a red light.
Another car pulled up next to you.
There were three men inside.
They pulled a gun and dragged your mom