ER s12e07 Episode Script

The Human Shield

Previously on E.
- We gotta clean this place up.
- Gallant won't be here for three days.
I want it nice for him.
He's been there a long time.
Hi, I'm Zoe.
- 14 years old? - Why didn't you tell me how old you are? Well, you never asked.
Zoe, I'm gonna give you a prescription for doxycycline for the chlamydia.
It's just that you've been warned three times and We're gonna have to let you go.
Who's this Clemente guy, anyway? That's it.
I'm done arguing with a television set.
It's believed to suppress radical formation- Did you just call me a television set? Is he gonna be the new department chief? - We're forming a search committee.
- The guy must be angling for it, right? You gonna eat your eggs? They're cold.
What about your waffles? I'm not hungry.
I got a stomachache.
Wanna bring them home with you? Mr.
Coogy might wanna eat them later.
He doesn't like waffles.
Excuse me.
Could we get the bill, please? I'm sorry.
Our machine's still out.
Would you like more coffee? Uh, no, thanks.
It should be just a couple minutes.
Come on.
We're gonna get out of here.
Grab your coat.
Hurry up.
- You want your picture? - No.
No, no.
This way.
Let's go.
You can't come back here, sir.
Hey! Hey.
I like your picture, okay? I think we should keep it.
- Damn! - I'm hit! Don't move.
Stay down.
Easy, hon.
You'll be okay.
We're gonna take care of you.
Try to stay still, okay? Call for another rig.
This is 73.
We need backup.
Copy, 73.
On its way.
Put him down! Darrel! Security! - What the hell are you doing? - Checking for internal bleeding.
By sticking your finger in my butt? Called a guaiac test.
Oh, jeez.
Get that away from me.
- You got crap on my nose.
- You okay? - Oh, man.
That's horrible! - Yeah, I'm fine.
I'm okay.
That guy's terrible.
Somebody, give me a towel.
Oh, my God! Guaiac's negative.
Give him two of Ativan.
Make it four.
- C-spine and first day of labs.
- Oh, it's horrible.
I need a tetanus shot.
- Yes? - Have you seen your buddy K.
? - Nope.
- Me neither.
I'm gonna broom him.
- You can't fire him, he's a volunteer.
- A very involuntary volunteer.
- I need kids we can count on.
- All right.
I'll talk to him.
Okay, okay, okay, kids, gather round.
It's showtime.
Yo, Lockhart, Barnett, come on, fall in.
You too, Pratt.
All right.
In order to bring this ER into the 21 st century we'll be introducing new equipment and new procedures on a regular basis.
Now, first up my lovely assistant will demonstrate the patient communication board.
No more pens and paper.
This will make everyone's life easier.
From now on, intubated patients can point, circle or mark any questions or requests they have.
Beautifully done.
Next up, will be the Freedom Splint.
The federal regulations are discouraging the use of wrist restraints which, by the way, should be checked every 10 minutes.
What's so funny, Barnett? Uh, I just find that hard to believe.
There's quite a few cases of patients unattended for a few hours who have lost hands to ischemia.
Therefore, we are gonna start using the Freedom Splint.
Any volunteers? Volunteers.
Any volunteers? Hey.
- Thank you, Jerry.
- All right.
The Freedom Splint is less restrictive and should be used before any hard or soft restraints.
The splint is very helpful in preventing obtunded or combative patients Ah.
from pulling out tubes, picking at wound sites and disrupting lifesaving medical equipment.
Oh, yeah.
- Woo-hoo.
- Thank you, I think.
What's the occasion? Playboy doing a "Girls of the ER" edition? Bugger off, Frank.
- You do look very nice.
- Michael's coming home today.
Well, hello, soldier.
Vic, Darrel just put his head through the supply cabinet.
Give him five of Haldol.
Wait, make it 10.
He's like a rogue elephant.
What, shoot it from a tranquilizer gun? We got one of those? It was a joke.
Hey, X-ray, you and me, tag team.
- You distract him, I shoot him.
- Distract with what? You pretend to be a rodeo clown.
Come on, do something.
You go first.
Heads up, guys, multiple GSWs coming in.
Abby, you're with me.
Neela, call the O.
Make sure a suite is open.
Pratt, prepare Trauma 1 and 2.
I'll clear the rooms.
Call the blood bank.
- Tell them we'll need some O-neg.
- Okay! Is this a gang shooting? Father used his daughter as a human shield.
- Oh, lovely.
- Yeah.
- Well, you missed show-and-tell.
- Huh? Clemente is implementing some changes.
New equipment.
They gonna make him head of the ER? That's what they're saying.
The guy who got you and Neela suspended for working on a monkey? - It was a chimp.
- If he wants the position, he can have it.
He can open a petting zoo in the doctor's lounge.
Ten-year-old, single GSW to the right chest.
BP, 85/60.
Pulse, 120.
- Pulse ox? - Ninety-six on two liters.
- What's your name? - Vincent calls me Mezoti.
- Who's Vincent? - Guy she was with.
She's a kidnap victim.
Her abductor started shooting.
- We returned fire.
- You shot her? No, I had a clear shot.
But the guy's gun must've discharged when he went down.
- Is Vincent dead? - Seventy-three's bringing him in.
Guy got popped a bunch of times, once in the head.
- He shot one of our guys.
- Got this? - Yep.
- Okay, I'll wait for the next one.
Come on.
Let's get you fixed up, okay? - It really hurts.
- I know.
We're gonna make it stop hurting real soon, okay? - I lost Coogy.
- Who's Coogy? My stuffed puppy.
Maybe the police found him.
I'm sure he's okay.
One's open, blood's on its way.
- Need a hand? - No, I think we got this.
Thank you, Sam.
Nice mustache.
Ian, uh, Summerlin? Your buddies do that? I wouldn't call them my buddies, but, uh, yeah.
- We live in the same dorm.
- Freshman? How'd you guess? Thought campus life was supposed to be fun.
If you like being tortured.
- You've been vomiting? - Yeah, I puked all night.
Keg party? Pass out, wake up with a bad hangover and a Magic Marker facial? Something like that.
Okay, well, you don't have a fever, so it's probably not viral.
Your BP's a little low, which means you're maybe dehydrated.
All right.
Thank you.
Um - If I have to puke again? - Ah.
Here you go.
Uh, you got anything a little bigger? Well, if it isn't the hatchet lady.
Which beloved employee are you axing today? Stick a sock in it, Frank.
I'm sending Haleh her last check.
You want to include a note? Haleh was Eve's idea.
I was just following orders.
That's what Himmler said.
You got a letter here somewhere from your jailbird boyfriend.
Probably marrying his cellmate.
Jimmy Howe, 25.
GSW to the upper arm, lot of blood loss.
Have no fear, Dr.
Pratt is here.
- This isn't the shooter? - No.
This is my first week riding solo.
I just got out of the academy.
- The bullet snuck under his vest.
- The other guy's critical.
We took what they told us.
- BP, 100/65.
Pulse, 120.
- Must've bagged the brachial artery.
- I can't feel my hand.
- Median nerve too.
- Am I gonna lose my arm? - No, we can repair the artery.
- You okay with this? - Yup.
I'm all over it.
- Where you been? - Doing stuff.
I'll do some stuff on your head.
We need O- neg from the blood bank.
Go now! Never seen him move that fast.
I can't move my hand.
- May have bruised the nerve.
- What's this? Penetrating axillary trauma with neurovascular deficit.
You wanna clamp the bleeder? - If we can visualize it.
- I'm getting dizzy.
Don't let me die.
- You won't die.
- Don't let me die.
- Hey, you with the 23rd? - What? Yeah.
Ready? One, two, three.
My father and brother are with the 17 and the 109.
- Really? - Uh-huh.
You know Joe Butchitelli? Yeah, he helped me through the academy.
He's your brother? No, he gave me my first orgasm.
What? It was a milestone.
How's the pulse ox? - Holding on 92.
- What's the status on the other patients? Uh, Pratt's got a cop with a grazing GSW to the upper arm.
There's another victim en route.
All right.
I'm on my way down.
The station confirmed her ID.
Her name's Sydney Carlyle.
She was abducted in a campsite from upstate New York in August.
Is your real name Sydney? It's okay.
You can tell me.
- Yes.
- Yeah? We're gonna have to do a rape exam.
I'll open a kit.
Sydney, we're gonna check between your legs, okay? Is Vincent dead? Vincent Jansen, the creep who took her.
- I don't know.
- They shot him.
How big's the pneumothorax? Abby.
Multiple abrasions adjacent to the external genitalia.
Four lacerations to the labia in various stages of healing.
Did Vincent hurt you? Did he touch you in your private parts? Only when we play the married game.
Vincent loves me.
Systolic's down to 70.
Hey, shooter's here.
Thinking about a chest tube? - Abby? - Yeah.
What? - Chest tube.
- Yeah.
- They're processing the film.
- Okay.
Don't wait.
Just do it now.
Betadine and Steri-Drape.
Vincent Jansen, 34, multiple GSWs to the chest and abdomen.
- One to the melon.
- You didn't intubate.
- Spontaneous resps, satting at 96.
- He needs two IVs.
Full up! Exam 2.
- How's the little girl? - She's stable.
- Tony Gates.
- Dr.
- BP's at 100 palp.
- Should've needled the chest.
- No time.
- He's bleeding out.
He shot through our windshield, almost blew Gates' head.
I saw my life flash before my eyes.
I think we were on a beach.
Can we focus here? I lost the radial pulse.
- Needs two chest tubes and central line- - Yowza, look at that head shot.
He needs a couple of chest tubes- - Isn't that your patient? - I can do that with my eyes closed.
It's probably best if you didn't.
I'll call you if I need help.
Yeah, you'll call me.
His head could roll off, you wouldn't call me.
- Is that good? - Couldn't be better.
- Okay, just sliding off the vest.
Okay, we need to lift your arm to take a look.
- All right.
Got it.
- Oh, God.
I'm bleeding out.
- No, you're not.
- Jimmy, look at me.
Look at me.
Is Marty Stats still the desk sergeant at the 23? What? Yeah.
He used to babysit me.
You know he's got a metal plate in his head? - I need a procedural tray.
- Right away.
- What's happening? - Sterile gloves, please.
- What's happening? - We need to clamp the artery you severed.
- Oh, man.
- Can I steal your HemoCue? - Help yourself.
- Eve, you want me to take over for you? Sure.
Yeah, that would be good.
I gotta go check on the others.
Hang in there, Jimmy.
I'll be right back.
Cut, please.
Did they find Coogy? - Who is that? - Um, her stuffed animal.
He's a puppy.
- I don't know.
- Great.
Hang on.
- I got her mom.
- Okay.
Vaseline gauze dressing on that.
Hi, Mrs.
Carlyle, this is Abby Lockhart.
I'm treating your daughter.
Uh, yes, she was shot in the chest.
But we're doing all we can for her, and she's doing well.
She's a very brave little girl.
Uh, sure.
Just a minute.
Two hundred cc's in the Thora-Seal.
It's your mom.
Mom? I miss you too.
I am.
I will.
I love you too.
Hi, I'll give you back to the police now.
We have to treat your daughter, but we'll see you in a couple hours.
Carlyle? Officer Yau.
It's okay, Sydney.
You're safe now.
Your parents are coming to get you, and nobody can hurt you here.
What about Vincent? Don't worry about him anymore.
- How's the chest tube output? - Less than 500 cc's.
Small hemothorax.
Should be able to manage her conservatively.
Hey, nice lid.
You get a free bowl of soup with that? Pressure's down, 80/50.
Okay, call for type-specific and, uh, run in 500 of saline.
No, let's not do that.
Hi, there.
I'm Dr.
We'll put a little glop on your belly.
Then, we'll take this camera to look inside, okay? Are you the little princess I heard was coming this morning? I'm not a princess.
Um, she's hypotensive.
- Hypotensive can be a good thing.
- What are you talking about? Leave her systolic at 80, right, Dr.
Dubenko? Right.
Permissive hypotension.
Landmark papers by Bickell and Mattox.
With vascular injury, you need a low pressure to stabilize the clots.
You usually blast away blood and fluids.
And then you raise the pressure and blow out the clot.
Lots of sub-Q air in the chest wall, but the belly's dry.
We never allow the pressure to drift this low, so I'm checking with Kovac.
Abby, the chief of surgery agrees with our plan.
We're gonna make you brand-new, all right, sweetie pie? Okay, I'm in.
Hooking it up.
Sounds like tension pneumo here.
Okay, 0 silk and Xeroform next.
Five centimeters in the Thora-Seal.
Pressure's up, 120/70.
He just needs a little blood to his brain.
Nice work.
I heard Gallant's home on leave.
I didn't get a chance to see him last time.
Actually, he gets home today.
Hopefully he'll be here longer this time.
Well, tell him to stop by.
I'll buy him a beer.
Hey, this guy just looked at me.
Four-by-fours and Elastoplasts.
He's got spontaneous eye-opening.
- We're on your side! - Son of a- Stop! You have tubes in your chest.
Push four of Versed.
Stop it! You're hurting me! No! Don't shoot! Don't shoot! Neela.
- God! - I'm trying.
You okay? Yeah, his head injury isn't as bad as it looks.
No, it's a clean frontal-lobe injury.
No vital functions are affected, but he'll have ongoing impulse-control problems.
- Where-? Where's Sydney? - Safe from you.
I didn't hurt her.
- I took care of her.
- You raped her.
You don't understand.
I need to see her, please, okay? - Sydney! - Shut up.
- Oh, God.
I didn't do anything wrong.
- Sounds like the lung is back up.
You think you know me, but you don't.
She loves me.
- Not much blood from the chest.
- It's all in the belly.
She needed me.
- She wanted me.
- Looks like hemoperitoneum.
- And a grade-four hepatic injury.
- Grade-four? A.
chopped liver.
I know what you're thinking.
You want me to die.
I want you to shut up.
- Tachy at 120.
HemoCue is eight.
- Can you transfuse another two units? - How soon can he go up to the O.
? - No vacancy.
- I can turn over a room in 20 minutes.
- Okay.
You've got 10.
Have the blood bank stay ahead four units.
Maybe you should just let me die.
- A little more exposure? - Sure.
Suction? - I got your blood.
- Great, thanks.
Give it to her, and get over here.
- More four-by-fours? - You read my mind.
- You visualize the brachial? - I'm working on it.
- Eve was complaining about you today.
- I don't even know who that is.
The nurse manager.
Tall, blond? Oh, yeah, that amazon? She doesn't like me.
Hey, show some respect.
This is her turf, you're lucky to be here.
You wanna do your community service in some smelly-ass soup kitchen? - Well, do you? - No.
- Better get your act together, then.
- Okay.
There it is.
Ease up on the gauze.
- Whoa, Ray! - Sorry about that.
Proximal pressure.
I'm telling you, I hear one more complaint about you, and your ass- - One hell of a pep talk.
- Let's get a gurney in here.
- How much saline has she had? - Very little.
It's TKO.
- BP's 80 palp.
- Why aren't you giving her fluids? Permissive hypotension.
We don't wanna disrupt hemostasis.
- When's she going to the O.
? - We're waiting.
You can't do permissive hypotension without a plan.
Give her a liter wide-open.
I've had experience with this, it works.
I don't want our Residents in the position of using unproven therapies on critical patients.
Kovac, we need you back in here.
Get her pressure up to 100 systolic.
- Dr.
- Just a minute, please.
All right, well, CT's calling about your patient, Darrel Insley.
Yeah? So, what did Big Darrel do now? He stopped breathing.
And why the hell would he do that? Don't give a fluid bolus unless the M.
drops below 70.
- BP's down to 60 palp.
- The packed cells? - Units three and four.
- Hang another two.
Jansen? Vincent? - Can you hear me? - Sux and etomidate, 8-0 tube.
- Can we get him upstairs? - No O.
for 10 minutes.
- At least move him to pre-op.
- He'll bleed in the elevator.
Our job is to save lives, not judge them.
Death is the easy way out.
He deserves to rot in jail.
I'm in, bag him.
What are you doing? - Exploratory laparotomy.
- Here? Now? Sterile drapes, cutdown tray, masks and gowns.
Scrub in, Neela.
You wanna save this guy? It's the only way I know how.
Sydney? Come on, honey.
Come on, baby.
Hey, Luka! Sydney? Come on, Sydney.
Come on.
Let's stay awake.
Say hi to your mom and dad, huh? Sydney? Somebody get Kovac in here now.
Tachy to 150.
BP not registering.
Starting CPR.
I can't get a pulse.
- What do you need? - Help.
She's going down.
Squeeze in saline, give me two units packed cells.
You did type and cross her? - I did.
- Where's she bleeding? I don't know.
Chest tube slowed to 300 cc's.
Belly's clean.
Stay ahead of a patient like this.
- My Attending felt otherwise.
- I'm the Attending now.
Prep the chest.
If she's not back with a saline bolus, crack her.
- I was just talking to her.
- Go ahead and intubate.
Got it.
- Here goes nothing.
- All right.
Oh, looking good.
Dry as a bone.
Okay, moist four-by-four's.
Let down the weitlaners.
Did you save my arm? Bleeding is controlled.
Got this from here? Piece of cake.
Dry Kerlix, please.
- What's his damage? - One-and-a-half-centimeter scalp lac.
- Am I gonna have a scar? - Oh, nothing anybody will be able to see.
- What if I shave my head? - Not a good idea.
Not with that helmet.
- Two to three staples ought to do it.
- I got this.
I never fainted before.
Probably the best thing you could've done today.
- What do you mean? - Eve was gonna give you the boot.
Now she'll probably let you stay, just out of pity.
Hold still.
- Ow! - Yeah, that's gonna burn a little.
It got a little tricky, but he's a tough kid.
He's gonna be just fine.
Good to see you.
I'll come find you guys when I have more details.
- Got a thing for the boys in blue, huh? - Oh, no.
I know half of them.
My dad was a cop, retired.
My brother.
- You're engaged? - No, I was.
A few years ago.
He was killed on the job.
- I'm so sorry.
- Thanks.
I still have a thing for that uniform, though.
- Can I ask you a question? - Sure.
Under what circumstances would a prisoner be transferred across states? - Your ex? - He wrote me a letter.
He's being moved from Canyon City in Colorado to Cook County.
It could be a lot of reasons, but I can check it out for you.
Sam, this man is looking for Dr.
- She is with a patient.
- That's what I told him.
- Dad, please.
Can we just go? - Zoe.
Excuse me, uh, I wanna talk to this doctor right now.
Yeah, well, you're gonna have to wait.
Unless I can help you.
She wrote this prescription for my daughter and I wanna know why.
- Doesn't your daughter know? - She won't tell me.
- Dad, you're making a scene- - Shh.
If your daughter won't tell you, sir, there's nothing we can do about it.
Excuse me.
Yes, there is.
You can get this damn doctor for me right now before I hit this whole place with a malpractice suit.
- I got lawyers, lady.
- Yeah? Well, I've got Jerry.
So unless you wanna be carried out of here like a dirty diaper, take a seat.
Come on, Zoe.
You know, I abhor violence.
Yeah, I know that, but he doesn't.
So give him your best tough-guy face.
Here we go.
From the xiphoid to the symphysis pubis.
- What kind of retractor do you need? - The human kind.
Lots of exposure.
- What's this? - Linea alba.
Straight through it to the pre-peritoneal fat.
- Retract the deep fascia.
Got it.
Neela, you got a call on line one.
It sounds urgent.
- Take a message.
You need scissors? - Nope.
Poke a finger through the peritoneum and tear it open.
It's from a Lt.
He's calling from a Camp Claiborne in Iraq.
Stand back.
Oh, God.
I can't take it, Jerry.
Get a number.
Lap pads.
Not responding to fluids.
She's in P.
- Brady to 60.
-10 blade to Abby.
Rib spreader to me.
I'm not used to doing this on kids.
They're much the same, just everything's smaller.
Pleura is dry.
Check the pericardium.
Oh, my God.
It's full of blood.
Really full.
- Damn it.
She's in tamponade.
- Too much pressure on the heart.
- She collapsed her ventricles.
- Pick up a Metz.
Where's Clemente? Three lap pads around the suprahepatic space.
Three around Morrison's.
And the liver is packed off.
Eight units in, pressure's up to 90 systolic.
- That'll do.
- O.
's ready.
It helps to compress the liver up against the diaphragm.
- That was brilliant.
- Another five minutes we'd have been taking him to the morgue.
Let's go.
Sorry about your floor.
Ready for another unit.
- What the hell happened? - Cardiac tamponade.
It was a peripheral wound.
A bullet's trajectory can go anywhere.
She had a hemothorax.
She was only bleeding in the chest.
She's bleeding in the pericardium.
Pressure kept her heart from filling.
There was no indication of tamponade.
Didn't you check for effusion on ultrasound? Of course, but there was sub-Q air.
I couldn't get a clear view.
She needed volume to fill her ventricle and you withheld fluids.
Based on what we knew, permissive hypotension was reasonable.
It killed her.
Um, her parents are coming here to take her home.
They think she was rescued.
Can we keep her alive until they get here? Okay.
Let's cross-clamp the aorta.
She's not bleeding in her belly.
She's gone.
This will help perfuse her heart and brain till we get more blood in.
Vascular clamp.
Vascular clamp! Dr.
What's the word on that little girl? They're working.
The guy you brought in pulled through.
Wish it was the other way around.
Well, at least child molesters don't last long in prison, right? Are you a Hawks fan? - Excuse me? - Chicago Blackhawks.
I have two tickets to Friday's game against the Kings.
You interested? You, me, hot wings, cold beer? Sorry.
You more a theater gal? I figured as much.
I also have tickets to the opera and the philharmonic.
- What? You moonlight as a scalper? - No.
Actually my cousin does.
I appreciate it, but I don't get much time off.
Yeah, I know that story.
You know what, we'll just stay home.
We'll stay home, order a deep-dish, you can quiz me on renal pathophysiology.
What do you know about it? Not enough, that's why I need your help.
It's one of my fourth-year electives.
- Fourth year of what? - Medical school.
You know, I just do this for the free coffee.
Look, maybe some other time.
I'm sorry.
I have to deal with something urgent.
No problem.
I'll see you around.
- You have that lieutenant's number? - Yeah.
- Did he say what it was about? - Sorry.
Don't you have something sarcastic to say, Frank? No.
Hey! Hey, is this you? Dr.
Rasgotra? - Yes.
- Great.
You mind telling me what these are for? You see the patient's name below mine? That's who the prescription is for.
Unless you're Zoe Butler, I can't tell you anything.
Look, if you treated my daughter, I need to know why.
I'm sorry, sir.
There are confidentiality rules.
Confidentiality? She's a little kid.
You didn't have my permission to treat her.
You know what, I wanna see your supervisor.
- Let's go.
- He won't tell you anything different.
- In these situations- - What situations? Is she pregnant? Is she using drugs? What? - I'm her father.
I have a right to know.
- Dad, please.
If you want information, it has to come from Zoe, not from me.
Excuse me.
- I'm Dr.
- I've got this.
- You her boss? - Ray.
Yeah, um Mr.
Butler, my name's Ray Barnett, and the thing is- I, uh, need to speak with you in private.
- Neela- - Ray.
- Let me deal with this.
- No.
- I can handle this.
- You can't.
- Yes, I can.
- How? By talking? Telling him his daughter has a sexually transmitted disease? - If you do, it's a breach of confidentiality.
- I wanna do the right thing.
You wanna violate her privacy too? What you did is a crime, Ray.
If you tell him the truth, you'll go to jail.
You know that, right? The best thing you can do is just let it go and allow me to deal with this.
Clear! - Asystole.
- Resume compressions.
See if you can find a hole in the right ventricle.
- Did she have a high-dose epi? - Five minutes ago.
If there's cardiac injury to occlude, we'll get ventricular filling.
Pulseless V-fib and asystole for 25 minutes.
Still not perfusing with open compressions.
- I'm giving her another chance.
- All you're giving her is more abuse.
Stop it.
Just stop it.
Three forty-nine.
I'll sew up the chest before the family gets here.
Camp Claiborne.
Hello, I'm trying to reach a Lt.
Strickland, please.
Your name and to what this is regarding, please.
Neela Rasgotra.
I'm returning his call.
One moment, ma'am.
Come on.
- Miss Rasgotra? - Yes.
I understand you're a friend of Michael Gallant.
- Yes, yes, I am.
- I have some bad news, ma'am.
There was an incident outside of Mosul.
Insurgents struck a convoy at the airport.
- Hello? - I'm afraid, I can't Lieutenant, can you hear me? - I can't tell you - Lt.
Strickland, are you there? several casualties.
Michael's unit had a heavy patient flow.
He will be unable to make it home on leave as anticipated.
The CASH is incommunicado right now so he asked me to pass this information on to you.
But Michael's all right? He's not injured or anything.
No, maream.
A little homesick and sand-weary, I imagine, but he's fine.
Uh, thank you, lieutenant.
I appreciate the phone call.
Yourere welcome, maream.
Have a good night.
Hey, does this look like a subdural to you? Right here.
- No.
- No.
Ninety-five percent of the time, controlled hypotension would've worked.
- Make sure you tell that to her family.
- Come on.
There's no reason she should've had tamponade.
All I know is that she did.
And if she'd been given fluids, she would have survived.
That's not a certainty.
We would've seen the signs.
We could've drained the pericardium.
Look, I did what I thought was in her best interest.
- Even when two doctors disagreed? - Dubenko agreed with me.
You'd do the same even if he hadn't.
That's your style.
Do whatever you want, regardless of what anyone else thinks.
- You don't like my style? What is that? - We were all here a long time before you.
We work together.
You're the new guy.
- You need to fit in, not us.
- What is this, a social club? If you can't, then we have a problem.
I take risks to save my patients.
Especially if you suck in the Residents.
- They need to be taught fundamentals.
- I'm about cutting-edge medicine.
- Not esoteric unproven studies! - I see a problem, I fix it, bam! - What? - Maybe, you should fix that.
- Ah.
- Here you go.
Does this happen often? Only after five or six beers and a bar fight.
People just seem really wired after what happened here today.
You picked up on that too, huh? Maybe we should have a critical incident debrief- Yeah, that's a great idea.
Barnett, we'll have a critical incident debrief in Exam 3 after shift.
- Why? - Why do you think? This was a tough shift for people.
It helps if we can get a chance to decompress before we go home.
Yeah, well, that's why God created beer, right? - This thing's mandatory? - Yes.
Pass it on.
What do you think? Kovac versus Clemente in a street fight? Kovac has size but I have a feeling Clemente's kind of squirrelly.
I think you need help.
What are you doing? Nothing.
What happened to your nose? Kovac.
He hit you? No, but I bet he would've liked to have.
You know, the last time I got one of these was when Tina Marino caught me with her cousin.
Let me see.
Let me see.
- I think you need to be packed.
- It's tapering off.
- Yeah, that's not working.
- Lockhart, I'm fine.
I'm fine.
I'm really sorry about the little girl.
Me too.
I was trying to save her, despite what Dr.
Kovac might think.
I know.
I'm really, really sorry.
Put your head back.
Hey, Kerry.
Have you found someone to replace Susan as chief of the ER? We're still looking at candidates.
Is, uh, Clemente the favorite? He's certainly up there.
Why? I'm just not sure he's the right person for the job.
Yeah, well, if you think of somebody better, feel free to give me a call.
Uh, what about me? You? I didn't think you wanted to be chief.
Luka, it's really not your style.
Maybe it's time for me to change my style.
I've been here for a long time.
I know the people, I know the department.
I just wanna put my name into the mixture.
All right.
I'll let the committee know you're interested.
Thank you.
Eve's waiting for you guys in Exam 3 for the big powwow.
- She said it was mandatory.
- So did Clemente.
They want us to express our feelings about what happened today.
Well, today sucked.
Good night.
Was it mandatory for everyone except the Attendings? Edna Cassleman, 56 found down in the park, altered, no sign of trauma.
Thank you, Edna.
Tell Eve I'm with a patient.
Well, it can't be that bad, can it? It's not that.
Michael's leave has been postponed.
I'm sorry.
Can I come by the house tonight, pick up my amp? Yeah.
I really don't feel like sticking around for this damn thing.
I'll ditch if you do.
I've got dinner reservations at Gibson's if you wanna grab a drink or five.
Wow, I like the way you think, roomie.
Your treat, right? - As long as you stop calling me that.
- Okay.
How's the nose? Seems to be working.
Thank you.
The hell with this.
Go home.
See you later.
Eve, I thought it was a great idea.
I really did.
This department needs a lot of work.
This department needs a kick in the ass.
Her parents show up? No.
They should be here soon.
After all she's been through maybe she's better off.
I'm not sure anybody's better off dead.
We, uh, recovered this in the parking lot.
She was asking for it earlier.
I gotta go check in on Officer Howe.
I hear he's driving the nurses upstairs crazy.
How much trouble will we get in for not showing? I'm not working until Saturday.
- Things will have blown over by then.
- You're kidding me.
I'm working tomorrow.
Now I'll get punished for both of us.
Whoa! Stop it! Stop it! Security! Someone, call security! Security! Mr.
Butler! Mr.
Butler, stop it! You ever come near my daughter again, and I'll kill you.
You hear me? Ray - I'm fine.
- Ray.
I'm fine.
- each other.
Three wide- pinpoint across the Chicago area.
I'm gonna go ahead and widen the view out.
Big storms across central Illinois.
This is along the- - Hey.
- Hey.
Wanna come in? You didn't, uh You didn't go to the debriefing.
- Did you? - Yeah.
It was just me, Eve and Clemente.
You hungry? Want some pizza? - I can warm it up in- - I'm not hungry.
Mad about something? What do you think? Yes? Well, I didn't need to go to the debriefing- Yeah, I don't care about that.
- What are you talking about? - I'm talking about you and Clemente.
And whatever it is that is going on between the two of you.
If you wanna get into a pissing match with him, fine.
- Leave me out of it.
- He was wrong.
Oh, yeah.
And that's the most important thing, isn't it? He was wrong and you were right.
And while you were arguing about it, the little girl died.
As if she hadn't suffered enough.
She was 10 years old, Luka.
And he had her for months, and I just I just can't stop thinking about what she must've gone through.
And I can't stop thinking about how afraid she must've been.
And I can't stop thinking about why we couldn't save her.
I just