ER s14e05 Episode Script

Under The Influence

Greg, Greg.
Wait up, wait up.
Thyrotoxic crisis.
You give Propylthiouracil or methimazole? You've got a patient in thyroid storm? - Go with PTU.
- What dose? - I'll look it up for you.
- Eh! Six hundred migs.
- Why'd you ask? - Written boards are in a week.
Failure's not an option.
We quiz each other, we'll nail it.
Morris, if you don't know your stuff by now, then you never will.
You see that? - See what? - That vixen, the way she smiled.
- What are you talking about? Yep, they all want a bite of the forbidden fruit.
At the coffee shop, at the gym, at the bank.
Women are coming on to me like crazy ever since Hope gave me this ring.
You and Hope got engaged? - No, it's a promise ring.
Yeah? What'd you promise? - To be faithful while we're apart.
That's sweet.
Or stupid.
No, what's stupid is I should have put this ring on years ago.
- I could have tapped so many hotties.
- Anybody seen Abby? - No, she's not on till 10.
- All right, Morris, belly-pain lady in 3.
Gotta keep me away from the ladies.
- She's 85, man.
- Perfect.
Sixty percent, 700 cc's, AC 14.
- Moretti's looking for you.
- Taking this guy to ICU.
- In the break room.
- He has to wait.
- It's important.
- What does he want? - Don't shoot the messenger.
All right, I'll be right up.
- You summoned me? - Dr.
I'm playing by your rules, I'm doing my time upstairs.
- I don't know what else to do.
- I spoke with Dr.
This about my Coumadin overdose with the GI bleed? - No.
- I ordered FFP.
The blood bank was responsible for delay.
- I'm not familiar with that case, "but " - Pneumothorax on the COPD'er? - Even the radiologist missed it.
- Dr.
Gates, look When the guy deteriorated, I had the chest tube in.
- Even before they processed the film.
- Dr.
Gates, if I might.
About what? Okay, I just wanted to congratulate you on your fine work in the ICU.
- You do? - Yes.
Shuster has given you rave reviews for your performance.
- She did? - Yep.
And I think you're ready to come back to the ER.
I am? Really? Yes.
All right.
Then I'll finish up my work this week and then I'Il Well, you do whatever you have to do, but I want you back on the floor today.
Today? All right.
Thank you.
This was to be a simple bowel resection.
I never should've promised he'd make it to the Packers game.
- The family here? - Yeah, there's a son named Jeremy.
- He just drove up from Notre Dame.
- Great.
- I'm Dr.
- Hi.
Yeah, I've been waiting for you.
Surgery took a little longer than expected.
That's okay, I was fine here.
There were some complications, I'm afraid.
- Sorry to hear that.
- Would you like to sit down? No, I'm good.
Well, during surgery, we think he suffered a heart attack.
- Really? - Yeah, he's on a ventilator.
And IV meds to maintain his blood pressure.
Oh, man, that's never good.
Are you all right? I gotta admit I'm a little bit nervous, but I'm really, really psyched to be here.
Your father's in critical condition.
What? - Oh, no, he's not.
- I don't think you understand.
- Actually, I do.
- Jeremy, this is very serious.
Listen, my name is Harold Zelinsky.
My father died 10 years ago.
I'm your new intern.
- You are? - Uh-huh.
Excuse me.
Do you have any news about my dad? Hello.
Oh, hey, Luka.
No, I'm awake.
I've been calling for three hours.
I was exhausted, so I shut the ringer off so I could get some sleep.
- Is that Joe? - Yeah.
- So he's okay now? - Yeah, he just woke up.
Hi, baby.
Good morning.
Sorry I wasn't around.
We got stuck at the hospital with my dad.
I tried calling you at work.
They filled me in, told me his MRI was normal.
Yeah, yeah.
He's fine.
With the spinal fracture, even after surgery, my dad can't move his legs.
So when he gets home, he'll have to get around in a wheelchair.
Wanna sit down? We're building ramps for the steps and handrails for the bathroom.
Yeah, how soon can you fly home? We need to fix up the house.
It's a lot of work.
You can just call the airline and just get on the standby flight, right? There's a seat available on the redeye tonight.
I'm sorry, but it's gonna be at least another week.
Another week? Luka, Luka.
Why can't your brother just finish up? Hey, I know you don't like it.
I don't like it either.
But I need to do this, okay? Please, just don't make it harder.
Okay, but we miss you.
I miss you too.
We miss you a lot.
All right, let's set up for irrigation.
- I'll come back once the skin is numbed.
- Serum osmolality calculation.
Serum ozzims? Two times sodium plus glucose over 18 plus BUN over 2.
Way to go.
Morris, somebody's waiting for you.
See what I'm talking about? Here's the Levaquin you ordered.
So you came to drop off an antibiotic? I can't say that I agree with your assessment.
And you're invited to my opening.
Your opening? Pharmacy's my day job, but sculpture's my passion.
I do a lot of figures.
Mainly nudes.
- You like art? - I love it.
I'm gonna put this up in the lounge in case anyone's interested.
No, this invitation's just for you.
- Assess that, Dr.
County general on 2B.
Morris and Pratt are the Attendings.
Frank is the grouchy clerk.
This is Harold Zelinsky, my new intern.
Don't go far, we got two car-crash victims en route.
Grab your coat and meet me outside Trauma.
It's gonna be awesome working with you guys.
That kid's an intern? What is he like, 12? - Keep getting younger.
- Or we keep getting older.
- Looks like he's in high school.
- I asked, he said he was 25.
- No, man, he's lying.
First one to verify his age wins the pot.
Who's in? I'm with that.
What you got? - Bevan Wong driver of a solo car versus utility pole.
- Remember what happened? Not really.
I do.
Fell asleep at the wheel, went off the road.
- Tracy Martinez, front seat passenger.
BEv AN: I didn't fall asleep.
Are you okay, baby? I think so.
How about you? I'm okay.
- Any neck pain, any chest pain? - Dr.
Gates, back in the saddle, huh? - Yep.
Possible syncope at the wheel.
He works all night at a warehouse.
Wiggle your toes for me, Bevan.
- Good, now squeeze my hand.
- I should've been driving.
I don't like you driving when you're pregnant.
How far along are you? - Twenty weeks.
I got this.
- No, I got it.
- No, I'm good.
- Were you wearing your seat belt? Always.
We'll check you and the baby, make sure everybody's healthy.
The success or failure of your interns depends on you.
- Looking forward to be a good mentor.
- Not a mentor.
You're their taskmaster.
- They need to be whipped.
- That's not my style.
You should make it your style.
Fear is what motivates them to learn and excel.
- They should hate you.
- There are other ways It's worked for decades of surgical residents.
You need to be Lou Gossett to their Richard Gere.
- You're from Connecticut, right? - Yeah.
Only two things come out of Connecticut, steers and queers.
Which one are you, boy? I don't see no horns.
Doesn't quite work with Connecticut.
I'm not joking, Neela.
Without discipline, interns screw up.
And if he screws up, you screw up.
You want your first-choice elective? Bring him to his knees.
What have we got, Zelinsky? I was supposed to wait for you before I went in.
Know what it means to be proactive? You could've been through your assessment.
Get right on it.
Am I understood? - Where are we? - Good vitals, no obvious injuries.
- First crit is 39, stable.
This your new intern? Harold Zelinsky, Nurse Marquez, Dr.
- Hello.
- Hi, I'm Dr.
Rasgotra from Surgery.
- Nice to meet you.
Okay, fetal Doppler and Surgilube.
- Is there anything I can do to help? No, just stand back and observe.
- How do you like your iPod? - It's cool.
Abdomen's soft and non-tender.
I remember when you had to go to the record store to buy music.
- I bought my first CD when I was 10.
SonoSite's ready.
What was that, like mid-'90s? Eminem? - He wasn't around yet.
- Right, right.
Probably Spice Girls? "Mozart Clarinet Concerto in A Major," Richard Stoltzman, soloist.
Zelinsky, take a look.
You might learn something.
No abruption.
That's good? Very good.
Okay, serial crits, fetal monitor and send off a A what? You know, the test.
The test for fetal-maternal blood exchange.
- Kleihauer-Betke.
- Right.
No evidence of pravia.
Type and Rh to the blood bank.
- You all right? - Yeah.
I was just up all night with a bad stomach.
It's probably a virus.
- So, what, do you need an IV? - No.
Take a nap, get some rest.
- No, it's all right, I just need to - It's slow right now.
Go before we get slammed.
- Really? - Yeah, go.
- What are you doing? - Just taking this off for the x-ray.
Please don't lose it.
It was my grandma's.
C- spine's clear, let's sit him up.
- Do you want cardiac enzymes? - No.
How about a head CT? - No.
No headache, no focal findings.
I forgot to eat breakfast.
- Maybe that's why I got dizzy.
Well, you got a lot on your mind.
Boy or girl? We wanna be surprised.
- You got kids? - Yeah, I have a little girl.
- She doesn't live with me, but Okay, if I send him to get an x-ray? - It's up to Dr.
- You'll get a better film in Radiology.
You know what? Let's leave him here.
If it's simple fainting, symptoms last a couple minutes.
His dizziness only lasted a few seconds.
Could indicate dangerous cardiac arrhythmia.
- Valid point.
- I've got something dangerous? We're gonna keep you on a heart monitor.
Give me another listen, huh? - Seen the Wood's lamp? Nope.
- Are you still okay? Yeah.
You know what? You're working too hard.
- How's the baby? Okay.
- They did an ultrasound? Yeah, they did.
- We'll let you guys chat in a minute.
Come on, lie down and relax.
I don't feel so good.
V- tach.
Bevan, Bevan.
Unresponsive, no pulse.
- Charge to 360.
Everyone clear? MORETTl: Okay.
- Back in sinus.
- He's a healthy 22-year-old.
- Do you need me? - No, just the Wood's lamp.
Sorry, I'll put up a "do not disturb" sign.
Thank you.
No ectopy on lidocaine.
Is this gonna keep happening? I don't know.
You ever have chest pain? - Your father have heart disease? - No.
Any drug use? Look, we live in a studio apartment.
I'm trying to save up for a two bedroom before the baby comes.
I work at a print shop.
Then pull the graveyard at a furniture warehouse.
So you took something to stay awake? - Couple nights ago, I took a pill.
- Like speed? I don't know, my friend gave it to me.
You think it messed up my heart? Well, you know, it probably wasn't that.
Your, EKG has a different kind of abnormality.
It could be a condition that you were born with.
- Want to have Cardiology come down? - Yeah.
I wanna be a good dad.
I'm trying.
I'm really trying.
Hey, Security needs a photocopy of your driver's license.
- I don't have one.
- You don't? I took Driver's Ed in high school.
I never got around to taking the test though.
Rasgotra's waiting for this.
How do you get places? I take the El.
If the weather's good, I ride my bike.
Do you want a copy of my hospital ID? No, no, I'll talk to the authorities, find out what we need.
Repeat crit is 38.
- You figure it out? No, he's crafty.
Zelinsky, your progress notes and dressing changes? They're all done.
- Does the baby have ascites? - We're focusing on the placenta.
Looks like pleural effusions too.
I think you're right in the way of my screen.
Step back, please.
Is my baby okay? - No, the heart's beating well.
Could be iso-immunization if the mom's Rh negative - She's Rh positive.
- What are you talking about? - There are some fluid collections.
- Are you with children a lot? - I teach preschool.
- Can you page OB? - The kids gave her a virus - I get colds.
Twenty percent of hydrops is caused by parvo.
- It's an infection amongst toddlers.
- Is it serious? There's increased risk of fetal abnormalities and miscarriage.
Oh, my God.
Parvo is one of the few treatable etiologies of Hydrops fetalis.
- You're pretty lucky, if that's it.
Lucky? You just said I could lose my baby.
- No, not with a UV transfusion.
- Look.
I know this is hard.
But we're gonna do everything we can to help you and your baby, okay? Vincent Greco, skin infection.
I got two boils, here, here.
- How long have you had them? - About a week.
Started out like a pimple.
I tried hot compresses, but they just kept growing.
- And do you work out a lot? - Yeah, I'm a personal trainer.
Well, gyms have nasty germs.
It looks like I'm gonna have to open SURl: Sorry.
- Did you have a nice nap, Dr.
Lockhart? Yes, thank you.
Can you tell me why Gates has two patients on the board? Got stuck with a V-tach arrest.
- Is the patient in V-tach right now? - Cardiology is on their way.
Then he can come down and pitch in.
I think there's benefit to his staying with the patient.
- Greg, you have something to ask me? - No.
Oh, right, the boards.
Don't know, antidote for aspirin overdose? Come on, you call that a ques? Okay, new deal.
From now on, tough questions and only when we're stressed.
That will re-create anxiety of test day.
Come on, let me check some labs.
Com? What the hell is that? Ordering herbal anaphrodisiacs.
- You need aphrodisiacs? No, no, no.
"Curbs your libido and puts the brakes on sexual energy.
These tablets ensure a lust-free day.
" What? You've seen what's happening.
I need this stuff.
You wanna lose your libido? Get married and have a kid.
Well, I'm impressed.
It usually takes an OB to pick up hydrops.
It wasn't that tough to diagnose.
The ascites was a clear tip-off.
Tracy, this is Dr.
Coburn from OB.
- Hi.
- Hi.
Your blood test shows you had a recent parvovirus infection.
- I had a bad cold in August.
- That was it.
We're concerned about the possible effects " in" your baby's bone marrow.
Blood velocity in the brain is 44 centimeters per second.
That is not what we were hoping for.
Indicates a severe anemia.
I went to the clinic.
My blood count was fine.
You're not anemic.
Your baby is.
So we need to give a transfusion directly into the umbilical cord.
- Are you sure? - Without it, there's a risk of fetal death.
Seventy percent.
With it, there's a very high probability of a cure.
Ninety percent.
You wanna stick a needle in the umbilical cord? It's the only way to help.
Although there is a slight possibility of a miscarriage.
Seven percent.
Well, just look at the numbers.
The benefits outweigh the risks by a factor of 12.
- I wanna talk to Bevan.
- He's with the cardiologist.
- Can he be here when you do it? - Lf it's okay with Dr.
- I need him with me.
- Okay, I'll go get things set up.
Zelinsky will assist you.
When I first found out " I" wasn't sure I wanted the baby.
But then Bevan stepped up.
He said we could do it together.
It made us closer.
Everything was really good.
It can still be good.
I thought it was a blessing getting pregnant.
Now I'm not so sure.
Is it sharp here? VINCENT: Can't feel a thing.
Let me know if anything hurts.
- That's a lot of pus.
- Good thing I came in.
Smells anaerobic.
You want a wound culture? - Jin Kim? Right here.
Are you going to be my doctor? Nope, actually, no.
No, I'm not.
Lockhart, can I take over, please? Lady with foot pain in Exam Two I need you to see.
Sounds good.
Heart sounds good.
EKG shows ST segment elevation in V one, two and three.
I'm thinking Brugada Syndrome.
What? Dr.
Gates will be back to discuss all of my recommendations.
- Please, can I go in with Tracy? - Yeah, soon as I get back.
It's not Brugada.
Ventricular arrhythmia in an Asian man, classic EKG findings? That's not ST elevation.
- It's early repolarization.
- How'd you explain the v-tach? Gee, maybe it has something to do with the amphetamines in his urine.
He took a pill three days ago.
But nothing since then.
And every drunk with an ETOH of 500 only had two beers.
Repeat his cardiac enzymes.
If they're negative, I'll clear him for discharge.
- Or jail for DUl.
- He had a cardiac arrest.
- Amphetamines.
- Think it can happen again? - Not unless he takes more drugs.
- I disagree with you.
If it's Brugada, could happen any time.
He needs an implantable defibrillator.
Well, let's continue this discussion after you complete a cardiology fellowship.
This is a good guy here.
Why are you writing him off? He's had eight hours of normal monitoring.
That's not enough.
Keep him overnight.
Don't tell me how to practice medicine.
I am not admitting a speed freak.
Can you hold it down? It was a mistake.
A one-time thing.
A kid who's popping amphetamines doesn't need the CCU, he needs rehab.
Better learn to take the advice of a senior consultant if you intend on finishing your residency.
- Any more pain, Mr.
Greco? - No, I'm fine.
- Dr.
Morris, my daughter, Layna.
Uh He needs to be admitted to the IV antibiotics for the hospital.
I mean You know what I mean.
Let's get a dressing on this.
It looks pretty bad.
It's not that flesh-eating bacteria, is it? - No, this will clear up in a few days.
- Thank God.
- I've got your clinda.
- Are we out of Kerlix? I don't think so.
So, doctor, may I ask, what kind of car do you drive? Yeah, a BMW 328.
Not bad, but I'd love to see you in a Z4.
I sell luxury cars.
A man like you deserves something sexy.
Anything else, Dr.
Morris? Some tape.
So, what's your wife in? Actually, I'm not married.
Oh, really? So the ring's just to sweeten the pot? All we have is three-inch.
I've heard you can make that work.
Hey, Sam, where'd you move the boyfriend? - Bevan Wong? - Exam 3 with Chuny.
- We're waiting on Troponins.
- We have time.
Will you talk to Kayson? Override the chief of Cardiology and demand admission? Yeah.
Think about working with Dr.
Kayson in the future.
- Think about saving lives now.
- You have to defer to the consultants.
- Yeah, well, what if they're wrong? - Get creative.
Could the needle hurt the baby? - There's a small chance.
But Tracy wants to have the transfusion.
- She decided on her own? - Mm-hm.
Can I talk to her about it? I don't think she wants to see you right now.
Because of the speed? It was only once.
- It's not like I'm a tweaker or - She's a little disappointed.
I won't listen to his crap anymore.
I should have known.
He used to deejay at warehouse parties.
He'd be out all night.
- I thought he was different now.
- I think he is.
He lied to me.
He was like: "I'm gonna work hard and support you and the baby and be a good dad.
" - He's trying to step up.
- By getting high? - By almost getting us killed? - People change, Tracy.
I used to get high all the time.
Made a lot of dumb mistakes.
- I straightened out when it mattered.
- He's not like that.
- He proved it.
- He messed up.
You know, sometimes things aren't always right or "wrong " black or white.
My baby's sick.
Might not even make it.
Can we not talk about this right now? Okay.
You look very lost.
Yeah, I'm looking for Tracy Martinez.
They pointed me in this direction.
They said she was in Trauma 1.
Yes, I'm Dr.
Gates and the good news is you're very, very warm.
- Because Trauma 1 is right there.
- Thank you.
So you're a friend? Not exactly.
Julia Dupree.
I'm the on-call chaplain.
- So they called you for a consultation? - Yeah.
Good, I'm very familiar with the "case " so if you have any questions No, I think I can manage.
Thank you, doctor.
The nerve gets compressed and inflamed right here.
So, what should we do? There's a pad for your "arch " " but" you're gonna have to stop with the high heels.
- Are you serious? - I'm sorry, can you? Can you make her stop? - She's expressing her frustration.
- Yes, well, so am I.
Emily, give that to Mommy.
Ah! I'll be right back.
Your lady has a Morton's Neuroma.
I figured, thanks.
Well, looks like further surgery won't be necessary.
- How's it going, Dad? - Much better, sweetheart.
- Thank you.
- This guy is the best.
You ever been inside a Shelby? Those are some tight little numbers.
Didn't we talk about this? I was perfectly clear about my situation.
- What situation? - Hey, Sophia.
- Hey.
I see you've met my sister? Twins? We were hoping we could take you out for a test drive.
- So you two work together? We do everything together.
Advancing the needle.
When my friends had babies, they were all so happy.
I thought I could handle it.
It's okay to be afraid.
I'd be scared out of my mind.
I'm not strong enough to do this alone.
Hey, I think you might surprise yourself.
There's the tip.
- I'm not so sure.
Really shows up.
- You wanna say a prayer? It's etched, echo tipped.
- We can do it together.
Move to the right toward Mom's feet.
There's the cord.
Packed cells and platelets are up.
How big is the umbilical vein? At 20 weeks, about a millimeter.
All right, I'm in.
You hit that with a 22-gauge? Sick.
Zelinsky, I need you to check on the rule out appy.
Right now? I don't want her to perf, go.
Pull off 1 cc for the lab.
- It's okay so far? It's perfect, couldn't be better.
Must have been one hell of a prayer.
Don't worry, Harold.
She's having a bad day.
I'll be in Trauma if you need me.
Got it.
- Gates, is that even your patient? I'm taking care of the boyfriend.
He's concerned.
I'm very concerned too.
You've been working on this for eight hours.
They have special needs.
Medical, social, psychological.
- You're not in the ICU anymore.
- Top three organisms for neonatal sepsis.
Reboot to ER mode.
Stabilize and pass off to the admitting team.
Appropriate if it was pneumonia or cellulitis.
- I need an answer.
- Shut up.
- Let me just check.
- What did I say? - I'm discharging Bevan.
- No, you're not.
- Gates.
- Gotta deal with this.
Feeling some pressure? Excellent.
Name three bacteria for neonatal sepsis.
- Bend over and kiss my ass.
- Those are not bacteria.
Group B strep, E.
Coli and Listeria.
Not bad, Abby.
That's turbulent flow in the Uv.
- Excuse me.
My intern's in with your belly pain guy.
But Dr.
Coburn, I had a question for you.
Another consult? - No, not exactly.
Could you find me when you're done here? Go with the platelet infusion.
Eighteen cc's of packed cells are in.
So I hear Luka's in Europe.
Something about his dad? Multiple myeloma.
- Oh, I'm sorry.
Well, things are a little bit better.
He should be home soon.
Must be hard.
- You managing with Joe? - Mm.
Joe's amazing.
You should see him.
He's walking, babbling, feeding himself.
He loves the books you got him for his birthday.
Good Night, Gorilla has to be the last book every night.
You drank.
When? Last night.
- You wanna get to a meeting? - I don't have time to go to a meeting.
I don't need to go to a meeting.
I just I had a bad day.
A very bad day.
And it was just one time.
Not gonna start drinking again.
Really? Are you an alcoholic? - Yes, but - Yes, but? All those years that you were sitting in meetings, were you an alcoholic then? Yes or no? Okay, keep drinking.
- Do the research, see what happens.
- I can handle this.
Let me know how it works for you.
Okay, I've got a clinic full of patients.
Janet, Janet, you're my sponsor.
I was your sponsor, but now it's very simple.
If you've decided you're not an alcoholic, I can't help you.
If you are, I'll be your sponsor again and I'll support you in recovery.
Let me know what you decide.
MORETTl: It's really It's okay.
You can call me any time.
Good luck on your midterms.
I love you too.
Was my son.
In Rhode Island.
He's having a hard time in college.
- Really? - Yeah.
He's a long way from home.
I don't know if it's the normal school stress or if it's "more " But I feel like he's not telling me stuff, you know? It's hard to know what's going on with "someone " " even" if they're your own kid.
I'm sorry, but they're waiting for me to sign out.
Good night, Abby.
- Migraine lady's groaning.
- Another four more of MS.
- You out of here? - I'm trying.
Frank, did Ortho call back yet? Oh, damn it, another dead end.
You said this would be easy.
Sure you spelled his name right? - Frank? There's no mortgage, there's no credit cards, not even student loans.
- Well, maybe he had a full scholarship.
- Hello? Ortho? Not yet.
I can't even find a birth record.
- What are you doing? Check on Neela's intern.
Yeah, we're gonna figure out his age.
I'm here late because our clerk can't get CT results or call consults.
And my Attendings don't have time to hear about a migraine DKA, femur fracture, or an incarcerated hernia because they're busy playing "how old is the intern"? A couple minutes.
- We've been here.
These are my pass-ons.
Harold, how old are you? - Twenty-five.
That's an intern? How old were you during the O.
Trial? - Uh Well, that was, like, 1995 - You're not 25.
- You're right, I'm 19.
Nineteen? No way.
I started college when I was 12.
Med school at 15.
- How is that possible? I was home-schooled.
I got a perfect score on the SATs when I was 11.
- So I knew I was ready for college.
- What? Perfect score.
All right, let's go and check on that rule out appy.
Gates? - Can I talk to you for a minute? Yep.
I understand that Dr.
Kayson wrote a discharge order for Bevan Wong.
- And that you canceled it? - This your idea of problem solving? - Didn't know what else to do.
Well, did you consider a Holter monitor? What about a transfer? Runs of V-tach.
I need a doctor in here.
Open the crash cart.
MORETTl: Call Kayson.
- Dr.
Morris? - Dr.
Morris? - Your dad got moved upstairs.
We just wanted to say goodbye.
You've been very wonderful.
Uh Just doing my job.
It's too bad things didn't work out.
We could've had some fun.
- "Ciao.
" See you.
Frank, how about the LFT's on my hepatitis guy? - Called five minutes ago.
- Call again, been three hours.
Abby's right.
Why can't anything get done here? - Tell me the Ottawa Ankle Rules.
- Where's his chart? The ankle rules.
There's only five of them.
I don't have time for your stupid games.
Going again.
Normal sinus.
- Strong carotid.
- What happened? Pulseless V-tach.
- You're kidding.
MORETTl: Take a look at the strip.
Hundred and fifty amiodarone.
Recurrent ventricular arrhythmias in the absence of amphetamines.
Possible he'll need an implantable defibrillator.
Glad I didn't discharge him.
He would've died on the way home.
Yeah, good thing we got busy with another trauma.
I'll go prep the EPS lab.
- You all right, Dr.
Gates? - Yeah.
MORETTl: Hey, Jack, hold on.
Welcome back.
Sometimes I wish I could just see the patients by myself.
- Without the residents.
- Life would be so much easier.
I know.
They don't listen, they don't want to learn.
- Well, they think they know everything.
- And you know the worst part? Every now and then, they turn out to be right.
Excuse me, miss? Is that yours? I miss you too, baby.
Is it hot down there? Really? So, what are you wearing right now? Like a tank top? All hot and sweaty and clinging to your skin? - I need this bed.
- Yes, thank you.
Could you page Urology for Dr.
Morris in the ER? Thanks.
Hope, you still there? So when you're all hot and steamy, what do you do to cool off? Oh, I'm so jealous.
You're that close to the Caribbean? Do they have any topless beaches? You are such a bad girl.
Wouldn't mind going skinny dipping with you late at night.
Yeah? Yeah.
Then I'll take you back to your tent.
Right, hut.
Oh! I'll sneak into your hut one of these nights and Hold on, hold on.
Can I use your rig for five minutes? I have an administrative tour.
Take your time, I'm gonna grab some dinner.
Okay, okay, okay, where were we? Right, right, right.
You're fast asleep, naked under satin sheets.
First, I gently nibble on your toes, then your ankles.
Now I'm licking the back of your knee.
- My baby's okay? - Everything looks great.
No contractions, hydrops should resolve in a couple of weeks.
So did you hear about Bevan? Heard his heart was bad again.
Yeah, but this time there were no amphetamines in his system.
We think it's called Brugada Syndrome.
He was born with an electrical problem in his heart.
So it wasn't the drugs? And he'll need a shock box in his chest.
Okay, but he still took speed.
Once, to get through work.
And he realized it was wrong.
And he promised, from now on, nothing stronger than coffee.
You think he means it? - I guess I should go see him.
- Lf you're ready.
- Hey.
- I'm gonna go talk to Bevan.
- Good, I think that's a good thing.
You know that guy Robert Frost? He was right.
Robert Frost? He said, "The only way out is always through.
" - Done a great job with her.
- Oh, I just held her hand.
Told her it was okay to be mad at God.
- Is that right? - Yeah, I get mad at God all the time.
It's actually done wonders for our relationship.
I haven't been struck down by lightning.
Yeah, not yet.
All right, so how does someone like you become a chaplain? I mean, is there a lot of training? No worse than med school.
So I guess So I guess you'd have to give up a lot of things, huh? Well, I don't know, aren't there like vows or something? Dr.
Gates, I'm not a nun and I'm not a saint.
I'm a woman who happens to be a chaplain.
- And you don't really get that, do you? - Yes, I do.
Get what? That I have a spiritual life and a spiritual career but I live in the real world.
That sounds nice.
You should try it sometime.
I don't know.
Maybe it's not too late to switch to something else.
Seriously, I don't think I can take a year of this.
Hey, listen, I gotta go.
Call you later.
- Do you wanna start evening rounds? - No, there's a trauma coming in.
- You all right? - Yeah.
Are you? - You're "not?" - No.
No, I'm fine.
This is all because I've been riding you so hard? Bollocks, come on.
I'm not really a mean person.
My boss told me I had to be that way so you'd work harder and learn more.
- It's not working.
- Yeah, I knew this was stupid.
- But you were so convincing.
- But I think you're doing a fine job.
From now on, I'm gonna be a lot nicer and a lot more supportive, okay? - Okay.
- No more unnecessary scut.
No more pimping for humiliation, no more taking credit for your good ideas.
Don't believe a word I'm about to say.
- What? - Just play along.
- What's coming in? - Stab wound to the chest.
Don't set foot in that trauma until you advance the drains write your progress notes and check preop labs for tomorrow's OR cases.
- Am I clear? - Yes.
- Yes, what? - Yes, Dr.
Well, what are you waiting for? Nice.
Now that's what I'm talking about.
- What do you got coming in? - Stab wound under the left nipple.
- I can stay if you want.
- No, we got it.
Good work today.
Nice to have you back.
Beautiful night, isn't it? Everything okay, Dr.
Morris? Oh, yeah.
Everything's good, real good.