ER s14e10 Episode Script

300 Patients

Luka.
Is the stroller in the car? No, it's down here in the living room.
Can we carry it on the plane? No.
We're gonna have to check it at the gate.
"And all through the house not a creature was stirring " not" even a mouse.
" Mouse.
Okay.
Hey, the flight's at 10 tonight, right? I'm gonna run errands.
Dry cleaners, bank.
It shouldn't take long.
No, sweetheart, you stay here with Daddy, okay? - Let Daddy finish the book.
Joe, let's go.
Look at the tree, huh? Help me how to count how many Santas we got.
- You okay? - Yeah, are you? Yeah.
I'll be back in an hour or two, okay? Bye.
Mama, mama, mama.
I saw "Frosty the Snowman" on TV last night.
- It's December 6.
- I know.
By the time the Yuletide gets here, you're already sick of it.
We work for the County, they all gotta get equal time.
Christmas, Hanukkah, Kwanza.
Why can't people agree on one date and be done with it? Damn, what a messed up board.
Messed up floor.
It's like Calcutta around here.
Calcutta on a bad day.
We signed in 142 on the night shift.
- That's a new record.
- You must be proud.
I'm too tired to go home.
I'm gonna sleep in the call room.
Poor kid's a zombie.
A hundred and forty-two, huh? Hey, we keep this thing cranking, we could hit 300.
Yeah, that'd be quite a milestone.
Forget it.
- Never had over 250 in a 24-hour period.
Dream big, Frank.
We have to sign in, what, 14 patients an hour for the next 12 hours? - Too rich for me.
- No, you guys could split it.
Put up a hundred each against my three.
- I'm in.
- Oh, Lord, when is he gonna learn? Looks like I'm gonna be able to get the wife that toaster she's been hinting for.
Frank, you romantic fool.
Admin sent this down.
- Oh, put that by Trauma.
New portable CT scanner.
That's the holiday gift for the ER, in lieu of the T-shirts we normally get.
Oh, too bad.
I love those shirts.
Hey, guys.
Everybody see my memo? I saw your memo.
- What memo? - What memo? I'm going around to all the departments " and" I'm doing blessing ceremonies and memorials.
And today is the ER's turn.
Well, you know, that sounds nice and very cleansing, but no.
- We're busy.
- It's not really our thing.
Yeah, why don't your try Oncology.
They love all that touchy-feely crap.
Come on, guys.
This could be cool.
Enlightening.
Gratifying.
Don't shoot the kid down.
How open-minded of you, Dr.
Gates.
Thank you.
I do my best, Miss Dupree.
Good, so I'll see you all later.
- Are you and her? - Wait a second.
- Are you banging the chaplain? Pratt? Hey, Pratt.
- Yeah? Melissa Tanner, 61.
Restrained driver, TC in respiratory distress.
- You're on the chopper today, huh? - Logging hours, part of Transpo training.
- She's unresponsive.
What's this scar? Looks like a thoracotomy.
Sats are dropping.
All right, 100 percent non-rebreather and a portable chest.
- Morris? What do we got here? That's her son, Lowell.
Down syndrome, facial lac, a few contusions.
- Found walking on the scene.
- Is Mommy okay? - Yeah, we're helping her now.
- Need me? No, I got this.
Push some charts.
Harold? Who are you supposed to be, Merlin? - I need a ladder out in the bay.
- You need a ladder for what? Holy cow! Is that what I think it is? It's not a cow, no.
What is this? We had a dress rehearsal for a hospital holiday pageant.
Surgery got the Nativity scene.
Congratulations.
And this camel they got from somewhere bit Lucien on the leg.
Well, why the hell did you bring it here? Oh, we were just down the street.
Well, we need to take a culture.
You need a shave.
There might be an exotic organism that needs targeted therapy, so All right, let's give this a shot.
My dad raised horses.
Allow me.
Okay, buddy, this won't hurt.
Just a little bit.
No, this will be easy.
Come on.
Hold it.
I'll get it.
I'll get it.
All right.
Let me just All right.
Come here.
You know, I'm starting to think this is not such a good idea.
Well, we've gotta get a swab, Tony.
All right.
Easy there, big fellow.
Oh, Harold, can you grab my phone from my back pocket? Sure thing.
We'll still have noon conference, Neela.
Make that fat embolus presentation without me.
You have it on your laptop, right? "Missed call.
Abby.
" Yeah, but I left it at home.
Okay, well, you go home after morning rounds and get it.
Sorry about this.
Hey, Neela.
I left a message on your cell.
I was just wondering if you were home right now.
Luka's father died and we're flying to Croatia tonight.
I left a few things in the closet " so" I thought I'd just come by and pick them up.
All right, talk to you later.
Thanks for helping sell those guys on the ceremony.
- Oh, I'll proselytize for you any day.
- Nice to know I have an acolyte.
Pulse ox down to 84.
- No pneumothorax.
- Any rib fractures? - Don't think so.
Intubation tray.
Hey, mind if I try? I need 10 supervised - No, this isn't a good teaching case.
- Patent airway, shouldn't be tricky.
She's had thoracic surgery with lousy reserve.
- Once we paralyze, every second counts.
- Give Sam a try.
Here.
Suction.
Twenty of etomidate, 100 of sux.
Oh, guys, this CT is cool.
- Hey, what's up with her kid? Oh, just a few scratches.
Whoa, noncontrast scan in 15 seconds.
- She's out.
- Go, go.
- How about we fire this baby up? Quiet, Morris.
- Got it.
Nice.
We're not radiating every patient because we got a toy.
- Good breath sounds.
End-tidal is yellow.
Good, let's call for a vent.
Hey, Morris, see if you can get the history from her son.
Kid doesn't say much.
I talked to him on the chopper.
Call for a portable chest.
- Okay, 151, 152, 153.
- What are you doing? - Just tracking the census.
Sam, how's my mommy? She's doing better.
We're helping her breathe right now.
Do you know if your mom takes any medicine? Lots of pills.
She's sick.
Do you remember when she had an operation? How about the name of her doctor? It's okay.
The husband's number was in her wallet, so I'll call him.
- You're gonna call my dad? - Mm-hm.
Continuous NG, recheck lytes, write the order, then go get your file.
Oh, will do.
I'm gonna be upstairs in my office while my anti-camel drip kicks in.
I'm running home.
Be about half an hour.
Dr.
Zelinsky will start up any consult orders you might need.
You mean Harold? Please hurry back.
The husband of the woman we choppered in is on his way here.
- Okay.
- Hey, Sam.
Coming to my séance? I'm off shift.
I'm pretty beat.
- That's too bad.
- Yeah.
Plus, to be honest, my relationship with religion's kind of complicated.
So is mine.
But you know, it's not exactly a religious ceremony.
Well, I was raised in a pretty strict household.
A lot of talk about sin and damnation, and it never did that much for me.
Do you believe in God? Some days, it's tough.
And other days? Other days, I thank him for showing up.
Or her.
Or whatever.
Well, if you change your mind about our get-together we'll be here.
I hear you've been riding rigs all over town.
- You never asked me.
- I go where they tell me, Zades.
Wish I could get into that paramedic conference.
What? Sternback's case review? Yeah, I hear it's interesting.
He goes through every tough ambulance run.
Yeah, you can learn a lot.
So you coming or not? - Can you get me in? - I got connections.
- Let's go.
- Yeah.
- Hi.
- Abby.
- I didn't know you were coming over.
- I left you messages.
Oh, no problem.
I just need to pick up my computer.
- You're watching Tv? - Yeah, I was just checking the weather.
- What's going on? - I was running a few errands.
And I remembered there was a coat I left here that I wanted to pick up.
I had a drink.
You had a drink? Yeah.
What are you doing? Oh, jeez.
Just forget it, I'm gonna go.
- Abby.
- Yeah.
I'm just gonna go, okay? Is this what's been going on these last few weeks? What's been going on the past couple of weeks? The way you've been acting? At Ike's, how far away you seemed? - That time you asked to - Sometimes you are such a child.
- Stop it, I'm trying to help you.
- I don't need it, really.
You've gotta stop this.
Think about Joe, think about Luka.
And I really don't expect you to even begin to understand this.
- Lf you love them, you'll do something - If I love them? Please, I'm your friend.
Are you about to lecture me on love with your track record? Don't.
Because I'm thinking right now, Ray is really wishing he didn't meet you.
You don't live here anymore.
Get out.
She has end-stage emphysema.
Used to smoke three packs a day.
She still tries to sneak one every now and then.
Yeah, we noticed the scar on her chest.
Yeah, she had lung reduction surgery about 10 years ago.
It worked.
I mean, it worked for a while.
But she's been on home oxygen 24/7 for almost a year now.
L We didn't realize.
We thought maybe her lungs were bruised in the collision.
No.
She shouldn't have been driving.
She knows that.
I offered to hire a driver.
Well, the ventilator's helping her to breathe.
No, no, she's a DNR.
She does not wanna be kept alive by a machine.
Well, we can take off the support if that's what you and your son decide.
- He didn't say anything about it.
- My what? Your son.
Lowell.
He's right there in the next room.
I don't know who that is.
So you thinking of making a change? Maybe.
Had enough, huh? I don't know.
I was a traveler for a long time before I got to Chicago.
Been a nurse at County for over four years now.
Kind of weird for me.
I used to be wired for change.
Whoa, hold on! Hey, you okay, Sam? Yeah.
You? Banged up my knee.
You all right? I think.
There's a kid.
Hey, Zadro! Stay in the car.
Evie! Hey, I'm a nurse.
I'm gonna help you, okay? - Evie! Hey, honey, what's your name? Oh, God.
Evie.
Where do you hurt, Evie? Evie.
- Down there.
No obvious head trauma.
- Did that car hit her? - I'm all right, Mom.
- Where's Nina? - Who's Nina? - My dog.
Is she okay? A broken bone in her pelvis.
Everything else, good.
- Her neck? Bruised it on the way down.
- You breathing okay? - Yeah.
Sats are good.
BP 118 over 76.
Hey! Stay there, sir! Is that brother drunk? - I bet his dumb ass is drunk.
Evie.
Nothing but liquor stores and churches around here.
Hey, Sam, go check him.
I'll call for backup.
Excuse me, coming through.
- Excuse me.
Asshole.
- You hit a kid.
- Been drinking? Hey, come, on, back off, okay? You hit a little girl.
- What is your name, sir? Del.
Del, do you remember anything? Do you know what happened? When? Here you go.
Oh, thank you.
Mind if I? Oh, no.
Thanks.
What's his name? His name is Lowell.
Lowell.
Look, I'm sorry you had to find out this way.
That your wife had a kid with someone else.
Oh, no.
No.
No, that wasn't it.
Melissa and I were We were in our 40s.
We thought we were past our having-children time.
Then she got pregnant.
That was in 1983.
I knew something was wrong right away.
I could tell by the looks on the doctors' faces.
They told us about Down syndrome.
We realized how hard it would be.
We weren't ready for it.
I convinced her that it would be better That it would be better for all of us What would? Giving him up? Do you know why he was in the car with her? Hey, Pratt.
You seen Skye? You should ask him.
- What? She's not in her office.
She's not on today.
What's up? Luka's father passed away.
What? Oh, I'm sorry to hear that.
Yeah, so we're leaving for Croatia tonight.
I need to take a leave of absence.
- Hey, you okay? - Yeah.
- You sure? - Yeah, I'm sure.
I mean, his father just died.
Give me a break.
All right.
Well fill out the paperwork.
And I'll tell Skye about it.
Thanks.
- A little oxygen in your nose.
- Okay.
I think the girl stopped moving.
- I saw her get hit, it was bad.
You think she could die? - No.
- Go help with the girl.
- Paramedics are with her.
This jerk's feeling no pain.
He's concussed.
He's not drunk.
- Come on, that girl needs you more.
- Hey! Why don't you back off and let me do my work, okay? - Okay.
Give her some room.
- Yeah, thank you.
Cool.
Hey! - Little drunk bitch! - Hey.
Hey, Zadro! Frank? I need two more charts.
- You're pathetic.
- No, no, it's the funniest thing.
As I was getting my coffee, I noticed that Conchita has carpal tunnel.
From working the register.
Yeah, and Bheru here has a bad back from lifting heavy boxes.
I'm thinking I slipped a disk.
- Bring it on, we haven't even hit 200.
- Are you serious? Yeah, give me your card and PIN.
I'll save you a trip to the ATM.
It's not over till it's over, Frank.
A fool and his money are soon parted, Morris! Labs are back.
Vitals are stable.
Yeah, everything looks good.
No serious injuries, Lowell.
Mommy was taking me to a new place to live.
You know, your mom's not doing well.
- She needs air.
- Yeah.
She's getting sicker.
Mommy comes every Thursday.
But she's too sick now.
Is my dad here? I heard he's coming.
Which one is he? I can find out and I'll bring you to him.
No.
No, you don't you wanna meet him? He didn't want me when I was a baby.
Well, you know, dads can change their minds.
- Really? - Really.
Yep.
My dad was kind of like your dad.
Did he change his mind? I like to think he did.
- Oh, hi, Abby.
- Hi.
- Sorry, do you mind? I have to - Yeah.
What are you doing? Oh, you haven't heard? We're doing a memorial and blessing ceremony.
- Who's bringing the Kool-Aid? - It's nothing scary.
Don't worry.
You should come, check it out.
I don't think so.
Oh, everyone could use a blessing now and then.
Or a memorial.
Abby, do I piss you off? - Excuse me? - I was wondering.
No, you don't piss me off.
I don't know you, really, "so " If there was ever anything you needed to talk about Why would I need that? It's kind of why I'm here.
Okay.
You know, there's this story I know, I know, bear with me.
- It's about this little boy who asks his mother " " "Do you think I can pick up that big rock over there?" And she says, "Yes, I'm certain you can lift it.
If you use all your strength.
" So he goes over and he tries to lift the rock.
He tries a bunch of times, until finally he says, "I couldn't do it.
" So she goes over there.
And together, they lift the rock.
Wow, that's great.
And she explains to him that sometimes using all your strength means asking for help.
The floor's under control.
We got no incoming traumas.
- Want us to round up the troops? - Yeah, let's get while the getting's good.
- Sorry.
- Sorry, Neela.
No, it's my fault.
My mind is somewhere else.
Oh, me too.
I heard about your father.
Sorry.
Thanks.
Yeah.
Just when I thought he was out of the woods for a while.
Have you seen Abby today? Something the matter? She was just supposed to be home a while ago.
She must've gotten caught up with something here.
Yeah, maybe she got caught up with some work.
The names of those who've passed on while under our care.
We take time from our busy day to pay respect to the mothers and fathers husbands and wives, sisters and brothers sons and daughters who are no longer with us.
Think of one patient who's changed you in some way.
Hold them in your memory.
Were they inspiring? Funny? Courageous? Did they challenge you? Teach you something about yourself? Were they searching for something? Was their heart filled with love? As you hold them in your mind, ask yourself: "Which of their qualities can become part of my life?" Sorry, multiple trauma rolling in.
I waited as long as I could.
- Another time.
Gates, Morris, let's go.
Two ORs on standby.
Page Dubenko.
Yeah, I got it.
What is it? Blunt trauma.
Auto versus peds.
You said you'd be back an hour ago.
I didn't know where you were.
Well, here I am.
There's no way.
Anatomy is distorted.
- I thought her breathing was okay.
- It was.
- Gonna grab the fiber-optic scope.
I'll bag her.
Is there a problem? What are you doing? Tell me.
- Joyce, wait outside.
- No, I need to be here.
Just give us a few minutes, okay? You said it was a scratch.
There's more swelling in her throat.
So she can't breathe? We're helping her.
Would you like to sit down? Sorry.
- Oh, God.
Oh, my God.
My baby.
My baby.
Oh, my God.
My baby's hurt? God.
No.
Oh, God.
You're Lowell's dad? Yeah.
Have the balls to go in there.
I don't know what to tell you.
KOv AC: What's going on? Nothing! - Lf you don't wanna come to Croatia - No, that's not it.
- Then what? I just have a lot to deal with it.
That's all.
Since I got back, you haven't seemed happy.
You avoid me, hardly touch.
Do you think I'm blind? - Don't be ridiculous.
- Am I? Look, you were just gone forever.
It was a lot of stress.
- Taking care of Joe and supporting us.
- Supporting us? Yeah, there were bills to pay.
All we had was my salary.
- So you're mad I wasn't working? - No, that's not it, no.
It's just hard for me to just turn it back on.
Turn what back on? When did it turn off? I know you.
I know when something's wrong.
- Do you still love me? - Of course, I still love you.
- Why would you ask me that? - Why do you think? Just talk to me.
Hey.
Look, I have to go and finish my leave request.
And then we'll go to Croatia and then everything will be different.
Okay? You can't just hide forever, you know.
You can't.
- Hey, what - I'll see you at home.
- All I can see are arytenoid folds.
- Sats are way down.
- Let's do a surgical airway.
She's too young to crike.
Formal trake? Prep the neck.
- Will take too long.
Twenty minutes.
She doesn't have 20 minutes.
Jet ventilation? Requires a regulator.
Release valve.
By the time you get that, she'll be traked.
- I can do it with a cannula.
- Get out of here.
- Will take me 30 seconds.
- Fine.
Lost the pulse.
PEA.
I'm starting compressions.
Are you sure he wants to meet me? He was asking the same question.
Will? Will you come in with me? That's not a problem.
Someone's here to see you.
Hello.
My name is Pierce.
My name is Lowell.
Lowell.
Lowell, I'm your father.
Nice to meet you.
Okay, Morris, steady the hub.
Nasal cannula at 15.
Okay, 10 blade.
Tip suction.
Okay, when I cover the open prong, she's gonna get a blast of oxygen.
Hold CPR.
That's hot.
One second on, four off.
Where'd you learn this? Transport.
- Got a pulse.
- Gates needs a surgeon now.
- I got it.
BP 110 over 60.
Big epidural, he blew a pupil.
JARvlK: Heart rate's dropping.
Atropine? Two amps.
- He needs the OR.
- He'll never make it to the OR.
- Seventy over 50.
Dopamine.
- Hey, what about a burr hole? - We need a drill.
He got kicked in the head.
Can you show me bone windows? - He's seizing.
Four of Ativan.
- Looks like a circular skull fracture.
Brilliant, prep for a cut down.
Sorry your thing got interrupted.
Life in the ER, I guess.
We'll finish later.
Why did you tell me that story before? I like it.
I thought you might too.
Hey, Frank, did that fax come in yet for Melissa Tanner? Greg, thanks for taking care of this thing with Skye for me.
Let Luka know we're thinking about him.
- Okay.
- Fax is right here on the chart.
- That the DNR? - Yup.
"No intubation, no CPR.
" Is her husband comfortable honoring her wishes? Yeah.
So I guess we extubate.
And she's gonna die in a few hours.
Lowell needs to understand that.
It doesn't seem right.
Kid's never had a real family.
And on the same day that they finally get together " he's" gonna lose his mom.
Makes me wanna call my folks.
You okay? My mom died when I was a kid.
Breast cancer.
We were close.
And I lost her pretty early.
I don't know why I'm even talking about this.
Must be that time of year, you know? I'll go talk to them.
Heart rate's down, 20.
Start pacing him.
You know he's gonna arrest soon.
Elevating the fragment.
Suction.
- What the hell is all this? Draining an epidural bleed.
You did a burr hole? We didn't have to.
JARvlK: Heart rate's 80, bounding pulse.
Mayday hits a three-pointer at the buzzer.
You people are crazy.
I'm gonna go and help Dubenko with the trake.
I'll be right back.
Heard you were a seasoned pro out there today.
You'd think that.
I hit somebody.
How is that? How are you? Yeah, I've had worse.
Harold, what's next? - Chuny, I got this.
A vertical incision through the third and fourth.
- You bitch! - Remember the girl you're worried about? - We're trying to save her now.
- Yeah, plenty of doctors.
- You messed me up.
This is a sterile procedure.
- I need you to step back! - Hey! Let go! Get off me! - Hey, let go of me! - Stay down! - Stay there! Don't move! Get off me! Get off me! Not so tough now, are you? Lowell, a long time ago " your" mom decided she didn't wanna be put on a breathing machine.
- She wants to die? - Not exactly, no.
And son, living on the machine she wouldn't She wouldn't be able to do things that she loved.
She wouldn't be able to visit you.
And she'd be stuck in a bed, unable to walk or talk or eat.
She'd just get sicker and sicker.
Mommy? Are you sure you don't want the machine? She doesn't want it.
That means in a little while, we're gonna pull out that tube.
Okay.
And she'll probably die not too long after that.
Could she get better? I don't think so, Lowell.
But she might.
Well Lowell, we'll pray for that.
We'll pray for that.
Mommy, you don't have to die today.
And we're gonna go on the airplane.
Can you say airplane, huh? - Hey.
- Hey.
And the propeller.
Yeah.
Put it here.
Where's Niko? He went to buy a present for his wife.
And are we ready to fly now? Ready to fly.
We're gonna fly.
Where are we gonna put Joe in the airplane? On a window seat, huh? Joe.
Come.
Luka, I need help.
I started drinking again.
When? The night Joe got hurt.
And I I can't stop.
I thought when I came back we just needed to get used to being married again.
But then things didn't get better and I thought - So, what do we do? - I need to fix it.
I need to go somewhere.
A facility with professionals and get better.
And I need to believe it this time, and I need you to believe it.
And I need you to help me.
So So take Joe go to Croatia for your father while I do that.
- You want us to go without you? - Yeah.
- You're his mother.
- I know that.
I know that.
But I haven't been a very good one.
And I honestly don't think I can be until I deal with this.
Can't we do this together? This is how we do it together.
You have to help me do it alone.
That's it? Is there anything else? What do you mean? That you wanna tell me? You know, I just I was out of control.
I got out of control and I I did some things.
What kind of things? Things I'm ashamed of.
Okay, just tell me everything.
Luka.
And after all this, after everything, you don't wanna tell me? Not tonight.
- It's my fault, isn't it? - No, don't, please don't.
I should've come home earlier.
- I shouldn't have left.
- No, I should've been able to handle this.
- I broke my promise.
- Don't do that, okay? Don't.
I screwed up.
I screwed up because I couldn't keep it together.
- This is my fault.
- I'm so sorry.
And please don't.
Don't.
Just don't.
I'm sorry.
- Hey.
- Hi.
Neurosurgery finished with the driver from your MVC.
- He's waking up.
- Oh, that's good to know.
Nice move in there.
You okay? Oh, yeah, I'm fine.
I did a little cage fighting back in medical school, so.
It showed, good thing Harold was there to save your ass.
Is that what happened? Come on, Harold.
Seriously, thank you.
And I don't care what anybody says, Gates.
- I think you're a half-decent guy.
- Sam, is that a new patient? - No.
- Damn.
With 15 minutes to go, the patient count is 263.
I need another two nurses here.
Food poisoning at the Christmas potluck.
Hallelujah! And now take a deep breath in.
And blow it out.
Good.
Good.
Well, that's good.
Hi, Mommy.
Hi, baby.
I love you.
I love you too.
I couldn't forget him.
I never knew how to tell you.
Don't worry about anything now.
He's our son.
I'll take care of him.
Ha Ladies and gentlemen.
The official census for the past 24 hours stands at 299.
Triage is empty.
Which means, we will each be $ 100 richer in 10, nine, eight seven, six, five four, three, two Ah! Son of a bitch! Lily, make a chart for Frank! You have a serious gambling problem.
Three-view hand x-ray, ibuprofen and an ice pack.
Three hundred! Yes, yes, yes, it's me! Julia's ready, we moved to Trauma 2.
Water is the source of all life.
It's used in healing rituals all over the world in almost every faith.
Water is an element of cleansing and purification.
Today, we use sterile saline.
It's what we work with.
And water doesn't get much cleaner than that.
"Earlier, we talked about" what our patients do for us.
How they affect us.
Stay with us.
Now we'll honor what we do for them.
And pay thanks for the abilities we've been "given " hoping that we may continue to use them to serve our community.
So let's each dip our hands in the water.
May we all have the strength, dexterity and sensitivity to carry out the mission of healing.
And may our hands be blessed.
We have our dead.
And we have let them go.
Now, let's turn our attention back to the work of the living.