ER s14e14 Episode Script

Owner of a Broken Heart

Ladies, I'm so sorry.
I got to go.
- Now? - Mm-hm.
What about dinner? You can order room service.
Anything you want.
I'll be back for breakfast.
Baby, that is very, very tempting but You know how devoted I am to my work " so" we'll save it for round two, okay? Hey.
I didn't know you were on.
Yeah, I just started.
Are you waiting for the chest pain? Uh-uh.
At least it's not raining.
Okay, about Ike's the other night, I'm I had a few drinks, and I really wasn't trying to I get it.
You do? Good.
I don't want anything to be weird.
I know you have something going on with Julia.
I don't wanna She's in Nepal, actually, on a spiritual retreat.
- Oh, really? Oh.
- Mm-hm.
Well, good.
Then we can have some time to get it out of our system.
I mean, get over it.
- And forget it ever happened.
- Okay.
- Okay? And just get back to normal.
- All right.
- Right.
Can I get some help over here? What happened? She stopped breathing.
- What's her name? - Mia.
Mia, open your eyes.
- Does she have asthma? - No, I think it's her heart.
And last but not least, Trauma One.
I really appreciate the tour, I know how busy you are.
- Is that a ruby? - Yeah.
- Oh.
- Heh.
You know, rubies have a lot of power.
According to Vedic astrology they bestow courage, vitality and spiritual insight.
- Spiritual insight.
- Excuse me.
- Hey, heard you got a sick one.
- Yep.
- This is Mia, her boyfriend Jordan.
- Pertinent history? - She had a heart transplant last year.
Excuse me, doctor? - Simon Brenner.
Heard you're starting today.
I'm Dr.
Keep her on 15 liters.
- Pulse ox, 85, tachy at 135.
Set up for intubation.
Drop, etomidate and sux.
- I'm doing it.
- She had heart failure? - Not since the transplant.
- She's been doing well.
- Hey, Mia.
Give me a deep breath for me.
Can you do that? Doctors, you mind if I try something? - Like what? - Sublingual captopril of nitrate.
- I'm Simon, new attending.
- Sam.
- Let's start airway first.
- This is only gonna take a second.
We got to put her on a breathing machine.
She really hated that after surgery.
When her lungs are this bad, we don't have a choice.
- Ready with thorazine.
What's going on? - Whoa, whoa.
You're at the hospital, honey.
Pulse ox is 95.
Those lips, those eyes, it'd be a crime to intubate a face like that.
What'd you get me? You all right? We don't talk much anymore.
Like we don't know what to say.
Well, we should fix that.
I miss you, Abby.
Abby? - Janet.
Hold on.
I thought you'd be waiting for me downstairs.
Come in, I just checked the website and the flight's delayed.
God, I wish I'd known.
I rushed over here.
Oh, I'm sorry.
I just found out.
And it's like only an hour.
I can get you a cup of coffee if you want.
- What's wrong? - Nothing.
- Abby.
- What? I'm going to go.
I promise this time.
I'm gonna go.
It's been a week.
He's been waiting a week for you.
I'm not so sure about that.
You can't keep putting it off.
What if it doesn't work? - It works as long as you believe in it.
- I'm not talking about the program.
I'm talking about my marriage.
I just I don't know if I can fix it.
What does it mean when a phone doesn't even go to voicemail? Is there an attending around? - That would be Dr.
- Ah.
Laverne St.
John, - Really? With an overnight? - Some girls have all the fun.
Why don't you get started with Dr.
He's in Exam Two.
- Right there.
- Thanks.
- Mm-hm.
You giving her to new guy? He seems to know how to do everything.
Morris, I said no.
Stop bugging me.
This is for the advancement of science, Frank.
That's what Dr.
Mengele said.
Great, thank you.
She'll be right up.
- Wanna make a quick hundred bucks? - Does it involve a French maid's outfit? No, I have a proposal due tomorrow.
I need one test subject.
What you have to do? Study the effects of conducted electrical weapons.
- Tasers? - It's just a five second shock.
- We record all your vitals - Forget it.
How about for 200? - E and B's ready.
- Can I go with her? - It's best if you stay down here.
- Is that okay with you? It's not like I haven't had a biopsy before.
I'll be waiting here for you.
He seems like a good guy.
Yeah, he really is.
- How long you been together? - About a year, I guess? It was 14 months ago.
A few days after she got the heart.
You met in the hospital? She was in cardiac rehab.
We hit it off pretty quickly.
He drove me to my doctors' "appointments " made sure I had my meds.
I called him my recovery buddy.
I can't imagine being without her.
Well, you're lucky to have found that, especially so young.
Every day, I thank God for bringing us together.
Let's stock continuous albuterol at 20nl.
- Dr.
- Hey.
Thank you for the med student.
Intelligent and enthusiastic and docile.
I'm surprised you didn't keep her for yourself.
Doctor, this whole orientation shift, it's a formality.
It's wasn't really my idea.
So let's make it work.
No sense getting in the same case.
Instead of burdening you, I'll see patients on my own? - Lf that's what you want.
- Best for everyone.
There's a trauma coming in, want me to take it? - Sure, thanks.
Hey, Sam, family in Exam 4, they're requesting a chaplain.
- Well, who's filling in for Julia? - I asked Father Brian.
Who's that? Temp chaplain? No, he's Julia's replacement.
She quit.
Pratt, it's a double trauma.
All right, come on.
Let's clear two rooms.
Kelly Robinson, 69, assisted living resident.
Victim of assault.
Chest trauma, facial lat.
- I'm Dr.
- It hurts to breathe.
- Who beat her up? - That old bitch.
- Because you dropped me, dummy.
- She fell backwards off a table.
Right onto my head.
- Few seconds at best.
- It was an accident.
The hell it was.
Then she started kicking and punching like a lunatic.
Let's settle down.
- We'll get her in Trauma 2.
- I'll take her in Trauma 2.
Go ahead, you can have it.
- What was she doing on the table? - We had a communal living workshop.
It was a trust exercise.
I'll never trust you again, whore.
You know what? I feel like my whole life I haven't had control of a single thing.
It's like I've just been, like, floating.
Well, that's the disease.
Drinking takes over, it directs your impulses.
You stay out of its grip, you keep control.
- Yeah, well, maybe it's too late.
- All right.
Thinking like that only opens up the way to a relapse.
- Are you looking for an excuse? - No.
I'm not looking for excuses.
It's just how many chances do you get? I'm already, like, two or probably three past what anyone actually deserves.
So who decides how many chances you deserve? I don't know.
Maybe he does.
Yeah, he came to see me.
Two weeks into rehab.
I was very moved that he would come all that way for me, but, you know There's more to it than that.
There's some pictures when I brought Joe to the seaside.
You didn't bring him? I only came for a day or two to take care of some things, yeah.
- And I thought it might be too hard.
- Probably, yeah.
What things? You said "take care of some things.
" Uh I quit.
I'm not gonna work at County again.
Just after everything with my father, with you I was thinking I need something else.
Are you gonna stop practicing medicine? I don't know.
Maybe a different area.
- Well - Ah.
It's like those halls are haunted to me.
I mean, not exactly haunted, it's "just " - I need a clean break.
- Yeah.
So I gotta go.
So I'm done here in two weeks.
And I didn't Do you wanna come back here? Or should I meet you and Joe in Croatia? We'll see.
What do you mean, "we'll see"? Right now it feels good for Joe and me to be there with my family.
I think he's happy.
Me too.
Um Yeah, we'll see where we are when you're done here.
- How you feel, how I feel.
- You know, Luka Hey, and I also hope you'll let me know when you wanna tell me the truth.
About what? Sats at 92.
Okay, excuse us while we talk shop? Okay, what do you think about.
10 in this left costal margin? Let's do a chest x-ray to rule out pneumothorax.
Got any better ideas? - Are we worried about the spleen? - I don't know.
- You want morphine? - Fentanyl.
Why don't you head next door.
Maybe Dr.
Pratt could use some help.
- But, I We're okay in here.
Laverne, what's another way to diagnose a collapsed lung? You hear that, you old battleaxe, you collapsed my lung.
Screw you, you had it coming.
- How much Ativan? - Start with two.
You're just an old tart.
- She's combative from the trauma.
- I'm not combative.
- I thought you're with Brenner.
- He sent me in here.
Senile kook.
This is all your fault.
You are rough on each other.
What are you, professional wrestlers? We used to work together.
We were librarians.
Is that a blown pupil? All right, 15 liters O2 by mass.
Let's mix up mannitol and make sure Do you need me, Dr.
Pratt? - What's going on in there? - Dr.
Brenner didn't like any of my ideas.
- He suggested I go to library and read.
- What? He also suggested I use a different eye shadow and do something different with my hair.
- He what? - Yeah.
Please don't make us go back in there.
Call CT.
She needs to be in the scanner as soon as the mannitol is in.
Put her on a portable monitor, I'll be right back.
And this is fentanyl.
This is the really good stuff.
I mean, for the special patients.
While we fix you up, you're gonna be floating in a state of bliss.
You know, I know this is your first day and I don't wanna embarrass "you " but this is a teaching hospital.
So that means that you have to actually teach.
You see, those guys, they look up to us as examples.
So this is me trying to preserve their illusion that you are actually worthy of their admiration.
Okay? All right.
One more thing, keep a lid on talking about people's hair and their "makeup " " or" I'll make sure Human Resources throws you right out on your ass.
I didn't realize you were running the floor, Greg.
Keep it up, man.
And I'll make you real familiar with the floor.
All right, guys, it's all good.
Brenner will see you now.
Hey, Pratt told me that the chaplain quit.
You didn't mention that.
Yeah, I didn't think it was that important.
Did she find another job? I think she's gonna stay in Nepal for a couple years.
A couple years.
We broke up.
Just a little embarrassing being dumped like that.
Well, it happens.
Not really.
It's new to me.
You're such an ass.
Gates, are the biopsy results back? Your rejection fraction dropped from 60 percent to 25 percent.
That doesn't sound very good.
And under the microscope, we see that your heart is full of white blood cells.
So your immune system is attacking the heart.
It's rejection.
But you can treat it, can't you? What do we need to do? This medication is to stop the rejection.
What if that doesn't work? Don't worry, it's gonna work.
Worst-case scenario, you go back on the transplant list.
Maybe there's some better medicines you don't know about.
- Shouldn't there be a specialist here? - Jordan.
- This is what Cardiology recommends.
- The heart she's got is perfectly fine.
It's a good heart.
Just find a way to keep it working.
- Thank you.
- What are you thinking? - Ahem.
That I've been here before.
That I'm gonna have to be honest with him about something " I" don't really wanna talk about.
Well, it's possible that the details don't matter.
He's smart enough to know that the behavior was a disease.
So don't tell him? It's about what they need to hear, not about what you need to say.
So tell the truth.
Unless it's too difficult, in which case lying is okay.
- To omit, maybe.
- Omit.
Janet, omit is a nice word for lie.
And it's like he knows.
He knows.
He knows there's more to it than I told him.
- All right.
- It's - Easy.
- It was Kevin Moretti.
- Hmm.
It all makes more sense now.
- What does? When Luka came to Chicago, he came to see me at the hospital.
- He did? - Yeah, you were deep in recovery then.
I didn't think it would help you to know.
It might set you back.
- This is my marriage, Janet.
- We shouldn't even be discussing this.
- She won't tell me.
- That's her choice.
I've tried to accept that because I want her to get better but how much am I to take? I can't talk to you about this.
And I don't know anything that's going to help you.
You stay committed to each other.
Everything can work out.
That great, that's really great.
- Is that how it worked for you? - No.
Your husband left you, you've been alone ever since.
I have stayed healthy and made life work.
What about your husband? Your kids, are they happy? - We get by.
- You get by? And learn how to live with collateral damage? Everybody's got collateral damage.
I'll keep that in mind.
I thought it was just venting, frustration.
I've seen that before.
I didn't realize it.
- How really torn up he was inside.
- Man.
That there really was something more that he needed to know.
You still want Neurosurg? No, the head CT was normal, there's no bleed.
- What about the blown pupil? - I don't know.
But call Ortho for the hand.
I'll be next door.
How we doing in here? - Great.
Brenner's superb.
He put this in, it didn't even hurt.
- A nickel every time a woman said that.
- All right, easy now, doctor.
Status? I diagnosed pneomothorax using ultrasound thus saving her any unnecessary radiation to thyroid and breasts.
What about our residents, getting hands-on experience? Assisting the whole time.
Laverne prepped us up with Betadine and Larry took the packaging off the chest tube.
Brenner, mind if I get your opinion on an x-ray? Yeah.
I'm just gonna start on this facial laceration.
- That's okay, Dr.
Weston's - Six of barkin.
There you go.
You won't even have a scar.
Thank God you're here.
So am I right in understanding that this injury is the result of a patient punching a coworker? Yeah, you should see if you can recruit her for hockey team.
Ortho only has one more week to abuse me.
And what, ahem, is this? That's your patient's crown.
She was the team leader Don't touch that.
That's thorn apple.
It's a "Datura Stramonium.
" It's a powerful anticholinergic.
You get any in your eye, you'll be fixed and dilated.
That explains her blown pupil.
You were worried that it was No, I was never, I'm good I'm Simon Brenner.
- Neela Rasgotra from Surgery.
- Lovely to meet you.
- I look forward to working with you.
- Likewise.
Think I can get you for five minutes in private? You'll have to take a number.
I've got unstable GI bleed and then check on Kelly, but lovely to meet you.
New attending? Seems like a nice bloke.
- Is that what you call it? - He's clearly smart.
I didn't know anything about thorn apple, did you? I've heard of it.
Rasgotra, I have an emergency consult.
I've gotta reduce - This is critical, it can't wait.
- What is so critical? - My career.
- Morris, I'm trying to see a patient.
You know the expression "publish or perish"? If I don't get this, I could be seeing earaches at Wal-Mart.
What do you want from me? I'll simply monitor all your physiological parameters for five minutes following a brief application Get that thing away from me.
What? There's nothing to worry about.
My study passed the investigational review board This is the stupidest thing I've ever heard.
- I desperately need a test subject.
- Then why don't you just Taser yourself.
Okay, T3 is in.
He's making sure my parents are okay.
They don't freak out.
Well, any guy who can handle his in-laws is a keeper.
So, Mia " I'm" trying to figure out why "you're " - Why you're in rejection.
- Doesn't that happen sometimes? Back when I was getting a transplant, they told me that.
It's not as common in this type of situation unless someone stopped taking their meds.
Do you ever forget to do that? My medication? No.
Your cyclosporine is pretty low.
About half of what it should be.
I try to take them.
I do.
Your meds are keeping you alive, Mia.
I know that you know that.
Don't tell him, please.
Why, because he'd get upset that you're killing yourself? - That's not what I'm doing.
- Then what? I don't know.
I don't know.
I know he loves me, I know that.
- It's just that - That guy wants you healthy.
What's the problem? My heart.
It came from his fiancée.
She got into a bike accident, was brain-dead and a couple of days after the transplant he started to visit, offered to help.
And I felt so bad for him.
He was destroyed.
So he's not your boyfriend? It didn't start off like "that " but a couple of months ago, I realized I let it go too far.
It's my fault.
So you stopped taking the meds? I started doing things that didn't make "sense " because I care about him.
I wanna help him, but it's just He's not the one.
Getting sober means being honest with yourself and with the people you love, and you were right before.
It means being honest about everything.
Yeah, well, here's the thing.
I'm a liar.
I grew up lying about my crazy mother and now I lie to my husband and I lie to my coworkers.
- I lie to myself - Abby.
I lie to my sponsor.
I drank at work.
Damn it.
Displaced femoral neck fracture, right? You asking me? No, that's what it is.
I'll get a hair traction.
No, I wanna try 5 pounds of Bucks Traction.
- Are you sure? - Yeah, Sam, I'm sure.
We all lie.
I am 12 years sober.
And I can't say I know that I won't relapse at some point.
But I sure as hell believe that I won't.
And that is the best thing I got going for myself.
Every day I look in the mirror and try to tell myself the truth.
What if I can't? You already are.
Hey, Bettina.
It's Greg.
Check your cell, there's something wrong with your voicemail.
Anyway, I'm here in the ER.
I'll be here all night, so if you get this, call me.
- Dr.
- I already said no.
I'll take the shock, you fire the weapon.
- Go away.
- I got a release form.
Clearing you of any responsibility in event of Okay, think about it and, you know, get back to me later.
- Tony.
- No.
Hey, there.
- Hey.
Gates says you're not feeling so good.
We're giving her diuretics to dry out the lungs and IV meds to increase her cardiac output.
Well, whatever you gotta do to keep that ticker going.
If it doesn't work, we may need to intubate.
Just to help the lungs.
If her heart keeps failing, Mia is at risk for arrhythmias, cardiac arrest Can we not talk about that now? Jordan I am so grateful for everything that you've done for me.
I've done it for us.
This past year has been a gift.
I know that.
I will know that for the rest of my life.
But I think We were both at very intense points in our lives and I think we got a little confused.
Confused? I know it's hard.
You know what? But I think you understand what I'm trying to say.
You know what? I think we should talk when you feel better.
I got to go outside, I promised I'd call your mother.
- Jordan.
- Uh You know she's gonna be upset if she can't get through, "so " I'm gonna call.
I'll come back when she calls.
- Hey, Jordan.
- I got to make a call.
Hey, buddy, come on.
Let's go take a walk.
Let's take a walk, Jordan, okay? And I was thinking of a poem before, actually.
Before, when I was getting ready.
And I think it starts: I carry your heart in my heart.
You are a good nurse, Abby.
But you could be a great doctor.
You just need a little confidence.
I am never without it.
Oh, my God.
I'm sorry.
I just can't stop thinking about What she must have gone through " and" I can't stop thinking about how afraid she must have been " and" I can't stop thinking about why we couldn't save her.
I just Anywhere I go, you go.
A compass? I know it's corny, but it seems we always find each other.
Oh, man.
- What? - I'm pregnant.
I carry your heart.
I carry it in my heart.
What if I don't know how to love it right? "Abby.
" "I'm afraid I'd mess it up, Luka.
" We won't.
Ask me again.
Ask me to marry you.
I guess what I'm saying is, let's just try to love each other and Persevere.
- Chuny, have you seen Brenner around? - In Trauma.
He's playing peacekeeper with the two ladies.
As someone once said: "To forgive is to set a prisoner free, and realize that prisoner was you.
" Michelle.
I'm sorry I hurt you.
Look, we need to talk.
And I'm sorry I didn't use my full strength to catch you.
Now, doesn't that feel good? Not as good as when I'm doing her boyfriend.
- You lying strumpet, you will rot.
- It's the truth.
Come on, let's go.
Larry, Laverne, they're all yours.
Think those two can handle that? Yeah, they could handle a lot if you let them.
- That's right, you said that before.
- No disrespect.
But you're making it real hard for me to respect you.
You're taking the procedures.
Not letting them do physicals.
- They don't know what they're doing.
- They've been to med school.
- You've either got it or you don't.
- Excuse me? You know what I'm talking about.
Some catch on, others never get it.
Yeah, but it's our job to train them.
That is sweet, Greg, but it's also a complete waste of time.
- Are you serious? - Look, I teach people that can benefit.
What about Larry and Laverne? Well, they're adorable and eager and absolutely clueless.
I could spoon-feed everything I know.
It'd pass to them like a case of cholera.
So, what do you suggest instead? Encourage them to find new careers.
I don't know where you came from, but this is a teaching hospital.
So if you can't accept that everybody needs to learn " then" you don't belong here.
Okay, sorry.
Remind me again.
You're not the Chief of Department, right? - No, I'm not.
- Okay, that's great.
So you do things your way, and I'll stick with the way that works.
Shift's over.
It's been a pleasure, but I gotta go.
I got a date.
I got two, actually.
- Hey, I'm not the only who thinks - Good night, Dr.
All right, I knew you'd change your mind.
You ready to shoot me? Beth and I met our senior year in college.
We got engaged two years later, we'd never spend a day apart.
She must have been pretty special.
It seemed wrong when I lost her.
Not like it didn't happen, but like it shouldn't happened.
It couldn't have happened.
When I heard they'd found a recipient, I just wanted to meet her.
That information is usually confidential, Jordan.
I did some snooping around.
You know, I was a man on a mission.
It's all I had left of her.
First love is rough.
It's hard trying to find that feeling again.
When I finally met Mia I just wanted to stay connected, you know? Maybe it's time to let go.
Let go of Mia? Let go of Beth.
- Tony, her sats are bottoming out.
- Mia? - Hundred percent? - Yeah, but it's not helping.
Call RT, get a vent.
Already did.
- What's happening? - Her breathing is getting worse.
Pulse ox, 82, on 15 liters.
She maxed out on the present.
Got to thread BiPAP.
- It's okay, you'll be okay.
Systolic's on 70.
Add dopamine.
Run a five.
Hundred of lidocaine and open the crash cart.
It's like a sterilization scene out of some bad sci-fi movie.
If it means no more children for Morris, it's a service to mankind.
- Too late, Frank, my stuff's on ice.
Okay, okay.
- Ready, set Hold on.
I have to record data for a full five minutes after the shock.
So whatever happens, do not touch me.
- You don't have to worry about that.
- No, I'm serious.
You can mess up the EKG, skin resistance, pulse pressure All right.
We got it, okay? Here we go.
- One, two Wait, wait, wait.
In 1921, Walter Reed infected his team with yellow fever.
In 1929, Werner Forssmann catheterized his own heart.
In the spirit of these great pioneers, I, Arc Aah! Oh, my God.
Hang in there, Morris.
It will only last five seconds.
Just a sting.
All right.
Has it been five seconds? All right, all right.
Stop the trigger, Pratt! No, no, I did.
Definitely more than five seconds.
- Pull the leads off.
- No.
No, it says don't touch them.
I'm trying, Morris.
This stupid thing.
What the hell is wrong with this thing? The battery should be gone by now.
Oh, Greg, stop.
- No, I'm trying.
- It's killing the son of a bitch.
- He's had enough, stop it.
Come on.
- Jeez.
- Archie? Archie? - Morris? Archie? - Talk to us.
- Morris? Is he breathing? It's okay, Mia.
- It's okay, Mia.
- How are we on dopamine? Twelve mics.
BiPAP 20 over 10.
Systolic's 120.
This thing.
It's keeping you alive.
- My back.
- You wanna sit up? - Jordan.
- I know.
I know.
Oh How are you doing? I can't move.
You'll be fine in a few hours.
You depleted all the acetylcholine in your muscles.
From one shock? You don't remember? Was that a standard issue stun gun? I had the guys in bioengineering make some modifications.
That explains it.
What? It was a long shock.
Over two minutes.
I'm sorry, Morris.
- Did you keep the monitors going? - Yeah.
Send off a CBC, chem-20, CK and troponin.
I need an EKG, ABG and cardiac echo.
- Vitals, cue 15 minutes.
- Relax.
Nobody's ever been Tasered this long before.
- It's publishable.
- You should get some rest.
I'd hug you guys but I can't lift my arms.
- Hey.
- You look better.
- Feeling better.
I'll go home before work.
I'll call you tomorrow? - Sounds good.
- Hey, thanks a lot for your help.
- I think it's gonna be okay.
It's just hard thinking a piece of a girl I fell in love with is gonna go on " and" have a life I won't be a part of, won't know about.
You guys will still be friends, I'm pretty sure.
It's not the same.
Heart's just an organ, right? Whew.
It's almost 6 a.
It's like a ghost town in here for once.
Exam 4 is open.
Why don't you go take a rest.
Maybe I will.
The last time I checked, the rack's all clear.
Well, I have at least a good hour of paperwork.
I'm all done.
Lucky you.
Well, it's my third night in a row.
I am pretty beat.
Well, you have time to go rest before the shift change.
Yeah, good.
And thanks.