ER s15e20 Episode Script

Shifting Equilibrium

-So.
-So.
-Listen.
-I'm sorry.
-I'm sorry things got so weird.
-I really didn't-- -Shouldn't have been such a-- Okay.
-I know kind of I sprung things on you.
You go first.
I know I've been somewhat closed-off about all this but I was afraid that if I discussed it with you, you'd convince me to stay.
Well, I certainly would have tried.
But you know what?.
It's a good thing you're going.
-lt is?.
-Yep.
Adjusting to a new environment, a new way of doing things.
You will gain so much confidence from that.
Well, I hope so.
When you're sick of your third-rate, community trauma center-- Now it's third-rate?.
-Demoted from B-list.
-You always, always have a job here.
-Really?.
-Yeah.
Six months, six years.
I don't know.
Not sure, but you will be back.
County is in your blood.
And until then, my friend, good luck.
Get out of here already.
NEELA: Lucien.
I don't know if I can do this without you.
Of course you can.
You'll see.
You'll see.
Now go.
You get out of here.
Please.
Go.
Please.
MRA's gonna tell us if there's blood in his brain.
Well, that's the hope.
And if there is, then what?.
Brain surgery?.
Possibly.
Jay, I know how much you need to talk to him.
Okay, I'm gonna do everything that I can to make that happen.
No, no.
He has to wake up.
Dr.
Brenner.
Dr.
Brenner.
WOMAN [ON PA] : Your attention, please.
Change of gate announcement for flight JR-2309.
This flight has now been canceled.
Where have you been?.
Frank really out did himself.
I took Mr.
Walters up to the MRA suite, they' re gonna try and squeeze him in.
-What?.
-Nothing.
If it turns out to be an aneurysm, they can embolize it if it's caught early.
You don't think Neela noticed that you weren't there?.
I meant to go, but I was dealing with this-- You couldn't find five minutes to stop by?.
Gates, I'm signing out to Morris for a while.
It's me.
I'm at the airport.
Could really use some of your sage wisdom right now.
Can you call me when you get this?.
Thanks.
Bye.
BARTENDER: What can I get you?.
-Glenfiddich straight, please.
Need some warming up, do we?.
-Off to someplace sunny?.
-Y es, actually.
Beach vacation?.
Business trip?.
-Sort of.
-Sort of?.
-It's a new job.
I' m moving.
-Really?.
What do you do?.
-l, uh-- BRENNER: Neela.
I couldn't let you go like this.
-What are you drinking?.
-Uh, what do you got on tap?.
No, uh, actually, forget that.
Soda water with a-- With a lime.
Thanks.
Thank God for this storm or you'd be somewhere over Missouri by now.
Geography's pretty good for a foreigner.
Look, l, um-- I just-- I thought that if I didn't catch you now, then maybe we'd never speak again.
Today's been strange and difficult.
Yeah.
Yeah, I know.
For me too.
Oh, and don't mutter in Spanish when you're angry.
It's a cliche.
I understand a lot more than you think I understand.
Fine, you win.
I'll stay home with my hair in curlers, knitting and baking.
You know that's not what I'm talking about.
-Apple pie or cherry?.
-lf you'd just listen to what I'm saying.
Give up, Archie.
This conversation is over.
Well, okay.
Have a great day.
And please accept my sincere apology for giving a rat's ass.
-Everything okay?.
-Everything is fine.
What do we got?.
Uh, one-story fall with LOC, that's all I know.
-What the hell is that?.
-It's something for Neela.
-It's her last day.
-Pinata?.
-What is she, 5?.
-It's not just any pinata-- I had this custom made.
It's a Gandhi pinata.
That is scary.
Uh, not to mention offensive.
Who's gonna wanna bash Gandhi's head in with a bat?.
You have no sense of culture.
Gary Walters, 53, fell head-first down a flight of stairs after a few too many.
GARY: I slipped on the rug.
Observed LOC, awake at scene, but disoriented.
BRENNER: Do you know what day it is?.
-I told you, I slipped on the rug.
Okay, Gates, what do you want?.
Uh, head CT, C-spine, trauma labs, tox screen and, uh, ETOH level.
SAM: I'm on it.
-Good.
And, uh, get him to surgery.
-They're gonna need to see him.
-Neela's already on the floor.
She's guarding.
How's the CBC?.
-First was good.
-Send a repeat now.
Does anything hurt you, ma'am?.
-Remember what happened today?.
REBECCA: Nobody will listen.
Drove her motorcycle into the museum warning about the end of the world.
-Psych history?.
-lt seems.
-I'll check if she has a record here.
REBECCA: Equilibrium is shifting.
I thought that was just me on account of it being my last day here.
-It's Claudia's first day back at work.
MARQUEZ: Good.
MORRlS: I mean, I'm not sure that it is.
LFTs and lipase are normal.
I think, ma'am, you might be my last surgical case.
I thought I was okay with it.
I really did.
It's her job and I respect that, but she got shot.
Why couldn't I fall for a nice librarian?.
A librarian in Springfield died last month.
Bookshelf fell on her.
-I swear, it was in the paper.
-Guys, we need a surgeon in here.
NEELA: Andrew, check the tox screen and let Dubenko know we've got a possible laparotomy.
What've you got?.
fell down a staircase.
Multiple contusions to head, hip and back.
Decreased on the left, sats in the 8Os.
Hello, I'm Dr.
Rasgotra.
-Do you remember falling?.
-I was dizzy, I guess I tripped.
Smells like ETOH was involved.
-Belly's benign, I figured you'd sign off.
-Happy to help.
SONY A: Thank God.
GARY: I'm fine.
You're not fine.
Just a few scrapes and this headache won't go away.
-All right, a little pinch here.
-What are you doing?.
Well, he may have broken a rib when he fell, punctured a lung.
-Tube'll help inflate it.
-When is this gonna stop?.
-It's not even 1 0.
-Mom, don't start.
-Woke up this morning with a headache.
-It's called a hangover.
I just needed something for the pain.
He's a drunk, but you've probably figured that out by now.
-Let the doctors work.
-Two people ahead.
Type and cross and let me know when the scan is back, please.
Sorry, uh, my in-laws have been through some messy stuff.
No worries.
NEELA: We all have messes in our past.
Shouldn't have been hard on you.
Wasn't the best way to end things.
-You were right.
-I was righteous.
Which isn't my best quality, honestly.
For my whole adult life, I've been doing exactly what you said.
-I'm not sure what you mean.
-Disappearing.
Using sex as an escape or worse, as a weapon, a way of disarming people.
Look at you two.
So sweet.
Like nobody else is in the room.
-You want another round?.
-Uh, sure.
Yeah.
[EKG BEEPlNG] I'm in.
0-silk, elastoplast.
I'll get the Thora-Seal.
Hey, guys, look.
-lrregular rhythm, looks like A-fib.
-Nice pick up.
Do you have a history of atrial fibrillation?.
He didn't tell you?.
You didn't tell them?.
-I don't know, I forgot.
-Forgot.
That's a load of crap.
It's okay.
What meds is he on?.
Uh, calcium blockers and some other pill to thin his blood.
-Coumadin.
-He's bad about taking his meds.
He drinks.
He forgets.
Or at least that's what he says.
But really, it's a death wish.
He thinks if he doesn't take his pills he'll figure out a way to disappear.
-Don't talk about me like I'm not here.
-Today of all days, you couldn't control yourself?.
What's so special about today?.
-It's been 1 O years.
SONY A: Here we go.
He has this pathetic need to tell everyone.
Mom.
Please.
Um, today is the anniversary of their son's death so everyone's a bit tense.
My dad blames himself.
I let Timmy go.
I'll be outside.
LlLY: Mom.
Sam, add an lNR and rush the head scan, please.
I keep thinking it's gonna get easier, it doesn't.
NEELA: Staircase fall in 1 with a pneumo and a headache and a motorcycle crash in 2 with a seatbelt sign.
Okay, sounds good.
Who do you want me to see first?.
Motorcycle looks like she might need O.
R.
and you know what?.
-This'll be case number 25OO.
-25OO?.
No way.
Y eah, can you believe it?.
I'll have logged That's impressive.
-Serial crits?.
-Not back yet.
Ah, surgeons, perfect timing.
I have a question for you.
MARQUEZ: Haldol's in.
NEELA: How's she doing?.
-Fast is negative, CBC's good.
DUBENKO: Hi, I'm Dr.
Dubenko.
-Reckoning is here.
-Okay.
Why are eschatological delusions common among psychotic patients?.
-Escha-what?.
-Eschatology.
Pertaining to the end of the world.
I checked, no psych hospitalization at County.
She doesn't look familiar.
-There's no hiding from the fifth cycle.
-Okay, sweet dreams, my dear.
-Your girlfriend gets shot on the job.
-Uh-huh.
Seeing that you care about her and want her to not die you gently suggest that she do another job.
Is that sexist?.
-No.
No.
No.
-Yes.
Yeah.
-No.
Tomato, ""tomato.
"" -What?.
Rigid abdomen, probably needs the O.
R.
You can scrub in.
-Awesome.
She's seizing.
-Oh, boy.
Look out.
I see that.
Two of Ativan.
Crank up O2.
Haldol lowers the seizure threshold.
Call me when she's ready for the scanner.
-Andrew, let's go.
-You want me to cover the ER?.
Forget about the ER, meet us upstairs.
You've got to log case number 2500.
What's with him?.
NEELA: Denial, avoidance.
Fear.
There's so many things I've missed out on because I was afraid.
Well, you're obviously not afraid to fly in really bad weather.
[BOTH CHUCKLE] You know, when I was 6 my, um, aunt took me to a toy store and gave me 5 pounds and said I could buy anything I wanted.
I wandered around the store for what seemed like hours terrified I'd choose the wrong thing.
Wrong doll and my sister would laugh.
Wrong book, my brothers would take it.
Wrong teddy, the kids at school would think I was a baby.
I left the store with nothing.
My father put the money in the bank.
Sensible kid.
Well, the point is, is that for as long as I can remember I've carried this irrational dread of making a mistake.
It's with me all the time.
And why on earth I decided to become a doctor where the cost of a mistake is so high.
-It's insane.
-It's masochistic.
I know.
And this is all my way of saying I know I helped screw things up.
I'm not following.
Well, there's-- [SlGHS] So many times in my life, I've-- I've failed to take a chance.
Even when it was clear to everyone else, including me, that I should have.
That's why I gotta go.
Even if it scares the hell out of me.
I just don't want to be that person anymore, you know?.
Me either.
Don't worry, Neela.
I'm not here to try and convince you to stay.
Then why are you here?.
I really, really don't know.
[BOTH CHUCKLE] How'd you get past security?.
Don't you have to have a ticket?.
You bought a ticket.
So you got any, um, good ideas of things to do in Detroit?.
Detroit?.
Y eah, well, it was the only way.
It just seemed wrong.
It just seemed terribly wrong to let you go and not even say goodbye.
Do you wanna take a walk?.
Head looks good, Mr.
Walters.
No bleeding.
[GARY GROANS] -You didn't need to stay for this.
-I know.
I wanted to.
GARY: Jay was my boy's best friend.
-One, two, three.
He pulled Tim out of the water.
Did CPR for an hour till the coast guard got there.
Let's not go there, okay?.
After the funeral, everyone got on with their lives.
Jay came by every day just to check on us.
It was just an excuse to flirt with your daughter.
-lt looks like it worked.
-We've been married three years now.
I lost Tim, but you became like a son to me.
All right, all right.
At least you're affectionate when you're drunk.
DUBENKO: You guys having a party?.
We need the scanner.
-Hello, Mr.
-Walters.
-How are you feeling?.
-My head's killing me.
But the, uh, CT's clear.
No bleed?.
No edema?.
-Who's that?.
-The other case.
Staircase fall.
Uh, did you think of tapping him?.
-Uh, tap him?.
Why?.
-I don't wanna miss subarachnoid bleed.
Could be the cause and not show up on the CT.
-That's pretty rare.
-Extremely rare.
I know, but the cause of his dizziness, the headache before the fall.
-He was drinking.
-Well, his ETOH wasn't all that high.
-Not for a chronic alcoholic.
-We don't tap all our negative CTs.
Well, if it was up to me we would.
Let's not risk missing something we can fix.
-You on board with this?.
-Me?.
I trust her instincts.
She's gonna be her own boss starting tomorrow so I don't have much leverage, really.
The ad said snake charmer.
I brought tarantulas too if you think she'd prefer that.
No, I was thinking of a turban and a flute and a snake in a basket.
Not this S & M getup.
-People dig the outfit.
-lt won't work.
Go.
Here.
For your trouble.
What was that?.
Ah, when Neela first got here, we kind of got off on the wrong foot.
I said some things I shouldn't have said about her ethnic background, and.
Frank, come on.
That was six years ago, I'm sure she's over it.
Well, I would just like to show her how much I've changed.
Why don't you try something simple, like flowers.
-Flowers?.
-Yeah.
That's not even remotely original or cultural.
Just because her parents were born in lndia doesn't mean she's gonna appreciate some kind of lndian cliche.
In fact, she may very well find it offensive.
What?.
She's English, Frank.
Okay, so a Gandhi pinata or a turbaned snake charmer is gonna end up working against you here.
Well, thank you, Sam, I'll take that under advisement.
-No free fluid.
-Aorta's intact.
-And lVC.
-Kidneys look functional.
-Ureters.
-I know how to read an abdominal scan.
-Of course you do.
-What's going on?.
-I'll meet you in the O.
R.
-The O.
R?.
But the scan's perfect.
Rigid abdomen, it's surgical.
Doesn't matter what the scan says.
Her vitals are good, her counts are unchanged.
Why not watch her in the lCU, move her at first sign of instability?.
-By then she'll be unstable.
-Lucien-- Small bowel perforation, mesenteric injury.
Let's not risk missing something we can fix, right?.
Meet you in the O.
R.
in 1 0.
Sometimes there can be a head bleed which we can't see on CT.
A more sensitive test is to place a small needle into the spinal canal and remove some fluid.
If the lab finds red blood cells then we know there's a problem.
What are the risks?.
Infection and bleeding are the main ones, but we'll take precautions to avoid both.
What do you think, Jay?.
Right.
Fluro's here, so we should step out.
Hang in there, Dad.
Dr.
Brenner, no disrespect but, uh, this is stupid.
His mental status is getting worse, we don't have a good explanation.
-Subarachnoid bleed's a theory.
-Except that he's on Coumadin.
The chances of bleeding complications is higher than even finding a problem.
His lNR is less than two.
There's something subtle that led Neela to ask for this.
Yeah, it's her last day, she doesn't wanna make a mistake.
But she'll feel bad if the procedure leads to an uncontrollable spinal bleed.
Got your LP kit.
I'm not gonna do it.
We'll use Fluro, give FFP, it'll be fine.
You will be there to assist.
We could go in laparoscopically.
Have a look.
-We'll be doing it open.
-Recovery time would be easier.
I'm aware of advantages of laparoscopy.
All serial ultrasounds are fine, normal CT, vitals are good, crit is stable.
You wanted to log 2500 surgeries.
Don't rush a patient to surgery because you're mad at me.
I'm not mad.
I'm amused by your narcissism but the patient has a surgical abdomen, okay?.
I suggest it is your judgment being clouded by the significance of the day.
Lucien, please.
-Why don't you say what you need to?.
-I don't need to say anything.
One minute you're strange and loopy, the next you're gritting your teeth.
Look, it isn't personal.
Maybe you can just wish me luck.
I'd like to, but I can't.
I can't accept the fact that you've accepted a job at an academically and clinically inferior institution to spite me.
NEELA: Oh, now who's the narcissist?.
ANDREW: Patient is prepped, Ancef is running.
DUBENKO: Can't wish you luck, I want you to hate it.
-You are unbelievable.
-I haven't spent these years helping you be an incredible talent so you could work at a B-list institution.
-T en blade to Dr.
Wade.
ANDREW: Sweet.
NEELA: It's not B-list, you're a snob.
-You're better than that place.
They have a busy trauma service and catchment area.
DUBENKO: No medical school, research.
-Which allows me my time in the O.
R.
Why can't you respect that?.
DUBENKO: I imagined something better for you.
NEELA: No, it's not what you imagined for you.
Which is fine.
But it's my life.
If I stay here, I'll always be your protegee, little Neela.
It's time to move on.
DUBENKO: What the hell are you doing?.
You just contaminated yourself.
-Hyperpigmentation.
ANDREW: Starting the incision.
Andrew, wait, stop.
-Go and get the Woods Lamp.
-Why?.
Just get it.
Go.
Now.
-Bingo.
-Wow! Hey, what the hell?.
NEELA: Call Heme, they'll admit her.
-Heme?.
NEELA: Doesn't have internal bleed, she's acute porphyria.
DUBENKO: Disorder of heme synthesis pathway.
NEELA: Rigid abdomen, hyperpigmentation on the extremities psychosis, seizures, it all fits.
Y eah, she's the right age for first presentation.
Okay, reverse the anesthesia, she doesn't need surgery.
I guess 2499 will have to be enough.
That's a big needle.
Y eah, well, if we've done our job right, he won't feel a thing.
You do a lot for their family.
I've no choice, I married into it.
-Lily's worth it, though.
BRENNER: That's better.
I'm in.
I don't feel right.
Hold on.
Almost done.
-Gary?.
You okay?.
-Take the needle out.
-Almost done.
-Take the needle out.
-He's bradying down.
-Damn it.
Another unit of FFP.
Mr.
Walters?.
[EKG BEEPlNG] Mr.
Walters?.
All right, Jay, talk to him.
-His heart rate is 48.
-Wake up, do you hear me?.
BRENNER: Transcutaneous pacer.
GATES: Atropine in.
Chase it with epi.
I've lost the pulse.
-Oh, my God, what's happening?.
-His heart is beating dangerously slow.
It could be a vagal reflex or to do with what's going on in his brain.
GATES: Overdosed on the calcium blockers?.
-Let's get 500 of calcium gluconate.
-Don't do this.
Atropine and set up for a dopa infusion.
-Let's pace him.
-lt was a fight, okay?.
A stupid fight.
Increase voltage.
We need a hand in here.
I meant to tell you so many times.
It's not what you think.
-lncrease the volume.
-It's not what you think.
He slipped.
-lt was an accident.
-All right.
Quiet.
We got capture.
It's a strong carotid.
This is good.
I'm sorry.
I'll go let the family know he's okay.
Jay.
What's going on?.
I met a man today who accidentally killed his best friend.
That's awful.
They were out on a boat, and they got into a fight over a girl.
And the guy punched his friend and he tripped and fell overboard.
-And that was that.
-They brought the friend to the ER?.
This happened 1 0 years ago.
Now, the guy never told the family the truth until today.
And for years they were-- Well, their lives just stopped.
-Sad.
-Y eah.
Thank you for helping me see that I was stuck too.
You know, I'm the last person who should be telling-- Neela, look, you were right.
I can't love anyone until I sort some stuff out.
But maybe, because of you, I've started to do that.
Simon-- This is why I came here.
Neela, this really-- God, this mattered so much to me.
Thank you.
Thank you for saying that.
You know, it's gonna be so weird not to see you all every day.
Frank, the soft collar ever come down from central?.
Yes.
HALEH: Were you gonna tell me or keep me waiting?.
I forgot.
So shoot me.
Don't tempt me.
-Could you get it please?.
-No.
-No?.
-Oh, I'm gonna miss this.
Neela.
Morris has a complicated hand lac he wants you to look at.
-Okay.
Well, might be my last consult.
SAM: Curtain 3.
Can you lay hands on my rule-out appy?.
-Page Andrew, I have a plane to catch.
-All right, cool.
NEELA: Wow, what happened here?.
Oh, Dr.
Rasgotra, this is Ed McDow.
And this is what happens when a tug of war gets out of hand.
Get it?.
Out of hand?.
Ha, ha.
Company picnic.
The winning team gets the close parking for a year.
Wow.
Rope wrapped so tight it went numb.
Didn't feel it cutting through the skin.
Well, you're lucky.
It almost took the whole thing off.
I was so focused on the game.
I just couldn't let go.
I was gonna have Ortho do it, but the edges approximate nicely and there's no neurovascular damage so thought I'd give-- Ow! -Did it go through the glove?.
-Ah, yes.
-Damn it.
-I'm sorry.
It's not your fault, really.
I'll be right back.
You need to, uh, irrigate that -then go see Employee Health.
-I know.
-Closed-bore needle is a very low risk.
-I know.
-But you still need to check for hepatitis.
-I know.
Man, what is going on today?.
A PCP vigilante chucks a mayo stand at my head a 7-year-old Republican bit me while I was irrigating his lac and now, this-- Oh, my God.
I am an ass.
I'm not following.
-Uh, come with me.
-I'm gonna be late for the-- It's important, I swear.
-Frank, I'm gonna be late for the pl-- ALL: Surprise! [lNDlAN MUSlC PLAYlNG ON CD PLAYER] [ALL CHEERlNG] GATES: This is amazing.
-Frank did it all.
NEELA: Wow! -Thank you.
Admit it.
You thought we forgot.
-No.
-Or didn't care?.
-Maybe.
-How could you think that?.
Nobody stands up to our bone-head attendings like you.
Who's gonna get tough central lines?.
Or chew out the lazy Radiology residents?.
Or teach me how to do, like, everything?.
-T o Neela! ALL: T o Neela! Haleh, I think this is what you were looking for.
I didn't know if this wall really existed or it was just a rumor.
I knew this day would come, but so soon?.
Stop it, Haleh, you're gonna make me cry.
NEELA: Excuse me, can you help me, sir? -You need to find a triage nurse.
-No, l' m sorry.
I work here.
-Lucky you.
I' m supposed to start today.
Neela Rasgotra.
Rag what?.
DUBENKO: You 're a really good surgeon, Neela.
A few more years and you could be great.
Thank you.
ABBY : I was wondering if you didn 't mind, do you think you could lead the way and stand up there with me when we do this?.
You mean, uh, I'd be your maid of honor?.
NEELA: I'd be honored.
GALLANT : But out in the bay this morning, I was, uh-- I was thinking about asking you out.
I was thinking of saying yes.
PRATT : Thirty-two-year-old mother of two with a rare blood disorder.
Still alive tonight.
JAY: Dr.
Brenner?.
Dr.
Brenner?.
[CELL PHONE RlNGS] Oh, God.
Thank God it's you.
Please tell me I'm not making a horrible mistake.
Of course, you're not making a mistake.
But how does one know?.
How does one ever know?.
[SlGHS] -You're doing that thing you do.
-What thing?.
That existential crisis-spin-out thing that never leads you anywhere.
-Hey, maybe you should have a drink.
-I've had three.
Oops! Hey, slow down everybody.
Slow down.
Thursday is my day to do this childcare swap thing.
I hate Thursdays.
Abby, you'd tell me if you thought I was making a mistake, right?.
-I would.
-You promise?.
If this doesn't make sense, I don't know what does.
Just get off the phone and get on the damn plane.
Okay.
-I'm hanging up now.
-Okay.
-You still there?.
-Yes.
-I'm getting on the plane.
-Good idea.
NEELA: Bye.
PlLOT [ON PA]: Ladies and gentlemen tower's telling us it'll be at least an hour before they clear us for takeoff.
We apologize for the delay, we 'll keep you advised.
Hey, Sam.
Um, what happened to our staircase guy?.
LP came back positive for blood as they were sliding him into MRA.
-T ony's upstairs with him in Angio.
-Okay.
Thanks.
Hey, Dr.
Brenner.
-Have you seen Archie around?.
-I'm here.
-What is going on?.
-Come with me.
I stuck myself with a needle today and it made me realize that I was an ass this morning about your work thing.
-An ass.
-I get it, Archie.
What's with the pie?.
A symbol of my temporary chauvinism and a gesture of apology.
My original idea was to bake you a pie wearing nothing but an apron but I had to work late and I don't own an apron.
-Me either.
-See?.
We're perfect.
If you can handle being with a guy who gets stuck by needles and kicked by patients and takes an occasional slug of radiation to his cojones.
[CHUCKLES] What are you talking about?.
Well, then I can certainly stomach some occasional gunfire.
As long as you promise not to get shot again.
[SPEAKlNG lN SPANlSH] What?.
See, I just wanted to see how much Spanish you really understand.
[LAUGHS] GRAHAM: See that?.
GATES: Y eah, I think so.
BRENNER: Ten-millimeter aneurysm at the vertebrobasilar junction.
The headache he had was probably the initial leak.
GRAHAM: Yeah, leak was tiny.
No way it would show up on CT.
More contrast, please.
By all rights, this thing should have been missed.
-It's nice work.
-Neela was right.
GRAHAM: We use electrolytically detachable coils to fill the lumen.
BRENNER: Cool.
GRAHAM: Clot forms around the coils, blocking off the aneurysm Ieaving the vessel open.
Dome-to-neck ratio looks-- [MACHlNE BEEPlNG] Damn it.
Stop the heparin.
ANESTHESlOLOGlST: It's off.
-What's happening?.
Coil went beyond the confines of the road map.
-You ruptured the aneurism?.
-Looks that way.
Contrast.
-Doesn't he need the O.
R?.
-We can continue with softer coil.
I'm not waiting around to test that theory.
GATES: Heart rate's down.
-This is Dr.
Brenner from the ER.
I need an O.
R.
and a neurosurgeon for an acute cerebral hemorrhage.
I believe that's my call to make.
-Get the portable monitor.
ANESTHESlOLOGlST: Systolic's 62.
-lt'll limit the bleeding.
-And deprive the brain of oxygen.
ANESTHESlOLOGlST: What are you doing?.
-Taking care of my patient.
GATES: I got the femoral site covered.
GRAHAM: This is totally out of line.
I'm gonna write you guys up.
Hey.
-You're still here?.
-I crashed in the call room for a bit.
The, uh, the surgeons were able clip the aneurism quickly so the bleeding was contained to a very small area.
Is he gonna have brain damage?.
He's got a very good chance of doing well.
But we won't know the answer to that for a while.
[JAY SlGHS] Where is your wife?.
She went home for a shower.
I don't know what she's gonna do now.
About us.
-You two will work through it.
-Easy for you to say.
BRENNER: The truth is a time bomb.
But once it's out, it can't hurt you anymore.
You can move on, you can move forward.
Get some rest, Jay.
I'll, um-- I'll drop by later.
Thanks.
I'll appreciate that.
MAN [ON RADlO]: --bill to crack down on experiments on animals is to become law today.
Animal-rights activists have been pushing for the bill for nine years and have taken part in mass demonstrations.
The bill will outline just what animals will be allowed to be used in labs along with penalties.
-How are you doing?.
-Fine, you?.
Sure.
Fine.
DUBENKO : Andrew, what do you think of the patient's tachycardia?.
Uh, probably volume-related but could be due to fever, pain, infection.
Mm-hm.
Good, more.
ANDREW: Uh, drug withdrawal, toxins, vascular.
More.
Uh, trauma, iatrogenic.
-Neela never taught you VlNDlCATE?.
-No.
It's my favorite mnemonic for post-op rounds.
Excuse us, Dr.
Brenner.
If you run through this on all your post-ops -you will never miss major complication.
-Mm-hm.
-V is for?.
ANDREW: Vascular.
DUBENKO: I is for?.
ANDREW: lnfection?.
-lnflammation?.
DUBENKO: Don't ask me, tell me.
[RAP MUSlC PLAYlNG ON HEADPHONES] [ELEVATOR DlNGS] You can come in now.
What happened to you?.
Uh, ahem, I'm sorry, I was up all night.
I see.
So.
How was your week?.
[SlGHS] Can you excuse me for a second?.
Finally.
You're really here?.
Yeah.
I really am.