Transplant (2020) s03e07 Episode Script
Work to Rule
1
I know you probably
want me to tell Amira
Well, are you already planning
for us to not work out?
I'll recover from the episode,
but it'll never be behind me.
That's why I was kind of hoping
that you would let
me come back to emerg.
While we can't always control the wait,
we can improve how the
patient experiences it.
It's just one piece of a larger puzzle
I'm trying to put together,
and the reason you hired me.
And also because we knew you'd
approach change deliberately.
The hospital's been
talking to Roberta Matheson
and she wants you to admit fault.
She wants me to admit I'm an abuser.
I was messed up long before the crash.
- I'm not gonna live a lie.
- I need a doctor!
- Okay. I am a doctor.
- No! Get off of me!
Ah! You want me to use my injury
- to get some sympathy from Devi.
- Uh, well,
if you know that, then
why don't you do it?
What if that woman reacted to me?
In a discriminatory way?
That's my school audition song.
Amira, you forged my signature.
If I don't get in, none
of this will matter anyway.
You don't want me to be happy,
you act like you're doing a good job,
but they were good parents, you're not.
Well, you and I disagree.
We'll talk about it
when I get there, okay?
Rania was caught off-guard,
but uh, she said that
I should just let Amira
stay there and calm down.
Yeah. That sounds like good advice.
No, I told her to get
Amira's things ready.
- Bash, I
- You should go home.
- I'll call you when I'm done.
- No, Bash, wait, wait.
Why don't you just just
play this out for a second?
What are you gonna do?
You're gonna get there,
you're gonna drag her out by force?
- She's my responsibility.
- Yes, and she's safe.
With someone that you trust and
someone that she's comfortable with.
She's my family. Are
you really suggesting
that I just don't do anything
because we had an argument
about where she should go to school!
Bash, being a teenage girl is so hard,
it's like your brain's on fire,
you feel scared and fierce
and fragile all at once.
I'm just I'm suggesting patience.
You're suggesting I do nothing.
No. No, not nothing.
Just take time.
Get perspective.
- One night.
- Two nights.
And then she comes home.
(THEME MUSIC)
And once the patient
receives a hospital ID,
you can only search for that patient
using the last six
digits of that number.
If you type in seven,
the computer's gonna think
you're looking for labs. Don't do it.
Speaking of labs
Theo, thanks for picking
up that shift today.
Sure. Uh, not the best time I realize,
but I'm not going to
apologize to Roberta Matheson
and go on the record as an abuser.
If you have an issue
with that, let me know.
- No photocopying.
- No unpaid overtime.
And all our breaks are
taken outside emerg.
- Yeah, sorry, why is that?
- Because normally we get roped
into work during our breaks.
By doctors that are still
asking us to do more.
We're just trying to make
sure we're on the same page
about the nursing situation.
To be clear, this is not a union action.
This is a work-to-rule
initiated by our emerg nurses.
They'll be performing
strictly contractual duties.
No treatments that doctors
should be billing for,
no portering, no cleaning.
Please know that we are
doing everything that we can
to address nurses issues
around workflow changes
and some unexpected
burdens falling their way.
More like all expected burdens.
Okay.
- Hey.
- Hey.
- Tight spot. I know.
- Yeah.
I've added temps.
- Thanks for approving the overages.
- Calling in casuals is not sustainable.
And with a province-wide shortage,
how many are even emerg nurses?
- One in four.
- You're still happy you walked into this?
Okay, but communication scores are up
in the surveys we've been collecting,
- and that's with all of these challenges.
- No, no, no,
- data does not drive change.
- Uh-huh.
And the contingency
budget dries up next week
- and money's gotta come from somewhere.
- Understood.
- If you want the benefit of my experience
- Of course.
Stop trying to be a friend to all.
There is no way that everyone
walks out of this unscathed.
Hey, what do we got?
I've got Solomon Morris,
23, found down on Bay Street.
And I've got Brock
Paulson, nasal fracture
after passing out behind
the wheel of his car.
- So, he hit Mr. Morris?
- I hit a tree, on Sherbourne.
Oh God, I hope I
didn't hit a person too.
My heart's pounding in my chest.
BP's stable, but he's tachy
We tried radioing in,
but no one answered.
Word at our station house is
your nurses are on work to rule?
Was Mr. Morris struck by a vehicule?
Because those two streets
are nowhere near each other.
No evidence of trauma,
but we can't rouse him.
Wait, I'm confused,
which one's more urgent?
- We picked them up separately.
- Who's going where?
Claire, are you still
on routing now because
It's not complicated, guys. Uh, Theo,
take trauma, and Mags, recess.
(INDISTINCT CHATTER)
- (MOANING)
- How much did she drink?
A few tequilas, but she's
been vomiting bile repeatedly.
No evidence of gallstones.
X-ray shows distended bowel.
But that could be from the
adenocarcinoma in her pancreas.
Have you called her oncologist?
Zola says her prognosis is three
years at best, even if they resect.
- She starts treatment next week.
- Then we need to get in there.
Investigate what's up with the
bowel so she makes it that far.
- You're thinking laparoscopy?
- Exploratory lap.
We don't wanna cause any
damage that would delay chemo.
There is a spot on the board at
11:00 PM. I'm happy to stay.
- (COUGHING)
- Nice one!
I appreciate the commitment, Dr Hamed,
but we need to bump someone
before she gets emergent.
All we found on him
was a driver's license
- from the state of Oklahoma.
- BP's ninety over seventy now.
Where are we on that ECG?
Theo, everyone else is spoken for.
- You okay to go this alone?
- Depends what we're looking at.
Can you help me cut here?
Just so I know, was is this work
action mean for you as an NP?
That you treat me as an
RN until it's resolved.
Irma, O-two, and monitor his breathing.
Hematoma DVT?
No, it's cold, not warm. Pallor, wooden.
Can I get a pressure needle?
Theo, his BP's dropping.
Injecting saline.
Eighty millimeters mercury.
- Acute compartment syndrome.
- Without obvious trauma?
If we don't relieve the pressure
in his leg, he could lose it.
He needs an urgent
fasciotomy. Can you help?
Yes, but nurses' duties only.
Okay.
His rate's climbing. 195. He's in SVT.
Joanie, grab a crash cart just in case.
- And we need some ice.
- Sorry, Mags, there's no way
I'm crossing the nurses pickup
line, official or otherwise.
Oh my God. Well, if you see
a nurse, ice on the way out?
Excuse me.
Crazy here today. Sorry to pile on.
I know. It's really
not your fault, Brock.
Usually, I just hold my nose,
close my mouth and push out air
- to slow it down, but I can't now.
- Right.
People who know vagal
maneuvers like that
usually have heart problems.
Mine just races sometimes,
though this might be a record.
Hmm. Do you smoke or do you
use any recreational drugs?
Well, as a personal
trainer, I keep it tight.
Uh, no alcohol, no smoke,
no toxins of any kind.
Well, something must
have caused you to faint,
vasovagal syncope can sometimes
- have underlying
- I was on my way home from a therapy session
and feeling intensely.
- Yeah, well, physical therapy can be taxing.
- No, the other kind.
We were really digging
deep today, and it
it brought up a lot of emotions.
(GROANING)
Hey, give me a sec?
I need some ice! Hello?!
Okay, you're gonna sit
up, face dive for me,
next level vagal maneuver.
A good three beats. There you go.
One Mississippi, two Mississippi,
three Mississippi. Okay,
it's good, you can lay down.
There you go. Okay, ice his
nose on the way to imaging,
and we need a detailed echo.
No, I've been tested before,
there's nothing wrong with my heart.
We need to make sure. Ten
on ten off with the ice
while they image and I'll come
and fix your nose once you're back.
(BEEPING)
- Where are we on the fentanyl?
- Coming in.
- Claire, you able to retract?
- I can only hand you instruments.
- Right.
- I am here to support.
You tell me what you
need and you'll have it.
Okay, retracting.
Fascia's exposed. Scissors, thank you.
O-two sat's plummeting! Irma, bag!
- He's not breathing?
- It's not there!
Why weren't you watching for that?
His sats were fine on the screen.
Fentanyl can depress resp rate.
In trauma, you need to watch the
patient, not just the monitor.
Hey, guys, if I don't cut soon,
we're gonna have a
whole other problem here.
Mm-hmm.
Okay. Go.
Okay. This compartment's released.
I'll do the other side and then,
we'll cover with wet dressings.
I need surgery? Right now?
It's the only way to figure
out what's causing the problem.
I mean, it's obviously my cancer,
- coupled with bad behavior.
- Say "Ah".
We're staying positive, remember?
- Are you two sisters?
- Friends.
Um, we met in seventh grade.
- Via dork radar.
- We were the good kids.
Did our homework. Followed the rules.
Yeah. When I got my diagnosis,
Riley dropped everything
and convinced me to say screw
the rules, until treatment starts.
Last night was a dine and
dash at her ex's restaurant.
Tonight, we're supposed to
spray paint Zola's letter
of resignation on her boss's car.
- Yeah.
- The jerk shorted her sick pay.
Light felony is less scary than surgery.
Well, laparoscopy is the
safest kind of surgery.
The usual rate of complication
is between five to ten percent.
Statistically, I shouldn't be
dying of cancer at thirty either.
Maybe if you tell us what to expect?
- Knowledge is power, right?
- Absolutely.
So we put several cameras
through small incisions,
find the obstruction
and see if we can fix it.
Can you take the mass out too?
Unfortunately, we have
to deal with this first
before anyone can take on your pancreas.
Boss, if you can skinny dip
in a stranger's freezing cold
pool at 3:00 AM, you can do this.
Here's a gown for you.
She does need to get changed now.
Hey.
- I love you, Boss.
- I love you too.
- I'll see you on the other side.
- No, no, Riley, I
I'm in love with you.
I think I always have been.
We said screw rules,
right? I'll see you after?
Yeah.
What's wrong? Are you okay?
Why do you always assume the worst?
Mags, I don't need to be
disassembled mentally right now.
Okay, okay, I was just
I was thinking that maybe we could
try something different tonight.
How about we have dinner with friends?
And don't say you're working
because I checked the board,
and everyone can bring food,
and you wouldn't have to do anything.
Just enjoy the company of
others. What do you say?
Bash, it's been four
days since Amira left
and we talked about getting perspective,
but all you do is work and worry.
I know you'd rather do it yourself,
but that's why we're
in the "you talk, I act"
stage of our relationship.
So, next step?
Scan and run the bowel, look for
obstructions, masses and adhesions.
When I was practicing, I had
trouble orienting the camera.
Remember to pull back the camera
to widen the field of view.
Colon is distended, but
no visible obstructions?
Could be ileus, but why?
Alright, let's get a
look at the pancreas.
Now, the grasper.
Someone said you had a daughter.
You've been pulling a lot of
late nights, how do you manage?
- Amira's my sister.
- Oh.
Uh, she's
- with a friend who helps out.
- Oh.
My daughters are in university now,
but they'd be the first
to tell you that I didn't
exactly ace that balancing act.
Oh.
Does that look like calcification?
And pseudocysts.
- Which indicates?
- Pancreatitis, not cancer.
That explains the ileus.
This woman has spent the last
month of her life preparing to die.
Well, she won't, at
least, not from cancer.
But let's get a sample to the lab.
If her pancreas has necrotized,
she's not out of the woods.
Lift, lift, lift,
lift. Go back, go back.
That's better. Gotcha.
Hello? Hello? Hey!
Anyone? Uh, I think I need help!
Hey, Brock, you're back from imaging.
Uh, I never went. I'm guessing
that HR number is my heart.
- Should it be north of 200?
- Yeah, no, tell me how you're feeling?
- Like maybe they forgot about me.
- Okay. lie back down.
(GRUNTS)
Oh, Brock! Arnold!
Adenosine. He's back in SVT.
- It's not stocked. I'll go get some.
- No, no time. We need to cardiovert.
200 J, synchronized.
- Charging.
- Clear.
- Hey, you okay?
- Yeah.
- You with me?
- Yeah.
I asked a casual to
get him to radiology,
if she had done that he
wouldn't have been alone!
Can you help?
Or maybe someone reminded that
nurse that she's not a porter
and moving patients is
not part of her contract.
Which means the porters available
are busy and in short supply.
- And that's part of the problem!
- You know, I would've taken him myself,
but I had to wait for my
own heart to stabilize.
So we have to pick up your slack?
When it affects a patient's well-being,
we do what's necessary, Arnold!
Enough! Both of you!
Sérieusement !
- Oh no. No, no, no.
- No, hey, Solomon, hey, look!
You're in the hospital, it's okay!
We're taking good care of you, no
Slow down. Alright, look at me.
There is a large surgical
incision on your leg, okay?
- I know it's disorienting.
- What happened?
They found you collapsed on the
street with compartment syndrome.
It means your leg was seconds
away from losing its blood supply.
- I need to leave.
- No, you need to stay.
Okay? At least until
the swelling goes down.
Listen, hey, listen, listen.
Man, I promise, alright?
You can tell me whatever happened.
Okay? I'm required to
keep it confidential.
I'm not a criminal.
I'm a culinary student.
- And I can't pay for this.
- Okay. Um, you're
you're from out of the country, right?
Alright, then your
tuition covers health-care.
Not if I lose my
scholarship and flunk out.
Look, I have sickle cell anemia.
I kept missing classes, I was
trying to get it under control,
but the meds the meds are expensive.
Compartment syndrome can be
a complication of sickling.
If you knew you had to manage this,
can I ask why you didn't
pick a school closer to home?
No insurance at home either.
I thought I'd take a swing, you know?
But now you've cut me open,
and I'm gonna get a bill
I won't be able to pay.
Look, there is a very serious
risk of you getting an infection
if you leave here, Solomon.
We don't charge by the hour, okay?
So just just sit tight.
We can figure this out.
What do you mean I don't have cancer?
Your diagnosis has a very
real but small margin of error.
Symptoms very closely mimic
autoimmune pancreatitis.
But I've been so sick.
Pancreatitis can cause extreme
pain and make you very ill,
but we've got you on
fluids and antibiotics.
But this means she's gonna live?
This is great news!
All the things we did
were for no reason?
Boss, it's okay, you got swept up
What if I was holding
onto that for a long time?
Then I don't know what
you want me to say.
You can talk to me about it.
- Or you can go.
- That's not fair.
I've been here supporting you, and now,
- I have to justify how I care about you?
- No, you've been here because
it worked out for you,
your marriage ended,
and you were freaked out
about your own future.
Look, our concern right now
is whether your pancreas is necrotizing.
Which means if parts of it are dying.
Now we've sent samples over to our lab,
and we'll be repeating
a CT in the morning.
Zola needs to rest right now.
- So, Riley, maybe you should come back later.
- No.
She should go.
(SCOFFS) What now?
Just uh,
try to get as much rest as you can.
Okay. Here you go.
Uh can we skip whatever that is?
I tend to react to medication.
Yeah. It's just a mild analgesic.
I mean, we can, but
unless you're allergic,
- you're gonna want the freezing.
- Um,
- alright.
- Yeah? Okay.
Here you go.
One, two, three.
Your heart imaging came back normal
- which doesn't explain the arrhythmia.
- I told you it would be
Okay, this is gonna be uncomfortable.
- I'll do it quickly.
- (GRUNTS)
Alright. Ready?
- Yep.
- One, two, three
- (GRUNTS)
- Here you go. Okay.
Doing great, doing great.
- (GRUNTS)
- You're doing great.
Okay. So this will keep the bone aligned
and we can take it out in about a week.
It is burning? Or is
it uncomfortable?
- Well
- Let me see.
Okay, you have hives now.
Are you sure you're not allergic?
They'll go away as quickly as they can.
I normally try to avoid
telling people this but,
I'm an HSP.
Highly sensitive person.
I fainted because I was spent
emotionally from therapy.
The stress from the
crash made my heart race
and I thought I'd been
forgotten so I panicked.
My body plays by its own rules.
And when I explain this to
doctors, they look at me
well, like you are now.
No I mean, there
is literature on people
who feel feelings more deeply,
but there's no data
connecting it to SVT.
No, my thing's like,
the opposite of science.
I mean, there's no medical cause
for what happened to me today
other than being a more fragile person.
Mm.
You're not convinced.
Even though your test shows nothing.
No, I still would like to sign you
for a test called electrophysiology,
it'd be a bit more invasive,
but at least we can rule
out anything serious.
Well, how invasive?
Because I'm telling you,
there's nothing medically wrong with me.
But Brock, your heart
was beating so fast
that we had to shock you.
We need to make sure.
Then if it is something serious?
Well, then we try to fix it.
And you don't have to
feel fragile anymore.
Ah, hopefully not much longer.
Claire! The guy in A, Mr. Morris
What is it, Nancy? I've got
four places I need to be.
The fasciotomy patient
needs to get admitted
- and his infusion is almost done.
- Yes so check the chart orders.
They're not there. And
I know I'm not supposed
- to chase down doctors right now.
- I'll handle it.
Theo, why didn't you
admit Solomon Morris?
Um, he is a sickler with no insurance.
So if I waive my fee on the fasciotomy
and we keep him in emerg, he
won't get billed for a room.
Great, so you get to
magnanimously waive your fee,
while my team does all the
monitoring and the treatments?
I'm trying to help someone in
a desperate situation, Claire.
And we're trying to make sure
every other patient's looked after.
Are you? Or are you more
concerned about your work stoppage?
Look, I know it's been
a little bumpy, but
do you really not see the value of
what Dr Devi's trying to do here?
Do you not see how hypocritical that is?
All the labor in her plan fell on us
and you are doing the same
thing right now with Solomon.
Fine. Then I will monitor him myself.
You're gonna check his
fluids every 20 minutes?
Change the bedpan? And what happens
if a trauma comes in and you can't?
Who do you think wears that?
Write your instructions on his
chart, and leave it with me.
No, it's a question of resources.
We're looking into it today.
I'm waiting to hear back on that.
Okay, bye.
That was extremely unprofessional of me
to lose my cool like that
in front of my patient.
- Agreed.
- He's stable.
Um, I think. He says the
cause of his heart event
is that he's a highly sensitive person,
but I still want him to
go for electrophysiology.
I have a cousin who's an HSP.
He's an artist.
Some people feel more deeply,
but their bodies pay
for it in either ways.
So you think it's a real thing.
They say Einstein was one
and he was frequently ill.
But I mean, definitely
get your guy checked out.
And it wasn't just
about Brock with Arnold.
My own heart rate spiked
and I needed to get it down.
Are you feeling better?
Yeah, and I didn't mean
to say that to pile on
and I wasn't disregarding your
instructions, I've got your back.
I could swing a physician's
assistant for the day.
No, thanks, but I'm sure
you've got other places
that need support. But
thank you. Appreciate it.
Actually, I read this article,
about 500 doctors in
Quebec that rejected raises
in a bid to divert money toward nurses.
I'm pretty sure that staff
here would feel the same way.
Let me see what else I can dig up
before we resort to crowdsourcing.
- Okay.
- Okay.
Hello? Guys? (DOOR CLOSING)
June? I was just finishing my prayers.
Uh I'm early.
Mags said 6:30, uh, I
can run some errands.
- No, no, don't be ridiculous.
She's still on shift.
Uh, fridge? Alright. Should I take that?
Uh, you know, Singh let
me jump in on a lab today.
He did not let me operate Hal.
Uh, that could take years,
so don't worry about it.
Well, he did ask me about Amira.
Just uh, how we balance and all that.
He started talking about his daughters.
- Really?
- Mm-hmm.
These are good.
You make yourself at home.
The aromatics add like a
whole other layer to this.
It's it's amazing, just trust me.
Dammit! How are you so fast?
We want to choose toppings.
You know, technically, manaeesh
is a breakfast flatbread,
- but
- Move, move, move! Ah!
Okay. I'll just plate it then.
So, seriously no other
takers of what will easily be
the best gin martini they've ever had?
Why don't I just go help Bash.
How's that going? Your health stuff?
(SIGHING) It's messy.
I mean, you can't really
stop saving someone's life
because your heart rate spikes.
You know, people telegraph
support, but the truth is
I'm just a burden, and
accepting those limitations
and that everybody else
knows about them yep.
- (GRUNTS)
- You know
most people just say "fine".
Boom! You're done.
It's exactly because of that attitude
that there are no systems
in place for someone like me.
Uh, I was kidding.
But if you wish to risk arrhythmia,
I'd be happy to give you
the best two out of three.
Oh, you're on.
Okay, so everybody tells a story
from the age that they roll.
- And then we go eat.
- Pass.
- I love these games.
- You love these games.
Can you please explain to them
why this is not a good idea?
The sooner we play, the sooner we eat.
- You serious right now?
- Roll the dice!
(ALL): Roll the dice! Roll the dice!
- Roll the dice!
- Alright, just stop.
(LAUGHING)
Oh, there we go! That's the spirit!
- Woo!
- Nine.
So, when I was nine, there were
these woods outside my school,
and I would go out back, burying
myself in leaves and sticks,
and just wait stealth mode for
someone to come and find me,
but no one ever came so I was like
playing hide and go seek by myself.
- Oh.
- June, that's like the saddest story
- I've ever heard in my life.
- No, it was funny
It was hide and seek
Okay, whatever, you guys weren't there.
Well, when I was nine, I
pooped in a kitty litter box
and blamed it on the dog.
- (LAUGHING)
- It's disgusting.
Still glad you invited me?
(LAUGHING)
Why are you here so late?
- Contractual hours only, remember?
- We're off the clock.
Look, taking breaks on schedule
and not doing unpaid work is one thing.
I know today was rough.
I don't get my tired ass out of bed
every morning for the garbage pay.
- I do it for the patients.
- Are people getting hurt because of us?
Guys, you can't crack on me.
How can you not care about
what we're saying, Claire?
I was accused of that today by a doctor.
I didn't expect it from you.
You asked me to fight and I fought.
We have leverage now, if
we back down we lose it.
Devi was okay with you not apologizing?
Not really, but uh
- feel like my job is pretty safe.
- Not worried?
Uh no, standing on principle is
gonna be a risk, but uh, weirdly no.
Why, should I be?
I mean sounds like your
safety net is airtight.
- I'm a privileged ass.
- You said it, not me.
You know, we'd only
really need a third of ED
giving a small percentage of the wages.
Mags, that's not gonna be an easy sell.
- No, I know, but
- Who's selling what?
No, I'm just running
an informal poll to see
who'd be willing to subsidize
another full-time nurse
- or at least cover the overtime.
- I'm all for it.
And not just 'cause
I'm a privileged ass.
Well then, that's a
slippery slope, isn't it?
Asking individuals to solve
an institutional problem?
Yeah, no, maybe, but since
I'm like directly contributing
to the burden of the nurses,
I don't have the luxury
of waiting for the institution.
You know, I wanna know what
Devi thinks about all this.
Since when?
Since when? Since Novak
asked me to make her an ally
for the sake of Trauma OR?
- Why would he do that?
- Because he's Novak
and he's a mid-level misogynist.
- Low-level misogynist.
- Mid-level.
Anyways, he cares about the
work that we're doing down there.
Is that really necessary? I mean,
our work should speak for itself.
Easy for you to say. You've
done what, two procedures
with Singh and he's out here
telling you his life story.
Singh, really? What did he say?
- He mentioned his daughters.
- He had daughters?
- It's not a big deal.
- Seriously?
I was his resident for three years.
I bet you I can go in there
do a Whipple blindfolded
and he'd end up taking you for dinner.
Okay, okay, but that's
probably more like
a father-to-father thing.
- Bash has Amira.
- June has Shay.
And has June talked to Singh about Shay?
No, no, that is not the point.
The point is that men
just feel more comfortable
talking to other men and
that's just a subtle way
that we get edged out.
You're doing it right now.
- (LAUGHING)
- Okay, speaking of father,
how have you been
since Amira's been gone?
Other than torturing himself endlessly?
Um, she said she's not
ready to be around me yet.
And uh, part of me thinks
I should just give in.
Oh then, she'll know
she can hold you hostage
- and get whatever she wants.
- Even though she has a point?
Anyone wants more wine?
You know, you could use this
opportunity to reset things.
And when she is ready to talk,
you'd have somewhere to go with her.
Bash, I was I was
just trying to help.
I know how how hard it's been.
You have no idea what
it's been like for us.
Okay?
I could fix this with some super glue.
I shoudn't have lost my temper.
You're allowed to be upset when
something you care about breaks.
You seem better.
With the distance from the crash,
and I know it's been a journey
since your marriage, uh
Broke. (CHUCKLING)
Eh, I mean it's hard to have
perspective when you're in it, but
the girls and I are finding a rhythm.
It's nice to feel like
I can see the other side.
- Any idea what's there?
- (CHUCKLING)
You know, when I met you, I was like
I was just a passenger in my own life.
And then you
You had no safety net,
and just so unafraid of
doing what you believed in.
- I just I just have more practice, Theo.
- Oh, don't deflect man.
Or do, if you have to. (CHUCKLING)
It's just
My life is better with you in it.
And she's gonna come back.
You'll see.
So, are things okay with Bash?
Is that another one of those questions
where I'm just supposed to say "fine"?
And I'm very well aware
that you think I should mind
my own business with him and Amira.
You know, it's weird. My baking
skills, Michelin-star level.
My relationship skills have
not been getting great reviews.
So are you gonna let
me scrub in on those,
or do I have to cozy up
and make you an ally first?
That depends, is that a dig
about the whole Devi thing?
Because you know you're
the one who keeps telling me
- to make connections.
- It just seems like such
a cynical reaction to what
you said before about Singh.
I'm being strategic, Mags.
Look, she already told me
she's rethinking Trauma OR.
And don't act like you're
not doing the same thing.
- No, I'm
- Yeah, no.
You're supporting her
for your own benefit.
I believe in her. I'm trying
to build something real.
Oh, I'm sorry that I
can't just strip naked
and bare my soul, Mags, alright?
- I'm built different.
- Fine.
But you're not that little girl
burying herself in
leaves anymore either.
People are looking for you, June.
You need to stop with that, alright?
Just forget that I said that. Ah!
(MOANING)
Here.
- Thanks, guys.
- Thanks, Mags.
- Thanks for coming. Good night.
- See you tomorrow.
(DOOR CLOSING)
I know we're going to
talk about it, so let's go.
Please, Mags, drag it out of me.
Okay. If you don't want to, that's fine.
Good.
How am I supposed to know
what you've been through
if you keep walling
off parts of yourself?
You know, people keep saying
that, you, Rania, Amira,
why can't people just
let me be who I am?
I don't know, I can't
speak for those two,
but I know that if
I'm in a relationship,
I need to be let in. I need intimacy.
- We have that. I thought we did.
- Clearly, if I'm bringing it up.
And what do you mean,
"you can't speak for them"?
All you do is speak for other people.
What's it like, Mags,
always knowing exactly
- what people are afraid of?
- It's terrible!
I think you're so afraid that
there isn't a place for you
that you can't help prove
how essential you are.
I hate
needing something from you
that you don't wanna give me.
And you've barely touched
me since my heart
Okay, so we're talking about sex,
- I'm not talking
- No, intimacy! I'm talking about real intimacy!
But for you doesn't that
just mean like fixing me?
Like I'm some kind of medical
mystery that you get off on solving?
Bashir, are you suggesting
that I'm attracted to your pain?
- Is that what you're saying?
- Tell me I'm wrong.
I think you would know who
you are without your pain.
I think you you cling to it.
And you keep it shrouded
in mystery because
you know it draws me in
and because you want me
to come digging for it.
How long have you been
waiting to say that?
You tell me I'm wrong.
- Clear a path, please!
- (GRUNTS)
- Solomon!
- (BREATHING HEAVILY)
What are you doing out here?
- I'm gonna get some help.
- No, no, no!
- No one else from the hospital!
- Can you give him some space?
You should still be in your bed.
At like 4:00 AM, some
new doctor came in,
and told the nurse they had to admit me.
Which means I'd be getting billed.
When they weren't looking,
I left and I figured
I'd recover at home, but when
the painkillers wore off
You had to come back.
Only now, triage said I had to
pay upfront unless I'm critical.
I was gonna start over at another ER,
but when I tried to stand up again
Look, you're anemic from
the sickling, alright?
- You need blood transfusions, pain meds
- I know! I know!
What am I supposed to do?
Riley. You're not supposed to be here.
I lied to a nurse and
said I was her sister.
She's so much worse.
They're saying her pancreas
is necrotic and she's septic.
And choices will have to be made?
Is there any way we can
contact her immediate family?
Her mom's gone, her
dad's in assisted living
and he's not in a
position to make decisions.
- Who does that fall on?
- Her doctors.
We do the best we can to make
informed decisions on her behalf.
She would do everything
she could to fight this.
I knew how she felt.
I maybe even liked knowing it.
I do love her, just not
in the way she wants me to.
I'm sorry, but you're not family.
Except I am!
And if anyone is speaking
for her, it should be me.
Dr Olsen. I was gonna come find you.
If we scale back 20 percent of
what's allocated to Trauma OR,
we can fund raises
- for the nurses to compensate
- You have a problem with Trauma OR?
I think it has certain
advantages, but I also think
it's run by a man who
isn't a team player.
So you're punishing doctors now?
- What?!
- I've heard from multiple sources
that you're gonna be asking them
to personally subsidize nurses?
- I'm sorry, you heard that where?
- Do you have any idea
how something that provocative
makes the hospital look?
Makes me look? As CMO?
Like we can't handle a budget?
Like we don't care about retention?
Just hold on, um,
doctors foregoing pay
was an idea brought to me by a resident.
- I shut it down.
- Obviously not hard enough.
When I said "don't be everyone's
friend" that didn't mean
taking a flamethrower to people
that are trying to help you.
I turned my life upside
down to come here.
The only reason I did that is
because I care about people.
That doesn't mean you
know how to lead them.
Fix this. Today.
Page me when she's ready.
Let me know how long for the
interventional radiologist,
and I'll have Dr Hamed set up the suite.
I was just going to book an OR
to remove the dead
tissue from her pancreas.
You want to send her back to surgery?
No, just start with the
percutaneous drainage
and we'll see how she
reacts to that first.
And risk more bacteria
going into her bloodstream?
She has a fully inflamed
pancreas, it's the safest option.
No, it's the less effective option.
Okay. Look, I'm hearing you,
but this is up to us, which
really means it's up to me.
Look, her friend is here
and she's adamant that Zola
- would not want to play it safe.
- And what is this,
a friend with power of attorney, Bash?
At least Singh should hear both sides.
Oh. Would you like to go over my head?
If this is you feeling Singh
and I are pushing you out,
I would never do that
to you. As your friend.
Look, just set her up for drainage.
- June.
- What?!
Your hand may be infected.
Well, these are all of the sample
packs of hydroxyurea I could find.
There should be enough
there to manage your anemia
and sickle cell pain for two months.
Thank you. And uh, what about my leg?
Well, we'll check to make
sure it's not infected.
These transfusions should help.
But if you notice any
swelling, you can just call me.
But look, Solomon, this is
all just a stop gap, alright?
You're eventually gonna
have to make a plan.
Maybe even head home to reset.
Yeah, no. I made a choice
to go after something
and I don't plan to give up.
Are we burnt?
I might be.
But you, you have
nothing to worry about.
Suction carefully. Don't
compromise the vital tissues.
BP's dropping, she's coding.
Starting compressions.
Charge to 150 and call for more bodies!
Clear!
- Resuming compressions!
- Charge 200.
Clear!
- We've got sinus. She's stabilizing.
- I need more light.
What happened? What is this?
- Get over here, June.
- This is Zola?
Debridement of necrotic tissue,
but the septic shock proved
more than her body could handle.
Are you helping or hovering, June?
- Going in with the ligature.
- While she's doing that,
tell me why this happened, Dr Hamed?
It's a statistical risk
of the surgical procedure.
Which is why I told Dr
Hamed to play it safe
with percutaneous drainage
and not to jump into surgery.
He talked the family through
both options, they chose surgery.
Friend. Not family.
As in no legal status.
- It's more complicated.
- Scrub out, Dr Hamed.
We're a team, not a one-man band,
I will not have surgeons who
don't tell me the whole story.
- Sir
- You heard me. Go.
Dr Curtis, take over.
- (SIGHING)
- Brock.
They're telling me that you're having
second thoughts, what's going on?
I don't wanna do this.
I should've said so yesterday
when you scheduled it.
- I'm sorry.
- It's okay.
I'm sorry, can you give us
a minute please? Thank you.
(SIGHING) That poor
woman got me on that table
and was about to sedate
me and thread a wire
from my thigh to my heart,
and Mags, I couldn't
Brock, you're not gonna feel anything.
- I'll react to the sedation.
And definitely the wire,
but that's not it.
Something inside me, it feels wrong.
And when it feels wrong,
I've learned to trust that.
I just I thought that
you wanted to know for sure.
No, you wanted to know.
I already do.
And I promise to always wear
my heart-rate watch from now on,
but I spent all night thinking
about how hard I've worked to accept
that this is how things are for me.
And how I don't need anyone
else to believe me or fix me.
- I like how I am.
- Why?
(LAUGHING)
Why do I like myself?
I didn't mean I
didn't mean I'm sorry.
Okay, sure, I feel stress and
pain more palpably, but also,
I feel the good stuff more too.
And I have to believe
it's a price worth paying.
Even if you don't.
Dr Curtis. You okay?
Just buried in leaves.
I let this fester too long,
and now, I'm paying the price.
But that's not all?
I had to shut down my resident
today and he's also my friend.
I can either channel my
inner bitch or let my feelings
govern how I do my job.
And risk losing everything
you've worked for.
If we revert to status quo,
will you take your
demands off the table?
- Pressure from on high?
- You predicted this, Claire.
That my big ideas would hurt your team.
Well, I get no satisfaction
from being right.
Not when the hospital's
solution is budget over patients.
Mm-hmm.
I will discharge Solomon today.
You should admit him.
Claire, look, you don't
have to be a part of this,
but I'm not gonna make
this guy's situation
any harder than it already is.
Okay, Theo, just look.
You took his address out of our system?
Yeah, when he came back this morning.
It's the only way we can admit,
treat and ensure he never sees a bill.
- I didn't know we could do that.
- We can't.
Word is you are an attending again?
- Is that official?
- Yeah.
(LAUGHING)
(INDISTINCT CHATTER)
Hey! It's Dr Hamed.
Dr Curtis said you're
not my doctor anymore.
Yeah, I was just, uh
Spray paint's off the table, so
Instead of firing her boss,
she's firing her oncologist.
- Dr Hamed.
- Mm-hmm?
Thank you. For fighting for us.
Does this mean you two are okay?
We agreed to move
messily into the future.
Whatever that means.
I'm going to tell Amira to
stay as long as she wants.
I'm just packing some
things she'll need.
Why don't you let me help you?
I know you probably
want me to tell Amira
Well, are you already planning
for us to not work out?
I'll recover from the episode,
but it'll never be behind me.
That's why I was kind of hoping
that you would let
me come back to emerg.
While we can't always control the wait,
we can improve how the
patient experiences it.
It's just one piece of a larger puzzle
I'm trying to put together,
and the reason you hired me.
And also because we knew you'd
approach change deliberately.
The hospital's been
talking to Roberta Matheson
and she wants you to admit fault.
She wants me to admit I'm an abuser.
I was messed up long before the crash.
- I'm not gonna live a lie.
- I need a doctor!
- Okay. I am a doctor.
- No! Get off of me!
Ah! You want me to use my injury
- to get some sympathy from Devi.
- Uh, well,
if you know that, then
why don't you do it?
What if that woman reacted to me?
In a discriminatory way?
That's my school audition song.
Amira, you forged my signature.
If I don't get in, none
of this will matter anyway.
You don't want me to be happy,
you act like you're doing a good job,
but they were good parents, you're not.
Well, you and I disagree.
We'll talk about it
when I get there, okay?
Rania was caught off-guard,
but uh, she said that
I should just let Amira
stay there and calm down.
Yeah. That sounds like good advice.
No, I told her to get
Amira's things ready.
- Bash, I
- You should go home.
- I'll call you when I'm done.
- No, Bash, wait, wait.
Why don't you just just
play this out for a second?
What are you gonna do?
You're gonna get there,
you're gonna drag her out by force?
- She's my responsibility.
- Yes, and she's safe.
With someone that you trust and
someone that she's comfortable with.
She's my family. Are
you really suggesting
that I just don't do anything
because we had an argument
about where she should go to school!
Bash, being a teenage girl is so hard,
it's like your brain's on fire,
you feel scared and fierce
and fragile all at once.
I'm just I'm suggesting patience.
You're suggesting I do nothing.
No. No, not nothing.
Just take time.
Get perspective.
- One night.
- Two nights.
And then she comes home.
(THEME MUSIC)
And once the patient
receives a hospital ID,
you can only search for that patient
using the last six
digits of that number.
If you type in seven,
the computer's gonna think
you're looking for labs. Don't do it.
Speaking of labs
Theo, thanks for picking
up that shift today.
Sure. Uh, not the best time I realize,
but I'm not going to
apologize to Roberta Matheson
and go on the record as an abuser.
If you have an issue
with that, let me know.
- No photocopying.
- No unpaid overtime.
And all our breaks are
taken outside emerg.
- Yeah, sorry, why is that?
- Because normally we get roped
into work during our breaks.
By doctors that are still
asking us to do more.
We're just trying to make
sure we're on the same page
about the nursing situation.
To be clear, this is not a union action.
This is a work-to-rule
initiated by our emerg nurses.
They'll be performing
strictly contractual duties.
No treatments that doctors
should be billing for,
no portering, no cleaning.
Please know that we are
doing everything that we can
to address nurses issues
around workflow changes
and some unexpected
burdens falling their way.
More like all expected burdens.
Okay.
- Hey.
- Hey.
- Tight spot. I know.
- Yeah.
I've added temps.
- Thanks for approving the overages.
- Calling in casuals is not sustainable.
And with a province-wide shortage,
how many are even emerg nurses?
- One in four.
- You're still happy you walked into this?
Okay, but communication scores are up
in the surveys we've been collecting,
- and that's with all of these challenges.
- No, no, no,
- data does not drive change.
- Uh-huh.
And the contingency
budget dries up next week
- and money's gotta come from somewhere.
- Understood.
- If you want the benefit of my experience
- Of course.
Stop trying to be a friend to all.
There is no way that everyone
walks out of this unscathed.
Hey, what do we got?
I've got Solomon Morris,
23, found down on Bay Street.
And I've got Brock
Paulson, nasal fracture
after passing out behind
the wheel of his car.
- So, he hit Mr. Morris?
- I hit a tree, on Sherbourne.
Oh God, I hope I
didn't hit a person too.
My heart's pounding in my chest.
BP's stable, but he's tachy
We tried radioing in,
but no one answered.
Word at our station house is
your nurses are on work to rule?
Was Mr. Morris struck by a vehicule?
Because those two streets
are nowhere near each other.
No evidence of trauma,
but we can't rouse him.
Wait, I'm confused,
which one's more urgent?
- We picked them up separately.
- Who's going where?
Claire, are you still
on routing now because
It's not complicated, guys. Uh, Theo,
take trauma, and Mags, recess.
(INDISTINCT CHATTER)
- (MOANING)
- How much did she drink?
A few tequilas, but she's
been vomiting bile repeatedly.
No evidence of gallstones.
X-ray shows distended bowel.
But that could be from the
adenocarcinoma in her pancreas.
Have you called her oncologist?
Zola says her prognosis is three
years at best, even if they resect.
- She starts treatment next week.
- Then we need to get in there.
Investigate what's up with the
bowel so she makes it that far.
- You're thinking laparoscopy?
- Exploratory lap.
We don't wanna cause any
damage that would delay chemo.
There is a spot on the board at
11:00 PM. I'm happy to stay.
- (COUGHING)
- Nice one!
I appreciate the commitment, Dr Hamed,
but we need to bump someone
before she gets emergent.
All we found on him
was a driver's license
- from the state of Oklahoma.
- BP's ninety over seventy now.
Where are we on that ECG?
Theo, everyone else is spoken for.
- You okay to go this alone?
- Depends what we're looking at.
Can you help me cut here?
Just so I know, was is this work
action mean for you as an NP?
That you treat me as an
RN until it's resolved.
Irma, O-two, and monitor his breathing.
Hematoma DVT?
No, it's cold, not warm. Pallor, wooden.
Can I get a pressure needle?
Theo, his BP's dropping.
Injecting saline.
Eighty millimeters mercury.
- Acute compartment syndrome.
- Without obvious trauma?
If we don't relieve the pressure
in his leg, he could lose it.
He needs an urgent
fasciotomy. Can you help?
Yes, but nurses' duties only.
Okay.
His rate's climbing. 195. He's in SVT.
Joanie, grab a crash cart just in case.
- And we need some ice.
- Sorry, Mags, there's no way
I'm crossing the nurses pickup
line, official or otherwise.
Oh my God. Well, if you see
a nurse, ice on the way out?
Excuse me.
Crazy here today. Sorry to pile on.
I know. It's really
not your fault, Brock.
Usually, I just hold my nose,
close my mouth and push out air
- to slow it down, but I can't now.
- Right.
People who know vagal
maneuvers like that
usually have heart problems.
Mine just races sometimes,
though this might be a record.
Hmm. Do you smoke or do you
use any recreational drugs?
Well, as a personal
trainer, I keep it tight.
Uh, no alcohol, no smoke,
no toxins of any kind.
Well, something must
have caused you to faint,
vasovagal syncope can sometimes
- have underlying
- I was on my way home from a therapy session
and feeling intensely.
- Yeah, well, physical therapy can be taxing.
- No, the other kind.
We were really digging
deep today, and it
it brought up a lot of emotions.
(GROANING)
Hey, give me a sec?
I need some ice! Hello?!
Okay, you're gonna sit
up, face dive for me,
next level vagal maneuver.
A good three beats. There you go.
One Mississippi, two Mississippi,
three Mississippi. Okay,
it's good, you can lay down.
There you go. Okay, ice his
nose on the way to imaging,
and we need a detailed echo.
No, I've been tested before,
there's nothing wrong with my heart.
We need to make sure. Ten
on ten off with the ice
while they image and I'll come
and fix your nose once you're back.
(BEEPING)
- Where are we on the fentanyl?
- Coming in.
- Claire, you able to retract?
- I can only hand you instruments.
- Right.
- I am here to support.
You tell me what you
need and you'll have it.
Okay, retracting.
Fascia's exposed. Scissors, thank you.
O-two sat's plummeting! Irma, bag!
- He's not breathing?
- It's not there!
Why weren't you watching for that?
His sats were fine on the screen.
Fentanyl can depress resp rate.
In trauma, you need to watch the
patient, not just the monitor.
Hey, guys, if I don't cut soon,
we're gonna have a
whole other problem here.
Mm-hmm.
Okay. Go.
Okay. This compartment's released.
I'll do the other side and then,
we'll cover with wet dressings.
I need surgery? Right now?
It's the only way to figure
out what's causing the problem.
I mean, it's obviously my cancer,
- coupled with bad behavior.
- Say "Ah".
We're staying positive, remember?
- Are you two sisters?
- Friends.
Um, we met in seventh grade.
- Via dork radar.
- We were the good kids.
Did our homework. Followed the rules.
Yeah. When I got my diagnosis,
Riley dropped everything
and convinced me to say screw
the rules, until treatment starts.
Last night was a dine and
dash at her ex's restaurant.
Tonight, we're supposed to
spray paint Zola's letter
of resignation on her boss's car.
- Yeah.
- The jerk shorted her sick pay.
Light felony is less scary than surgery.
Well, laparoscopy is the
safest kind of surgery.
The usual rate of complication
is between five to ten percent.
Statistically, I shouldn't be
dying of cancer at thirty either.
Maybe if you tell us what to expect?
- Knowledge is power, right?
- Absolutely.
So we put several cameras
through small incisions,
find the obstruction
and see if we can fix it.
Can you take the mass out too?
Unfortunately, we have
to deal with this first
before anyone can take on your pancreas.
Boss, if you can skinny dip
in a stranger's freezing cold
pool at 3:00 AM, you can do this.
Here's a gown for you.
She does need to get changed now.
Hey.
- I love you, Boss.
- I love you too.
- I'll see you on the other side.
- No, no, Riley, I
I'm in love with you.
I think I always have been.
We said screw rules,
right? I'll see you after?
Yeah.
What's wrong? Are you okay?
Why do you always assume the worst?
Mags, I don't need to be
disassembled mentally right now.
Okay, okay, I was just
I was thinking that maybe we could
try something different tonight.
How about we have dinner with friends?
And don't say you're working
because I checked the board,
and everyone can bring food,
and you wouldn't have to do anything.
Just enjoy the company of
others. What do you say?
Bash, it's been four
days since Amira left
and we talked about getting perspective,
but all you do is work and worry.
I know you'd rather do it yourself,
but that's why we're
in the "you talk, I act"
stage of our relationship.
So, next step?
Scan and run the bowel, look for
obstructions, masses and adhesions.
When I was practicing, I had
trouble orienting the camera.
Remember to pull back the camera
to widen the field of view.
Colon is distended, but
no visible obstructions?
Could be ileus, but why?
Alright, let's get a
look at the pancreas.
Now, the grasper.
Someone said you had a daughter.
You've been pulling a lot of
late nights, how do you manage?
- Amira's my sister.
- Oh.
Uh, she's
- with a friend who helps out.
- Oh.
My daughters are in university now,
but they'd be the first
to tell you that I didn't
exactly ace that balancing act.
Oh.
Does that look like calcification?
And pseudocysts.
- Which indicates?
- Pancreatitis, not cancer.
That explains the ileus.
This woman has spent the last
month of her life preparing to die.
Well, she won't, at
least, not from cancer.
But let's get a sample to the lab.
If her pancreas has necrotized,
she's not out of the woods.
Lift, lift, lift,
lift. Go back, go back.
That's better. Gotcha.
Hello? Hello? Hey!
Anyone? Uh, I think I need help!
Hey, Brock, you're back from imaging.
Uh, I never went. I'm guessing
that HR number is my heart.
- Should it be north of 200?
- Yeah, no, tell me how you're feeling?
- Like maybe they forgot about me.
- Okay. lie back down.
(GRUNTS)
Oh, Brock! Arnold!
Adenosine. He's back in SVT.
- It's not stocked. I'll go get some.
- No, no time. We need to cardiovert.
200 J, synchronized.
- Charging.
- Clear.
- Hey, you okay?
- Yeah.
- You with me?
- Yeah.
I asked a casual to
get him to radiology,
if she had done that he
wouldn't have been alone!
Can you help?
Or maybe someone reminded that
nurse that she's not a porter
and moving patients is
not part of her contract.
Which means the porters available
are busy and in short supply.
- And that's part of the problem!
- You know, I would've taken him myself,
but I had to wait for my
own heart to stabilize.
So we have to pick up your slack?
When it affects a patient's well-being,
we do what's necessary, Arnold!
Enough! Both of you!
Sérieusement !
- Oh no. No, no, no.
- No, hey, Solomon, hey, look!
You're in the hospital, it's okay!
We're taking good care of you, no
Slow down. Alright, look at me.
There is a large surgical
incision on your leg, okay?
- I know it's disorienting.
- What happened?
They found you collapsed on the
street with compartment syndrome.
It means your leg was seconds
away from losing its blood supply.
- I need to leave.
- No, you need to stay.
Okay? At least until
the swelling goes down.
Listen, hey, listen, listen.
Man, I promise, alright?
You can tell me whatever happened.
Okay? I'm required to
keep it confidential.
I'm not a criminal.
I'm a culinary student.
- And I can't pay for this.
- Okay. Um, you're
you're from out of the country, right?
Alright, then your
tuition covers health-care.
Not if I lose my
scholarship and flunk out.
Look, I have sickle cell anemia.
I kept missing classes, I was
trying to get it under control,
but the meds the meds are expensive.
Compartment syndrome can be
a complication of sickling.
If you knew you had to manage this,
can I ask why you didn't
pick a school closer to home?
No insurance at home either.
I thought I'd take a swing, you know?
But now you've cut me open,
and I'm gonna get a bill
I won't be able to pay.
Look, there is a very serious
risk of you getting an infection
if you leave here, Solomon.
We don't charge by the hour, okay?
So just just sit tight.
We can figure this out.
What do you mean I don't have cancer?
Your diagnosis has a very
real but small margin of error.
Symptoms very closely mimic
autoimmune pancreatitis.
But I've been so sick.
Pancreatitis can cause extreme
pain and make you very ill,
but we've got you on
fluids and antibiotics.
But this means she's gonna live?
This is great news!
All the things we did
were for no reason?
Boss, it's okay, you got swept up
What if I was holding
onto that for a long time?
Then I don't know what
you want me to say.
You can talk to me about it.
- Or you can go.
- That's not fair.
I've been here supporting you, and now,
- I have to justify how I care about you?
- No, you've been here because
it worked out for you,
your marriage ended,
and you were freaked out
about your own future.
Look, our concern right now
is whether your pancreas is necrotizing.
Which means if parts of it are dying.
Now we've sent samples over to our lab,
and we'll be repeating
a CT in the morning.
Zola needs to rest right now.
- So, Riley, maybe you should come back later.
- No.
She should go.
(SCOFFS) What now?
Just uh,
try to get as much rest as you can.
Okay. Here you go.
Uh can we skip whatever that is?
I tend to react to medication.
Yeah. It's just a mild analgesic.
I mean, we can, but
unless you're allergic,
- you're gonna want the freezing.
- Um,
- alright.
- Yeah? Okay.
Here you go.
One, two, three.
Your heart imaging came back normal
- which doesn't explain the arrhythmia.
- I told you it would be
Okay, this is gonna be uncomfortable.
- I'll do it quickly.
- (GRUNTS)
Alright. Ready?
- Yep.
- One, two, three
- (GRUNTS)
- Here you go. Okay.
Doing great, doing great.
- (GRUNTS)
- You're doing great.
Okay. So this will keep the bone aligned
and we can take it out in about a week.
It is burning? Or is
it uncomfortable?
- Well
- Let me see.
Okay, you have hives now.
Are you sure you're not allergic?
They'll go away as quickly as they can.
I normally try to avoid
telling people this but,
I'm an HSP.
Highly sensitive person.
I fainted because I was spent
emotionally from therapy.
The stress from the
crash made my heart race
and I thought I'd been
forgotten so I panicked.
My body plays by its own rules.
And when I explain this to
doctors, they look at me
well, like you are now.
No I mean, there
is literature on people
who feel feelings more deeply,
but there's no data
connecting it to SVT.
No, my thing's like,
the opposite of science.
I mean, there's no medical cause
for what happened to me today
other than being a more fragile person.
Mm.
You're not convinced.
Even though your test shows nothing.
No, I still would like to sign you
for a test called electrophysiology,
it'd be a bit more invasive,
but at least we can rule
out anything serious.
Well, how invasive?
Because I'm telling you,
there's nothing medically wrong with me.
But Brock, your heart
was beating so fast
that we had to shock you.
We need to make sure.
Then if it is something serious?
Well, then we try to fix it.
And you don't have to
feel fragile anymore.
Ah, hopefully not much longer.
Claire! The guy in A, Mr. Morris
What is it, Nancy? I've got
four places I need to be.
The fasciotomy patient
needs to get admitted
- and his infusion is almost done.
- Yes so check the chart orders.
They're not there. And
I know I'm not supposed
- to chase down doctors right now.
- I'll handle it.
Theo, why didn't you
admit Solomon Morris?
Um, he is a sickler with no insurance.
So if I waive my fee on the fasciotomy
and we keep him in emerg, he
won't get billed for a room.
Great, so you get to
magnanimously waive your fee,
while my team does all the
monitoring and the treatments?
I'm trying to help someone in
a desperate situation, Claire.
And we're trying to make sure
every other patient's looked after.
Are you? Or are you more
concerned about your work stoppage?
Look, I know it's been
a little bumpy, but
do you really not see the value of
what Dr Devi's trying to do here?
Do you not see how hypocritical that is?
All the labor in her plan fell on us
and you are doing the same
thing right now with Solomon.
Fine. Then I will monitor him myself.
You're gonna check his
fluids every 20 minutes?
Change the bedpan? And what happens
if a trauma comes in and you can't?
Who do you think wears that?
Write your instructions on his
chart, and leave it with me.
No, it's a question of resources.
We're looking into it today.
I'm waiting to hear back on that.
Okay, bye.
That was extremely unprofessional of me
to lose my cool like that
in front of my patient.
- Agreed.
- He's stable.
Um, I think. He says the
cause of his heart event
is that he's a highly sensitive person,
but I still want him to
go for electrophysiology.
I have a cousin who's an HSP.
He's an artist.
Some people feel more deeply,
but their bodies pay
for it in either ways.
So you think it's a real thing.
They say Einstein was one
and he was frequently ill.
But I mean, definitely
get your guy checked out.
And it wasn't just
about Brock with Arnold.
My own heart rate spiked
and I needed to get it down.
Are you feeling better?
Yeah, and I didn't mean
to say that to pile on
and I wasn't disregarding your
instructions, I've got your back.
I could swing a physician's
assistant for the day.
No, thanks, but I'm sure
you've got other places
that need support. But
thank you. Appreciate it.
Actually, I read this article,
about 500 doctors in
Quebec that rejected raises
in a bid to divert money toward nurses.
I'm pretty sure that staff
here would feel the same way.
Let me see what else I can dig up
before we resort to crowdsourcing.
- Okay.
- Okay.
Hello? Guys? (DOOR CLOSING)
June? I was just finishing my prayers.
Uh I'm early.
Mags said 6:30, uh, I
can run some errands.
- No, no, don't be ridiculous.
She's still on shift.
Uh, fridge? Alright. Should I take that?
Uh, you know, Singh let
me jump in on a lab today.
He did not let me operate Hal.
Uh, that could take years,
so don't worry about it.
Well, he did ask me about Amira.
Just uh, how we balance and all that.
He started talking about his daughters.
- Really?
- Mm-hmm.
These are good.
You make yourself at home.
The aromatics add like a
whole other layer to this.
It's it's amazing, just trust me.
Dammit! How are you so fast?
We want to choose toppings.
You know, technically, manaeesh
is a breakfast flatbread,
- but
- Move, move, move! Ah!
Okay. I'll just plate it then.
So, seriously no other
takers of what will easily be
the best gin martini they've ever had?
Why don't I just go help Bash.
How's that going? Your health stuff?
(SIGHING) It's messy.
I mean, you can't really
stop saving someone's life
because your heart rate spikes.
You know, people telegraph
support, but the truth is
I'm just a burden, and
accepting those limitations
and that everybody else
knows about them yep.
- (GRUNTS)
- You know
most people just say "fine".
Boom! You're done.
It's exactly because of that attitude
that there are no systems
in place for someone like me.
Uh, I was kidding.
But if you wish to risk arrhythmia,
I'd be happy to give you
the best two out of three.
Oh, you're on.
Okay, so everybody tells a story
from the age that they roll.
- And then we go eat.
- Pass.
- I love these games.
- You love these games.
Can you please explain to them
why this is not a good idea?
The sooner we play, the sooner we eat.
- You serious right now?
- Roll the dice!
(ALL): Roll the dice! Roll the dice!
- Roll the dice!
- Alright, just stop.
(LAUGHING)
Oh, there we go! That's the spirit!
- Woo!
- Nine.
So, when I was nine, there were
these woods outside my school,
and I would go out back, burying
myself in leaves and sticks,
and just wait stealth mode for
someone to come and find me,
but no one ever came so I was like
playing hide and go seek by myself.
- Oh.
- June, that's like the saddest story
- I've ever heard in my life.
- No, it was funny
It was hide and seek
Okay, whatever, you guys weren't there.
Well, when I was nine, I
pooped in a kitty litter box
and blamed it on the dog.
- (LAUGHING)
- It's disgusting.
Still glad you invited me?
(LAUGHING)
Why are you here so late?
- Contractual hours only, remember?
- We're off the clock.
Look, taking breaks on schedule
and not doing unpaid work is one thing.
I know today was rough.
I don't get my tired ass out of bed
every morning for the garbage pay.
- I do it for the patients.
- Are people getting hurt because of us?
Guys, you can't crack on me.
How can you not care about
what we're saying, Claire?
I was accused of that today by a doctor.
I didn't expect it from you.
You asked me to fight and I fought.
We have leverage now, if
we back down we lose it.
Devi was okay with you not apologizing?
Not really, but uh
- feel like my job is pretty safe.
- Not worried?
Uh no, standing on principle is
gonna be a risk, but uh, weirdly no.
Why, should I be?
I mean sounds like your
safety net is airtight.
- I'm a privileged ass.
- You said it, not me.
You know, we'd only
really need a third of ED
giving a small percentage of the wages.
Mags, that's not gonna be an easy sell.
- No, I know, but
- Who's selling what?
No, I'm just running
an informal poll to see
who'd be willing to subsidize
another full-time nurse
- or at least cover the overtime.
- I'm all for it.
And not just 'cause
I'm a privileged ass.
Well then, that's a
slippery slope, isn't it?
Asking individuals to solve
an institutional problem?
Yeah, no, maybe, but since
I'm like directly contributing
to the burden of the nurses,
I don't have the luxury
of waiting for the institution.
You know, I wanna know what
Devi thinks about all this.
Since when?
Since when? Since Novak
asked me to make her an ally
for the sake of Trauma OR?
- Why would he do that?
- Because he's Novak
and he's a mid-level misogynist.
- Low-level misogynist.
- Mid-level.
Anyways, he cares about the
work that we're doing down there.
Is that really necessary? I mean,
our work should speak for itself.
Easy for you to say. You've
done what, two procedures
with Singh and he's out here
telling you his life story.
Singh, really? What did he say?
- He mentioned his daughters.
- He had daughters?
- It's not a big deal.
- Seriously?
I was his resident for three years.
I bet you I can go in there
do a Whipple blindfolded
and he'd end up taking you for dinner.
Okay, okay, but that's
probably more like
a father-to-father thing.
- Bash has Amira.
- June has Shay.
And has June talked to Singh about Shay?
No, no, that is not the point.
The point is that men
just feel more comfortable
talking to other men and
that's just a subtle way
that we get edged out.
You're doing it right now.
- (LAUGHING)
- Okay, speaking of father,
how have you been
since Amira's been gone?
Other than torturing himself endlessly?
Um, she said she's not
ready to be around me yet.
And uh, part of me thinks
I should just give in.
Oh then, she'll know
she can hold you hostage
- and get whatever she wants.
- Even though she has a point?
Anyone wants more wine?
You know, you could use this
opportunity to reset things.
And when she is ready to talk,
you'd have somewhere to go with her.
Bash, I was I was
just trying to help.
I know how how hard it's been.
You have no idea what
it's been like for us.
Okay?
I could fix this with some super glue.
I shoudn't have lost my temper.
You're allowed to be upset when
something you care about breaks.
You seem better.
With the distance from the crash,
and I know it's been a journey
since your marriage, uh
Broke. (CHUCKLING)
Eh, I mean it's hard to have
perspective when you're in it, but
the girls and I are finding a rhythm.
It's nice to feel like
I can see the other side.
- Any idea what's there?
- (CHUCKLING)
You know, when I met you, I was like
I was just a passenger in my own life.
And then you
You had no safety net,
and just so unafraid of
doing what you believed in.
- I just I just have more practice, Theo.
- Oh, don't deflect man.
Or do, if you have to. (CHUCKLING)
It's just
My life is better with you in it.
And she's gonna come back.
You'll see.
So, are things okay with Bash?
Is that another one of those questions
where I'm just supposed to say "fine"?
And I'm very well aware
that you think I should mind
my own business with him and Amira.
You know, it's weird. My baking
skills, Michelin-star level.
My relationship skills have
not been getting great reviews.
So are you gonna let
me scrub in on those,
or do I have to cozy up
and make you an ally first?
That depends, is that a dig
about the whole Devi thing?
Because you know you're
the one who keeps telling me
- to make connections.
- It just seems like such
a cynical reaction to what
you said before about Singh.
I'm being strategic, Mags.
Look, she already told me
she's rethinking Trauma OR.
And don't act like you're
not doing the same thing.
- No, I'm
- Yeah, no.
You're supporting her
for your own benefit.
I believe in her. I'm trying
to build something real.
Oh, I'm sorry that I
can't just strip naked
and bare my soul, Mags, alright?
- I'm built different.
- Fine.
But you're not that little girl
burying herself in
leaves anymore either.
People are looking for you, June.
You need to stop with that, alright?
Just forget that I said that. Ah!
(MOANING)
Here.
- Thanks, guys.
- Thanks, Mags.
- Thanks for coming. Good night.
- See you tomorrow.
(DOOR CLOSING)
I know we're going to
talk about it, so let's go.
Please, Mags, drag it out of me.
Okay. If you don't want to, that's fine.
Good.
How am I supposed to know
what you've been through
if you keep walling
off parts of yourself?
You know, people keep saying
that, you, Rania, Amira,
why can't people just
let me be who I am?
I don't know, I can't
speak for those two,
but I know that if
I'm in a relationship,
I need to be let in. I need intimacy.
- We have that. I thought we did.
- Clearly, if I'm bringing it up.
And what do you mean,
"you can't speak for them"?
All you do is speak for other people.
What's it like, Mags,
always knowing exactly
- what people are afraid of?
- It's terrible!
I think you're so afraid that
there isn't a place for you
that you can't help prove
how essential you are.
I hate
needing something from you
that you don't wanna give me.
And you've barely touched
me since my heart
Okay, so we're talking about sex,
- I'm not talking
- No, intimacy! I'm talking about real intimacy!
But for you doesn't that
just mean like fixing me?
Like I'm some kind of medical
mystery that you get off on solving?
Bashir, are you suggesting
that I'm attracted to your pain?
- Is that what you're saying?
- Tell me I'm wrong.
I think you would know who
you are without your pain.
I think you you cling to it.
And you keep it shrouded
in mystery because
you know it draws me in
and because you want me
to come digging for it.
How long have you been
waiting to say that?
You tell me I'm wrong.
- Clear a path, please!
- (GRUNTS)
- Solomon!
- (BREATHING HEAVILY)
What are you doing out here?
- I'm gonna get some help.
- No, no, no!
- No one else from the hospital!
- Can you give him some space?
You should still be in your bed.
At like 4:00 AM, some
new doctor came in,
and told the nurse they had to admit me.
Which means I'd be getting billed.
When they weren't looking,
I left and I figured
I'd recover at home, but when
the painkillers wore off
You had to come back.
Only now, triage said I had to
pay upfront unless I'm critical.
I was gonna start over at another ER,
but when I tried to stand up again
Look, you're anemic from
the sickling, alright?
- You need blood transfusions, pain meds
- I know! I know!
What am I supposed to do?
Riley. You're not supposed to be here.
I lied to a nurse and
said I was her sister.
She's so much worse.
They're saying her pancreas
is necrotic and she's septic.
And choices will have to be made?
Is there any way we can
contact her immediate family?
Her mom's gone, her
dad's in assisted living
and he's not in a
position to make decisions.
- Who does that fall on?
- Her doctors.
We do the best we can to make
informed decisions on her behalf.
She would do everything
she could to fight this.
I knew how she felt.
I maybe even liked knowing it.
I do love her, just not
in the way she wants me to.
I'm sorry, but you're not family.
Except I am!
And if anyone is speaking
for her, it should be me.
Dr Olsen. I was gonna come find you.
If we scale back 20 percent of
what's allocated to Trauma OR,
we can fund raises
- for the nurses to compensate
- You have a problem with Trauma OR?
I think it has certain
advantages, but I also think
it's run by a man who
isn't a team player.
So you're punishing doctors now?
- What?!
- I've heard from multiple sources
that you're gonna be asking them
to personally subsidize nurses?
- I'm sorry, you heard that where?
- Do you have any idea
how something that provocative
makes the hospital look?
Makes me look? As CMO?
Like we can't handle a budget?
Like we don't care about retention?
Just hold on, um,
doctors foregoing pay
was an idea brought to me by a resident.
- I shut it down.
- Obviously not hard enough.
When I said "don't be everyone's
friend" that didn't mean
taking a flamethrower to people
that are trying to help you.
I turned my life upside
down to come here.
The only reason I did that is
because I care about people.
That doesn't mean you
know how to lead them.
Fix this. Today.
Page me when she's ready.
Let me know how long for the
interventional radiologist,
and I'll have Dr Hamed set up the suite.
I was just going to book an OR
to remove the dead
tissue from her pancreas.
You want to send her back to surgery?
No, just start with the
percutaneous drainage
and we'll see how she
reacts to that first.
And risk more bacteria
going into her bloodstream?
She has a fully inflamed
pancreas, it's the safest option.
No, it's the less effective option.
Okay. Look, I'm hearing you,
but this is up to us, which
really means it's up to me.
Look, her friend is here
and she's adamant that Zola
- would not want to play it safe.
- And what is this,
a friend with power of attorney, Bash?
At least Singh should hear both sides.
Oh. Would you like to go over my head?
If this is you feeling Singh
and I are pushing you out,
I would never do that
to you. As your friend.
Look, just set her up for drainage.
- June.
- What?!
Your hand may be infected.
Well, these are all of the sample
packs of hydroxyurea I could find.
There should be enough
there to manage your anemia
and sickle cell pain for two months.
Thank you. And uh, what about my leg?
Well, we'll check to make
sure it's not infected.
These transfusions should help.
But if you notice any
swelling, you can just call me.
But look, Solomon, this is
all just a stop gap, alright?
You're eventually gonna
have to make a plan.
Maybe even head home to reset.
Yeah, no. I made a choice
to go after something
and I don't plan to give up.
Are we burnt?
I might be.
But you, you have
nothing to worry about.
Suction carefully. Don't
compromise the vital tissues.
BP's dropping, she's coding.
Starting compressions.
Charge to 150 and call for more bodies!
Clear!
- Resuming compressions!
- Charge 200.
Clear!
- We've got sinus. She's stabilizing.
- I need more light.
What happened? What is this?
- Get over here, June.
- This is Zola?
Debridement of necrotic tissue,
but the septic shock proved
more than her body could handle.
Are you helping or hovering, June?
- Going in with the ligature.
- While she's doing that,
tell me why this happened, Dr Hamed?
It's a statistical risk
of the surgical procedure.
Which is why I told Dr
Hamed to play it safe
with percutaneous drainage
and not to jump into surgery.
He talked the family through
both options, they chose surgery.
Friend. Not family.
As in no legal status.
- It's more complicated.
- Scrub out, Dr Hamed.
We're a team, not a one-man band,
I will not have surgeons who
don't tell me the whole story.
- Sir
- You heard me. Go.
Dr Curtis, take over.
- (SIGHING)
- Brock.
They're telling me that you're having
second thoughts, what's going on?
I don't wanna do this.
I should've said so yesterday
when you scheduled it.
- I'm sorry.
- It's okay.
I'm sorry, can you give us
a minute please? Thank you.
(SIGHING) That poor
woman got me on that table
and was about to sedate
me and thread a wire
from my thigh to my heart,
and Mags, I couldn't
Brock, you're not gonna feel anything.
- I'll react to the sedation.
And definitely the wire,
but that's not it.
Something inside me, it feels wrong.
And when it feels wrong,
I've learned to trust that.
I just I thought that
you wanted to know for sure.
No, you wanted to know.
I already do.
And I promise to always wear
my heart-rate watch from now on,
but I spent all night thinking
about how hard I've worked to accept
that this is how things are for me.
And how I don't need anyone
else to believe me or fix me.
- I like how I am.
- Why?
(LAUGHING)
Why do I like myself?
I didn't mean I
didn't mean I'm sorry.
Okay, sure, I feel stress and
pain more palpably, but also,
I feel the good stuff more too.
And I have to believe
it's a price worth paying.
Even if you don't.
Dr Curtis. You okay?
Just buried in leaves.
I let this fester too long,
and now, I'm paying the price.
But that's not all?
I had to shut down my resident
today and he's also my friend.
I can either channel my
inner bitch or let my feelings
govern how I do my job.
And risk losing everything
you've worked for.
If we revert to status quo,
will you take your
demands off the table?
- Pressure from on high?
- You predicted this, Claire.
That my big ideas would hurt your team.
Well, I get no satisfaction
from being right.
Not when the hospital's
solution is budget over patients.
Mm-hmm.
I will discharge Solomon today.
You should admit him.
Claire, look, you don't
have to be a part of this,
but I'm not gonna make
this guy's situation
any harder than it already is.
Okay, Theo, just look.
You took his address out of our system?
Yeah, when he came back this morning.
It's the only way we can admit,
treat and ensure he never sees a bill.
- I didn't know we could do that.
- We can't.
Word is you are an attending again?
- Is that official?
- Yeah.
(LAUGHING)
(INDISTINCT CHATTER)
Hey! It's Dr Hamed.
Dr Curtis said you're
not my doctor anymore.
Yeah, I was just, uh
Spray paint's off the table, so
Instead of firing her boss,
she's firing her oncologist.
- Dr Hamed.
- Mm-hmm?
Thank you. For fighting for us.
Does this mean you two are okay?
We agreed to move
messily into the future.
Whatever that means.
I'm going to tell Amira to
stay as long as she wants.
I'm just packing some
things she'll need.
Why don't you let me help you?